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https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#1
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29282107/thoracic-ultrasound-for-pleural-effusion-in-the-intensive-care-unit-a-narrative-review-from-diagnosis-to-treatment
#2
REVIEW
E Brogi, L Gargani, E Bignami, F Barbariol, A Marra, F Forfori, L Vetrugno
Pleural effusion (PLEFF), mostly caused by volume overload, congestive heart failure, and pleuropulmonary infection, is a common condition in critical care patients. Thoracic ultrasound (TUS) helps clinicians not only to visualize pleural effusion, but also to distinguish between the different types. Furthermore, TUS is essential during thoracentesis and chest tube drainage as it increases safety and decreases life-threatening complications. It is crucial not only during needle or tube drainage insertion, but also to monitor the volume of the drained PLEFF...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29280335/amyloidosis-diagnosed-in-cytology-specimen-of-pleural-effusion-a-case-report
#3
Rashmi Manur, Ihab Lamzabi
Amyloidosis is a rare condition resulting from extracellular deposition of amyloid, a fibrillary material derived from various precursor proteins. Involvement of the pleura by amyloidosis is a rare but serious complication. Pleural amyloidosis is primarily diagnosed by identifying amyloid deposition by histology on pleural biopsy specimens. Hereby, we report a case of systemic amyloidosis where we were able to identify amyloid in a pleural effusion specimen sent for cytopathology evaluation. A 59-year-old male with newly diagnosed multiple myeloma and systemic amyloidosis underwent therapeutic thoracentesis...
December 27, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29276672/combined-pleuroscopy-and-endobronchial-ultrasound-for-diagnosis-and-staging-of-suspected-lung-cancer
#4
Macarena R Vial, George A Eapen, Roberto F Casal, Mona G Sarkiss, David E Ost, Erik Vakil, Horiana B Grosu
The standard approach to staging of lung cancer in patients with pleural effusion (clinical M1a) is thoracentesis followed by pleural biopsies if the cytologic analysis is negative. If pleural biopsy findings are negative, endobronchial ultrasound-guided transbronchial needle aspiration is used to complete the staging process and, in some cases, obtain diagnosis. In this case series we report 7 patients in which a combined procedure was performed for staging of known or suspected lung cancer. We found that the combined approach was both feasible and safe in this case series...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29229484/prenatal-growth-characteristics-and-pre-postnatal-management-of-bronchopulmonary-sequestrations
#5
John S Riley, John W Urwin, Edward R Oliver, Beverly G Coleman, Nahla Khalek, Julie S Moldenhauer, Susan S Spinner, Holly L Hedrick, N Scott Adzick, William H Peranteau
PURPOSE: The prenatal natural history of intralobar and extralobar bronchopulmonary sequestrations (BPSs), including lesion growth patterns and need for prenatal intervention, have not been fully characterized. We review our series of BPSs to determine their natural history and outcomes in the context of the need for prenatal intervention. METHODS: A retrospective review of the pre/postnatal course of 103 fetuses with an intralobar (n=44) or extralobar BPS (n=59) managed at a single institution between 2008 and 2015 was performed...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29229117/outcomes-of-fetuses-with-primary-hydrothorax-that-undergo-prenatal-intervention-prenatal-intervention-for-hydrothorax
#6
Rodrigo A Mon, Marjorie C Treadwell, Deborah R Berman, Lori Day, Jeannie Kreutzman, George B Mychaliska, Erin E Perrone
BACKGROUND: Primary hydrothorax is a congenital anomaly affecting 1 in 10,000-15,000 pregnancies. The natural history of this condition is variable with some fetuses having spontaneous resolution and others showing progression. The associated pulmonary hypoplasia leads to increased perinatal morbidity and mortality. Optimal prenatal intervention remains controversial. METHODS: After obtaining the Institutional Review Board approval, a retrospective review of all patients evaluated for a fetal pleural effusion in the Fetal Diagnosis and Treatment Center at The University of Michigan, between 2006 and 2016 was performed...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29221292/a-comparative-study-of-conventional-cytology-and-cell-block-method-in-the-diagnosis-of-pleural-effusion
#7
Theerada Assawasaksakul, Viboon Boonsarngsuk, Pimpin Incharoen
Background: In a patient with pleural effusion, cytological study (CS) is one of the most useful investigations, especially when malignancy is suspected. Instead of applying only CS, the pleural fluid can be further processed using the cell block (CB) technique, which may augment the diagnostic utility. The aim of this study was to compare the diagnostic yields of CS, CB, and the combination of both, regardless of the etiology of pleural effusion. Methods: A cross-sectional study was conducted on patients with pleural effusions who underwent thoracentesis from June 2015 to May 2016...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218743/repeatability-of-pleural-adenosine-deaminase-measurements-in-diagnostic-evaluation-of-pleural-effusions
#8
Ourania S Kotsiou, Panagiota Tzortzi, Rafailia A A Beta, Athanasios Kyritsis, Konstantinos I Gourgoulianis
BACKGROUND: A follow-up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural ADA values across repeated thoracenteses in different types of pleural effusions (PEs) and to evaluate whether ADA variance, in regard to the cutoff value of 40 U/L, affected final diagnosis. METHODS: A total of 131 patients with PEs of various etiologies underwent three repeated thoracenteses. ADA values were subsequently estimated...
