Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement.

Inducible laryngeal obstruction (ILO) describes an inappropriate, transient, reversible narrowing of the larynx in response to external triggers. ILO is an important cause of a variety of respiratory symptoms and can mimic asthma. Current understanding of ILO has been hampered by imprecise nomenclature and variable approaches to assessment and management. A task force of the European Respiratory Society (ERS) and European Laryngological Society (ELS) was thus set up to address this, and to identify research priorities.A literature search identified relevant articles published until June 2016, using all identifiable terms for ILO, although including only articles using laryngoscopy. In total, 172 out of 252 articles met the inclusion criteria, summarised in sections on diagnostic approach, aetiology, comorbidities, epidemiology and treatment. The consensus taxonomy published by ERS, ELS and the American College of Chest Physicians (ACCP) in 2015 is used throughout this statement.We highlight the high prevalence of ILO and the clinical impact for those affected. Despite recent advances, most aspects of this condition unfortunately remain incompletely understood, precluding firm guidance. Specifically, validated diagnostic and treatment algorithms are yet to be established, and no randomised control studies were identified in this search; hence we also make recommendations for future research.

Correlation between epicardial adipose tissue thickness and the degree of coronary artery atherosclerosis

Background/aim: The purpose of the current study was to evaluate the thickness of the epicardial adipose tissue and its association with the degree of coronary artery disease in a group of autopsied cases. Materials and methods: A number of 79 cases were included in the study. Five preestablished incisions of the epicardial adipose tissue (EAT) were made on each of the hearts. These five points were next to/on the path of the major coronary vessels. The degree of coronary atherosclerosis was evaluated during the autopsy. Results: The results revealed the greatest thickness of the EAT on the incision made on the anterior and posterior wall of the right ventricle. EAT was thicker in cases presenting atherosclerosis degree I or II in two of the coronary arteries, the left circumflex artery and left main artery; on the left anterior descending artery, higher EAT thickness associated with fourth degree atherosclerosis. Conclusion: Epicardial adipose tissue thickness was greater at the incision points situated on the right side of the heart. Greater EAT thickness was associated significantly with early atherosclerosis development in three of the coronary arteries (LCx, LMA, LADA).

ERS/ELS/ACCP 2013 international consensus conference nomenclature on inducible laryngeal obstructions.

Individuals reporting episodes of breathing problems caused by re-occurring variable airflow obstructions in the larynx have been described in an increasing number of publications, with more than 40 different terms being used without consensus on definitions. This lack of an international consensus on nomenclature is a serious obstacle for the development of the area, as knowledge from different centres cannot be matched, pooled or readily utilised by others. Thus, an international Task Force has been created, led by the European Respiratory Society/European Laryngological Society/American College of Chest Physicians. This review describes the methods used to reach an international consensus on the subject and the resulting nomenclature, the 2013 international consensus conference nomenclature.

Anonymity and live-donor transplantation: an ELPAT view.

Anonymity of donors or recipients in living-donor transplantation is a complex issue and practice varies widely. There are compelling arguments for maintaining anonymity of both parties before unspecified donor transplantation and specified indirect transplantation. After transplantation, there are still good reasons to avoid disclosure of identities. Although anonymity could be lifted if both parties explicitly request it, there are significant, potentially negative consequences of such an approach. Both donor and recipient should be counseled regarding these, and transplant teams should consider the considerable financial and psychosocial costs if problems are encountered as a result of contact. Given the recent rise in the number of unspecified living-donor transplants and through paired exchange schemes, it is vital that data are collected regarding the effects of maintaining or revoking anonymity after transplantation.

Biostatistical study of suicide features in Mures County (Romania).

UNLABELLED: Mures County (580,000 inhabitants) has constantly higher yearly suicide rates (23-32%ooo) compared to Romania's national average (12-14%ooo). We performed a prospective study with the aim to find characteristics that should help the preventive management. Autopsy is compulsory by law in violent deaths; therefore, all suicide cases are referred to our Institute. During the period 2005-2006 we completed a multi-item questionnaire in each suicide case from a total of 273. Beside age, sex, marital status, occupation and economical status, we also investigated religious adherence, type of alcoholic beverages consumed, blood alcohol concentration, previous suicide attempts, farewell notes, medical background, behavioral changes. RESULTS: sex distribution was M:F=4.8:1; average age for suicide victims was 51 years, the interquartile range was 38-62 years for men and 45-70 years for women. Hanging is by far the most used method for suicide in our region, 80% of the cases. Marital status (married/non-married) does not seem to influence suicide conduct. Social inactivity (workless, non-occupied) was observed in 65% of the victims. In rural areas we found a double suicide rate, rural/urban ratio was 2/1 while the population is equally distributed in towns and villages in our province (50%); we also noticed a seasonal variation of suicides in rural areas (with peaks in June and August) whereas in urban areas differences were statistically not significant. Ethnic Hungarians have double suicide rates compared to Romanians. Recent alcohol ingestion was noticed in 60% of men and only 27% of women suicides.