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empyema management

Laurence Ducharme-Crevier, Michele G Mills, Priya M Mehta, Craig M Smith, Mark S Wainwright
BACKGROUND: The primary objective of this study was to characterize changes in cerebral blood flow measured using transcranial Doppler in children with central nervous system infections. We hypothesized that children with central nervous system infections have abnormal cerebral blood flow, associated with a greater frequency of complications and poor neurological outcome. METHODS: We conducted a single-center, retrospective study of children admitted to the neonatal or pediatric intensive care unit with central nervous system infection and undergoing transcranial Doppler as part of routine care between March 2011 and July 2015...
September 4, 2016: Pediatric Neurology
Nancy Y Chen, Jeffrey M Bender, Jennifer Dien Bard, Margaret J Trost, Mark H Corden
No abstract text is available yet for this article.
October 14, 2016: Hospital Pediatrics
Diana Sbiti-Rohr, Alexander Kutz, Mirjam Christ-Crain, Robert Thomann, Werner Zimmerli, Claus Hoess, Christoph Henzen, Beat Mueller, Philipp Schuetz
OBJECTIVE: To investigate the accuracy of the National Early Warning Score (NEWS) to predict mortality and adverse clinical outcomes for patients with community-acquired pneumonia (CAP) compared to standard risk scores such as the pneumonia severity index (PSI) and CURB-65. DESIGN: Secondary analysis of patients included in a previous randomised-controlled trial with a median follow-up of 6.1 years. SETTINGS: Patients with CAP included on admission to the emergency departments (ED) of 6 tertiary care hospitals in Switzerland...
2016: BMJ Open
Yasser Aljehani, Zahra Al-Matar, Samah Nawar
Vacuum-assisted closure (VAC) is gaining popularity in the management of many types of acute and chronic wounds. The use of VAC devices in thoracic surgery is limited, but it appears to be promising in complex cases of empyema thoraces. We report a case of empyema necessitans, in which VAC was used to achieve complete wound healing after open drainage which was communicating with the pleural space.
2016: Case Reports in Surgery
Florian J Segerer, Karin Seeger, Anna Maier, Christine Hagemann, Christoph Schoen, Mark van der Linden, Andrea Streng, Markus A Rose, Johannes G Liese
OBJECTIVE: To evaluate the initial management of pediatric parapneumonic effusion or pleural empyema (PPE/PE) with regard to length of hospital stay (LOS). METHODS: Collection of pediatric PPE/PE cases using a nationwide surveillance system (ESPED) from 10/2010 to 06/2013, in all German pediatric hospitals. Inclusion of PPE/PE patients <18 years of age requiring drainage or with a PPE/PE persistence >7 days. Staging of PPE/PE based on reported pleural sonographic imaging...
September 20, 2016: Pediatric Pulmonology
Chigozirim Ekeke, Stephen Noble, Robert E Merritt
Intrapleural foreign bodies are rare and there are few reports on the occurrence and management of this uncommon clinical presentation. We report a case of a patient with a history of ingesting multiple foreign bodies, which resulted in multiple laparotomy procedures for extraction. The patient recently required surgical removal of innumerable ingested foreign bodies from the stomach and developed a left empyema post-operatively. Subsequent imaging studies revealed evidence of a foreign object in the left pleural space without evidence of an esophageal perforation or diaphragm injury...
August 2016: Journal of Thoracic Disease
T Potzger, M Ried, H-S Hofmann
UNLABELLED: Parapneumonic pleural effusion (PPE) occurring in early-stage (stage I) pleural empyema (PE) can be managed by chest tube drainage, which should be performed as soon as possible, to achieve re-expansion of the pulmonary parenchyma. Chronic disease leads to fibrin deposits on both pleural surfaces (stage II), followed by a thickened pleura peel (stage III). A trapped or compressed lung can only be released by surgical decortication, which may be performed with a minimally-invasive approach (video-assisted thoracoscopy) or an open technique (thoracotomy)...
