scholarly journals A Case Series of Using Aspiration Catheter for the Management of Spontaneous Pneumothorax

2003 ◽  
Vol 10 (4) ◽  
pp. 233-237 ◽  
Author(s):  
AYC Siu ◽  
CH Chung
Keyword(s):  
Spontaneous Pneumothorax ◽  
Case Series ◽  
Airway Disease ◽  
Seldinger Technique ◽  
Chronic Obstructive ◽  
Chest Drain ◽  
X Rays ◽  
Initial Experience ◽  
Local Experience ◽  
History Of

Introduction Catheter aspiration is a relatively new treatment for spontaneous pneumothorax in emergency departments in Hong Kong. It causes less pain and shortens hospitalisation. However, there is limited local experience especially in regard to the target group that can be benefited. We reported on the initial experience of catheter aspiration in the management of spontaneous pneumothorax in our emergency department. Method Patients (age >=16 years) presenting with spontaneous pneumothorax were recruited. Patients with history of asthma or chronic obstructive airway disease were excluded. History of smoking, previous pneumothorax and pleurodesis were recorded. The aspiration catheter was inserted by the Seldinger technique. The extent of pneumothorax was assessed from the chest X-ray and initial aspirated volume. Successful patients were observed in the department and discharged if chest X-rays were reassuring after 12 hours. Factors associated with the outcome of patients were analysed. Result Seventeen patients were recruited from October 1999 to September 2000. Their age ranged from 16 to 40 years (mean 22.6). The overwhelming majority (16) was male. Twelve cases (70.6%) occurred on the left side. Five patients had previous pneumothorax and one had previous pleurodesis. Fifteen succeeded in immediate re-expansion, but seven re-collapsed during observation. The overall success rate was 47.1%. Initial aspiration volume >2,000 ml was associated with early failure (p=0.01). Conclusion Our initial experience did not support catheter aspiration to completely replace chest drain in the initial management of spontaneous pneumothorax. The procedure is likely to fail if the initial aspirated volume is greater than 2,000 ml. Further study is needed to identify the subgroup that may be benefited.

scholarly journals The Effectiveness of Catheter Aspiration in the Treatment of Spontaneous Pneumothorax

2002 ◽  
Vol 9 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Syh Tang ◽  
Hl Lau ◽  
Jts Chan
Keyword(s):  
Spontaneous Pneumothorax ◽  
Case Series ◽  
Uneventful Recovery ◽  
Seldinger Technique ◽  
High Recurrence Rate ◽  
British Thoracic Society ◽  
Chest Drain ◽  
X Rays ◽  
Initial Attempt ◽  
Case Series Study

Catheter aspiration is a simple and minimal invasive method to treat spontaneous pneumothorax. It was recommended by British Thoracic Society in 1993 as the treatment for spontaneous pneumothorax. This study was designed to evaluate the effectiveness of catheter aspiration in the treatment of spontaneous pneumothorax. The protocol involved catheter placement by using Seldinger technique and serial chest X-rays were used to document the degree of lung re-expansion. We report a case series study in which eight patients were recruited into the study. All patients' pneumothorax re-expanded well after the initial attempt of aspiration. However, during the observation period, 5 patients had recurrence of pneumothorax requiring further aspiration. Despite that, these 5 patients finally required chest drain insertion. The remaining 3 patients were discharged after aspiration and were followed up on the following day. Two patients had recurrent pneumothorax and required further intervention. One patient had uneventful recovery. Conclusion catheter aspiration was effective in relieving spontaneous pneumothorax but with a high recurrence rate.

