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https://www.readbyqxmd.com/read/28694705/management-of-malignant-pleural-effusion-challenges-and-solutions
#1
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/28638007/-re-operations-in-patients-with-heart-wounds
#2
Yu A Radchenko, M M Abakumov, E S Vladimirova, A N Pogodina, O V Nikitina
AIM: To define the risk factors of complications which are followed by re-operations in patients with cardiac and pericardial wounds and to prevent these complications. MATERIAL AND METHODS: Retrospective and prospective analysis of 1072 victims with cardiac and pericardial injuries for 35 years was performed. Overall mortality was 17.2%. 98 patients died during surgery. Postoperative bleeding was observed in 38 (3.9%) cases. RESULTS: In 28 cases re-operations were performed for bleeding-related complications...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#3
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28476108/diaphragmatic-surgery-and-related-complications-in-primary-cytoreduction-for-advanced-ovarian-tubal-and-peritoneal-carcinoma
#4
Shuang Ye, Tiancong He, Shanhui Liang, Xiaojun Chen, Xiaohua Wu, Huijuan Yang, Libing Xiang
BACKGROUND: To evaluate the procedures and complications of diaphragm peritonectomy (DP) and diaphragm full-thickness resection (DFTR) during primary cytoreduction for advanced stage epithelial ovarian cancer. METHODS: All the patients with epithelial ovarian carcinoma who underwent diaphragm procedures at our institution between January 2009 and August 2015 were identified. Clinicopathological data were retrospectively collected from the patients' medical records...
May 5, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28453807/attrition-in-patients-with-single-ventricle-and-trisomy-21-outcomes-after-a-total-cavopulmonary-connection
#5
Anastasios C Polimenakos, Sujata Subramanian, Chawki ElZein, Michel N Ilbawi
OBJECTIVES: Data are limited regarding the management of children with trisomy 21 (T21) syndrome and a functional single ventricle (FSV). We evaluated patients with T21 and a FSV who had a total cavopulmonary connection (TCPC). METHODS: From September 1999 to August 2012, 139 patients with a FSV underwent a TCPC. Sixty-five had unbalanced atrioventricular septal defect. Thirteen had T21. Three (of 13) had heterotaxy syndrome. The mean age at the Fontan operation was 27...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28410638/utility-of-objective-chest-tube-management-after-pulmonary-resection-using-a-digital-drainage-system
#6
Kazuya Takamochi, Kota Imashimizu, Mariko Fukui, Tatsuo Maeyashiki, Mikiko Suzuki, Takuya Ueda, Hironori Matsuzawa, Shunki Hirayama, Takeshi Matsunaga, Shiaki Oh, Kenji Suzuki
BACKGROUND: We sought to evaluate the clinical utility of chest tube management after pulmonary resection based on objective digital monitoring of pleural pressure and digital surveillance for air leaks. METHODS: We prospectively recorded the perioperative data of 308 patients who underwent pulmonary resection between December 2013 and January 2016. We used information from a digital monitoring thoracic drainage system to measure peak air leakage during the first 24 hours after the operation, patterns of air leakage over the first 72 hours, and patterns of pleural pressure changes until the chest tubes were removed...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28403094/less-invasive-management-of-deep-neck-infection-and-descending-necrotizing-mediastinitis-a-single-center-retrospective-study
#7
Dong Wei, Ling Bi, Huiyong Zhu, Jianfeng He, Huiming Wang
By a 7-year retrospective review, we reported our experience in management of descending necrotizing mediastinitis (DNM) and deep neck infection (DNI). A retrospective design was used to reveal the clinical characteristics of DNI and DNM. The clinical outcome was analyzed to validate less invasive management. We reviewed 82 patients between 2009 and 2016, 12 of which were diagnosed as DNM by clinical and computed tomography findings. A total of 35 patients had relevant systemic conditions, mainly diabetes mellitus (19 patients)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28370693/computed-tomography-scoring-system-for-discriminating-between-parapneumonic-effusions-eventually-drained-and-those-cured-only-with-antibiotics
#8
José M Porcel, Marina Pardina, Carmen Alemán, Esther Pallisa, Richard W Light, Silvia Bielsa
BACKGROUND AND OBJECTIVE: Due to limited data, we aimed to develop and validate a computed tomography (CT)-based scoring system for identifying those parapneumonic effusions (PPEs) requiring drainage. METHODS: A retrospective review of all patients with PPE who underwent thoracentesis and a chest CT scan before any attempt to place a tube thoracostomy, if applicable, over an 8-year period was conducted. Eleven chest CT characteristics were compared between 90 patients with complicated PPEs (CPPEs), defined as those which eventually required chest drainage, and 60 with non-complicated effusions (derivation sample)...
