Chest
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Review Case Reports
Pleuropulmonary complications of enteral tube feedings. Two reports, review of the literature, and recommendations.
Enteral tube feeding is an attractive alternative to intravenous alimentation for nutritional support. As previously used nasogastric tubes have been replaced with narrow-bore nasogastric tubes, the spectrum of complications seen with these devices has changed. We report a previously undescribed event associated with narrow-bore nasogastric tube feeding, review the literature, noting predisposing factors and complications, and suggest guidelines to avoid pitfalls of insertion and the ensuing adverse effects.
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Asthma in children has many special features which deserve consideration. This disease is probably underdiagnosed and is often undertreated. Vague, persistent respiratory symptoms, especially chronic cough, may often be due to asthma. ⋯ Nevertheless, many children with moderate or severe asthma will continue to be troubled by intermittent or chronic airway obstruction into adulthood, and they require long-term, anticipatory treatment programs. Comprehensive care will optimize the quality of life for the affected children and their families, and it will minimize the discomfort and restrictions to which some of them have been subjected unnecessarily. Asthma in childhood, especially when not well controlled, may constitute a risk factor for the development of chronic obstructive pulmonary disease in adulthood; however, this is as yet only suspected and not proved.
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With improvement in computed tomography (CT) technology, including faster scanning and images with better detail, the indications for CT of the thorax have expanded. In many instances, data collected on earlier-generation scanners no longer apply. This report is an update of CT scanning of the thorax and includes information on the role of CT in diagnosis when specific clinical syndromes and diseases are suspected. It also addresses controversial subjects, such as the role of CT scanning in the staging of bronchogenic carcinoma and the evaluation of the solitary pulmonary nodule, as well as suggesting guidelines for deciding when a CT scan of the thorax is indicated.