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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/28410259/central-venous-catheter-placement-in-the-left-internal-jugular-vein-complicated-by-perforation-of-the-left-brachiocephalic-vein-and-massive-hemothorax-a-case-report
#3
Lindsay R Wetzel, Priyesh R Patel, Nicholas L Pesa
An elderly male presented for emergent repair of a ruptured abdominal aortic aneurysm. For anticipated volume resuscitation, vasopressor administration, and hemodynamic monitoring, a large-bore central venous catheter was placed in the left internal jugular vein under ultrasound guidance before surgical incision. Initially, there were no readily apparent signs of venous perforation. However, a massive left hemothorax developed because of perforation of the brachiocephalic vein and violation of the pleural space...
April 13, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28409687/the-evolving-role-of-the-indwelling-tunneled-pleural-catheter-a-means-to-an-end
#4
A Christine Argento, Frank Schembri
No abstract text is available yet for this article.
April 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28409042/nephrologists-hate-the-dialysis-catheters-a-systemic-review-of-dialysis-catheter-associated-infective-endocarditis
#5
Kalyana C Janga, Ankur Sinha, Sheldon Greenberg, Kavita Sharma
A 53-year-old Egyptian female with end stage renal disease, one month after start of hemodialysis via an internal jugular catheter, presented with fever and shortness of breath. She developed desquamating vesiculobullous lesions, widespread on her body. She was in profound septic shock and broad spectrum antibiotics were started with appropriate fluid replenishment. An echocardiogram revealed bulky leaflets of the mitral valve with a highly mobile vegetation about 2.3 cm long attached to the anterior leaflet...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28399830/electromagnetic-navigation-bronchoscopy-to-access-lung-lesions-in-1-000-subjects-first-results-of-the-prospective-multicenter-navigate-study
#6
Sandeep J Khandhar, Mark R Bowling, Javier Flandes, Thomas R Gildea, Kristin L Hood, William S Krimsky, Douglas J Minnich, Septimiu D Murgu, Michael Pritchett, Eric M Toloza, Momen M Wahidi, Jennifer J Wolvers, Erik E Folch
BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is an image-guided, minimally invasive approach that uses a flexible catheter to access pulmonary lesions. METHODS: NAVIGATE is a prospective, multicenter study of the superDimension™ navigation system. A prespecified 1-month interim analysis of the first 1,000 primary cohort subjects enrolled at 29 sites in the United States and Europe is described. Enrollment and 24-month follow-up are ongoing. RESULTS: ENB index procedures were conducted for lung lesion biopsy (n = 964), fiducial marker placement (n = 210), pleural dye marking (n = 17), and/or lymph node biopsy (n = 334; primarily endobronchial ultrasound-guided)...
April 11, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28360465/diagnosis-and-management-options-in-malignant-pleural-effusions
#7
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/28359216/revisiting-ultrasound-guided-subclavian-axillary-vein-cannulations
#8
Mourad H Senussi, Phani C Kantamneni, Ali Omranian, Mani Latifi, Tarik Hanane, Eduardo Mireles-Cabodevila, Neal F Chaisson, Abhijit Duggal, Ajit Moghekar
The Centers for Disease Control and Prevention guidelines for the prevention of catheter-related bloodstream infections suggest using "a subclavian site, rather than an internal jugular or a femoral site, in adult patients." This recommendation is based on evidence of lower rates of thrombosis and catheter-related bloodstream infections in patients with subclavian central venous catheters (CVCs) compared to femoral or internal jugular sites. However, preference toward a subclavian approach to CVC insertion is hindered by increased risk of mechanical complications, especially pneumothorax, when compared to other sites...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28326798/indwelling-pleural-catheters-for-patients-with-hematologic-malignancies-a-14-year-single-center-experience
#9
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/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#10
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28316788/chemical-pleurodesis-using-mistletoe-extracts-via-spray-catheter-during-medical-thoracoscopy-for-management-of-malignant-pleural-effusion
#11
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/28315045/late-onset-chest-wall-abscess-due-to-a-biodegradable-rib-pin-infection-after-lung-transplantation
#12
Yasufumi Goda, Toyofumi F Chen-Yoshikawa, Masaaki Kusunose, Masatsugu Hamaji, Hideki Motoyama, Kyoko Hijiya, Akihiro Aoyama, Hiroshi Date
A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space...
