Chest
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To evaluate all tube thoracostomies (TTs) done by pulmonary/critical care fellows and attending physicians in the Medical University of South Carolina's health-care system documenting patient demographics, indication for placement, size and characteristics of the tube, and associated problems. ⋯ Tube thoracostomy can be safely performed by pulmonologists with relatively few associated problems.
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To establish an updated classification for near-drowning and drowning (ND/D) according to severity, based on mortality rate of the subgroups. ⋯ The study revealed that it is possible to establish six subgroups based on mortality rate by applying clinical criteria obtained from first-aid observations. These subgroups constitute the basis of a new classification.
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Multicenter Study Comparative Study
A new self-administered questionnaire to monitor health-related quality of life in patients with COPD. Ambulatory Care Quality Improvement Project (ACQUIP) Investigators.
To develop and validate a brief, computer-scannable, self-administered questionnaire to monitor health-related quality of life in patients with COPD. The Seattle Obstructive Lung Disease Questionnaire (SOLQ) consists of 29 items measuring four health dimensions: physical function, emotional function, coping skills, and treatment satisfaction. ⋯ The SOLQ is a reliable, valid, and responsive measure of physical and emotional function, coping skills, and treatment satisfaction. Brief, self-administered, and computer scannable, it is useful in monitoring long-term outcomes among large groups of COPD patients.
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We sought to determine the current practice habits among clinicians treating spontaneous pneumothorax and bronchopleural fistula. ⋯ Marked practice variation exists in clinicians' approaches to the management of spontaneous pneumothorax and bronchopleural fistulas that is partially explained by differences between pulmonologists and thoracic surgeons. A national consensus statement is needed to guide randomized studies in pneumothorax management.
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We did a retrospective study in 12 patients with iatrogenic tracheal or tracheobronchial ruptures treated since 1975. Ten female subjects, one male subject, and one child (age range, 8 to 72 years), all of whom had undergone intratracheal intubation, were admitted to the hospital. Four patients had been intubated with a double-lumen catheter (two Carlens type with carinal spur, two Robertshaw without spur), and seven had had "high volume-low pressure" tubes, placed under emergency conditions in three of those seven cases. ⋯ The longest interval until diagnosis was 5 days; only then did the patient show subcutaneous emphysema and have retrosternal pain. All patients had surgical repair. Nine recovered without sequelae, and three died of septic multiorgan failure.