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British Thoracic Society national pleural procedures audit 2010

In this report, we detail the results of the 2010 BTS national pleural procedures audit, to which 58 hospitals covering a collective population of more than 20 million patients contributed data regarding local pleural procedure practice and training policies and the process and complications associated with a total of 824 chest drain insertions. The results highlight a promising increase in the use of real time ultrasound guidance for pleural procedures but also deficiencies in pre-procedure consent practice and a significant rate of avoidable minor complications such as drain fall-out and procedure related pain. Action points for improvement to local pleural procedure practice are suggested.

TB/HIV: An Orphan Disease?

Authors: Brust JC, O'Donnell MR, Metcalfe JZ PMID: 21642250 [PubMed - in process] (Source: American Journal of Respiratory and Critical Care Medicine)

Intersections Between Pulmonary Development and Disease.

Authors: Whitsett JA, Haitchi HM, Maeda Y Recent advances in cellular, molecular, and developmental biology have revolutionized our concepts regarding the process of organogenesis that have important implications for our understanding of both lung formation and pulmonary disease pathogenesis. Pulmonary investigators have long debated whether developmental processes are recapitulated during normal repair of the lung or in the setting of chronic pulmonary diseases. While the cellular events involved in lung morphogenesis and those causing pulmonary disease are likely to include processes that are distinct, there is increasing evidence that the pathogenesis of many lung disorders involves the same genetic machinery that regulates cell growth, specification, and differentiation during norm...

Has My Patient Responded? Interpreting Clinical Measurements such as the Six Minute Walk Test.

Authors: Dolmage TE, Hill K, Evans RA, Goldstein RS To correctly interpret clinical measurements it is necessary to understand the standard deviation and the standard error; the former reflects the range or variability of individuals within a sample and the latter reflects the precision for which the group parameters have been estimated. When evaluating an individual patient, test measurement properties such as repeatability will assist in concluding whether a repeated test, measured to monitor the response to an intervention, has changed beyond its natural variability. Using the "best" test has an inherent bias and ignores the natural test variation, whereas the average of repeated tests is more representative of the true value making it more discriminative to change. Serial measureme...

Non-invasive Ventilation and Weaning in Chronic Hypercapnic Respiratory Failure Patients: A Randomized Multicenter Trial.

CONCLUSIONS: No difference was found in the reintubation rate between the three weaning strategies. NIV decreases the intubation duration and may improve the weaning results in difficult-to-wean CHRF patients by reducing the risk of post-extubation ARF. The benefit of rescue NIV in these patients deserves confirmation. Clinical trials registration information available at www.clinicaltrials.gov, i.d. NCT00213499. PMID: 21680944 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

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