No abstract

No abstract

Long-term outcomes of EVALI: a 1-year retrospective study E-cigarette, or vaping, product useassociated lung injury (EVALI) was first described in 2019, 1 and according to the US Centers for Disease Control and Prevention (CDC) at the end of 2020, 2807 patients were admitted to hospitals with EVALI and 68 died. 2 The long-term respiratory sequelae and outcomes in patients with EVALI remain unknown. We previously reported acute findings from patients with EVALI at the University of Pittsburgh Medical Center 3 and here, we report the long-term clinical characteristics and outcomes of patients with EVALI 1 year after initial hospital admission.We retrospectively reviewed electronic medical records of 41 patients diagnosed with confirmed or probable EVALI (on the basis of CDC diagnostic criteria) 1 and admitted to any of the University of Pittsburgh Medical Center hospitals between July, 2019, and Sept, 2020. Predefined outcomes of interest were type and duration of symptoms, all-cause mortality, readmissions or emergency department encounters, and chest radiographical and pulmonary function abnormalities. Data are presented as the number of patients with percentages or as medians with IQR. This research was reviewed by the University of Pittsburgh Institutional Review Board and determined to be exempt from informed consent. The funders (National Institutes of Health, Breathe Pennsylvania, and Parker B Francis Foundation) of this research Correspondence had no role in the design, data collection, data analysis, data interpretation, and writing of the report, or the decision to submit for publication.Patient characteristics at the time of initial hospital admission are shown in the appendix (p 2). Median patient age was 21•0 years (IQR 18•5-31•0), patients were mostly men (32 [78%]

BACKGROUND: Pre-exposure prophylaxis (PrEP) for HIV is effective, yet many providers continue to lack knowledge and comfort in providing this intervention. It remains unclear whether internal medicine (IM) residents receive appropriate training in PrEP care and if this affects their future practices. OBJECTIVE: We sought to evaluate the relationship between current IM residents' prior PrEP training and knowledge, comfort, and practice regarding the provision of PrEP. DESIGN AND PARTICIPANTS: We created an online survey to assess IM residents' knowledge, attitudes, and behaviors related to PrEP. The survey was distributed among five IM programs across the USA. KEY RESULTS: We had a 35% response rate. Of 229 respondents, 96% (n = 220) had heard of PrEP but only 25% (n = 51) had received prior training and 11% (n = 24) had prescribed PrEP. Compared with those without, those with prior training reported good to excellent knowledge scores regarding PrEP (80% versus 33%, p < 0.001), more frequent prescribing (28% versus 7%, p = 0.001), and higher comfort levels with evaluating risk for HIV, educating patients, and monitoring aspects of PrEP (75% versus 26%, 56% versus 16%, and 47% versus 8%, respectively; all p values < 0.0001). While only 25% (n = 51) had received prior training, 75% (n = 103) of respondents reported that training all providers at their continuity clinic sites would improve implementation. CONCLUSIONS: We found that prior training was associated with higher levels of self-reported PrEP knowledge, comfort, and prescribing behaviors. Given the significant need for PrEP, IM residents should be trained to achieve adequate knowledge and comfort levels to prescribe it. This study demonstrates that providing appropriate PrEP training for IM residents may lead to an increase in the pool of graduating IM residents prescribing PrEP.KEY WORDS: HIV pre-exposure prophylaxis; resident education.