Pulmonary Medicine

Nov 01, 2021 Issue
Vocal Cord Dysfunction: Rapid Evidence Review [Article]

Vocal cord dysfunction (i.e., vocal cords closing when they should be opening, particularly during inspiration) should be suspected in patients presenting with inspiratory stridor or wheezing; sudden, severe dyspnea (without hypoxia, tachypnea, or increased work of breathing); throat or chest tightn...

Nov 01, 2021 Issue
Antibiotic Therapy Does Not Prevent Death or Acute Exacerbations in Adults with Idiopathic Pulmonary Fibrosis [POEMs]

The study found an increased number of adverse events without any significant benefit from antimicrobial therapy compared with usual care alone for adults with IPF. The study was terminated earlier than planned because of futility and the possibility of significantly increased harm.

Nov 15, 2020 Issue
Watch-and-Wait Strategy Is an Option for Primary Spontaneous Pneumothorax [POEMs]

Conservative observation of patients presenting with a first primary spontaneous pneumothorax is as effective as immediate chest tube insertion in achieving full lung re-expansion at eight weeks.

Sep 1, 2020 Issue
Cloudy Pleural Fluid on Thoracentesis [Photo Quiz]

A man with a history of COPD from long-term tobacco use presented to the ER with worsening shortness of breath over the past week.

Jun 15, 2020 Issue
Acute Respiratory Distress Syndrome: Diagnosis and Management [Article]

Acute respiratory distress syndrome is noncardiogenic pulmonary edema that manifests as rapidly progressive dyspnea, tachypnea, and hypoxemia. Most cases are associated with pneumonia or sepsis; coronavirus disease 2019 is also a cause. Treatment is supportive and includes mechanical ventilation, prophylaxis for stress ulcers and venous thromboembolism, nutritional support, and treatment of the underlying injury.

Jan 15, 2020 Issue
Short-Term Systemic Corticosteroids: Appropriate Use in Primary Care [Article]

Short-term systemic corticosteroids are frequently prescribed for adults by primary care physicians; however, short courses of the steroids are associated with adverse effects, including hyperglycemia, elevated blood pressure, mood disturbance, sepsis, and fracture. There is evidence against corticosteroid use in patients with acute bronchitis, acute sinusitis, carpal tunnel, and allergic rhinitis and for its use in patients with Bell palsy and acute gout. There is insufficient evidence supporting its use for patients with pharyngitis, lumbar radiculopathy, and herpes zoster.

Jul 1, 2018 Issue
Nebulized Hypertonic Saline for Bronchiolitis [Medicine by the Numbers]

Despite reported benefits associated with the use of hypertonic saline for bronchiolitis, we have chosen a yellow recommendation because the more recent trials and systematic reviews have shown either much smaller effect size or no benefit at all compared with the older trials. Learn more.

Jan 1, 2018 Issue
Tuberculosis: Guidelines for Diagnosis from the ATS, IDSA, and CDC [Practice Guidelines]

Persons with Mycobacterium tuberculosis infection may have no clinical evidence of disease and present asymptomatically, known as latent tuberculosis infection (LTBI) or symptomatically, known as tuberculosis (TB). The American Thoracic Society (ATS), Infectious Diseases Society of America (IDSA), a...

Jan 15, 2017 Issue
Neck Crepitus in a Runner [Photo Quiz]

A man presented with right-sided neck, throat, and ear pain after a five-mile run.

Sep 15, 2016 Issue
Pulmonary Hypertension: Diagnosis and Treatment [Article]

Diagnosing pulmonary hypertension can be challenging because of nonspecific symptoms that may be attributed to comorbidities. Using a stepwise approach, physicians can minimize risks and avoid unnecessary testing. Treatment generally focuses on the underlying condition and may involve referral to an expert center.

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