British Thoracic Society Quality Standard for Clinically Significant Bronchiectasis in Adults 2022.

This British Thoracic Society Quality Standard for Clinically Significant Bronchiectasis in Adults 2022 aims to encourage good practice by setting standards of high-quality respiratory care that services should follow.

Providing evidence-based care for adult patients with bronchiectasis.

Bronchiectasis is a long-term respiratory disease in which there is permanent bronchial dilatation, and it is associated with recurrent cough, sputum production and respiratory tract infections. The incidence and prevalence of bronchiectasis is rising, but it can be challenging to identify and manage this disease. The British Thoracic Society published its latest guideline for bronchiectasis in adults in 2019.

Primary care implications of the British Thoracic Society Guidelines for bronchiectasis in adults 2019.

The British Thoracic Society (BTS) Guidelines for Bronchiectasis in adults were published in January 2019, and comprise recommendations for treatment from primary to tertiary care. Here, we outline the practical implications of these guidelines for primary care practitioners. A diagnosis of bronchiectasis should be considered when a patient presents with a recurrent or persistent (>8 weeks) productive cough.

British Thoracic Society guideline for bronchiectasis in adults.

The full British Thoracic Society Guideline for Bronchiectasis in Adults is published in . The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline.

COLONIC DIVERTICULOSIS AND DIVERTICULAR HEMORRHAGE IN A GERIATRIC FEMALE ORANGUTAN ( PONGO ABELII).

A 57-yr-old female Sumatran orangutan ( Pongo abelii) presented with signs of intermittent lethargy and inappetence, then subsequently developed profuse hemorrhagic diarrhea. Colonoscopy under anesthesia revealed diverticulosis of the descending colon, with multiple large diverticula containing fecoliths. There was no evidence of diverticulitis, but a regenerative anemia had developed following an acute diverticular bleed.

HEREDITARY FACTOR VII DEFICIENCY IN THE ASIAN ELEPHANT (ELEPHAS MAXIMUS) CAUSED BY A F7 MISSENSE MUTATION.

Hereditary disorders and genetic predispositions to disease are rarely reported in captive and free-ranging wildlife, and none have been definitively identified and characterized in elephants. A wild-caught, 41-yr-old male Asian elephant ( Elephas maximus ) without an apparent increased bleeding tendency was consistently found to have prolonged prothrombin times (PTs, mean=55±35 s) compared to 17 other elephants (PT=10±2 s). This elephant's partial thromboplastin times (PTT) fell within the normal range of the other elephants (12-30 s).

BIOMED-2 PCR assays for IGK gene rearrangements are essential for B-cell clonality analysis in follicular lymphoma.

B-cell clonality analysis is commonly performed by polymerase chain reaction (PCR) targeting the IGH genes although a high false-negative rate is recognized for germinal centre/post-germinal centre B-cell malignancies, especially follicular lymphoma. We assessed the diagnostic value of BIOMED-2 IGK assays and investigated the cause of IGH PCR failure in 77 patients with follicular lymphoma. Using the full set of BIOMED-2 reactions, clonal immunoglobulin gene rearrangements were detected in 74 (96%) cases.

Credibility of a meta-analysis: evidence-based practice concerning soy intake and breast cancer risk in premenopausal women.

Purpose: To report the findings from a critical appraisal concerning the credibility of a meta-analysis (M-A) about the role of dietary soy intake in reducing breast cancer risk. The use of an evidence-based, advanced nursing practice framework was used to appraise the M-A.

Approach: The clinical question was developed from a problem that could be encountered in clinical practice.

Breast feeding practices and views among diabetic women: a retrospective cohort study.

Objective: to explore the pattern and experiences of breast-feeding practices among diabetic women.

Design: retrospective cohort study using maternal records and postal questionnaires in a Baby-Friendly hospital.

Participants: diabetic mothers including women with gestational diabetes, and type 1 and 2 diabetes mellitus.

A practical strategy for the routine use of BIOMED-2 PCR assays for detection of B- and T-cell clonality in diagnostic haematopathology.

BIOMED-2 polymerase chain reaction (PCR) assays for clonality analysis of immunoglobulin (IG) and T-cell receptor (TCR) gene rearrangements were evaluated in routine haematopathological practice where paraffin-embedded tissues constitute the majority of specimens. One hundred and twenty-five fresh/frozen and 316 paraffin specimens were analysed for DNA quality and clonality. Seventy-nine per cent of paraffin specimens yielded PCR products of over 300 bp.

A splendid tree frog with edema syndrome and intestinal adenocarcinoma.

A splendid tree frog (Pelodryas splendida) presented with subcutaneous edema extending along its dorsum from head to vent, which resolved with improvement of ambient temperature and humidity conditions in its enclosure. Four months later, this same frog presented in a moribund state with intracoelomic fluid accumulation. An intestinal adenocarcinoma, a rarely reported neoplasm in amphibians, was diagnosed post mortem.

An outbreak of mycobacteriosis in Gouldian finches caused by Mycobacterium peregrinum.

An outbreak of mycobacteriosis was detected in an aviary containing Gouldian finches (Erythrura gouldiae) and golden shouldered parrots (Psephotus chrysopterygius). Affected birds developed granulomatous lesions, usually of the liver and intestine. Mycobacterium peregrinum, a species of the Mycobacterium fortuitum group, was cultured on pooled samples of intestinal tract from 31 euthanized finches.

Identifying sources of fecal contamination inexpensively with targeted sampling and bacterial source tracking.

Most bacterial source tracking (BST) methods are too expensive for most communities to afford. We developed targeted sampling as a prelude to BST to reduce these costs. We combined targeted sampling with three inexpensive BST methods, Enterococcus speciation, detection of the esp gene, and fluorometry, to confirm the sources of fecal contamination to beaches on Georgia's Jekyll and Sea Islands during calm and stormy weather conditions.