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L’examen extemporané en pathologie thoracique. Le point de vue du pathologiste

L’examen extemporané sur une lésion thoracopulmonaire présente un intérêt indiscutable lorsque le bilan préopératoire n’a pas apporté la preuve de sa nature exacte. Cet examen, dont le seul objectif est de guider le chirurgien dans son geste, revêt une importance particulière en pathologie pulmonaire du fait de l’accès difficile des lésions et de la morbi-mortalité potentielle d’une chirurgie en deux temps. Son importance décisionnelle reste majeure dans un grand nombre de situations cliniques et la qualité de sa réalisation justifie un partenariat fort entre chirurgien thoracique et pathologiste, dans un esprit de confiance mutuelle qui s’élabore avec le temps et l’expérience. Après avoir exposé les indications et les modalités pratiques de l’examen extemporané, nous en préciserons les limites en insistant sur les situations difficiles pour le pathologiste et les demandes d’extemporané peu recommandables en pratique.

Extemporaneous examination of a thoracopulmonary lesion has an unquestionable interest when pre-surgical diagnostic workup has not allowed determining its exact nature. This examination, the sole objective of which is to guide the surgical approach, is especially important in lung pathology, due to the limited non-surgical access to thoracic lesions and the morbidity and mortality of repeated surgery. Its yield as a decision-making procedure is of utmost importance in many clinical situations, and a close collaboration between thoracic surgeons and pathologists is required to ensure its quality, in a context of mutual confidence that requires time and experience. After a presentation of the indications and practical modalities of extemporaneous examination, we will underline its limitations and insist on difficult situations for the pathologist and inadequate indications.

Early antibiotic treatment for Pseudomonas aeruginosa eradication in patients with cystic fibrosis: a randomised multicentre study comparing two different protocols

Conclusions No superiority of treatment under study was demonstrated in comparison to the reference treatment. Early eradication treatment was associated with an increase in S maltophilia. (Source: Thorax)

[Non-invasive home mechanical ventilation: qualification, initiation, and monitoring.]

Authors: Kampelmacher MJ Abstract Following the introduction of non-invasive positive pressure ventilation (NPPV), the number of patients using home mechanical ventilation has increased substantially and continues to rise worldwide. This is primarily explained by both the effectiveness and comfort that are offered by NPPV in most patients, and particularly in patients with chest wall and neuromuscular diseases. For clinically stable patients the qualification for NPPV largely depends on the presence of complaints or signs of (nocturnal) hypoventilation with accompanying hypercapnia. For patients who are referred by an ICU there are additional prerequisites. In any case, the aims of NPPV should be met and NPPV should be effective. The initiation of NPPV, whether in the clinic or not...

Childhood Virus RSV Shows Promise Against Adult Cancer

RSV, a virus that causes respiratory infections in infants and young children, selectively kills cancer cells while leaving healthy cells alone, researchers from the School of Medicine at The University of Texas Health Science Center San Antonio said. Santanu Bose, Ph.D., of the School of Medicine, is the inventor on a pending U.S. patent of RSV as an oncolytic therapy. This represents a new use for the virus. Bandana Chatterjee, Ph.D., of the School of Medicine and the South Texas Veterans Health Care System, is the co-inventor... (Source: Health News from Medical News Today)

Global Lung Initiative issues more precise spirometry benchmarks

NEW YORK (Reuters Health) - A new series of spirometry benchmarks aims to set a worldwide standard for the technique, experts announced last week at the European Respiratory Society's annual meeting in Vienna, Austria. (Source: Modern Medicine)

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