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https://www.readbyqxmd.com/read/29898894/clinical-predictors-of-successful-and-earlier-pleurodesis-with-a-tunnelled-pleural-catheter-in-malignant-pleural-effusion-a-cohort-study
#1
Pen Li, Alison Graver, Sarah Hosseini, Sunita Mulpuru, Lorraine Cake, Lynn Kachuik, Tinghua Zhang, Kayvan Amjadi
BACKGROUND: Tunnelled pleural catheters used to treat malignant pleural effusions may achieve pleurodesis. We aimed to identify factors associated with higher pleurodesis rates and earlier catheter removal. METHODS: We retrospectively reviewed a prospective database of tunnelled pleural catheters inserted consecutively between May 2006 and June 2013 for confirmed malignant pleural effusion. The cohort included patients who underwent medical thoracoscopy. Clinical, radiologic and pleural fluid data were recorded...
April 2018: CMAJ Open
https://www.readbyqxmd.com/read/29889952/management-of-suspected-tension-pneumothorax-in-tactical-combat-casualty-care-tccc-guidelines-change-17-02
#2
Frank K Butler, John B Holcomb, Stacy Shackelford, Harold R Montgomery, Shawn Anderson, Jeffrey S Cain, Howard R Champion, Cord W Cunningham, Warren C Dorlac, Brendon Drew, Kurt Edwards, John V Gandy, Elon Glassberg, Jennifer Gurney, Theodore Harcke, Donald A Jenkins, Jay Johannigman, Bijan S Kheirabadi, Russ S Kotwal, Lanny F Littlejohn, Matthew Martin, Edward L Mazuchowski, Edward J Otten, Travis Polk, Peter Rhee, Jason M Seery, Zsolt Stockinger, Jeremy Torrisi, Avi Yitzak, Ken Zafren, Scott P Zietlow
This change to the Tactical Combat Casualty Care (TCCC) Guidelines that updates the recommendations for management of suspected tension pneumothorax for combat casualties in the prehospital setting does the following things: (1) Continues the aggressive approach to suspecting and treating tension pneumothorax based on mechanism of injury and respiratory distress that TCCC has advocated for in the past, as opposed to waiting until shock develops as a result of the tension pneumothorax before treating. The new wording does, however, emphasize that shock and cardiac arrest may ensue if the tension pneumothorax is not treated promptly...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29883216/minimally-invasive-palliative-interventions-in-advanced-lung-cancer
#3
Christopher Mallow, Margaret Hayes, Roy Semaan, Thomas Smith, Russell Hales, Roy Brower, Lonny Yarmus
Lung cancer is the leading cause of cancer related deaths in the United States. Nearly 85% of all lung cancers are diagnosed at a late stage, with an associated five-year survival rate of 4%. Malignant central airway obstruction and malignant pleural effusions occur in upwards of 30% of these patients. Many of these patients are in need of palliative interventions for symptom control and to help improve their quality of life. Areas covered: This review covers the treatment modalities of malignant central airway obstruction and malignant pleural effusion...
June 8, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29881588/abnormal-presentation-of-ascending-cholangitis
#4
Mark Scaife, Ryan Abegglen, Christina Vila, Kurt Stahlfeld
Ventriculo-peritoneal, -gallbladder, -pleural, -atrial, and -jugular shunts are all viable options in the treatment of hydrocephalus 1, 2, 3. Retrieval of these catheters can often be very difficult and may be unsuccessful or incomplete. Retained catheters can result in unforeseen and unexpected complications.
June 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29875590/bedside-pleuroscopy-in-the-intensive-care-unit
#5
Hean Ooi
Objectives: It is not always possible to move critically ill patients to the operating or endoscopy room for a pleuroscopy. Bedside pleuroscopy is indicated for these patients. The aim of this study was to investigate the safety and complications of bedside pleuroscopy in an Intensive Care Unit (ICU). Materials and Methods: The patients who had undergone routine examinations for pleural effusion, with no established diagnosis at the previous admission were included in this analysis...
April 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29874900/malignant-pleural-effusion-from-metastatic-prostate-cancer-a-case-report-with-unusual-cytologic-findings
#6
Jinyoung Jeon, Tae-Jung Kim, Hong Sik Park, Kyo-Young Lee
We present a case of 55-year-old man who complained of dyspnea and sputum for a month. He was an ex-smoker having a history of prostate cancer and pulmonary tuberculosis. Chest radiographs revealed small to moderate amount of bilateral pleural effusions. Pigtail catheters were inserted and drainage was performed. The pleural fluid contained malignant cells, arranged in large clusters and tightly cohesive groups. These cytologic findings could not with certainty be ascribed to prostate cancer. We performed immunocytochemical (ICH) panel studies to determine the origin of cancer metastasis...
