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Thoracentesis

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https://www.readbyqxmd.com/read/28670061/thoracentesis-reverting-cardiac-tamponade-physiology-in-a-patient-with-myxedema-coma-and-large-pleural-effusion
#1
Monia E Werlang, Mario R Pimentel, Jose L Diaz-Gomez
A large pleural effusion causing cardiac tamponade physiology and severe hemodynamic compromise is an uncommon event. We report a case of a 53-year-old woman with severe hypothyroidism presenting with myxedema coma and refractory shock. Her hemodynamic status failed to respond to fluid resuscitation and vasopressors. A transthoracic echocardiogram and chest radiograph demonstrated a pericardial fluid accumulation associated with a large left-sided pleural effusion. Thoracostomy tube insertion resulted in prompt improvement of the patient's hemodynamic status...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28641878/diagnosis-and-management-of-pleural-transudates
#2
Lucía Ferreiro, José M Porcel, Luis Valdés
Various clinical trials have been published on the optimal clinical management of patients with pleural exudates, particularly those caused by malignant tumors, while little information is available on the diagnosis and treatment of pleural transudates. The etiology of pleural transudates is wide and heterogeneous, and they can be caused by rare diseases, sometimes constituting a diagnostic challenge. Analysis of the pleural fluid can be a useful procedure for establishing diagnosis. Treatment should target not only the underlying disease, but also management of the pleural effusion itself...
June 19, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28638284/how-much-negative-pressure-are-we-generating-during-thoracentesis
#3
Abdul Hamid Alraiyes, Fayez Kheir, Kassem Harris, Thomas R Gildea
No abstract text is available yet for this article.
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28616270/urinothorax-a-systematic-review
#4
María E Toubes, Adriana Lama, Lucía Ferreiro, Antonio Golpe, José M Álvarez-Dobaño, Francisco J González-Barcala, Esther San José, Nuria Rodríguez-Núñez, Carlos Rábade, Tamara Lourido, Luis Valdés
BACKGROUND: The characteristics of patients with urinothorax (UT) are poorly defined. METHODS: A systematic review was performed searching for studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of UT. Case descriptions and retrospective studies were included. RESULTS: The review included 78 studies with a total of 88 patients. Median age was 45 years, male/female ratio was 1.6:1 and in 76% of cases the etiology was trauma...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28601213/treatment-of-thoracic-trauma-lessons-from-the-battlefield-adapted-to-all-austere-environments
#5
REVIEW
Lanny F Littlejohn
Severe thoracic trauma in the backcountry can be a formidable injury pattern to successfully treat. Traumatic open, pneumo-, and hemothoraces represent some of the most significant patterns for which advanced equipment and procedures may help leverage morbidity and mortality, particularly when evacuation is delayed and environmental conditions are extreme. This paper reviews the development of successful techniques for treating combat casualties with thoracic trauma, including the use of vented chest seals and the technique of needle thoracentesis...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28554579/wall-suction-assisted-image-guided-thoracentesis-a-safe-alternative-to-evacuated-bottles
#6
H Kim, P B Shyn, L Wu, V M Levesque, R Khorasani, S G Silverman
AIM: To compare the safety of evacuated bottle-assisted thoracentesis with wall suction-assisted thoracentesis. MATERIALS AND METHODS: An institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study of 161 consecutive patients who underwent 191 evacuated bottle-assisted thoracenteses from 1 January 2012 to 30 September 2012, and 188 consecutive patients who underwent 230 wall suction-assisted thoracenteses from 1 January 2013 to 30 September 2013 was conducted...
May 26, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28539992/bi-directional-hepatic-hydrothorax
#7
Madhan Nellaiyappan, Anastasios Kapetanos
A 59-year-old male with alcoholic cirrhosis presented to our hospital with an acutely painful umbilical hernia, and 4 mo of exertional dyspnea. He was noted to be tachypneic and hypoxic. He had a massive right sided pleural effusion with leftward mediastinal shift and gross ascites, with a tense, fluid-filled, umbilical hernia. Emergent paracentesis with drain placement and a large volume thoracentesis were performed. Despite improvement in dyspnea and drainage of 15 L of ascitic fluid, the massive transudative pleural effusion remained largely unchanged...