December 7, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29204338/giant-left-atrium-encountered-during-right-sided-thoracentesis
#9
Rashmi Advani, Benjamin T Galen
Giant left atrium is an uncommon pathology to encounter during bedside chest ultrasound, but is an important structure to be aware of when considering thoracentesis. This cardiac structure could easily be mistaken for loculated pleural fluid. This case also supports growing evidence that expert users can safely perform thoracentesis without completely reversing therapeutic anticoagulation.
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29197468/characteristics-of-patients-with-myelomatous-pleural-effusion-a-systematic-review
#10
V Riveiro, L Ferreiro, M E Toubes, A Lama, J M Álvarez-Dobaño, L Valdés
BACKGROUND: Myelomatous pleural effusion (MPE) is rare in multiple myeloma, and therefore its characteristics are not well defined. METHODS: A systematic review (4 online databases) was conducted of articles describing the clinical characteristics of patients with MPE, pleural effusion's biochemical characteristics and treatment efficacy. We analysed isolated cases and small retrospective series. RESULTS: We included 98 articles with a total of 153 patients with MPE...
November 29, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29187476/a-case-of-the-resected-lymphohistiocytoid-mesothelioma-bap1-is-a-key-of-accurate-diagnosis
#11
Taichi Matsubara, Gouji Toyokawa, Yuichi Yamada, Kazuki Nabeshima, Naoki Haratake, Yuka Kozuma, Takaki Akamine, Shinkichi Takamori, Fumihiro Shoji, Tatsuro Okamoto, Yoshihiko Maehara
BACKGROUND: Malignant mesothelioma (MM) is a well-known malignant tumor that occurs in the pleura and is histopathologically classified into three subtypes. Lymphohistiocytoid mesothelioma (LHM) is considered a variant of epithelioid MM, and few cases have been reported. First case of LHM was reported by Henderson et al. in 1988. It is difficult to precisely diagnose LHM, and it is often misdiagnosed as reactive mesothelial cell proliferation. CASE REPORT: An 82-year-old man, with the smoking history of nine pack-years, was referred to our Department due to an abnormal shadow and pleural effusion in the left lung field on the chest X-ray imaging...
December 2017: Anticancer Research
https://www.readbyqxmd.com/read/29169646/development-of-an-intelligent-surgical-training-system-for-thoracentesis
#12
Hirenkumar Nakawala, Giancarlo Ferrigno, Elena De Momi
Surgical training improves patient care, helps to reduce surgical risks, increases surgeon's confidence, and thus enhances overall patient safety. Current surgical training systems are more focused on developing technical skills, e.g. dexterity, of the surgeons while lacking the aspects of context-awareness and intra-operative real-time guidance. Context-aware intelligent training systems interpret the current surgical situation and help surgeons to train on surgical tasks. As a prototypical scenario, we chose Thoracentesis procedure in this work...
November 20, 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29157740/unplanned-readmissions-after-open-thoracoabdominal-aortic-aneurysm-repair
#13
Darrell Wu, Matt D Price, Hiruni S Amarasekara, Susan Y Green, Sandra J Woodside, Adam Tullos, Qianzi Zhang, Joseph S Coselli, Scott A LeMaire
BACKGROUND: Although reducing the incidence of unplanned readmission after thoracoabdominal aortic aneurysm (TAAA) repair represents an important opportunity to improve outcomes, predictors of readmissions are not known. We sought to characterize and identify factors associated with unplanned readmission after discharge in survivors of open TAAA repair. METHODS: Through prospective phone contact and retrospective record review, we determined the frequency and characteristics of unplanned readmissions within 30 days of discharge in 363 patients who were discharged after open TAAA repair...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29131120/a-prospective-study-to-evaluate-a-diagnostic-algorithm-for-the-use-of-fluid-lymphocyte-subset-analysis-in-undiagnosed-unilateral-pleural-effusions
#14
Giles Dixon, Rahul Bhatnagar, Natalie Zahan-Evans, Amelia O Clive, Paul F Virgo, Mary T Brett, Sophie H Otton, Andrew R L Medford, Nick A Maskell
BACKGROUND: Haematological malignancy is an important cause of pleural effusion. Pleural effusions secondary to haematological malignancy are usually lymphocyte predominant. However, several other conditions such as carcinoma, tuberculosis, and chronic heart failure also cause lymphocytic effusions. Lymphocyte subset (LS) analysis may be a useful test to identify haematological malignancy in patients with lymphocytic effusions. However, research into their utility in pleural effusion diagnostic algorithms has not yet been published...
