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thoracic empyema

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https://www.readbyqxmd.com/read/28087049/-the-benefits-of-digital-chest-drainage-in-pleural-decortication-in-thoracic-empyema-prospective-randomized-control-trial
#1
José M Mier, Gildardo Cortés-Julián, Juan Berrios-Mejía, Zotés Víctor-Valdivia
BACKGROUND: Prolonged air leak after pleural decortication is one of the most frequent complications. OBJECTIVE: The aim of this study is to compare the effects of prolonged air leak between the digital chest drainage (DCD) system and the classic drainage system in patients with empyema class IIB or III (American Thoracic Society classification) in pleural decortication patients. MATERIAL AND METHODS: A total of 37 patients were enrolled in a prospective randomized control trial over one year, consisting of 2blinded groups, comparing prolonged air leak as a main outcome, the number of days until removal of chest drain, length of hospital stay and complications as secondary outcomes...
January 10, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28054136/-role-of-imaging-procedures-in-clarification-of-complications-of-pneumonia
#2
K Lampichler
CLINICAL ISSUE: Despite a considerable number of antimicrobial agents and interdisciplinary treatment options, lower respiratory tract infections are still associated with high morbidity and mortality rates. Infections of the respiratory tract can lead to severe complications, such as empyema, lung abscesses and acute respiratory distress syndrome (ARDS). Besides intrapulmonary complications pneumonia can also impair other organs due to a systemic inflammatory response. Underlying cardiovascular diseases, such as chronic heart failure, arteriosclerosis and dysrhythmia can either deteriorate due to infections or be newly manifested as a result of pneumonia...
January 2017: Der Radiologe
https://www.readbyqxmd.com/read/28052108/heme-oxygenase-1-deficiency-diminishes-methicillin-resistant-staphylococcus-aureus-clearance-due-to-reduced-tlr9-expression-in-pleural-mesothelial-cells
#3
Satindra Gahlot, Najmunnisa Nasreen, Judith A Johnson, Steven A Sahn, Kamal A Mohammed
Methicillin Resistant Staphylococcus aureus (MRSA) cause pneumonia and empyema thoraces. TLR9 activation provides protection against bacterial infections and Heme oxygenase-1 (HO-1) is known to enhance host innate immunity against bacterial infections. However, it is still unclear whether HO-1 regulates TLR-9 expression in the pleura and modulates the host innate defenses during MRSA empyema. In order to determine if HO-1 regulates host innate immune functions via modulating TLR expression, in MRSA empyema, HO-1+/+ and HO-1-/- mouse pleural mesothelial cells (PMCs) were infected with MRSA (1:10, MOI) in the presence or absence of Cobalt Protoporphyrin (CoPP) and Zinc Protoporphyrin (ZnPP) or CORM-2 (a Carbon monoxide donor) and the expression of mTLR9 and mBD14 was assessed by RT-PCR...
2017: PloS One
https://www.readbyqxmd.com/read/28049376/management-of-pleural-space-after-lung-resection-by-cryoneuroablation-of-phrenic-nerve
#4
Xiao-Jie Pan, De-Bin Ou, Xing Lin, Ming-Fang Ye
OBJECTIVES: Residual air space problems after pulmonary lobectomy are an important concern in thoracic surgical practice, and various procedures have been applied to manage them. This study describes a novel technique using controllable paralysis of the diaphragm by localized freezing of the phrenic nerve, and assesses the effectiveness of this procedure to reduce air space after pulmonary lobectomy. METHODS: In this prospective randomized study, 207 patients who underwent lobectomy or bilobectomy and systematic mediastinal node dissection in our department between January 2009 and November 2013 were randomly allocated to a cryoneuroablation group or a conventional group...
January 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28003678/usefulness-of-thoracoscopic-debridement-for-chronic-empyema-after-an-extrapleural-pneumonectomy
#5
Hidejiro Torigoe, Shinichi Toyooka, Hiromasa Yamamoto, Junichi Soh, Shinichiro Miyoshi
We present the case of a 65-year-old Japanese man diagnosed with chronic empyema (without a bronchopleural fistula) that occurred 7 months after he underwent an extrapleural pneumonectomy for right malignant pleural mesothelioma (MPM). Following thoracic drainage and irrigation for 1 month, we performed surgery by a thoracoscopic approach, in light of his general condition. We performed debridement and removal of the Gore-Tex polytetrafluoroethylene (PTFE) patch that had been used for the reconstruction of the diaphragm and the pericardium...