548 Heterotopic Ossification or Dystrophic Calcinosis Cutis in Burn Scars - A Case Series

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S122-S123
Author(s):  
Sigrid A Blome-Eberwein ◽  
Cassandra Pinataro
Keyword(s):  
Heterotopic Ossification ◽  
Calcium Metabolism ◽  
Case Reports ◽  
Case Series ◽  
Preoperative Assessment ◽  
X Rays ◽  
Calcinosis Cutis ◽  
Pathologic Evaluation ◽  
Burn Survivors ◽  
History Of

Abstract Introduction Heterotopic ossification of large joints is a commonly seen and described entity in Burn survivors. We have observed a rather uncommon phenomenon in a series of 4 Burn survivors who presented to our Burn center for scar treatment and open wounds many years after their injuries. A chronic, small, splinter-like subcutaneous irritation led to open wounds and infections in their burn scars. A similar condition is known as dystrophic calcinosis cutis in the dermatologic literature, but caused by calcium metabolism changes in otherwise healthy skin. Methods The demographics and history of illness was documented in all 4 patients. A literature review was performed. The calcified bone-like irritant was removed surgically in all patients, sometimes in more than one location. Pathologic evaluation was performed on the removed specimen. Strategies leading to healing of the wounds were evaluated. Results Four publications were found addressing this phenomenon in Burn scars, all case reports. All of our patients had undergone curettage of the lesions by a dermatologist in the past without resolution. All lesions were excised surgically and proved to extend subcutaneously far more extensively than the visible skin lesion. X rays proved not helpful in preoperative assessment of the extent. All wounds healed after the irritant was removed. Conclusions All lesions appeared to have formed along tendon or fascia remnants underneath the burn scars, exerting pressure on the overlying epithelium which eventually led to breakdown and necrosis. This finding prompted the term “heterotopic cutaneous ossification”. Chronic tension and inflammation were assumed in the etiology, rather than calcium metabolism abnormalities or systemic connective tissue disease, which were not present in these patients. Research is needed to establish the prevalence, cause, and prevention of this condition in Burn survivors.

scholarly journals  Early surgical intervention is indicated for recurrent spontaneous pneumothorax in children and adolescents

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Cody Tragesser ◽  
Brian W. Gray, MD ◽  
Matthew P. Landman, MD, MPH
Keyword(s):  
Recurrence Rate ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Surgical Intervention ◽  
Univariate Analysis ◽  
X Rays ◽  
Radiographic Findings ◽  
Radiographic Measurements ◽  
Ipsilateral Recurrence ◽  
History Of

Background: Primary spontaneous pneumothorax (PSP) occurs most often in adolescent patients. There is consensus that surgical intervention plays an important role in preventing recurrence, however, the optimum timing of surgery is debated. We hypothesize that clinical and radiographic factors are associated with eventual need for surgery.  Experimental Design: We searched the medical record for PSP patients between ages 9 and 21 treated from 1/1/08 to 12/31/17 and collected data on chest tube management, radiographic measurements, operative management, and recurrence. We performed univariate analysis on relationships between admission events and eventual surgery or other management strategies.  Results: We identified 68 PSP admissions from 31 patients. Considering only first-time admissions, there was no association between eventual surgery and clinical factors and radiographic findings.  The single factor associated with eventual surgery was history of pneumothorax in any lung (p=0.015). For patients with prior pneumothorax who underwent surgery, operation the day after admission would have reduced hospital stay by an average of 1.5 days (min=0, max=9) and an average of 2.2 days (min=0, max=10) if performed on the day of admission, with a mean 1.85 fewer chest x-rays (min=0, max=7). Considering only first admissions, ipsilateral recurrence rate was 16.7% after surgery, 46.7% after chest tube alone, and 100% after observation alone.  Conclusion: This analysis suggests that though eventual surgery is difficult to predict, ipsilateral recurrence rate is reduced following surgery. Furthermore, earlier operation in recurrent patients could reduce resource utilization. Thus, expedited surgical treatment may merit consideration in patients with a history of pneumothorax. 

scholarly journals Epidemiological and clinical characteristics of 671 COVID-19 patients in Henan Province, China

2020 ◽  
Vol 49 (4) ◽  
pp. 1085-1095
Author(s):  
Yifei Nie ◽  
Jitian Li ◽  
Xueyong Huang ◽  
Wanshen Guo ◽  
Xiaobai Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Case Series ◽  
Henan Province ◽  
X Rays ◽  
Illness Onset ◽  
Medical Disorders ◽  
History Of ◽  
The Mean ◽  
Wet Market ◽  
Mean Time

