Dtsch Arztebl Int
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The insertion of a chest tube in cases of large pleural effusion or spontaneous pneumothorax is a common surgical procedure often performed by a physician in training under the supervision of a senior physician. ⋯ Re-expansion edema is a rare, potentially life-threatening complication of the drainage of a spontaneous pneumothorax. With early recognition and timely treatment, complete resolution can be achieved. Risk factors include rapid re-expansion of the lung, young patient age, and a large pneumothorax persisting longer than 24 hours. If these risk factors are present, the chest tube should be inserted without primary suction. Doing so allows the lung to re-expand more slowly and may prevent this severe complication.
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The purpose of patient surveys is to measure the quality of health care from the patient's point of view. They are recommended as a way to detect the strengths and weaknesses of patient care and to locate areas of potential improvement. ⋯ The questionnaires documented high overall satisfaction with oncology practices with little variation among the individual items. There were a few specific areas that accounted for the differences between well and poorly rated practices and physicians; in these areas, there is a potential for improvement.
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Posterior tarsal tunnel syndrome is an uncommon clinical entity which is sometimes misdiagnosed in patients with pain of the retromalleolar region and the plantar aspect of the foot. Surgical intervention is recommended for correctly diagnosed posterior tarsal tunnel syndrome. ⋯ Accurate diagnosis requires the evaluation of relevant clinical, neurological, and neurophysiological findings along with the careful consideration of other possible diagnoses. High success rates of 44% to 91% are reported after operative treatment. The results are better in idiopathic than in posttraumatic cases. If surgery fails, re-operation is indicated only in patients with inadequate release.