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Pleura

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71 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27866276/manual-intrapleural-saline-flushing-plus-urokinase-a-potentially-useful-therapy-for-complicated-parapneumonic-effusions-and-empyemas
#1
José M Porcel, Horacio Valencia, Silvia Bielsa
PURPOSE: We sought to evaluate the safety profile and effectiveness of manual pleural saline flushing, in addition to urokinase, for managing complicated parapneumonic effusions and empyemas. METHODS: Retrospective comparative review of 23 consecutive patients with complicated parapneumonic effusions or empyemas who received saline flushing plus urokinase through small-bore chest catheters, and 39 who were only treated with fibrinolytics. Both groups had similar baseline characteristics and treatments were mostly protocol-driven...
November 19, 2016: Lung
https://www.readbyqxmd.com/read/27865321/chest-tubes-generalities
#2
REVIEW
Federico Venuta, Daniele Diso, Marco Anile, Erino A Rendina, Ilaria Onorati
Insertion, management, and withdrawal of chest tubes is part of the routine activity of thoracic surgeons. The selection of the chest tube and the strategy for each of these steps is usually built on knowledge, practice, experience, and judgment. The indication to insert a chest tube into the pleural cavity is the presence of air or fluid within it. Various types and sizes of chest tubes are now commercially available.
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865322/thoracic-trauma-which-chest-tube-when-and-where
#3
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
https://www.readbyqxmd.com/read/27865323/chest-tube-management-after-surgery-for-pneumothorax
#4
REVIEW
Cecilia Pompili, Michele Salati, Alessandro Brunelli
There is scant evidence on the management of chest tubes after surgery for pneumothorax. Most of the current knowledge is extrapolated from studies performed on subjects with lung cancer. This article reviews the existing literature with particular focus on the effect of suction and no suction on the duration of air leak after lung resection and surgery for pneumothorax. Moreover, the role of regulated suction, which seems to provide some benefit in reducing pneumothorax recurrence after bullectomy and pleurodesis, is discussed...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865324/modern-techniques-to-insert-chest-drains
#5
REVIEW
Philip J McElnay, Eric Lim
Both physicians and surgeons insert chest drains by various techniques-including Seldinger and "wide-bore" methods. The indications include hemothorax, pneumothorax, pleural effusion, and postoperative care in thoracic surgery. Given their invasive nature, there is significant potential for complications; however, this can be minimized by following a meticulous technique, which is herein described for both Seldinger and "wide-bore" drain insertion.
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865325/suction-or-nonsuction-how-to-manage-a-chest-tube-after-pulmonary-resection
#6
REVIEW
Gaetano Rocco, Alessandro Brunelli, Raffaele Rocco
Despite several randomized trials and meta-analyses, the dilemma as to whether to apply suction after subtotal pulmonary resection has not been solved. The combination of a poorly understood pathophysiology of the air leak phenomenon and the inadequate quality of the published randomized trials is actually preventing thoracic surgeons from abandoning an empirical management of chest drains. Even digital systems do not seem to have made the difference so far. Based on the evidence of the literature, the authors propose a new air leak predictor score (ALPS) as a contributing step toward appropriateness in using intraoperative sealants, opting for an external suction and managing and chest tubes...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865326/when-to-remove-a-chest-tube
#7
REVIEW
Nuria M Novoa, Marcelo F Jiménez, Gonzalo Varela
Despite the increasing knowledge about the pleural physiology after lung resection, most practices around chest tube removal are dictated by personal preferences and experience. This article discusses recently published data on the topic and suggests opportunities for further investigation and future improvements.
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865327/indwelling-pleural-catheters-a-clinical-option-in-trapped-lung
#8
REVIEW
Luca Bertolaccini, Andrea Viti, Simona Paiano, Carlo Pomari, Luca Rosario Assante, Alberto Terzi
Malignant pleural effusion (MPE) symptoms have a real impact on quality of life. Surgical approach through video-assisted thoracic surgery provides a first step in palliation. In patients unfit for general anesthesia, awake pleuroscopy represents an alternative. Sclerosing agents can be administered at the bedside through a chest tube. Ideal treatment of MPE should include adequate long-term symptom relief, minimize hospitalization, and reduce adverse effects. Indwelling pleural catheter (IPC) allows outpatient management of MPE through periodic ambulatory fluid drainage...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865328/errors-and-complications-in-chest-tube-placement
#9
REVIEW
Pier Luigi Filosso, Francesco Guerrera, Alberto Sandri, Matteo Roffinella, Paolo Solidoro, Enrico Ruffini, Alberto Oliaro
Chest drain placement is one of the most common surgical procedures performed in routine clinical practice. Despite the many benefits, chest tube insertion is not always a harmless procedure, and potential significant morbidity and mortality may exist. The aim of this article was to highlight the correct chest tube placement procedure and to focus on errors and clinical complications following its incorrect insertion into the chest.
