Most thoracic surgeons in Europe are unaware of ergonomic guidelines and do not practise them, hence they suffer varying degrees of physical discomfort arising from ergonomic issues.

Background/Objective:Inefficient nursing care of chest drains may associated with unacceptable and sometimes life-threatening complications. This report aims to ascertain the level of knowledge of care of chest drains among nurses working in wards in a teaching hospital in Nigeria.Methods:A cross-sectional study among nurses at teaching hospital using pretested self-administered questionnaires.Results:The majority were respondents aged between 31 and 40 years (45.4%) and those who have nursing experience between 6 and 10 years. Only 37 respondents (26.2%) had a good knowledge of nursing care of chest drains. Knowledge was relatively higher among nurses who cared for chest drains daily, nurses who have a work experience of <10 years, low-rank nurses and those working in the female medical ward; however, the relationship cant (P > 0.05). Performance was poor on the questions on position of drainage system were not statistically significant with relationship to waist level while mobilizing the patient, application of suction to chest drains, daily changing of dressing over chest drain insertion site, milking of tubes and drainage system with dependent loop.Conclusion:The knowledge of care of chest drains among nurses is poor, especially in the key post procedural care. There is an urgent need to train them so as to improve the nursing care of patients managed with chest drains.

The chosen therapeutic approach was feasible and showed no side-effects. Yet, neither mortality nor multiple organ failure were significantly improved by the applied short-term adjuvant therapy. Thus, for future trials in severely-ill patients a longer treatment period and/or combinations of antithrombin III with other anti-inflammatory agents should be considered.

Systemic air embolism is known to rarely complicate blunt chest trauma. However, cerebral infarction caused by air emboli possibly originating from a traumatic pneumatocele has not been previously reported. We report a case of a 46-year-old woman who sustained blunt chest trauma with multiple rib and clavicular fractures, hemothorax and a huge, tense traumatic pneumatocele. She subsequently developed clinical and radiologic features of cerebral infarction. The cerebral infarct is likely to be secondary to cerebral air embolism originating from a traumatic pneumatocele.

The present analyses of different surgical training systems show that training of surgical residents significantly contributes to hospital costs. These are predominantly caused by prolonged operation times of residents with increased work load for other staff members in the operating room. In addition, the productivity of surgical residents is less compared to experienced surgeons. On the other hand, hospital managements save money by the lower standard wages paid to the residents. The amount of educational costs is difficult to determine because surgical training takes place as on the job training. Therefore, from an economic point of view, the two products patient care and surgical training are difficult to separate. There are no reliable cost analyses available for the German training system. At present surgical training is indirectly financed by the DRG (diagnosis-related groups) flat rates of the health insurance. Possible options of financing the surgical training are additional funding from the health department or redistribution with supplemental payment for those surgical departments which contribute significantly more to the residents' training. Statements of medical associations, health departments and health insurances demonstrate the difficulty to come to an agreement concerning the finances of the training system. Despite this controversial discussion it should be taken into consideration that there is no alternative to a high quality surgical training as this is the basis for an effective health system.

The treatment of pain after thoracic surgery is a challenge and takes place in the individual clinics mostly according to clinic internal standards. It exists no currently valid S3 guideline for the treatment of acute perioperative and posttraumatic pain. For an effective pain treatment as well individual pain experience as the pain intensity of the various thoracic surgical procedures must be considered. Regular pain assessment with appropriate methods and their documentation form the basis for adequate and adapted pain therapy.There are a number of different pain therapy methods, non-medicamentous and drug-based methods, whose effectiveness is described in the literature partially different. For the treatment of acute postoperative pain after thoracic surgery, mainly drug-related procedures are used, except for physiotherapy as a non-medicamentous method. Increasingly, alternative procedures for the peridural catheter as a therapeutic gold standard in the treatment of pain after thoracic surgery are used. Their application can be integrated into a therapeutic algorithm.

More and more women suffer from lung cancer. In comparison to the male patients they are younger and more likely never-smokers. Adenocarcinomas are more frequently in women than in men. Their long-time survival post curative resection in early stage non-small-cell lung cancer is better than in men. Women show frequently more molecular changes: more molecular targets are found. Therefore they might benefit more from target-oriented stratified medical treatments. This overview comments on the gender-specific differences in diagnostics, treatment and outcome of lung cancer.

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