: the canary in the coal mine?

() is a species of nontuberculous mycobacteria (NTM) that rarely causes infection. It has previously been labeled the most common NTM contaminant. Bronchiectasis is a disease characterized by abnormal airway dilation leading to chronic cough, sputum production and pulmonary infections.

Do Not Give Up Your Stethoscopes Yet-Telemedicine for Chronic Respiratory Diseases in the Era of COVID-19.

Telemedicine in its many forms has been utilized across numerous medical specialties to facilitate and expand access to medical care, optimize existing healthcare infrastructure to encourage patient-provider communication, reduce provider burnout, and improve patient surveillance. Since the emergence of the novel coronavirus (COVID-19) pandemic there has been widening of existing socioeconomic disparities in healthcare access for those with chronic respiratory diseases, sparking interest in expanding the use of telemedicine modalities to enhance access to pulmonology specialist care, pulmonary rehabilitation, symptom monitoring, and early identification of clinical exacerbations. Furthermore, the use of telemedicine has been expanded into the intensive care setting to improve patient outcomes and offset provider demands following the increase in critically ill patients due to COVID-19.

The Impact of Connective Tissue Diseases on the Inpatient Outcomes of Congestive Heart Failure Patients.

Background Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are autoimmune diseases with chronically elevated inflammatory activity. Treatments typically have been aimed at decreasing inflammation. While RA and SLE are known to have a high incidence of congestive heart failure (HF), the mechanism behind this remains elusive.

Catholic social teaching: Precepts for healthcare reform.

The Patient Protection and Affordable Health Care Act of 2010 accelerated bureaucratic appropriation of health care in the United States. Persuaded by laudable intentions of expanded access to care for millions of uninsured Americans, healthcare cost control, and improved medical quality, supporters are now confronted by the unintended consequences of greater government control of health care. The four primary principles of Catholic social teaching guide a best response to our neighbor's healthcare needs.

Marginalizing women: images of pregnancy in williams obstetrics.

This research analyzes the historical development of the medical construction of the pregnant body in 17 of 20 editions of Williams Obstetrics, an obstetrical textbook published continually from 1904 to 1997. Examination of the visual imagery of these works produced three key findings. First, depictions of the healthy or "normal" pregnant body are virtually absent throughout the series.

Selective use of off-pump coronary bypass surgery reduces mortality and neurologic morbidity associated with high-risk coronary bypass surgery: a 400-case comparative experience.

The frequency of use of off-pump coronary artery bypass (CAB) surgery to surgically treat coronary artery disease has varied greatly from center to center and from surgeon to surgeon because of preference, training, and experience. We report an experience with 400 consecutive isolated CAB procedures selectively managed with on-pump or off-pump surgery, according to the perceived potential for aortic embolization or stroke as determined by clinical and imaging determinations. The off-pump CAB group (46 patients) was 7.

Improving outcomes in coronary surgery: the impact of echo-directed aortic cannulation and perioperative hemodynamic management in 500 patients.

Background: Stroke and death continue to occur perioperatively associated with on-pump and off-pump coronary artery bypass grafting surgery (CABG) procedures. We report on a prospectively implemented multifaceted strategy to improve short-term outcomes associated with on-pump CABG.

Methods: Five hundred consecutive patients from a single teaching institution undergoing standardized on-pump nonreoperative CABG between June 1996 and July 2003 were entered into the New York State Cardiac Surgery database, a verified comprehensive clinical registry.

Surgical physician assistants help solve contemporary problems.

Recent surveys performed by the AAPA estimate that in 2002 approximately 183 million visits were made to PAs and 223 million medications were prescribed or recommended by PAs. The AAPA estimates that just more than 46,000 PAs currently are in clinical practice, with New York and California having the largest numbers of practicing PAs. Helen Keller said, "The most pathetic person in the world is the person who has sight but no vision.

Base rates of malingering and symptom exaggeration.

Base rates of probable malingering and symptom exaggeration are reported from a survey of the American Board of Clinical Neuropsychology membership. Estimates were based on 33,531 annual cases involved in personal injury, (n = 6,371). disability (n = 3,688), criminal (n = 1,341), or medical (n = 22,131) matters.

Opportunities--and challenges--in the surgical subspecialties.

