Hypothyroidism and ventilator dependency.

Four patients with long-term ventilator dependency and severe hypothyroidism discovered in a single year are described. Correction of hypothyroidism was helpful in weaning three patients from the ventilator. The fourth patient died of other medical problems. None of these patients had goiter or clinical evidence of hypothyroidism. Hypothyroidism was discovered during workup for neurologic or cardiologic problems. Although hypothyroidism is not a common cause of ventilator dependency, it might be more common than we think.

Chronic diaphragmatic hernia. A difficult diagnosis.

Chest pain is commonly caused by disorders of the heart, lungs, and chest wall. Pinpointing the exact cause is often a diagnostic challenge. In this article, the authors describe the evaluation and treatment of a patient with sharp chest pain of unusual origin.