Edited by Drummond Rennie, MD, Deputy Editor (West), and Don Riesenberg, MD, Senior Editor.
To the Editor.— The recent study by Light et al1 on the use of intrapleural tetracycline to prevent recurrent spontaneous pneumothorax is an excellent example of a statistically significant improvement in outcome associated with an overall persistently poor outcome.Although it was true that 41% of untreated patients had recurrence, so did an astounding 25% of men treated with a drug that caused severe chest pain in over half. Even patients with primary pneumothorax (who presumably were younger and healthier) had a 10.5% recurrence rate with treatment. Thoracotomy with pleural abrasion is associated with a low risk of serious complications, with the risk greatest in elderly patients with chronic obstructive pulmonary disease, but typically carries a recurrence rate of less than 1%.2 Thus, a blanket recommendation to attempt intrapleural installation of tetracycline to prevent recurrent spontaneous pneumothorax is unjustified.Given that treatment with intrapleural tetracycline still results in
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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