August 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28351595/congenital-chylothorax
#9
REVIEW
Mohammad A Attar, Steven M Donn
Congenital chylothorax (CC) results from multiple lymphatic vessel anomalies or thoracic cavity defects and may accompany other congenital anomalies. Fetal chylothorax may increase the risk of death and complications from pleural space lymphatic fluid accumulation, which compromises lung development, pulmonary, and cardiovascular function and from complications arising from the loss of drained lymphatic contents. Prenatal interventions might improve survival in severe cases of fetal chylothorax. The neonatal treatment strategy is generally supportive with interventions that include thoracostomy drainage and attempts to decrease chyle flow using a stepwise approach that begins with the least invasive means...
March 25, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28324671/dose-de-escalation-of-intrapleural-tissue-plasminogen-activator-therapy-for-pleural-infection-the-alteplase-dose-assessment-for-pleural-infection-therapy-project
#10
Natalia Popowicz, Oliver Bintcliffe, Duneesha De Fonseka, Kevin G Blyth, Nicola A Smith, Francesco Piccolo, Geoffrey Martin, Donny Wong, Anthony Edey, Nick Maskell, Y C Gary Lee
RATIONALE: Intrapleural therapy with a combination of tissue plasminogen activator (tPA) 10 mg and DNase 5 mg administered twice daily has been shown in randomized and open-label studies to successfully manage over 90% of patients with pleural infection without surgery. Potential bleeding risks associated with intrapleural tPA and its costs remain important concerns. The aim of the ongoing Alteplase Dose Assessment for Pleural infection Therapy (ADAPT) project is to investigate the efficacy and safety of dose de-escalation for intrapleural tPA...
June 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28215134/drainage-of-pleural-effusion-improves-diaphragmatic-function-in-mechanically-ventilated-patients
#11
Michele Umbrello, Giovanni Mistraletti, Andrea Galimberti, Ilaria R Piva, Ottavia Cozzi, Paolo Formenti
BACKGROUND: Pleural effusion adversely affects the pressuregenerating capacity of the diaphragm. It uncouples the lung and chest wall, which may result in diaphragmatic dysfunction. Information on the effects of effusion drainage on diaphragmatic function is limited, but several studies report relief of dyspnoea after drainage, which was attributed to improved diaphragmatic mechanics, even if this issue was never formally addressed. OBJECTIVE: To investigate the effect of drainage of unilateral pleural effusion on diaphragmatic function...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28193088/scrotal-abscess-a-rare-presentation-of-complicated-necrotizing-pancreatitis
#12
Seyyedhadi Mirhashemi, Mohsen Soori, Gholamhossein Faghih, Hassan Peyvandi, Omid Shafagh
Acute pancreatitis is characterized by activation of digestive enzymes inside the pancreas. In severe pancreatitis, necrosis of pancreas and surrounding tissues may occur. Acute necrotizing pancreatitis commonly presents as pancreatic abscess occasionally with systemic complications. Rarely, necrotic tissue may be drained from scrotum due to retroperitoneal extension of necrotic process. Here, we report a case of acute necrotizing pancreatitis in a 29-year-old man who presented with severe abdominal pain, nausea and vomiting...
