Thorax
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The National Institute for Health and Clinical Excellence recently published a clinical guideline on the management of venous thromboembolic disease and thrombophilia testing. Several stand-out recommendations are made which may be practice changing for many physicians, such as catheter-directed thrombolysis for ilio-femoral deep venous thrombosis, routine cancer screening and extended duration of anticoagulation for unprovoked events. In this article, we summarise the key points of the guideline and discuss remaining areas of controversy.
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Interferon gamma release assays (IGRAs) are the first new diagnostic tests for latent tuberculosis (TB) infection (LTBI) since the century-old tuberculin skin test (TST). They are cell-mediated immune-based blood tests that have revolutionised LTBI diagnosis and are increasingly recommended by national guidelines. ⋯ Current and planned clinical research will fill the gaps in the evidence-base, narrowing the areas of uncertainty and informing future policy. Translational research into next-generation IGRAs and new T cell-based diagnostic platforms will likely overcome the limitations of current IGRAs in the near future.