Asthma Control in Cities of Developing Countries: Results of a Five-City Survey

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Most Influential Medical Publications of the Last 20 Years (1990-2012): a Collection from Journals with the Highest Impact Factor

As the performance of the clinical medicine relies on evidence-based facts as well as particular landmark researches; this collection of influential medical articles that changed and/or guided most current recommendations used in the daily basis of clinical medicine gives the top spotlight of new trends of management and treatment. The compilation is made from a search into MEDLINE; PubMed; DynaMed; CINAHL; and Academic Search Premier as well as systematically from reference lists of studies and relevant reviews. The inclusion criterion was based on the impact factor of publishing journals that were mostly renowned magazines; which expresses a measurement of the frequency that an article has been cited during a period of time. 478 articles classified according to specialties and sub-specialties were collected from 103 medical journals published approximately in a period of 20 years (1990-2012). In fact; referral materials (Books et Encyclopedias; on-line links; etc) sustained the selecting process that; although we assume exhaustive in the methodology used; but exiguous considered how challengeable and quickly-progressing clinical researches are; gave the most eventful recent researches that had influenced the clinical Medicine. However; opinions expressed within articles compiled are not necessary gold standards or landmarking facts; though they open the perspective on multiple interchangeable evidence-based factors that guide the universal tendency upon the medical management. Thus; regarded how fast medical researches and new facts progress; we recommend checking furthermore on diagnostic and treatment new approaches

Early experience with outpatient tube drainage for management of pleural collections

BACKGROUND: Increasing cases of pleural effusion leads to pressure on bed spaces and a stretch of the limited facilities available for intervention in our centre. This therefore prompted a search for acceptable alternative way of treatment. OBJECTIVE: To evaluate the use of ambulatory drainage system for chronic infectious and malignant pleural effusion on outpatient basis. METHODS: Eight of 113 routinely performed closed tube thoracostomies drainage were converted to ambulatory drainage system at the time of patients' discharge to follow-up clinic. This was after the catheter care had been thoroughly explained to the patients and their relatives. RESULTS: Eight patients (seven males and one female) had ambulatory outpatient tube management. Their mean age was 44.9 ± 18years with a range of 22­70 years. Histologically confirmed causes of the effusion were; metastatic adenocarcinoma in two(25%) of the cases; chronic non-specific inflammation in another two(25%) and tuberculous empyema thoracis in three(37.5%) one of whom had TB/HIV co-infection and one(12.5%) of chronic bacterial parapneumonic empyema. One case each of metastatic adenocarcinoma and chronic nonspecific suppuration had failed chemical pleurodesis before the outpatient drainage procedure. Half of the cases (including tuberculous and non-tuberculous) were successfully weaned off their catheters. Minor complications such as pain, discomfort, minimal stoma bleeding, and peri-catheter leak were recorded. Rapid fluid re-accumulation prevented weaning in two (25%) of the cases. CONCLUSION: Out-patient chest tube drainage is effective for the management of both malignant and suppurative pleural effusion. This approach would reduce the ever increasing cost of hospital care for this group of patients. WAJM 2009; 28(6): 364­367