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Talc slurry

Rahul Bhatnagar, Emma K Keenan, Anna J Morley, Brennan C Kahan, Andrew E Stanton, Mohammed Haris, Richard N Harrison, Rehan A Mustafa, Lesley J Bishop, Liju Ahmed, Alex West, Jayne Holme, Matthew Evison, Mohammed Munavvar, Pasupathy Sivasothy, Jurgen Herre, David Cooper, Mark Roberts, Anur Guhan, Clare Hooper, James Walters, Tarek S Saba, Biswajit Chakrabarti, Samal Gunatilake, Ioannis Psallidas, Steven P Walker, Anna C Bibby, Sarah Smith, Louise J Stadon, Natalie J Zahan-Evans, Y C Gary Lee, John E Harvey, Najib M Rahman, Robert F Miller, Nick A Maskell
BACKGROUND: Malignant pleural effusion affects more than 750,000 persons each year across Europe and the United States. Pleurodesis with the administration of talc in hospitalized patients is the most common treatment, but indwelling pleural catheters placed for drainage offer an ambulatory alternative. We examined whether talc administered through an indwelling pleural catheter was more effective at inducing pleurodesis than the use of an indwelling pleural catheter alone. METHODS: Over a period of 4 years, we recruited patients with malignant pleural effusion at 18 centers in the United Kingdom...
April 5, 2018: New England Journal of Medicine
Maria Aurora Mendes, Nuno China Pereira, Carla Ribeiro, Manuela Vanzeller, Teresa Shiang, Rita Gaio, Sérgio Campainha
INTRODUCTION: The optimal chest tube type and size for drainage and chemical pleurodesis of malignant pleural effusions remains controversial. This retrospective study was conducted to compare the efficacy of conventional versus pigtail chest tube in the treatment of malignant pleural effusions. METHODS: Patients submitted to chest tube drainage and slurry talc pleurodesis due to malignant pleural effusion in our pulmonology ward from 2012 to 2016 were eligible...
March 30, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Shinya Sakata, Yuichiro Matsuoka, Kenta Kawahara, Yosuke Kakiuchi, Akira Takaki, Akiyuki Hirosue, Ryoji Yoshida, Sho Saeki, Kazuhiko Fujii, Hideki Nakayama
A 70-year-old Japanese man with recurrent squamous cell carcinoma of the head and neck presented with severe interstitial pneumonia associated with nivolumab, after talc slurry pleurodesis. Following the development of malignant pleural effusion, he underwent chest drainage and was administered intrathoracic talc as a pleurodesis. Two weeks later, we administered nivolumab (3mg/kg) to be repeated every 2 weeks. However, on day 12, chest computed tomography scan demonstrated diffuse non-segmental ground-glass opacity and mild bronchiectasis...
March 2018: Respiratory Investigation
Jacopo Vannucci, Guido Bellezza, Alberto Matricardi, Giulia Moretti, Antonello Bufalari, Lucio Cagini, Francesco Puma, Niccolò Daddi
Talc pleurodesis has been associated with pleuropulmonary damage, particularly long-term damage due to its inert nature. The present model series review aimed to assess the safety of this procedure by examining inflammatory stimulus, biocompatibility and tissue reaction following talc pleurodesis. Talc slurry was performed in rabbits: 200 mg/kg checked at postoperative day 14 (five models), 200 mg/kg checked at postoperative day 28 (five models), 40 mg/kg, checked at postoperative day 14 (five models), 40 mg/kg checked at postoperative day 28 (five models)...
January 2018: Experimental and Therapeutic Medicine
Kasia Czarnecka-Kujawa, Alain Tremblay, Kazuhiro Yasufuku, Anna Sczaniecka, Sujeeth Parthiban, Lawrence Kunz, David Dillard, Xavier Gonzalez
BACKGROUND: Needle samples may not provide sufficient diagnostic material for the assessment of mediastinal lymph nodes. OBJECTIVE: The study compared the specimen size and diagnostic performance of a new 19-G endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) needle to that of a standard 22-G EBUS-TBNA needle in a swine model of granulomatous lymphadenopathy. METHODS: Granulomatous inflammation was induced in mediastinal lymph nodes (LNs) of 10 domestic swine by injection of talc slurry...
2018: Respiration; International Review of Thoracic Diseases
P S Santos, M A Marques, C Cruz, H Monteiro, F Fradinho
INTRODUCTION: Malignant pleural effusions are an important burden of malignant disease. Slurry talc pleurodesis remains one of the most common and effective therapeutic options. AIM: Investigate the predictive factors related with the efficacy of this technique in malignant pleural effusions. METHODS: Retrospective analysis of all pleurodesis performed during a 10-year period in a Pulmonology Unit. All demographic and clinical data were collected, including the histologic tumoral type and the biochemical, microbiological and cytological fluid features...
