We read with interest the article regarding right heart thrombus by Crowell et al (Chest 88; 94:1236-39). In the discussion, the presence of a central venous catheter is not mentioned as a cause of right heart thrombus, although in the literature the incidence is up to 29 percent. In the following case report, we would [...]

We have read with interest the retrospective study by Leslie et al (Chest 1988; 94:603-08) on the clinical features of patients with undiagnosed pleural effusions subjected to repeat pleural biopsies with the purpose of distinguishing those patients with nonspecific pleuritis (NPE) from malignant (MPE) or tuberculous pleural eflusions (TPE). According to their analysis, all patients [...]

The mechanism of ventilatory impairment at maxi­mal exercise in COPD cannot be stated with certainty, although the preponderance of evidence indicates that diaphragmatic fatigue is not the major limiting factor. In the present study the lack of a tachypneic response during recovery suggests that diaphragmatic fatigue was not present, which is consistent with the findings [...]

Spirometric and Vo,^ values were within normal limits in the control group (Table 1). In the patients with COPD, mean FEVi was 43 percent of predicted (SD, 15 percent), and Voa was significantly reduced at 15.9 ml/kg/min (SD, 3.25 ml/kg/min; p<0.001 vs controls).

Patients with COPD (n = 16) were recruited from the outpatient department of the Albuquerque VA Medical Center for participation in this study. All were clinically stable and had not had an exacerbation of their disease for at least six weeks prior to study. In all patients, arterial blood gas analysis at rest revealed oxygen [...]

To patients with COPD, exercise performance is limited by reduced ventilatory capacity. Al­though many studies have documented the correlation between reduced work capacity and spirometric in­dices of airflow obstruction, recovery from exercise has received little attention in COPD. The metabolic cost of exercise involves not only the performance of external work, but the demands of [...]

Two recent randomized trials of mechanically ventilated intensive care unit patients given stress ulcer prophylaxis with sucralfate compared to conven­tional agents, found lower rates of pneumonia in patients given sucralfate. In Trybas study, rates of pneumonia were increased 3-fold for patients receiv­ing antacids compared to those given sucralfate. In the study by Driks et al, [...]