keyword
https://read.qxmd.com/read/34717795/resident-macrophage-dependent-immune-cell-scaffolds-drive-anti-bacterial-defense-in-the-peritoneal-cavity
#21
JOURNAL ARTICLE
Adrián Vega-Pérez, Laura H Villarrubia, Cristina Godio, Alejandra Gutiérrez-González, Lidia Feo-Lucas, Margarita Ferriz, Natalia Martínez-Puente, Julieta Alcaín, Alfonso Mora, Guadalupe Sabio, María López-Bravo, Carlos Ardavín
Peritoneal immune cells reside unanchored within the peritoneal fluid in homeostasis. Here, we examined the mechanisms that control bacterial infection in the peritoneum using a mouse model of abdominal sepsis following intraperitoneal Escherichia coli infection. Whole-mount immunofluorescence and confocal microscopy of the peritoneal wall and omentum revealed that large peritoneal macrophages (LPMs) rapidly cleared bacteria and adhered to the mesothelium, forming multilayered cellular aggregates composed by sequentially recruited LPMs, B1 cells, neutrophils, and monocyte-derived cells (moCs)...
November 9, 2021: Immunity
https://read.qxmd.com/read/34559458/management-of-parapneumonic-pleural-effusion-in-children-is-there-a-role-for-corticosteroids-when-conventional-nonsurgical-management-fails-a-single-center-15-year-experience
#22
JOURNAL ARTICLE
Matthieu Thimmesch, André Mulder, Frédéric Lebrun, Frédéric Piérart, Caroline Genin, Isabelle Loeckx, Pierre Demaret
OBJECTIVE: Description of the use of corticosteroids for the management of parapneumonic pleural effusion in children. METHODS: Retrospective single-center observational study of all children hospitalized with a diagnosis of parapneumonic pleural effusion during a 15-year period. RESULTS: We documented 97 cases of parapneumonic effusion during the study period, with a median age (interquartile range [IQR]) of 43 (33-61) months. Most of the children benefited from an evacuation of the pleural effusion (89/97, 91...
January 2022: Pediatric Pulmonology
https://read.qxmd.com/read/34401297/bilateral-empyema-secondary-to-hemophilus-influenzae-epiglottitis
#23
Aleksandr Kalininskiy, Justin M Weis
An empyema is a collection of pus in the pleural space, often due to aerobic bacteria, that requires drainage typically done with a small bore chest tube and fibrinolytics. The large majority of empyemas are unilateral. Bilateral empyemas are rare, usually non-infectious and typically require surgical management. We report a case of Hemophilus influenzae epiglottitis complicated by bilateral culture proven empyema successfully managed without surgery. The aim of this report is to present a rare complication of epiglottitis and discuss the theoretical issues with management of multiple infected pleural spaces requiring fibrinolytics...
2021: Respiratory Medicine Case Reports
https://read.qxmd.com/read/34040914/delayed-pneumothorax-post-transbronchial-biopsy-a-case-report
#24
Mohammed Alsaggaf, Ali Khalofa, Rahul Khosla
Bronchoscopy is a common and safe procedure with low mortality rates and complications. The risk of pneumothorax (PTX) post bronchoscopy is estimated to be 0.1% but increases to 1-6% with the addition of transbronchial lung biopsy (TBB) to the procedure. Studies have shown that a short observation period is adequate after TBB, and the usual practice is to perform a portable chest radiograph (CXR) to rule out PTX. Delayed PTX is a rare complication post-TBB and very few cases have been reported in the literature...
April 21, 2021: Curēus
https://read.qxmd.com/read/33976889/intrapleural-fibrinolysis-in-acute-non-traumatic-retained-haemothorax
#25
Chuan T Foo, Jurgen Herre
Haemothorax is an accumulation of blood in the pleural space. Retained haemothorax refers to blood that cannot be drained from the pleural cavity and is associated with an increased risk of empyema and fibrothorax often necessitating surgical evacuation. We describe our experience of using intrapleural fibrinolytic therapy in three patients with different bleeding risk and acute non-traumatic retained haemothorax. The first was a 41-year-old female with disseminated Candida guilliermondii sepsis and an iatrogenic haemothorax, second was a 48-year-old female with transfusion-dependent acute myeloid leukaemia and spontaneous haemothorax, and the third was a 72-year-old female with spontaneous haemothorax from newly diagnosed lung cancer...
