Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Jul 2012
Comparative cost analysis of endobronchial ultrasound-guided and blind TBNA in the evaluation of hilar and mediastinal lymphadenopathy.
The superior accuracy of endobronchial ultrasound (EBUS) averts many diagnostic surgical procedures. This likely leads to significant cost savings despite an increased per procedure cost. We sought to compare the true costs of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) compared with "blind" fiberoptic bronchoscopy-transbronchial needle aspiration (FB-TBNA) factoring in the impact of diagnostic surgical procedures in the diagnosis of mediastinal lymphadenopathy. ⋯ EBUS-TBNA is less expensive than blind FB-TBNA in the evaluation of thoracic lymphadenopathy when accounting for diagnostic surgical procedures.
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J Bronchology Interv Pulmonol · Jul 2012
ReviewRationale for the development and the mechanism of action of endoscopic thermal vapor ablation (InterVapor) for the treatment of emphysema.
Emphysema remains a disabling disease despite current treatment. Novel approaches to the underlying physiological abnormalities responsible for symptom generation are warranted. ⋯ InterVapor induces lung volume reduction in patients with emphysema. The mechanism of action is through a thermally induced inflammatory response followed by healing with subsequent remodeling of tissue (fibrosis and distal atelectasis).
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J Bronchology Interv Pulmonol · Jul 2012
Case ReportsMounier-Kuhn syndrome and bilateral vocal cord paralysis.
Mounier-Kuhn syndrome is a rare disorder of unknown cause that is characterized by atrophy of the elastic and smooth muscle of the tracheobronchial tree leading to tracheobronchomegaly and bronchiectasis. The syndrome is likely underdiagnosed, because the patients usually present with common respiratory symptoms such as productive cough and usually labeled as chronic obstructive pulmonary disease. Diagnosis is established on the basis of radiologic findings. ⋯ Symptomatic patients may require endobronchial stenting if airway collapse is encountered. Here, we described a patient who presented with hoarseness and pneumonia. Further studies confirmed the diagnosis of Mounier-Kuhn syndrome with bilateral vocal cord paralysis.
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J Bronchology Interv Pulmonol · Jul 2012
Case ReportsPleuroscopic retrieval of a sewing needle from the pleural cavity under conscious sedation by a chest physician.
We report a case of a young man who presented with a left-sided pneumothorax after suffering an accidental penetrating injury by a sewing needle to the anterior chest wall. Chest radiograph and the computed tomography of the thorax revealed that the needle was in the pleural cavity and there was an associated pneumothorax. ⋯ The sewing needle was successfully retrieved by a medical pleuroscopy. The patient recovered without any consequences and was discharged home after 24 hours of observation.
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J Bronchology Interv Pulmonol · Apr 2012
Case ReportsAcute central airway obstruction: an occupational hazard: aspiration of crack cocaine.
Foreign body aspiration is the fourth leading cause of death due to unintentional injuries. In 2004, 4470 people died because of inhalation or ingestion of food and other objects as per the National Safety Council Report. We report a rare case of accidental aspiration of an intact bag of cocaine, presenting with acute central airway obstruction and cardiopulmonary arrest, highlighting the challenges in the diagnosis and management strategies for this entity.