PubMed · 14811727
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A MARRA. 1950. [Bronchospirometry].. https://pubmed.ncbi.nlm.nih.gov/14811727/
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BACKGROUND: The transition from medical resident to subspecialty fellow is a critical time period in fellowship training that has not been well described. The current practices of fellow orientation in pulmonary and critical care training programs are not known. OBJECTIVES: The aim of this study was to describe orientation practices for training programs in the United States. METHODS: A 10-question survey was sent via e-mail to program directors of pulmonary/critical care fellowship programs identified on the American Thoracic Society (ATS) web-page of current programs. RESULTS: Eighty-seven programs responded (61.7%), of which 86% had a formal orientation program. The mean time spent in fellow orientation was 5-10 h in didactic sessions and 0-5 h in wet labs. The most frequent didactic sessions were bronchoscopy in 69 programs (80.2%), pulmonary function testing in 63 programs (73.3%) and orientation to hospital services in 63 programs (73.3%). The most frequent use of wet labs was in bronchoscopy training in 60 programs (81.1%) and ventilators in 45 programs (60.8%). Simulators were used in 37 programs (43%). The majority reported that these areas were covered with on the job training, without a formal designated orientation. CONCLUSION: This survey demonstrated that early fellow training differs across programs in both time spent and clinical and procedural topics covered. An early, standardized approach to clinical and procedural training can assure appropriate exposure that cannot be guaranteed by on the job training. To provide justification for such an approach, clinical outcomes need to be correlated with training methods.
OBJECTIVE: The aims of the study were to evaluate duration of symptoms, clinical manifestation, radiological findings, fibrobronchoscopic findings, and the complications of airway foreign body (FB). METHODS: A retrospective review of 304 children who had airway FB removed via fibrobronchoscopy from January 1997 to June 2003 was conducted in the Children's Hospital of Zhejiang University School of Medicine, China. Two hundred eight boys and 96 girls were included. Their ages ranged from 2 months to 11 years, and the median was 18 months. RESULTS: Three patients died; 81.24% of the patients had a history of FB aspiration, and the most frequent clinical manifestation was paroxysmal coughing (89.25%). Positive radiological findings were found in 90.13% of patients, and the most common type of FB was peanut (35.53%). Serious complication of lung was found in 65 patients, and the associated factors were age, sex, and times of fibrobronchoscopy and location of FB in the right or left lung. CONCLUSIONS: FB aspiration remains a major cause of morbidity and mortality in childhood. Education aimed at increasing diagnostic acumen of the physicians and heightening of public awareness are the most important steps needed to reduce the morbidity and mortality.
Surgical repair of congenital diaphragmatic hernia (CDH) can be performed by means of either direct suturing of the diaphragm or positioning of a prosthetic patch. However, half of all prosthetic patches show evidence of reherniation. We describe the case of an 8-year-old girl who presented with prosthesis dislocation and fistulization in the right lower bronchus as a complication of a CDH repair that she underwent when she was 1 year old. Abdominal ultrasound and magnetic resonance imaging suggested a hernia relapse, whereas chest computed tomographic scan failed to identify the diaphragmatic defect. Only fibrobronchoscopy allowed fistulization of the prosthesis into the bronchi to be correctly diagnosed.