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Thoracentesis

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
October 23, 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
#7
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
https://www.readbyqxmd.com/read/29030781/clinical-and-imaging-features-in-lung-torsion-and-description-of-a-novel-imaging-sign
#8
Mark M Hammer, Rachna Madan
PURPOSE: We set out to identify the clinical and imaging features seen in lung torsion, a rare but emergent diagnosis leading to vascular compromise of a lobe or entire lung. METHODS: We retrospectively identified 10 patients with torsion who underwent chest CT. We evaluated each case for the presence of bronchial obstruction and abnormal fissure orientation. In seven patients who underwent contrast-enhanced CTs, we assessed for the presence of the antler sign, a novel sign seen on axial images demonstrating abnormal curvature of the artery and branches originating on one side...
October 13, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29021516/human-herpesvirus-8-unrelated-primary-effusion-lymphoma-like-lymphoma-following-tyrosine-kinase-inhibitor-treatment-for-chronic-myelogenous-leukemia
#9
Minoru Kojima, Naoya Nakamura, Jun Amaki, Hiroki Numata, Masashi Miyaoka, Tadashi Motoori, Koshi Matsumoto, Kiyoshi Ando
A 69-year-old man was diagnosed with chronic myelogenous leukemia (CML) and treated with dasatinib. After two years on dasatinib, the patient achieved complete molecular response, but dasatinib treatment was discontinued due to exacerbation of pleural effusion. Nilotinib and imatinib were started but stopped due to an increase in pleural effusion. Thoracentesis was performed and he was diagnosed with human herpesvirus 8-unrelated primary effusion lymphoma (PEL)-like lymphoma. Complex chromosomal abnormality, including BCL6 rearrangement, was found on chromosome analysis...
2017: Journal of Clinical and Experimental Hematopathology: JCEH
https://www.readbyqxmd.com/read/28994887/hepatic-hydrothorax-about-a-hospital-serie-of-63-cases
#10
Leila Mouelhi, Oussama Daboussi, Nadia Cheffi, Kaouther El Jery, Yosra Said, Sana Khedher, Mohamed Salem, Radhouane Dabbèche, Fatma Houissa, Taoufik Najjar
BACKGROUND: Hepatic hydrothorax is a less common complication of cirrhosis with an estimated prevalence of 10- 15%. In the vast majority of cases, ascites are also present but significant pleural effusion may develop in patients without ascites. Hepatic hydrothorax is associated with cirrhosis whatever its etiology. The prognosis of hepatic hydrothorax remains unclear and is closely related to available therapeutic options. The aim of our study is to determine the prevalence of hydrothorax in cirrhotic patients, detail its clinical and therapeutic characteristics, and study the evolutive profile of cirrhotic patients with hydrothorax by comparing it to those without hydrothorax...
December 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28991950/hospital-privileging-practices-for-bedside-procedures-a-survey-of-hospitalist-experts
#11
Trevor P Jensen, Nilam J Soni, David M Tierney, Brian P Lucas
Many hospitalists are routinely granted hospital privileges to perform invasive bedside procedures, but criteria for privileging are not well described. We conducted a survey of 21 hospitalist procedure experts from the Society of Hospital Medicine Point-of-Care Ultrasound Task Force to better understand current privileging practices for bedside procedures and how those practices are perceived. Only half of all experts reported their hospitals require a minimum number of procedures performed to grant initial (48%) and ongoing (52%) privileges for bedside procedures...
October 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28991771/surgical-treatment-of-pleural-empyema-our-results
#12
Goran Kondov, Zoran Spirovski, Irena Kondova-Topuzovska, Anita Kokareva, Risto Colanceski, M Srceva, Borislav Kondov, I Dzikovski, N Toleska-Dimitrovska, Sanja Petrusevska-Marinkovic
Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce morbidity, mortality and duration of hospital stay. Unfortunately, advanced stages of empyema need to use extensive surgery - decortications or thoracoplasty. Early recognition of the parapneumonic effusion and the adequate treatment with thoracentesis or pleural drainage, which is minimally invasive, is possible not to prograde the process and not to become empyema. AIM: To analyze the results of the surgical treatment in patients with empyema treated at Clinic for thoracic surgery...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28983677/reduced-dose-c-arm-computed-tomography-applications-at-a-pediatric-institution
#13
Michael Acord, Sphoorti Shellikeri, Seth Vatsky, Abhay Srinivasan, Ganesh Krishnamurthy, Marc S Keller, Anne Marie Cahill
BACKGROUND: Reduced-dose C-arm computed tomography (CT) uses flat-panel detectors to acquire real-time 3-D images in the interventional radiology suite to assist with anatomical localization and procedure planning. OBJECTIVE: To describe dose-reduction techniques for C-arm CT at a pediatric institution and to provide guidance for implementation. MATERIALS AND METHODS: We conducted a 5-year retrospective study on procedures using an institution-specific reduced-dose protocol: 5 or 8 s Dyna Rotation, 248/396 projection images/acquisition and 0...
