JAMA : the journal of the American Medical Association
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In situations characterized by a substantial decrease in lung compliance and a large alveolar-arterial oxygen tension gradient, positive end-expiratory pressure (PEEP) ventilation is often effective in enhancing arterial oxygen content. It may have a variable effect on cardiac output based in part on the level of end-expiratory pressure, the state of intravascular volume, and the pathophysiology of the underlying pulmonary abnormality. It is most beneficial in conditions manifesting diminished lung compliance. ⋯ It may not prevent and may actually favor accumulation of interstitial lung water. Commonly employed levels of PEEP result in a 7% incidence of pneumothorax. The most advantageous level of PEEP is variable and is determined by sequential monitoring of multiple physiologic indexes.
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Many concepts pertaining to urinary tract infections and considered to be established or dogma are, in fact, incorrect or subject to modification. The physician should not be too rigid in his thinking regarding this disorder, as new knowledge constantly becomes available, disproving previously cherished beliefs. The case described appears to underscore this better than any hypothetical situation.
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This study was undertaken to determine the relationship between thyroid supplements and breast cancer. The incidence of breast cancer among the patients who received thyroid supplements was 12.13%, while in the control group it was 6.2%. ⋯ The incidence of breast cancer among nulliparous women who received thyroid supplements was 33%, while in the nulliparous women without thyroid supplements the incidence was only 9.25%. Even in a specific age group, the incidence rate of breast cancer was higher among patients receiving thyroid supplements, when compared to the control patients in the same age group.