J-tip spring guidewire entrapment by an inferior vena cava filter.

The number of complications between guidewires and inferior vena cava filters is unknown and most likely underreported. Since 1993, at least 17 cases of central venous catheter guidewires entangled in inferior vena cava filters have been reported. The placement of both devices in the intensive care setting has increased the number of incidents in which a guidewire from a central venous catheter becomes entrapped in an inferior vena cava filter. The authors report a case in which entrapment of a guidewire occurred without causing displacement of the filter. In addition, a review of simple but useful recommendations to prevent and manage these complications is presented.

Early respiratory abnormalities in emergency services police officers at the World Trade Center site.

The effects of exposure to the environment around the World Trade Center after the attack of September 11, 2001, are not fully described. We evaluated 240 police first-responders; respiratory symptoms occurred in 77.5% but resolved or improved in around three fourths of subjects by the time of their evaluation (mean 69 days after the attack). Cough was the most common symptom (62.5%). Spirometric abnormalities were mild and occurred in 28.8%. Independent risk factors for abnormal spirometry were previous pulmonary disease or symptoms (adjusted odds ratio, 2.76) and intensity of exposure (AOR, 2.32). Previous pulmonary conditions were associated with obstructive defects (P<0.002). Exposure intensity was associated with a lower forced vital capacity (P<0.03) and a higher prevalence of abnormal spirometry (P<0.03). Officers with dyspnea, chest discomfort, or wheeze were more likely to have abnormal spirometry (P=0.04). A significant minority of officers had symptoms a few months after the exposure. Long-term effects of this respiratory tract exposure will need additional evaluation.