March 17, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28275481/the-influence-of-chest-tube-size-and-position-in-primary-spontaneous-pneumothorax
#13
Sara S Riber, Lars P S Riber, Winnie H Olesen, Peter B Licht
BACKGROUND: Optimal chest tube position in the pleural cavity is largely unexplored for the treatment of primary spontaneous pneumothorax (PSP). We investigated whether type, size and position of chest tubes influenced duration of treatment for PSP. METHODS: A retrospective follow-up study of all patients admitted with PSP over a 5-year period. Traumatic, iatrogenic and secondary pneumothoraxes were excluded. Gender, age, smoking habits, type and size of chest tube used (pigtail catheter or surgical chest tube) were recorded from the patients' charts...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28271728/comparing-approaches-to-the-management-of-malignant-pleural-effusions
#14
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/28257316/pleural-diseases
#15
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/28242159/-hydrothorax-as-a-complication-of-a-ventricle-peritoneal-shunt-a-case-report
#16
Raúl M Yéboles, Lorena Vázquez, Marta Seoane, Susana Castro, Beatriz Ruiz
The ventricle peritoneal (VP) shunt is commonly used in the treatment of hydrocephalus. It is a relatively simple and effective technique, but around 70% of the patients with a VP shunt have a complication in their lifetime. Most of these complications are due to infection or mechanical dysfunction. The thoracic complications are rare. The present case is one of the small number of them found in the literature, describing hydrothorax as a complication of a VP shunt without catheter migration and without ascites...
February 24, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28241247/peritoneal-dialysis-vs-furosemide-for-prevention-of-fluid-overload-in-infants-after-cardiac-surgery-a-randomized-clinical-trial
#17
David M Kwiatkowski, Stuart L Goldstein, David S Cooper, David P Nelson, David L S Morales, Catherine D Krawczeski
Importance: Fluid overload after congenital heart surgery is frequent and a major cause of morbidity and mortality among infants. Many programs have adopted the use of peritoneal dialysis (PD) for fluid management; however, its benefits compared with those of traditional diuretic administration are unknown. Objective: To determine whether infants randomized to PD vs furosemide for the treatment of oliguria have a higher incidence of negative fluid balance on postoperative day 1, as well as avoidance of 10% fluid overload; shorter duration of mechanical ventilation, intensive care unit stay, and inotrope use; and fewer electrolyte abnormalities...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28235492/anesthesia-management-with-ultrasound-guided-thoracic-paravertebral-block-for-donor-nephrectomy-a-prospective-randomized-study
#18
Ozlem Yenidünya, Huseyin Yuce Bircan, Dilek Altun, Ismail Caymaz, Alp Demirag, Ayda Turkoz
STUDY OBJECTIVE: To determine the efficacy of ultrasound-guided thoracic paravertebral block intraoperatively and 24 hours postoperatively in patients undergoing donor nephrectomy. DESIGN: Prospective randomized controlled study. SETTING: Private foundation university hospital; November 2014 to June 2015. PATIENTS: Thirty-two patients undergoing donor nephrectomy (exclusion criteria: coagulation disorders, allergy to local anesthetics, and unwillingness to participate)...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28185770/pulmonary-intraparenchymal-blood-patching-decreases-the-rate-of-pneumothorax-related-complications-following-percutaneous-ct-guided-needle-biopsy
#19
Peter Graffy, Scott B Loomis, Perry J Pickhardt, Meghan G Lubner, Douglas R Kitchin, Fred T Lee, J Louis Hinshaw
PURPOSE: To investigate whether an autologous intraparenchymal blood patch (IPB) reduces the rate of pneumothorax-related complications associated with computed tomography (CT)-guided lung biopsies. MATERIALS AND METHODS: This study included 834 patients: 482 who received an IPB and 352 who did not. Retrospective review was performed of all CT-guided lung biopsies performed at a single institution between August 2006 and September 2013. Patients were excluded if no aerated lung was crossed...
February 6, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28157793/ultrasound-guided-subclavian-vein-cannulation-in-low-birth-weight-neonates
#20
Ulrik Lausten-Thomsen, Zied Merchaoui, Cécile Dubois, Sergio Eleni Dit Trolli, Nolwenn Le Saché, Mostafa Mokhtari, Pierre Tissières
OBJECTIVES: Central venous access in critically ill, small infants remains technically challenging even in experienced hands. Several vascular accesses exist, but the subclavian vein is often preferred for central venous catheter insertion in infants where abdominal malformation and/or closure of the vein preclude the use of umbilical venous catheters, as catheterization of the subclavian vein is easier in very short necks than the internal jugular vein for age-related anatomical reasons...
February 2017: Pediatric Critical Care Medicine
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