Chest
-
To investigate the microbiological spectra, patient outcome, and prognostic factors of pulmonary fungal infection. ⋯ Pulmonary fungal infection of community-acquired origins is becoming a serious problem. It should be taken into consideration for differential diagnosis of community-acquired pneumonia. Furthermore, acute invasive fungal infection is associated with a much higher mortality rate for patients with nosocomial infection or complicating respiratory failure. Early diagnosis with prompt antifungal therapy, or even with surgical intervention, might be warranted to save patients' lives.
-
To compare the prevalence and severity of sleep apnea between premenopausal and postmenopausal women, and to determine whether these differences are affected by the body mass index (BMI) and neck circumference. ⋯ There may be functional, rather than anatomic, differences in the upper airway between premenopausal and postmenopausal women, which may account for the observed differences in apnea prevalence and severity.
-
Comparative Study
Use of small-bore vs large-bore chest tubes for treatment of malignant pleural effusions.
To evaluate the efficacy of small-bore (12 French vanSonnenberg) catheters compared with standard large-bore chest tubes in the drainage and sclerotherapy of malignant pleural effusions. ⋯ We were unable to detect any major differences in outcomes with the use of either size of chest tube. Our study suggests that small-bore catheters may be effective in the treatment of malignant pleural effusions and deserve further evaluation in prospectively designed trials.
-
Less than 35% of patients suspected of having pulmonary embolism (PE) actually have PE. Safe bedside methods to exclude PE could save health-care resources and improve access to diagnostic testing for suspected PE. In patients with suspected PE, we sought to determine the sensitivity, specificity, and negative predictive value of (1) a steady-state end-tidal alveolar dead space fraction (AVDSf) of < 0.15, (2) a negative D-dimer result, and (3) the combination of a steady-state end-tidal AVDSf of < 0.15 and a negative D-dimer result. ⋯ This simple combination of bedside tests may safely rule out PE without further diagnostic testing in large numbers of patients with suspected PE.
-
To assess continuous positive airway pressure (CPAP) compliance and factors associated with CPAP compliance among Chinese patients with obstructive sleep apnea (OSA). ⋯ CPAP usage and compliance were high in this patient population. A high baseline AHI was the only significant independent predictor of better CPAP compliance.