Panminerva medica
-
Bronchoscopy is the most important tool in diagnosis of respiratory diseases, but also provides therapeutic options in various disorders. Besides hemoptysis, airway stenoses are a frequent indication for therapeutic bronchoscopy interventions. Thereby, a broad spectrum of endoscopic techniques including electrocautery, argon plasma coagulation, laser treatment, cryosurgery and stent implantation is available. In the last decade, development of new endoscopic modalities provides also treatment of patients with chronic obstructive pulmonary disease and uncontrolled asthma.
-
Transthoracic ultrasonography (US) has become an essential modality for the evaluation of a wide range of thoracic pathologies by respiratory, emergency and critical care physicians. It can be performed with entry-level equipment and by personnel with minimal training. Its advantages include low cost, lack of radiation and immediate application at the point of care. ⋯ US-assisted fine needle aspiration and/or cutting needle biopsy of extrathoracic lymph nodes, lesions arising from the chest wall, pleura, peripheral lung and mediastinum are safe and have a high yield in the of hands of clinicians. US can potentially also guide aspiration and biopsy of diffuse pulmonary infiltrates, consolidations and lung abscesses. Transthoracic US may also be used for the detection of pulmonary embolism.
-
Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by recurrent episodes of partial or complete upper airway collapse during sleep that is highlighted by a reduction in, or complete cessation of, airflow despite documented on going inspiratory efforts. Due to the lack of adequate alveolar ventilation that results from the upper airway narrowing, oxygen saturation may drop and partial pressure of CO2 may occasionally increase. The events are mostly terminated by arousals. ⋯ Obviously, epidemiological studies investigating the prevalence of OSAHS are all biased by the lack of a uniform definition. The prevalence of an AHI of >5 events · h-1 in a general population (without taking into account symptoms of sleepiness) has previously been estimated to be 24% in a male population. When symptoms of sleepiness were also taken into account, the prevalence decreased to 4% in males and 2% in females.