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pneumothorax management

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https://www.readbyqxmd.com/read/29150031/thoracic-surgery-in-the-pregnant-patient
#1
REVIEW
Brian Whang
Thoracic surgeons are sometimes asked to consult on the management of a patient who is pregnant. Conditions commonly encountered are empyema, spontaneous pneumothorax, and diaphragmatic hernia. Lung cancer is rarely seen in pregnancy, but its incidence is rising. Diagnostic imaging and perioperative management involve the navigation of fetal risks and nuances in maternal physiology. Shared decision making within a multidisciplinary framework will optimally guide the course of management.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#2
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29140122/lymphangioleiomyomatosis-diagnosis-and-management-high-resolution-chest-computed-tomography-transbronchial-lung-biopsy-and-pleural-disease-management-an-official-american-thoracic-society-japanese-respiratory-society-clinical-practice-guideline
#3
Nishant Gupta, Geraldine A Finlay, Robert M Kotloff, Charlie Strange, Kevin C Wilson, Lisa R Young, Angelo M Taveira-DaSilva, Simon R Johnson, Vincent Cottin, Steven A Sahn, Jay H Ryu, Kuniaki Seyama, Yoshikazu Inoue, Gregory P Downey, MeiLan K Han, Thomas V Colby, Kathryn A Wikenheiser-Brokamp, Cristopher A Meyer, Karen Smith, Joel Moss, Francis X McCormack
BACKGROUND: Recommendations regarding key aspects related to the diagnosis and pharmacological treatment of lymphangioleiomyomatosis (LAM) were recently published. We now provide additional recommendations regarding four specific questions related to the diagnosis of LAM and management of pneumothoraces in patients with LAM. METHODS: Systematic reviews were performed and then discussed by a multidisciplinary panel. For each intervention, the panel considered its confidence in the estimated effects, the balance of desirable (i...
November 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29125632/median-sternotomy-versus-intercostal-thoracotomy-for-lung-lobectomy-a-comparison-of-short-term-outcome-in-134-dogs
#4
Seth Bleakley, Kevin Phipps, Brian Petrovsky, Eric Monnet
OBJECTIVE: To compare short-term outcomes between dogs undergoing lung lobectomy via median sternotomy (MS) or intercostal thoracotomy (ICT). STUDY DESIGN: Retrospective case control study. METHODS: Medical records of dogs that underwent lung lobectomy via MS or ICT at a single institution were reviewed for demographics, intraoperative findings, and postoperative management and outcomes. Dogs with pleural effusion, pneumonia, migrating foreign body, lung abscess, spontaneous pneumothorax, or lung lobe torsion were excluded...
November 10, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29125442/long-term-outcomes-after-surgical-treatment-of-pediatric-neurogenic-thoracic-outlet-syndrome
#5
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29124026/risk-factors-for-pneumonia-in-ventilated-trauma-patients-with-multiple-rib-fractures
#6
Hyun Oh Park, Dong Hoon Kang, Seong Ho Moon, Jun Ho Yang, Sung Hwan Kim, Joung Hun Byun
Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29123840/a-system-of-delivering-medical-staff-members-by-helicopter-to-manage-severely-wounded-patients-in-an-area-where-medical-resources-are-limited
#7
Kohei Ishikawa, Kazuhiko Omori, Hiromichi Ohsaka, Kei Jitsuiki, Toshihiko Yoshizawa, Yasumasa Oode, Mutsumi Sakurada, Atsuhiko Mogami, Youichi Yanagawa
Aim: We review the case of a severely injured patient to evaluate the system of delivering medical staff by helicopter in areas with limited medical resources. Methods: The patient's chart was reviewed, summarized, and presented. Results: A 22-year-old woman attempted a suicidal fall after using a knife to stab herself. She was transported to a local hospital. A radiological study revealed fractures to the patient's face and the base of her skull, pneumocephalus, traumatic subarachnoid hemorrhage, stab wounds to the neck and chest, pneumothorax, unstable pelvic fracture, and right femoral shaft fracture...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29119067/experience-with-ambulatory-management-of-pleural-pathologies-utilizing-small-bore-indwelling-pleural-catheters
#8
Imad-Ud-Din Saqib, Mobeen Iqbal, Atif Rana, Saira Hassan
Introduction Pleural effusion is the excess fluid that accumulates in the pleural space. Pneumothorax is the collection of free air in the pleural cavity, while empyema is the collection of pus in the pleural cavity. Such pleural pathologies pose a great challenge to patients and health care professionals alike. While multiple management options exist, the major portion of it is carried out in the inpatient setting. We sought to evaluate the ambulatory use of indwelling pleural catheters for pleural pathologies, including malignant pleural effusion, empyema, and primary spontaneous pneumothorax...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29105540/mechanically-ventilating-the-severe-asthmatic
