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Pleural disease

Justin K Lui, Lidia Spaho, Erik Holzwanger, Rosa Bui, Jennifer S Daly, Adel Bozorgzadeh, Scott E Kopec
Chronic liver disease has been associated with pulmonary dysfunction both before and after liver transplantation. Post-liver transplantation pulmonary complications can affect both morbidity and mortality often necessitating intensive care during the immediate postoperative period. The major pulmonary complications include pneumonia, pleural effusions, pulmonary edema, and atelectasis. Poor clinical outcomes have been known to be associated with age, severity of liver dysfunction, and preexisting lung disease as well as perioperative events related to fluid balance, particularly transfusion and fluid volumes...
January 1, 2018: Journal of Intensive Care Medicine
Alessio Campisi, Andrea Dell'Amore, Domenica Giunta, Stefano Congiu, Niccolò Daddi, Giampiero Dolci
Primary spontaneous pneumothorax has been defined as the disease of the 'young and healthy'. There are multiple possible therapies and in recent years, surgery has evolved towards the use of the uniportal thoracoscopic approach. The objective of our study is to describe and present an innovative approach to access to the thoracic cavity in patients with spontaneous pneumothorax. The surgery was performed using a single access of 20 mm at the level of the 8th intercostal space. For the isolation and suspension of any dystrophic area, we use a 'loop' of non-absorbable braided suture inserted through the IV intercostal space and successive wedge resection using an endoscopic 10 mm mechanical stapler...
2018: Journal of Visualized Surgery
Yen-Yu Lin, Wen-Hu Hsu, Mei-Han Wu, Teh-Ying Chou
A 47-year-old woman presented with spontaneous right side pneumothorax. Image studies showed consolidations and reticular opacities involving the pleural and subpleural regions of bilateral lungs. Wedge biopsy specimens of right upper, middle and lower lobes showed fibrosis of the visceral pleura and subpleural area in all three lobes, more significant in the upper lobe. Elastic Van Gieson stain showed a pattern of alveolar septal elastosis with intra-alveolar fibrosis. The clinical presentation and pathological findings are compatible with pleuroparenchymal fibroelastosis, a rare and distinct type of interstitial lung disease...
2018: SAGE Open Medical Case Reports
Kyung Won Doo, Bomi Kim
Castleman's disease (CD) is an uncommon benign lymphoproliferative disorder which most commonly involves the mediastinum but rarely affects the pleura. We report a case of unicentric CD that presents as a pleural mass in a 45-year-old man, which was subsequently resected followed by an unexpected diagnosis on histologic examination. Although rare, CD should be included in the differential diagnosis of well-enhancing pleural mass.
February 2018: Radiology Case Reports
Bastien Provost, Gilles Missenard, Ciprian Pricopi, Olaf Mercier, Sacha Mussot, Dominique Fabre, Nathaniel Langer, Olivier Mir, Cécile Le Pechoux, Philippe Dartevelle, Elie Fadel
BACKGROUND: Radiotherapy has long been the treatment of choice for local control of Ewing sarcoma of the chest wall (ESCW). However, there is debate regarding the use of surgery versus RT. Our objective was to identify risk factors that may affect long-term outcomes of non-metastatic ESCW all treated with preoperative chemotherapy followed by en-bloc resection and adjuvant Chemotherapy or Chemoradiation. METHODS: Between 1996 and 2014, 30 patients with a median age of 25 years (SD +/-8...
March 15, 2018: Annals of Thoracic Surgery
Charu Aggarwal, Andrew R Haas, Susan Metzger, Laura K Aguilar, Estuardo Aguilar-Cordova, Andrea G Manzanera, Gregoria Gómez-Hernández, Sharyn I Katz, Evan W Alley, Tracey L Evans, Joshua M Bauml, Roger B Cohen, Corey J Langer, Steven M Albelda, Daniel H Sterman
Gene-mediated cytotoxic immunotherapy (GMCI) is an immune strategy implemented through local delivery of an adenovirus-based vector expressing the thymidine kinase gene (aglatimagene besadenovec, AdV-tk) followed by anti-herpetic prodrug valacyclovir. A phase I dose escalation trial of GMCI followed by chemotherapy was conducted in patients with malignant pleural effusion (MPE). AdV-tk was administered intrapleurally (IP) in three cohorts at a dose of 1 × 1012 to 1013 vector particles. Primary endpoint was safety; secondary endpoints included response rate, progression-free survival, and overall survival...
