We found clinically significant proteinuria to be absent in stable outpatients with OSA. Proteinuria in patients with OSA should not be attributed to sleep apnea and warrants further evaluation.

SBRT for tumors > 5 cm is effective, with good local control rates and acceptable toxicity. The main pattern of failure is distant, suggesting a possible role for systemic chemotherapy in these patients.

The safety with regard to bleeding complications of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) of hilar and mediastinal lymphadenopathy has been well established. The real-time visualization of targeted and surrounding structures allows the operator to avoid puncturing even small vessels. However, on occasions, the only way to reach the target is by traversing vessels. We report 2 cases of right hilar masses that were successfully diagnosed with EBUS-TBNA performed by traversing the pulmonary artery without any complications. We suggest that transpulmonary artery needle aspiration can be safely conducted but should be performed only by experienced operators and should be reserved as a last resort for making a diagnosis.

Background:Placement of endobronchial valves for bronchopleural fistula (BPF) is not always straightforward. A simple guide to the steps for an uncomplicated procedure does not encompass pitfalls that need to be understood and overcome to maximize the efficacy of this modality.Objectives:The objective of this study was to discuss examples of difficult cases for which the placement of endobronchial valves was not straightforward and required alterations in the usual basic steps. Subsequently, we aimed to provide guiding principles for a successful procedure.Methods:Six illustrative cases were selected to demonstrate issues that can arise during endobronchial valve placement.Results:In each case, a real or apparent lack of decrease in airflow through a BPF was diagnosed and addressed. We have used the selected problem cases to illustrate principles, with the goal of helping to increase the success rate for endobronchial valve placement in the treatment of BPF.Conclusions:This series demonstrates issues that complicate effective placement of endobronchial valves for BPF. These issues form the basis for troubleshooting steps that complement the basic procedural steps.