The field of interventional pulmonology (IP) has grown from a fringe subspecialty utilized in only a few centers worldwide to a standard component in advanced medical centers. IP is increasingly recognized for its value in patient care and its ability to deliver minimally invasive and cost-effective diagnostics and treatments. This article will provide an in-depth review of advanced bronchoscopic technologies used by IP physicians focusing on pulmonary nodules. While most pulmonary nodules are benign, malignant nodules represent the earliest detectable manifestation of lung cancer. Lung cancer is the second most common and the deadliest cancer worldwide. Differentiating benign from malignant nodules is clinically challenging as these entities are often indistinguishable radiographically. Tissue biopsy is often required to discriminate benign from malignant nodule etiologies. A safe and accurate means of definitively differentiating benign from malignant nodules would be highly valuable for patients, and the medical system at large. This would translate into a greater number of early-stage cancer detections while reducing the burden of surgical resections for benign disease. There is little high-grade evidence to guide clinicians on optimal lung nodule tissue sampling modalities. The number of novel technologies available for this purpose has rapidly expanded over the last decade, making it difficult for clinicians to assess their efficacy. Unfortunately, there is a wide variety of methods used to determine the accuracy of these technologies, making comparisons across studies impossible. This paper will provide an in-depth review of available data regarding advanced bronchoscopic technologies.
This article considers the significance of eating and drinking within a series of diaries and journals produced in British colonial India during the Indian Rebellion of 1857. The discussion of food and drink in this context was not simply a means to add color or compelling detail to these accounts, but was instead a vital ingredient of the authors’ understanding of health and medical treatment. These texts suggest a broader colonial medical understanding of the importance of regulating diet to maintain physical health. Concern with food, and the lack thereof, was understandably a key element in diaries, and in the eyewitness accounts kept by British soldiers, doctors, and civilians during the rebellion. At a narrative level, mention of food also functioned as a trope serving to increase dramatic tension and to capture an imagery of fortitude. In references to drink, by contrast, these sources reveal a conflict between professional and lay opinions regarding the use of alcohol as part of medical treatment. The accounts show the persistent use of alcohol both for medicinal and restorative purposes, despite growing social and medical anxieties over its ill-effects on the body. Close examination of these references to food and drink reflect the quotidian habits, social composition, and the extent of professional and lay knowledge of health and medicine in colonial British India.
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