scholarly journals Is the recurrence of primary spontaneous pneumothorax predictable?

2019 ◽  
Vol 6 (6) ◽  
pp. 1890
Author(s):  
Murat Saricam
Keyword(s):  
Body Mass Index ◽  
Retrospective Study ◽  
Spontaneous Pneumothorax ◽  
Smoking Status ◽  
Male Gender ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode ◽  
Chest Tubes ◽  
First Onset

Background: Recurrence of Primary Spontaneous Pneumothorax (PSP) constitutes a serious challenge for both physicians and patients.Methods: A retrospective study was conducted in 115 patients who had chest tubes at their first onset of PSP. Considering the development of recurrence, two groups were composed and comparatively examined in terms of age, body mass index, smoking status, side and size of initial pneumothorax, presence of bulla and duration of chest tube drainage at the first episode.Results: Among 115 patients with PSP, 24 cases developed recurrence. Male gender was prominently relevant to develop recurrent PSP (p=0.034) whereas remaining inspected parameters revealed no significant relationship with a relapse. Interval between first onset and recurrence of PSP was calculated as 9.2 months. Interestingly, most of the patients developed recurrence in low-temperature months.Conclusions: Recurrence of PSP is substantially unpredictable. Therefore, close follow-up of cases in the following year of their first episode and also informing the patients about probability of a relapse and measures to consider under this circumstance is of great importance.

scholarly journals Fate of contralateral asymptomatic bullae in patients with primary spontaneous pneumothorax

2020 ◽  
Vol 58 (2) ◽  
pp. 365-370
Author(s):  
Hyo Jun Jang ◽  
Jun Ho Lee ◽  
Seung Hyuk Nam ◽  
Sun Kyun Ro
Keyword(s):  
Spontaneous Pneumothorax ◽  
Multivariable Analysis ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode ◽  
High Resolution Computed Tomography ◽  
Contralateral Lung ◽  
Younger Age ◽  
Independent Risk Factors ◽  
The Impact

Abstract OBJECTIVES This retrospective cohort study aimed to analyse the impact of asymptomatic blebs/bullae on the occurrence of primary spontaneous pneumothorax (PSP) by monitoring the natural course of contralateral blebs/bullae in patients with ipsilateral pneumothorax. METHODS From January 2003 to December 2017, 1055 patients [age 19.6 ± 3.98 years (mean ± standard deviation), 953 men] experiencing the first episode of unilateral PSP were enrolled in this study, excluding patients aged 30 years or more. The presence, number and maximal size of the blebs/bullae were investigated in contralateral asymptomatic lungs based on high-resolution computed tomography. RESULTS Multiple and single blebs/bullae were noted in contralateral lungs in 425 (40.3%) and 88 (8.3%) patients, respectively. The median follow-up period was 44.0 (interquartile range 71.5) months. The 1-, 3- and 5-year cumulative occurrence rates of PSP in contralateral lungs were 7.9%, 13.7% and 16.7%, respectively. On multivariable analysis, younger age [hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.12–1.27; P < 0.001) and multiple bullae (HR 4.42, 95% CI 3.06–6.38; P < 0.001) were independent risk factors for spontaneous pneumothorax in the contralateral lung. The 5-year cumulative occurrence rates of PSP were significantly higher in patients with multiple blebs/bullae than in those with no or a single bleb/bulla (28.2% vs 8.5%, respectively; P < 0.001). CONCLUSIONS Asymptomatic blebs/bullae often lead to PSP. If the patient is eligible for surgery for pneumothorax, preemptive surgery for contralateral bullae could be considered, especially in patients with multiple blebs/bullae.

scholarly journals Does the Chest Tube Removal Time Influence the Outcomes of Primary Spontaneus Pneumothorax First Episode Management?

2019 ◽  
Vol 18 (4) ◽  
pp. 239-245
Author(s):  
Matas Mongirdas ◽  
Audrius Untanas ◽  
Žymantas Jagelavičius ◽  
Ričardas Janilionis
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode ◽  
Air Leak ◽  
Removal Time ◽  
Tube Removal ◽  
Significant Difference ◽  
Chest Tube Removal

Background / objectives. The main treatment option for the first episode of primary spontaneous pneumothorax is chest tube drainage, however, whether delayed chest tube removal might influence the recurrence is unclear.Methods. A prospective study, which included 50 patients, with an initial episode of primary spontaneous pneumothorax was performed. Patients were randomized into two groups according to the chest tube removal time: 1-day and 5-days after the air-leak has stopped. All patients were followed-up for at least six months. Both groups were compared according to the recurrence rate and possible complications.Results. There were 39 (78%) men and the median age was 27 (23–35) years. Successful management with a chest tube was achieved in 43 (86%) patients, others were operated on because of the continuous air-leak or relapse of the pneumothorax after the chest tube was removed. Significant difference was not found comparing groups by age, gender, side, tobacco smoking, alpha-1-antitrypsin level, rate of prolonged air-leak, necessity of surgery, and the mean follow-up time. There was a significant difference between groups in hospitalization time: 1-day group – 6 (4–12), 5-days group – 8 (7–10) days, p = 0.017. Five (20%) patients from 1-day group and 3 (12%) from 5-days group had a recurrence, however the difference was not significant (p = 0.702). There were no significant differences comparing groups by the recurrence time or complications.Conclusions. The recurrence rate of primary spontaneous pneumothorax was higher if the chest tube was removed earlier, however not significantly. More data and longer follow-up are necessary to confirm these findings.