February 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28156621/comparison-of-two-indwelling-pleural-catheter-types-for-malignant-pleural-effusions
#13
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
https://www.readbyqxmd.com/read/28131104/a-simplified-technique-for-drainage-of-chronic-calcified-pleural-empyema
#14
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/28104132/everolimus-induced-systemic-serositis-after-simultaneous-liver-and-kidney-transplantation-a-case-report
#15
K Kim, D W Jeong, Y H Lee, Y G Kim, J-Y Moon, K-H Jeong, T W Lee, C-G Ihm, S-H Joo, H-C Park, S-H Lee
Although everolimus, a mammalian target of rapamycin inhibitor, has been used as a potent immunosuppressive agent in organ transplantation, data regarding its adverse effect profile compared with that of sirolimus in clinical circumstances are limited. A 50-year-old man who underwent simultaneous liver and kidney transplantation 14 months previously was admitted with large pleural effusion, pericardial effusion, and ascites. Laboratory findings and cultures for possible infectious causes were all negative. Pericardial window surgery with drainage of the pericardial fluid was performed on day 3...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28087049/-the-benefits-of-digital-chest-drainage-in-pleural-decortication-in-thoracic-empyema-prospective-randomized-control-trial
#16
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/28040756/current-practices-in-the-management-of-malignant-pleural-effusions-a-survey-among-members-of-the-european-society-of-thoracic-surgeons
#17
Marco Scarci, Edward Caruana, Luca Bertolaccini, Benedetta Bedetti, Alessandro Brunelli, Gonzalo Varela, Kostas Papagiannopoulos, Jaroslaw Kuzdzal, Gilbert Massard, Enrico Ruffini, Pierre Emmanuel Falcoz, Isabelle Opitz, Hasan Batirel, Alper Toker, Gaetano Rocco
Objectives: Malignant pleural effusion (MPE) commonly complicates advanced malignancy and their exact management is still undefined. We undertook a survey to determine the current practice among members of the European Society of Thoracic Surgeons (ESTS). Methods: A cross-sectional survey focused on the current practice of management of MPE was developed by the authors. The questions were outlined after a review of the literature and circulated in an Internet-based survey format...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27904839/noncardiac-thoracic-surgery-in-abidjan-from-1977-to-2015
#18
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/27891283/streptococcus-intermedius-causing-necrotizing-pneumonia-in-an-immune-competent-female-a-case-report-and-literature-review
#19
Faris Hannoodi, Israa Ali, Hussam Sabbagh, Sarwan Kumar
We report a case of a 52-year-old immunocompetent Caucasian female treated for necrotizing Streptococcus intermedius pneumonia and review available literature of similar cases. Our patient presented with respiratory failure and required hospitalization and treatment in the intensive care unit. Moreover, she required surgical drainage of right lung empyema as well as decortication and resection. The review of literature revealed three cases of S. intermedius pneumonia, one of which was a mortality. Comparison of the published cases showed a highly varied prehospital course and radiological presentations, with a symptomatic phase ranging from 10 days to five months...
2016: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/27865322/thoracic-trauma-which-chest-tube-when-and-where
#20
REVIEW
Tamas F Molnar
Clinical suspicion of hemo/pneumothorax: when in doubt, drain the chest. Stable chest trauma with hemo/pneumothorax: drain and wait. Unstable patient with dislocated trachea must be approached with drain in hand and scalpel ready. Massive hemo/pneumothorax may be controlled by drainage alone. The surgeon should not hesitate to open the chest if too much blood drains over a short period. The chest drainage procedure does not end with the last stitch; the second half of the match is still ahead. The drained patient is in need of physiotherapy and proper pain relief with an extended pleural space: control the suction system...
February 2017: Thoracic Surgery Clinics
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