Thorax
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Comparative Study
Significant differences in flow standardised breath sound spectra in patients with chronic obstructive pulmonary disease, stable asthma, and healthy lungs.
Spectral characteristics of breath sounds in asthma and chronic obstructive pulmonary disease (COPD) have not previously been compared, although the structural differences in these disorders might be reflected in breath sounds. ⋯ The observed differences in frequency content of breath sounds in patients with asthma and COPD may reflect altered sound generation or transmission due to structural changes of the bronchi and the surrounding lung tissue in these diseases. Spectral analysis of breath sounds may provide a new non-invasive method for differential diagnosis of obstructive pulmonary diseases.
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This study was carried out to establish a reliable bank of information on the spectral characteristics of chest wall breath sounds from healthy men and women, both non-smokers and smokers. ⋯ These data define the boundaries of normal chest wall breath sounds and may be used as reference for comparison with abnormal sounds.
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A case is described of fulminant community-acquired pneumococcal pneumonia in a 16 year old girl with no previous history of respiratory disease or any predisposing factors. She required extracorporeal membrane oxygenation (ECMO) until the diagnosis could be made and appropriate antibiotic therapy established.
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Randomized Controlled Trial Comparative Study Clinical Trial
Measuring the systemic effects of inhaled beclomethasone: timed morning urine collections compared with 24 hour specimens.
Inhaled glucocorticoid therapy has systemic effects including hypothalamic-pituitary-adrenal (HPA) suppression. The optimal test for detecting these effects has not been defined. ⋯ UCC ratios are as sensitive as the more cumbersome 24 hour urinary free cortisol excretion, and more sensitive than single morning plasma cortisol measurements, in detecting the effects of inhaled beclomethasone on the HPA axis.
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Ultrasound guided transthoracic needle aspiration biopsy has recently been used to obtain specimens for histological diagnosis of pulmonary and mediastinal tumours. Conventional real time, grey scale puncture guiding devices cannot differentiate vascular structures, and clear visualisation of the needle shaft or tip within a desired target is not always possible. This study describes a new built-in colour Doppler ultrasound puncture guiding device and assesses the relative safety of transthoracic needle aspiration biopsy of thoracic tumours by grey scale or colour Doppler ultrasound guidance. ⋯ By using the colour Doppler ultrasound puncture device, vascular structures surrounding or within the target tumour can be verified. Visualisation of the needle shaft or tip is also better. Biopsy routes can be selected to avoid puncturing vessels. This approach should be particularly helpful for guiding biopsies of mediastinal tumours, where puncturing the heart or great vessels is a potential complication.