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Ulku Aka Akturk, Dilek Ernam, Makbule Ozlem Akbay, Nagihan Durmus Koçak, Erhan Ogur, Ilim Irmak
OBJECTIVES: Pleural effusion is a common diagnostic and clinical problem. The differential diagnosis of pleural effusion may be difficult and may require several procedures, including invasive ones. Certain studies have investigated biochemical parameters to facilitate the diagnosis of exudative pleural effusion; however, it remains a challenging problem in clinical practice. We aimed to investigate the potential role of the neutrophil-lymphocyte ratio, which can be easily obtained by determining the cell count of the pleural fluid, in the differential diagnosis of exudative pleural effusion...
October 1, 2016: Clinics
J M Porcel, E Cases-Viedma, S Bielsa
OBJECTIVE: Pleural fluid aspiration is a routine procedure for pulmonologists and internists. Our aim was to evaluate technical and methodological aspects of diagnostic and therapeutic thoracenteses performed by last two-year residents of Pulmonology and Internal Medicine. METHODS: An online 24-item questionnaire was sent to participants, and responses were evaluated according to the medical specialty. RESULTS: The survey was completed by 139 (17...
October 4, 2016: Revista Clínica Española
Trevor Jensen, Andrew Lai, Michelle Mourad
No abstract text is available yet for this article.
September 30, 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Jeong Min Ko, Jisoon Kim, Soo-An Park, Kwang Nam Jin, Myeong Im Ahn, Seok-Chan Kim, Dae Hee Han
BACKGROUND: In patients who have difficulty sitting, thoracentesis is attempted in a supine position via lateral approach. Recently, a new table has been designed for supine thoracentesis. This table has gaps that allow access to the posterolateral and posterior hemithorax. OBJECTIVES: To compare important safety-related parameters between lateral, posterolateral, and posterior approaches in supine thoracentesis. MATERIALS AND METHODS: First, two cadavers were placed supine on a table featuring gaps allowing access to the posterolateral and posterior hemithorax...
April 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
H Drinhaus, T Annecke, J Hinkelbein
Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space (Monaldi-position) or in the anterior to mid-axillary line of the 4th/5th intercostal space (Bülau-position)...
October 2016: Der Anaesthesist
Adriana Lama, Lucía Ferreiro, María E Toubes, Antonio Golpe, Francisco Gude, José M Álvarez-Dobaño, Francisco J González-Barcala, Esther San José, Nuria Rodríguez-Núñez, Carlos Rábade, Carlota Rodríguez-García, Luis Valdés
BACKGROUND: Pseudochylothorax (PCT) (cholesterol pleurisy or chyliform effusion) is a cholesterol-rich pleural effusion (PE) that is commonly associated with chronic inflammatory disorders. Nevertheless, the characteristics of patients with PCT are poorly defined. METHODS: A systematic review was performed across two electronic databases searching for studies reporting clinical findings, PE characteristics, and the most effective treatment of PCT. Case descriptions and retrospective studies were included...
August 2016: Journal of Thoracic Disease
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)
Fabien Maldonado, David Feller-Kopman
No abstract text is available yet for this article.
October 2016: Expert Review of Respiratory Medicine
Narin Sriratanaviriyakul, Hanh H La, Timothy E Albertson
BACKGROUND: Chronic eosinophilic pneumonia is a rare idiopathic interstitial lung disease. The nearly pathognomonic radiographic finding is the peripheral distribution of alveolar opacities. Pleural effusions are rarely seen. We report a case of chronic eosinophilic pneumonia with transudative eosinophilic pleural effusion. CASE PRESENTATION: A 57-year-old Hispanic woman, a nonsmoker with a history of controlled asthma, presented to the hospital with unresolving pneumonia despite three rounds of antibiotics over a 2-month period...
2016: Journal of Medical Case Reports
Jared W Meeker, Amy L Jaeger, William P Tillis
Reexpansion pulmonary edema (RPE) is a rare complication that can occur after rapid reinflation of the lung following thoracentesis of a pleural effusion or chest tube drainage of pneumothorax. The severity in clinical presentation can be widely varied from radiographic changes only to rapidly progressive respiratory failure requiring mechanical ventilation. The quick nature of onset and potential for serious decline in a previously stable patient makes it important to prepare, recognize, diagnose, and appropriately manage patients who develop RPE...
2016: Journal of Community Hospital Internal Medicine Perspectives
Laura Sommer Hansen, Vibeke Elisabeth Hjortdal, Carl-Johan Jakobsen, Johan Heiberg, Marie Maagaard, Erik Sloth
OBJECTIVES: Recent studies conclude that cardiac surgery patients are prone to both mortality and morbidity in the weeks after discharge. Complications such as pleural and pericardial effusions may influence physical recovery due to symptoms such as dyspnoea, chest pain and fatigue. Dedicated follow-up and timely treatment of postoperative complications are suggested. METHODS: A randomized, controlled intervention trial including 76 patients, in the ratio of 1 : 1...