September 2016: Zentralblatt Für Chirurgie
Sayako Morikawa, Takuya Okamura, Tomoyuki Minezawa, Yasuhiro Goto, Masamichi Hayashi, Teppei Yamaguchi, Sumito Isogai, Yuki Mieno, Naoki Yamamoto, Sakurako Uozu, Toru Nakanishi, Mitsushi Okazawa, Kazuyoshi Imaizumi
BACKGROUND: Bronchial occlusion with an Endobronchial Watanabe Spigot (EWS) has been shown to be useful in managing prolonged bronchopleural fistulas and intractable hemoptysis. EWS bronchial occlusion using a curette is less technically demanding. This retrospective study evaluated the clinical utility and simplicity of this method. METHODS: A total of 18 consecutive patients (15 men, 3 women, aged 47-85 years) who underwent bronchial occlusion using an EWS from April 2012 to August 2014 were evaluated...
September 5, 2016: Therapeutic Advances in Respiratory Disease
Huff 'n Puff, John Massie
No abstract text is available yet for this article.
August 2016: Journal of Paediatrics and Child Health
Pier Luigi Filosso, Alberto Sandri, Francesco Guerrera, Andrea Ferraris, Filippo Marchisio, Giulia Bora, Lorena Costardi, Paolo Solidoro, Enrico Ruffini, Alberto Oliaro
Tube thoracostomy is usually the first step to treat several thoracic/pleural conditions such as pneumothorax, pleural effusions, haemothorax, haemo-pneumothorax and empyema. Today, a wide range of drains is available, ranging from small to large bore ones. Indications for an appropriate selection remains yet matter of debate, especially regarding the use of small bore catheters. Through this paper, we aimed to retrace the improvements of drains through the years and to review the current clinical indications for chest drain placement in pleural/thoracic diseases, comparing the effectiveness of small-bore drains vs...
July 2016: Journal of Thoracic Disease
Dragan Subotic, Piotr Yablonskiy, Giorgia Sulis, Ioan Cordos, Danail Petrov, Rosella Centis, Lia D'Ambrosio, Giovanni Sotgiu, Giovanni Battista Migliori
Tuberculosis (TB) is still a major public health concern, mostly affecting resource-constrained settings and marginalized populations. The fight against the disease is hindered by the growing emergence of drug-resistant forms whose management can be rather challenging. Surgery may play an important role to support diagnosis and treatment of the most complex cases and improve their therapeutic outcome. We conducted a non-systematic review of the literature based on relevant keywords through PubMed database. Papers in English and Russian were included...
July 2016: Journal of Thoracic Disease
Rui Mao, Peng-Qing Ying, Dong Xie, Chen-Yang Dai, Jun-Yan Zha, Tao Chen, Ge-Ning Jiang, Ke Fei, Chang Chen
BACKGROUND: Bronchopleural fistula (BPF) is an infrequent but life-threatening complication after lung surgery. Tentative closure of the fistula and irrigation have been the conventional treatments, but are also surgically challenging and associated with a considerable failure rate. This study reports on a conservative practice of this difficult issue, in aim to examine its outcomes. METHOD: All enrolled cases were handled consecutively from September 2006 to June 2015...
July 2016: Journal of Thoracic Disease
Janalee Stokken, Eisha Wali, Troy Woodard, Pablo F Recinos, Raj Sindwani
BACKGROUND: Giant frontal mucoceles, characterized by significant intracranial and/or intraorbital extension, can present with significant neurologic symptoms. Although typical mucoceles are managed endoscopically, giant mucoceles are often treated with an open or combined approach due to various concerns, including frontal lobe displacement, size, and rapid decompression of the intracranial component. The impact of significant intracranial extension on outcomes is not well described...
July 2016: American Journal of Rhinology & Allergy
Dennis Lourdusamy, Lubna B Munshi, Sherif Ali Eltawansy
Spontaneous Bacterial Empyema (SBEM) denotes infection of the pleural fluid in the absence of pneumonia. Almost all cases of SBEM in literature are described in a background of ascites secondary to cirrhosis. Contiguous spread of the infected ascitic fluid through defects in the diaphragm is the most likely mechanism of SBEM. Most of these cases are transudative in nature and are managed with antibiotics. Literature on SBEM in the absence of cirrhosis or ascites is very limited so far. We describe a 59 year old female with ESRD status post renal transplant, on chronic immunosuppression for renal allograft rejection who was admitted with pleuritic chest pain that turned to be secondary to right sided pleural effusion...