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865329/management-of-chest-drains-after-thoracic-resections
#10
REVIEW
Pier Luigi Filosso, Alberto Sandri, Francesco Guerrera, Matteo Roffinella, Giulia Bora, Paolo Solidoro
Immediately after lung resection, air tends to collect in the retrosternal part of the chest wall (in supine position), and fluids in its lower part (costodiaphragmatic sinus). Several general thoracic surgery textbooks currently recommend the placement of 2 chest tubes after major pulmonary resections, one anteriorly, to remove air, and another into the posterior and basilar region, to drain fluids. Recently, several authors advocated the placement of a single chest tube. In terms of air and fluid drainage, this technique demonstrated to be as effective as the conventional one after wedge resection or uncomplicated lobectomy...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27845052/the-management-of-benign-pleural-effusions-using-indwelling-pleural-catheters-a-systematic-review-and-meta-analysis
#11
Monali Patil, Samjot Singh Dhillon, Kristopher Attwood, Marwan Saoud, Abdul H Alraiyes, Kassem Harris
INTRODUCTION: Indwelling pleural catheter (IPC), which was initially introduced for the management of recurrent malignant effusions, could be a valuable management option for recurrent benign pleural effusions (BPE) in place of chemical pleurodesis. The purpose of this study is to analyze the efficacy and safety of IPC in the management of refractory non-malignant effusions. METHODS: We conducted a systematic review and meta-analysis on the published literature...
November 11, 2016: Chest
https://www.readbyqxmd.com/read/27794408/imaging-in-pleural-mesothelioma-a-review-of-the-13th-international-conference-of-the-international-mesothelioma-interest-group
#12
REVIEW
Samuel G Armato, Kevin G Blyth, Jane J Keating, Sharyn Katz, Selina Tsim, Johan Coolen, Eyjolfur Gudmundsson, Isabelle Opitz, Anna K Nowak
Imaging plays an important role in the detection, diagnosis, staging, response assessment, and surveillance of malignant pleural mesothelioma. The etiology, biology, and growth pattern of mesothelioma present unique challenges for each modality used to capture various aspects of this disease. Clinical implementation of imaging techniques and information derived from images continue to evolve based on active research in this field worldwide. This paper summarizes the imaging-based research presented orally at the 2016 International Conference of the International Mesothelioma Interest Group (iMig) in Birmingham, United Kingdom, held May 1-4, 2016...
November 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/27803156/effectiveness-of-chemical-pleurodesis-in-spontaneous-pneumothorax-recurrence-prevention-a-systematic-review
#13
R J Hallifax, A Yousuf, H E Jones, J P Corcoran, I Psallidas, N M Rahman
OBJECTIVES: Spontaneous pneumothorax is a common pathology. International guidelines suggest pleurodesis for non-resolving air leak or recurrence prevention at second occurrence. This study comprehensively reviews the existing literature regarding chemical pleurodesis efficacy. DESIGN: We systematically reviewed the literature to identify relevant randomised controlled trials (RCTs), case-control studies and case series. We described the findings of these studies and tabulated relative recurrence rates or ORs (in studies with control groups)...
November 1, 2016: Thorax
https://www.readbyqxmd.com/read/27803756/dasatinib-induced-pleural-effusion-chylothorax-an-option-to-consider
#14
Lucía Ferreiro, Esther San-José, Juan Suárez-Antelo, Luis Valdés
Dasatinib is a drug for treatment of oncogene fusion protein BCR-ABL-positive chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia resistant/intolerant to imatinib. Pleural effusion (PE) is a common adverse effect, and in this context, we present four cases seen due to this cause. One of them is a chylothorax. The PE grade is variable, and the physiopathology is not well established, although a block in T-lymphocyte function or inhibition of platelet-derived growth factor receptor-β is suggested being involved...
