Internal medicine journal
-
Internal medicine journal · Dec 2008
Using simulation models to teach junior doctors how to insert chest tubes: a brief and effective teaching module.
Pleural procedures may cause serious complications when incorrectly carried out. There is a need to find effective methods for teaching how to insert a chest drain safely. ⋯ A brief teaching module using a simulation model is effective in improving confidence and skill in chest tube insertion.
-
Internal medicine journal · Nov 2008
Comparative StudyEndoscopic ultrasound-guided fine-needle aspiration when combined with positron emission tomography improves specificity and overall diagnostic accuracy in unexplained mediastinal lymphadenopathy and staging of non-small-cell lung cancer.
The aim of this study was to assess the incremental value of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) to positron emission tomography (PET) in the diagnosis of unexplained mediastinal lymphadenopathy and staging of non-small-cell lung cancer (NSCLC). ⋯ This study suggests that EUS-guided FNA complements PET by improving the overall specificity and thereby the accuracy for diagnosis of unexplained mediastinal lymphadenopathy. It provides a minimally invasive technique to assess the mediastinum in patients with NSCLC and is particularly valuable in cases in which PET findings are equivocal.
-
Internal medicine journal · Nov 2008
Case ReportsTako-tsubo-like cardiomyopathy after EpiPen administration.
Tako-tsubo-like cardiomyopathy is characterized by acute chest pain, electrocardiographic changes and increased cardiac enzymes in the absence of obstructive coronary vessel disease. We describe the development of tako-tsubo-like cardiomyopathy in an elderly woman after the use of an EpiPen for generalized urticaria and angioedema. As adrenaline may participate in the pathogenesis of this condition, the need for careful patient selection and education in the use of adrenaline self-injectors remains imperative.