June 7, 2018: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/29862030/pre-edit-protocol-for-a-randomised-feasibility-trial-of-elastance-directed-intrapleural-catheter-or-talc-pleurodesis-edit-in-malignant-pleural-effusion
#7
Geoffrey A Martin, Selina Tsim, Andrew C Kidd, John E Foster, Philip McLoone, Anthony Chalmers, Kevin G Blyth
Introduction: Non-expansile lung (NEL) is a common cause of talc pleurodesis (TP) failure in malignant pleural effusion (MPE), but is often occult prior to drainage. Reliable detection of NEL would allow patients to be allocated between intrapleural catheter (IPC) and TP. High pleural elastance (PEL ) has been associated with NEL in observational studies. Pre-EDIT is a randomised feasibility trial of elastance-directed IPC or TP (EDIT) management using a novel, purpose-built digital pleural manometer (Rocket Medical, UK)...
2018: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29846987/high-power-and-short-duration-ablation-for-pulmonary-vein-isolation-safety-efficacy-and-long-term-durability
#8
Michael Barkagan, Fernando M Contreras-Valdes, Eran Leshem, Alfred E Buxton, Hiroshi Nakagawa, Elad Anter
INTRODUCTION: PV reconnection is often the result of catheter instability and tissue edema. High-power short-duration (HP-SD) ablation strategies have been shown to improve atrial linear continuity in acute pre-clinical models. This study compares the safety, efficacy and long-term durability of HP-SD ablation with conventional ablation. METHODS AND RESULTS: In 6 swine, 2 ablation lines were performed anterior and posterior to the crista terminalis, in the smooth and trabeculated right atrium, respectively; and the right superior PV was isolated...
May 30, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29804087/right-sided-hydrothorax-a-peritoneal-dialysis-dilemma
#9
Haytham Allaham, Dania Hudhud, William Salzer
We present a 23-year-old female patient with a chief complaint of progressively worsening dyspnoea of 2 days duration. Her medical history was significant for end stage renal disease secondary to membranoproliferative glomerulonephritis. A peritoneal dialysis (PD) catheter was placed 8 weeks prior to admission. She did not miss any of the PD sessions prior to this admission. Vital signs were significant for hypoxemia. Physical examination was remarkable for right-sided basilar crackles with no other signs of fluid overload...
May 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29803762/-review-of-recent-important-papers-in-interventional-pulmonology
#10
Gaëtane Michaud
Interventional pulmonology is an innovative branch of pulmonary medicine that uses minimally invasive diagnostic and therapeutic approaches to airway, parenchymal and pleural disease. The authors review recent high impact trials including randomized trials describing the use of endobronchial coils and valves in the management of severe emphysema. We also present novel approaches to the palliation of malignant and benign pleural effusion including increasing the frequency of drainage and instillation of talc via tunneled pleural catheters...
May 24, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29724179/urinothorax-after-ultrasonography-guided-renal-biopsy-a-case-report
#11
Tae Won Lee, Ha Nee Jang, Hyun Seop Cho, See Min Choi, Bong-Hoi Choi, Eunjin Bae, Se-Ho Chang, Dong Jun Park
BACKGROUND: Urinothorax is defined as the presence of urine in the pleural space and is a rather rare cause of transudate pleural effusion. The potential etiologies are urinary tract obstruction and trauma. Diagnosis requires a high index of clinical suspicion and the condition is completely reversible following relief of underlying disease. CASE PRESENTATION: We report a 27-year-old man who developed urinothorax after renal biopsy. Urine leakage was confirmed with 99m Tc DTPA (diethylenetriaminepentacetate) and single-photon emission computed tomography scans and retrograde pyelography...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29666098/a-misplaced-peripherally-inserted-central-catheter-presenting-as-contralateral-pleural-effusion
#12
Jogender Kumar, Sudeep K C, Kanya Mukhopadhyay, Somosri Ray
A preterm neonate born at 27 weeks, with a birth weight of 555 g, was on continuous positive airway pressure (CPAP) for apnoea of prematurity and initially received total parenteral nutrition (TPN) through the umbilical venous catheter. Peripherally inserted central catheter (PICC) was inserted in the left basilica vein on day 8 to continue TPN. The baby developed respiratory distress with persistent hypoxia after TPN was initiated through the PICC line. The baby required mechanical ventilation due to worsening of respiratory distress, and chest X-ray, as well as ultrasound conducted 12 hours, postinfusion of TPN revealed right-sided pleural effusion...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29644288/massive-bilateral-chylothorax-post-blunt-trauma
#13
Christina Kozul, Karishma Jassal, Rodney Judson
Chylothorax caused by blunt trauma is extremely rare. We present a case of bilateral massive chylothorax post blunt trauma and a review of the literature regarding the identification and management of this rare diagnosis. An eighteen-year-old male was involved in a motor vehicle crash where he sustained multiple injuries including a right, moderate to large, haemopneumothorax, a small left haemopneumothorax, left T8, T9, L1 and L2 acute transverse process fractures and fractures of bilateral 11th ribs. An intercostal catheter was inserted on the right side which initially drained blood-stained fluid however milky colour fluid was noted to be draining 11 h post insertion...
