The "hot seat" experience: a multifaceted approach to the teaching of ethics in a dental curriculum.

The subject of ethics and the teaching of skills associated with ethical reasoning in a predoctoral dental curriculum are as important as clinical skills development, but there is no single approach to teaching ethics in dentistry. This article aims to describe the didactic approach used to teach dental ethics and ethical reasoning in the first year of the D.M.

Diurnal variations in human pulmonary function.

Pulmonary function has circadian modulations. Variations in human pulmonary function during the daytime hours (diurnal variations) remain to be well characterized. Discerning these variations will contribute to better understanding the relationship between biorhythms and lung physiology and to improving clinical management of pulmonary diseases.

An evolving community-based dental course on professionalism and community service.

In 2007, the Faculty of Dentistry at the University of British Columbia formally introduced the course Professionalism and Community Service (PACS) in year one of its dental curriculum. PACS features community-based dental education as an experiential learning pedagogy, as well as additional themes that support the community experience. PACS will be incorporated into all four years of the curriculum, with health promotion activities in community sites as the focus in years one and two and the provision of patient care in community clinics in years three and four.

Malignant pleural effusions in lymphoproliferative disorders.

In order to determine variables that correlate with malignant pleural effusion and mortality in patients with lymphoproliferative disorders and pleural effusion, a retrospective study was performed. Clinical data of hospitalized patients with a lymphoid malignancy and pleural effusion who underwent thoracentesis from January 1993 to December 2002 were collected. A logistic regression analysis was carried out to determine prognostic variables that predict malignant pleural effusion and hospital mortality.

Cavitary lung masses in SLE patients: an unusual manifestation of CMV infection.

The typical radiographical findings of cytomegalovirus pneumonitis are bilateral interstitial infiltrates. In this study, the current authors describe two patients on corticosteroid treatment for systemic lupus erythematosus, complicated by histologically confirmed cytomegalovirus pneumonitis, presenting as cavitary masses. This rare presentation of cytomegalovirus pneumonitis broadens the differential diagnosis of cavitary lesions to include cytomegalovirus infection in immunocompromised individuals.

Legionella micdadei infection presenting as severe secretory diarrhea and a solitary pulmonary mass.

Sixty percent of infections with non-pneumophila species of Legionella are caused by Legionella micdadei. Although diarrhea is a common symptom of legionellosis, including that due to L. micdadei infection, severe, life-threatening diarrhea is rare.

Sinoatrial block complicating legionnaire's disease.

A 59 year old woman presented with acute onset of fever, chills, diaphoresis, vague chest discomfort, and was found to be hypotensive and tachypnoeic. An electrocardiogram demonstrated sinoatrial block with a junctional rhythm between 50 and 80 beats/min. All cultures were negative and imaging studies unrevealing.

Pulmonary complications in chronic lymphocytic leukemia.

Background: Although pulmonary complications account for significant morbidity and mortality in patients with chronic lymphocytic leukemia (CLL), to the authors' knowledge there are sparse data available in published literature. The authors evaluated pulmonary complications in patients with CLL and identified prognostic variables that predict hospital mortality in these patients.

Methods: Clinical data were analyzed retrospectively from patients with CLL who required hospitalization for a respiratory illness at a tertiary care institution from January 1993 to December 2001.

Pneumomediastinum simulating a panic attack in a patient with anorexia nervosa.

Objective: Pneumomediastinum is a rare complication of anorexia nervosa. Although the mechanism is unknown, severe malnutrition may affect lung mechanics by altering the connective tissue, predisposing to pneumomediastinum.

Method: We describe a young male with anorexia nervosa and panic disorder who presented with symptoms similar to those of a panic attack and was diagnosed with spontaneous pneumomediastinum.

Lung hernia as a sequela to limited-access mitral valve surgery.

We report a case of a 36-year-old man who developed a lung hernia after a minimally invasive mitral valve repair. Lung hernias are uncommon. Most are acquired and may be classified as traumatic, spontaneous, pathologic, or postoperative.

Corticosteroid responsive fludarabine pulmonary toxicity.

Fludarabine monophosphate is a purine nucleoside antimetabolite with efficacy in the treatment of lymphoproliferative disorders and chronic lymphocytic leukemia. It is the 2-fluoro, 5' phosphate derivative of 9-beta-D-arabinofuranosyl adenine (ara-A, vidarabine) and the mechanism of action is through inhibition of DNA synthesis and the cytolytic effects through the induction of endonuclease-independent apoptosis.

Fulminant ischaemic colitis with atypical clinical features complicating sickle cell disease.

Clinically significant ischaemic bowel injury is an exceedingly rare complication of sickle cell disease. It manifests as acute surgical abdomen and may respond to conservative treatment. An unusual fatal case of ischaemic colitis with minimal abdominal findings in a young male during a sickle cell vaso-occlusive pain crisis is described.

Legionnaire's disease associated with acute encephalitis and arrhythmia.

Objective: To report an unusual, life-threatening combination of neurologic, cardiac, and gastrointestinal symptoms in the presence of a community-acquired pneumonia.

Design: Case report.

Setting: University hospital.

Adult Still's disease and respiratory failure in a 74 year old woman.

A case of adult onset Still's disease in an elderly woman, that was associated with severe respiratory failure and multiorgan dysfunction, is reported. Histopathology was confirmed on open lung biopsy.

Possible levofloxacin-induced acute hepatocellular injury in a patient with chronic obstructive lung disease.

Levofloxacin is one of the most commonly prescribed antibiotics for both inpatient and outpatient care of respiratory tract infection. It is generally well tolerated, and it has an excellent safety profile. We report a case of severe acute liver toxicity that apparently complicated intravenous administration of levofloxacin, which resolved after discontinuation of the drug.

Intrathoracic desmoid tumor mimicking primary lung neoplasm.

Most reported thoracic desmoid tumors originate from the chest wall. However, intrathoracic desmoid tumors are rare. The pathogenesis of these tumors is unclear but antecedent trauma and operation have been implicated.

Asymptomatic expectoration of surgical staples complicating lung volume reduction surgery.

Lung volume reduction surgery (LVRS) has recently been introduced as a palliative treatment for patients with severe emphysema. The most common postoperative complication is persistent air leak requiring prolonged tube thoracostomy. We describe a unique case of a patient with severe emphysema who underwent LVRS and presented, about a year later, with the repeated expectoration of surgical staples.

Reexpansion pulmonary edema after VATS successfully treated with continuous positive airway pressure.

Reexpansion pulmonary edema is a well-described complication of treatment for pleural effusion and pneumothorax. It is very rarely described in association with anesthesia and video-assisted thoracoscopic surgery. The etiology is unclear but several mechanisms have been proposed.

Pulmonary arteriovenous malformations: a clinical review.

Pulmonary arteriovenous malformations (PAVMs) are a rare clinical entity. Most of them are associated with hereditary haemorrhagic telangiectasia. The usual clinical presentation is exertional dyspnoea and hypoxaemia.

Yellow nail syndrome: resolution of yellow nails after successful treatment of breast cancer.

Yellow nail syndrome (YNS) is a rare entity of unknown cause in which congenitally hypoplastic lymphatics play a major role in the clinical manifestations of the disease. YNS has been associated with many malignancies and immune disorders. We report a case of new-onset YNS associated with breast cancer and dramatic improvement in the yellow nails with cancer treatment.