#9
Abdullah E Laher, Sean K Buchanan
The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to various other pathologies requiring mechanical ventilation, acute asthma is generally associated with better outcomes. This review serves as a practical guide to the physician managing patients with severe acute asthma requiring mechanical ventilation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29099006/a-26-year-old-man-with-dyspnea-and-chest-pain
#10
Saurabh Mittal, Akanksha Jain, Sudheer Arava, Vijay Hadda, Anant Mohan, Randeep Guleria, Karan Madan
A 26-year-old smoker male presented with a history of sudden onset dyspnea and right-sided chest pain. Chest radiograph revealed large right-sided pneumothorax which was managed with tube thoracostomy. High-resolution computed tomography thorax revealed multiple lung cysts, and for a definite diagnosis, a video-assisted thoracoscopic surgery-guided lung biopsy was performed followed by pleurodesis. This clinicopathologic conference discusses the clinical and radiological differential diagnoses, utility of lung biopsy, and management options for patients with such a clinical presentation...
November 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29080710/conservative-management-in-traumatic-pneumothoraces-an-observational-study
#11
Steven P Walker, Shaney L Barratt, Julian Thompson, Nick A Maskell
BACKGROUND: Traumatic pneumothoraces are a common consequence of major trauma. Despite this, there is a paucity of literature regarding their optimal management, including the role of conservative treatment. The aim of this study was to assess the treatment, complications and outcomes of traumatic pneumothoraces in patients presenting to a Major Trauma Centre. METHODS: The prospectively collected Trauma Audit and Research Network (TARN) database was used to identify all patients presenting with traumatic pneumothoraces to a UK Major Trauma Centre from April 2012 to December 2016...
October 25, 2017: Chest
https://www.readbyqxmd.com/read/29079373/longest-delayed-hemothorax-reported-after-blunt-chest-injury
#12
Darren Yap, Miane Ng, Madhu Chaudhury, Nik Mbakada
INTRODUCTION: Blunt chest injury is a common presentation to the emergency department. However, a delayed hemothorax after blunt trauma is rare; current literature reports a delay of up to 30days. We present a case of 44-day delay in hemothorax which has not been previously reported in current literature. CASE REPORT: A 52-year-old Caucasian male first presented to the emergency department complaining of persistent right sided chest pain 2weeks after having slipped on a wet surface at home...
October 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29078667/uniportal-video-assisted-thoracic-surgery-for-pneumothorax-and-blebs-bullae
#13
REVIEW
Luca Bertolaccini, Alessandro Pardolesi, Jury Brandolini, Piergiorgio Solli
The last British Society of Thoracic Surgeons guidelines of 2010 for the management of primary spontaneous pneumothorax (PSP) stated that, after the first recurrence, the treatment of PSP should be a surgical operation, like a bullectomy accompanying with a procedure for inducing pleural adhesions. Therefore, the surgical approach is considered the best treatment to minimise the risk of recurrence in patients who experienced a PSP. There is substantial evidence in the literature demonstrating that the minimally invasive approach should be preferred to the thoracotomic procedure since it can reduce the postoperative pain and it is associated with a faster recovery of the physical and working activity...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29076204/variation-in-nurse-self-reported-practice-of-managing-chest-tubes-a-cross-sectional-study
#14
Cui Lu, Ying-Hui Jin, Weijie Gao, Yue-Xian Shi, Xinhua Xia, Wen-Xi Sun, Qi Tang, Yunyun Wang, Ge Li, Jinhua Si
AIMS AND OBJECTIVES: This study aims to reveal nurses' self-reported practice of managing chest tubes and to define decision-makers for these practices. BACKGROUND: No consensus exists regarding ideal chest-tube management strategy, and there are wide variations of practice based on local policies and individual preferences, rather than standardized evidence-based protocols. DESIGN: This article describes a cross-sectional study. METHODS: Questionnaires were emailed to 31 hospitals in Tianjin, and the sample consisted of 296 clinical nurses whose work included nursing management of chest drains...