February 21, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
Marjolaine Morgand, Alexandre Leclercq, Mylène M Maury, Hélène Bracq-Dieye, Pierre Thouvenot, Guillaume Vales, Marc Lecuit, Caroline Charlier
OBJECTIVES: Listeria monocytogenes (Lm) is a foodborne human pathogen responsible for severe infection, including septicemia, neurolisteriosis, maternal-fetal and focal infections. Little is known about Lm-associated respiratory tract or lung infections. METHODS: Retrospective study of culture-proven cases of Lm pleural infections and pneumonia reported to the French National Reference Center for Listeria from January 1993 to August 2016. RESULTS: Thirty-eight consecutive patients with pleural infection (n=32), pneumonia (n=5), or both (n=1) were studied...
March 13, 2018: Clinical Microbiology and Infection
Midori Tanaka, Hidenobu Ishii, Hayato Moribuchi, Yoshiko Naito, Norikazu Matsuo, Masayuki Nakamura, Takaaki Tokito, Koichi Azuma, Kazuhiko Yamada, Tomoaki Hoshino
Small-cell lung cancer (SCLC) combined with epidermal growth factor receptor (EGFR) mutations is extremely rare, and standard chemotherapeutic strategies have not yet been established. In the present study, we report a case of a 67-year-old man who presented with combined SCLC with EGFR mutation (exon 19 deletion). Systemic chemotherapy with cisplatin and irinotecan was initiated as first-line chemotherapy, and computed tomography findings revealed tumor shrinkage after two cycles of chemotherapy. However, after the third cycle of the treatment, disease progression was observed including the appearance of pleural and pericardial effusion...
March 15, 2018: Investigational New Drugs
Tina Streitparth, Denis Schumacher, Robert Damm, Bjoern Friebe, Konrad Mohnike, Ortrud Kosiek, Maciej Pech, Jens Ricke, Florian Streitparth
Purpose: The purpose of this study was to evaluate the efficacy, safety and predictive factors of RFA of primary and secondary lung malignancies. Patients and Methods: 79 patients with 129 primary and secondary lung malignancies were enrolled in a retrospective study. We treated 74 pulmonary metastases of colorectal cancer, 13 malignant melanoma lesions, 13 renal cancer metastases, 5 primary lung malignancies and 24 tumors of other different entities. All patients were considered to be unsuitable candidates for surgery, radiotherapy or chemotherapy...
February 20, 2018: Oncotarget
Shudan Wang, Noam Broder, Paula Marchetta, Johannes Nowatzky
A 46-year-old Hispanic man presented with fever, genital ulcers, left eye redness and chest pain. Physical examination was notable for a healed oral ulcer and scrotal ulcers, and bilateral superficial thrombophlebitis. He was found to have new-onset pancytopenia. CT of the chest showed pericardial and pleural effusions and rapidly progressing inflammation of the aortic arch and ascending vessels. Although the patient had Behcet's disease (BD)-like symptoms, pancytopenia could not be explained by the diagnosis, prompting a bone marrow biopsy which showed myelodysplastic syndrome...
March 15, 2018: BMJ Case Reports
Rafael E de la Hoz, Jonathan Weber, Dongming Xu, John T Doucette, Xiaoyu Liu, Deborah A Carson, Juan C Celedón
We examined the chest CT scans of 1,453 WTC responders using the International Classification of High-resolution CT for Occupational and Environmental Respiratory Diseases. Univariate and bivariate analyses of potential work-related pleural abnormalities were performed with pre-WTC and WTC-related occupational exposure data, spirometry, demographics and quantitative CT measurements. Logistic regression was used to evaluate occupational predictors of those abnormalities. Chest CT scans were performed first at a median of 6...
March 15, 2018: Archives of Environmental & Occupational Health
Ahmed A Aljohaney
OBJECTIVES: To determine the mortality rates and predictors among patients hospitalized with active tuberculosis (TB) at King Abdulaziz University Hospital (KAUH) in Jeddah. METHODS: A retrospective study was performed on 291 active TB patients hospitalized in KAUH, Jeddah, Saudi Arabia from December 2011 to December 2016. Medical records were collected and evaluated using a dedicated data extraction sheet. The records included demographics, clinical, radiological, laboratory, and drug resistance data...
March 2018: Saudi Medical Journal
Arnaud Boyer, Eddy Pasquier, Pascale Tomasini, Joseph Ciccolini, Laurent Greillier, Nicolas Andre, Fabrice Barlesi, Celine Mascaux
Drug repurposing is the use of known drugs for new indications. Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. So far, few treatments have been approved in this disease. However, its incidence is expected to increase significantly, particularly in developing countries. Consequently, drug repurposing appears as an attractive strategy for drug development in MPM, since the known pharmacology and safety profile based on previous approvals of repurposed drugs allows for faster time-to-market for patients and lower treatment cost...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
A Skiada, C Lass-Floerl, N Klimko, A Ibrahim, E Roilides, G Petrikkos
The diagnosis and treatment of mucormycosis are challenging. The incidence of the disease seems to be increasing. Hematological malignancies are the most common underlying disease in countries with high income and uncontrolled diabetes in developing countries. Clinical approach to diagnosis lacks sensitivity and specificity. Radiologically, multiple (≥10) nodules and pleural effusion are reportedly associated with pulmonary mucormycosis. Another finding on computerized tomography (CT) scan, which seems to indicate the presence of mucormycosis, is the reverse halo sign...
