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https://www.readbyqxmd.com/read/28426471/advances-in-the-management-of-malignant-pleural-effusion
#1
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...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28426468/indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax
#2
Kevin P Haas, Alexander C Chen
PURPOSE OF REVIEW: Hepatic hydrothorax is a complication of end-stage liver disease that may have significant associated morbidity. Sodium restriction and diuretic therapy are the mainstays of treatment, though up to a quarter of patients will become refractory to this and will require a pleural drainage procedure. Thoracentesis, transjugular intrahepatic portosystemic shunt, and chemical pleurodesis all have variable success rates and associated complications in the management of hepatic hydrothorax...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28406718/pleural-touch-preparations-and-direct-visualization-of-the-pleura-during-medical-thoracoscopy-for-the-diagnosis-of-malignancy
#3
Horiana B Grosu, Macarena R Vial, Erik Vakil, Roberto F Casal, George A Eapen, Rodolfo Morice, John Stewart, Mona G Sarkiss, David E Ost
RATIONALE: During diagnostic thoracoscopy, talc pleurodesis following biopsy is appropriate if the probability of malignancy is sufficiently high. Findings on direct visual assessment of the pleura during thoracoscopy, rapid onsite evaluation (ROSE) of touch preparations (touch preps) of thoracoscopic biopsy specimens and preoperative imaging, may help predict the likelihood of malignancy; however, data on the performance of these methods are limited. OBJECTIVE: To assess the performance of ROSE of touch preps, direct visual assessment of the pleura during thoracoscopy and preoperative imaging in diagnosing malignancy...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28360465/diagnosis-and-management-options-in-malignant-pleural-effusions
#4
REVIEW
Ramakant Dixit, K C Agarwal, Archana Gokhroo, Chetan B Patil, Manoj Meena, Narender S Shah, Piyush Arora
Malignant pleural effusion (MPE) denotes an advanced malignant disease process. Most of the MPE are metastatic involvement of the pleura from primary malignancy at lung, breast, and other body sites apart from lymphomas. The diagnosis of MPE has been traditionally made on cytological examination of pleural fluid and/or histological examination of pleural biopsy tissue that still remains the initial approach in these cases. There has been tremendous advancement in the diagnosis of MPE now a day with techniques i...
March 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28344925/chest-drain-size-the-debate-continues
#5
REVIEW
Robert J Hallifax, Ioannis Psallidas, Najib M Rahman
PURPOSE OF REVIEW: Small-bore chest tubes are widely used in the management of common pleural disease. Guidelines suggest that patients with malignant pleural effusions, pneumothorax and pleural infection may be successfully managed with small-bore drains. However, good quality data is often lacking. This article reviews the evidence for the treatment efficacy and potential adverse effects of different chest tube sizes. RECENT FINDINGS: In a large randomised study, the small difference in pain scores between large and small drains was not clinically significant...
2017: Current Pulmonology Reports
https://www.readbyqxmd.com/read/28338551/standardizing-robotic-lobectomy-feasibility-and-safety-in-128-consecutive-lobectomies-within-a-single-healthcare-system
#6
John F Lazar, Laurence N Spier, Alan R Hartman, Richard S Lazzaro
OBJECTIVE: Single-surgeon cohorts assessing robotically assisted video-assisted thoracic (RA-VATS) lobectomy have reported good outcomes, but there are little data regarding multiple surgeons applying a standard technique in separate hospitals. The purpose of this study was to show how a standardized robotic technique is both safe and reproducible between surgeons and institutions. METHODS: From July 1, 2012, to October 1, 2013, patients undergoing RA-VATS lobectomy for both benign and malignant disease were identified from a prospectively collected database of two thoracic surgeons from different hospitals within the same healthcare system and retrospectively analyzed...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28326798/indwelling-pleural-catheters-for-patients-with-hematologic-malignancies-a-14-year-single-center-experience
#7
Saadia A Faiz, Priyanka Pathania, Juhee Song, Liang Li, Diwakar D Balachandran, David E Ost, Rodolfo C Morice, Vickie R Shannon, Lara Bashoura, George A Eapen, Carlos A Jimenez
RATIONALE: Placement of an indwelling pleural catheter is an established modality for symptom relief and pleurodesis in the treatment of malignant pleural effusion. Concerns remain regarding possible infectious complications, risk of hemorrhage, and the rate of pleurodesis with the use of pleural catheters in the treatment of hematologic malignancies. OBJECTIVES: The goals of our study were: (1) to evaluate the safety and cumulative incidence of pleurodesis with indwelling pleural catheters for patients with hematologic malignancies; and (2) to evaluate overall survival of this cohort of patients with pleural effusions...
