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https://www.readbyqxmd.com/read/28096829/is-it-possible-to-standardize-the-treatment-of-primary-spontaneous-pneumothorax-part-1-etiology-symptoms-diagnostics-minimally-invasive-treatment
#1
Wojciech Rokicki, Marek Rokicki, Jacek Wojtacha, Marek Filipowski, Agata Dżejlili, Damian Czyżewski
The authors of this report present the history of primary spontaneous pneumothorax (PSP) treatment, its etiology, clinical symptoms, and diagnostic methodology. Further, they discuss minimally invasive methods of treating PSP such as thoracentesis and chemical pleurodesis. They discuss the pros and cons of each method, emphasizing that, according to the international recommendations, they should be used as the first line of treatment for PSP.
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28069787/bilateral-indwelling-pleural-catheter-for-hepatic-hydrothorax
#2
Rossella D'Amato, Luisa E Eiroa González, Ana Isabel Hernández Méndez
A 68-year-old man with alcoholic liver cirrhosis and portal hypertension was admitted due to ascites. Bilateral severe hepatic hydrothorax did not resolve despite sodium restriction, and diuretic treatment, requiring repeated thoracentesis for relief of dyspnoea. Curative options, as transjugular intrahepatic portosystemic shunt and liver transplantation were both contraindicated. An attempt of pleurodesis was ineffective. Bilateral insertion of tunnelled pleural catheter allowed symptom control and home discharge...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28050477/transthoracic-biopsy-causes-massive-subcutaneous-emphysema-in-a-low-risk-patient
#3
Fikri Selcuk Simsek, Yusuf Dag
Subcutaneous Emphysema (SE) can be defined as air leakage under skin from the respiratory or gastrointestinal system. It is frequently accompanied by pneumomediastinum. Thoracentesis, image-guided lung biopsies, pulmonary diseases and therapies resulting in necrosis can cause this pathology. The risk of pneumothorax and SE increased with the distance of the lesion to the pleura, and small size of the lesion. Although, our patient had low risk for SE, there were minimal pneumothoraces and massive SE. We consider that tumour necrosis and subcutaneous tissue may be related via transthoracic biopsy and this leads to massive SE...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28040615/should-procedural-skills-be-a-part-of-the-acute-care-nurse-practitioner-curriculum
#4
Amita Avadhani
Invasive procedures are an integral component of the time sensitive management of the acute and critically ill patients. Acute Care Nurse Practitioner (ACNP) students aspiring to be employed in their roles in the acute care settings cannot be autonomous in their practices unless they have a minimum level of proficiency to perform life sustaining invasive procedures. Offering additional level of benefits of safety and quality in healthcare, simulation as a teaching method has grown in popularity among various levels of education among variety of disciplines...
March 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28028308/metastatic-squamous-cell-carcinoma-of-the-pleura-a-rare-complication-of-hidradenitis-suppurativa
#5
Kiran Joglekar, Christopher Jackson, Dipen Kadaria, Amik Sodhi
BACKGROUND Squamous cell carcinoma (SCC), also known as Marjolin ulcer, is a rare complication of hidradenitis suppurativa (HS). Metastatic SCC from HS typically involves the axial skeleton or abdominopelvic viscera. Metastatic disease to the lungs is a rare phenomenon with only three reported cases of lung parenchyma. We present a biopsy proven case of metastatic SCC to the pleura from gluteal HS. CASE REPORT A 46-year-old male with a history of recently diagnosed Marjolin ulcer secondary to gluteal HS was transferred to our intensive care unit for acute hypoxemic respiratory failure secondary to recurrent pleural effusion...
December 28, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27979723/pleural-effusions-in-non-transplanted-cystic-fibrosis-patients
#6
Adam R Belanger, Kimtuyen Nguyen, Umar Osman, Christopher R Gilbert, Katie Allen, Ahmad Farid Al Rais, Lonny Yarmus, Jason A Akulian
BACKGROUND: Pleural effusions are considered rare in cystic fibrosis (CF) patients. There is a paucity of available information in the literature concerning the nature and significance of pleural effusions in non-transplanted CF patients. METHODS: We conducted a multicenter retrospective evaluation of non-transplanted adult CF patients. Given the small sample size, only descriptive statistics were performed. RESULTS: A total of 17 CF patients with pleural effusion were identified, of whom 9 patients underwent thoracentesis...
December 12, 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/27959649/hemothorax-after-thoracentesis
#7
Ittikorn Spanuchart, Scott Gallacher
A 65-year-old woman with atherosclerotic cardiovascular disease and renal failure was hospitalized for acute respiratory failure and bilateral pleural effusions associated with pneumonia (Panel A). To rule out the presence of empyema, a diagnostic, ultrasonography-guided thoracentesis was performed..
