State-of-the-art: Radiological investigation of pleural disease.

Pleural disease is common. Radiological investigation of pleural effusion, thickening, masses, and pneumothorax is key in diagnosing and determining management. Conventional chest radiograph (CXR) remains as the initial investigation of choice for patients with suspected pleural disease. When abnormalities are detected, thoracic ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) can each play important roles in further investigation, but appropriate modality selection is critical. US adds significant value in the identification of pleural fluid and pleural nodularity, guiding pleural procedures and, increasingly, as "point of care" assessment for pneumothorax, but is highly operator dependent. CT scan is the modality of choice for further assessment of pleural disease: Characterising pleural thickening, some pleural effusions and demonstration of homogeneity of pleural masses and areas of fatty attenuation or calcification. MRI has specific utility for soft tissue abnormalities and may have a role for younger patients requiring follow-up serial imaging. MRI and PET/CT may provide additional information in malignant pleural disease regarding prognosis and response to therapy. This article summarises existing techniques, highlighting the benefits and applications of these different imaging modalities and provides an up to date review of the evidence.

Summary of the British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults.

Flexible bronchoscopy is an essential, established and expanding tool in respiratory medicine. Its practice, however, needs to be safe, effective and for the right indications to maximise clinical utility. This guideline is based on the best available evidence and is a revised update of the British Thoracic Society guideline on diagnostic flexible bronchoscopy.

Illusory continuity of tonal and infratonal periodic sounds.

Temporal induction can restore masked or obliterated portions of signals so that tones may seem continuous when alternated with sounds having appropriate spectral composition and intensity. The upper intensity limits for the induction of tones (pulsation thresholds) are related to masking functions and have been used to define the characteristics of frequency domain (place) analysis of tones. The present study has found that induction also occurs for infratonal periodic sounds that require a time domain analysis for perception of acoustic repetition. Limits for temporal induction were determined for iterated frozen noise segments from 10-2000 Hz alternated with a louder on-line noise. Masked thresholds were also obtained for the pulsed signals presented along with continuous noise, and it was found that the relation between induction limits and masking changed with frequency. The results obtained for induction and masking are discussed in terms of general principles governing restoration of obliterated sounds.