Update on chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease is one of the most significant chronic illnesses of adults. Comprehensive care of the affected patient requires the medical-surgical nurse to have knowledge of the disease process, collaborative management, and nursing care based on research and current practice guidelines.     

Elective transplant pneumonectomy in a 38-year-old man.

Transplant pneumonectomy is a rarely performed procedure. It is occasionally carried out in the course of retransplantation. To our knowledge, resection of a transplanted lung without its replacement and with successful outcome in the adult has not been previously reported. We present a case of elective left transplant pneumonectomy in a 38-year-old man 6 years after left single-lung transplant. At 12 months after resection, the patient remains well, with good exercise tolerance.     

In situ saphenous vein bypass grafts: angiographic evaluation and interventional repair of complications

In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications.     

Etiology of low back pain in elite boardsailors.

Seven elite boardsailors reporting nonradiating low back pain without leg pain during sailing volunteered for detailed examination. In these subjects, the onset of pain was limited to those occasions when sailing positions were held for a significant period of time, e.g., close hauled sailing or in light winds. No pain was described at any other time. The determination of possible antecedent factors was based on the results of clinical assessment, radiological evaluation, and computer tomography (CT) scanning. Apart from limited flexibility in some subjects, the clinical examination of these athletes was normal; CT changes in this group were limited to disc protrusions and bulges, and pars interarticularis defects. Despite the small number of subjects in the present report, it appears that the frequency of these problems exceeds that in the normal population. It may be possible to suggest that risk factors such as body position during prolonged sailing, particularly under light wind conditions without a harness, and limited flexibility may be associated with the radiological findings and may be implicated in the presence of low back pain, although further investigations appears warranted.