November 10, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29125270/alternative-incision-sutureless-aortic-valve-replacement-propensity-matched-comparison-between-partial-sternotomy-and-right-anterior-minithoracotomy
#15
Daniyar Gilmanov, Marco Solinas, Giuseppe Santarpino, Pier A Farneti, Michele Murzi, Theodor Fischlein, Steffen Pfeiffer
BACKGROUND: Sutureless aortic valve prostheses have the potential to augment the adoption of alternative incision approaches for aortic valve replacement (AVR). Still, we lack the evidence on which surgical approach is best associated with sutureless AVR. METHODS: Data on 483 patients undergoing sutureless small incision AVR between 2010-2014 in two European institutions (207 with partial sternotomy (MS) and 276 via right anterior minithoracotomy (RAMT)) have been retrospectively analyzed...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29115028/thoracentesis-in-advanced-cancer-patients-with-severe-thrombocytopenia-ultrasound-guide-improves-safety-and-reduces-bleeding-risk
#16
Elena Orlandi, Chiara Citterio, Pietro Seghini, Camilla Di Nunzio, Patrizia Mordenti, Luigi Cavanna
BACKGROUND: Patients with severe thrombocytopenia are considered at risk for bleeding during invasive procedures like thoracentesis. The use of ultrasound (US) significantly reduces the rate of pneumothorax from thoracentesis, but there is a lack of data on safety and efficacy of US guidance in reducing bleeding complications in thoracentesis performed on patients with severe thrombocytopenia. METHODS: We retrospectively analyzed the efficacy and safety of thoracentesis in cancer patients with severe thrombocytopenia...
November 8, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29068818/simulation-based-mastery-learning-for-thoracentesis-skills-improves-patient-outcomes-a-randomized-trial
#17
Jeffrey H Barsuk, Elaine R Cohen, Mark V Williams, Jordan Scher, Sasha F Jones, Joe Feinglass, William C McGaghie, Kelly O'Hara, Diane B Wayne
PURPOSE: Physicians-in-training often perform bedside thoracenteses in academic medical centers, and complications are more common among less experienced clinicians. Simulation-based mastery learning (SBML) is one potential solution to this problem. This study evaluated the effects of a randomized trial of thoracentesis SBML on patient complications: iatrogenic pneumothorax (IP), hemothorax, and reexpansion pulmonary edema (REPE). METHOD: The authors randomized internal medicine residents to undergo thoracentesis SBML at a tertiary care academic center from December 2012 to May 2016...
October 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29063807/unilateral-pleural-effusion-as-the-sole-clinical-presentation-of-severe-ovarian-hyperstimulation-syndrome-a-systematic-review
#18
Mohamad Irani, Alex Robles, Vinay Gunnala, Pak Chung, Zev Rosenwaks
The pathophysiology of isolated pleural effusion in ovarian hyperstimulation syndrome (OHSS) is not well defined. The objective of the current review is to delineate the pathophysiology, risk factors, preventive measures, and therapeutic options of isolated pleural effusion in severe OHSS. Major databases were searched until June 2016. Studies evaluating women who presented with pleural effusion as the sole extra-ovarian manifestation of severe OHSS were included. Data were extracted from 24 articles encompassing 30 reported cases...
October 24, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29059269/the-practice-and-implications-of-finding-fluid-during-point-of-care-ultrasonography-a-review
#19
REVIEW
Rachel B Liu, Joseph H Donroe, Robert L McNamara, Howard P Forman, Chris L Moore
Importance: Point-of-care ultrasonography (POCUS) is an increasingly affordable and portable technology that is an important part of 21st-century medicine. When appropriately used, POCUS has the potential to expedite diagnosis and improve procedural success and safety. POCUS is now being adopted in medical education as early as the first year of medical school. While potentially powerful and versatile, POCUS is a user-dependent technology that has not been formalized or standardized yet within internal medicine residency training programs...
December 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29049780/video-assisted-thoracic-surgery-is-associated-with-better-short-term-outcomes-than-open-thoracotomy-in-adult-patients-with-intralobar-pulmonary-sequestration
#20
Qiuyuan Li, Dong Xie, Alan Sihoe, Jie Dai, Haifeng Wang, Diego Gonzalez-Rivas, Yuming Zhu, Gening Jiang
OBJECTIVES: This study was aimed to investigate potential benefits of thoracoscopic surgery for intralobar pulmonary sequestration in adult patients in terms of short-term surgical outcomes when compared with open surgery. METHODS: Data of 110 consecutive adult patients undergoing thoracoscopic surgery or open surgery for intralobar sequestration from January 2000 to December 2015 at our institution were reviewed. A total of 42 video-assisted thoracic surgery cases and 68 open surgery cases were identified...
September 26, 2017: Interactive Cardiovascular and Thoracic Surgery
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