July 2017: Revista Portuguesa de Pneumologia
P Sivakumar, A Douiri, A West, D Rao, G Warwick, T Chen, L Ahmed
INTRODUCTION: The development of malignant pleural effusion (MPE) results in disabling breathlessness, pain and reduced physical capability with treatment a palliative strategy. Ambulatory management of MPE has the potential to improve quality of life (QoL). The OPTIMUM trial is designed to determine whether full outpatient management of MPE with an indwelling pleural catheter (IPC) and pleurodesis improves QoL compared with traditional inpatient care with a chest drain and talc pleurodesis...
October 18, 2016: BMJ Open
Kango Nohara, Kazuto Takada, Eiji Kojima, Kiyoko Ninomiya, Shoko Miyamatsu, Takahiro Shimizu, Tsutomu Sakurai, Takaaki Mizuno, Yuuki Yamashita
BACKGROUND: The choice of an optimal sclerosant for pleurodesis for malignant pleural effusion remains controversial. This retrospective clinical study compared the efficacy and safety of two sclerosants; talc slurry (talc-s) and OK-432. METHODS: We compared the characteristics, 30/90-day success rates, and adverse events in patients with lung adenocarcinoma who underwent pleurodesis by using either OK-432 or talc-s. Propensity score matching was used to compare the two scelrosants...
September 2016: Respiratory Investigation
Susan Walker, Marijana Zubrinic, Christine Massey, Yaron Shargall, Eric Bédard, Gail Darling
BACKGROUND: In a patient population with a limited life expectancy, malignant pleural effusion can significantly impact quality of life (QoL). Different treatment options are available, each with its own effect on QoL. To date, satisfaction with treatment options has not been evaluated. PURPOSE: To evaluate QoL and satisfaction with treatment using patient-reported outcomes for four different treatment strategies. DESIGN: A prospective, cohort study that compared four treatment options: indwelling pleural catheter (IPC); video assisted thoracic surgery (VATS) and IPC; chest tube and talc slurry; and VATS talc poudrage...
July 2, 2016: International Journal of Palliative Nursing
Amelia O Clive, Hayley E Jones, Rahul Bhatnagar, Nancy J Preston, Nick Maskell
BACKGROUND: Malignant pleural effusion (MPE) is a common problem for people with cancer as a result of malignant infiltration of the pleura. It is usually associated with considerable breathlessness. A number of treatment options are available to manage the uncontrolled accumulation of pleural fluid including administration of a pleurodesis agent (either via a chest tube or at thoracoscopy) or indwelling pleural catheter insertion. OBJECTIVES: To ascertain the optimal management strategy for adults with malignant pleural effusion in terms of pleurodesis success...
May 8, 2016: Cochrane Database of Systematic Reviews
Alexandra Bucknor, Karen Harrison-Phipps, Thomas Davies, Levon Toufektzian
A best evidence topic was written according to a structured protocol. The question addressed was whether silver nitrate (SN) is an effective means of pleurodesis. A total of 42 papers were identified using the reported search, of which 8 represented the best evidence to address the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Three studies assessed the efficacy of SN in inducing pleurodesis in patients with malignant pleural effusion (MPE)...
October 2015: Interactive Cardiovascular and Thoracic Surgery
Srinivas Mummadi, Anusha Kumbam, Peter Y Hahn
BACKGROUND: Malignant Pleural Effusion (MPE) is common with advanced malignancy. Palliative care with minimal adverse events is the cornerstone of management. Although talc pleurodesis plays an important role in treatment, the best modality of talc application remains controversial.   OBJECTIVE: To compare rates of successful pleurodesis, rates of respiratory and non-respiratory complications between thoracoscopic talc insufflation/poudrage (TTI) and talc slurry (TS)...
2014: F1000Research
Sam A Walling, Hajime Kinoshita, Susan A Bernal, Nick C Collier, John L Provis
A cementitious system for the immobilisation of magnesium rich Magnox sludge was produced by blending an Mg(OH)2 slurry with silica fume and an inorganic phosphate dispersant. The Mg(OH)2 was fully consumed after 28 days of curing, producing a disordered magnesium silicate hydrate (M-S-H) with cementitious properties. The structural characterisation of this M-S-H phase by (29)Si and (25)Mg MAS NMR showed clearly that it has strong nanostructural similarities to a disordered form of lizardite, and does not take on the talc-like structure as has been proposed in the past for M-S-H gels...
