742 research outputs found

    Initial Polish experience of Flexible 19 gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

    Get PDF
    ┬á INTRODUCTION: EBUS is a well established minimally invasive diagnostic tool for mediastinal and hilar lymphadenopathy. The novel ViziShot Flex 19G needle (Olympus Respiratory America, Redmond, WA, USA) was introduced in 2015 in order to improve loaded scope flexion and to obtain larger tissue samples for analysis. The aims of this study were to assess diagnostic yield of Flex 19G needles and to present endoscopistÔÇÖs feedback about the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). MATERIAL AND METHODS: The Flex 19G needles were used in patients with hilar and/or mediastinal adenopathy in two Polish pulmonology centers. Cytology smears and cell blocks (CB) were prepared. The prospective analysis was performed due to collected data. RESULTS: Twenty two selected patients with confirmed adenopathy on chest-CT (mean age 58 ┬▒ 12) underwent EBUS-TBNA with use of Flex 19G needles. All procedures occurred to be diagnostic for smears (yield 100%). The malignancy was found in 15 cases (68.2%), and benign adenopathy in 7 (31.8%). In 12 of 14 cases of lung cancer (yield 85.7%) CB were diagnostic for immunohistochemical and molecular staining. After puncturing nodes, especially in hilar position not extensive bleeding was observed. Comparing to standard 21/22G EBUS-TBNA endoscopists underlined better flexion of loaded scope and sample adequacy and found non-significant differences in another biopsy details. CONCLUSIONS: The first Polish experience with use of Flex 19G EBUS-TBNA needle occurs to be similar in performance with standard technique with use of 22/21G needles and presents high diagnostic yield for lung cancer diagnostics, especially when preparing CB. A safety profile of the biopsy is acceptable.

    Initial Polish experience of flexible 19 gauge endobronchial ultrasound-guided transbronchial needle aspiration

    Get PDF
    Introduction: EBUS is a well established minimally invasive diagnostic tool for mediastinal and hilar lymphadenopathy. The novel ViziShot Flex 19G needle (Olympus Respiratory America, Redmond, WA, USA) was introduced in 2015 in order to improve loaded scope flexion and to obtain larger tissue samples for analysis. The aims of this study were to assess diagnostic yield of Flex 19G needles and to present endoscopistÔÇÖs feedback about the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Material and methods: The Flex 19G needles were used in patients with hilar and/or mediastinal adenopathy in two Polish pulmonology centers. Cytology smears and cell blocks (CB) were prepared. The prospective analysis was performed due to collected data. Results: Twenty two selected patients with confirmed adenopathy on chest-CT (mean age 58 ┬▒ 12) underwent EBUS-TBNA with use of Flex 19G needles. All procedures occurred to be diagnostic for smears (yield 100%). The malignancy was found in 15 cases (68.2%), and benign adenopathy in 7 (31.8%). In 12 of 14 cases of lung cancer (yield 85.7%) CB were diagnostic for immunohistochemical and molecular staining. After puncturing nodes, especially in hilar position not extensive bleeding was observed. Comparing to standard 21/22G EBUS-TBNA endoscopists underlined better flexion of loaded scope and sample adequacy and found non-significant differences in another biopsy details. Conclusions: The first Polish experience with use of Flex 19G EBUS-TBNA needle occurs to be similar in performance with standard technique with use of 22/21G needles and presents high diagnostic yield for lung cancer diagnostics, especially when preparing CB. A safety profile of the biopsy is acceptable

    Wst─Öpne polskie do┼Ťwiadczenia z u┼╝yciem ig┼éy Flex 19G do przezoskrzelowej biopsji pod kontrol─ů ultrasonografii wewn─ůtrzoskrzelowej

