Hemoptysis: indications for bronchoscopy

Article Abstract:

Coughing up blood (hemoptysis) is a frightening experience that sometimes occurs during minor upper respiratory tract infections or bronchitis. This symptom is responsible for about 15 percent of pulmonary consultations, and bronchoscopy (examination of the airways with a fiberoptic instrument) is often performed to find the location of the bleeding and to rule out a tumor. There is agreement that bronchoscopy should be performed when a chest X-ray indicates an abnormality, but there is little agreement about how to proceed when no abnormality is apparent. Some authors have found high rates of cancer in these patients and recommend an aggressive approach, while others have found a lower risk and follow a more conservative approach. This study of 170 bronchoscopies performed on patients between the ages of 16 and 85 explores the risk factors that indicate when the procedure should be used. All these patients had normal or nonlocalizing chest X-rays. Only three carcinomas were found. This rate of 2.5 percent was somewhat lower than rates reported by most other studies of hemoptysis without X-ray abnormalities; the range was from under 1 percent to 6 percent. If bronchoscopy is limited to patients with two or more of the following risk factors, namely male sex, age over 40, and a 40-pack-year smoking history, a 29 percent reduction in the number of bronchoscopies would be achieved. For patients who do not have these risk factors, a conservative approach, including an ear, nose and throat examination and examination of sputum cells, is a reasonable approach. (Consumer Summary produced by Reliance Medical Information, Inc.)

Management, Risk factors, Lung cancer, Bronchoscopy

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From lung injury to fibrosis

Article Abstract:

The article discusses the causes, diagnosis and the treatments for idiopathic pulmonary fibrosis (IPF), the most common form of lung fibrosis. Lysophosphatidic acid (LPA) is found to be a major mediator that facilitates lung injury to lead to fibrosis.

Care and treatment, Diagnosis, Lung diseases, Pulmonary fibrosis

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