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Update in interventional pulmonology: A prologue to a new review series

The past decade has witnessed an unprecedented explosion of technological innovations in the field of Interventional Pulmonology (IP), with broad clinical applications crossing specialty lines including such various disease processes as lung cancer, asthma, chronic obstructive pulmonary diseases and pleural infections, among others. Bronchoscopists now routinely use advanced navigation techniques to reach once inaccessible lesions, can obtain large biopsy specimens safely by cryobiopsies and process these specimens optimally to identify molecular alterations allowing for individualized cancer management.

Pleural disease experts have accrued a large body of evidence supporting minimally invasive management of pleural infections or malignant pleural effusions that were, until recently, primarily addressed surgically. Such a paradigm shift has led to an increased awareness among IP specialists of the growing need for a standardization of practice, ...

Low‐flow oxygen: How much is your patient really getting?

Supplemental oxygen is one of the most commonly prescribed treatments in medical care. At any given time, up to a quarter of hospitalized patients receive oxygen therapy and data from the United Kingdom suggest that 34% of all ambulance transports involve the delivery of oxygen.

Although guidelines suggest that oxygen is not a treatment for breathlessness in the absence of hypoxaemia, in a Victorian Emergency Department audit, the most common reasons for oxygen administration were shortness of breath, chest pain and hypoxaemia (in that order). The efficacy of oxygen therapy depends on the fraction of inspired oxygen (FiO2), which in turn depends on the oxygen supply and delivery method. Low-flow oxygen delivery systems deliver oxygen at flow rates below the patient's inspiratory flow rate, entrain room air and provide a variable FiO2.

Nasal cannulae-delivering (low) flow rates of 2–4 L/min or more are provided to patients almost automatically in a range of common clinical situations, without the oxygen even necessarily being ‘prescribed’. Rule of thumb suggests that for patients with a normal rate and depth of breathing, each litre per minute increase of nasal oxygen increases the fraction of inspired oxygen (FiO2) by approximately 4%. ...

Acute bronchiolitis in infants, a review

Acute viral bronchiolitis is one of the most common medical emergency situations in infancy, and physicians caring for acutely ill children will regularly be faced with this condition. In this article we present a summary of the epidemiology, pathophysiology and diagnosis, and focus on guidelines for the treatment of bronchiolitis in infants.

The cornerstones of the management of viral bronchiolitis are the administration of oxygen and appropriate fluid therapy, and overall a "minimal handling approach" is recommended. Inhaled adrenaline is commonly used in some countries, but the evidences are sparse. Recently, inhalation with hypertonic saline has been suggested as an optional treatment.

When medical treatment fails to stabilize the infants, non-invasive and invasive ventilation may be n...

Antiadhesive and antibiofilm activity of hyaluronic acid against bacteria responsible for respiratory tract infections

In conclusion, hyaluronic acid is characterized by notable antiadhesive properties, while it shows a moderate activity against bacterial biofilm. As bacterial adhesion to oral cells is the first step for colonization, these results further sustain the role of hyaluronic acid in prevention of respiratory infections.

Comparison of same day diagnostic tools including Gene Xpert and unstimulated IFN-gamma for the evaluation of pleural tuberculosis: a prospective cohort study

Conclusion: The usefulness of Xpert MTB/RIF to diagnose pleural TB is limited by its poor sensitivity. IFN-gamma is an excellent rule-in test and, compared to ADA, has significantly better sensitivity and rule-out value in a TB-endemic setting.

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