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Electronic cigarettes (e-cigarettes) are electronic devices designed to vaporize chemical compounds. The device is made up of a mouthpiece, liquid tank, a heating element, and a battery. E-cigarette use may pose health risks in the form of cardiovascular and respiratory diseases. These health risks have implications to not only the primary user, but the aerosols can also cause secondhand and thirdhand injuries to others in the vicinity. Acute lung injury may also be associated with the use of e-cigarettes, but the underlying cause remains unknown. Clinicians, including hospitalists, pulmonologists, intensivists, medical examiners, pathologists, and the like, should report possible cases as the medical community continues to assess the health risks of e-cigarette use., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Oriakhi et al.)

Background : Advance directives have been established as a legal document that ensures patients' wishes are followed if/when they cannot make medical decisions for themselves. The concept, advance directive, is rooted in the ethical principle of patient's autonomy. New York State recognizes three types of advance directives: New York State Health Care Proxy, Living Wills, and Do Not Resuscitate (DNR) order. A common misnomer in healthcare is the idea that advance directives are for the elderly or patients with terminal illness. As per New York State statutes, everyone older than 18-years-old should have an advance directive to avoid conflicts in times of crisis. It has been shown that most patients believe it is their physician's responsibility to initiate an advance directive discussion and residents are at the forefront of most health facilities. Objective : To assess the knowledge and attitude of internal medicine residents towards advance directive and to improve residents' skills and confidence on advance directive discussion. Design : We carried out a prospective study to assess the knowledge and attitude of the internal medicine residents towards advance directive to validate the need to implement didactic sessions and simulations. Results : Fifty out of the 75 internal medicine residents of Harlem Hospital Center participated in the study. Most of the responders indicated that they lacked sufficient knowledge in advance directive discussion and indicated that they were interested in didactic sessions and simulations related to how to help patients with advance directives. Conclusion : Our study showed that most of the residents lacked sufficient knowledge in advance directives discussions and the importance of its incorporation into residency training education., (© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.)