The visionary physicians who brought physician assistants (PAs) into the surgical suite saw that these professionals were well suited to collaborate with surgeons, who were facing the dual challenges of rapidly developing surgical technology and the need to manage costs. Two significant factors that will shape the future for surgical PAs are the downsizing of the surgical physician workforce and recent mandates limiting the hours that surgical residents are permitted to work.

Treatment of post-concussion syndrome following mild head injury.

Approximately 38% of patients who sustain head trauma characterized by a brief disturbance of consciousness and clinically unremarkable neuroradiologic findings meet International Classification of Diseases 10th edition (ICD-10) diagnostic criteria for postconcussion syndrome (PCS). Physicians treat a majority of cases with nonsteroidal analgesics or antidepressants, and refer about 40% for psychological consultation. Psychological treatment typically involves education, reassurance, and reattribution of symptoms to benign causes.

Combined injuries--soft tissue management.

The combination of severe bone and soft tissue injuries challenges all hand surgeons. Immediate restoration of all damaged structures is the goal whenever possible, integrating soft tissue techniques with principles of internal fixation. Debridement must be radical and resulting defects in bone, vessel, nerve, tendon and skin must be reconstituted with the combination of free and vascularized grafts.

Our military heritage.

The decade of the sixties was one of dramatic change in American culture. Looking back, the change that had the most effect on readers of this journal was the creation of the physician assistant profession. The original members of our profession were all former military medical corpsmen.

Preoperative factors and outcome after lunate decompression for Kienböck's disease.

Preoperative factors and outcome were studied after lunate decompression for Kienböck's disease. Twenty-three patients treated with radial shortening or scaphoid-trapezium-trapezoid fusion were evaluated. The mean follow-up was 59 months.

Professional challenges in the coming decade.

Last month, as part of our observance of the 15th anniversary of Physician Assistant journal, members of our Editorial Board offered their views on turning points in the history of the PA profession. In this issue, we jump from the past to the future, with perspectives on the main crises or changes facing the profession in the coming decade. You may agree or disagree with these viewpoints.

HIV roundtable. Professional perspectives.

As the HIV epidemic escalates, concern is mounting over the implications of infection among health care workers. Should all medical professionals be tested? Should supervisors and/or patients be notified if the results are positive? Should the infected PA continue to practice? What about performing surgery? Should he or she be considered impaired? And what about the long-term stress of working with HIV patients? Experts discuss the AAPA's latest recommendations, and share suggestions on prevention and patient care with the audience.

Granular cell tumor of the palmar cutaneous branch of the median nerve.

Granular cell tumor rarely occurs in the hand. A patient with this tumor involving the palmar cutaneous branch of the median nerve, and twelve-month follow-up is discussed. This lesion, similar to neurofibromas, can infiltrate peripheral nerves and cannot be dissected from them.

Violence prevention: a challenge for health care practitioners.

Interpersonal violence has reached epidemic proportions in the United States. Principles of preventive medicine can be applied to help curb the growing rates of assault, murder, and rape. Health care providers should become leaders in the fight against violence.

Human immunodeficiency virus and the cardiac surgeon: a survey of attitudes.

The decision to operate on carriers of the human immunodeficiency virus (HIV) who need an urgent cardiac operation is difficult. There is a lack of knowledge about the effect of the presence of HIV on operative risk, about the effect of cardiopulmonary bypass on the progression of HIV infection to acquired immunodeficiency syndrome (AIDS), and about the risk to the cardiac surgical team of operating on 1 or more HIV carriers. This lack of knowledge is exacerbated by the strict regulations surrounding testing.

Cardiac surgery in human immunodeficiency virus (HIV) carriers.

Unlabelled: Intravenous drug addicts have always been at risk for acquiring infective endocarditis. In the United States in recent years, as many as 50% of addicts have become infected also with the human immunodeficiency virus (HIV). Since testing became available in late 1984, we have knowingly performed open cardiac surgery for endocarditis 11 times in HIV-positive patients.

The intercalated tendon graft for treatment of extensor pollicis longus tendon rupture.

Twenty-one patients with ruptures of the extensor pollicis longus tendon were treated with a subcutaneously placed free tendon graft. The repair was performed a mean of 6 weeks after rupture, range from 1 to 21 weeks. Data was collected on 19 of these patients, with a mean follow-up of 30 months, range from 6 to 124 months.