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pleural empyema

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https://www.readbyqxmd.com/read/28324171/risk-factors-for-delayed-gastric-emptying-after-esophagectomy
#1
Frank Benedix, Tobias Willems, Siegfried Kropf, Daniel Schubert, Patrick Stübs, Stephanie Wolff
PURPOSE: Delayed gastric emptying (DGE) is a common functional disorder after esophagectomy with gastric tube reconstruction. Little is known about risk factors that can predict this debilitating complication. METHODS: Patients who underwent elective esophagectomy from 2008 to 2016 in a single center were retrospectively reviewed. Diagnosis of DGE was based on clinical, radiological, and endoscopic findings. Uni- and multivariate analyses were performed to identify patient-, tumor-, and procedure-related factors that increase the risk of DGE...
March 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28304084/surgical-versus-non-surgical-management-for-pleural-empyema
#2
REVIEW
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28293000/-endobronchial-watanabe-spigot-in-treating-pleural-empyema-with-fistula
#3
Atsushi Sekimura, Takashi Yoshimatsu, Naoki Yamashita, Hanae Higa, Takeaki Miyata, Daigo Kawano, Tetsuya So
For pleural empyema with fistula, fenestration and subsequent omental plombage, and thoracoplasty are frequently necessary. A 57-year-old man was transported by ambulance because of impaired consciousness and septic shock due to pleural empyema on the right caused by a ruptured lung abscess. We performed empyema curettage urgently, drained 800 ml of purulent pleural effusion, and inserted 3 chest tubes. Postoperative air leakage from the ruptured lung abscess of the middle lobe was noted, and respiratory failure was prolonged...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28273226/parapneumonic-pleural-effusion-reality-and-strategies-in-an-amazon-university-hospital
#4
Claudia Giselle Santos Arêas, Geraldo Roger Normando Júnior, Orlando Sandoval Farias Júnior, Irna Carla DO Rosário Souza Carneiro
OBJECTIVE: to define the profile and analyze the postoperative evolution of children with parapneumonic pleural effusion (PPE), and to evaluate strategies used in the presence of diagnostic and therapeutic limitations, emphasizing the open thoracic drainage (OTD) . METHODS: we conducted a cross-sectional, prospective, analytical study in which we followed children admitted in an Amazon university hospital with surgically addressed PPE, from October 2010 to October 2011...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28251028/empyema-due-to-streptococcus-pneumoniae-serotype-9v-in-a-child-immunized-with-13-valent-conjugated-pneumococcal-vaccine
#5
Murat Sütçü, Hacer Aktürk, Fatih Karagözlü, Ayper Somer, Nezahat Gürler, Nuran Salman
BACKGROUND: Clinical vaccine failure is the occurence of the specific vaccine-preventable disease in an appropriately and fully vaccinated person after enough time has elapsed for protection against the antigens of the vaccine to develop. Fully immunized cases with pneumoccal vaccine may sometimes develop a complicated pneumonia with empyema caused by a vaccine serotype. CASE REPORT: A 2 year-old male patient was admitted with the complaints of fever. On the basis of findings and laboratory results, the patient was diagnosed as having empyema...
January 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28249343/predictors-of-outcome-in-modern-surgery-for-lung-abscess
#6
Michael Schweigert, Norbert Solymosi, Attila Dubecz, Joseph John, Doug West, Paul Leonhard Boenisch, Riyad Karmy-Jones, Carlos F Giraldo Ospina, Ana Beatriz Almeida, Helmut Witzigmann, Hubert J Stein
Background Surgery for lung abscess is a challenging task. Timing and indications for surgery are not well established. Identification of predictors of outcome could help to clarify the role of surgery. Methods Patients who underwent major thoracic surgery for infectious lung abscess were identified at six centers for general thoracic surgery in Germany, Spain, the United Kingdom, and the United States. Study period was 2000 to 2016. Results There were 91 patients. Pulmonary sepsis (48), pleural empyema (43), persistent air leakage (25), acute renal failure (12), and respiratory failure with mechanical ventilation (25) were already preoperatively present...
March 1, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28215651/behaviour-of-nucleated-cells-in-various-types-of-pleural-effusion
#7
L Ferreiro, T Pereiro, E San José, M E Toubes, J Suárez-Antelo, J M Álvarez Dobaño, F J González Barcala, N Rodríguez Núñez, A Lama, L Valdés
INTRODUCTION: To know the behavior of cellular components of pleural fluid can help focus the differential diagnosis of a pleural effusion. Our objective was to assess their composition in different types of pleural effusions and assess whether it provides relevant clinical information. PATIENTS AND METHODS: Observational, cross-sectional and retrospective study in which the cellular components of pleural effusions of different etiology were analyzed. Pleural effusions were classified as neutrophilic, lymphocytic (≥50% of each one of them), eosinophilic (≥10%) or mesothelial (>5%) and were grouped into six diagnostic categories RESULTS: 1...
February 16, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28203426/a-novel-technique-for-chest-drain-removal-using-a-two-layer-method-with-triclosan-coated-sutures
#8
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In thoracic surgery, a thoracic drain is always inserted after the surgical procedure. Repair of the wound after removal of the thoracic tube is performed postoperatively, but no universally standard methods currently exists for this tube removal. Here we report a technique using triclosan-coated sutures that is used in thoracic surgery in our hospital. There are several advantages of this technique. First, there is no need for stitches removal on follow-up. Second, it prevents the leakage of pleural exudate because of the tight two-layer sutures...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28186288/granulated-sugar-in-the-complex-management-of-empyema-from-broncho-pleural-fistula
#9
Leonardo Duranti, Luca Tavecchio, Giovanni Leuzzi, Ugo Pastorino
No abstract text is available yet for this article.
