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Background: Endobronchial Ultrasound (EBUS) has emerged as a crucial tool for diagnosing intrathoracic disorders, particularly in the staging of lung cancer. However, its diagnostic capabilities in the context of benign and rare diseases remain a subject of debate., Aim: to investigate the diagnostic yield and safety of EBUS-transbronchial mediastinal cryobiopsy (EBUS-TMC) in comparison to EBUS-transbronchial needle aspiration (TBNA) for a broad spectrum of intrathoracic diseases., Methods: a single-centre retrospective observational study conducted on 48 patients who underwent both EBUS-TBNA and endobronchial ultrasound-transbronchial mediastinal cryobiopsy (EBUS-TMC) in the same procedure between August 2021 and October 2023., Results: The overall diagnostic yield of EBUS-TMC surpassed that of EBUS-TBNA (95.8% vs 54.1 %), notably excelling in the diagnosis of sarcoidosis (92.8% vs 78.5 %), rare mediastinal disorders (100% vs 0 %), hyperplastic lymphadenopathy (100% vs 0 %), and lymphoproliferative disease (100% vs 0 %). No significant differences were observed in the diagnosis of NSCLC and SCLC. Samples obtained through EBUS-TMC facilitated the acquisition of NGS and immunohistochemical analyses more readily., Conclusion: EBUS-TMC may contribute to the precise diagnosis and subtyping of mediastinal diseases, especially lymphomas and rare mediastinal tumors, thereby reducing the number of non-diagnostic procedures., Competing Interests: Conflicts of interest None., (Copyright © 2023. Published by Elsevier España, S.L.U.)

Introduction: Transbronchial lung cryobiopsy has been recommended as an acceptable alternative to surgical approach for making a histopathological diagnosis in patients with interstitial lung disease (ILD) of undetermined type. In limited diseases (especially if distributed along the subpleural region), sampling the specific area in which the pathological process is more represented could be challenging. Aim of the study was to determine the potential benefit of utilizing cone-beam computed tomography-guided cryobiopsy in patients with limited extent of ILD on CT scan and determine the single impact of each sequential biopsy progressively increasing the total number of biopsies., Methods: This study is a prospective analysis of patients with undetermined ILD and CT scan extent <15% undergoing cone-beam CT-guided cryobiopsy. Each biopsy sample was collected and processed individually and pathologic interpretations were performed sequentially with the pathologist reformulating a new report with the addition of each sample (cumulative yield)., Results: Thirty six patients were enrolled. Pathological diagnostic yield was >90%, with almost 80% of diagnostic samples being the first one; when a second biopsy was performed, mean diagnostic yield increased with only a moderately significant difference. No severe adverse events were observed; pneumothorax was documented in 27.8% of the cases., Conclusion: Sequential individual collection and pathologic interpretation of each biopsy sample has confirmed the possibility of obtaining a diagnostic specimen at the first pass if transbronchial cryobiopsy is performed under cone-beam CT., (© 2024 S. Karger AG, Basel.)

Purpose of the Research: transbronchial lung cryobiopsy has been recently accepted as a valid and less invasive alternative to surgical lung biopsy. The purpose of this randomized controlled study was to evaluate, for the first time, the quality and safety of biopsy specimens obtained by using the new disposable 1.7-mm cryoprobe compared with the standard re-usable 1.9 mm cryoprobe in the diagnosis of diffuse parenchymal lung diseases., Methods: 60 consecutive patients were prospectively enrolled and randomly assigned to two different groups: 1.9 mm (group A) and 1.7 mm (group B); primary endpoints were pathological and multidisciplinary diagnostic yield, sample size and complication rate., Principal Results: the pathological diagnostic yield of cryobiopsy was 100% in group A and 93.3% in group B (p = 0.718); cryobiopsy median diameter was 6.8 mm in group A and 6.7 mm in group B (p = 0,5241). Pneumothorax occurred in 9 patients in group A and 10 in group B (p = 0.951); mild-to-moderate bleeding in 7 cases and 9 cases in group A and B respectively (p = 0.559). No death or severe adverse events were observed., Conclusions: there was no statistically significant difference between the two groups, regarding diagnostic yield, adverse events and sampling adequacy., Competing Interests: Conflicts of interest VP has served as a paid consultant to Erbe, Germany; none of all others have any potential conflicts of interest with any companies/organizations whose products or services may be discussed in this paper., (Copyright © 2023. Published by Elsevier España, S.L.U.)

It is still controversial whether surgical or nonsurgical treatment approaches are most appropriate for empyema in children, and there are no data regarding the role of medical thoracoscopy in this population. The aim of this study was to describe our experience with medical thoracosocpy in children with multiloculated and organizing pneumonia. We retrospectively reviewed children admitted to our hospital with a diagnosis of empyema from 2011 to 2021 and treated with medical thoracoscopy. A total of six patients with empyema were treated by medical thoracoscopy; empyema was multiloculated in five cases and organized in one case; all children in the study recovered completely with full lung expansion after chest X-rays, and no disease sequelae were reported after clinical follow-up. Our small case series suggests that in selected cases, medical thoracoscopy could safely and effectively treat pleural empyema in children, with less invasiveness and reduced psychological consequences., (© 2023 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.)

Evaluated the outcome of a combined behavioral therapy, comprising relaxation training, temperature biofeedback, and cognitive training, administered in a school setting, at posttreatment, and 7-month follow-up, on a group of schoolchildren with migraine. Comparison between the experimental group (n = 32) and the waiting-list control group (n = 9) showed a treatment effect on headache frequency and duration but not on intensity. Using a 50% reduction in the headache activity as a criterion for clinical improvement, 45% of the children in the experimental group were clinically improved at the end of the treatment. The treated subjects were found to have maintained significant improvement at follow-up. Sex, headache history, age, and psychosomatic complaints before the training emerged as predictors of outcome. A decrease in state anxiety and an increase in the ability to relax during the sessions contributed to headache improvement. Finally, the acquired capacity to raise one's finger temperature during the biofeedback sessions was related to headache reduction after the training.

We present clinical and biochemical data on a further patient with hyperargininaemia and the results of neurophysiological tests both before and during dietary treatment with an essential amino acid mixture. With normalisation of plasma arginine concentrations, neurological functions improved and brain stem auditory evoked potentials normalized suggesting a partially reversible central conduction disorder. Neuroradiological findings included cerebral cortical atrophy on computed tomography scan and patchy abnormal myelination on magnetic resonance imaging (MRI). The typical clinical picture is discussed with reference to published therapeutical trials.

During a three months period 472 newborns between the fourth and eighth day of life were examined neurologically. Three of them had lateral rectus muscle paralysis. Two of the three were delivered by forceps. A follow up examination in six weeks showed that ocular movements spontaneously returned to normal. The children developed normally without neurological or ophthalmological sequelae. The cause and the localisation of the lesion will be discussed.