Study Objective: To assess the ability of endobronchial ultrasonography (EBUS) using a guide sheath (EBUS-GS) to diagnose peripheral pulmonary lesions.
Method: We devised a technique for EBUS-GS covering a miniature probe, and 150 lesions were evaluated in a prospective open study. In this procedure, the probe covered by a guide sheath is introduced into the lesion via the working channel of a bronchoscope. The probe is withdrawn, while the guide sheath is left in situ. A brush or biopsy forceps is introduced through the guide sheath into the lesion.
Results: One hundred sixteen of 150 EBUS-GS procedures (77%) were diagnostic. Cases in which the probe was located within the lesion had a significantly higher diagnostic yield (105 of 121 cases, 87%) than when the probe was located adjacent to it (8 of 19 cases, 42%) [p < 0.0001, chi(2)]. The diagnostic yield from EBUS-GS in lesions = 10 mm (16 of 21 lesions, 76%), >10 to = 15 mm (19 of 25 lesions, 76%; p = 0.99, chi(2)), >15 to = 20 mm (23 of 35 lesions, 66%; p = 0.41, chi(2)), and > 20 to = 30 mm (33 of 43 lesions, 77%; p = 0.96, chi(2)) were similar, demonstrating the efficacy of EBUS-GS even in lesions = 10 mm in diameter. In 54 of 81 lesions = 20 mm, fluoroscopy was not able to confirm whether the forceps reached the lesion. However, the yield was the same with (67%, 18 of 27 lesions) and without (74%, 40 of 54 lesions) successful fluoroscopy (p = 0.96, chi(2)). Moderate bleeding occurred in two patients (1%); there were no other complications.
Conclusions: EBUS-GS is a useful method for collecting samples from peripheral pulmonary lesions, even those too small to be visualized under fluoroscopy.
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http://dx.doi.org/10.1378/chest.126.3.959 | DOI Listing |
Endoscopy
February 2025
Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Japan.
Mol Biol Rep
January 2025
Department of Pharmacology, School of Health Sciences, Central University of Punjab, Bathinda, 151401, India.
Background: Multiple sclerosis (MS) is a chronic autoimmune condition that damages the myelin sheath of neurons in the central nervous system, resulting in compromised nerve transmission and motor impairment. The astrocytopathy is considered one of the prominent etiological factor in the pathophysiology of demyelination in MS. The expression level of ceramide synthase-2 (CS-2) is yet to be established in the pathophysiology of astrocytopathy although the derailed ceramide biosynthetic pathways is well demonstrated in the pathophysiology of demyelination.
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January 2025
Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland. Electronic address:
Background: We have previously demonstrated that an extrafascial injection of 20 ml of local anaesthetic for interscalene brachial plexus block (ISB) reduces the rate of hemidiaphragmatic paralysis by 70% compared with an intrafascial injection, with similar efficacy. In this double-blind trial, we tested the hypothesis that a local anaesthetic volume of 10 ml injected extrafascially would reduce the rate of hemidiaphragmatic paralysis vs a volume of 20 ml, while providing similar analgesia.
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Intensive Care Med
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Global Health Research Group in Acquired Brain and Spine Injuries, Cambridge, UK.
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View Article and Find Full Text PDFSci Rep
January 2025
Department of Cardiology, Peking University International Hospital, Peking University, Beijing, 102206, China.
This study aims to assess the clinical efficacy and feasibility of the Perclose ProGlide Suture-Mediated Closure System (Abbott Vascular, Redwood City, CA, USA) for transbrachial access. A total of 100 patients from July 2020 to December 2023 were included in this retrospective study. Among them, 40 patients underwent ProGlide-guided suture closure following brachial artery (BA) puncture, while 60 patients received traditional manual compression.
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