    Get PDF
    WST─śP: EBUS (endobronchial ultrasonography) jest ma┼éoinwazyjn─ů metod─ů diagnostyczn─ů o dobrze ugruntowanej pozycji w diagnostyce limfadenopatii ┼Ťr├│dpiersia i wn─Ök p┼éucnych. ViziShotFlex 19G needle to nowa ig┼éa przeznaczona do zastosowania w tym badaniu wprowadzona na rynek przez firm─Ö Olympus w 2015 roku. Jej konstrukcja ma zapewni─ç wi─Öksz─ů gi─Ötko┼Ť─ç uzbrojonego endoskopu oraz uzyskanie wi─Ökszej ilo┼Ťci materia┼éu tkankowego do analizy. Cele niniejszej pracy to ocena wydolno┼Ťci diagnostycznej procedury EBUS-TBNA (EBUS ÔÇö transbronchial needle aspiration) z zastosowaniem ig┼éy Flex 19G oraz prezentacja opinii endoskopist├│w na temat badania z jej u┼╝yciem. MATERIA┼ü I METODY: Ig┼éy Flex 19G zastosowano w diagnostyce pacjent├│w z adenopati─ů ┼Ťr├│dpiersia i/lub wn─Ök w dw├│ch o┼Ťrodkach pulmonologicznych w Polsce. Wykonywano zar├│wno rozmazy cytologiczne, jak i bloki kom├│rkowe (CB ÔÇö cell blocks). Dokonano prospektywnej analizy zebranych danych. WYNIKI: Dwudziestu dw├│ch wybranych pacjent├│w z adenopati─ů potwierdzon─ů w tomografii komputerowej (┼Ťrednia wieku 58 ┬▒ 12 lat) podano badaniu EBUS-TBNA z u┼╝yciem igie┼é Flex 19G. Wszystkie wykonane rozmazy cytologiczne okaza┼éy si─Ö diagnostyczne (wydolno┼Ť─ç diagnostyczna 100%). Z┼éo┼Ťliwy charakter zmiany stwierdzono w 15 przypadkach (68,2%), natomiast ┼éagodn─ů adenopati─Ö u 7 pacjent├│w (31,8%). W 12 z 14 przypadk├│w raka p┼éuca wykonane CB mog┼éy by─ç u┼╝yte do oznacze┼ä immunohistochemicznych i molekularnych. Po biopsji w─Öz┼é├│w ch┼éonnych, zw┼éaszcza wn─Ökowych, nie obserwowano nasilonego krwawienia. W por├│wnaniu ze standardow─ů procedur─ů EBUS-TBNA z u┼╝yciem ig┼éy 21/22G endoskopi┼Ťci podkre┼Ťlali wi─Öksz─ů gi─Ötko┼Ť─ç uzbrojonego endoskopu oraz jako┼Ť─ç bioptatu, natomiast w pozosta┼éych aspektach biopsji r├│┼╝nice by┼éy nieznacz─ůce. WNIOSKI: Pierwsze polskie do┼Ťwiadczenia z u┼╝yciem igie┼é Flex 19G okazuj─ů si─Ö by─ç podobne do standardowej techniki z u┼╝yciem igie┼é 21/22G oraz prezentuj─ů wysok─ů wydolno┼Ť─ç diagnostyczn─ů w raku p┼éuca, szczeg├│lnie z zastosowaniem CB. Profil bezpiecze┼ästwa biopsji jest akceptowalny.WST─śP: EBUS (endobronchial ultrasonography) jest ma┼éoinwazyjn─ů metod─ů diagnostyczn─ů o dobrze ugruntowanej pozycji w diagnostyce limfadenopatii ┼Ťr├│dpiersia i wn─Ök p┼éucnych. ViziShotFlex 19G needle to nowa ig┼éa przeznaczona do zastosowania w tym badaniu wprowadzona na rynek przez firm─Ö Olympus w 2015 roku. Jej konstrukcja ma zapewni─ç wi─Öksz─ů gi─Ötko┼Ť─ç uzbrojonego endoskopu oraz uzyskanie wi─Ökszej ilo┼Ťci materia┼éu tkankowego do analizy. Cele niniejszej pracy to ocena wydolno┼Ťci diagnostycznej procedury EBUS-TBNA (EBUS ÔÇö transbronchial needle aspiration) z zastosowaniem ig┼éy Flex 19G oraz prezentacja opinii endoskopist├│w na temat badania z jej u┼╝yciem. MATERIA┼ü I METODY: Ig┼éy Flex 19G zastosowano w diagnostyce pacjent├│w z adenopati─ů ┼Ťr├│dpiersia i/lub wn─Ök w dw├│ch o┼Ťrodkach pulmonologicznych w Polsce. Wykonywano zar├│wno rozmazy cytologiczne, jak i bloki kom├│rkowe (CB ÔÇö cell blocks). Dokonano prospektywnej analizy zebranych danych. WYNIKI: Dwudziestu dw├│ch wybranych pacjent├│w z adenopati─ů potwierdzon─ů w tomografii komputerowej (┼Ťrednia wieku 58 ┬▒ 12 lat) podano badaniu EBUS-TBNA z u┼╝yciem igie┼é Flex 19G. Wszystkie wykonane rozmazy cytologiczne okaza┼éy si─Ö diagnostyczne (wydolno┼Ť─ç diagnostyczna 100%). Z┼éo┼Ťliwy charakter zmiany stwierdzono w 15 przypadkach (68,2%), natomiast ┼éagodn─ů adenopati─Ö u 7 pacjent├│w (31,8%). W 12 z 14 przypadk├│w raka p┼éuca wykonane CB mog┼éy by─ç u┼╝yte do oznacze┼ä immunohistochemicznych i molekularnych. Po biopsji w─Öz┼é├│w ch┼éonnych, zw┼éaszcza wn─Ökowych, nie obserwowano nasilonego krwawienia. W por├│wnaniu ze standardow─ů procedur─ů EBUS-TBNA z u┼╝yciem ig┼éy 21/22G endoskopi┼Ťci podkre┼Ťlali wi─Öksz─ů gi─Ötko┼Ť─ç uzbrojonego endoskopu oraz jako┼Ť─ç bioptatu, natomiast w pozosta┼éych aspektach biopsji r├│┼╝nice by┼éy nieznacz─ůce. WNIOSKI: Pierwsze polskie do┼Ťwiadczenia z u┼╝yciem igie┼é Flex 19G okazuj─ů si─Ö by─ç podobne do standardowej techniki z u┼╝yciem igie┼é 21/22G oraz prezentuj─ů wysok─ů wydolno┼Ť─ç diagnostyczn─ů w raku p┼éuca, szczeg├│lnie z zastosowaniem CB. Profil bezpiecze┼ästwa biopsji jest akceptowalny

