Risks of visual emphysema associated with lung nodules based on low-dose CT

Introduction Lung cancer screening with low‑dose CT(LDCT) has been shown to detect lung cancer early stage in high-risk subjects. Almost 50% of patients who underwent LDCT screening had lung nodules coexisting with emphysema or COPD. It is still not clear whether emphysema increased the risk for lung nodules. To explore the association between visual emphysema and lung nodules with low-dose CT. Methods The baseline low-dose CT scans of 1166 participants from a prospective lung cancer screening study were used for the detection of lung nodules and emphysema. The presence of lung nodules, emphysema and subtypes of emphysema were visually assessed. All the non-calcified nodules independent of size were included in the analysis. Multivariable logistic regression analyses were performed to estimate the association between the presence, subtypes of emphysema, and lung nodules. In this way, odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. All analyses were adjusted for age, gender, BMI, and smoking status. Results Lung nodules were identified in 907 (78.1%) participants, 674 (58.0%) of whom were diagnosed with emphysema. The participants with lung nodules were older (mean 61.7 vs 59.3 years, p < 0.001), prone to males(47.0% vs 35.7%, p < 0.001) and current smokers(25.4% vs 16.1%, p < 0.001). Participants with emphysema had a higher risk for lung nodules (OR:2.13; 95%CI:1.58-2.87). In terms of the subtypes of emphysema, participants with the centrilobular emphysema had a 2 fold increased risk for the presence of lung nodules(OR:2.15, 95%CI:1.59-2.92) even after adjustment for the covariates, but not for the participants with paraseptal emphysema(OR:1.87, 95%CI:0.84-4.17). Conclusion Emphysema based on low-dose CT is an independent risk factor for lung nodules. The next step is to evaluate whether participants with emphysema and lung nodules are also at increased risk to develop lung cancer

Risks of visual emphysema associated with lung nodules based on low-dose CT

Introduction Lung cancer screening with low‑dose CT(LDCT) has been shown to detect lung cancer early stage in high-risk subjects. Almost 50% of patients who underwent LDCT screening had lung nodules coexisting with emphysema or COPD. It is still not clear whether emphysema increased the risk for lung nodules. To explore the association between visual emphysema and lung nodules with low-dose CT. Methods The baseline low-dose CT scans of 1166 participants from a prospective lung cancer screening study were used for the detection of lung nodules and emphysema. The presence of lung nodules, emphysema and subtypes of emphysema were visually assessed. All the non-calcified nodules independent of size were included in the analysis. Multivariable logistic regression analyses were performed to estimate the association between the presence, subtypes of emphysema, and lung nodules. In this way, odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. All analyses were adjusted for age, gender, BMI, and smoking status. Results Lung nodules were identified in 907 (78.1%) participants, 674 (58.0%) of whom were diagnosed with emphysema. The participants with lung nodules were older (mean 61.7 vs 59.3 years, p < 0.001), prone to males(47.0% vs 35.7%, p < 0.001) and current smokers(25.4% vs 16.1%, p < 0.001). Participants with emphysema had a higher risk for lung nodules (OR:2.13; 95%CI:1.58-2.87). In terms of the subtypes of emphysema, participants with the centrilobular emphysema had a 2 fold increased risk for the presence of lung nodules(OR:2.15, 95%CI:1.59-2.92) even after adjustment for the covariates, but not for the participants with paraseptal emphysema(OR:1.87, 95%CI:0.84-4.17). Conclusion Emphysema based on low-dose CT is an independent risk factor for lung nodules. The next step is to evaluate whether participants with emphysema and lung nodules are also at increased risk to develop lung cancer

[New Dutch practice guideline for administration of vitamin K to full-term newborns]

Item does not contain fulltextVitamin K-deficiency can cause haemorrhage in newborns and infants from the first hours up to several months after birth. These 'vitamin K deficiency bleedings' (VKDB) can be divided into 3 forms: early (occur in the first hours after birth), classic (first week after birth) and late (between the 2nd and the 12th week of life). The current Dutch vitamin K practice guideline consists of prophylactic administration of 1 mg vitamin K orally directly after birth and a daily dose of 25 mug from day 8 onwards. The current prophylactic treatment provides good protection against VKDB for healthy, breastfed infants. However, the current prophylactic treatment provides insufficient protection for a specific group of infants, namely breastfed infants with defective fat absorption (in cholestasis), leading to less efficient absorption of vitamin K by the body. Anually approximately 5 infants from this group suffer serious haemorrhage. After evaluation of current literature and advice from The Health Council of the Netherlands, vitamin K dosage was adapted for all breastfed infants from day 8 to 3 months (12th week of life) following birth: the daily dose was raised from 25 microg to 150 microg per day