October 2016: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/27777372/current-best-practice-in-the-evaluation-and-management-of-malignant-pleural-effusions
#15
Steven Walker, Anna C Bibby, Nick A Maskell
Malignant pleural effusions (MPEs) are an important cause of cancer-related mortality and morbidity. It is a heterogeneous group of conditions, which leads to debilitating symptoms and confers a poor prognosis. Recent well-designed randomized trials have provided a broader evidence base for an expanding range of treatment options. Together, with new prognostic scoring systems and a greater understanding of how different patient phenotypes respond to treatment, this allows greater personalization of management...
October 24, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27737563/chest-computed-tomographic-image-screening-for-cystic-lung-diseases-in-patients-with-spontaneous-pneumothorax-is-cost-effective
#16
Nishant Gupta, Dale Langenderfer, Francis X McCormack, Daniel P Schauer, Mark H Eckman
RATIONALE: Patients without a known history of lung disease presenting with a spontaneous pneumothorax are generally diagnosed as primary spontaneous pneumothorax. However, occult diffuse cystic lung diseases such as Birt-Hogg-Dubé syndrome (BHD), lymphangioleiomyomatosis (LAM), and pulmonary Langerhans cell histiocytosis (PLCH) can also first present with a spontaneous pneumothorax, and their early identification by high-resolution computed tomographic (HRCT) imaging of chest has implications for subsequent management...
October 13, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27759752/pneumomediastinum-as-a-complication-of-mdma-3-4-methylenedioxymetamfetamine-ecstasy-ingestion
#17
Suleiman Ezoubi, Hassan Kahal, William Stephen Waring
MDMA (3,4-methylenedioxymethamfetamine, Ecstasy) is a widely used recreational drug. We present a case of pneumomediastinum as a complication of MDMA use in a 21-year-old man with no previous history of lung or gastrointestinal pathology. We have performed a literature review, and summarised the symptoms, signs, and prognosis for this under-recognised complication of a commonly used recreational drug. We recommend enquiring about illicit drug use in any patient presenting with spontaneous pneumomediastinum.
2016: Acute Medicine
https://www.readbyqxmd.com/read/27742781/endobronchial-valves-for-bronchopleural-fistula-pitfalls-and-principles
#18
Dany Gaspard, Thaddeus Bartter, Ziad Boujaoude, Haroon Raja, Rohan Arya, Nikhil Meena, Wissam Abouzgheib
BACKGROUND: Placement of endobronchial valves for bronchopleural fistula (BPF) is not always straightforward. A simple guide to the steps for an uncomplicated procedure does not encompass pitfalls that need to be understood and overcome to maximize the efficacy of this modality. OBJECTIVES: The objective of this study was to discuss examples of difficult cases for which the placement of endobronchial valves was not straightforward and required alterations in the usual basic steps...
October 14, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/17621614/pneumothorax-an-update
#19
REVIEW
Graeme P Currie, Ratna Alluri, Gordon L Christie, Joe S Legge
Pneumothorax is a relatively common clinical problem which can occur in individuals of any age. Irrespective of aetiology (primary, or secondary to antecedent lung disorders or injury), immediate management depends on the extent of cardiorespiratory impairment, degree of symptoms and size of pneumothorax. Guidelines have been produced which outline appropriate strategies in the care of patients with a pneumothorax, while the emergence of video-assisted thoracoscopic surgery has created a more accessible and successful tool by which to prevent recurrence in selected individuals...
July 2007: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27655919/experience-with-indwelling-pleural-catheters-in-the-treatment-of-recurrent-pleural-effusions
#20
Michel Chalhoub, Zulfiqar Ali, Louis Sasso, Michael Castellano
Recurrent pleural effusions are frequently encountered in clinical practice. Whether malignant or nonmalignant, they often pose a challenge to the practicing clinician. When they recur, despite optimum medical therapy of the underlying condition and repeated thoracenteses, more invasive definitive approaches are usually required. Since its introduction in 1997, the PleurX catheter became the preferred method to treat recurrent malignant pleural effusions. Since then, a number of publications have documented its utility in managing recurrent nonmalignant pleural effusions...
September 21, 2016: Therapeutic Advances in Respiratory Disease
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