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Cutting Edge Technologies in Respiratory Research: lung function testing

AbstractPulmonary function testing is part of routine clinical practice in respiratory medicine. It is based around spirometry, which will remain the central measurement of lung function given its prognostic significance and its integral role in defining severity of airways disease. However, there is an increasing body of evidence from studies using new methods of lung function measurement which are providing new insights into pathophysiology of disease. This body of data is forming a basis for their future clinical role, once the economics of producing the relevant devices becomes attractive. The forced oscillation technique and multiple breath nitrogen washout are currently the most commonly used of the newer lung function techniques, which are refinements of long‐established technique...

Bronchial brushings for investigating airway inflammation and remodelling

ABSTRACTAsthma is the commonest medical cause for hospital admission for children in Australia, affects more than 300 million people worldwide, and is incurable, severe in large number and refractory to treatment in many. However, there have been no new significant treatments despite intense research and billions of dollars. The advancement in our understanding in this disease has been limited due to its heterogeneity, genetic complexity and has severely been hampered particularly in children by the difficulty in obtaining relevant target organ tissue. This review attempts to provide an overview of the currently used and recently developed/adapted techniques used to obtain lung tissue with specific reference to the airway epithelium. (Source: Respirology)

Procalcitonin guidance for reduction of antibiotic use in low‐risk outpatients with community‐acquired pneumonia

Conclusions:  Under PCT guidance, antibiotic use was reduced and duration of antibiotic treatment was shortened in low‐risk outpatients with CAP, without apparent harm. (Source: Respirology)

The minimum period of polysomnography required to confirm a diagnosis of severe obstructive sleep apnoea

Conclusions:  Partial‐night PSG is effective for diagnosing severe OSA. If there is an unabridged PSG recording indicating an AHI of ≥30/h for 2 h, severe OSA can be diagnosed and PAP titration initiated. (Source: Respirology)

Pleural controversy: Closed needle pleural biopsy or thoracoscopy—Which first?

ABSTRACTThe most efficient and cost‐effective approach to the diagnosis of pleural exudates remains controversial. Important considerations include the respective diagnostic yields of thoracocentesis, closed pleural biopsy and thoracoscopy; the incremental gain in diagnostic yield when sequentially combining these investigations; and the role of various image modalities. The diagnostic yield of thoracocentesis is in the order of 60% for malignancy and >90% for tuberculosis. A second aspiration may increase the yield for malignancy, but a third is generally superfluous. Many authorities consider thoracoscopy the investigation of choice in exudative pleural effusions where a thoracocentesis was nondiagnostic and particularly when malignancy is suspected. It allows for the direct inspect...

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