Respirology : official journal of the Asian Pacific Society of Respirology
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Endobronchial ultrasound (EBUS) has increased the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPL). However, certain lesions cannot be localized by EBUS, and the factors associated with the visibility of PPL by EBUS have not been investigated. This study evaluated the factors predicting the visualization of EBUS in PPL and the diagnostic yield of EBUS-guided transbronchial biopsy (TBB). ⋯ Lesion size is a significant factor predicting visualization of EBUS for PPL. The location of PPL on CT scans and position of the probe are significantly related to a higher diagnostic yield with EBUS-guided TBB.
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The idiopathic interstitial pneumonias are a heterogeneous group of diffuse parenchymal lung diseases with varying degrees of inflammation and fibrosis, like interstitial pulmonary fibrosis. Functional exercise tolerance and quality of life have been shown to be significantly affected in patients with lung fibrosis. ⋯ In the current review we will present a rationale for pulmonary rehabilitation in patients with lung fibrosis and the effects of this type of non-pharmacological intervention on exercise capacity and quality of life. In addition, we will discuss possibilities for palliative care in these patients.
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Randomized Controlled Trial
Topical lidocaine through the bronchoscope reduces cough rate during bronchoscopy.
Topical lidocaine is often administered through the flexible bronchoscope in an attempt to reduce excessive coughing and patient discomfort. With the increasing use of sedation, including opiates that possess central cough suppressant effects, and the potential for serious clinical toxicity, the need for evidence regarding the efficacy of topical lidocaine is important. This study assessed whether topical lidocaine through the bronchoscope could reduce cough and stridor rate. ⋯ Topical lidocaine through the bronchoscope significantly decreased cough frequency and the total dose of sedation required during flexible bronchoscopy.
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Few longitudinal studies have examined the risk factors and natural history of adult-onset asthma. This study assessed the subject characteristics and lifestyle factors that predicted the new diagnosis of asthma in adulthood and how these factors changed over time in those who developed asthma compared with those who do not. ⋯ Adult-onset asthma has risk factors that are distinct from those observed in childhood asthma. The presence of upper airway symptoms including rhinitis, as well as lifestyle factors, such as smoking, predicts those at greatest risk. However, neither pre-existing atopy nor new atopy as measured by skin prick tests was associated with adult-onset asthma.
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Although endoscopic ultrasound-guided fine needle aspiration can be helpful when combined with bronchoscopic procedures, endoscopic ultrasound-guided fine needle aspiration is not available as a conjunctive procedure with bronchoscopy at many institutions. This study evaluated the feasibility and the additional role of transoesophageal fine needle aspiration using a convex probe ultrasonic bronchoscope (EUS-B-FNA). ⋯ EUS-B-FNA is a technically feasible and safe procedure, which may be an alternative to endoscopic ultrasound-guided fine needle aspiration as a procedure that complements bronchoscopy. Additional diagnostic yield can be obtained by combining EUS-B-FNA with bronchoscopic procedures.