April 1, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Ka Pang Chan, Deirdre B Fitzgerald, Y C Gary Lee
PURPOSE OF REVIEW: Pleural infection remains an important pulmonary disease, causing significant morbidity and mortality. There is a resurgence of disease burden despite introduction of antibiotics and pneumococcal vaccines. A revisit of the pathogenesis and update on intervention may improve the care of pleural infection. RECENT FINDINGS: Recent studies have uncovered the prognostic implication of the presence of a pleural effusion in patients with pneumonia. Identifying where the bacteria lives may have diagnostic and therapeutic implications...
March 13, 2018: Current Opinion in Pulmonary Medicine
Hiroaki Kuroda, Shnsuke Mori, Hirotaka Tanaka, Tatsuya Yoshida, Tetsuya Mizuno, Noriaki Sakakura, Yasushi Yatabe, Hiroshi Iwata, Yukinori Sakao
Background: We previously proposed measuring tumor size using mediastinal window setting on high-resolution computed tomography (CT) as a simple and useful modality for preoperative prognostication of small adenocarcinoma. Hence, the importance of tumor volume and positron emission tomography (PET) for preoperative prognostication of clinical stage IA (cIA) adenocarcinoma was studied. Materials and Methods: We retrospectively evaluated total 324 patients who underwent pulmonary resection of cIA adenocarcinoma between July 2008 and August 2015...
February 13, 2018: Oncotarget
Hisanori Fukunaga, Yasuko Tatewaki, Tatsushi Mutoh, Hideo Shimomura, Shuzo Yamamoto, Chiaki Terao, Tomoko Totsune, Manabu Nakagawa, Yasuyuki Taki
BACKGROUND Primary cardiac lymphoma is rare and can be an aggressive disease, depending on the grade. A case is reported of low-grade primary cardiac lymphoma associated with a pericardial effusion. 18F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT) imaging was useful in the diagnosis and in evaluating the disease activity in this case. CASE REPORT A 72-year-old Japanese woman visited a general practitioner, complaining of dyspnea associated with cardiac tamponade. Pericardiocentesis was performed, and Group V malignant cells were identified by cytology, suspicious for malignant lymphoma...
March 14, 2018: American Journal of Case Reports
David B Nelson, Myrna Cb Godoy, Marcelo F Benveniste, Jitesh B Shewale, Jonathan D Spicer, Kyle G Mitchell, Wayne L Hofstetter, Reza J Mehran, David C Rice, Boris Sepesi, Garrett L Walsh, Ara A Vaporciyan, Stephen G Swisher, Jack A Roth, Mara B Antonoff
BACKGROUND: Ground glass opacities pose diagnostic challenges, and even after malignancy is confirmed, prognosis is often unclear. We sought to identify clinicoradiographic features that could predict aggressive tumor biology in lung adenocarcinoma with associated ground glass components. METHODS: A retrospective review of patients with resected lung adenocarcinoma from 2008-2013 was performed. Detailed radiographic features were reviewed by two radiologists. Logistic regression was used to identify risks of poor differentiation or a composite outcome of nodal metastases/lymphovascular invasion...
March 10, 2018: Annals of Thoracic Surgery
Sara A Hayes, James Huang, Jennifer Golia Pernicka, Jane Cunningham, Junting Zheng, Chaya S Moskowitz, Michelle S Ginsberg
BACKGROUND: The aim of this study was to assess pre-operative computed tomography (CT) characteristics of thymic carcinomas and to investigate which features could predict an incomplete surgical resection. A secondary aim was to correlate pre-operative imaging features with Masaoka stage. METHODS: In this study, approved by our Institutional Review Board, two readers retrospectively reviewed pre-operative CTs at our tertiary referral oncology center between 1994 and 2014...
March 10, 2018: Annals of Thoracic Surgery
Muhammet Furkan Korkmaz, Ahmet Güzel, Mehmet Açıkgöz, Ali Okuyucu, Hasan Alaçam
OBJECTIVES: Community-acquired pneumonia (CAP) in children is one of the most important causes of mortality and morbidity in developing countries. Therefore, it is very important for clinicians to detect the presence and severity of pneumonia. Proadrenomedullin (Pro-ADM) and Interleukin-1β (IL-1β) are thought to have potential for CAP evaluation in children. We sought to investigate the value of Pro-ADM and IL-1β levels for severity assessment and outcome prediction in children with CAP...
January 2018: Annals of Clinical and Laboratory Science
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