Narrow band imaging (NBI) during medical thoracoscopy: first impressions

<p>Abstract</p> <p>Background</p> <p>This is the first ever evaluation of narrow band imaging (NBI), an innovative endoscopic imaging procedure, for the visualisation of pleural processes.</p> <p>Methods</p> <p>The pleural cavity was examined in 26 patients with pleural effusions using both white light and narrow band imaging during thoracoscopy under local anaesthesia.</p> <p>Results</p> <p>In the great majority of the patients narrow band imaging depicted the blood vessels more clearly than white light, but failed to reveal any differences in number, shape or size. Only in a single case with pleura thickened by chronic inflammation and metastatic spread of lung cancer did narrow band imaging show vessels that were not detectable under white light.</p> <p>Conclusion</p> <p>It is not yet possible to assess to what extent the evidence provided by NBI is superior to that achieved with white light. Further studies are required, particularly in the early stages of pleural processes.</p

Gemcitabine combined with oxaliplatin in pretreated patients with malignant pleural mesothelioma: an observational study

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to investigate the efficacy and safety of oxaliplatin ± gemcitabine in patients with diffuse malignant pleural mesothelioma (MPM) pretreated with pemetrexed.</p> <p>Methods</p> <p>The study enrolled consecutive patients with relapsed MPM, all of them pretreated with a platin-pemetrexed-based chemotherapy. Oxaliplatin 80 mg/m²was administered as monotherapy or in combination with gemcitabine 1000 mg/m²given on day 1 and 8. Cycles were repeated every 21 days. The primary endpoints were response rate and disease control rate. Secondary endpoints included overall survival (OS), time to tumour progression (TTP), progression-free survival (PFS), time to treatment failure (TTF), and toxicity.</p> <p>Results</p> <p>Between February 2005 and September 2007 29 patients (median age: 65.0 years, World Health Organisation (WHO) performance status: 0–3) were enrolled. The follow-up period encompassed 5.4 to 97.4 weeks (median: 24.3 weeks). Out of these 29 patients, 15 were treated in second, 10 in third, 3 in fourth and 1 in fifth line, respectively. The majority of the patients received the combination oxaliplatin and gemcitabine (n = 25 vs. 4; 86.2 vs. 13.8%).</p> <p>The median overall survival (OS) was 71.7 weeks (30.6–243.3 weeks), whereas survival from the start of oxaliplatin/gemcitabine-treatment was 24.3 weeks (5.4–97.3 weeks). Median time to tumour progression (TTP) was 9.3 weeks (3.0–67.6 weeks).</p> <p>Partial response (PR) was observed in 2 patients (6.9%), stable disease (SD) for at least three courses of treatment in 11 patients (37.9%). Thus, disease control rate was 44.8%, whereas 16 of 29 patients exhibited progressive disease (55.2%).</p> <p>The toxicity profile was favourable, with no WHO grade 4-toxicities, only few dose-reductions were performed due to non-symptomatic haematotoxicities (neutropenia, thrombopenia). Mild WHO grade 2 neurotoxicity was seen in 6 patients.</p> <p>Conclusion</p> <p>Pemetrexed-pretreated patients with progressive MPM may benefit from a consecutive chemotherapy with oxaliplatin and gemcitabine without significant toxicity.</p

Clinical Study The Use of Interferon Gamma Release Assays in the Diagnosis of Active Tuberculosis

Interferon gamma release assays (IGRAs) are in vitro immunologic diagnostic tests used to identify Mycobacterium tuberculosis infection. They cannot differentiate between latent and active infections. The cutoff suggested by the manufacturer is 0.35 IU/mL for latent tuberculosis. As IGRA tests were recently approved for the differential diagnosis of active tuberculosis, we assessed the diagnostic accuracy of the latest generation IGRA for detection of active tuberculosis in a low-incidence area in Germany. Our consecutive case series includes 61 HIV negative, Mycobacterium tuberculosis culture positive patients, as well as 234 control patients. The retrospective analysis was performed over a period of two years. In 11/61 patients with active tuberculosis (18.0%) the test result was &lt;0.35 IU/mL, resulting in a sensitivity of 0.82. We recommend establishing a new cut-off value for the differential diagnosis of active tuberculosis assessed by prospective clinical studies and in various regions with high and low prevalence of tuberculosis

Morphometrical analysis of transbronchial cryobiopsies

The recent introduction of bronchoscopically recovered cryobiopsy of lung tissue has opened up new possibilities in the diagnosis of neoplastic and non-neoplastic lung diseases in various aspects. Most notably the morphological diagnosis of peripheral lung biopsies promises to achieve a better yield with a high quality of specimens. To better understand this phenomenon, its diagnostic options and perspectives, this study morphometrically compares 15 cryobiopsies and 18 transbronchial forceps biopsies of peripheral lung tissue a priori without considering clinical hit ratio or integration of results in the clinical diagnostic processing. Cryotechnically harvested specimens were significantly larger (mean: 17.1 ± 10.7 mm2 versus 3.8 ± 4.0 mm2) and contained alveolar tissue more often. If present, the alveolar part in cryobiopsies exceeded the one of forceps biopsies. The alveolar tissue of crybiopsy specimens did not show any artefacts. Based on these results cryotechnique seems to open up new perspectives in bronchoscopic diagnosis of lung disease

Thoracic oncology in Europe: the ERS action plan by the Thoracic Oncology Assembly.

EditorialSCOPUS: ed.jinfo:eu-repo/semantics/publishe

La consommation urbaine des céréales traditionnelles dans la province du Limpopo (Afrique du Sud). Les attentes des consommateurs constituent-elles des opportunités pour les petits producteurs ?

National audienceL'objectif de l'étude était de décrire les pratiques de consommation du mil et du sorgho développées par des Sud-Africains urbains et d'identifier leur potentielle acceptation de produits venant de la petite agriculture. Des données qualitatives ont été récoltées à Polokwane (province du Limpopo) grâce à des entretiens individuels et à des discussions de groupes. Il apparaît que le sorgho disponible dans les points de vente en ville est largement consommé, principalement sous forme de bouillie, mais aussi de pâte et de bière. Le sorgho est perçu comme un produit nutritif, bon pour la santé mais difficile à cuisiner et à conserver après cuisson. Le mil n'est pas disponible en ville et souffre d'une image démodée. Les céréales locales peuvent être un moyen pour les petits agriculteurs d'atteindre le marché urbain car : (1) il existe une demande non satisfaite qui correspond d'une part à un besoin de "tradition" et, d'autre part, à un besoin de produits adaptés au style de vie urbain ; (2) de nombreux consommateurs urbains seraient prêts à acheter des produits de la petite agriculture parce qu'ils veulent soutenir les petits agriculteurs ou parce qu'ils pensent que ces produits sont de meilleure qualité que les produits "industriels"