Abstract Background Despite many reports on the characteristics of coronavirus disease 2019 (COVID-19) in Wuhan, China, relatively little is known about the transmission features of COVID-19 outside Wuhan, especially at the provincial level. Methods We collected epidemiological, demographic, clinical, laboratory, radiological and occupation information, along with contact history, of 671 patients with laboratory-confirmed COVID-19 reported from January 23 to February 5, 2020, in Henan province, China. We described characteristics of these cases, compared the diagnostic accuracy and features of blood testing, computed tomography (CT) scans and X-rays, and analysed SARS-CoV-2 transmission sources and patients’ occupations in Henan province. Results The mean age of patients in this case series was 43 years, 56.2% were male and 22.4% had coexisting medical disorders. The death rate was 0.3%. Fourteen patients did not show any symptoms. Lymphocyte percentage was associated with disease severity (χ2 = 6.71, P = 0.035) but had a large variation in each sample group. The mean time from illness onset to diagnosis was 5.6 days. A total of 330 patients had ever lived in or visited Wuhan, 150 had contact with confirmed cases, 323 had been to a hospital and 119 had been to a wet market. There were 33 patients who did not have a traceable transmission source, with 21.2% of these being farmers and 15.2% being workmen. Conclusions Lymphocyte percentage was a sign of severe COVID-19 in general but was not a good diagnostic index. Longer time from illness onset to diagnosis was associated with higher COVID-19 severity, older age, higher likelihood of having coexisting cardiovascular diseases including hypertension, and being male. Farming was found to be a high-risk occupation in Henan province, China.

scholarly journals Spontaneous Pneumothorax in COVID-19 Patients Treated with High-Flow Nasal Cannula outside the ICU: A Case Series

2021 ◽  
Vol 18 (4) ◽  
pp. 2191
Author(s):  
Magdalena Nalewajska ◽  
Wiktoria Feret ◽  
Łukasz Wojczyński ◽  
Wojciech Witkiewicz ◽  
Magda Wiśniewska ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Previous History ◽  
Case Series ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Positive Effects ◽  
Non Invasive ◽  
Global Pandemic ◽  
History Of

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic and a burden to global health at the turn of 2019 and 2020. No targeted treatment for COVID-19 infection has been identified so far, thus supportive treatment, invasive and non-invasive oxygen support, and corticosteroids remain a common therapy. High-flow nasal cannula (HFNC), a non-invasive oxygen support method, has become a prominent treatment option for respiratory failure during the SARS-CoV-2 pandemic. HFNC reduces the anatomic dead space and increases positive end-expiratory pressure (PEEP), allowing higher concentrations and higher flow of oxygen. Some studies suggest positive effects of HFNC on mortality and avoidance of intubation. Spontaneous pneumothorax has been observed in patients suffering from SARS-CoV-2 pneumonia. Although the viral infection itself contributes to its development, higher PEEP generated by both HFNC and mechanical ventilation is another risk factor for increased alveoli damage and air-leak. Herein, we present three cases of patients with no previous history of lung diseases who were diagnosed with COVID-19 viral pneumonia. All of them were supported with HFNC, and all of them presented spontaneous pneumothorax.

Hafnia alvei pneumonia: a rare cause of infection in the multimorbid or immunocompromised

2020 ◽  
Vol 13 (12) ◽  
pp. e237061
Author(s):  
Austin Begbey ◽  
Joseph Henry Guppy ◽  
Chithra Mohan ◽  
Simon Webster
Keyword(s):  
Case Series ◽  
Chronic Obstructive ◽  
Productive Cough ◽  
Commensal Bacterium ◽  
Radiological Findings ◽  
Obstructive Pulmonary Disease ◽  
Hafnia Alvei ◽  
Night Sweats ◽  
History Of ◽  
Cultured Bacteria

