[The role of an interventional pulmonologist in the management of metastatic pleural effusions (MPE)]. / Place du pneumologue interventionnel dans la gestion des pleurésies métastatiques.

An interventional pulmonologist possesses expertise in minimally invasive diagnostic and therapeutic procedures involving the airways, lungs and pleura. A malignant pleural effusion (MPE), which occurs in 20% of cancer patients, can be a daunting diagnostic challenge insofar as the pleural cavity is a closed cavity. In these patients, treatment may consequently be delayed before a precise diagnosis can be given. In the meantime, an interventional pulmonologist is called upon to carry out a wide range of examinations in order to establish the etiological diagnosis and to treat the symptoms of an MPE patient. Classical medical thoracoscopy, also called "pleuroscopy", is the reference method in MPE diagnosis because it allows visualization of the pleural cavity, pleural biopsy under direct visual control, providing excellent diagnostic yield. Over the past decade, new diagnostic methods have emerged, such as ultrasound-guided biopsy, as well as different interventions, such as indwelling pleural catheters, aimed at improving the quality of life of MPE patients, for whom therapeutic options are limited. The objective of this review of the literature is to point out the role of the interventional pulmonologist in the management of MPE by detailing the various diagnostic and therapeutic methods he possesses at the present time.

[School feeding program in Guatemala: technology transfer to artisan bakers, producers of the nutritionally improved cookie]. / Programa de alimentación escolar de Guatemala: transferencia de tecnología a panificadores artesanales, productores de la galleta nutricionalmente mejorada.

The Ministry of Education of Guatemala requested from the Institute of Nutrition of Central America and Panama (INCAP), the development of a solid food for delivery to school children who attend the official schools throughout the country. INCAP developed and transferred the processing technology to produce a nutritionally improved cookie to artisan bakers from the different regions of the country. The present paper describes the technological process, focusing on the training, supervision and quality control actions executed with approximately 100 micro baking enterprises, in 1988 and 1989. These actions have had a positive impact on the bakeries, a fact evidenced by the significant improvement of the conditions and processes of the nutritionally improved cookie production. The performance of the above-mentioned activities has allowed us to detect necessities, for the solution of which research and development of technologies are most important for their immediate transference to artisan bakers. Nevertheless, it is necessary to monitor and control the transferred technology, and efforts must continue to increase the effectiveness of the whole system which involves technology transference model, created for this project.