Turning an entire hospital site into a smoke-free environment sounds like a daunting project but good communication and careful preparation can lead to success.

Tuberculosis is a severe, infectious disease caused by Mycobacterium tuberculosis. The aim of this review was to present the efficacy of linezolid as an agent against multidrug and extensively drug-resistant tuberculosis as gathered from many recent research studies. Linezolid seems to have strongly the potential of being used as an anti-tuberculosis agent because it blocks bacterial ribosomal protein synthesis. Nevertheless caution is required because of the adverse effects it causes, especially when the linezolid daily dosage exceeds 600 mg. The most severe adverse effects include anemia, peripheral neuropathy, optic neuropathy and thrombocytopenia. Still, more trials and research need to be done in order to gather more information and value the cost-benefit dosage of the treatment.

A pulmonary nodule is a common incidental finding on chest imaging, which includes a wide variety of differential diagnosis. Pulmonary hyalinising granuloma is a rare disease aetiology of pulmonary nodule(s). We report a 74-year-old female who was referred to the respiratory clinic with incidental finding of a solitary pulmonary nodule on chest X-ray. CT confirmed the presence of a 1.2 cm solitary pulmonary nodule in the left upper lobe with no lymphadenopathy. The patient underwent wedge resection, and histopathological examination of the lesion confirmed pulmonary hyalinising granuloma. In most previously reported cases, patients had multiple lesions on chest radiography. Solitary pulmonary lesion is an uncommon presentation of this clinical entity and only a few cases have been reported in the literature.

The change agent component of the specialist nurse role can be effective in service review and management. This was put into effect in one hospital to enable the lung biopsy service to become an efficient, high-quality patient-centred resource for patients who are suspected of having lung cancer.

Abstract Aim: To evaluate whether a reduced volume of a higher-concentration iodinated contrast medium delivered with a multiphasic injection could be used in computed tomography pulmonary angiography (CTPA) to achieve a reduction in dose without adversely affecting image quality. Materials and methods: The CTPA images were retrospectively evaluated of 69 patients who received 100 ml of 300 mg iodine/ml ioversol, injected at constant rate of 5 ml/s and 70 patients who received 75 ml of 350 mg iodine/ml ioversol contrast medium delivered using a multiphasic injection protocol (starting at 5 ml/s and reducing exponentially). The degree of opacification in the proximal pulmonary arteries was measured in Hounsfield units. Results: The groups did not differ in terms of age, sex distribution, or weight. The mean iodine dose was lower in the 75 ml of 350 mg iodine/ml group (26.25 versus 29.5 g, p < 0.0001). Mean opacification did not differ significantly between the 75 ml of 350 mg iodine/ml and 100 ml of 300 mg iodine/ml groups in the main pulmonary artery (365 versus 331, p = 0.055) although it was significantly higher in the 75 ml group in the right (352 versus 315, p = 0.024) and left pulmonary arteries (347 versus 312, p = 0.028). Opacification correlated positively with age and negatively with weight (p < 0.001) and when these effects had been accounted for, the differences in opacification were not statistically significant in the main (p = 0.23), right (p = 0.11), or left pulmonary arteries (p = 0.13). The number of suboptimally opacified studies (opacification of less than 250 HU in main pulmonary artery) did not differ between the groups (12 versus 13, p = 0.83). Conclusion: A reduction in iodine dose can be achieved without adversely affecting pulmonary arterial enhancement in CTPA by administering a smaller volume of high-concentration contrast medium using a multiphasic injection protocol.