Hafnia alvei is a rare, poorly understood commensal bacterium which has, on occasion, been shown to infect humans. We present two cases. The first patient presented with a 1-week history of dyspnoea, pleurisy and a productive cough, and the second with a prodrome of fatigue and night sweats. The former had a history of severe chronic obstructive pulmonary disease and the latter had a history of Crohn’s disease. Both patients had underlying comorbidities and immunosuppression, but differed in presentation, radiological findings and recovery. This case series aims to remind readers of the broad differential of pathogens that can lead to disease in the immunocompromised and that one should not dismiss atypical cultured bacteria as commensal too hastily.

scholarly journals Blastoschizomyces capitatus pulmonary infections in immunocompetent patients: case report, case series and literature review

2017 ◽  
Vol 146 (1) ◽  
pp. 58-64 ◽  
Author(s):  
M. B. TANABE ◽  
S. A. PATEL
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Treatment Options ◽  
Case Series ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Infectious Risk ◽  
History Of ◽  
Blastoschizomyces Capitatus ◽  
Immunocompetent Patients

SUMMARYBlastoschizomyces capitatus is an uncommon opportunistic yeast associated with infections in neutropaenic patients secondary to haematological malignancies, with a special predilection for the lungs. Globalisation and population migration impact on the epidemiology of infection with this organism but its effect on the immunocompetent population has rarely been described. We present here a case report, an overview of 11 other cases published between 2000 and 2016, and a comprehensive literature review of Blastoschizomyces pneumonia in the non-immunocompromised. The median age at diagnosis was 68 years (range 40–86 years) and more than half the cases reported a positive history of either current or past tobacco smoking. Six cases had either clinical or radiological evidence of chronic obstructive pulmonary disease and three had a history of prior treated tuberculosis. Fluconazole and itraconazole, alone or in combination, was the most utilised treatment. We conclude that unlike most other invasive yeast species, B. capitatus poses an infectious risk for immunocompetent patients, usually of middle to older age with risk factors for distorted lung architecture. Further research is warranted into the pathophysiology of Blastoschizomyces infections in the immunocompetent, including standardised treatment options.

scholarly journals Re-expansion Pulmonary Edema in a patient with Secondary Spontaneous Pneumothorax Following Closed Thoracostomy: A Case Report

2021 ◽  
Vol 18 (3) ◽  
pp. 61-65
Author(s):  
Seon Woo Oh ◽  
Su Wan Kim
Keyword(s):  
Pulmonary Edema ◽  
Pulmonary Disease ◽  
Spontaneous Pneumothorax ◽  
Vital Signs ◽  
Tension Pneumothorax ◽  
Chronic Obstructive ◽  
Supportive Treatment ◽  
Obstructive Pulmonary Disease ◽  
History Of ◽  
Ventilator Care

Although re-expansion pulmonary edema (RPE) is rare (incidence rate <1%), it is associated with a mortality rate of >20%; therefore, early diagnosis and treatment are important. We report a case of RPE following chest tube insertion in a patient with spontaneous pneumothorax. We have specifically focused on the mechanism underlying RPE and the possible etiology. An 82-year-old man with a history of chronic anemia, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension was referred to the emergency department for management of recurrent right-sided pneumothorax. We performed emergency closed thoracostomy for suspected tension pneumothorax, which led to stabilization of the patient’s vital signs; however, he coughed up frothy pink sputum accompanied by severe right-sided chest pain 30 min postoperatively. The patient showed new-onset right pulmonary consolidation on chest radiography, as well as desaturation, tachycardia, and tachypnea and was diagnosed with RPE. He was transferred to the intensive care unit for mechanical ventilation and supportive treatment using diuretics, ionotropic agents, and prophylactic antibiotics. RPE gradually resolved, and the patient was extubated 3 days after admission. He has not experienced recurrent pneumothorax or pulmonary disease for 4 months. We emphasize the importance of RPE prevention and that aggressive ventilator care and supportive treatment can effectively treat RPE following an accurate understanding of the underlying pathogenetic mechanisms and risk factors.

scholarly journals Pulmonary rheumatoid nodules leading to spontaneous pneumothorax

