975. Preparing for Fellowship in Internal Medicine With a Focus on Pulmonary or Critical Care Medicine: Major Principles and New Realities.
作者: Matthew C Miles.;Peter Lenz.;Jennifer McCallister.;Kristin M Burkart.;Candace Huebert.;Jason Moore.;Laura Hinkle.;Briana Short.;Brent Bagley.;Gabriel Bosslet.
来源: Chest. 2024年165卷6期1458-1468页
In this article, the authors provide guidance for applicants to any subspecialty in the medical specialties matching program, with a particular focus on those seeking a match into a pulmonary or critical care medicine training program, or both. The preparation, application, interview, ranking, and match steps are used to discuss available literature that informs this process. Preparing a fellowship application is discussed in terms of personal career goals, and specific strategies are suggested that can help a candidate to assess a program's fit with those goals. In addition to review of recent data on virtual interviewing and interview questioning, the authors provide practical recommendations for candidates seeking to maximize their success in the current interview environment. Finally, key points about generating a rank order list are summarized. This resource will prove useful to any candidate pursuing medical subspecialty training in the current era.
976. Point-of-Care Lung Ultrasound in Emergency Medicine: A Scoping Review With an Interactive Database.
作者: Stig Holm Ovesen.;Andreas Hvilshøj Clausen.;Hans Kirkegaard.;Bo Løfgren.;Rasmus Aagaard.;Søren Helbo Skaarup.;Michael Dan Arvig.;Morten Hjarnø Lorentzen.;Anne Heltborg Kristensen.;Mariana Bichuette Cartuliares.;Casper Falster.;Liting Tong.;Alessandra Rabajoli.;Ronja Leth.;Janeve Desy.;Irene W Y Ma.;Jesper Weile.
来源: Chest. 2024年166卷3期544-560页
This scoping review was conducted to provide an overview of the evidence of point-of-care lung ultrasound (LUS) in emergency medicine. By emphasizing clinical topics, time trends, study designs, and the scope of the primary outcomes, a map is provided for physicians and researchers to guide their future initiatives.
977. Antithrombotic Therapy for VTE Disease: Compendium and Review of CHEST Guidelines 2012-2021.
作者: Scott M Stevens.;Scott C Woller.;Lisa Baumann Kreuziger.;Kevin Doerschug.;Geert-Jan Geersing.;Frederikus A Klok.;Christopher S King.;Susan Murin.;Janine R E Vintch.;Philip S Wells.;Suman Wasan.;Lisa K Moores.
来源: Chest. 2024年166卷2期388-404页
The American College of Chest Physicians (CHEST) Antithrombotic Therapy for Venous Thromboembolism Disease evidence-based guidelines are now updated in a more frequent, focused manner. Guidance statements from the most recent full guidelines and two subsequent updates have not been gathered into a single source. An international panel of experts with experience in prior antithrombotic therapy guideline development reviewed the 2012 CHEST antithrombotic therapy guidelines and its two subsequent updates. All guideline statements and their associated patient, intervention, comparator, and outcome questions were assembled. A modified Delphi process was used to select statements considered relevant to current clinical care. The panel further endorsed minor phrasing changes to match the standard language for guidance statements using the modified Grading of Recommendations, Assessment, Development, and Evaluations (ie, GRADE) format endorsed by the CHEST Guidelines Oversight Committee. The panel appended comments after statements deemed as relevant, including suggesting that statements be updated in future guidelines because of interval evidence. We include 58 guidance statements from prior versions of the antithrombotic therapy guidelines, with updated phrasing as needed to adhere to contemporary nomenclature. Statements were classified as strong or weak recommendations based on high-certainty, moderate-certainty, and low-certainty evidence using GRADE methodology. The panel suggested that five statements are no longer relevant to current practice. As CHEST continues to update guidance statements relevant to antithrombotic therapy for VTE disease, this article serves as a unified collection of currenrtly relevant statements from the preceding three guidelines. Suggestions have been made to update specific statements in future publications.
978. Atrial Arrhythmias in Patients With Pulmonary Hypertension.
作者: Kyle O'Meara.;Gregory Stone.;Eric Buch.;Adam Brownstein.;Rajan Saggar.;Richard Channick.;Alexander E Sherman.;Aron Bender.
来源: Chest. 2024年166卷1期201-211页
Atrial arrhythmias (AA) are common in patients with pulmonary hypertension (PH) and contribute to morbidity and mortality. Given the growing PH population, understanding the pathophysiology, clinical impact, and management of AA in PH is important.
979. Interdisciplinary Diagnosis and Management of Patients With Interstitial Lung Disease and Connective Tissue Disease.
作者: Sabina A Guler.;Tobias Scheschkowski.;Anja Renner.;Lea Kämpf.;Matthias Gasser.;Britta Maurer.
来源: Chest. 2024年166卷2期352-361页
A diagnosis of interstitial lung diseases (ILD) can be challenging, and the identification of an associated connective tissue disease (CTD) is crucial to estimate prognosis and to establish the optimal treatment approach. Diagnostic delay, limited expertise, and fragmented care are barriers that impede the delivery of comprehensive health care for patients with rare, complex, and multiorgan diseases such as CTD and ILD. In this article, we present our perspective on the interdisciplinary diagnosis and interprofessional treatment of patients with ILD and suspected CTD or CTD at risk of ILD. We outline the structure of our service, delineating the roles and responsibilities of the team members. Additionally, we provide an overview of our patient population, including diagnostic approaches and specific treatments, and illustrate a patient case. Furthermore, we focus on specific benefits and challenges of joint interdisciplinary and interprofessional patient consultations. The importance of rheumatology and pulmonology assessments in specific patient populations is emphasized. Finally, we explore future directions and discuss potential strategies to improve care delivery for patients with CTD-associated ILD.
980. Comparison Between REVEAL Lite 2 and COMPERA 2.0 for Risk Stratification in Pulmonary Arterial Hypertension.
作者: Sandeep Sahay.;Nelson Villasmil Hernandez.;Fredrick Wang.;Matthew Wooten.;Duc T Nguyen.;Charles Fauvel.;Raymond Benza.;Edward A Graviss.
来源: Chest. 2024年166卷2期373-387页
Risk stratification is the cornerstone of the management of pulmonary arterial hypertension (PAH). Current European Society of Cardiology/European Respiratory Society guidelines recommend using the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) three-strata risk model at baseline and the COMPERA 2.0 four-strata model at follow-up. However, the guidelines did not take into consideration other available risk scores such as the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL) Lite 2.
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