Clin Med
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Endobronchial ultrasound has become increasingly used in the UK as a lung cancer staging and diagnostic tool. It has many applications especially in the mediastinal lymph nodes but also the vascular structures as well as the airway wall itself. ⋯ There are, however, training issues and revenue-based tariff systems have been slow to reflect this innovation. Future developments may include routine use in the assessment of central pulmonary vasculature and assessment of airway wall remodelling.
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The earliest sign of DN is the development of microalbuminuria which is associated with a significant risk of both progressive renal failure and premature death from cardiovascular disease. Optimal glycaemic and BP control, including the use of RAAS blocking drugs, can prevent, slow and even reverse the processes causing DN.