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https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#1
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29199894/local-and-systemic-effects-of-a-silver-nitrate-coated-indwelling-pleural-catheter-in-an-animal-model-of-pleurodesis
#2
Alain Tremblay, Christine T Kearney, Chris Hanks, Jennifer Hughes Hanks, David S White, Marcia E Pereira, Craig E Zook, Karen Sargis, Luke Zhang
Purpose/Aim of the study: This study assessed the safety and potential toxicity of a silver nitrate coated indwelling pleural catheter (SNCIPC) designed to create pleurodesis in a large animal model. MATERIALS AND METHODS: Sixteen animals underwent insertion of either a SNCIPC or an uncoated silicone catheter. Half of the animals were sacrificed at day 7 and the others at day 30. Animal weight and assessment of well-being, pleural fluid and blood collection were performed at regular intervals...
December 4, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29188375/tunneled-pleural-catheter-use-for-pleural-palliation-does-not-increase-infection-rate-in-patients-with-treatment-related-immunosuppression
#3
Candice L Wilshire, Christopher R Gilbert, Brian E Louie, Ralph W Aye, Alexander S Farivar, Eric Vallières, Jed A Gorden
PURPOSE: Concerns for infections resulting from antineoplastic therapy-associated immunosuppression may deter referral for symptom palliation with a tunneled pleural catheter (TPC) in patients with malignant/para-malignant pleural effusions (MPE/PMPE). While rates of TPC-related infections range from 1 to 21%, those in patients receiving antineoplastic therapy with correlation to immune status has not been established. We aimed to assess TPC-related infection rates in patients on antineoplastic therapy, determine relation to immune system competency, and assess impact on the patient...
November 29, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29164255/effect-of-an-indwelling-pleural-catheter-vs-talc-pleurodesis-on-hospitalization-days-in-patients-with-malignant-pleural-effusion-the-ample-randomized-clinical-trial
#4
RANDOMIZED CONTROLLED TRIAL
Rajesh Thomas, Edward T H Fysh, Nicola A Smith, Pyng Lee, Benjamin C H Kwan, Elaine Yap, Fiona C Horwood, Francesco Piccolo, David C L Lam, Luke A Garske, Ranjan Shrestha, Christopher Kosky, Catherine A Read, Kevin Murray, Y C Gary Lee
Importance: Indwelling pleural catheter and talc pleurodesis are established treatments for malignant pleural effusions among patients with poor prognosis. Objective: To determine whether indwelling pleural catheters are more effective than talc pleurodesis in reducing total hospitalization days in the remaining lifespan of patients with malignant pleural effusion. Design, Setting, and Participants: This open-label, randomized clinical trial included participants recruited from 9 centers in Australia, New Zealand, Singapore, and Hong Kong between July 2012 and October 2014; they were followed up for 12 months (study end date: October 16, 2015)...
November 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29150040/management-of-malignant-lung-entrapment-the-oncothorax
#5
REVIEW
Roman Petrov, Charles Bakhos, Abbas E Abbas
Pleural metastasis is a common occurrence in up to 30% of patients with metastatic cancer. When lung entrapment and loculation of fluid occur, treatment is more difficult and we have named this condition "oncothorax." The malignant adhesions that entrap the lung in an oncothorax are not typically amenable to surgical decortication. The standard approach for managing these patients is to place an indwelling catheter. Other options may include pleurectomy and decortication, intrapleural hyperthermic chemoperfusion, and intrapleural photodynamic therapy...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29131094/pleurodesis-using-mistletoe-extract-delivered-via-a-spray-catheter-during-semirigid-pleuroscopy-for-managing-symptomatic-malignant-pleural-effusion
#6
Jung Seop Eom, Hyo Yeong Ahn, Jeong Ha Mok, Geewon Lee, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee
BACKGROUND: Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis. OBJECTIVE: We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE...
