Fiducial marker placement with electromagnetic navigation bronchoscopy: a subgroup analysis of the prospective, multicenter NAVIGATE study.

Background: Fiducial markers (FMs) help direct stereotactic body radiation therapy (SBRT) and localization for surgical resection in lung cancer management. We report the safety, accuracy, and practice patterns of FM placement utilizing electromagnetic navigation bronchoscopy (ENB).

Methods: NAVIGATE is a global, prospective, multicenter, observational cohort study of ENB using the superDimension™ navigation system.

Results of the First American Prospective Study of Intravenous Iron in Oral Iron-Intolerant Iron-Deficient Gravidas.

Background: Anemia affects up to 42% of gravidas. Neonatal iron deficiency is associated with low birth weight, delayed growth and development, and increased cognitive and behavioral abnormalities. While oral iron is convenient, up to 70% report significant gastrointestinal toxicity.

Squamous cell carcinoma of the ascending colon: two cases.

Squamous cell carcinoma (SCC) of the colon without known primary source is a rare finding that needs aggressive management. We report two cases of SCC of the colon without any clear extra-colonic source despite extensive workup. In our experience, the clinical course and prognosis are largely dependent on the presence of metastatic disease at diagnosis.

Thermal ablation for asthma: current status and technique.

Bronchial thermoplasty (BT) is a novel technique used in the treatment of severe asthma. A catheter is advanced through the bronchoscope and directed radiofrequency waves are applied to the segmental bronchi to reduce airway smooth muscle mass. Several randomized clinical trials demonstrate improvement in quality of life and reduction in exacerbation rates after treatment.

Role of electromagnetic navigational bronchoscopy in pulmonary nodule management.

The incidence of pulmonary nodules and lung cancer is rising. Some of this increase in incidence is due to improved pick up by newer imaging modalities. However, the goal is to diagnose these lesion, many of which are located in the periphery, by safe and relatively non-invasive methods.

Percutaneous Bullectomy in Conjunction with Endobronchial Valve Placement as an Alternative to Surgical Management of Giant Bullae.

We present the first reported case of the treatment and management of a giant bulla using percutaneous bullectomy and endobronchial valve placement. A 74-year-old woman with chronic obstructive pulmonary disease and a known large bulla in the left chest presented to the emergency department with acute-onset confusion after a traumatic fall. She was subsequently diagnosed with an intracranial hemorrhage in the distribution of the right basal ganglia.

Mesenteric Fibromatosis in Crohn's Disease as a Potential Effect of Adalimumab.

A 36-year-old woman with no medical or surgical history was evaluated for weight loss. Abdominal computed tomography (CT) showed signs of Crohn's disease, which was later confirmed endoscopically. She was started on tumor necrosis factor-α (TNF-α) inhibitor therapy.

Blue rubber bleb nevus syndrome: a rare presentation of late-onset anemia and lower gastrointestinal bleeding without cutaneous manifestations.

Blue rubber bleb nevus syndrome (BRBNS) is a congenital disorder with characteristic venous anomalies that can present with varying degree of blood loss. The most clinically significant symptoms in adults include gastrointestinal (GI) bleeding and iron deficiency anemia. Severe complications can include intestinal torsion, intussusception, and even perforation, with each leading to significant morbidity and mortality.

Risks and benefits in treatment of mediastinal abscess by endobronchial ultrasound-guided transbronchial needle aspiration.

Introduction: Mediastinal abscess is a fatal condition, treatment of mediastinal abscess is with antibiotics and sometimes surgery for debridement and drainage. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe assessment and candidate treatment method of mediastinal lesions.

Objectives: This study aimed to HYPERLINK "javascript:void(0);" discuss risks and benefits in treatment of mediastinal abscess by EBUS-TBNA.

Emergency department variation in utilization and diagnostic yield of advanced radiography in diagnosis of pulmonary embolus.

Background: There is growing pressure to measure and reduce unnecessary imaging in the emergency department.

Objective: We study provider and hospital variation in utilization and diagnostic yield for advanced radiography in diagnosis of pulmonary embolism (PE) and to assess patient- and provider-level factors associated with diagnostic yield.

Methods: Retrospective chart review of all adult patients presenting to four hospitals from January 2006 through December 2009 who had a computed tomography or ventilation/perfusion scan to evaluate for PE.

Thoracoscopic detection of occult indeterminate pulmonary nodules using bronchoscopic pleural dye marking.

Background: The annual incidence of a small indeterminate pulmonary nodule (IPN) on computed tomography (CT) scan remains high. While traditional paradigms exist, the integration of new technologies into these diagnostic and treatment algorithms can result in alternative, potentially more efficient methods of managing these findings.

Methods: We report on an alternative diagnostic and therapeutic strategy for the management of an IPN.