Chest
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Randomized Controlled Trial Comparative Study Clinical Trial
Salmeterol administration by metered-dose inhaler alone vs metered-dose inhaler plus valved holding chamber.
To determine whether a spacer device designed as a valved holding chamber with a flow signal increases the efficacy of the long-acting beta(2)-agonist, salmeterol, in patients who use incorrect technique with metered-dose inhaler (MDI) alone. ⋯ We conclude that patients who have poor timing and rapid inhalation with salmeterol MDI alone will have greater increases in PEF at 4 h and 6 h and no additional side effects if the dose is administered with a valved holding chamber that is used correctly. Further study is needed regarding other errors in MDI technique with salmeterol.
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To assess late complications following percutaneous tracheostomy using the Griggs technique. ⋯ Following Griggs percutaneous tracheostomy, 8 of 25 patients developed moderate tracheal dilatation, and none developed a tracheal stenosis. The cosmetic result after Griggs tracheostomy is good, but the number of patients with minor voice changes is high. A further investigation of long-term outcome following Griggs tracheostomy is necessary.
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Chemical pleurodesis is an effective treatment for malignant pleural effusion and pneumothorax. This mode of therapy is, however, less widely accepted in the treatment of patients with refractory benign or undiagnosed pleural effusion. ⋯ Chemical pleurodesis, and specifically talc slurry, is an effective treatment for recurrent benign or undiagnosed pleural effusion. This procedure is safe and easily performed and, in selected cases, can be performed in an outpatient day-care setting.