Lung radiodensity along the needle passage is a quantitative predictor of pneumothorax after CT-guided percutaneous core needle biopsy.

AIM: To analyse whether the lowest value of lung radiodensity along the passage of the biopsy needle is a quantitative predictor of pneumothorax. MATERIALS AND METHODS: CT-guided percutaneous core needle biopsy (PCNB) procedures performed at Zhongnan Hospital were analysed retrospectively. Age, gender, lesion size, lesion depth, lesion location, patient position, number of passages, needle pleural angle, pulmonary bleeding, and lung radiodensity along the needle passage were collected and classified by the extent of pneumothorax. Univariate analysis and multiple logistic regression analysis were assessed to explore the independent risk factors for pneumothorax. RESULTS: Six hundred and seventy-seven cases were included in the study, including 456 males and 221 females. Pneumothorax occurred in 40.18% of cases, of which 82.4% were mild, 14% were moderate, and 3.7% were severe. Univariate and multivariate analysis showed that lesion size ≤2 cm (p=0.002), two or more passages (p=0.033), and lung radiodensity of -850 HU or less (p≤0.001) were independent risk factors for pneumothorax; bleeding (p<0.001) was a protective factor for pneumothorax. CONCLUSIONS: The lowest value of lung radiodensity along the needle passage was a quantitative predictor of pneumothorax. A value of -850 HU or less was an independent risk factor for pneumothorax. As the value decreased, there was a higher risk of occurrence of more severe pneumothorax.

The diagnostic accuracy of CT-guided percutaneous core needle biopsy and fine needle aspiration in pulmonary lesions: a meta-analysis.

AIM: To determine and compare the diagnostic value of computed tomography (CT)-guided percutaneous core needle biopsy (PCNB) and percutaneous fine-needle aspiration biopsy (PNAB) in pulmonary lesions. MATERIALS AND METHODS: PubMed, EMBASE, and the Web of Science were systematically searched for relevant studies that investigated the diagnostic accuracy of CT-guided PCNB and/or PNAB for pulmonary lesions up to December 2014. After study selection, data extraction, and quality assessment, the sensitivity (SEN), specificity (SPE), diagnostic odds rate (DOR), positive likelihood ratios (PLR), negative likelihood ratios (NLR), and summary receiver operating characteristic (SROC) curves were calculated using the Meta-Disc 1.4 software. RESULTS: Nineteen publications, including 21 independent studies, met the inclusion criteria. Of them, 15 studies were included in the PCNB group and six studies in the PNAB group. The pooled SEN, SPE, DOR, PLR, NLR, and SROC were 0.95, 0.99, 54.72, 0.06, 821.90, and 0.98 in the PCNB group and 0.90, 0.99, 24.71, 0.14, 210.72, and 0.98 in the PNAB group, respectively. CONCLUSION: Based on current evidence, both PCNB and PNAB can be used as diagnostic methods to distinguish benign and malignant pulmonary lesions; the difference between PCNB and PNAB regarding diagnostic accuracy of benign or malignant pulmonary lesions is not obvious.

Providing instrumental social support is more beneficial to reduce mortality risk among the elderly with low educational level in Taiwan: a 12-year follow-up national longitudinal study.

BACKGROUND: To evaluate whether the effects of providing or receiving social support are more beneficial to reduce mortality risk among the elderly with different educational levels. METHODS: In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was initiated from 1996 until 2007. The complete data from 1492 males and 1177 females aged ≥67 years were retrieved. Participants received financial, instrumental, and emotional support, and they actively provided instrumental and emotional support to others and involved in social engagement. Education attainment was divided into two levels: high and low. The low education level included illiterate and elementary school. The high education level included junior high school to senior high school and above college. Cox regression analysis was used to examine the association between providing or receiving social support on mortality with different educational levels. RESULTS: The average age of the participants in 1996 was 73.0 (IQR=8.0) years, and the median survival following years (1996-2007) of participants was 10.3 (IQR=6.7) years. Most participants were low educational level including illiterate (39.3%) and elementary school (41.2%). Participants with high educational level tend to be younger and more male significantly. On the contrary, participants with low educational level tend to have significant more poor income, more depression, more cognition impairment, more with IADL and ADL disability than high educational level. Most participants received instrumental support from others (95.5%) and also provided emotional support to others (97.7%). Providing instrumental support can reduce 17% of mortality risk among the elderly with a low level of education after adjusting several covariates [Hazard ratio (HR) = 0.83; 95% confidence interval (CI) = 0.70-0.99; p = 0.036]. CONCLUSIONS: Providing instrumental social support to others confer benefits to the giver and prolong life expectancy among the elderly with low educational levels.

Laser assisted ultrasound guided aspiration improves procedure time and reduces number of withdrawals.

This study evaluated the performance of in-vitro freehand aspiration of a simulated cyst with ultrasound aspiration guided by a newly designed laser assisted (LA) device. The LA device was equipped with an adjustable light source generating a sector light plane. This laser light plane was parallel to and overlapped the ultrasound acoustical plane, to help with needle positioning. Five operators randomly performed 30 freehand or LA ultrasound guided aspirations of a simulated cyst. The frequency was set at 8 MHz and depth at 4 cm. Procedure time and number of syringe withdrawals were statistically compared before and after using the LA device. Both experienced and inexperienced operators required significantly less time to perform the aspiration and had fewer syringe withdrawals when using the LA device. The LA device provides a reference plane in space, allowing the operator to more accurately position and adjust needle direction. Additional in-vivo testing is required to test the clinical practicability.