Purpose: Idiopathic pulmonary fibrosis (IPF) is a common cause of pulmonary fibrosis, with millions of individuals affected in the world. Patients may use multiple resources to educate themselves regarding their illness, including popular social media video hosting site YouTube. We set out to determine the quality of patient education material discussing IPF available on YouTube. Methods: 100 consecutive videos were surveyed for review, of which 59 were included in the final analysis. Three independent blinded reviewers were assigned to score each video on a scoring system designed along patient education material available publicly at the American Thoracic Society and the American College of Chest Physicians. Scores by each reviewer were compared to others using means, standard deviation, Cohen's Kappa, and intra-class reliability. Results: Video content had a mean score of 5.9, SD 3.96 out of a maximum of 20 points. Cohen's Kappa between the three raters was calculated to a value of 0.92 and Interclass reliability was 0.79 (0.70-0.86, 95% CI) indicating appropriateness of comparison between the three raters. Conclusion: Patient education material regarding IPF on YouTube was found deficient in quantity and quality. Providers should be aware of the best information resources available and utilize these to educate their patients.
Loperamide is a widely available, over-the-counter medication. The advent of the opioid epidemic has seen cases of loperamide overdose being reported. The common side effects of the medication can be relatively benign, but at high doses, loperamide can precipitate life-threatening arrhythmias. Our case highlights rare side effects of loperamide overdose inducing ventricular tachycardia, with unfavorable consequences. This case emphasizes that the distribution and availability of this medication should be restricted, to be a prescription drug, to prevent overdose and adverse outcomes.
Fever is frequent in patients with neurologic injury. Differentiating infectious fever from central fever can be challenging. It is important to diagnose the cause of fever in the neurological intensive care unit because of the detrimental effects of fever on brain injured patients. This is a comprehensive review of the role of the two commonly available biomarkers, C-reactive protein and procalcitonin in differentiating the central fever from infectious fever.
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