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https://www.readbyqxmd.com/read/29346248/the-utility-of-ultrasound-to-diagnose-tunnel-tract-infection-related-to-indwelling-pleural-catheters
#1
Jose Cardenas-Garcia, Neal Fitzpatrick, George Z Cheng
Indwelling pleural catheter (IPC) infections lead to increased morbidity and treatment failure in patients with chronic recurrent pleural effusions. Ultrasonography is a readily available diagnostic tool used by pulmonologists on a daily basis. Ultrasonography has been used to identify the etiology of indwelling peritoneal catheter obstruction, including infection of the exit site and tunnel tract. The use of ultrasonography to identify tunnel-tract infection involving IPC has not been reported. We describe the ultrasonographic characteristics of 3 cases of confirmed tunnel-tract infection and compared them with noninfected chronic IPCs...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29325199/-efficacy-and-safety-of-indwelling-pleural-catheters
#2
Eva Lücke, Uwe Steffen, Sandra Riedel, Jens Schreiber
In symptomatic malignant pleural effusions, mostly in a palliative situation, therapeutic procedures should be chosen to improve dyspnoea and the concomitant impairment of quality of life. Indwelling pleural catheters (IPC) have played an increasing role in recent years. The efficacy and safety of this method have not been adequately clarified under real-life clinical conditions. 94 patients, in whom IPC had been implanted because of a clinical indication, were analysed retrospectively with respect to efficacy and safety, together with patient characteristics, peri- and postinterventional complications, e...
January 11, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#3
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/29230111/letter-to-the-editor-catheter-track-metastasis-with-indwelling-pleural-catheter
#4
Sara Zank, Elham Abboud, Wissam Jaber, Abdul Hamid Alraiyes
No abstract text is available yet for this article.
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#5
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29199894/local-and-systemic-effects-of-a-silver-nitrate-coated-indwelling-pleural-catheter-in-an-animal-model-of-pleurodesis
#6
Alain Tremblay, Christine T Kearney, Chris Hanks, Jennifer Hughes Hanks, David S White, Marcia E Pereira, Craig E Zook, Karen Sargis, Luke Zhang
Purpose/Aim of the study: This study assessed the safety and potential toxicity of a silver nitrate coated indwelling pleural catheter (SNCIPC) designed to create pleurodesis in a large animal model. MATERIALS AND METHODS: Sixteen animals underwent insertion of either a SNCIPC or an uncoated silicone catheter. Half of the animals were sacrificed at day 7 and the others at day 30. Animal weight and assessment of well-being, pleural fluid and blood collection were performed at regular intervals...
November 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29164255/effect-of-an-indwelling-pleural-catheter-vs-talc-pleurodesis-on-hospitalization-days-in-patients-with-malignant-pleural-effusion-the-ample-randomized-clinical-trial
#7
RANDOMIZED CONTROLLED TRIAL
Rajesh Thomas, Edward T H Fysh, Nicola A Smith, Pyng Lee, Benjamin C H Kwan, Elaine Yap, Fiona C Horwood, Francesco Piccolo, David C L Lam, Luke A Garske, Ranjan Shrestha, Christopher Kosky, Catherine A Read, Kevin Murray, Y C Gary Lee
Importance: Indwelling pleural catheter and talc pleurodesis are established treatments for malignant pleural effusions among patients with poor prognosis. Objective: To determine whether indwelling pleural catheters are more effective than talc pleurodesis in reducing total hospitalization days in the remaining lifespan of patients with malignant pleural effusion. Design, Setting, and Participants: This open-label, randomized clinical trial included participants recruited from 9 centers in Australia, New Zealand, Singapore, and Hong Kong between July 2012 and October 2014; they were followed up for 12 months (study end date: October 16, 2015)...
November 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29150040/management-of-malignant-lung-entrapment-the-oncothorax
#8
REVIEW
Roman Petrov, Charles Bakhos, Abbas E Abbas
Pleural metastasis is a common occurrence in up to 30% of patients with metastatic cancer. When lung entrapment and loculation of fluid occur, treatment is more difficult and we have named this condition "oncothorax." The malignant adhesions that entrap the lung in an oncothorax are not typically amenable to surgical decortication. The standard approach for managing these patients is to place an indwelling catheter. Other options may include pleurectomy and decortication, intrapleural hyperthermic chemoperfusion, and intrapleural photodynamic therapy...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29119067/experience-with-ambulatory-management-of-pleural-pathologies-utilizing-small-bore-indwelling-pleural-catheters
#9
Imad-Ud-Din Saqib, Mobeen Iqbal, Atif Rana, Saira Hassan
Introduction Pleural effusion is the excess fluid that accumulates in the pleural space. Pneumothorax is the collection of free air in the pleural cavity, while empyema is the collection of pus in the pleural cavity. Such pleural pathologies pose a great challenge to patients and health care professionals alike. While multiple management options exist, the major portion of it is carried out in the inpatient setting. We sought to evaluate the ambulatory use of indwelling pleural catheters for pleural pathologies, including malignant pleural effusion, empyema, and primary spontaneous pneumothorax...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29111830/surgical-and-non-surgical-management-of-malignant-pleural-effusions
#10
Deirdre B Fitzgerald, Coenraad F N Koegelenberg, Kazuhiro Yasufuku, Y C Gary Lee
Optimal management of malignant pleural effusion (MPE) is important in the care of patients with advanced cancer. Surgical (especially video-assisted thoracoscopic surgery (VATS)) and non-surgical strategies are available. Clinicians should be aware of the evidence supporting the use of different modalities to guide treatment choice. Areas covered: This review covers published evidence of the advantages and disadvantages of VATS and non-surgical alternatives for MPE management. Expert commentary: Randomized clinical trials (RCTs) are needed to define the roles and benefits of VATS as existing literature is often flawed by selection bias...