March 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28316788/chemical-pleurodesis-using-mistletoe-extracts-via-spray-catheter-during-medical-thoracoscopy-for-management-of-malignant-pleural-effusion
#8
Jung Seop Eom, Tae Hwa Kim, Geewon Lee, Hyo Yeong Ahn, Jeong Ha Mok, Min Ki Lee
We present three cases of successful chemical pleurodesis with a liquid solution of mistletoe extract using a spray catheter during medical thoracoscopy. The medical thoracoscopy was performed in all presented cases to remove pleural effusion and conduct chemical pleurodesis to manage symptomatic malignant pleural effusion. A spray catheter was used to instil the mistletoe extract evenly into the pleural cavity, and there were no pleurodesis-related complications. Respiratory symptoms caused by pleural effusion improved after pleurodesis, and successful pleurodesis was maintained for more than 3 months after medical thoracoscopy in all three patients...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28271728/comparing-approaches-to-the-management-of-malignant-pleural-effusions
#9
José M Porcel, Macy Mei-Sze Lui, Andrew D Lerner, Helen E Davies, David Feller-Kopman, Y C Gary Lee
Management of symptomatic malignant pleural effusions is becoming more complex due to the range of treatment options, which include therapeutic thoracenteses, thoracoscopic talc pleurodesis, bedside pleurodesis with talc or other sclerosing agents via small-bore chest catheters, indwelling pleural catheters, surgery, or a combination of some of these procedures. Areas covered: Recent advances for the expanding range of treatment options in malignant pleural effusions are summarized, according to the best available evidence...
April 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28271362/mesothelioid-reaction-following-talc-pleurodesis-a-case-report
#10
Tatyana Faynberg, Neha Patel, Amrit P Nayar, Alan J Shienbaum
INTRODUCTION: Talc pleurodesis is a well-established procedure performed to obliterate the pleural space to prevent recurrent pleural effusion and/or recurrent pneumothorax. Pleurodesis is commonly accomplished by draining the pleural fluid, if present, followed by either a mechanical procedure, such as abrasion, pleurectomy, or instillation of a chemical irritant into the pleural space, which results in inflammation and fibrosis which obliterates the pleural space. The reported complications of talc pleurodesis are hypoxemia, hypotension, tachycardia, dyspnea, chest pain, and fever...
March 7, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28267436/management-of-persistent-air-leaks
#11
REVIEW
Karen C Dugan, Balaji Laxmanan, Septimiu Murgu, D Kyle Hogarth
Alveolar-pleural fistulas causing persistent air leaks are associated with prolonged hospital stays and high morbidity. Prior guidelines recommend surgical repair as the gold standard for treatment, albeit a solution with limited success. In patients who have recently undergone thoracic surgery or in which surgery would be contraindicated based on severity of illness, there has been a lack of treatment options. This review describes a brief history of treatment guidelines for persistent air leaks. In the past 20 years, newer and less invasive treatment options have been developed...
March 3, 2017: Chest
https://www.readbyqxmd.com/read/28257316/pleural-diseases
#12
Stefano Gasparini, Martina Bonifazi
PURPOSE OF REVIEW: Due to the increasing burden of pleural diseases worldwide, a personalized cost-effective management of these conditions is essential to optimize the healthcare sources. The current review is focused on latest evidence in diagnostic work-up and management of pleural diseases. RECENT FINDINGS: Recent research highlights the increasing role of thoracic ultrasound in both diagnostic and therapeutic interventions and the potential suitability of cytological sampling from pleural effusions for molecular analysis, essential requirement for a satisfactory test in the era of personalized anticancer therapy...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28248571/spontaneous-pneumothoraces-in-patients-with-birt-hogg-dub%C3%A3-syndrome
#13
Nishant Gupta, Elizabeth J Kopras, Elizabeth P Henske, Laura E James, Souheil El-Chemaly, Srihari Veeraraghavan, Matthew G Drake, Francis X McCormack
RATIONALE: Spontaneous pneumothorax is a common complication of Birt-Hogg-Dubé syndrome (BHD). The optimal approach to treatment and prevention of BHD-associated spontaneous pneumothorax, and to advising BHD patients regarding risk of pneumothorax associated with air travel is not well established. METHODS: Patients with BHD were recruited from the Rare Lung Diseases Clinic Network and the BHD Foundation, and surveyed about disease manifestations and air travel experiences...
March 1, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28241848/yellow-nail-syndrome-a-review
#14
REVIEW
Stéphane Vignes, Robert Baran
Yellow nail syndrome (YNS; OMIM 153300, ORPHA662) is a very rare disorder that almost always occurs after 50 years of age but a juvenile or familial form has also been observed. YNS is diagnosed based on a triad associating yellow nail discoloration, pulmonary manifestations (chronic cough, bronchiectasia, pleural effusion) and lower limb lymphedema. Chronic sinusitis is frequently associated with the triad. YNS etiology remains unknown but a role of lymphatic impairment is usually evoked. YNS is more frequently isolated but may be associated in rare cases with autoimmune diseases, other clinical manifestations implicating lymphatic functions or cancer and, hence, is also considered a paraneoplastic syndrome...
