PEPID's February Newsletter
In This Issue
A Pulmonary Condition Linked to Dust Inhalation
Black lung disease, also known as coal workers’ pneumoconiosis (CWP), is a chronic and potentially fatal respiratory condition caused by inhalation of coal mine dust, including respirable crystalline silica. The disease primarily affects coal miners and progresses over years of exposure, with symptoms typically emerging after prolonged asymptomatic periods. Clinical manifestations include dyspnea, chronic cough, and increased phlegm, with tobacco use exacerbating disease progression. Severe cases may lead to complications such as progressive massive fibrosis (PMF), respiratory failure, or heart failure. Diagnosis relies on occupational history, pulmonary function tests (PFTs), and imaging studies like chest X-rays, which may show characteristic nodular patterns or fibrotic changes. Differential diagnoses include silicosis, COPD, tuberculosis, and interstitial lung disease. While there is no cure, treatment focuses on symptom management using bronchodilators, inhaled steroids, and supplemental oxygen, with lung transplantation considered for advanced cases. Preventive strategies emphasize reducing dust exposure through protective equipment, dust control measures, and regular medical surveillance with chest X-rays and physical exams. For more detailed guidance, refer to PEPID's black lung disease monograph.
A Chronic Inflammatory Disease Linked to Food and Environmental Allergens
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disease of the esophagus characterized by esophageal dysfunction and a pathologic infiltration of eosinophils. Triggered by allergens from food or the environment, EoE predominantly affects men and often coexists with atopic conditions such as asthma, food allergies, and seasonal allergies. Symptoms include dysphagia, food impaction, and chest pain, with tenderness on abdominal palpation occasionally observed during physical exams. Diagnosis requires upper endoscopy with biopsies from multiple esophageal sites, revealing features such as longitudinal furrows, mucosal rings, and strictures, though some patients may present with a normal-appearing esophagus. Treatment involves dietary elimination of common allergens (e.g., cow’s milk, wheat, eggs) and pharmacological management, including proton pump inhibitors, topical corticosteroids (e.g., fluticasone or budesonide), or systemic steroids in refractory cases. Esophageal dilation is recommended for strictures or rings, and endoscopic removal is necessary for food impaction. Lifelong management through dietary modifications, medications, and regular follow-ups is essential for controlling symptoms and preventing complications. For more detailed guidance, refer to PEPID's EoE monograph.
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Top Challenges Faced by Emergency Medicine Residents and How to Overcome Them
Emergency medicine residency is a fast-paced, high-stakes journey that tests a physician's resilience, decision-making, and ability to adapt under pressure. But the challenges, such as long hours, sleep deprivation, and emotional exhaustion, are not without solutions. In this article, we explore the top obstacles EM residents face and provide practical strategies for overcoming them. From mastering time management to building emotional resilience, discover how these strategies can help residents thrive, not just survive, and build a rewarding career in emergency medicine. Read the full article on PEPID Pulse.