Reexpansion pulmonary edema.

Unilateral reexpansion pulmonary edema (RPE) is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. Although RPE generally is believed to occur only when a chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid, in this review 15 of 47 cases of RPE available for assessment occurred when the pulmonary collapse was of short duration or when the lung was reexpanded without suction. The pathogenesis of RPE is unknown and is probably multifactorial. Implicated in the etiological process of RPE are chronicity of collapse, technique of reexpansion, increased pulmonary vascular permeability, airway obstruction, loss of surfactant, and pulmonary artery pressure changes. Since the outcome of RPE was fatal in 11 of 53 cases reviewed (20%), physicians treating lung collapse must be aware of the possible causes and endeavor to prevent the occurrence of this complication.

Drug counselors' perceptions of clients: demographic, personality and psychopathology correlates.

Counselors' interpersonal perceptions of their clients in outpatient drug treatment were studied. Factor analysis produced three general factors, interpreted as perceptions of manageability, treatment readiness, and suitability for group treatment. Counselor perception of client interpersonal attractiveness did not emerge as a separate factor, but appeared equally significantly related to each of the first two factors. Correlates of counselor perceptions were sought among measures of client program performance, demographic and drug use history, psychopathology, and counselor background and personality. With one exception, measures of clients' actual program performance were the best predictors of counselors' perceptions of clients. Clinical implications are discussed.

Staffing patterns of American methadone maintenance programs.

Methadone maintenance is the most frequently utilized treatment for heroin addiction and also represents one of the best AIDS-prevention tools for the IV drug using population. Despite these important roles, very little has been reported about how methadone maintenance clinics are staffed. Surveys covering various aspects of program operations, including staffing, were sent to all clinics (N = 557) listed in the 1984 National Directory of Drug Abuse and Alcohol Treatment Programs. Using ANOVA, staffing patterns were compared across programs as a function of clinic size, city size, region of the country, and funding resources. While few differences were found based on city or clinic size, staffing patterns varied as a function of regional location as well as the sources of a clinic's funding.

Promotion and enforcement of patients' rights.

European health systems have experienced a "right-revolution" in the last 10 years'. The existence of a large number of policy trends and normative initiatives in European countries demonstrates a strong interest in patients' rights. The increasing interest and involvement of the general public is also decisive and can favour further development and involvement by policy-makers and the legislators. Numerous measures exist to promote and enforce patients' rights. It is now time for the anti-cancer associations to play an active role in this important event and to try to define a new mission for the benefit of the patients.