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pleural effusion guidelines

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https://www.readbyqxmd.com/read/28509402/a-combined-hands-on-teaching-program-and-clinical-pathway-focused-on-pleural-ultrasound-and-procedure-supervision-transforms-pleural-procedure-outcomes
#1
Timothy Edwards, Alistair Cook, Matthew Salamonsen, Farzad Bashirzadeh, David Fielding
INTRODUCTION: Management of pleural effusions is a common diagnostic and management problem. We reviewed the outcomes from pleural procedures after the instigation of pleural effusion management guidelines focusing on pleural ultrasound and a hands-on teaching program followed with procedure supervision that enabled many operators to perform such procedures. METHODS: A retrospective analysis of all procedures performed for pleural effusions on medical patients. Outcomes were assessed prior to the instigation of pleural effusion management guidelines (pleural pathway) and hands-on teaching (January 2010 to June 2011) and following these interventions (January 2012 to June 2013)...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28443595/evaluation-of-the-diagnostic-role-of-bedside-lung-ultrasonography-in-patients-with-suspected-pulmonary-embolism-in-the-emergency-department
#2
Hüseyin Acar, Serkan Yılmaz, Elif Yaka, Nurettin Özgür Doğan, Asım Enes Özbek, Murat Pekdemir
BACKGROUND: Despite the existence of detailed consensus guidelines, challenges continue to exist regarding efficient, appropriate and safe imaging methods for the diagnosis of suspected pulmonary embolism. AIMS: This study was conducted to investigate the role of wedge sign, B-lines and pleural effusion seen on bedside lung ultrasound in the diagnosis of pulmonary embolism. STUDY DESIGN: Diagnostic accuracy study. METHODS: During the first evaluation of patients with suspected pulmonary embolism, bedside lung ultrasound was performed, and the B-lines, wedge sign, and pleural effusion were investigated...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#3
Hussnain S Mirza, Gregory Logsdon, Anoop Pulickal, Mark Stephens, Rajan Wadhawan
Point-of-care (POC) ultrasound refers to the use of portable imaging. Although POC ultrasound is widely available to the neonatologists in Australia and Europe, neonatologists in the United States report limited availability. Our objective was to seek the US neonatologists' perception of barriers and prerequisites in adopting POC ultrasound in neonatal intensive care units. An online survey link was sent via e-mail to 3000 neonatologists included in the database maintained by the American Academy of Pediatrics...
April 20, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28402401/a-benchmarking-project-on-the-quality-of-previous-guidelines-about-the-management-of-malignant-pleural-effusion-from-the-european-society-of-thoracic-surgeons-ests-pleural-diseases-working-group
#4
Luca Bertolaccini, Benedetta Bedetti, Alessandro Brunelli, Katerina Marinova, Federico Raveglia, Gaetano Rocco, Yaron Shargall, Piergiorgio Solli, Gonzalo Varela, Kostas Papagiannopoulos, Jaroslaw Kuzdzal, Gilbert Massard, Enrico Ruffini, Pierre-Emmanuel Falcoz, Carlos Martinez-Barenys, Isabelle Opitz, Hasan F Batirel, Alper Toker, Marco Scarci
OBJECTIVES: In the European Society of Thoracic Surgeons (ESTS) survey about management of malignant pleural effusions (MPE), 56% of respondents are not informed of any relevant clinical guidelines and 52%, who are aware of the existence of guidelines, declared that they are in need of updating or revision. The ESTS Pleural Diseases Working Group developed a benchmarking project on quality of previous guidelines on the management of MPE. METHODS: The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was used to assess each guideline...
April 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28378056/analysis-of-adverse-events-associated-with-dasatinib-and-nilotinib-treatments-in-chronic-phase-chronic-myeloid-leukemia-patients-outside-clinical-trials
#5
Koung Jin Suh, Ji Yun Lee, Dong-Yeop Shin, Youngil Koh, Soo-Mee Bang, Sung-Soo Yoon, Seonyang Park, Inho Kim, Jeong-Ok Lee
We analyzed adverse events (AEs) in 201 chronic phase CML patients treated with nilotinib (n = 120) or dasatinib (n = 81) as first- or second-line therapy. The dasatinib group had significantly higher grade 3-4 AEs compared to the nilotinib group (22 vs. 54%, p < 0.001), and had more frequent dose reduction, interruption, and discontinuation (p < 0.001, p = 0.004, and p = 0.006, respectively). Of 59 patients who discontinued treatment, 47 (80%) discontinued treatment due to AEs; 50% of the AEs causing drug discontinuation were of grade 2 severity...
April 4, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28350729/real-time-ultrasound-guided-thoracentesis
#6
Rachel Krackov, Denise Rizzolo
Clinicians commonly see patients with pleural effusions requiring thoracentesis. The latest evidence-based guidelines for thoracentesis recommend real-time ultrasound guidance for the safest outcomes from this procedure. This article reviews real-time ultrasound guidance for thoracentesis to help referring clinicians understand the technique and the guidelines for the performance of thoracentesis.