February 27, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28236589/radiofrequency-ablation-of-pulmonary-tumors-near-the-diaphragm
#15
T Iguchi, T Hiraki, H Gobara, H Fujiwara, J Sakurai, Y Matsui, T Mitsuhashi, S Toyooka, S Kanazawa
PURPOSE: To retrospectively evaluate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of lung tumors located near the diaphragm. MATERIALS AND METHODS: A total of 26 patients (15 men, 11 women; mean age, 61.5 years±13.0 [SD]) with a total of 29 lung tumors near the diaphragm (i.e., distance<10mm) were included. Mean tumor diameter was 11.0mm±5.3 (SD) (range, 2-23mm). Efficacy of RFA, number of adverse events and number of adverse events with a grade≥3, based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4...
February 21, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28216863/efficacy-and-safety-of-povidone-iodine-pleurodesis-in-malignant-pleural-effusions
#16
Hadi Kahrom, Manouchehr Aghajanzadeh, Mohammad Reza Asgari, Mahdi Kahrom
INTRODUCTION: Malignant pleural effusion (MPE) is determined by the detection of malignant cells in pleural fluid or pleural tissue. Neoplasm of lung, breast, ovary and lymphoma are the causes of more than 75% of MPE. Pleurodesis is a usual technique in the management of MPE to achieve a symphysis between two layers of the pleura, and various chemical agents have been used in an attempt to produce pleurodesis. With regard to complications and limitations of these sclerosing agents, efficacy and safety of povidone-iodine have been investigated in this study...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28215672/study-of-poly-%C3%A9-caprolactone-membranes-for-pleurodesis
#17
Ke-Cheng Chen, Min-Shu Hsieh, Yun-Ru Li, Yong-Chong Lin, Hong-Shiee Lai, Ming-Jium Shieh, Jin-Shing Chen, Tai-Horng Young
BACKGROUND/PURPOSE: Pleurodesis with biomaterial membrane is an emerging treatment method for pneumothorax. However, the ideal one for the common disease is still under debate. METHODS: We investigate the Poly-ε-caprolactone (PCL) membrane pleurodesis by using New Zealand White rabbits, which was sacrificed for examination one month later. Moreover, inflammation and fibrosis scoring were done under microscopic evaluation, as well as Western blot analysis in vitro and in vivo...
February 16, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28180108/acute-respiratory-distress-syndrome-after-viscum-album-pleurodesis-for-primary-spontaneous-pneumothorax
#18
Dongsub Noh, Joon Suk Park, Doo Yun Lee
A 52-year-old male patient who underwent multiple wedge resections experienced postoperative acute respiratory distress syndrome in both lungs after Viscum album pleurodesis. Despite initial rapid deterioration in clinical condition and rapid progression of bilateral lung infiltration, he exhibited a relatively smooth clinical recovery with marked response to glucocorticoid treatment. Our case report suggests that care must be taken to guard against the development of acute respiratory complications in the use of Viscum album for pleurodesis...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28168984/pleurectomy-versus-pleural-abrasion-for-primary-spontaneous-pneumothorax-in-children
#19
Shahrzad Joharifard, Brian A Coakley, Sonia A Butterworth
PURPOSE: Primary spontaneous pneumothorax (PSP) represents a common indication for urgent surgical intervention in children. First episodes are often managed with thoracostomy tube, whereas recurrent episodes typically prompt surgery involving apical bleb resection and pleurodesis, either via pleurectomy or pleural abrasion. The purpose of this study was to assess whether pleurectomy or pleural abrasion was associated with lower postoperative recurrence. METHODS: The records of patients undergoing surgery for PSP between February 2005 and December 2015 were retrospectively reviewed...
January 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28156621/comparison-of-two-indwelling-pleural-catheter-types-for-malignant-pleural-effusions
#20
Sushilkumar Satish Gupta, Abhinav Binod Chandra
205 Background: Indwelling pleural catheter (IPC) placement is an alternative to chemical pleurodesis for malignant pleural effusion (MPE), a complication of advanced cancer. In 1997 an IPC was approved which uses vacuum bottles (VB) for drainage (PleurX, Becton, Dickinson and Company, Franklin Lakes, NJ), and later another IPC system, which employs a manually operated vacuum pump (VP) for drainage (Aspira, Bard Access Systems, Salt Lake City, UT). Most studies comparing IPC versus chemical pleurodesis used the VB IPC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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