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Successful Treatment of Lung Cancer by Multimodal Endobronchial Interventions.

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The innovation of thoracic interventions, such as endobronchial ultrasound and photodynamic ablation, has changed the interventional management of lung cancer.

In this case report, we discuss the case of a successful treatment of endobronchial squamous cell carcinoma occluding the left upper lobe bronchus by a minimally invasive transbronchial approach. This case was initially planned for a sleeve left upper lobectomy. The careful assessment of radiological and ultrasonographic imaging concluded that the tumor was early-stage lung cancer. Multimodal endobronchial treatment cured the lung cancer without a thoracotomy. Pulmonary function was well preserved and no recurrence was found for more than 5 years.

Even in the presence of a bulky endobronchial tumor, if there is no clear evidence of extraluminal invasion by computed tomography scan, a local bronchoscopic staging of the disease is mandatory. © 2014 S. Karger AG, Basel.

Chronic thromboembolic pulmonary hypertension.

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CTEChronic thromboembolic pulmonary hypertension (CTEPH) is a rare but debilitating and life-threatening complication of acute pulmonary embolism. CTEPH results from persistent obstruction of pulmonary arteries and progressive vascular remodelling. Not all patients presenting with CTEPH have a history of clinically overt pulmonary embolism.

The diagnostic work-up to detect or rule out CTEPH should include ventilation-perfusion scintigraphy, which has high sensitivity and a negative predictive value of nearly 100%.

CT angiography usually reveals typical features of CTEPH, including mosaic perfusion, part or complete occlusion of pulmonary arteries, and intraluminal bands and webs. Patients with suspected CTEPH should be referred to a specialist centre for right-heart catheterisation and pulmonary angiography.

Surgical pulmonary endarterectomy remains the treatment of choice for CTEPH and is associated with excellent long-term results and a high probability of cure. For patients with inoperable CTEPH, various medical and interventional therapies are being developed.

Camels Confirmed as Source of Human MERS Infection

Camels_MERSWe describe the isolation and sequencing of Middle East respiratory syndrome coronavirus (MERS-CoV) obtained from a dromedary camel and from a patient who died of laboratory-confirmed MERS-CoV infection after close contact with camels that had rhinorrhea.

Nasal swabs collected from the patient and from one of his nine camels were positive for MERS-CoV RNA. In addition, MERS-CoV was isolated from the patient and the camel. The full genome sequences of the two isolates were identical. Serologic data indicated that MERS-CoV was circulating in the camels but not in the patient before the human infection occurred.

These data suggest that this fatal case of human MERS-CoV infection was transmitted through close contact with an infected camel.

Phospholipids in pulmonary drug delivery

Pulmonary delivery is becoming the standard route of administration for treating respiratory disorders such as asthma and chronic obstructive pulmonary disease. It is also gaining interest for non‐invasive systemic delivery of peptides and proteins. A limited number of excipients is approved or authorized for the pulmonary tract. This restricts the commercial potential of some formulations. Phospholipids and more particularly 1,2‐dipalmitoyl‐sn‐glycero‐3‐phosphocholine (DPPC) are the main components of lung surfactant and are recognized as generally recognized as safe (GRAS) excipients for pulmonary drug delivery by the Food and Drug Administration. Moreover, phospholipids could modulate the physicochemical properties of drug delivery systems and therefore the drug release and/...

A prospective investigation into the clinical impact of 4D-PET/CT in the characterisation of solitary pulmonary nodules

4D-PET_CTThe addition of 4D-PET/CT is most likely to have an impact on those nodules initially classified as indeterminate on standard WB-PET/CT. In lesions classified as benign or malignant on standard WB-PET/CT the addition of a 4D-PET/CT is less likely to impact lesion classification.

While 4D-PET/CT does improve the measurement of the metabolic signal, it does not overcome inherent limitations of FDG in differentiating a malignant lesion from inflammatory processes, correct for partial volume effects or compensate for the low intrinsic FDG-avidity of some malignancies.

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