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Thoracentesis

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https://www.readbyqxmd.com/read/28426468/indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax
#1
Kevin P Haas, Alexander C Chen
PURPOSE OF REVIEW: Hepatic hydrothorax is a complication of end-stage liver disease that may have significant associated morbidity. Sodium restriction and diuretic therapy are the mainstays of treatment, though up to a quarter of patients will become refractory to this and will require a pleural drainage procedure. Thoracentesis, transjugular intrahepatic portosystemic shunt, and chemical pleurodesis all have variable success rates and associated complications in the management of hepatic hydrothorax...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28411293/safe-and-effective-bedside-thoracentesis-a-review-of-the-evidence-for-practicing-clinicians
#2
REVIEW
Richard Schildhouse, Andrew Lai, Jeffrey H Barsuk, Michelle Mourad, Vineet Chopra
BACKGROUND: Physicians often care for patients with pleural effusion, a condition that requires thoracentesis for evaluation and treatment. We aim to identify the most recent advances related to safe and effective performance of thoracentesis. METHODS: We performed a narrative review with a systematic search of the literature. Two authors independently reviewed search results and selected studies based on relevance to thoracentesis; disagreements were resolved by consensus...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28392947/nuclear-imaging-to-detect-diaphragmatic-perforation-as-a-rare-complication-of-microwave-ablation
#3
Stephanie Cull, Gebran Khneizer, Abhishek Krishna, Razi Muzaffar, Sameer Gadani, Zafar Jamkhana
Acquired diaphragmatic perforation leading to massive hepatic hydrothorax and respiratory failure is a rare complication of microwave ablation (MWA) of hepatocellular carcinoma (HCC). Imaging modalities to detect pleuroperitoneal communication remain poorly described. We report a nuclear imaging technique used to efficiently diagnose and locate diaphragmatic defects. A 57-year-old male with cirrhosis and HCC presented with respiratory distress after undergoing MWA of a HCC lesion. He was admitted to the intensive care unit for noninvasive positive pressure ventilator support...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28383303/early-hospital-readmissions-and-mortality-in-patients-with-decompensated-cirrhosis-enrolled-in-a-large-national-health-insurance-administrative-database
#4
Steven J Scaglione, Leanne Metcalfe, Stephanie Kliethermes, Ivan Vasilyev, Rebecca Tsang, Allyce Caines, Shaham Mumtaz, Vik Goyal, Asra Khalid, David Shoham, Talar Markossian, Amy Luke, Howard Underwood, Scott J Cotler
BACKGROUND: Patients with decompensated cirrhosis have high rates of morbidity and mortality and frequently require hospital admission. Few studies have examined early readmission as an indicator of 90 day and overall mortality. Analysis of large databases is needed to evaluate the association between early readmission and mortality in decompensated cirrhosis. METHODS: We analyzed 5 years of private, employer-based, health insurance claims data associated with HealthCare Services Corporation on 13...
April 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28370693/computed-tomography-scoring-system-for-discriminating-between-parapneumonic-effusions-eventually-drained-and-those-cured-only-with-antibiotics
#5
José M Porcel, Marina Pardina, Carmen Alemán, Esther Pallisa, Richard W Light, Silvia Bielsa
BACKGROUND AND OBJECTIVE: Due to limited data, we aimed to develop and validate a computed tomography (CT)-based scoring system for identifying those parapneumonic effusions (PPEs) requiring drainage. METHODS: A retrospective review of all patients with PPE who underwent thoracentesis and a chest CT scan before any attempt to place a tube thoracostomy, if applicable, over an 8-year period was conducted. Eleven chest CT characteristics were compared between 90 patients with complicated PPEs (CPPEs), defined as those which eventually required chest drainage, and 60 with non-complicated effusions (derivation sample)...
March 30, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28370388/quality-of-widely-available-video-instructional-materials-for-point-of-care-ultrasound-guided-procedure-training-in-internal-medicine
#6
Aditi Khandelwal, Luke A Devine, Mirek Otremba
OBJECTIVES: Many instructional materials for point-of-care ultrasound (US)-guided procedures exist; however, their quality is unknown. This study assessed widely available educational videos for point-of-care US-guided procedures relevant to internal medicine: central venous catheterization, thoracentesis, and paracentesis. METHODS: We searched Ovid MEDLINE, YouTube, and Google to identify videos for point-of-care US-guided paracentesis, thoracentesis, and central venous catheterization...