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28344925/chest-drain-size-the-debate-continues
#7
REVIEW
Robert J Hallifax, Ioannis Psallidas, Najib M Rahman
PURPOSE OF REVIEW: Small-bore chest tubes are widely used in the management of common pleural disease. Guidelines suggest that patients with malignant pleural effusions, pneumothorax and pleural infection may be successfully managed with small-bore drains. However, good quality data is often lacking. This article reviews the evidence for the treatment efficacy and potential adverse effects of different chest tube sizes. RECENT FINDINGS: In a large randomised study, the small difference in pain scores between large and small drains was not clinically significant...
2017: Current Pulmonology Reports
https://www.readbyqxmd.com/read/28217253/miliary-tuberculosis-infection-during-hepatitis-c-treatment-with-sofosbuvir-and-ledipasvir-plus-ribavirin
#8
Maria Pilar Ballester-Ferré, Fernando Martínez, Natalia Garcia-Gimeno, Francisco Mora, Miguel A Serra
Chronic hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. In the last 5 years, treatment for HCV infection has experienced a marked development. In 2014, the use of ledipasvir/sofosbuvir with or without concomitant weight-based ribavirin was approved with a very significant increase in the sustained virological response. However, new side effects have been associated. We report the first case of an HCV infected patient treated for 12 wk with the combination of sofosbuvir/ledipasvir plus ribavirin who developed a miliary tuberculosis (TB) infection while on therapy...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28158976/the-role-of-serum-procalcitonin-in-establishing-the-diagnosis-and-prognosis-of-pleural-infection
#9
Giles Dixon, Adriana Lama-Lopez, Oliver J Bintcliffe, Anna J Morley, Clare E Hooper, Nick A Maskell
BACKGROUND: Bacterial pleural infection requires prompt identification to enable appropriate investigation and treatment. In contrast to commonly used biomarkers such as C-reactive protein (CRP) and white cell count (WCC), which can be raised due to non-infective inflammatory processes, procalcitonin (PCT) has been proposed as a specific biomarker of bacterial infection. The utility of PCT in this role is yet to be validated in a large prospective trial. This study aimed to identify whether serum PCT is superior to CRP and WCC in establishing the diagnosis of bacterial pleural infection...
February 3, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28125148/use-of-indwelling-pleural-catheters-for-the-definitive-treatment-of-malignant-pleural-effusion
#10
Fernando Conrado Abrão, Igor Renato Louro Bruno de Abreu, Maria Gabriela Cavalcanti, José Franklin Soares Pompa-Filho
Objective: To evaluate the safety and feasibility of the use of indwelling pleural catheters (IPCs) in patients with malignant pleural effusion (MPE). Methods: We prospectively collected data from patients with MPE undergoing IPC placement between January of 2014 and July of 2015. All patients submitted to IPC placement had a life expectancy > 30 days, in accordance with the MPE treatment guidelines established by the British Thoracic Society. The data collected included gender, age, body mass index, primary cancer site, duration of IPC drainage, IPC-related complications, length of hospital stay, pleural effusion recurrence, and occurrence of spontaneous pleurodesis...
January 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28124965/-bacteremia-caused-by-ciprofloxacin-resistant-salmonella-serotype-kentucky-a-case-report-and-the-review-of-literature
#11
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28040756/current-practices-in-the-management-of-malignant-pleural-effusions-a-survey-among-members-of-the-european-society-of-thoracic-surgeons
#12
Marco Scarci, Edward Caruana, Luca Bertolaccini, Benedetta Bedetti, Alessandro Brunelli, Gonzalo Varela, Kostas Papagiannopoulos, Jaroslaw Kuzdzal, Gilbert Massard, Enrico Ruffini, Pierre Emmanuel Falcoz, Isabelle Opitz, Hasan Batirel, Alper Toker, Gaetano Rocco
OBJECTIVES: Malignant pleural effusion (MPE) commonly complicates advanced malignancy and their exact management is still undefined. We undertook a survey to determine the current practice among members of the European Society of Thoracic Surgeons (ESTS). METHODS: A cross-sectional survey focused on the current practice of management of MPE was developed by the authors. The questions were outlined after a review of the literature and circulated in an Internet-based survey format...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27993288/diagnosis-of-complicated-parapneumonic-effusion-by-pleural-ph-measurement-is-jeopardized-by-inadequate-physician-knowledge-and-guideline-discordant-laboratory-practice
#13
Lauren Ng, Eli Dabscheck, Mark Hew
Pleural fluid pH is a crucial determinant of complicated parapneumonic effusion diagnosis and the need for drainage. It is best measured by blood gas analyzer. We examined whether physicians were aware of this, and whether their laboratories measured pleural pH according to their expectations. Only 53% of physicians understood the need for blood gas analyzer measurements, only 50% of laboratories used blood gas analyzers, and only 35% of physicians correctly identified the method performed in their laboratory...
