Case 1 An 85-year-old female patient was hospitalized on July 7, 1984, for an open heal fracture. She had never been vaccinated against tetanus. She received a tetanus Iwoster injection, was operated on, and was put on a regimen of intravenous (IV) penicillin. On the fifth hospital day she experienced difficulty opening her mouth, and [...]
Although the incidence of tetanus has steadily declined over the years in industrialized countries, immunity against the disease is lacking or insufficient in more than 65 percent of the elderly population. Consequently, patients over the age of 60 years represent nearly 60 percent of total cases, and while optimal management in intensive care units has [...]
Routine chest roentgenograms following TBB rarely demonstrate a pneumothorax in patients without both chest pain and fluoroscopic findings of a pneumothorax. In no instance did any of the 305 routine chest roentgenograms obtained after TBB reveal an unsuspected pneumothorax. The two pneumothoraces which did occur were immediately diagnosed in the bronchoscopy suite by symptoms and [...]
There were 190 men and 115 women studied with a mean age of 51 years (range 18 to 87). Two of these patients had bronchoscopy and TBB during mechanical ventilation. Of the 305 patients, 146 had spirometry performed at the University of Virginia. Forty-one of these 146 patients (28 percent) had findings on spirometry of [...]
Transbronchial biopsy via the flexible fiberoptic bronchoscope is a common procedure in pulmonary medicine. Because pneumothorax is a recognized complication of this procedure, most bronchosco- pists routinely obtain chest roentgenograms after TBB. However, the proportion of these routine chest x-ray films which demonstrate an unsuspected pneumothorax is unknown. We hypothesized that routine post- biopsy chest [...]
the number of reference studies and equations available in the literature, surprisingly few equations are widely used. Three studies accounted for 85 percent of the equations used for standard spirometric indices. It was not uncommon for institutions to use a different reference equation for each spirometric parameter. While we are not aware of studies on [...]
Letters were mailed to the directors of training programs in adult respiratory disease listed by the American Thoracic Society. We requested specific citations for the prediction equations used for spirometry, lung volumes, carbon monoxide diffusing capacity, and airway resistance. We also asked for a description of how they dealt with ethnic differences in pulmonary function. [...]