    Sustainable low-field cardiovascular magnetic resonance in changing healthcare systems.

    Get PDF
    Cardiovascular disease continues to be a major burden facing healthcare systems worldwide. In the developed world, cardiovascular magnetic resonance (CMR) is a well-established non-invasive imaging modality in the diagnosis of cardiovascular disease. However, there is significant global inequality in availability and access to CMR due to its high cost, technical demands as well as existing disparities in healthcare and technical infrastructures across high-income and low-income countries. Recent renewed interest in low-field CMR has been spurred by the clinical need to provide sustainable imaging technology capable of yielding diagnosticquality images whilst also being tailored to the local populations and healthcare ecosystems. This review aims to evaluate the technical, practical and cost considerations of low field CMR whilst also exploring the key barriers to implementing sustainable MRI in both the developing and developed world

    Observation of tW production in the single-lepton channel in pp collisions at root s=13 TeV

    Get PDF
    A measurement of the cross section of the associated production of a single top quark and a W boson in final states with a muon or electron and jets in proton-proton collisions at root s = 13 TeV is presented. The data correspond to an integrated luminosity of 36 fb(-1) collected with the CMS detector at the CERN LHC in 2016. A boosted decision tree is used to separate the tW signal from the dominant t (t) over bar background, whilst the subleading W+jets and multijet backgrounds are constrained using data-based estimates. This result is the first observation of the tW process in final states containing a muon or electron and jets, with a significance exceeding 5 standard deviations. The cross section is determined to be 89 +/- 4 (stat) +/- 12 (syst) pb, consistent with the standard model.Peer reviewe

    Discutindo a educa├ž├úo ambiental no cotidiano escolar: desenvolvimento de projetos na escola forma├ž├úo inicial e continuada de professores