Tobacco use is the leading cause of preventable disease and death in the United States, resulting in more than 480,000 premature deaths and $289 billion in direct health care expenditures and productivity losses each year. Despite progress over the past several decades, millions of adults still smoke cigarettes, the most commonly used tobacco product in the United States. To assess progress made toward the Healthy People 2020 target of reducing the proportion of U.S. adults who smoke cigarettes to ≤12.0% (objective TU-1.1), CDC used data from the 2013 National Health Interview Survey (NHIS) to provide updated national estimates of cigarette smoking prevalence among adults aged ≥18 years. Additionally, for the first time, estimates of cigarette smoking prevalence were assessed among lesbian, gay, or bisexual persons (LGB) using NHIS data. The proportion of U.S. adults who smoke cigarettes declined from 20.9% in 2005 to 17.8% in 2013, and the proportion of daily smokers declined from 16.9% to 13.7%. Among daily cigarette smokers, the proportion who smoked 20-29 cigarettes per day (CPD) declined from 34.9% to 29.3%, and the proportion who smoked ≥30 CPD declined from 12.7% to 7.1%. However, cigarette smoking remains particularly high among certain groups, including adults who are male, younger, multiracial or American Indian/Alaska Native, have less education, live below the federal poverty level, live in the South or Midwest, have a disability/limitation, or who are LGB. Proven population-based interventions, including tobacco price increases, comprehensive smoke-free policies in worksites and public places, high-impact anti-tobacco mass media campaigns, and easy access to smoking cessation assistance, are critical to reducing cigarette smoking and smoking-related disease and death among U.S. adults, particularly among subpopulations with the greatest burden.

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Current Cigarette Smoking Among Adults - United States, 2016.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jhep.2003.50193

Nonalcoholic steatohepatitis: Summary of an AASLD Single Topic Conference

https://www.uky.edu/~achan2/pics/med/pe-tx-chest.pdf

Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

结节病易误诊,据王洪武等~([1])收集国内18篇关于此病误诊的文献,误诊率高达63.2%,当然有误诊就会有误治,如孙永昌等~([2])报道26例结节病在影像学检查诊断的第一印象中拟诊结核5例,其中就有2例完成规范的抗结核治疗,为此应引起临床对本病诊治的重视。

Sarcoidosis

Indoor air quality and health

Background Healthcare workers (HCWs) have been severely impacted by the COVID-19 pandemic. In addition to their risk of direct exposure to the virus, they were subjected to long working hours, scarcity of PPE, and additional stressors that impacted their psychological wellbeing. The purpose of this study was to assess anxiety and its predictors among a sample of HCWs at the American University of Beirut Medical Center (AUBMC) and to evaluate the association between resilience and anxiety. Methods This cross-sectional study was conducted using an online survey between March and June 2021 among HCWs at AUBMC. The psychosocial scale section included the 7-item generalized anxiety disorder (GAD-7) scale and a 25-item resilience scale, validated tools used to assess anxiety and resilience respectively. Data were analyzed on SPSS version 27, and descriptive statistics were applied. Predictors were evaluated using bivariate and multivariate linear regression. Results From a total of 92 participants, 75% were involved in direct patient care, and of those, 95% worked directly with suspected or confirmed COVID-19 patients. The majority (83%) had minimal to mild anxiety, whereas the rest had moderate to high anxiety levels. Around 41% reported moderately high to high resilience, 47% were found to be between the low end and moderate resilience scale and only 12% had very low or low resilience. More than 80% of the participants received PPE training, reported always working with adequate preventive infection control measures, and were vaccinated. Further, more than 70% of participants reported trusting the management and agreed that the safety of the workers is considered a high priority. No significant association between sociodemographic and COVID-19 work exposure factors with anxiety was found. Multivariate analysis results showed that a lower anxiety score was associated with higher resilience (p = 0.011). Conclusion This study has shown a strong association between low anxiety levels and high resilience scores in this group of mostly vaccinated HCWs caring for COVID-19 patients. The high percentage of vaccination along with PPE availability could explain the low anxiety levels reported among the participants.

https://www.dovepress.com/getfile.php?fileID=79609

Anxiety Among Healthcare Workers During COVID-19 Pandemic in Lebanon: The Importance of the Work Environment and Personal Resilience

Objective Describe health conditions and injury and illness rates in a population of United States mariners, an understudied workforce vital to economic security. Methods In this survey study, mariner health data was collected and analyzed to provide injury and illness rates (including mental health conditions) and associated risk factors. Results In this mariner population of highly tenured vessel masters and pilots, hypertension, obesity, sleep disorders, smoking, alcohol consumption, and symptoms of depression and anxiety were common. BMI ≥35 was associated with increased likelihood of work injury (OR 5.7; 95%CI 1.01, 32.59). Conclusions The mariners were in poor overall health, raising public health and safety concerns in this population of essential transportation workers. Follow-up studies including a wider distribution of domestic mariners (deck hands, engineers) would further characterize occupational risks.

Injury, Illness, and Mental Health Risks in United States Domestic Mariners.

Nonalcoholic steatohepatitis [1] (multiple letters)

Dietary vitamin A and prevalence of bronchial metaplasia in asbestos-exposed workers.

Most types of lung disease can be caused by work exposures including: asthma, chronic obstructive pulmonary disease (COPD), interstitial lung diseases, lung cancer, pulmonary infections, and pleural disease. It is important to recognize whether exposures in your workplace are contributing to your lung disease because often steps can be taken to prevent the lung disease or keep it from progressing.

/pdf/work-related-lung-diseases-50xpr3nquw.pdf

Carrie A. Redlich

Papers

Anxiety Among Healthcare Workers During COVID-19 Pandemic in Lebanon: The Importance of the Work Environment and Personal Resilience

Injury, Illness, and Mental Health Risks in United States Domestic Mariners.

Nonalcoholic steatohepatitis [1] (multiple letters)

Dietary vitamin A and prevalence of bronchial metaplasia in asbestos-exposed workers.

Work-Related Lung Diseases.