Background-The British Thoracic Society report on the diagnosis and treatment of the sleep apnoea/hypopnoea syndrome (SAHS) suggests that, ifthe pulse oximetry baseline oxygen saturation is above 90%,
Background:The presence of SARS-CoV-2 RNA in plasma has been linked to disease severity and mortality. We compared RT-qPCR to droplet digital PCR (ddPCR) to detect SARS-CoV-2 RNA in plasma from COVID-19 patients (mild, moderate, and critical disease).
Pulmonary aspergilloma is a rare complication of cystic fibrosis and is a contraindication to transplantation. The elimination of an aspergilloma in a 24 year old patient with cystic fibrosis by percutaneous instillation of amphotericin B is described, enabling her to be accepted on a lung transplantation programme. (Thorax 1995;50:809-810) Keywords: cystic fibrosis, aspergilloma, Aspergillus, amphotericin B.Poor pulmonary function led to referral for lung transplantation but she was thought unsuitable because of likely intraoperative contamination of the pleural space and airways by Aspergillus. We considered whether the aspergilloma might be excised before transplantation but the opinion of the thoracic surgeons was that the dangers of pleural dissemination, infection and respiratory failure would be too great. A one month course of intravenous amphotericin (1 mg/kg/day) failed to show any evidence of a change in the aspergilloma on the CT scan.Following reports of successful intracavitary treatment of aspergillomas by an indwelling catheter it was decided to attempt this method.'2 A 6-3 French polyethylene pigtail catheter (William Cook Europe, Bjaeverskov, Denmark) was inserted into the cavity using local anaesthesia and CT scan guidance (fig Ib). An initial dose of 5 mg amphotericin B was injected, gradually increasing to 50 mg/day in 20 ml 5% dextrose. Later a smaller total volume of 5 ml was found to be best. A total of 3 g was given over 60 days. Initially the instillation of this solution caused coughing which was relieved by the instillation of 2-4 ml of 1% lignocaine into the cavity before the amphotericin B. The method was taught to the
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