2012 ◽  
Vol 6 (4) ◽  
pp. 57-60
Author(s):  
KR Dewan ◽  
SK Nanda ◽  
RS Twayana
Keyword(s):  
Rheumatoid Arthritis ◽  
Spontaneous Pneumothorax ◽  
Metastatic Cancer ◽  
Airway Disease ◽  
Methotrexate Therapy ◽  
Chronic Obstructive ◽  
Chronic Obstructive Airway Disease ◽  
Medical Sciences ◽  
Rheumatoid Nodules ◽  
Long Time

Several pulmonary diseases are associated with spontaneous pneumothorax, including bronchial asthma, chronic obstructive airway disease, bronchiectasis, pneumonia, abscess, primary or metastatic cancer, and chronic interstitial lung disease.1 Spontaneous pneumothorax secondary to rheumatoid nodules which is one of the extra-articular manifestations of rheumatoid arthritis is rare but occasionally described.2There are some reports resulting in spontaneous pneumothorax especially on patients on methotrexate or leflunomide treatment.3We describe a case of rheumatoid arthritis who was on methotrexate therapy from a long time complicating in right sided spontaneous pneumothorax. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 57-60 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6729

scholarly journals 68 COVID-19 in children: A case series

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e48-e49
Author(s):  
Vinay Kukreti ◽  
Mahmoud Sakran ◽  
Sarah Tsimelkas ◽  
Jessie MacDonald ◽  
Anupma Wadhwa
Keyword(s):  
Descriptive Analysis ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Illness Severity ◽  
X Rays ◽  
Tertiary Care Centre ◽  
Presenting Symptoms ◽  
History Of

Abstract Primary Subject area Community Paediatrics Background The COVID-19 pandemic has had an overwhelming impact worldwide. Studies on pediatric populations remain limited, as the burden of disease in pediatric patients appears to be low at this time. Objectives To further describe clinical characteristics and severity of disease of confirmed pediatric COVID-19 patients seen and evaluated in a community-based hospital. Design/Methods A retrospective chart review of positive COVID-19 patients ≤ 18 years seen in COVID clinic or in the Emergency Department (ED) between April and December 2020 was performed. The results of nasopharyngeal swabs were confirmed using real-time reverse-transcription-polymerase chain reaction (RT-PCR) assays. A descriptive analysis of illness severity, performed via Excel 2019, was based on clinical presentation, laboratory data, and chest x-ray imaging. The categories of illness severity were: asymptomatic, mild, moderate, severe or critical. Results A total of 53 positive COVID-19 patients were enrolled in this study, which consisted of 24 (45.3%) males and 29 (54.7%) females. The median age was 7.5 years (2.4-12.8). The majority of patients presented with mild symptoms (64.2%), with fever and cough being the main symptoms in 20 (37.7%) and 16 (30.2%) cases, respectively. Other symptoms included sore throat (15.1%), diarrhea (13.2%), headache (9.4%), runny nose (7.5%) and abdominal pain (7.5%). The remaining patients (35.8%) were asymptomatic. Of note, one patient (1.9%) presented with COVID toes requiring referral to a tertiary centre, and one (1.9%) was diagnosed with acute appendicitis. A history of contact with a confirmed COVID-19-positive family member was present in 43 (81.1%) patients, and 6 (11.3%) reported a history of recent travel. Laboratory tests were performed in 7 (13.2%) patients, and chest x-rays were performed in 9 (17%). There were no abnormalities detected in either, other than an elevated CRP seen in one patient with appendicitis. Two (3.8%) patients were admitted, including the patient with appendicitis who developed a perforation and was later transferred to a tertiary care centre to undergo an appendectomy. The majority of patients (96.2%) were discharged home. Conclusion All patients either presented with mild symptoms or were asymptomatic. Fever and cough were the most common presenting symptoms. Due to this, the vast majority of patients were discharged home. The infection in the majority of patients could be traced to a positive family contact. Our findings are consistent with what has been observed previously in our centre as well as worldwide.

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