June 2021: Respirology Case Reports
https://read.qxmd.com/read/33976621/ambulatory-intrapleural-fibrinolytic-therapy-in-highly-viscous-recurrent-malignant-pleural-effusion
#26
Chuan Tai Foo, Jurgen Herre
Malignant pleural effusion (MPE) is common in lung cancer. We report a case of highly viscous recurrent MPE associated with lung cancer. The viscosity prohibited gravity-dependent drainage initially with a 6-Fr aspiration catheter and subsequently with a 12-Fr intercostal drain. The effusion was eventually evacuated after a single dose of intrapleural fibrinolytic therapy. This process was repeated a total of 13 times over a 12-month period in an ambulatory setting. No bleeding complications were observed. This case highlights the feasibility and safety of repeated intrapleural fibrinolysis in the management of highly viscous recurrent MPE in an ambulatory setting...
January 2021: Case Reports in Oncology
https://read.qxmd.com/read/33879116/medical-thoracoscopy-treatment-for-pleural-infections-a-systematic-review-and-meta-analysis
#27
JOURNAL ARTICLE
Michele Mondoni, Laura Saderi, Federica Trogu, Silvia Terraneo, Paolo Carlucci, Filippo Ghelma, Stefano Centanni, Giovanni Sotgiu
BACKGROUND: Complicated parapneumonic effusions and empyema represent advanced stages of pleural infections and are characterized by a high mortality. Medical thoracoscopy is a safe and minimally invasive endoscopic technique prescribed to treat severe pleural infections. However, only a few studies evaluated its success rate. A systematic review of observational studies was performed to assess the efficacy of medical thoracoscopy in patients with complicated parapneumonic effusions and empyema, as well as its predictive factors...
April 20, 2021: BMC Pulmonary Medicine
https://read.qxmd.com/read/33786143/pleural-empyema-in-children-benefits-of-primary-thoracoscopic-treatment
#28
JOURNAL ARTICLE
Roksana Barglik, Andrzej Grabowski, Wojciech Korlacki, Michał Pasierbek, Anna Modrzyk
INTRODUCTION: Pleural empyema is the condition of the pleural cavity when initially sterile pleural effusion has become infected. In the majority of cases, it is of parapneumonic origin. Parapneumonic effusions and pleural empyemata usually continuously progress in severity. The American Thoracic Society divides them into three stages: exudative, fibrinopurulent and organizing. The therapy depends on the stage. AIM: To assess whether thoracoscopy should be considered better than conservative treatment and to assess the feasibility of the thoracoscopic approach to the 3rd phase of pleural empyema...
March 2021: Videosurgery and Other Miniinvasive Techniques
https://read.qxmd.com/read/33624964/delayed-massive-haemothorax-following-thoracic-trauma
#29
JOURNAL ARTICLE
Idar Johan Brekke, Panagiotis Maidas, Lars Møller
BACKGROUND: Most cases of thoracic injury are the result of minor trauma, treated out of hospital. Approximately 10 % of patients with minor thoracic trauma develop delayed haemothorax, with risk of fibrosis and empyema. Traumatic diaphragmatic injury following blunt trauma can be difficult to diagnose, and is a rare condition associated with high-energy trauma. CASE PRESENTATION: A 63-year-old man with multiple rib fractures following a traffic accident was readmitted for chest tube drainage 19 days after trauma, due to delayed haemothorax...
February 23, 2021: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://read.qxmd.com/read/33600743/endothelial-cell-protein-c-receptor-deficiency-attenuates-streptococcus-pneumoniae-induced-pleural-fibrosis
#30
JOURNAL ARTICLE
Shiva Keshava, Jhansi Magisetty, Torry A Tucker, Weshely Kujur, Sachin Mulik, Charles T Esmon, Steven Idell, L Vijaya Mohan Rao, Usha R Pendurthi
Streptococcus pneumoniae is the leading cause of hospital community-acquired pneumonia. Patients with pneumococcal pneumonia may develop complicated parapneumonic effusions or empyema that can lead to pleural organization and subsequent fibrosis. The pathogenesis of pleural organization and scarification involves complex interactions between the components of the immune system, coagulation, and fibrinolysis. EPCR (endothelial protein C receptor) is a critical component of the protein C anticoagulant pathway...
