129 e-Letters

published between 2004 and 2007

  • Excluding LIP is essential before attributing a diagnosis of immune reconstitution inflammatory synd
    Daniel Richardson

    Dear Editor

    We thank Dr Singh for his/her comments on our case report.[1] We agree that LIP is an important differential diagnosis in this case and is associated with pulmonary nodules and pulmonary cysts, although they are usually perivascular.[1-3] Firstly we acknowledge an erratum in the text which was edited and submitted without re-review by the contributing pathologist (AR). Specifically there were numero...

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  • Length of tube in the underwater seal drain as fluid fills in
    Sridevi Valluri

    Dear Editor,

    Re: BTS guidelines for the insertion of a chest drain.

    This is a wonderful article on chest drain and everything related to it. I do understand that 1-2cm of tube should normally be left underwater when doing an underwater seal drain. My actual site of interest is regarding the length of the tube in the underwater seal when draining a pleural effusion. So when it starts filling in... should we...

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  • BTS recommendations for assessing risk and for managing Mycobacterium tuberculosis infection and dis
    Timothy P Cotter

    Dear Editor,

    The above guidelines will prove useful to rheumatologists or gastroenterologists who will be prescribing these revolutionary drugs for their patients. I, however, have difficulty with algorithm of figure where tuberculin testing comes before risk stratification. For patients with normal chest x-rays and a low risk stratification it will not really matter if their tuberculin test is positive or negativ...

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  • Re: Lets be honest
    Edward Howard

    Dear Dr Aziz,

    As a response to your letter 'Lets be honest', the amount of 'web hits' guidelines receive isn't usually translated into the amount of citations they may receive. The guidelines that the BTS produced that feature so prominently on the Thorax 'Top ten most read articles' have relatively low citations (ISI Web of Knowledge) - all the BTS Guidelines published in 2003 only received a total of 16 cites...

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  • Management of primary and secondary spontaneous pneumothorax
    Prashant S Borade

    Dear Editor,

    There is paucity of data with regards to the management of primary and secondary spontaneous pneumothorax.

    A study was conducted to evaluate whether patients with either primary or secondary spontaneous pneumothorax were managed according to current British Thoracic Society guidelines.

    56 consecutive patients with spontaneous pneumothorax were assessed over a 12-month period. In patients with...

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  • LIP reading is required!
    Navneet Singh

    Dear Editor,

    Richardson and colleagues have described the case of a 33 year old male who had coinfection with human immunodeficiency virus (HIV) and tuberculosis (TB) and developed cystic lesions in the lung after initiation of antiretroviral therapy.[1] The authors have explained these findings as being part of the immune reconstitution inflammatory syndrome (IRIS). IRIS or the paradoxical reaction is believed to...

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  • FEV1/PEF ratio: The forgotten measure of upper airway obstruction
    Daniel K C Lee

    Dear Editor,

    Several measures exist to aid the diagnosis of upper airway obstruction (UAO). These include subjective clinical signs such as the presence of stridor and objective measures such as the pattern of the flow-volume curve. However, by far the simplest and easily measured, but yet relatively unknown and underutilised, is the forced expiratory volume in 1 second (FEV1) / peak expiratory flow (PEF) rat...

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  • Lets be honest
    Imran Aziz

    Dear Editor,

    Although I was pleased to see the rise in impact factor of Thorax but I just looked at the list of 10 most 'read' articles in thorax.

    I was surprised to see all of them were part of guidelines published by the BTS and none were 'true' submissions to the journal.

    Although impact factors do not rely on 'web hits' but this does imply that the rise in Thorax's impact factor has more to do wi...

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  • Spontaneous pneumothorax in a bass player
    Sandra L. Hanson M.D.

    Dear Editor,

    I have just discharged a 28 year old male who had a pneumothorax after a night of playing bass guitar standing in front of a large amplifier. Although he has been playing in this band for years, this is his first pneumothorax. As standing in front of this amp may be the etiology, he intends to discontinue this practice and use earphones.

    I appreciated your article with other similar case hist...

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  • ARDS risk and ACE polymorphism
    Prasanta Padhan

    Dear Editor,

    ARDS remains a major cause of death, yet factors contributing to the syndrome have not yet been clearly identified. During its early stages, ARDS may include high-permeability pulmonary edema, loss of alveolar epithelial cells and neutrophil infiltration which may lead to remodelling of the alveoli and interstitium. Experimental findings suggested that activation of a renin-angiotensin system in the l...

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