RESUMO
The SARS-CoV-19 pandemic continues to be globally related with significant morbidity and mortality, making protective measures to prevent transmission of the virus still necessary. Healthcare employees are exposed to a higher risk of infection and this is particularly true when performing aerosol-generating procedures such as bronchoscopy.Since the publication of recommendations for performing a bronchoscopy in the times of COVID-19 more than six months ago, the risk situation has not changed significantly, but due to the considerable gain in knowledge in the meantime, an update of the recommendations was necessary.The updated recommendations include the reduction of aerosol formation, the personal protection of the people involved in the procedure, as well as measures to better organize the processes in the endoscopy suite in order to perform bronchoscopic procedures securely even in times of COVID-19.
Assuntos
COVID-19 , Pandemias , Broncoscopia , Pessoal de Saúde , Humanos , SARS-CoV-2RESUMO
Interventional treatment of emphysema offers a wide range of surgical and endoscopic options for patientes with advanced disease. Multidsciplinary collaboration of pulmonology, thoracic surgery and imaging disciplines in patient selection, therapy and follow up ensures treatment quality. The present joint statement describes the required structural and quality prerequsites of treatment centres.
Assuntos
Enfisema/terapia , Comunicação Interdisciplinar , Pulmão/fisiopatologia , Sociedades Médicas , Enfisema/diagnóstico , Alemanha , Humanos , Equipe de Assistência ao Paciente , Pneumonectomia , Pneumologia/normas , Radiografia , Cirurgia Torácica/normasRESUMO
COVID-19, caused by coronavirus SARS-CoV-2 is a new and ongoing infectious disease affecting healthcare systems worldwide. Healthcare worker are at high risk for COIVD-19 and many have been infected or even died in countries severely affected by COVID-19 like China or Italy. Bronchoscopy causes cough and aerosol production and has to be considered a significant risk for the staff to get infected. Particular recommendations should guide to prevent spreading COVID-19 and to protect healthcare worker when performing a bronchoscopy.
Assuntos
Broncoscopia , Infecções por Coronavirus , Controle de Infecções/métodos , Pandemias , Pneumonia Viral , Aerossóis , Betacoronavirus , Broncoscopia/métodos , COVID-19 , China , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Tosse , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , SARS-CoV-2RESUMO
Endobronchial Ultrasound (EBUS) with the two modalities curved and radial EBUS significantly improved the diagnostics in several pulmonary diseases. The examination and staging of mediastinal and hilar lymph nodes in patients with known or suspected lung malignancy as well as the evaluation of unknown pulmonary or mediastinal lesions can be achieved with minimal invasive means when using EBUS.âMore invasive surgical procedures for diagnostic purposes can be omitted. The diagnostic yield also increases when EBUS is applied in sarcoidosis or mediastinal lymph node tuberculosis but only to some extend in case of lymphoma. Samples obtained by EBUS-TBNA should be handled efficiently to allow molecular analysis in lung cancer. EBUS is a safe procedure, and complication rate is extremely low. Further advances of the EBUS technology focus on improving analysis of the information provided by the ultrasound image and a better tissue sampling by developing of new EBUS bronchoscopes and TBNA-needles.
Assuntos
Broncoscopia/métodos , Endossonografia/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias do Mediastino/diagnóstico por imagem , Biópsia por Agulha , Humanos , Neoplasias Pulmonares/patologia , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Linfoma/diagnóstico por imagem , Linfoma/patologia , Neoplasias do Mediastino/patologia , Estadiamento de Neoplasias , Sarcoidose Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/patologia , Sensibilidade e Especificidade , Tuberculose dos Linfonodos/diagnóstico por imagem , Tuberculose dos Linfonodos/patologiaRESUMO
We report on the first generation of 5.5-7.5 MeV protons by a moderate-intensity short-pulse laser (â¼5×10(17) W/cm(2), 40 fsec) interacting with frozen H(2)O nanometer-size structure droplets (snow nanowires) deposited on a sapphire substrate. In this setup, the laser intensity is locally enhanced by the snow nanowire, leading to high spatial gradients. Accordingly, the nanoplasma is subject to enhanced ponderomotive potential, and confined charge separation is obtained. Electrostatic fields of extremely high intensities are produced over the short scale length, and protons are accelerated to MeV-level energies.
RESUMO
To evaluate the incidence of therapy-related acute leukaemia (t-AL) after single-agent mitoxantrone (MITO) treatment, we reviewed medical records of patients in three studies of single-agent MITO therapy for multiple sclerosis (MS) and existing literature on MITO therapy in MS, leukaemia, and solid tumors. Of 1378 MITO recipients in the three MS studies (mean cumulative dose of 60 mg/m2 and mean follow-up of 36 months), one patient had t-AL, an observed incidence proportion of 0.07% [95% confidence interval (CI) = 0.00-0.40%]. There were no cases of t-AL in published reports of nine additional studies of single-agent MITO therapy for MS. There was one published case report of acute promyelocytic leukoemia detected five years after initiating MITO therapy for MS. The observed incidence proportion of t-AL is very low in patients who received MITO as single-agent therapy for MS. Although these observations provide preliminary reassurance, extended follow-up of these patients and those who receive higher cumulative doses of MITO is required to define the long-term risk of t-AL after MITO therapy for MS.