April 3, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28367295/development-of-pulmonary-air-leak-in-an-extremely-low-birth-weight-infant-without-mechanical-ventilation-a-case-report
#7
Eun Mi Kim, Ji Yeon Kim
A 34-year-old woman at 25 weeks 3 days was diagnosed with preterm labor and underwent an emergency cesarean section. The neonate did not cry or show any activity. The heart rate was 80 beats/min and the oxygen saturation on pulse oximetry (SpO2) was 77%. Immediately, positive pressure ventilation was delivered by T piece resuscitator, and then anesthesiologist performed endotracheal intubation. The neonate demonstrated severe cyanosis and the SpO2 dropped to 30%. Ventilation was not successful even after intubation, and we found neck crepitus, chest wall distension, and severe cyanosis on physical examination...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28350729/real-time-ultrasound-guided-thoracentesis
#8
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/28346035/one-needle-is-better-than-two-the-philosophy-surrounding-use-of-local-anesthesia-in-northern-india
#9
Maria Story
The author, an internal medicine resident in the United States, participated in an international elective through her postgraduate training program in a rural hospital in northern India. While performing a thoracentesis, she notes that local anesthesia has not been administered, which is seemingly the standard of care at this hospital. Several questionnaire studies about pain services and pain management in India are reviewed, and they reveal insights and severe limitations to effective management of hospitalized patients' pain...
March 27, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#10
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28245530/positive-pleural-cytology-is-an-indicator-for-visceral-pleural-invasion-in-metastatic-pleural-effusions
#11
Marios E Froudarakis, Jerôme Plojoux, Elise Kaspi, Stavros Anevlavis, Sophie Laroumagne, Georgia Karpathiou, Elisa Roca, Daniel Adler, Hervé Dutau, Philippe Astoul
INTRODUCTION: In case of undiagnosed pleural effusions, it is necessary to conduct thoracentesis with pleural fluid (PF) cytology. Yet, sensitivity of PF cytology is widely variable as a result of sample size, experience and preparation method. OBJECTIVES: The aim of this study was to assess whether pleural fluid (PF) cytology is correlated to visceral or parietal pleural invasion as assessed by thoracoscopy in metastatic pleural effusions. METHODS: All records of patients with pleural effusion were reviewed...
February 28, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28230045/the-single-chest-tube-versus-double-chest-tube-application-after-pulmonary-lobectomy-a-systematic-review-and-meta-analysis
#12
REVIEW
Xuefei Zhang, Desheng Lv, Mo Li, Ge Sun, Changhong Liu
OBJECTIVE: Draining of the chest cavity with two chest tubes after pulmonary lobectomy is a common practice. The objective of this study was to evaluate whether using two tubes after a pulmonary lobectomy is more effective than using a single tube. PATIENTS AND METHODS: We performed a meta-analysis of five randomized studies that compared the single chest tube with double chest tube application after pulmonary lobectomy. The primary end-point was amount of drainage and duration of chest tube drainage...
December 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28182812/management-and-outcomes-of-fetal-hydrops-in-a-tertiary-care-centre-in-singapore
#13
Xin Yi Thong, Le Ye Lee, Dawn Ak Chia, Yee Chee Wong, Arijit Biswas
Introduction: Fetal hydrops is a serious condition which can be caused by immune and non-immune aetiologies. We aimed to review the management of fetal hydrops at our hospital. Materials and Methods: A retrospective review of all cases of fetal hydrops diagnosed in our institution from 2006 to 2013 was carried out. Results: Out of the 30 cases of fetal hydrops diagnosed antenatally, 17 were cases of Bart's hydrops which were all terminated in-utero. Of the remaining 13 cases, 11 cases consisted of non-immune causes of hydrops...
