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Pleura

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81 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28271728/comparing-approaches-to-the-management-of-malignant-pleural-effusions
#1
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/28345480/ultrasound-in-the-management-of-pleural-disease
#2
Rachel M Mercer, Ioannis Psallidas, Najib M Rahman
Pleural disease encompasses a large range of conditions, is a common presentation to the acute medical take and often requires comprehensive investigation and treatment. Ultrasound is well recognised as a useful investigative tool in pleural disease especially in the field of pleural effusion, pleural thickening and interventional procedures. Thoracic ultrasound (TUS) has gained widespread use by physicians as evidence has shown a reduced rate of complications when performing pleural procedures with ultrasound guidance...
April 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28386166/primary-and-secondary-spontaneous-pneumothorax-prevalence-clinical-features-and-in-hospital-mortality
#3
Takuya Onuki, Sho Ueda, Masatoshi Yamaoka, Yoshiaki Sekiya, Hitoshi Yamada, Naoki Kawakami, Yuichi Araki, Yoko Wakai, Kazuhito Saito, Masaharu Inagaki, Naoki Matsumiya
Background. Optimal treatment practices and factors associated with in-hospital mortality in spontaneous pneumothorax (SP) are not fully understood. We evaluated prevalence, clinical characteristics, and in-hospital mortality among Japanese patients with primary or secondary SP (PSP/SSP). Methods. We retrospectively reviewed and stratified 938 instances of pneumothorax in 751 consecutive patients diagnosed with SP into the PSP and SSP groups. Factors associated with in-hospital mortality in SSP were identified by multiple logistic regression analysis...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28465661/primary-spontaneous-pneumothorax-admitted-in-emergency-unit-does-first-episode-differ-from-recurrence-a-cross-sectional-study
#4
S Kepka, J C Dalphin, A L Parmentier, J B Pretalli, M Gantelet, N Bernard, F Mauny, T Desmettre
Introduction. Management of primary spontaneous pneumothorax (PSP) consists of immediate resolution of pleural air, or observation, and prevention of recurrence. The risk factors for recurrence remain debated. Objectives. We aimed to describe and compare the characteristics of patients presenting a first episode of PSP to those of patients presenting a recurrent PSP, in order to identify factors potentially related to recurrence. Methods. We conducted a cross-sectional study including all admissions for PSP in the EDs of fourteen French public hospitals from 2009 to 2013...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28197215/pleural-procedures-in-the-management-of-malignant-effusions
#5
REVIEW
Lucía Ferreiro, Juan Suárez-Antelo, Luis Valdés
Malignant pleural effusion (MPE) is common in clinical practice, and despite the existence of studies to guide clinical decisions, it often poses diagnostic and therapeutic dilemmas. Once it is diagnosed, median survival does not usually exceed 6 months. The management of these patients focuses on symptom relief since no treatments have been shown to increase survival to date. Conversely, poor management can shorten survival. The approach must be multidisciplinary and allow for individualized care. Initial diagnostic procedures should be minimally invasive and, according to the results and other factors, procedures of increasing complexity will be selecting...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28127951/diagnostic-value-of-soluble-b7-h4-and-carcinoembryonic-antigen-in-distinguishing-malignant-from-benign-pleural-effusion
#6
Xiaogang Jing, Fei Wei, Jing Li, Lingling Dai, Xi Wang, Liuqun Jia, Huan Wang, Lin An, Yuanjian Yang, Guojun Zhang, Zhe Cheng
OBJECTIVE: To explore the diagnostic value of joint detection of soluble B7-H4 (sB7-H4) and carcinoembryonic antigen (CEA) in identifying malignant pleural effusion (MPE) from benign pleural effusion (BPE). METHODS: 97 patients with pleural effusion specimens were enrolled from the First Affiliated Hospital of Zhengzhou University between June 2014 and December 2015. All cases were categorized into malignant pleural effusion group (n=55) and benign pleural effusion group (n=42) according to etiologies...
