Respiratory medicine
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Respiratory medicine · Sep 1990
Randomized Controlled Trial Comparative Study Clinical TrialLocal anaesthesia for fibreoptic bronchoscopy: comparison between intratracheal cocaine and lignocaine.
In a double-blind study of 60 patients undergoing fibreoptic bronchoscopy we have compared the local anaesthetic effects of intratracheal injections of cocaine (4 ml, 2.5%) and lignocaine (4 ml, 4%). The two local anaesthetics were equally effective in terms of cough suppression, requirement for extra local anaesthetic, patient discomfort and operator acceptability.
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Respiratory medicine · Nov 1989
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized comparison of fine needle aspiration biopsy and fibreoptic bronchoscopy in the investigation of peripheral pulmonary opacities.
Twenty-nine patients, aged 66(+/- 7) years with a peripheral pulmonary opacity (mean diameter 3.6 +/- 1.8 cm) believed to be a tumor, were randomly allocated to initial investigation by either fibreoptic bronchoscopy or percutaneous fine needle aspiration biopsy, the latter performed under fluoroscopic control. The patients proceeded to the alternative investigation in the event of the first failing to achieve a diagnosis. ⋯ Overall, these figures were 25/28 fine needle aspiration biopsy and 2/15 fibreoptic bronchoscopy (P less than 0.01). These results confirm the clinical suspicion that fine needle aspiration biopsy is far more likely than fibreoptic bronchoscopy to establish the presence of malignancy in peripheral pulmonary opacities.
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Respiratory medicine · Jul 1989
The slowing of the decline in tuberculosis notifications and HIV infection.
Rates of tuberculosis in England and Wales increased slightly in 1986. Evidence is put forward to suggest that this is due to disease in older patients, particularly females. It is very unlikely, therefore, that the arrest in the decline in tuberculosis rates in the UK is related to HIV infection. Infection incurred during World War II is a more probable cause.
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The accuracy of prescriptions for bronchodilator drugs was monitored before and after an educational circular to the medical staff of five medical wards. The circular contained model prescriptions for beta-agonists alone and combined with ipratropium bromide. There was a significant improvement overall in the accuracy of prescribing.