November 10, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27916209/concordant-and-discordant-exudates-and-their-effect-on-the-accuracy-of-light-s-criteria-to-diagnose-exudative-pleural-effusions
#8
Lucía Ferreiro, Rolando Sánchez-Sánchez, Luis Valdés, Carlos E Kummerfeldt, John T Huggins
INTRODUCTION: To describe the incidence of discordant exudate (DE) effusions, their underlying etiologies and their effect on the accuracy of the Light's criteria to diagnose exudate effusions. METHODS: A retrospective review of pleural fluid analysis (PFA) from a cohort of patients with pleural effusion (PE) who underwent thoracentesis. PEs were defined as exudative based on the Light's criteria. The effusions were further classified in concordant or DE. RESULTS: From 847 PE samples, 611 (72...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27868100/nephropleural-fistula-effectively-managed-with-serial-thoracentesis-a-case-report
#9
Aaron D Baugh, Eslam Youssef, Syed Shafae Hasan, Nauman Saleem Siddiqui, Haitham Elsamoloty, Khaled Shahrour, Toseef Javaid
Nephropleural fistulae are rare but serious thoracic complications of percutaneous nephrolithotomy (PCNL). Herein, we present the management of a 54-year-old female with a delayed presentation of nephropleural fistula. The role of serial thoracentesis as a safe, less invasive, less painful alternative to tube thoracostomy is highlighted. In select cases, this may represent an attractive management strategy for nephropleural fistula after PCNL.
2016: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/27853046/imatinib-induced-pleural-effusion-a-case-report
#10
R Banka, Z Udwadia
Imatinib is a tyrosine kinase inhibitor and has rarely been reported to cause pleural effusion. We report the case of an 88-year-old male, known case of gastrointestinal stromal tumor on treatment with imatinib, who presented with a 2-week history of cough and dyspnea. He was diagnosed to have a right-sided pleural effusion and thoracentesis of the fluid revealed an exudate with low adenosine deaminase and negative cytology. Withdrawal of the drug lead to resolution of symptoms. We report this case to highlight the side effect profile of imatinib and warn physicians regarding this potential adverse effect which may be mistaken for metastasis or infection...
November 16, 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27846453/a-case-report-of-chylous-ascites-after-gastric-bypass-for-morbid-obesity
#11
Esmeralda Capristo, Valerio Spuntarelli, Giorgio Treglia, Vincenzo Arena, Alessandro Giordano, Geltrude Mingrone
INTRODUCTION: We described the case of a highly aggressive antral gastric carcinoma with a scarce symptomatology, in a patient undergone Roux-en-Y Gastric Bypass (RYGB) for obesity. PRESENTATION OF CASE: A 61 year-old white man in apparent good health, who underwent laparoscopic RYGB for obesity 18 months earlier, with a loss of 30kg, reported a sudden abdominal distension and breath shortness with a weight gain of 5kg in few days. Endoscopy of both upper gastro-intestinal tract and the colon were performed along with CT-scan and positron-emission tomography (PET) CT- scan...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27805531/postoperative-pleural-effusions-after-orthotopic-heart-transplant-cause-clinical-manifestations-and-course
#12
Gaye Ulubay, Elif Küpeli, Balam Er Dedekargınoğlu, Şerife Savaş Bozbaş, Mahal Alekberov, Özlem Salman Sever, Atilla Sezgin
OBJECTIVES: Postoperative pleural effusions are common in patients who undergo cardiac surgery and orthotopic heart transplant. Postoperative pleural effusions may also occur as postcardiac injury syndrome. Most of these effusions are nonspecific and develop as a harmless complication of the surgical procedure itself and generally have a benign course. Here, we investigated the cause and clinical and laboratory features of postoperative early and late pleural effusions in orthotopic heart transplant patients...
2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27803756/dasatinib-induced-pleural-effusion-chylothorax-an-option-to-consider
#13
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/27759851/role-of-the-neutrophil-lymphocyte-ratio-in-the-differential-diagnosis-of-exudative-pleural-effusion
#14
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
https://www.readbyqxmd.com/read/27717487/a-survey-to-medical-residents-on-the-performance-of-diagnostic-and-therapeutic-thoracenteses-a-training-gap
#15
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...
December 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27687258/can-lessons-from-systems-based-mastery-learning-for-thoracentesis-be-translated-to-hospitalists
#16
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
https://www.readbyqxmd.com/read/27679694/depth-of-pleural-effusion-in-thoracentesis-comparison-of-lateral-posterolateral-and-posterior-approaches-in-the-supine-position
#17
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
https://www.readbyqxmd.com/read/27629501/-chest-decompression-in-emergency-medicine-and-intensive-care
#18
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
https://www.readbyqxmd.com/read/27621864/characteristics-of-patients-with-pseudochylothorax-a-systematic-review
#19
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
https://www.readbyqxmd.com/read/27580053/hepatic-hydrothorax-clinical-review-and-update-on-consensus-guidelines
#20
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)
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