December 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27984383/hippocrates-quoted-if-an-empyema-does-not-rupture-death-will-occur-is-medical-thoracoscopy-able-to-make-it-rupture-safely
#6
Georgia Hardavella, Nikolaos A Papakonstantinou, Ioannis Karampinis, Gerasimos Papavasileiou, Shereen Ajab, Mohammed Shafaat, Stavros Malagaris, Nikolaos Anastasiou
BACKGROUND: The aim of this study was to evaluate the safety and efficacy of medical thoracoscopy through a single port [single-port medical thoracoscopy (S-MT)] for the treatment of empyema thoracis in its early stages. METHODS: We performed a retrospective analysis reviewing the medical records of 84 patients referred for empyema and treated by medical thoracoscopy at our Thoracic Departments from January 2001 until November 2014. S-MT was performed under local anesthesia with neuroleptoanalgesia and spontaneous breathing using a single 1-cm incision for debridement and lavage of the pleural cavity...
January 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#7
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27904839/noncardiac-thoracic-surgery-in-abidjan-from-1977-to-2015
#8
Yves Tanauh, Flavien Kendja, Hervé Yangni-Angate, Blaise Demine, Raphaël Ouédé, Maurice Kouacou
BACKGROUND: To report and analyze noncardiac thoracic operations performed at the Cardiology Institute of Abidjan (Institut de Cardiologie d'Abidjan) from 1977 to 2015. METHODS: This is a retrospective and descriptive study covering 39 years, from 1977 to 2015. This study period was divided into three periods of 13 years each: P1 from 1977 to 1989, P2 from 1990 to 2002 and P3 from 2003 to 2015. Medical records of 2014 operated patients were analyzed: 414 patients for P1, 464 patients for P2, 1,136 patients for P3...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27823364/medical-management-of-spinal-epidural-empyema-in-five-dogs
#9
Susana R Monforte Monteiro, Antonella Gallucci, Nicolas Rousset, Paul M Freeman, Edward J Ives, Gualtiero Gandini, Nicolas Granger, An E Vanhaesebrouck
CASE DESCRIPTION 5 dogs were examined because of clinical signs of myelopathy, including signs of pain associated with the spinal region and rapidly progressive neurologic deficits. CLINICAL FINDINGS In all dogs, results of MRI were consistent with spinal epidural empyema. Concurrent infectious processes were identified at adjacent or distant sites in all dogs, including diskospondylitis, prostatitis, dermatitis, paraspinal infection following a penetrating injury, urinary tract infection, and pyothorax. Bacteria were isolated from 3 dogs; Escherichia coli was isolated from blood, urine, and prostatic wash samples from 1 dog; a Pasteurella sp was isolated from a percutaneous aspirate from an adjacent infected wound in a second dog; and a Corynebacterium sp was isolated from a thoracic fluid sample from a third dog...
November 15, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27815709/stage-directed-therapy-of-pleural-empyema
#10
REVIEW
Martin Reichert, Matthias Hecker, Biruta Witte, Johannes Bodner, Winfried Padberg, Markus A Weigand, Andreas Hecker
PURPOSE: Intensivists and surgeons are often confronted with critically ill patients suffering from pleural empyema. Due to it' s multifactorial pathogenesis and etiology, medicals should be sensitized to recognize the different stages of the disease. Besides a whole bundle of different established classification systems, the progress of pleural effusions can be subdivided into the early exudative, the intermediate fibropurulent and the late organized phase according to the classification of the American Thoracic Society...
November 4, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27681234/thoracic-empyema-caused-by-campylobacter-rectus
#11
Tomoyuki Ogata, Teruo Urata, Daisuke Nemoto, Shigemi Hitomi
We report a case of thoracic empyema caused by Campylobacter rectus, an organism considered as a periodontal pathogen but rarely recovered from extraoral specimens. The patient fully recovered through drainage of purulent pleural fluid and administration of antibiotics. The present case illustrates that C. rectus can be a cause of not only periodontal disease but also pulmonary infection.
September 25, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27660730/the-application-of-vacuum-assisted-closure-device-in-the-management-of-empyema-necessitans
#12
Yasser Aljehani, Zahra Al-Matar, Samah Nawar
Vacuum-assisted closure (VAC) is gaining popularity in the management of many types of acute and chronic wounds. The use of VAC devices in thoracic surgery is limited, but it appears to be promising in complex cases of empyema thoraces. We report a case of empyema necessitans, in which VAC was used to achieve complete wound healing after open drainage which was communicating with the pleural space.
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27651934/asian-perspective-in-surgery-thoracic-surgery-in-turkey
#13
REVIEW
Akif Turna
Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surgeons. There are a number of reasons to predict that the number of thoracic surgical cases will be increased and new generation of thoracic surgeons will be operating more minimally invasive resectional surgeries for most lung cancer in future...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27607885/-decortication-in-pleural-empyema-reasonable-effects-on-lung-function
#14
T Potzger, M Ried, H-S Hofmann
UNLABELLED: Parapneumonic pleural effusion (PPE) occurring in early-stage (stage I) pleural empyema (PE) can be managed by chest tube drainage, which should be performed as soon as possible, to achieve re-expansion of the pulmonary parenchyma. Chronic disease leads to fibrin deposits on both pleural surfaces (stage II), followed by a thickened pleura peel (stage III). A trapped or compressed lung can only be released by surgical decortication, which may be performed with a minimally-invasive approach (video-assisted thoracoscopy) or an open technique (thoracotomy)...