May 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28528060/pulmonary-mucormycosis-treated-with-lobectomy
#8
Oluwatobi Afolayan, Hannah Copeland, Salman Zaheer, Jason M Wallen
A 57 year old man was referred from an outside facility for an unresolving pneumonia. Imaging of the chest demonstrated a right lung mass with a consolidation in the middle lobe, pleural effusion, and mediastinal lymphadenopathy. Cytologic examination of cultures from the bronchoscopy and thoracentesis did not yield a definitive diagnosis. Video-assisted thoracoscopic surgery (VATS) was performed because of a retained hemothorax and a suggestive lesion. Biopsy specimens obtained during VATS were consistent with mucormycosis...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28526059/severe-polyserositis-induced-by-the-13-valent-pneumococcal-conjugate-vaccine-a-case-report
#9
Pierre Tawfik, Elie Gertner, Charlene E McEvoy
BACKGROUND: The United States Advisory Committee on Immunization Practices recommends administration of the 13-valent pneumococcal conjugate vaccine in series with the 23-valent pneumococcal polysaccharide vaccine for prevention of pneumonia in the elderly. Reports of autoimmune or auto-inflammatory diseases as a result of pneumococcal vaccination, especially pneumococcal conjugate vaccine, are extremely rare. CASE PRESENTATION: We present a case of severe serositis in a 75-year-old Caucasian woman complicated by pericardial and pleural effusions in the setting of recent 13-valent pneumococcal conjugate vaccine vaccination and no other obvious etiology...
May 20, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28523130/the-development-of-uniportal-video-assisted-thoracoscopic-surgery-in-s%C3%A3-o-paulo-from-diagnosis-to-lobectomy
#10
Alexandre de Oliveira, Thais Amarante P P Couto
BACKGROUND: The use of uniportal video-assisted thoracoscopic surgery (VATS) has been increasing worldwide. Our main goal was to describe the evolution of uniportal surgery in the biggest private hospital in Latin America that is located in São Paulo, Brazil. METHODS: This descriptive and retrospective study included patients who underwent uniportal VATS in the thoracic surgical department of Beneficencia Portuguesa Hospital, after being referred to our team to undergo the aforementioned procedure within the period from February 2012 to March 2016...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28507831/streptococcus%C3%A2-gordonii%C3%A2-empyema-a-case-report-and-review-of-empyema
#11
Amanda M Krantz, Felicia Ratnaraj, Manasa Velagapudi, Mridula Krishnan, Nagarjuna R Gujjula, Pamela A Foral, Laurel Preheim
Streptococcus gordonii (S. gordonii) is a pioneer oral bacteria that is recognized as an agent of bacterial endocarditis. However, an extensive review of the literature revealed no reported case of S. gordonii causing empyema. We present a case of a 65-year-old male who presented with respiratory distress. Physical examination revealed several dental caries with decreased breath sounds in the bibasilar regions. A computed tomography (CT) scan of the chest and abdomen demonstrated left-sided pleural effusion and a 4...
April 12, 2017: Curēus
https://www.readbyqxmd.com/read/28507797/il15-induces-a-potent-antitumor-activity-in-nk-cells-isolated-from-malignant-pleural-effusions-and-overcomes-the-inhibitory-effect-of-pleural-fluid
#12
D Croxatto, S Martini, L Chiossone, F Scordamaglia, C F Simonassi, L Moretta, M C Mingari, P Vacca
Natural Killer (NK) cells are capable of recognizing and killing cancer cells and play an important role in tumor immunosurveillance. However, tumor-infiltrating NK cells are frequently impaired in their functional capability. A remarkable exception is represented by NK cells isolated from malignant pleural effusions (PE) that are not anergic and, upon IL2-induced activation, efficiently kill tumor cells. Although IL2 is used in various clinical trials, severe side effects may occur in treated patients. In this study, we investigated whether also other clinical-grade cytokines could induce strong cytotoxicity in NK cells isolated from pleural fluid of patients with primary or metastatic tumors of different origins...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28497416/internal-medicine-point-of-care-ultrasound-curriculum-consensus-recommendations-from-the-canadian-internal-medicine-ultrasound-cimus-group
#13
Irene W Y Ma, Shane Arishenkoff, Jeffrey Wiseman, Janeve Desy, Jonathan Ailon, Leslie Martin, Mirek Otremba, Samantha Halman, Patrick Willemot, Marcus Blouw
Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs...
May 11, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28489618/core-competencies-or-a-competent-core-a-scoping-review-and-realist-synthesis-of-invasive-bedside-procedural-skills-training-in-internal-medicine
#14
Ryan Brydges, Lynfa Stroud, Brian M Wong, Eric S Holmboe, Kevin Imrie, Rose Hatala
PURPOSE: Invasive bedside procedures are core competencies for internal medicine, yet no formal training guidelines exist. The authors conducted a scoping review and realist synthesis to characterize current training for lumbar puncture, arthrocentesis, paracentesis, thoracentesis, and central venous catheterization. They aimed to collate how educators justify using specific interventions, establish which interventions have the best evidence, and offer directions for future research and training...