January 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28130709/mortality-following-catheter-drainage-versus-thoracentesis-in-cirrhotic-patients-with-pleural-effusion
#14
Tsung-Hsing Hung, Chih-Wei Tseng, Chen-Chi Tsai, Yu-Hsi Hsieh, Kuo-Chih Tseng, Chih-Chun Tsai
BACKGROUND: Pleural effusion is an abnormal collection of body fluids that may cause related morbidity or mortality in cirrhotic patients. There are insufficient data to determine the optimal method of drainage, for symptomatic relief in cirrhotic patients with pleural effusion. AIMS: In this study, we compare the mortality outcomes of catheter drainage versus thoracentesis in cirrhotic patients. METHODS: The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify cirrhotic patients with pleural effusion requiring drainage between January 1, 2007, and December 31, 2010...
January 27, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28129318/initial-experience-with-minimally-invasive-surgical-exclusion-of-the-left-atrial-appendage-with-an-epicardial-clip
#15
Nathan E Smith, Jeevan Joseph, John Morgan, Saqib Masroor
OBJECTIVE: Atrial fibrillation (AF) is the primary cardiac abnormality associated with ischemic stroke. Atrial fibrillation affects 2.7 million people with a stroke rate of 3.5% per year. Most of the emboli in patients with nonvalvular AF originate in the left atrial appendage (LAA). Surgical exclusion of the LAA decreases the yearly risk of stroke to 0.7% when combined with a Maze procedure. Traditional oversewing the LAA from inside the left atrium is associated with a significant number of recanalizations of LAA...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28105155/efficacy-of-ultrasound-guided-thoracentesis-catheter-drainage-for-pleural-effusion
#16
Weitian Cao, Yi Wang, Ningming Zhou, Bing Xu
The factors influencing the efficacy of ultrasound-guided thoracentesis catheter drainage were investigated in the present study. A retrospective analysis of clinical data from 435 patients who presented with a pleural effusion was performed. Patients were divided into a control group and an intervention group. Thirty-seven patients in the control group were given standard care using pleural puncture to draw the excess fluid. The 398 patients in the intervention group were treated using ultrasound-guided thoracentesis catheter drainage...
December 2016: Oncology Letters
https://www.readbyqxmd.com/read/28102968/thoracic-ultrasound-recognition-of-competence-a-position-paper-of-the-thoracic-society-of-australia-and-new-zealand
#17
Jonathan P Williamson, Scott H Twaddell, Y C Gary Lee, Matthew Salamonsen, Mark Hew, David Fielding, Phan Nguyen, Daniel Steinfort, Peter Hopkins, Nicola Smith, Christopher Grainge
The ability to perform bedside thoracic ultrasound is increasingly recognized as an essential skill for thoracic clinicians, extending the clinical examination and aiding diagnostic and therapeutic procedures. Thoracic ultrasound reduces complications and increases success rates when used prior to thoracentesis or intercostal chest tube insertion. It is increasingly difficult to defend performing these procedures without real or near-real time image guidance. To assist thoracic physicians and others achieve and demonstrate thoracic ultrasound competence, the Interventional Pulmonology Special Interest Group (IP-SIG) of the Thoracic Society of Australia and New Zealand (TSANZ) has developed a new pathway with four components: (i) completion of an approved thoracic ultrasound theory and hands-on teaching course...
February 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28102814/successful-induction-of-peritoneal-dialysis-in%C3%A2-a%C3%A2-patient-with-massive-hydrothorax-due-to%C3%A2-pleuroperitoneal-communication%C3%A2
#18
Takahiro Uchida, Yuji Yamada, Toshihiko Imakiire, Naoki Oshima, Hiroo Kumagai
A 74-year-old woman with liver cirrhosis and chronic kidney disease (CKD) who had complained of chronic abdominal distension due to prominent ascites presented with sudden dyspnea. Chest radiography showed massive right pleural effusion that shifted the mediastinum. Peritoneal scintigraphy using <sup>99</sup>mTc-macroaggregated albumin revealed pleuroperitoneal communication (PPC). As her hydrothorax was refractory and frequent thoracentesis did not improve her respiratory distress, thoracoscopic surgery was performed for repair of the diaphragm defect...
April 2017: Clinical Nephrology
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
#19
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
#20
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
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