November 7, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29124008/rare-complicated-parapneumonic-effusion-mycoplasma-pneumoniae-with-new-onset-lupus-flare-case-report-and-literature-review
#7
Bharat Bajantri, Shaik Danial, Richard Duncalf, Misbahuddin Khaja
Mycoplasma pneumoniae has been associated with respiratory tract infections. Mycoplasma pneumoniae pneumonia-related pleural effusion is rarely reported. Extra-pulmonary abnormalities such as encephalitis, myocarditis, glomerulonephritis, and myringitis have been reported. However pulmonary manifestations in systemic lupus erythematosus include pneumonitis, pleurisy, interstitial lung disease, and thromboembolic disease. We present the case of a 26-year-old male who came for evaluation of fever, cough, and shortness of breath with right-sided chest pain...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29119067/experience-with-ambulatory-management-of-pleural-pathologies-utilizing-small-bore-indwelling-pleural-catheters
#8
Imad-Ud-Din Saqib, Mobeen Iqbal, Atif Rana, Saira Hassan
Introduction Pleural effusion is the excess fluid that accumulates in the pleural space. Pneumothorax is the collection of free air in the pleural cavity, while empyema is the collection of pus in the pleural cavity. Such pleural pathologies pose a great challenge to patients and health care professionals alike. While multiple management options exist, the major portion of it is carried out in the inpatient setting. We sought to evaluate the ambulatory use of indwelling pleural catheters for pleural pathologies, including malignant pleural effusion, empyema, and primary spontaneous pneumothorax...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29111830/surgical-and-non-surgical-management-of-malignant-pleural-effusions
#9
Deirdre B Fitzgerald, Coenraad F N Koegelenberg, Kazuhiro Yasufuku, Y C Gary Lee
Optimal management of malignant pleural effusion (MPE) is important in the care of patients with advanced cancer. Surgical (especially video-assisted thoracoscopic surgery (VATS)) and non-surgical strategies are available. Clinicians should be aware of the evidence supporting the use of different modalities to guide treatment choice. Areas covered: This review covers published evidence of the advantages and disadvantages of VATS and non-surgical alternatives for MPE management. Expert commentary: Randomized clinical trials (RCTs) are needed to define the roles and benefits of VATS as existing literature is often flawed by selection bias...
November 9, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29089460/measurements-obtained-from-esophageal-balloon-catheters-are-affected-by-the-esophageal-balloon-filling-volume-in-children-with-ards
#10
Justin C Hotz, Cary T Sodetani, Jeffrey Van Steenbergen, Robinder G Khemani, Timothy W Deakers, Christopher J Newth
INTRODUCTION: Esophageal balloon inflation volume may affect the accuracy of transpulmonary pressure estimates in adults, but the effect is unknown in pediatrics. Using a combination bench and human study, we sought to determine a range of optimal filling volumes for esophageal balloon catheters and to derive a technique to inflate catheters to yield the most accurate estimates of pleural pressure. METHODS: In the laboratory study, we evaluated 4 pediatric and adult esophageal balloon catheters, a liquid-filled catheter, and a micro-tip catheter, both with and without a model esophagus...
October 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29076276/hybrid-approach-to-laparoscopic-decapsulation-combined-with-splenic-artery-balloon-occlusion-in-a-patient-with-carbohydrate-antigen-19-9-producing-splenic-cysts
#11
Eri Maeda, Keiichi Okano, Hironobu Suto, Eisuke Asano, Minoru Oshima, Takayoshi Kishino, Masao Fujiwara, Naoki Yamamoto, Takayuki Sanomura, Yasuyuki Suzuki
INTRODUCTION: Carbohydrate antigen 19-9 producing splenic cysts are relatively rare and usually occur in women and young individuals. This report describes the use of a novel splenic-preserving surgical approach in the hybrid operating room to reduce the risk of bleeding. MATERIALS AND SURGICAL TECHNIQUE: A 27-year-old woman presented at our hospital with a chief complaint of chest pain. CT showed an encapsulated left pleural effusion and multiple splenic cysts...
November 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29075882/tip-migration-post-contrast-pressure-injection-through-pressure-injectable-peripherally-inserted-central-catheters-causing-vascular-injury-a-report-of-3-cases
#12
Michelle Craigie, Louise Meehan, John Harper
Pressure-injectable peripherally inserted central catheters are now widely used for contrast pressure injections for CT scans. While they are generally regarded as safe, they are not free from complication. In this case review, we present three cases of PICC tips migrating post-CT contrast pressure injection including into the pleural cavity and subsequent complications, to raise awareness of this complication not previously encountered in our institution. Level of Evidence Level 4, Case Series.
October 26, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29039690/unilateral-pulmonary-artery-pre-operative-occlusion-test-technical-feasibility-and-safety-prior-to-pneumonectomy-or-pleuropneumonectomy-for-malignancy
#13
Masashi Shimohira, Takuya Hashizume, Kengo Ohta, Kazushi Suzuki, Motoo Nakagawa, Yoshiyuki Ozawa, Katsuhiro Okuda, Satoru Moriyama, Ryoichi Nakanishi, Yuta Shibamoto
OBJECTIVE: The aim of the present study was to assess the technical feasibility and safety of the unilateral pulmonary artery occlusion (UPAO) test in pre-operative evaluation of pneumonectomy or pleuropneumonectomy for lung or pleural tumours. METHODS: The UPAO test was performed on 91 patients who were scheduled to undergo or were being considered for pneumonectomy or pleuropneumonectomy between June 2003 and July 2016. There were 74 males and 17 females, with a median age of 65 years (range, 23-80)...