July 11, 2016: European Journal of Cardio-thoracic Surgery
Astha Chichra, Mina Makaryus, Parag Chaudhri, Mangala Narasimhan
Bedside ultrasonographic assessment of the lung and pleura provides rapid, noninvasive, and essential information in diagnosis and management of various pulmonary conditions. Ultrasonography helps in diagnosing common conditions, including consolidation, interstitial syndrome, pleural effusions and masses, pneumothorax, and diaphragmatic dysfunction. It provides procedural guidance for various pulmonary procedures, including thoracentesis, chest tube insertion, transthoracic aspiration, and biopsies. This article describes major applications of ultrasonography for the pulmonary consultant along with illustrative figures and videos...
2016: Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
George Williams, Dipen Kadaria, Amik Sodhi
BACKGROUND Myelomatous pleural effusion (MPE) is a rare occurrence in patients with multiple myeloma (MM). Fewer than 20 cases of MPE have been reported as an initial manifestation of MM. Extramedullary plasmacytoma (EMP) occurs in fewer than 5% patients with MM, and mediastinal EMP is even rarer, with only about 80 cases reported in the literature. We present a case study involving a patient with concurrent MPE and mediastinal EMP as an initial manifestation of MM. CASE REPORT The patient was a 74-year-old nonsmoking female with a 3-month history of exertional dyspnea and back pain...
2016: American Journal of Case Reports
Alexander Zider, Nader Kamangar
An 80-year-old woman from Iran presented to our institution for evaluation of insidious onset of dyspnea and progressive hypoxemia. She had a history of hypertension, COPD attributed to secondhand smoke, and an unprovoked pulmonary embolus that was treated with lifelong anticoagulation. In addition, she had a history of latent TB status posttreatment with isoniazid 10 years prior. One year ago, home oxygen therapy was started at 4 L/min via nasal cannula, and because of her decline, her son had brought her to the United States 3 months earlier for medical help...
July 2016: Chest
Chang Ho Kim, So Yeon Lee, Yong Dae Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Jaehee Lee
Objective Although tuberculous pleural effusion (TPE) is commonly characterized by lymphocytic predominance and high adenosine deaminase (ADA) levels, it may present with neutrophilic predominance or low ADA levels, which are more commonly found in parapneumonic effusion (PPE) or malignant pleural effusion (MPE), respectively. A few studies have observed that the atypical pleural fluid profiles of these cases of TPE may resolve at follow-up thoracentesis. However, these observations were incompletely analyzed and lacked comparison with proper control groups...
2016: Internal Medicine
Ramesh L Narasimhan, Inderpaul S Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Ritesh Agarwal
Intrapleural foreign body is an uncommon condition, usually encountered in the setting of thoracic trauma, but can rarely complicate diagnostic procedures such as thoracentesis. The management involves urgent identification and removal of the foreign body. Although surgical extraction using thoracotomy or video-assisted thoracoscopic surgery under general anesthesia constitutes the primary management strategy, intrapleural foreign body can also be removed using medical thoracoscopy. Herein, we report the successful removal of 2 intrapleural foreign bodies using a rigid thoracoscope under local anesthesia and conscious sedation...
June 30, 2016: Journal of Bronchology & Interventional Pulmonology
Cynthia Kay, Erica M Wozniak, Aniko Szabo, Jeffrey L Jackson
OBJECTIVES: Explore the performance patterns of invasive bedside procedures at an academic medical center, evaluate whether patient characteristics predict referral, and examine procedure outcomes. METHODS: This was a prospective, observational, and retrospective chart review of adults admitted to a general medicine service who had a paracentesis, thoracentesis, or lumbar puncture between February 22, 2013 and February 21, 2014. RESULTS: Of a total of 399 procedures, 335 (84%) were referred to a service other than the primary team for completion...
July 2016: Southern Medical Journal
Trylon Mathew Tsang, Alfin Taddeo Okullo, Jeremy Field, Patrick Mamo
A 66-year-old man underwent a left minithoracotomy for pleural biopsies and thoracentesis. A left T3 paravertebral catheter was placed prior to induction of general anaesthesia, and a total of 20 mL of bupivacaine 0.25% administered. Postoperatively, ropivacaine 0.2% infusion was commenced at 10 mL/hour. Thirty-seven hours after the initial block, the patient developed convulsions without loss of consciousness. The ropivacaine infusion rate was unchanged and no further boluses had been given. He reported of perioral tingling, a burning sensation in his legs and penis and agitation...
2016: BMJ Case Reports
Katarzyna Krenke, Ewa Sadowy, Edyta Podsiadły, Waleria Hryniewicz, Urszula Demkow, Marek Kulus
BACKGROUND: An increasing incidence of parapneumonic effusion and pleural empyema (PPE/PE) has been reported in recent studies. As only few data on etiology of PPE/PE in Central Europe have been reported, we undertook a study on the etiology of PPE/PE in children, using both standard culture and molecular techniques. METHODS: This prospective study was conducted between June 2011 and December 2013. Consecutive children with PPE/PE complicating community acquired pneumonia, who required diagnostic/therapeutic thoracentesis were included...
July 2016: Respiratory Medicine
J M Porcel
Pleural ultrasonography is useful for identifying and characterising pleural effusions, solid pleural lesions (nodules, masses, swellings) and pneumothorax. Pleural ultrasonography is also considered the standard care for guiding interventionist procedures on the pleura at the patient's bedside (thoracentesis, drainage tubes, pleural biopsies and pleuroscopy). Hospitals should promote the acquisition of portable ultrasound equipment to increase the patient's safety.
June 6, 2016: Revista Clínica Española
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