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Panminerva Medica

Piero Candoli, Loris Ceron, Micaela Romagnoli, Lucio Michieletto, Simone Scarlata, Thomas Galasso, Fausto Leoncini, Valeria Pasini, Donatella Dennetta, Francesca Marchesani, Mariagioconda Zotti, Lorenzo Corbetta
Endobronchial ultrasound (EBUS) has revolutionized the field of bronchoscopy because it allows to observe peribronchial structures and distal peripheral lung lesions. The use of EBUS was first described by Hurte and Hanrath in 1992. EBUS technology exists in two forms: radial and convex transducer probes. The radial EBUS probe has a 20-MHZ (12-30 MHz available) rotating transducer that can be inserted together with or without a guide sheath through the working channel (2.0-2.8mm) of a standard flexible bronchoscope...
November 9, 2018: Panminerva Medica
Vanina Livi, Emanuela Barisione, Mario Salio, Lina Zuccatosta, Micaela Romagnoli, Alessia Praticò, Lucio Michieletto, Laura Mancino, Lorenzo Corbetta
Options for non-surgical tissue diagnosis of the peripheral nodule include CT scan-guided TTNA, fluoroscopy-guided bronchoscopy, radial endobronchial ultrasound (EBUS), electromagnetic navigation bronchoscopy (ENB), and virtual bronchoscopy navigation (VBN). For physicians who choose to pursue non-surgical biopsy, the decision to perform CT scan-guided or ultrasoundguided TTNA, conventional bronchoscopy or bronchoscopy guided by EBUS, ENB, or VBN will depend on a number of factors. CT scan-guided TTNA is preferable for nodules located near the chest wall or for deeper lesions, provided that there is no need to go through the fissures and there is no surrounding emphysema...
October 31, 2018: Panminerva Medica
Emanuela Barisione, Mario Salio, Micaela Romagnoli, Alessia Praticò, Lorenzo Corbetta
Transbronchial (TBL) cryobiopsy has been shown in the last decade to potentially represent an "innovative application" of an "old procedure" for the histologic diagnosis of diffuse interstitial lung diseases (DILDs). Thus, the technique of TBL cryobiopsy is now adopted for diagnostic purposes, transbronchially in peripheral airways to sample lung parenchyma, whereas this same technique was traditionally employed for therapeutic purposes, essentially for the management of malignant obstruction of central airways...
October 31, 2018: Panminerva Medica
Paolo Solidoro, Lorenzo Corbetta, Filippo Patrucco, Massimiliano Sorbello, Federico Piccioni, Luigia D'amato, Teresa Renda, Flavia Petrini
In the last decades, the use of flexible bronchoscopy (FB) has greatly increased in intensive care, anesthesia and thoracic surgery for diagnostic purpose, management of critical patients and to facilitate airway management for tracheal intubation, one lung ventilation and lung transplant management. The huge availability of endoscopic instruments and devices for airway management has amplified indications and possibilities for bronchoscopic procedures performed by intensive care physicians, anesthesiologist, endoscopists, and surgeons too...
October 31, 2018: Panminerva Medica
Paolo Carlucci, Marco Trigiani, Pier Anselmo Mori, Michele Mondoni, Valentina Pinelli, Angelo G Casalini, Emanuele G Conte, Giuseppe Buggio, Liliana Villari, Giampietro Marchetti
Diseases of the pleura and pleural space are common and present a significant contribution to the workload of respiratory physicians, accounting for an annual incidence of more than 1.5 million cases in the US with the majority of cases resulting from congestive heart failure, pneumonia, and cancer 1. Although the radiographic and ultrasonographic detection of pleural abnormalities may be obvious, the determination of a specific diagnosis can often represent a challenge. Since pleural effusions can develop as the result of over 50 different pleuropulmonary or systemic disorders, determining the cause of a pleural effusion can be greatly facilitated by the analysis of the pleural fluid obtained during an ultrasound guided thoracentesis...
