Respiration; international review of thoracic diseases
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Comparative Study
Lung ultrasonography may provide an indirect estimation of lung porosity and airspace geometry.
Echographic vertical artifacts (B-lines) in chest ultrasonography have often been associated with pathological patterns. A scientifically sound explanation of these artifacts has not yet been proposed. ⋯ Airspace geometry, frothy nature and porosity are the determinants of the different behavior of ultrasound interacting with the subpleural lung parenchyma. Chest ultrasound may thus be interpreted as an indirect 'estimator' of lung porosity.
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Chronic obstructive pulmonary disease (COPD) is a major public health burden and profoundly affects individuals suffering from the disease. However, the majority of subjects with COPD are still undiagnosed. ⋯ COPD in the primary-care setting is as prevalent and underdiagnosed as reported recently for the BOLD study. The surprisingly low participation rate of GPs and patients indicates that prevention of COPD is not a health priority, and that awareness for COPD has to heightened before case-finding strategies will be successful.
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Published data concerning the utility of computed tomography (CT)-based lung volumes are limited to correlation with lung function. ⋯ The CT Vratio had significant correlations with patient-centered outcomes and multidimensional COPD severity indices.
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There are various imaging methods in use designed to provide information on lung functional status, particularly gas exchange within specific lung segments. These complex imaging methods provide indirect information about volume and local lung function. ⋯ This new method enables gas sampling at the lung segment level. The concomitant display of local endocapnometry and endooximetry curves allows for a better identification of target zones for endoscopic emphysema treatments or to improve ventilation strategies for patients on respiratory support.
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Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an increasingly used mediastinal sampling technique. Many centres use conscious sedation in an ambulatory setting to optimise the flow of patients, save costs and shorten recovery time. The only EBUS-TBNA patient satisfaction study published so far used deep conscious sedation with propofol. To our knowledge, ours is the largest prospective study evaluating the experience of patients undergoing EBUS-TBNA using light conscious sedation without propofol. ⋯ This single-centre UK study confirms that EBUS-TBNA under light conscious sedation is a well-tolerated procedure maintaining the expected diagnostic performance, with patients reporting a high degree of satisfaction with both the test and the information received beforehand.