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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Lyme disease is rare in the U. K. but there is evidence of an increase in both prevalence of, and patient concern about, the infection. There are no published data characterising Lyme disease as it is seen in the U. ⋯ Screening enzyme immunoassay tests were negative in 39% and reference laboratory immunoblots were negative in 31% of patients, principally those with early infection. The majority of patients were cured with one course of antibiotic treatment, three patients had evidence of persistent infection after treatment and two required intravenous therapy. No cases of chronic Lyme disease were seen.