Future research and collaboration: the "SINERGIE" project on HCV (South Italian Network for Rational Guidelines and International Epidemiology).

The SINERGIE (South Italian Network for Rational Guidelines and International Epidemiology) project is intended to set up a collaborative network comprising virologists, clinicians and public health officials dealing with patients affected by HCV disease in the Calabria Region. A prospective observational data-base of HCV infection will be developed and used for studies on HCV natural history, response to treatment, pharmaco-economics, disease complications, and HCV epidemiology (including phylogenetic analysis). With this approach, we aim at improving the identification and care of patients, focusing on upcoming research questions. The final objective is to assist in improving care delivery and inform Public Health Authorities on how to optimize resource allocation in this area.

Experiences with laser bronchoscopy.

Laser bronchoscopy was performed 87 times in 58 patients over a three-year period at Wilkes-Barre General Hospital. Fifty-six patients (97 percent) had malignant disease, including bronchogenic carcinoma (46), metastatic neoplasm to bronchus or lung (eight), or direct extension of esophageal carcinoma (two); benign pathology included tracheal papillomatosis (one) and granulation tissue (one). Eighty-six percent of tumors were proximally located (trachea, carina, mainstem bronchi). A standardized procedure utilizing both rigid and flexible bronchoscopy and the Nd:YAG laser was employed, with two deaths (2.3 percent) and eight complications (9.2 percent). Results were good or excellent in all five patients treated for bleeding and in 68 of 82 patients (83 percent) treated for obstruction. The patient with an obstructing or bleeding endobronchial lesion can achieve palliation through Nd:YAG laser bronchoscopic resection.