October 31, 2018: Panminerva Medica
Ilaria Valentini, Luigi Lazzari, Lucio Michieletto, Margherita Innocenti, Francesca Savoia, Bruno Del Prato, Laura Mancino, Cristina Maddau, Annamaria Romano, Antonella Puorto, Alessandro Fois
Diagnostic bronchoscopy and tissue sampling techniques using forceps (endobronchial biopsy-EBB and transbronchial biopsies-TBB) or needle aspiration (transbronchial needle aspiration-TBNA), all performed with a flexible bronchoscope, are the basic elements of any interventional procedure. The flexible fibrobronchoscopy allows the visualization of the airways and is used both for diagnostic and therapeutic purposes. The working channel of both fibrobronchoscopes with optical fibers and video bronchoscopes, even if of relatively small diameter, allows the insertion of various diagnostic and therapeutic accessories...
October 31, 2018: Panminerva Medica
Lorenzo Corbetta, Luigi B Arru, Carlo Mereu, Valeria Pasini, Marco Patelli
Interventional Pulmonology (IP) is experiencing a rapid evolution of new technologies. There is a need to develop structured training programs, organized in high volume expert centres in order to improve trainee education, and including the development of validated metrics for their competency assessment. Concerning teaching methods, a gradual progression from theory to practice, using new teaching techniques, including live sessions and low and high fidelity simulation, flipped classroom models and problem-based learning (PBL) exercises would provide a training setting more suitable for our current need to improve skills and update professionals...
October 31, 2018: Panminerva Medica
Alessandro Di Cerbo, Federica Pezzuto, Antonio Scarano, Gianandrea Guidetti, Sergio Canello
No abstract text is available yet for this article.
October 10, 2018: Panminerva Medica
Anne-Laure Madika, Gilles Lemesle, Nicolas Lamblin, Thibaud Meurice, Olivier Tricot, Claire Mounier-Vehier, Christophe Bauters
BACKGROUND: Conflicting information exists about whether sex differences modulate outcome in patients with coronary artery disease (CAD). Our aim was to analyze baseline characteristics, medical management, risk factor control, and long-term outcome according to gender in patients with stable CAD. METHODS: We analyzed data from the contemporary multicenter CORONOR registry, which included 4184 consecutive outpatients with stable CAD. Follow-up was performed at 5 years with adjudication of clinical events...
October 10, 2018: Panminerva Medica
Seema Kumar, Tara Kaufman
Childhood obesity has assumed epidemic proportions and it is currently one of the most prevalent public health problems. The pathophysiology of excess weight gain is complex with interactions between genetic factors, environment and biological factors. In this review, we highlight the epidemiology of childhood obesity and discuss clinical evaluation of a child with obesity. A staged approach to treatment is detailed. We discuss the role of lifestyle modifications, pharmacotherapy and bariatric surgery as treatment strategies...
October 5, 2018: Panminerva Medica
Claudio F Simonassi, Maria Majori, Maria G Covesnon, Annalisa Brianti, Luigi Lazzari Agli, Eleonora Meoni, Antonella Ielpo
In clinical practice, interventional pulmonologist faces several situations which can lead to dramatic consequences especially on ventilation and require immediate intervention. We describe the main pathological conditions where urgent bronchoscopy is crucial because they act through mechanisms such as airway obstruction or alteration of the anatomic integrity of the tracheobronchial tree. We point out the problems resulting from inhalation of foreign bodies, one of the most dramatic respiratory emergencies typical of childhood which needs not only the appropriate endoscopic equipment suitable for the age, but also great experience in the management of the possible related complications...
October 5, 2018: Panminerva Medica
Mohammed A Aljama, M Hasib Sidiqi, David Dingli
Despite significant progress in our understanding and the development of novel therapies, most patients with multiple myeloma will experience relapse of their disease. Therapy of relapsed myeloma has improved due to the availability of novel agents that are highly active against the disease. However, the selection of therapy can be challenging due to the emergence of toxicities, comorbidities and frailty. In the following we discuss our approach to the treatment of the patient with relapsed myeloma.