November 9, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28951662/safety-and-performance-characteristics-of-outpatient-medical-thoracoscopy-and-indwelling-pleural-catheter-insertion-for-evaluation-and-diagnosis-of-pleural-disease-at-a-tertiary-center-in-canada
#11
Robert Kyskan, Pen Li, Sunita Mulpuru, Carolina Souza, Kayvan Amjadi
BACKGROUND: Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance characteristics of outpatient MT with indwelling pleural catheter (IPC) insertion in a large Canadian cohort. METHODS: This retrospective cohort study reviewed patients who underwent outpatient MT and IPC insertion under conscious sedation...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28918827/indwelling-pleural-catheters-for-nonmalignant-effusions-evidence-based-answers-to-clinical-concerns
#12
REVIEW
David Maurice Chambers, Bilal Abaid, Umair Gauhar
Pleural effusions occur in 1.5 million patients yearly and are a common cause of dyspnea. For nonmalignant effusions, initial treatment is directed at the underlying cause, but when effusions become refractory to medical therapy, palliative options are limited. Tunneled pleural catheters (TPCs) are commonly used for palliation of malignant effusions, but many clinicians are reluctant to recommend these devices for palliation of nonmalignant effusions, citing concerns of infection, renal failure, electrolyte disturbances and protein-loss malnutrition...
September 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28864054/quality-gaps-and-comparative-effectiveness-of-management-strategies-for-recurrent-malignant-pleural-effusions
#13
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/28799457/a-single-institution-experience-for-the-management-of-recurrent-pleural-effusions-with-tunneled-pleural-catheter-and-its-evolution
#14
Tuhina Raman, Nikhil Meena
BACKGROUND: Indwelling tunneled pleural catheters (TPCs) are increasingly being used to treat recurrent pleural effusions. There is also an increased interest in early pleurodesis in order to prevent infectious complications. We studied the time to removal and other outcomes for all the TPCs placed at our institution. METHODS: After institutional review board approval, records of patients who had had a TPC placed between July 2009 and June 2016 were reviewed; the catheters were placed in an endoscopy suite or during pleuroscopy with or without a sclerosant...
September 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28694705/management-of-malignant-pleural-effusion-challenges-and-solutions
#15
REVIEW
Erika Penz, Kristina N Watt, Christopher A Hergott, Najib M Rahman, Ioannis Psallidas
Malignant pleural effusion (MPE) is a sign of advanced cancer and is associated with significant symptom burden and mortality. To date, management has been palliative in nature with a focus on draining the pleural space, with therapies aimed at preventing recurrence or providing intermittent drainage through indwelling catheters. Given that patients with MPEs are heterogeneous with respect to their cancer type and response to systemic therapy, functional status, and pleural milieu, response to MPE therapy is also heterogeneous and difficult to predict...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28641878/diagnosis-and-management-of-pleural-transudates
#16
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/28625655/a-randomized-controlled-trial-comparing-indwelling-pleural-catheters-with-talc-pleurodesis-nvalt-14
#17
R C Boshuizen, V Vd Noort, J A Burgers, G J M Herder, S M S Hashemi, T J N Hiltermann, P W Kunst, J A Stigt, M M van den Heuvel
BACKGROUND: Symptomatic malignant pleural effusion (MPE) occurs frequently in patients with metastatic cancer. The associated prognosis is poor and the success rate of talc pleurodesis (TP) is low. Indwelling pleural catheters (IPCs) are commonly inserted when TP has been unsuccessful. METHODS: We compared talc pleurodesis with the use of an indwelling pleural catheter in patients with recurrent MPE in a multicenter randomized controlled trial (superiority design)...
June 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28574275/a-novel-drug-eluting-indwelling-pleural-catheter-for-the-management-of-malignant-effusions
#18
Rahul Bhatnagar, Natalie Zahan-Evans, Christine Kearney, Anthony J Edey, Louise J Stadon, Alain Tremblay, Nick A Maskell
No abstract text is available yet for this article.
June 2, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28487593/ovarian-carcinomatosis-in-a-dog-managed-with-surgery-and-intraperitoneal-systemic-and-intrapleural-chemotherapy-utilizing-indwelling-pleural-access-ports
#19
Matthew P Best, Angela E Frimberger
A 3-year-old Weimaraner dog was presented with bilateral papillary ovarian carcinoma and abdominal carcinomatosis. Treatment included ovariectomy, intraperitoneal cisplatin, and systemic carboplatin. Pleural carcinomatosis 473 days following surgery was treated with intrapleural cisplatin through indwelling pleural access ports. Euthanasia occurred 1154 days following surgery due to malignant pleural effusion without peritoneal effusion.
May 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28426471/advances-in-the-management-of-malignant-pleural-effusion
#20
Labib G Debiane, David E Ost
PURPOSE OF REVIEW: The current review describes the latest evidence in the management of malignant pleural effusions (MPE). RECENT FINDINGS: Daily drainage of indwelling pleural catheters achieved auto-pleurodesis at a higher rate compared with every-other-day drainage [0.47 vs. 0.24; difference in proportion of 0.23; 95% confidence interval (CI) 0.08-0.38; P = 0.003]. In patients with MPE undergoing talc pleurodesis, a large multicenter randomized clinical trial found that pain control with opiates vs...
July 2017: Current Opinion in Pulmonary Medicine
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