October 27, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29076100/thoracoscopic-management-of-blebs-resection-with-out-primary-pleurodesis
#15
Karina Miura da Costa, Amulya Kumar Saxena
OBJECTIVES: To review the literature for justification of thoracoscopic management of blebs in children. METHODS: PubMed database was reviewed for articles in English, Portuguese and Spanish using the key words "thoracoscopy", "bleb" and "child". Data was collected for age, gender, type of surgery performed, operating time, conversions, complications, recurrences, follow-up and mortality. RESULTS: Eleven studies with total 266 patients were included (27 bilateral cases; n = 293 surgeries)...
October 27, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29075497/traumatic-left-main-bronchial-rupture-delayed-but-successful-outcome-of-robotic-assisted-reconstruction
#16
Hu-Lin C Wang, Cheng-Hung How, Heng-Fu Lin, Jang-Ming Lee
Tracheobronchial injuries are rare but life-threatening conditions in patients with blunt thoracic trauma. The diagnosis and management of such injury may often be delayed due to other concomitant severe injuries. No reported case of a robotic-assisted bronchial reconstruction has ever been performed for a traumatic bronchial injury. A 23-year-old male suffered from traumatic left main bronchial (LMB) rupture with an initial presentation of pneumothorax and pneumomediastinum that eventually progressed to left main bronchus fibrosis and total obstruction, which led to left lung atelectasis and consolidation...
January 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29072869/research-protocol-intravenous-access-during-resuscitation-the-ivar-trial
#17
Pwb Nanayakkara, Y M Smulder
OBJECTIVE: To compare the effects of central versus peripheral drug administration on the rate of return of organised electrical activity and/or spontaneous circulation during CPR. STUDY DESIGN: Randomized clinical trial. STUDY POPULATION: Hospitalized patients and patients presenting at the emergency department, older than 18 years, requiring CPR. INTERVENTION: Central venous access Main study parameters/endpoints: Combined primary endpoint: rate of appearance of organised electrical activity or return of spontaneous circulation...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29043687/-pleural-cavity-concerns
#18
I Simal, M A García-Casillas, J Cerdà, L Pérez, B Fernández, M De la Torre, M Fanjul, E Molina, J C De Agustín
INTRODUCTION: Persistent air leak (PAL) is a common problem. We asses our experience in the management of these patients. MATERIAL AND METHODS: Retrospective review of patients with chest tubes after bronchopulmonary pneumothorax (due to lung resections, spontaneous pneumothorax, necrotizing pneumonia) from 2010 to 2015. We studied clinical data, PAL incidence, risk factors and treatment, considering PAL ≥ 5 days. RESULTS: Thirty-seven cases (28 patients) between 0-16years: 26 lung resections, 11 pneumothorax...
July 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29040482/strategies-to-reduce-pulmonary-complications-after-transhiatal-esophagectomy
#19
A M Gillinov, R F Heitmiller
Background: By eliminating a thoracotomy, transhiatal esophagectomy (THE) is purported to reduce postoperative pulmonary complications. However, data from many early series do not support this contention, documenting pulmonary complications in up to 50% of patients and pneumonia in 5%-20%. Since 1990, we have implemented a management strategy designed to maximize airway protection in the postoperative period. The purpose of this study was to determine the current incidence of pulmonary complications after transhiatal esophagectomy without thoracotomy...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29033202/-pyopneumothorax-in-rheumatoid-arthritis
#20
B Huret, S Boulanger, L Benhamed, X Deprez, D Caparros
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the joints but which frequently includes extra articular effects, including pulmonary nodules, which grow faster under immunosuppressive treatment. CASE REPORT: A 74 years old man, with mild asbestosis, underwent treatment with methotrexate then leflunomide (LEF) for seropositive RA. In February 2014, during monitoring of his asbestosis, chest CT scan showed the appearance of thick-walled cavitating lung nodules, with a central and sub pleural distribution...
October 12, 2017: Revue des Maladies Respiratoires
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