scholarly journals Patients characteristics associated with better glycemic response to teneligliptin and metformin therapy in type 2 diabetes: a retrospective study

2018 ◽  
Vol 5 (2) ◽  
pp. 424
Author(s):  
Pradeep V. Gadge ◽  
Roshani P. Gadge ◽  
Nikita D. Paralkar
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Retrospective Study ◽  
Blood Sugar ◽  
Therapeutic Effectiveness ◽  
Glycemic Response ◽  
Newly Diagnosed ◽  
Long Duration

Background: Teneligliptin was recently approved for type 2 diabetes (T2D) management in India and is used as monotherapy or in combination with different antidiabetic drugs. The aim of this study was to identify patients’ characteristics associated with better glycemic response to teneligliptin and metformin.Methods: A retrospective analysis of data was performed in patients of T2D with HbA1c above 7% who were treated with teneligliptin 20 mg/d as add on to metformin (500-100 mg/d) and whose follow-up data at 12-weeks was available. Fasting blood sugar (FBS) and post-prandial blood sugar (PPBS) changes were analysed.  Results: Among 66 patients included in analysis, mean age was 61.0±9.8 years and 53% were females. Median duration of diabetes was 2 years. At 12-weeks, a significant reduction PPBS was observed (mean change: -14.3 mg/dL, p=0.009) but not in FBS (mean change: -2.4 mg/dL, p=0.353). Among different patients’ characteristics, age ≤60 years (p=0.006), duration of ≤1 year (p=0.023), body-mass index ≥25 kg/m2 (p=0.009), presence of dyslipidemia (p=0.05) and absence of complications (p=0.012) were associated with significant reduction in PPBS but not in FBS.Conclusions: A younger, newly-diagnosed, obese T2D patients with dyslipidemia without any complications of diabetes can derive better therapeutic effectiveness from teneligliptin added to metformin. These findings need to be confirmed in large, prospective, long duration study.  

scholarly journals Optimal strategy for the first episode of primary spontaneous pneumothorax in young men

2002 ◽  
Vol 17 (3) ◽  
pp. 193-202 ◽  
Author(s):  
Takeshi Morimoto ◽  
Tsuguya Fukui ◽  
Hiroshi Koyama ◽  
Yoshinori Noguchi ◽  
Takuro Shimbo
Keyword(s):  
Optimal Strategy ◽  
Spontaneous Pneumothorax ◽  
Young Men ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode

scholarly journals What is the best treatment strategy for primary spontaneous pneumothorax? A retrospective study

2019 ◽  
Vol 45 ◽  
pp. 98-101 ◽  
Author(s):  
Yasuhiro Chikaishi ◽  
Masatoshi Kanayama ◽  
Akihiro Taira ◽  
Yusuke Nabe ◽  
Shinji Shinohara ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Treatment Strategy ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax

scholarly journals Falls and Depression in Men: A Population-Based Study

2015 ◽  
Vol 12 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Amanda L. Stuart ◽  
Julie A. Pasco ◽  
Felice N. Jacka ◽  
Michael Berk ◽  
Lana J. Williams
Keyword(s):  
Body Mass Index ◽  
Drug Use ◽  
Body Mass ◽  
Psychotropic Drug ◽  
Smoking Status ◽  
The Elderly ◽  
Population Based ◽  
Psychotropic Drug Use ◽  
Geelong Osteoporosis Study

The link between falls and depression has been researched in the elderly; however, little information is available on this association in younger adults, particularly men. This study sought to investigate the link between major depressive disorder (MDD) and falls in a population-based sample of 952 men (24-97 years). MDD was diagnosed utilizing the Structured Clinical Interview for DSM-IV-TR Research Version, Non-Patient edition, and categorized as 12-month/past/never. Body mass index and gait were measured; falls, smoking status, psychotropic medication use, and alcohol intake were self-reported as part of the Geelong Osteoporosis Study 5-year follow-up assessment. Thirty-four (3.6%) men met criteria for 12-month MDD, and 110 (11.6%) for past MDD. Of the 952 men, 175 (18.4%) reported falling at least once during the past 12 months. Fallers were older (66 [interquartile range: 48-79] vs. 59 [45-72] years, p = .001) and more likely to have uneven gait ( n = 16, 10% vs. n = 31, 4%, p = .003) than nonfallers. Participants with 12-month MDD had more than twice the odds of falling (age-adjusted odds ratio: 2.22, 95% confidence interval [1.03, 4.80]). The odds of falling were not associated with past depression ( p = .4). Further adjustments for psychotropic drug use, gait, body mass index, smoking status, blood pressure, and alcohol did not explain these associations. Given the 2.2-fold greater likelihood of falling associated with depression was not explained by age or psychotropic drug use, further research is warranted.

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