September 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27598645/nocardia-nova-causing-empyema-necessitatis-afterlung-re-transplantation-a-case-report
#15
Cecília Bittencourt Severo, Letícia Beatriz Matter, Flávio de Mattos Oliveira, Agueda Palmira Castagna Vargas, Sadi Marcelo Schio, José de Jesus Peixoto Camargo, Bruno Hochhegger, Luiz Carlos Severo
We report herein a case of thoracic infection due to Nocardia nova following lung re-transplantation performed for emphysema related to alpha-1-antitrypsin deficiency. The infection extended from the lung into the pleural space, thoracic wall, and mediastinum, presenting as pericarditis and empyema necessitatis. Nocardia nova was identified by 16S ribosomal deoxyribonucleic acid (rDNA) sequencing and phylogenetic analysis. According to a literature search of PubMed, LILACS and MEDLINE databases, we describe herein the first case of empyema necessitatis caused by N...
July 2016: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/27499983/when-size-matters-changing-opinion-in-the-management-of-pleural-space-the-rise-of-small-bore-pleural-catheters
#16
REVIEW
Pier Luigi Filosso, Alberto Sandri, Francesco Guerrera, Andrea Ferraris, Filippo Marchisio, Giulia Bora, Lorena Costardi, Paolo Solidoro, Enrico Ruffini, Alberto Oliaro
Tube thoracostomy is usually the first step to treat several thoracic/pleural conditions such as pneumothorax, pleural effusions, haemothorax, haemo-pneumothorax and empyema. Today, a wide range of drains is available, ranging from small to large bore ones. Indications for an appropriate selection remains yet matter of debate, especially regarding the use of small bore catheters. Through this paper, we aimed to retrace the improvements of drains through the years and to review the current clinical indications for chest drain placement in pleural/thoracic diseases, comparing the effectiveness of small-bore drains vs...
July 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27499941/the-aquamantys-%C3%A2-system-improves-haemostasis-and-pneumostasis-in-open-decortication-for-thoracic-empyema
#17
Edward J Caruana, Jakub Kadlec, Swetha Iyer, Aleksander Mani, Piergiorgio Solli, Marco Scarci
BACKGROUND: Decortication for thoracic empyema is associated with significant blood loss and prolonged postoperative air leak. We sought to assess the potential application of an irrigated-tip radiofrequency (RF) sealing device, in an attempt to reduce this morbidity. METHODS: Data for all patients undergoing open decortication (OD) for stage II thoracic empyema, using either conventional approach or facilitated by use of the Aquamantys(®) device, at a single thoracic surgical unit between April 2010 and July 2014, were retrospectively analysed...
July 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27464918/pleural-empyema-following-liver-resection-a-rare-but-serious-complication
#18
Claire Goumard, David Fuks, François Cauchy, Jacques Belghiti, Catherine Paugam-Burtz, Yves Castier, Olivier Soubrane
BACKGROUND: Postoperative pleural empyema following liver resection has not been thoroughly described in the literature yet. Hence, we aimed to describe characteristics of patients experiencing this complication. METHODS: Characteristics and outcomes of 21 patients who developed pleural empyema after hepatectomy, defined as a bacteriologically proven pleural infection with clinical and biological inflammatory signs requiring antibiotherapy and thoracic drainage, from 2001 to 2014, were retrospectively analyzed...
July 27, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27324324/thoracic-computed-tomography-is-an-effective-screening-modality-in-patients-with-penetrating-injuries-to-the-chest
#19
Aaron Strumwasser, Vincent Chong, Eveline Chu, Gregory P Victorino
BACKGROUND: The precise role of thoracic CT in penetrating chest trauma remains to be defined. We hypothesized that thoracic CT effectively screens hemodynamically normal patients with penetrating thoracic trauma to surgery vs. expectant management (NOM). METHODS: A ten-year review of all penetrating torso cases was retrospectively analyzed from our urban University-based trauma center. We included hemodynamically normal patients (systolic blood pressure ≥90) with penetrating chest injuries that underwent screening thoracic CT...
September 2016: Injury
https://www.readbyqxmd.com/read/27290712/-management-of-early-bronchopleural-fistula-after-pneumonectomy
#20
Y Li, Y Luan, Y B Cui, C Y Li
OBJECTIVE: To investigate the management of early bronchopleural fistula(BPF) within one month after pneumonectomy. METHODS: A total of 30 cases developed BPF within one month after pneumonectomy in recent 30 years were reviewed from First Hospital of Jilin University. All patients were treated by reoperation, closed drainage with or without open thoracic window, or endobronchial glue. RESULTS: Seventeen patients were returned to the operating room for reclosure of BPF, one patients died of BPF and 16 reoperations were successful...
June 7, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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