A Multicenter Study of the Causes and Consequences of Optimistic Expectations About Prognosis by Surrogate Decision-Makers in ICUs.

Objectives: Optimistic expectations about prognosis by surrogate decision-makers in ICUs are common, but there are few data about the causes and clinical consequences. Our objective was to determine the causes of optimistic expectations about prognosis among surrogates and whether it is associated with more use of life support at the end of life.

Design: Prospective, multicenter cohort study from 2009 to 2012.

Severe tracheomalacia in the ICU: identification of diagnostic criteria and risk factor analysis from a case control study.

Background: Severe tracheomalacia (STM) is being increasingly recognized as a cause for respiratory failure in the ICU. The diagnosis is often overlooked, as chest radiography appears normal, and the role of invasive diagnostic testing for this diagnosis is not well described in the ICU setting. The prevalence and risk factors for STM are not known, and computed tomography (CT) based diagnostic criteria for ventilated patients are not well studied.

Disseminated Coccidioidomycosis with Clinically Evident Splenomegaly in an Immunocompetent Host, First Case Reported in the literature.

Coccidioidomycosis is a dimorphic fungus endemic to the southwestern United States, Central and South America. We report a case of a previously healthy person who presented with respiratory failure and disseminated Coccidioidomycosis who eventually had a fatal outcome. Coccidioidomycosis, or "Valley Fever" has been called the "great imitator" (1) as it can have a wide variety of clinical presentations.

Nitrous oxide as an adjunct in tumescent liposuction.

Background: Nitrous oxide (N(2)O) has been used as an anesthetic for over 300 years. It is safe, easy to use, and effective. In this article we will document N(2)O use as an adjunct to tumescent liposuction.

Cutaneous effects of smoking.

Background: Cigarette smoking is the single biggest preventable cause of death and disability in developed countries and is a significant public health concern. While known to be strongly associated with a number of cardiovascular and pulmonary diseases and cancers, smoking also leads to a variety of cutaneous manifestations.

Objective: This article reviews the effects of cigarette smoking on the skin and its appendages.