May 9, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28483134/a-woman-in-her-30s-with-a-history-of-cervical-cancer-presents-with-shortness-of%C3%A2-breath-and-pleuritic-chest-pain
#15
Jing Gennie Wang, Patrick Gerard Cox
A woman in her 30s presented to the ED with a 3-month history of shortness of breath on exertion, dry cough, and pleuritic chest pain. A month ago, the patient was seen at an internal medicine clinic and was found to have a right pleural effusion. A thoracentesis revealed straw-colored fluid, a total nucleated cell count of 1,260 × 10(6)/L, and a differential with neutrophils of 0.15, lymphocytes of 0.55, macrophages/monocytes of 0.19, and eosinophils of 0.10. Fluid cytology and culture were negative. The patient was presumed to have a parapneumonic effusion and treated empirically with antibiotics...
May 2017: Chest
https://www.readbyqxmd.com/read/28474458/accuracy-of-complement-activation-product-levels-to-detect-infected-pleural-effusion-in-rats
#16
Guilherme E Peterson, Samanta S Silva, Sérgio L Amantéa, Patrícia Miorelli, Paulo Sanches, Jane Kulczynski, Eliane Roesch, José Carlos Fraga
BACKGROUND: Pleural empyema is a well-known complication of pneumonia. If treatment is delayed, empyema may increase morbidity and mortality in affected patients. Therefore, the identification of empyema biomarkers in parapneumonic pleural effusion is desirable. Previous research has suggested complement activation products as candidate empyema markers. OBJECTIVE: To compare the levels of complement activation products C3a, C5a, and C5b9 in pleural effusion induced by Staphylococcus aureus (SA), Streptococcus pneumoniae (SP), or turpentine (control)...
June 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28463475/echocardiographic-features-of-giant-right-atrial-diverticulum-in-a-dog
#17
S Park, M D Kittleson, D Yu, J Choi
A 12-year-old spayed female miniature Poodle presented for coughing, respiratory distress, and anorexia. After thoracentesis for pleural effusion, radiography revealed an enlarged cardiac silhouette with a bulge in the area of the body of the right atrium. Echocardiography revealed an anechoic chamber-like cavity lateral to the right atrium that communicated with the right atrium through a 13 mm defect in the right atrial free wall. Contrast echocardiography and color flow Doppler were used to prove that the cavity communicated with the right atrium...
May 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28448010/murine-left-anterior-descending-lad-coronary-artery-ligation-an-improved-and-simplified-model-for-myocardial-infarction
#18
Karla Reichert, Bonnie Colantuono, Isabella McCormack, Fernanda Rodrigues, Vasile Pavlov, M Ruhul Abid
Ischemic heart disease (IHD), or acute coronary syndrome (ACS), is one of the leading causes of death in the United States. IHD is characterized by reduced blood supply to the heart, resulting in the loss of oxygen to and the ensuing necrosis of the heart muscle. The MI model has gained popularity for its use as a short-term ischemia-reperfusion model and a long-term permanent ligation model. Below, we describe a reliable method for the permanent ligation of the LAD. With mouse genetic engineering technology becoming more advanced, and with an increasing availability of quality murine surgical instruments, the mouse has become a popular model for MI surgeries...
April 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28441375/primary-adrenal-angiosarcoma-a-rare-and-potentially-misdiagnosed-tumor
#19
Ariel Grajales-Cruz, Francis Baco-Viera, Ernesto Rive-Mora, Carlos Ramirez-Tanchez, David Tasso, Norma Arroyo-Portela, Elizabeth Calderon, Ilean Joan Padua-Octaviani, William Caceres-Perkins
A man aged 69 years presented with acute right flank pain secondary to a hemorrhagic large adrenal tumor. En bloc resection was performed to repair the inferior vena cava. Immunoperoxidase levels in the tumor were positive for factor VIII and CD31 and negative for S100, protein Melan-A, CD34, synaptophysin, chromogranin, desmin, muscle specific actin, ETFA (EMA), KRT20 (CK20), CDX2, TTF1, LNPEP (PLAP), inhibin, ?-fetoprotein, CD30, hepatocyte paraffin, and aberrant expression of cytokeratin 7 and pankeratin...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28440918/uremic-pleuritis-a-case-report-and-review-of-recurrent-exudative-pleural-effusions-in-children
#20
Matthew D McGraw, Csaba Galambos, Paul C Stillwell
Despite similar mechanisms driving pleural fluid accumulation, the causes of pleural effusions in children differ significantly from that of adults. When a pleural effusion re-occurs in an adult, literature recommends early thoracentesis, and consideration for pleuroscopy with biopsy to guide the diagnostic evaluation. In children, there is a paucity of literature for guiding management of recurrent exudative pleural effusion. We present an unusual pediatric case of uremic pleuritis with recurrent pericardial and exudative pleural effusions...
April 25, 2017: Pediatric Pulmonology
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