December 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28965174/lactate-determination-in-pleural-and-abdominal-effusions-a-quick-diagnostic-marker-of-exudate-a-pilot-study
#14
Giovanni Porta, Fabio G Numis, Valerio Rosato, Antonio Pagano, Mario Masarone, Giorgio Bosso, Claudia Serra, Luca Rinaldi, Maria C Fascione, Annalisa Amelia, Fiorella Paladino, Fernando Schiraldi
Pleural or abdominal effusions are frequent findings in ICU and Internal Medicine patients. Diagnostic gold standard to distinguish between transudate and exudate is represented by "Light's Criteria," but, unfortunately, the chemical-physical examination for their calculation is not a rapid test. Pursuing an acid-base assessment of the fluid by a blood-gas analyzer, an increase of lactate beyond the normal serum range is reported in the exudative effusions. The advantages of this test are that it is a very fast bed-side test, executable directly by the physician...
September 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28957888/usefulness-of-medical-thoracoscopy-in-the-management-of-pleural-effusion-caused-by-chronic-renal-failure
#15
Sara Colella, Federica Fioretti, Chiara Massaccesi, Gian L Primomo, Gianluca Panella, Vittorio D'Emilio, Riccardo Pela
INTRODUCTION: Although pleural effusion (PE) can be caused by several pathologies like congestive heart failure, infections, malignancies, and pulmonary embolism, it is also a common finding in chronic kidney disease (CKD). Diagnostic thoracentesis is of limited value in the differential diagnosis, and the role of more invasive investigations like medical thoracoscopy (MT) is still unclear. AIM: To evaluate the usefulness of MT in unexplained PE in CKD. MATERIALS AND METHODS: In the electronic database of our Institution, we retrospectively searched for patients with CKD who underwent MT for unexplained PE between January 2008 and August 2016...
October 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28932537/the-role-of-video-assisted-thoracoscopic-surgery-for-management-of-symptomatic-pleural-effusion-after-coronary-artery-bypass-surgery-a-best-evidence-topic-report
#16
REVIEW
Alfonso Fiorelli, Francesco Caronia, Aldo Prencipe, Mario Santini, Brendon Stiles
A best evidence topic in thoracic surgery was written addressing whether video-assisted thoracoscopic surgery (VATS) talc pleurodesis could be justified in patients with pleural effusion (PE) after coronary artery bypass graft (CABG) surgery and no-responded to repeated thoracentesis. Ten papers were identified to answer the question. Of these, two were case-series study including ≥4 patients, 7 retrospective analytical studies, and one observational study but no randomized controlled trial (RCTs) was included in the analysis...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28928841/lung-cancer-requires-multidisciplinary-treatment-to-improve-patient-survival-a-case-report
#17
Aldo Pezzuto, Fabrizio Terzo, Maria Laura Graziani, Alberto Ricci, Pierdonato Bruno, Salvatore Mariotta
The present study reports two cases of lung cancer with the involvement of the pleura. The diagnosis of adenocarcinoma with epidermal growth factor receptor (EGFR) mutation was made following repeated thoracentesis with cytology of pleural fluid and thoracoscopy with pleural biopsies. Talc pleurodesis was successfully performed in both cases subsequent to diagnosis. Following talc pleurodesis, the first patient (62 years old; male; non-smoker) underwent 3 cycles of cisplatin/vinorelbine chemotherapy, with a poor response...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28864054/quality-gaps-and-comparative-effectiveness-of-management-strategies-for-recurrent-malignant-pleural-effusions
#18
David E Ost, Jiangong Niu, Hui Zhao, Horiana B Grosu, Sharon H Giordano
BACKGROUND: Guidelines for recurrent malignant pleural effusions (MPEs) recommend definitive procedures, such as indwelling pleural catheters (IPCs) or pleurodesis, over repeat thoracentesis. We hypothesized that many patients have multiple thoracenteses rather than definitive procedures and that this results in more procedures and complications. METHODS: Retrospective cohort study using SEER-Medicare data from 2007 to 2011. Patients 66 to 90 years of age with an MPE were included...
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28840142/-18-f-fdg-pet-ct-in-pleural-epithelioid-hemangioendothelioma
#19
Domenico Albano, Giovanni Bosio, Andrea Tironi, Francesco Bertagna
Pleural epithelioid hemangioendothelioma (EHE) is a rare malignancy of vascular-endothelial origin with non-specific symptoms and an unpredictable outcome. Diagnosis of this condition by imaging modalities is challenging, and no standard therapeutic approaches have been established in this regard. In this paper, we described the case of a patient with a low-grade fever, coughing and chest pain who underwent (18)F-FDG PET/CT after a positive thorax CT showing multiple bilateral calcified pulmonary nodules and extensive right-sided pleural effusion...
2017: Asia Oceania Journal of Nuclear Medicine & Biology
https://www.readbyqxmd.com/read/28831322/intercostal-artery-laceration-rare-complication-of-thoracentesis-and-role-of-ultrasound-in-early-detection
#20
Wissam Mansour, Ghassan Samaha, Sandy El Bitar, Ziad Esper, Rabih Maroun
Hemothorax is a rare but potentially fatal postthoracentesis complication. Early clinical signs may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further bleeding. Following procedure, early bedside ultrasound findings can be vital for early detection. We report a case of massive hemothorax in a 63-year-old male following therapeutic thoracentesis. Diagnosis was made following highly suggestive sonographic findings prompting thoracotomy and lacerated intercostal artery cauterization...
2017: Case Reports in Pulmonology
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