October 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28986615/perforations-associated-with-peripherally-inserted-central-catheters-in-a-neonatal-population
#14
Andrew J Sertic, Bairbre L Connolly, Michael J Temple, Dimitri A Parra, Joao G Amaral, Kyong-Soon Lee
BACKGROUND: Peripherally inserted central catheters (PICCs) are increasingly used in neonates but perforations can result in devastating complications such as pericardial and pleural effusions. Identifying risk factors may guide surveillance and reduce morbidity and mortality. OBJECTIVE: To determine the risk factors for PICC perforation in neonates. MATERIALS AND METHODS: Retrospective case:control (1:2) study of neonates admitted between 2004-2014...
October 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28975363/decompression-of-tension-pneumothoraces-in-asian-trauma-patients-greater-success-with-lateral-approach-and-longer-catheter-lengths-based-on-computed-tomography-chest-wall-measurements
#15
S Goh, W R Xu, L T Teo
INTRODUCTION: Our study aims to compare the anterior and lateral approaches for needle thoracostomy (NT) and determine the adequacy of catheter lengths used for NT in Asian trauma patients based on computed tomography chest wall measurements. METHODOLOGY: A retrospective review of chest computed tomography scans of 583 Singaporean trauma patients during period of 2011-2015 was conducted. Four measurements of chest wall thickness (CWT) were taken at the second intercostal space, midclavicular line and fifth intercostal space, midaxillary line bilaterally...
October 3, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28951662/safety-and-performance-characteristics-of-outpatient-medical-thoracoscopy-and-indwelling-pleural-catheter-insertion-for-evaluation-and-diagnosis-of-pleural-disease-at-a-tertiary-center-in-canada
#16
Robert Kyskan, Pen Li, Sunita Mulpuru, Carolina Souza, Kayvan Amjadi
BACKGROUND: Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance characteristics of outpatient MT with indwelling pleural catheter (IPC) insertion in a large Canadian cohort. METHODS: This retrospective cohort study reviewed patients who underwent outpatient MT and IPC insertion under conscious sedation...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28937444/methylene-blue-for-bronchopleural-fistula-localization
#17
Kenneth K Sakata, Faria Nasim, Dante N Schiavo, Darlene R Nelson, Ryan M Kern, John J Mullon
A bronchopleural fistula (BPF) is a communication between the pleural space and the bronchial tree. BPFs are challenging to diagnose and are associated with a high morbidity and mortality. Sequential balloon occlusion is commonly used for localization of a BPF. We describe our experience with 4 cases of successful localization of the BPF by instillation of methylene blue into the pleural space through a pigtail catheter, with simultaneous bronchoscopic visualization of dye in the tracheobronchial tree. Two patients were treated with endobronchial valves and 3 had a surgical thoracic muscle flap placed...
September 20, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28918827/indwelling-pleural-catheters-for-nonmalignant-effusions-evidence-based-answers-to-clinical-concerns
#18
REVIEW
David Maurice Chambers, Bilal Abaid, Umair Gauhar
Pleural effusions occur in 1.5 million patients yearly and are a common cause of dyspnea. For nonmalignant effusions, initial treatment is directed at the underlying cause, but when effusions become refractory to medical therapy, palliative options are limited. Tunneled pleural catheters (TPCs) are commonly used for palliation of malignant effusions, but many clinicians are reluctant to recommend these devices for palliation of nonmalignant effusions, citing concerns of infection, renal failure, electrolyte disturbances and protein-loss malnutrition...
September 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28898618/-klebsiella-pneumoniae-from-k1-and-hypervirulent-clone-st23-first-documented-case-in-portugal
#19
Aida Pereira, Tiago Petrucci, Maria João Simões
The hypervirulent K1 serotype Klebsiella pneumoniae is responsible for a new invasive syndrome, typically associated to hepatic abscesses with extra-hepatic complications. Initially described in Taiwan, it has significantly spread to several Asian countries and more recently to Europe and North America, thus constituting an emerging and global problem. The authors describe a case report of a 64-years-old portuguese caucasian woman without any previous diseases or epidemiological risk factors such as trips or contact with Asian products or population, diagnosed with a pyogenic liver abscess with pleural effusion caused by this hyper-virulent strain...
June 30, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28888531/post-cardiac-injury-syndrome-an-atypical-case-following-percutaneous-coronary-intervention
#20
Silvia Paiardi, Francesco Cannata, Michele Ciccarelli, Antonio Voza
Post-cardiac injury syndrome (PCIS) is a syndrome characterized by pericardial and/or pleural effusion, triggered by a cardiac injury, usually a myocardial infarction or cardiac surgery, rarely a minor cardiovascular percutaneous procedure. Nowadays, the post-cardiac injury syndrome, is regaining importance and interest as an emerging cause of pericarditis, especially in developed countries, due to a great and continuous increase in the number and complexity of percutaneous cardiologic procedures. The etiopathogenesis seems mediated by the immunitary system producing immune complexes, which deposit in the pericardium and pleura and trigger an inflammatory response...
September 5, 2017: American Journal of Emergency Medicine
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