Chest
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Despite international treaties banning torture, it is still widely practiced by state agents and private citizens alike. Pulmonologists may encounter survivors of torture in routine clinical practice or in the context of a forensic medical evaluation. The Istanbul Protocol delineates the general approach to the effective medical examination, investigation, and reporting of an individual alleging torture, but relatively little text is devoted to the specific pulmonary manifestations of torture. This review intends to address this paucity.
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Multiple morbidity is the norm in advanced COPD and contributes to high symptom burden and worse outcomes. ⋯ Distinct comorbidity profiles can be identified in patients with COPD using standard EHR-based diagnostic codes, and these profiles are associated with subsequent acute and postacute care use. Population-based risk stratification schemes for end-to-end, comprehensive COPD management should consider integrating comorbidity profiles such as those found in this study.
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Symptoms of posttraumatic stress disorder (PTSD) are common in family members of patients who have died in the ICU. ⋯ ClinicalTrials.gov; No.: NCT02329418; URL: www.clinicaltrials.gov).
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The provision of palliative care for severe COPD remains low, resulting in unmet needs in patients and carers. ⋯ Palliative care increasingly is being implemented for nonmalignant diseases including COPD throughout the United Kingdom, although models of working vary. A theoretical model was developed to illustrate the concept and pathway of the integration of palliative care support. A standardized screening and needs assessment tool is required to improve timely palliative care and to address the significant needs of this population.