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Percutaneous thoracic interventions are among the most common procedures in today's medical practice. From the simple placement of a pleural drain to the ablation of lung tumors, the advent of image guidance has revolutionized minimally invasive procedures and has allowed for the introduction of new techniques and widened the range of indications. It is therefore imperative to understand the complications associated with these interventions and their management. This article illustrates the common complications associated with these interventions and highlights the relative safety of these interventions. [ABSTRACT FROM AUTHOR]

Polycythaemia vera (PV) is closely associated with both an acquired activating mutation of the JAK2 tyrosine kinase ( JAK2 V617 F) in granulocyte-derived DNA and increased granulocyte polycythaemia rubra vera-1 ( PRV-1) expression. In order to explore the correlation between these two biological markers and compare their diagnostic utility, mutation analysis for JAK2 V617 F and quantitative measurement of granulocyte PRV-1 expression were performed on the same study sample from 100 participants: 38 with PV, 22 with essential thrombocythaemia (ET), 10 with agnogenic myeloid metaplasia (AMM), 19 with secondary polycythaemia (SP) and 11 healthy volunteers. The respective overall (homozygous) JAK2 V617 F mutational frequencies were 95% (26%), 55% (0%), 30% (0%), 0% and 0%. The corresponding figures for increased PRV-1 expression were 89%, 18%, 20%, 21% and 9%. In patients with either ET or AMM, the likelihood of detecting JAK2 V617 F was significantly higher in the presence of an increased PRV-1 expression (83% vs. 38%; P = 0·05). Similarly, in patients with PV, homozygous as compared with heterozygous JAK2 V617 F correlated with higher levels of PRV-1 expression ( P = 0·11). The present study suggests an allele dose-dependent effect of JAK2 V617 F on granulocyte PRV-1 expression. However, compared with the PRV-1 assay, mutation screening for JAK2 V617 F displayed greater accuracy in distinguishing PV from SP. [ABSTRACT FROM AUTHOR]

In a prospective study, peripheral blood (PB) CD34 count, bone marrow histology and other clinical parameters were concurrently evaluated in 94 patients with myelofibrosis with myeloid metaplasia (MMM) and the study cohort followed for a minimum of 3 years. Median PB CD34 count was0·0547 × 109/l (range 0–5·345 × 109/l) with 86% of the patients displaying above normal levels (>0·005 × 109/l). In a multivariate analysis, only leucocyte count and PB blast percentage correlated with PB CD34 count in an independent and consistent fashion. After a median follow up of 41 months from PB CD34 analysis, 43 patients (46%) have died with a projected 5-year survival of 50%. In a univariate analysis, PB CD34 count above 0·1 × 109/l correlated significantly with shortened survival, leukaemic transformation and clinical progression. However, such statistical significance was lost during multivariate analysis, which identified only anaemia and leucocytosis as independent risk factors for shortened survival. Furthermore, sequential analysis of PB CD34 count was performed in 53 patients and 43% of those who progressed clinically did not display a concomitant rise in their PB CD34 count. The current prospective study does not support an independent prognostic value for PB CD34 count in MMM. [ABSTRACT FROM AUTHOR]

Abstract: Comparative genomic hybridization (CGH), using oligo arrays with either 44,000 or 105,000 oligonucleotides, was performed on granulocyte-derived DNA from 71 patients with BCR-ABL-negative classic myeloproliferative neoplasms (MPNs): 32 primary myelofibrosis (PMF), 26 polycythemia vera (PV) and 13 essential thrombocythemia (ET). Copy number changes (CNCs) were detected in 44%, 35%, and 15% of the cases with PMF, PV and ET, respectively. In ET and PMF, CNCs were more frequently detected in the presence of JAK2V617F (50% vs. 19%; p =0.05). Conventional chromosome analysis was obtained in 57 patients either at diagnosis or within 1 year of the array CGH study; all 21 patients with PV and 11 with ET displayed normal cytogenetic findings despite the presence of CNCs in 29% and 18%, respectively. In PMF, the respective rates of CNCs and abnormal karyotype were 48% and 36%; karyotypic abnormalities, including unbalanced translocations, were often detected by array CGH as chromosomal gains or losses. This preliminary report suggests a potential value for array CGH in terms of both clinical diagnostics and genomic research in MPNs. [Copyright &y& Elsevier]

Objectives: To standardize diagnostic investigations for myeloproliferative neoplasms (MPNs) to increase homogeneity in patient care and to streamline diagnostic approaches in the most efficient and cost-effective manner.Methods: The development of Canadian expert consensus recommendations for the diagnosis of MPNs began with a review of the following: clinical evidence, daily practice, existing treatment guidelines, and availability of diagnostic tools. Each group member was assigned a specific topic, which they discussed with the entire group during several consensus meetings.Results: This document provides the Canadian MPN group's recommendations, proposed diagnostic algorithms, and background evidence upon which decisions were made.Conclusions: Standardization of diagnostic investigations will increase homogeneity in patient care and provide a foundation for future clinical research in this rapidly evolving therapeutic area. Streamlining diagnostic approaches in the most efficient and cost-effective manner will also result in significant cost saving for the health care system. [ABSTRACT FROM AUTHOR]

Objectives: To standardize diagnostic investigations for myeloproliferative neoplasms (MPNs) to increase homogeneity in patient care and to streamline diagnostic approaches in the most efficient and cost-effective manner. Methods: The development of Canadian expert consensus recommendations for the diagnosis of MPNs began with a review of the following: clinical evidence, daily practice, existing treatment guidelines, and availability of diagnostic tools. Each group member was assigned a specific topic, which they discussed with the entire group during several consensus meetings. Results: This document provides the Canadian MPN group's recommendations, proposed diagnostic algorithms, and background evidence upon which decisions were made. Conclusions: Standardization of diagnostic investigations will increase homogeneity in patient care and provide a foundation for future clinical research in this rapidly evolving therapeutic area. Streamlining diagnostic approaches in the most efficient and cost-effective manner will also result in significant cost saving for the health care system. [ABSTRACT FROM AUTHOR]