February 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28137493/prehospital-nsaids-use-prolong-hospitalization-in-patients-with-pleuro-pulmonary-infection
#10
Ourania S Kotsiou, Sotirios G Zarogiannis, Konstantinos I Gourgoulianis
OBJECTIVE: Nonsteroidal anti-inflammatory drug (NSAID) pre-hospitalization consumption might affect the course of pneumonia. We opted to assess the potential effects of pre-hospitalization use of NSAIDs in patients with pleuropulmonary infection in the context of the duration of hospitalization. METHODS: A prospective observational study of 57 consecutive patients with a diagnosis of pneumonia and parapneumonic pleural effusion was conducted. The exact medication history the previous fifteen days was recorded...
February 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28131104/a-simplified-technique-for-drainage-of-chronic-calcified-pleural-empyema
#11
Sani Rabiou, Hama Younssa, James Didier, Magagi Ibrahim, Adamou Harissou, Ousseini Adakal, Rachid Sani
Chronic pleural pocket has well-known diagnosis and treatment principles since first described by Hippocrates 2,400 years ago. However, its treatment remains constant even though its causes, severity during management, and terrain vary considerably. In well-structured health care systems, posttuberculous empyema has become rare; its well-codified medical treatment relies on early diagnosis and adapted antibiotherapy, punctures/drainage, and appropriate intrapleural antifibrinolytics. In developing countries, a poor health organizational system increases the incidence of pleural pocket, which can progress until surgery is indicated...
January 28, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28108575/uniportal-thoracoscopic-decortication-for-pleural-empyema-and-the-role-of-ultrasonographic-preoperative-staging%C3%A2
#12
Stefano Bongiolatti, Luca Voltolini, Sara Borgianni, Roberto Borrelli, Giorgia Tancredi, Domenico Viggiano, Alessandro Gonfiotti
OBJECTIVES: The surgical approach to chronic pleural empyema is still controversial. Video-assisted thoracic surgery (VATS) debridement and decortication has shown favourable outcomes, while the uniportal VATS (U-VATS) approach is still anecdotal. We report our experience with ultrasonographic (US) preoperative staging followed by U-VATS decortication for pleural empyema. METHODS: We performed a retrospective analysis of patients who underwent surgical treatment of stage II and stage III pleural empyema from 2012 to 2015...
January 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28087049/-the-benefits-of-digital-chest-drainage-in-pleural-decortication-in-thoracic-empyema-prospective-randomized-control-trial
#13
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/28078131/a-novel-management-of-post-oesophagectomy-gastro-pleural-fistula
#14
Javaid Ishtiaq, Jonathan Sutton, Waqar Ahmed
Oesophageal anastomotic leak and fistula are major and life-threatening complications of oesophagectomy with resultant increased mortality. Non-operative approach of such cases should be the initial strategy. Re-operative surgery and/or stent insertion are considered if conservative measures failed. Although oesophageal stenting is a safe option for the leaks, stent migration and failure to completely cover large anastomotic leaks are the main complications and pitfalls of the procedure. These can be overcome by using multiple or larger stents...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28054135/-community-acquired-pneumonia
#15
S Poetter-Lang, C J Herold
CLINICAL ISSUE: The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters. STANDARD RADIOLOGICAL METHODS: For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. METHODICAL INNOVATIONS: Based on the evaluation of the different radiological patterns as well as their extent and distribution, a rough allocation to so-called pathogen groups as well as a differentiation between viral and bacterial infections are possible; however, because different pathogens cause different patterns an accurate correlation is not feasible by relying purely on imaging...
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
#16
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
#17
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/28009947/root-replacement-for-graft-infection-using-an-all-biologic-xenopericardial-conduit
#18
Sabina PW Guenther, Angela Reichelt, Sven Peterss, Maximilian Luehr, Erik Bagaev, Christian Hagl, Maximilian A Pichlmaier, Nawid Khaladj
BACKGROUND: The management of graft infection following ascending aortic replacement (AAR) and/or aortic valve replacement (AVR) with destruction of the root remains a challenge. Besides technical issues, the choice of graft material is controversial. The study aim was to investigate the initial results of aortic root replacement (ARR) as redo-surgery for infection using the xenopericardial all-biologic conduit (BioIntegral) as an alternative to a homograft or prosthetic material. METHODS: Between February 2013 and January 2015, a total of 18 consecutive patients (16 males, two females; mean age 61 ± 14 years) were reoperated on for infection at a mean of 55 ± 61 months (range: 3 to 219 months) following previous AVR (n = 6), supracoronary aortic replacement (SAR, n = 2), AVR + SAR (n = 1), root replacement (n = 7), and root reconstruction (n = 2)...
2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28003678/usefulness-of-thoracoscopic-debridement-for-chronic-empyema-after-an-extrapleural-pneumonectomy
#19
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/27987101/systemic-air-embolism-during-pleural-lavage-for-empyema
#20
Masatsugu Ohuchi, Shuhei Inoue, Yoshitomo Ozaki, Keiko Ueda
Pleural lavage has been considered a convenient and safe method that is often performed for empyema. We report a case of systemic air embolism that developed during pleural lavage. A 53-year-old man with empyema in the organizing phase suddenly developed paralysis of the left side of the body and altered level of consciousness during pleural lavage, which was performed in a sitting position without negative pressure suction. Systemic air embolism was diagnosed based on computed tomography. In this case, use of fibrinolytic agents, positioning during pleural lavage, and pressure in an empyema cavity may have predisposed to development of systemic air embolism...
December 16, 2016: General Thoracic and Cardiovascular Surgery
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