Low rates of eligibility for lung cancer screening in patients undergoing computed tomography coronary angiography.

Incidental findings, including pulmonary nodules, on computed tomography coronary angiography (CTCA) are common. Previous authors have suggested CTCA could allow opportunistic screening for lung cancer, though the lung cancer risk profile of this patient group has not previously been established. Smoking histories of 229 patients undergoing CTCA at two tertiary hospitals were reviewed and only 25% were current or former smokers aged 55-80 years old. Less than half of this group were eligible for screening based on the PLCOm2012 risk model. We conclude that routine screening in the form of full thoracic field imaging, of individuals undergoing CTCA is not appropriate as it would likely result in net harm.

A simple retarding-potential time-of-flight mass spectrometer for electrospray propulsion diagnostics.

The time-of-flight mass spectrometer (ToF-MS) is a useful tool for quantifying the performance of electrospray thrusters and characterizing their plumes. ToF-MS data can be used to calculate the mass-to-charge distribution in the plume, but the kinetic-energy-to-charge (i.e., the potential) distribution must be known first. Here we use a ToF-MS in tandem with a retarding potential (RP) analyzer. By sweeping the retarding potential through the range of potentials present in the plume, both the mass-to-charge distribution and the potential distribution can be measured independently. We demonstrate this technique in a case study using a capillary electrospray emitter and the ionic liquid propellant 1-Ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide, abbreviated EMI-Im. We report a linear correlation between retarding potential and mass-to-charge ratio that agrees with published data from more complex orthogonal RP/ToF-MS instruments. Calculated values for the jet velocity and jet breakup potential match within 2% and 12%, respectively. Using conventional ToF-MS, we estimated the propellant flow rate and compared those estimates to direct flow rate measurements. For flow rates between 233 pL/s and 565 pL/s, the error in ToF-based flow rate estimates ranged from -16% to -13% when the plume potential was assumed to be a function of mass-to-charge. Assuming a constant plume potential yielded mixed results. However, using the average stopping potential measured by a retarding potential analyzer resulted in higher errors, ranging from -26% to -30%. Data and MATLAB code are included as supplemental materials so that readers can easily apply the techniques described here. Supplementary Information: The online version contains supplementary material available at 10.1007/s44205-023-00045-y.

Validation of a single-use and reusable home sleep apnea test based on peripheral arterial tonometry compared to laboratory polysomnography for the diagnosis of obstructive sleep apnea.

STUDY OBJECTIVES: The objective of this study was to independently validate a disposable and a reusable home sleep apnea test (HSAT) recording on peripheral arterial tonometry, compared to laboratory polysomnography (PSG), for the diagnosis of obstructive sleep apnea (OSA). METHODS: 115 participants undergoing PSG for suspected OSA were recruited and fitted with the two study devices (NightOwl, Ectosense, Belgium). After exclusions were applied and device failures were removed, data from 100 participants were analyzed. HSAT-derived apnea-hypopnea index (AHI), OSA severity category, total sleep time, and oxygen desaturation index 3% were compared to PSG. RESULTS: Both study devices demonstrated satisfactory levels of agreement with minimal mean bias for determination of AHI and oxygen desaturation index 3% (disposable: AHI mean bias 2.04 events/h [95% limits of agreement -20.9 to 25.0], oxygen desaturation index 3% mean bias -0.21/h [-18.1 to 17.7]; reusable: AHI mean bias 2.91 events/h [-16.9 to 22.7], oxygen desaturation index 3% mean bias 0.77/h [-15.7 to 17.3]). Level of agreement diminished at higher AHI levels although misclassification for severe OSA occurred infrequently. Total sleep time level of agreement for the reusable HSAT was also satisfactory with minimal mean bias (4.18 minutes, -125.1 to 112.4), but the disposable HSAT was impacted by studies with high signal rejection (23.7 minutes, -132.7 to 180.1). Categorization of OSA severity demonstrated moderate agreement with laboratory PSG, with a kappa of 0.52 and 0.57 for the disposable and reusable HSATs respectively. CONCLUSIONS: The two HSAT devices were comparable and performed well compared to laboratory PSG for the diagnosis of OSA. CLINICAL TRIAL REGISTRATION: Registry: Australian New Zealand Clinical Trials Registry; Identifier: ANZCTR12621000444886. CITATION: Lyne CJ, Hamilton GS, Turton ARE, et al. Validation of a single-use and reusable home sleep apnea test based on peripheral arterial tonometry compared to laboratory polysomnography for the diagnosis of obstructive sleep apnea. J Clin Sleep Med. 2023;19(8):1429-1435.

Endobronchial use of gastrointestinal retrieval net for an aspirated dental crown.

INTRODUCTION/AIM: Flexible fiberoptic bronchoscopy is generally the first line procedure for airway foreign body removal. However, removal may be challenging when surface and/or other characteristics make grasping the object difficult. We present a case in which we used a gastrointestinal retrieval net to successfully extract a dental crown, a type of foreign body with difficult-to-grasp surface characteristics. METHODS: A 72-year-old male aspirated a dental crown during an attempted molar crown fitting. Semi-emergent flexible fiberoptic bronchoscopy was undertaken using an Olympus bronchoscope with a 2.8mm working channel. Attempts at retrieval using standard forceps, and a four-wire airway retrieval basket were unsuccessful. The retrieval net (RescueNet, Boston Scientific) is a device used in gastrointestinal procedures to retrieve foreign objects, food boluses and tissue fragments. The device's external catheter is 2.5mm in diameter and is passed through the working channel of an endoscope. The handle operates in a similar manner to conventional biopsy forceps and deploys a one-sided fishnet mesh basket with an adjustable string collar that can be manipulated to enclose a target. RESULTS: The dental crown was easily removed with the retrieval net on the second attempt. Upon review of the literature, endobronchial usage of retrieval nets was found to be rare. CONCLUSION: Clinicians should be aware that gastrointestinal retrieval nets are an option for the retrieval of airway foreign bodies.