October 5, 2018: Panminerva Medica
Alessandro Adriani, Davide G Ribaldone, Marco Astegiano, Marilena Durazzo, Giorgio M Saracco, Rinaldo Pellicano
Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder which presents with abdominal pain associated with alteration of bowel habits. IBS is a common condition affecting 9-23% of the general population, being the 80% female, with considerable impact on quality of life and health care costs. The exact pathogenesis of IBS remains elusive, but is clearly multifactorial and includes environmental and host factors. Management of patients with IBS is challenging since diagnosis and treatment could require several approaches with unsatisfactory results...
September 24, 2018: Panminerva Medica
Kamal Dua, Gaurav Gupta, Rajendra Awasthi, Dinesh K Chellappan
No abstract text is available yet for this article.
September 2018: Panminerva Medica
Kamal Dua, Jyotsana R Madan, Dinesh K Chellappan, Gaurav Gupta
No abstract text is available yet for this article.
September 2018: Panminerva Medica
Gaurav Gupta, Gautam Singhvi, Dinesh K Chellappan, Sanjay Sharma, Anurag Mishra, Rajiv Dahiya, Terezinha de Jesus Andreoli Pinto, Kamal Dua
Glioblastoma, also known as glioblastoma multiforme, is the most common and worldwide-spread cancer that begins within the brain. Glioblastomas represent 15% of brain tumors. The most common length of survival following diagnosis is 12 to 14 months with less than 3% to 5% of people surviving longer than five years. Without treatment, survival is typically 3 months. Among all receptors, special attention has been focused on the role of peroxisome proliferator-activated receptors (PPARs) in glioblastoma. PPARs are ligand-activated intracellular transcription factors...
September 2018: Panminerva Medica
Dinesh K Chellappan, Wei S Yap, Nurfatihah A Bt Ahmad Suhaimi, Gaurav Gupta, Kamal Dua
The prevalence of type 2 diabetes mellitus (T2DM) has been increasing at an alarming rate. With an increased understanding of the pathophysiology and pathogenesis of T2DM, various new therapeutic options have been developed to target different key defects in T2DM. Incremental innovations of existing therapies either through unprecedented drug combinations, modified drug molecules, or improved delivery systems are capable to nullify some of the undesirable side effects of traditional therapies as well as to enhance effectiveness...
September 2018: Panminerva Medica
Jiaxi Pan, Weiwei Wang, Xiaoxue Wu, Fanqi Kong, Jialin Pan, Jiafeng Lin, Minxue Zhang
BACKGROUND: To investigate the changes of inflammatory cytokines in cardiac pacing patients with atrial fibrillation and asymptomatic atrial fibrillation and the effects of metoprolol on them. METHODS: A total of 92 cardiac pacing patients with atrial fibrillation and asymptomatic atrial fibrillation in our hospital from April 2015 to March 2017 were selected and randomly divided into the control group and the observation group, with 46 cases in each group. Three months after pacemaker implantation, the control group was treated with aspirin, the observation group was treated with metoprolol on the basis of aspirin, and the curative effects were compared between the two groups...
September 2018: Panminerva Medica
Filippo Patrucco, Ludovica Venezia, Francesco Gavelli, Rinaldo Pellicano, Paolo Solidoro
Alpha-1 antitrypsin deficiency (AATD) is a clinically under-recognized inherited disorder affecting the lungs and the liver. The most common manifestations are pulmonary emphysema, bronchiectasis and liver disease. The recent publication of the European Respiratory Society statement on diagnosis and treatment of pulmonary diseases has replaced the 2003 American Thoracic Society and European Respiratory Society one. New outcome parameters have been introduced and validated by observational and randomized clinical trials, and new information about efficacy and safety of augmentation therapy have been published...
September 2018: Panminerva Medica
Alessandra Gasparini, Nicola Poloni, Ivano Caselli, Marta Ielmini, Camilla Callegari
No abstract text is available yet for this article.
September 2018: Panminerva Medica
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