Safety and diagnostic performance of pulmonologists performing electromagnetic guided percutaneous lung biopsy (SPiNperc)

Background and objectivePercutaneous lung biopsy for diagnostic sampling of peripheral lung nodules has been widely performed by interventional radiologists under computed tomography (CT) guidance. New technology allows pulmonologists to perform percutaneous lung biopsies using electromagnetic (EM) guided technology. With the adoption of this new technique, the safety, feasibility and diagnostic yield need to be explored. The goal of this study was to determine the safety, feasibility and diagnostic yield of EMâ guided percutaneous lung biopsy performed by pulmonologists.MethodsWe conducted a retrospective, multicentre study of 129 EMâ guided percutaneous lung biopsies that occurred between November 2013 and March 2017. The study consisted of seven academic and three community medical centres.ResultsThe average age of participants was 65.6â years, BMI was 26.3 and 50.4% were females. The majority of lesions were in the right upper lobe (37.2%) and left upper lobe (31.8%). The mean size of the lesions was 27.31â mm and the average distance from the pleura was 13.2â mm. Practitioners averaged two fineâ needle aspirates and five core biopsies per procedure. There were 23 (17.8%) pneumothoraces, of which 16 (12.4%) received smallâ bore chest tube placement. The diagnostic yield of percutaneous lung biopsy was 73.7%. When EMâ guided bronchoscopic sampling was also performed during the same procedural encounter, the overall diagnostic yield increased to 81.1%.ConclusionIn this large multicentred series, the use of EM guidance for percutaneous lung biopsies was safe and feasible, with acceptable diagnostic yield in the hands of pulmonologists. A prospective multicentre trial to validate these findings is currently underway (NCT03338049).Lung cancer screening has led to the discovery of over 1â million pulmonary nodules each year. New technology allows pulmonologists to perform percutaneous lung biopsies using electromagnetic (EM) guided technology. In this retrospective analysis, we demonstrate that EM percutaneous needle biopsy is safe, feasible and provides an acceptable diagnostic yield.See related EditorialPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149341/1/resp13471.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149341/2/resp13471_am.pd

Emotional Expressivity between the United States and Brazil

Emotional expression differs according to culture and gender. Understanding such differences is important for cross-cultural communication. Brazilians are stereotyped as more emotionally expressive than other cultures. Kring, Smith, and Neale developed an emotional expressivity scale (EES) that has not been used in Brazil. The EES does not differentiate between positive and negative emotions or the emotional expression source, so questions related to six emotions and parental emotional expressivity were added to the survey. Analysis of variance for EES ratings indicated no significant country differences, but did indicate significant gender differences with both U.S. and Brazil women reporting higher ratings than men. For specific emotions, Brazilians reported significantly more comfort for expressing nervousness and anger. Except for anger, women reported higher emotional expression than men. Only U.S. women's EES ratings were significantly correlated with perceived parental expressivity level. EES ratings significantly correlated with all emotions except for anger in both Brazil and the United States. The findings further validate the EES by demonstrating correlation between EES ratings and specific emotions. Additionally, results partially refute stereotypes about Brazilian emotional expression

Renoprotective effects of carvedilol in hypertensive-stroke prone rats may involve inhibition of TGFβ expression

1. The effect of carvedilol on renal function, structure and expression of TGFβ and the matrix proteins fibronectin, collagen I and collagen III, was evaluated in spontaneously hypertensive stroke-prone (SHR-SP) rats fed a high fat, high salt diet. 2. Carvedilol treatment for 11 to 18 weeks did not alter systolic blood pressure in SHR-SP rats, however, it resulted in a significant reduction in heart rate. 3. Carvedilol treatment reduced renal fibrosis and total, active and chronic renal damage to levels approaching those of WKY rats on a normal diet. 4. Urinary protein excretion was higher in SHR-SP rats (51±10 mg day(−1)) than WKY rats (18±2 mg day(−1)) and this was further increased when SHR-SP rats were fed a high fat, high salt diet (251±120 mg day(−1)). Treatment with carvedilol resulted in significantly lower urinary protein excretion (37±15 mg day(−1)). 5. The expression of TGFβ mRNA was significantly higher in SHR-SP rats compared to WKY rats and a further increase was observed when rats were fed a high fat, high salt diet. Renal TGFβ expression was significantly reduced by treatment with carvedilol. The expression of fibronectin and collagen I and collagen III mRNA showed a pattern similar to that observed with TGFβ mRNA expression. Collagen I mRNA expression followed a pattern similar to renal fibrosis. 6. These data indicate that carvedilol can provide significant renal protection in the absence of any antihypertensive activity and that the mechanisms involved in this action may include reduced expression of profibrotic factors such as TGFβ