2016: Respiratory Medicine Case Reports
Ira Erlichman, Oded Breuer, David Shoseyov, Malena Cohen-Cymberknoh, Benjamin Koplewitz, Diana Averbuch, Matti Erlichman, Elie Picard, Eitan Kerem
: The incidence of pediatric community acquired complicated pneumonia (PCACP) is increasing. Questions addressed: Are different types of PCACP one disease? How do different treatment protocols affect the outcome? METHODS: Retrospective analysis of medical records of PCACP hospitalizations in the three major hospitals in Jerusalem in the years 2001-2010 for demographics, clinical presentation, management, and outcome. RESULTS: Of the 144 children (51% aged 1-4 years), 91% of Jewish origin; 40% had para-pneumonic effusion (PPE), 40% empyema (EMP), and 20% necrotizing pneumonia (NP)...
July 8, 2016: Pediatric Pulmonology
Vincent Ceuterick, Herbert Decaluwé, Willy Coosemans, Philippe Nafteux, Hans Van Veer, Dirk Van Raemdonck, Paul De Leyn
Esophageal wall rupture after EUS-FNA for mediastinal staging is a severe complication. Here we describe the management of two patients with esophageal wall rupture and the presence of empyema. Management was in both cases surgical and consisted of a decortication via thoracotomy. Postoperative IV antibiotics and parenteral nutrition were continued until the first negative X-ray with gastrografin. Both patients recovered and left the hospital in good condition and with oral intake.
February 2016: Acta Chirurgica Belgica
Leonardo Duranti, Luca Tavecchio, Giovanni Leuzzi, Ugo Pastorino
We herein report a case of a 56-year old man who underwent an intrapericardial right pneumonectomy plus partial left atrial resection for a lung sarcomatoid carcinoma. One month after surgery, the patient developed a broncho-pleural fistula in the right main bronchus. After the failure of several consecutive conservative and surgical treatments (bronchoscopic submucosa injection of fibrin glue, thoracostomy, Amplatzer device placement, omentoplasty, VAC therapy), the patient developed a pleural empyema. So, we decided to fill the pleural space with granulated sugar (changing thoracostomy dressing daily) with subsequent clinical improvement, allowing a definitive surgical closure through a thoracoplasty...
July 1, 2016: European Journal of Cardio-thoracic Surgery
Aaron Strumwasser, Vincent Chong, Eveline Chu, Gregory P Victorino
BACKGROUND: The precise role of thoracic CT in penetrating chest trauma remains to be defined. We hypothesized that thoracic CT effectively screens hemodynamically normal patients with penetrating thoracic trauma to surgery vs. expectant management (NOM). METHODS: A ten-year review of all penetrating torso cases was retrospectively analyzed from our urban University-based trauma center. We included hemodynamically normal patients (systolic blood pressure ≥90) with penetrating chest injuries that underwent screening thoracic CT...
September 2016: Injury
R Miller, S Appleton
Postoperative complications can pose a significant obstacle in the ongoing management of surgical patients. However, it is pertinent to remember that postoperative events are not always complications of the preceding operation. We present the case of a patient with calculous cholecystitis and gallbladder empyema who underwent laparoscopic cholecystectomy. Postoperatively, he continued to have right upper quadrant pain associated with abnormal liver function tests. Ultimately, the cause of his postoperative symptoms was rather prosaic and ran counter to Occam's razor, the relevance of which is discussed below...
September 2016: Annals of the Royal College of Surgeons of England
Y Li, Y Luan, Y B Cui, C Y Li
OBJECTIVE: To investigate the management of early bronchopleural fistula(BPF) within one month after pneumonectomy. METHODS: A total of 30 cases developed BPF within one month after pneumonectomy in recent 30 years were reviewed from First Hospital of Jilin University. All patients were treated by reoperation, closed drainage with or without open thoracic window, or endobronchial glue. RESULTS: Seventeen patients were returned to the operating room for reclosure of BPF, one patients died of BPF and 16 reoperations were successful...
June 7, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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