ABSTRACT
Fuchs syndrome is a milder form of the Stevens-Johnson syndrome (SJS) spectrum with only mucosal involvement which can be triggered by Mycoplasma pneumonia (MP) infection. Treatment should be directed toward supportive care including ocular and mucous membrane care, fluids and nutritional support, and pain control. In addition, antibiotic and immunomodulatory treatments are discussed for this entity.
ABSTRACT
BACKGROUND AND OBJECTIVES: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure that has a well-established role in the diagnosis and staging of lung cancer. This technology is also widely used for the diagnosis of mediastinal masses and cysts as well as other inflammatory disorders such as sarcoidosis. However, the utility of this procedure in the diagnosis and subclassification of lymphoproliferative disorders (LPDs) is not clear. We performed a systematic review to evaluate EBUS-TBNA use in LPDs. MATERIALS AND METHODS: PubMed, EMBASE, MEDLINE, Cochrane Library Plus, and ISI Web of Knowledge were searched for studies of clinical trials in English reporting diagnostic performance of EBUS-TBNA in lymphoma until September 2014. The overall sensitivity, negative predictive value (NPV), and diagnostic accuracy were evaluated. RESULTS: Six trials involving 346 patients with suspected lymphoma were included. The overall sensitivity, NPV, and diagnostic accuracy ranged 38%-91%, 83%-96.4%, and 91%-97%, respectively. Further invasive surgery was needed only in 13-43% of the patients. None of the studies included in the present review reported important complications. CONCLUSION: Current evidence suggests that EBUS-TBNA can be used as an initial evaluation for patients with suspected lymphoma. Additional surgical procedures may be necessary if a sample is inadequate or negative with high suspicion of lymphoma. Further multicenter trials are needed to evaluate the diagnostic yield of EBUS-TBNA in lymphoma patients.
ABSTRACT
BACKGROUND: Thoracic ultrasound examination has become increasingly used as a valuable diagnostic tool for the bedside assessment of patients with respiratory distress. We implemented a thoracic ultrasonography curriculum for third year medical students with the goal of developing a model for teaching thoracic ultrasound skills to undergraduate medical students. METHODS: Seventy medical students completed a program comprised of a didactic and hands-on session in fundamental and thoracic ultrasonography. Knowledge assessment and students' questionnaire (on Likert scale 1-5) prior to and following the program were done to assess ultrasonography knowledge and perception of training effectiveness. An image acquisition skills assessment checklist was performed by the instructors after completing the program on all of the participants. RESULTS: The pre-intervention knowledge score was 52.05 percent. Post-intervention demonstrated significant improvement: 87.31 percent, p less than 0.001. There was a significant increase in comfort level, basic ultrasound knowledge, self-assurance, and motivation by students' self-assessments. The clinical relevance and course evaluation were rated high on Likert scale 4.41/5 and 4.47/5 respectively. Skills assessment checklist demonstrated students' ability to understand anatomic structures shown in ultrasonographic images and fundamental ultrasound skills. CONCLUSIONS: The knowledge of 70 medical students regarding thoracic ultrasound improved significantly after a short dedicated course. The evaluation of the program affirmed the value and clinical relevance of the curriculum to undergraduate medical education.