January 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/27803756/dasatinib-induced-pleural-effusion-chylothorax-an-option-to-consider
#14
Lucía Ferreiro, Esther San-José, Juan Suárez-Antelo, Luis Valdés
Dasatinib is a drug for treatment of oncogene fusion protein BCR-ABL-positive chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia resistant/intolerant to imatinib. Pleural effusion (PE) is a common adverse effect, and in this context, we present four cases seen due to this cause. One of them is a chylothorax. The PE grade is variable, and the physiopathology is not well established, although a block in T-lymphocyte function or inhibition of platelet-derived growth factor receptor-β is suggested being involved...
October 2016: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/27798020/optimum-a-protocol-for-a-multicentre-randomised-controlled-trial-comparing-out-patient-talc-slurry-via-indwelling-pleural-catheter-for-malignant-pleural-effusion-vs-usual-inpatient-management
#15
P Sivakumar, A Douiri, A West, D Rao, G Warwick, T Chen, L Ahmed
INTRODUCTION: The development of malignant pleural effusion (MPE) results in disabling breathlessness, pain and reduced physical capability with treatment a palliative strategy. Ambulatory management of MPE has the potential to improve quality of life (QoL). The OPTIMUM trial is designed to determine whether full outpatient management of MPE with an indwelling pleural catheter (IPC) and pleurodesis improves QoL compared with traditional inpatient care with a chest drain and talc pleurodesis...
October 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27581830/the-management-of-benign-non-infective-pleural-effusions
#16
REVIEW
Oliver J Bintcliffe, Gary Y C Lee, Najib M Rahman, Nick A Maskell
The evidence base concerning the management of benign pleural effusions has lagged behind that of malignant pleural effusions in which recent randomised trials are now informing current clinical practice and international guidelines.The causes of benign pleural effusions are broad, heterogenous and patients may benefit from individualised management targeted at both treating the underlying disease process and direct management of the fluid. Pleural effusions are very common in a number of non-malignant pathologies, such as decompensated heart failure, and following coronary artery bypass grafting...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27580053/hepatic-hydrothorax-clinical-review-and-update-on-consensus-guidelines
#17
Rana Khazar Al-Zoubi, Mouhanna Abu Ghanimeh, Ashraf Gohar, Gary A Salzman, Osama Yousef
Hepatic Hydrothorax (HH) is defined as a pleural effusion greater than 500 ml in association with cirrhosis and portal hypertension. It is an uncommon complication of cirrhosis, most frequently seen in association with decompensated liver disease. The development of HH remains incompletely understood and involves a complex pathophysiological process with the most acceptable explanation being the passage of the ascetic fluid through small diaphragmatic defects. Given the limited capacity of the pleural space, even the modest pleural effusion can result in significant respiratory symptoms...
August 31, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27556793/optimal-time-points-for-scintigraphic-imaging-of-pleuroperitoneal-shunts
#18
Matthew F Covington, Gagandeep Choudhary, Ryan J Avery, Elizabeth A Krupinski, Phillip H Kuo
OBJECTIVE: Nuclear imaging can confirm pleuroperitoneal shunt as the cause of pleural effusion. No society guidelines exist for scintigraphic pleuroperitoneal shunt detection. Our institutional protocol was evaluated to determine optimal imaging time points for shunt detection. METHODS: Pleuroperitoneal shunt studies over 4 years were blindly reviewed by 2 nuclear radiologists. Data from blinded review included presence or absence of pleuroperitoneal shunt, laterality of shunt and time points for shunt detection...
October 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27391122/dengue-score-a-proposed-diagnostic-predictor-for-pleural-effusion-and-or-ascites-in-adults-with-dengue-infection
#19
Suhendro Suwarto, Leonard Nainggolan, Robert Sinto, Bonita Effendi, Eppy Ibrahim, Maulana Suryamin, R Tedjo Sasmono
BACKGROUND: There are several limitations in diagnosing plasma leakage using the World Health Organization (WHO) guidelines of dengue hemorrhagic fever. We conducted a study to develop a dengue scoring system to predict pleural effusion and/or ascites using routine laboratory parameters. METHODS: A prospective observational study was carried out at Cipto Mangunkusumo Hospital and Persahabatan Hospital, Jakarta, Indonesia. Dengue-infected adults admitted on the third febrile day from March, 2010 through August, 2015 were included in the study...
July 8, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27219841/use-of-p16-fish-for-differential-diagnosis-of-mesothelioma-in-smear-preparations
#20
REVIEW
Kazuki Nabeshima, Shinji Matsumoto, Makoto Hamasaki, Tomoyuki Hida, Toshiaki Kamei, Kenzo Hiroshima, Tohru Tsujimura, Kunimitsu Kawahara
Because most of malignant pleural mesothelioma (MPM) patients first present with pleural effusion, detection of mesothelioma cells on effusion smears is critical for early diagnosis. Recently, accumulating evidence indicating that the cytological diagnosis of MPM supported by ancillary techniques is as reliable as that based on histopathology has led to new guidelines for the cytopathologic diagnosis of MPM. Based on the guidelines, a combination of cytomorphological criteria and verification by ancillary techniques is required for the cytologic diagnosis of MPM...
September 2016: Diagnostic Cytopathology
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