May 7, 2015: Dalton Transactions: An International Journal of Inorganic Chemistry
Suk Ju Cho, Su Wan Kim, Jee Won Chang
Chemical pleurodesis is widely recommended in the treatment of pulmonary air leak of different etiologies as well as malignant pleural effusions and chylothorax. Conventional chemical pleurodesis using erythromycin, tetracycline, hydrophilic fumed silica, autologous blood and talc slurry has been standardized, and its complications, including high fever, intractable chest pain, and acute lung injury, seem to be frequent. Viscum album extract is a new chemical agent for pleurodesis, and only a few studies have reported outcomes of such chemical pleurodesis in the treatment of malignant pleural effusion...
2014: Multidisciplinary Respiratory Medicine
Serkan Özkul, Akif Turna, Ahmet Demirkaya, Burcu Aksoy, Kamil Kaynak
BACKGROUND: Chemical pleurodesis can be palliative for recurrent, symptomatic pleural effusions in patients who are not candidate for a thoracic surgical procedure. We hypothesized that effective pleurodesis could be accomplished with a rapid method of pleurodesis as effective as the standard method. METHODS: A prospective randomized 'non-inferiority' trial was conducted in 96 patients with malignant pleural effusion (MPE) who are not potentially curable and/or not amenable to any other surgical intervention...
December 2014: Journal of Thoracic Disease
Liju Ahmed, Hugh Ip, Deepak Rao, Nishil Patel, Farinaz Noorzad
Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24) with a symptomatic malignant pleural effusion who underwent talc pleurodeses via IPCs between December 2010 and July 2013. Successful pleurodesis was achieved in 22 procedures (92%). There was one empyema, one hydropneumothorax, one recurrent effusion, and two minor complications: one drain site wound infection and one complaint of chest pain...
December 2014: Chest
Rahul Bhatnagar, Magda Laskawiec-Szkonter, Hania E G Piotrowska, Brennan C Kahan, Clare E Hooper, Helen E Davies, John E Harvey, Robert F Miller, Najib M Rahman, Nick A Maskell
INTRODUCTION: The management of recurrent malignant pleural effusions (MPE) can be challenging. Various options are available, with the most efficacious and widely used being talc pleurodesis. Talc can either be applied via a chest drain in the form of slurry, or at medical thoracoscopy using poudrage. Current evidence regarding which method is most effective is conflicting and often methodologically flawed. The TAPPS trial is a suitably powered, multicentre, open-label, randomised controlled trial designed to compare the pleurodesis success rate of medical thoracoscopy and talc poudrage with chest drain insertion and talc slurry...
November 26, 2014: BMJ Open
Edward T H Fysh, Rajesh Thomas, Catherine A Read, Ben C H Kwan, Ben C H Lam, Elaine Yap, Fiona C Horwood, Pyng Lee, Francesco Piccolo, Ranjan Shrestha, Luke A Garske, David C L Lam, Andrew Rosenstengel, Michael Bint, Kevin Murray, Nicola A Smith, Y C Gary Lee
INTRODUCTION: Malignant pleural effusion can complicate most cancers. It causes breathlessness and requires hospitalisation for invasive pleural drainages. Malignant effusions often herald advanced cancers and limited prognosis. Minimising time spent in hospital is of high priority to patients and their families. Various treatment strategies exist for the management of malignant effusions, though there is no consensus governing the best choice. Talc pleurodesis is the conventional management but requires hospitalisation (and substantial healthcare resources), can cause significant side effects, and has a suboptimal success rate...
November 6, 2014: BMJ Open
Pedro de Araujo, Ricardo Terra, Paulo Pêgo-Fernandes, Rodrigo Chate
Pleural DiseaseSESSION TYPE: Original Investigation SlidePRESENTED ON: Wednesday, October 29, 2014 at 02:45 PM - 04:15 PMPURPOSE: To investigate the impact of the pleural catheter position on the success of bedside pleurodesis, residual pleural space after effusion's drainage and acumulation of effusion pos pleurodesis in patientes with recurrent malignant pleural effusions (RMPEs).METHODS: We retrospectively analysed 80 patients with RMPEs treated with pleurodesis (talc or silver nitrate slurry) at our hospital between June 2009 and September 2013...
October 1, 2014: Chest
Nusret Ramić, Goran Krdžalić, Nermin Mušanović, Ferid Konjić, Sefika Umihanić, Suada Ramić, Jasminka Mustedanagić-Mujanović, Farid Ljuca, Enver Zerem
AIM: To determine the efficiency and safety of talc pleurodesis in treating the malignant pleural effusion and recurrent spontaneous pneumothorax. METHODS: The study included 54 patients with malignant pleural effusion and recurrent spontaneous pneumothorax, who underwent talc pleurodesis using the "talc slurry" method of pleural talc obliteration. RESULTS: Pleurodesis was successful in 52 (96%) patients. The average duration of thoracic drainage was 4...
August 2014: Medicinski Glasnik
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