December 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29629920/pleural-effusions-in-hematologic-malignancies-and-their-management-with-indwelling-pleural-catheters
#14
Erik Vakil, Carlos A Jimenez, Saadia A Faiz
PURPOSE OF REVIEW: Pleural effusions in patients with hematologic malignancy may represent malignant pleural effusion (MPE) or occur secondary to infection, treatment effects, and other common causes. The impact of MPE on prognosis in this cohort remains unclear. Indwelling pleural catheters (IPCs) are routinely placed for palliation of recurrent symptomatic MPEs, but perceived concerns over infection and bleeding may limit their use in patients with hematologic malignancies. However, recent evidence suggests IPCs are both well tolerated and effective in this cohort...
April 6, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29617585/outpatient-talc-administration-by-indwelling-pleural-catheter-for-malignant-effusion
#15
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/29617577/ultrasound-guidance-for-pleural-catheter-placement
#16
Adriano Peris, Lorenzo Tutino, Giovanni Cianchi, Gianfranco Gensini
New England Journal of Medicine, Volume 378, Issue 14, April 2018.
April 5, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29607152/wet-m1a-non-small-cell-lung-cancer-is-it-possible-to-predict-recurrence-of-pleural-effusion
#17
Fernando Conrado Abrao, Igor Renato Louro Bruno de Abreu, Geisa Garcia Viana, Mariana Campello de Oliveira, Elnara Marcia Negri, Riad Naim Younes
Background: The propose was to recognize risk factors of malignant pleural effusion (MPE) recurrence in patients with symptomatic M1a non-small cell lung cancer (NSCLC). Methods: All patients with NSCLC and MPE submitted to pleural palliative procedures were enrolled in a prospective study. Group I contained patients who had pleural recurrence, and Group II with no pleural recurrence. Prognostic factors for pleural recurrence were identified by univariable analysis, using Fisher's exact test for categorical variables and Student's t test for quantitative variables...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29592765/alternative-surgical-procedure-for-treating-superior-vena-cava-syndrome-in-a-hemodialysis-patient
#18
Chen L Yao, Zheng L Tan, Ran Tian, Peng Miao, Xin Chen, Zheng Y Yu
BACKGROUND: The incidence of superior vena cava syndrome has been increasing in hemodialysis patients with the widespread use of dialysis catheters. Although endovascular intervention remains the primary choice for treatment, the long-term patency rate is not optimistic. Occlusive lesions are often encountered that cannot be opened using this intervention. Therefore, we chose to present this case involving a pericardial patch used to reconstruct the superior vena cava in the treatment of catheter-associated chronic superior vena cava occlusion...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29587815/pleural-effusion-from-intrathoracic-migration-of-a-ventriculo-peritoneal-shunt-catheter-pediatric-case-report-and-review-of-the-literature
#19
Federica Porcaro, Emidio Procaccini, Maria Giovanna Paglietti, Alessandra Schiavino, Francesca Petreschi, Renato Cutrera
BACKGROUND: Pleural effusion is a rare complication of ventriculo-peritoneal (VP) cerebrospinal fluid (CSF) shunting and its diagnosis is difficult in patients with neurological and consciousness impairment. CASE REPORT: Herein we report the case of a child affected by Pfeiffer syndrome and hydrocephalus, shunted at the age of 3 months, who developed acute respiratory failure due to a right-sided pleural effusion 2 years later. Plain chest radiographs and computed tomography (CT) showed the intrathoracic migration of the right VP shunt abdominal tip...
March 27, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29568725/management-of-septated-malignant-pleural-effusions
#20
REVIEW
Radhika Banka, Dayle Terrington, Eleanor K Mishra
Purpose of Review: We review recent studies of patients with septated malignant pleural effusions, to understand what the clinical implications for patients are and what evidence-based methods should be used to manage these effusions. Recent Findings: Fibrinolytics improve effusion size assessed radiologically in patients with a chest drain inserted for septated malignant pleural effusions but this does not translate into an improvement in breathlessness relief or pleurodesis success...
2018: Current Pulmonology Reports
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