January 27, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28074083/management-of-malignant-pleural-effusion-with-asept%C3%A2-pleural-catheter-quality-of-life-feasibility-and-patient-satisfaction
#7
Inderdeep Dhaliwal, Masoud Mahdavian, Shabnam Asghari, Benson Chun To Wong, Rosalie Labelle, Kayvan Amjadi
Objective. The PleurX® IPC system has been used extensively in the past. Over time, management of MPE with the PleurX system can be costly. The new ASEPT pleural catheter, through advantages in design, may ultimately show cost savings. The primary outcome of this study was to evaluate safety and efficacy of the ASEPT system. Method. This single centre, prospective study enrolled 50 patients with MPE, who were followed for as long as they were alive with a catheter. Quality of Life (QoL) was assessed before, at 2 weeks, and 6 weeks after ASEPT catheter insertion using the EORTC QLQ-C30 and LC13 questionnaires...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27997741/advances-in-pleuroscopy
#8
REVIEW
Stavros Anevlavis, Marios E Froudarakis
OBJECTIVES: To describe the technique of pleuroscopy, its clinical uses such as diagnosis of exudative pleural effusion, treatment of pleural infection, treatment of pneumothorax and diagnosis and pleurodesis of malignant pleural mesothelioma. Also to describe the newer techniques developed such as minothoracoscopy, semirigid thoracoscopy, narrow band imaging pleuroscopy, infrared pleuroscopy, autofluorescence pleuroscopy. DATA SOURCE: We searched the pubmed the last decade for publications with the key words pleuroscopy, medical thoracoscopy, pneumothorax and pleuroscopy, malignant pleural mesothelioma, minothoracoscopy, semirigid thoracoscopy, autofluorescence pleuroscopy...
December 20, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27903668/malignant-pleural-mesothelioma-an-update-on-investigation-diagnosis-and-treatment
#9
REVIEW
Anna C Bibby, Selina Tsim, Nikolaos Kanellakis, Hannah Ball, Denis C Talbot, Kevin G Blyth, Nick A Maskell, Ioannis Psallidas
Malignant pleural mesothelioma is an aggressive malignancy of the pleural surface, predominantly caused by prior asbestos exposure. There is a global epidemic of malignant pleural mesothelioma underway, and incidence rates are predicted to peak in the next few years.This article summarises the epidemiology and pathogenesis of malignant pleural mesothelioma, before describing some key factors in the patient experience and outlining common symptoms. Diagnostic approaches are reviewed, including imaging techniques and the role of various biomarkers...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27898215/randomized-trial-of-pleural-fluid-drainage-frequency-in-patients-with-malignant-pleural-effusions-the-asap-trial
#10
RANDOMIZED CONTROLLED TRIAL
Momen M Wahidi, Chakravarthy Reddy, Lonny Yarmus, David Feller-Kopman, Ali Musani, R Wesley Shepherd, Hans Lee, Rabih Bechara, Carla Lamb, Scott Shofer, Kamran Mahmood, Gaetane Michaud, Jonathan Puchalski, Samaan Rafeq, Stephen M Cattaneo, John Mullon, Steven Leh, Martin Mayse, Samantha M Thomas, Bercedis Peterson, Richard W Light
RATIONALE: Patients with malignant pleural effusions have significant dyspnea and shortened life expectancy. Indwelling pleural catheters allow patients to drain pleural fluid at home and can lead to autopleurodesis. The optimal drainage frequency to achieve autopleurodesis and freedom from catheter has not been determined. OBJECTIVES: To determine whether an aggressive daily drainage strategy is superior to the current standard every other day drainage of pleural fluid in achieving autopleurodesis...
April 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27866276/manual-intrapleural-saline-flushing-plus-urokinase-a-potentially-useful-therapy-for-complicated-parapneumonic-effusions-and-empyemas
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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