April 2021: American Journal of Respiratory Cell and Molecular Biology
https://read.qxmd.com/read/33535429/the-contribution-of-the-urokinase-plasminogen-activator-and-the-urokinase-receptor-to-pleural-and-parenchymal-lung-injury-and-repair-a-narrative-review
#31
REVIEW
Torry A Tucker, Steven Idell
Pleural and parenchymal lung injury have long been characterized by acute inflammation and pathologic tissue reorganization, when severe. Although transitional matrix deposition is a normal part of the injury response, unresolved fibrin deposition can lead to pleural loculation and scarification of affected areas. Within this review, we present a brief discussion of the fibrinolytic pathway, its components, and their contribution to injury progression. We review how local derangements of fibrinolysis, resulting from increased coagulation and reduced plasminogen activator activity, promote extravascular fibrin deposition...
February 1, 2021: International Journal of Molecular Sciences
https://read.qxmd.com/read/33425359/intrapleural-alteplase-and-dnase-for-complex-tuberculous-pleurisy-a-medical-approach
#32
Xiong Khee Cheong, Mohamed Faisal Abdul Hamid
Tuberculous pleurisy is extra-pulmonary tuberculosis caused by Mycobacterium tuberculosis (MTB), which is one of the main cause of pleural effusions in developing countries. Intercostal chest catheter is useful for drainage of infected pleural fluid and facilitates sepsis control. However, management might be challenging in complex tuberculous pleural effusion as the septations within the effusion hinder pleural drainage. Intrapleural fibrinolysis therapy improved infected fluid drainage and septic parameter in parapneumonic effusions; however, there seems to be little data on its use in tuberculous pleurisy...
February 2021: Respirology Case Reports
https://read.qxmd.com/read/33316850/the-anti-adhesive-effect-of-anti-vegf-agents-in-experimental-models-a-systematic-review
#33
REVIEW
Dimitrios Giannis, Georgios Geropoulos, Ioannis A Ziogas, Jordan Gitlin, Alisha Oropallo
Adhesions constitute a major problem in abdominal-pelvic and thoracic surgery with significant impact in the postoperative quality of life and healthcare services utilization. Adhesiogenesis is the result of increased fibrin formation, impaired fibrinolysis, angiogenesis, and fibrosis. Despite the recent advancements, the ideal anti-adhesive agent remains to be determined. To this end, we performed a comprehensive literature search in PubMed, EMBASE, and Scopus databases to identify studies investigating the antiadhesive role of anti-VEGF agents in peritoneal, pleural, and pericardial experimental adhesion models...
December 14, 2020: Wound Repair and Regeneration
https://read.qxmd.com/read/33169591/cryptococcal-empyema-treated-with-tube-thoracostomy-and-intrapleural-fibrinolysis
#34
JOURNAL ARTICLE
Akshay Kohli, Ashutosh Sachdeva, Edward M Pickering
A 55-year old woman with a history of relapsed T-cell ALL presented with right pleuritic chest pain and decreased breath sounds over the right hemithorax. Imaging of the chest showed loculated effusions. Tube thoracostomy was performed with intrapleural application of alteplase and dornase alpha over a 3-day period. Repeat imaging demonstrated a marked decrease in the volume of the effusion. In most prior published cases of pleural cryptococcosis, surgical drainage was required in addition to prolonged antifungal agents...
November 10, 2020: Monaldi Archives for Chest Disease
https://read.qxmd.com/read/32864139/short-course-intrapleural-alteplase-and-dnase-in-complex-effusion-with-bleeding-risk
#35
Xiong Khee Cheong, Andrea Yu-Lin Ban, Mohamed Faisal Abdul Hamid
Pleural infection is an important clinical problem with significant morbidity. In poorly draining complex pleural effusions, the current management favours a less invasive image-guided placement of smaller bore catheters and adjunctive intrapleural fibrinolysis therapy (IPFT). We describe our experience of using IPFT in three patients with different bleeding risks with complex pleural effusions. The first was a 30-year-old with transfusion-dependent β-thalassemia with haemoglobin of 7.8 g/dL; second was an 87-year-old on dabigatran with haemoglobin of 10 g/dL; and the third was an 80-year-old with diffuse large B-cell lymphoma with haemoglobin of 8...
