When teaching a colleague about a pleural rub, explain that the sound is similar to that of a finger rubbing over a balloon.—DONNA BERTHOFF, FNP, PA-C, Syracuse, N.Y. (185-8)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.