October 2020: Respirology Case Reports
https://read.qxmd.com/read/32852350/protocol-driven-antibiotic-treatment-of-pediatric-empyema-after-fibrinolysis
#36
JOURNAL ARTICLE
Wendy Jo Svetanoff, Robert M Dorman, Charlene Dekonenko, Obiyo Osuchukwu, Shubhika Jain, Kartik Depala, Angela Myers, Tolulope A Oyetunji, Shawn D St Peter
BACKGROUND: The duration of antibiotic treatment after resolution of empyema in children is variable. We evaluated the efficacy and safety of a protocol-driven antibiotic regimen aimed to decrease antibiotic duration following treatment with fibrinolysis. METHODS: Our institutional protocol consisted of 7 further days of antibiotics upon removal of the thoracostomy tube, with the patient being afebrile, off supplemental oxygen, and having negative cultures. A prospective observational study was then performed between September 2014 and March 2019...
January 2021: Pediatric Infectious Disease Journal
https://read.qxmd.com/read/32160196/hyaluronic-acid-on-the-urokinase-sustained-release-with-a-hydrogel-system-composed-of-poloxamer-407-ha-p407-hydrogel-system-for-drug-delivery
#37
JOURNAL ARTICLE
Hao-Ying Hsieh, Wei-Yang Lin, An Li Lee, Yi-Chen Li, Yi-Jane Chen, Ke-Cheng Chen, Tai-Horng Young
Pleural empyema is an inflammatory condition characterized by accumulation of pus inside the pleural cavity, which is usually followed by bacterial pneumonia. During the disease process, the pro-inflammatory and pro-fibrotic cytokines in the purulent pleural effusion cause proliferation of fibroblasts and deposition of extracellular matrix, which lead to fibrin deposition and fibrothorax. Urokinase instillation therapy through a chest drainage tube is frequently used for fibrinolysis in patients with empyema...
2020: PloS One
https://read.qxmd.com/read/32069085/pleural-fluid-supar-levels-predict-the-need-for-invasive-management-in-parapneumonic-effusions
#38
JOURNAL ARTICLE
David T Arnold, Fergus W Hamilton, Karen T Elvers, Stuart W Frankland, Natalie Zahan-Evans, Sonia Patole, Andrew Medford, Rahul Bhatnagar, Nicholas A Maskell
Rationale: Parapneumonic effusions have a wide clinical spectrum. The majority settle with conservative management but some progress to complex collections requiring intervention. For decades, physicians have relied on pleural fluid pH to determine the need for chest tube drainage despite a lack of prospective validation and no ability to predict the requirement for fibrinolytics or thoracic surgery. Objectives: To study the ability of suPAR (soluble urokinase plasminogen activator receptor), a potential biomarker of pleural fluid loculation, to predict the need for invasive management compared with conventional fluid biomarkers (pH, glucose, and lactate dehydrogenase) in parapneumonic effusions...
June 15, 2020: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/31719986/intrapleural-urokinase-directly-under-medical-thoracoscopy-for-the-diagnosis-of-tuberculous-pleurisy
#39
Satoshi Terashita, Hiroaki Kawachi, Tomoko Tajiri, Susumu Noguchi, Tatsuyoshi Ikeue, Takakazu Sugita
Medical thoracoscopy, also called "local anesthetic thoracoscopy" and "pleuroscopy," is a minimally invasive single-port endoscopic technique that provides direct visualization of the pleural surfaces and channels to conduct diagnostic and therapeutic procedures. However, this technique is not helpful when substantial fibrous adhesions exist. We reported the first case of intrapleural urokinase directly under medical thoracoscopy for the diagnosis of malignant pleural mesothelioma with severe multiloculated pleural effusions in 2019...
January 2020: Respirology Case Reports
https://read.qxmd.com/read/31684683/intra-pleural-fibrinolytic-therapy-versus-placebo-or-a-different-fibrinolytic-agent-in-the-treatment-of-adult-parapneumonic-effusions-and-empyema
#40
JOURNAL ARTICLE
Emile S Altmann, Iain Crossingham, Stephen Wilson, Huw R Davies
BACKGROUND: Pleural infection, including parapneumonic effusions and thoracic empyema, may complicate lower respiratory tract infections. Standard treatment of these collections in adults involves antibiotic therapy, effective drainage of infected fluid and surgical intervention if conservative management fails. Intrapleural fibrinolytic agents such as streptokinase and alteplase have been hypothesised to improve fluid drainage in complicated parapneumonic effusions and empyema and therefore improve treatment outcomes and prevent the need for thoracic surgical intervention...
October 30, 2019: Cochrane Database of Systematic Reviews
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