scholarly journals Success of Using Iodopovidone as a Sclerosing Agent for Chemical Pleurodesis in a Tertiary Care Center: A Descriptive Cross-Sectional Study

2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Deebya Raj Mishra ◽  
Narendra Bhatta ◽  
Puru Koirala ◽  
Bhupendra Shah ◽  
Bidesh Bista ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Partial Response ◽  
Spontaneous Pneumothorax ◽  
Malignant Pleural Effusion ◽  
Treatment Success ◽  
Tertiary Care ◽  
Complete Response ◽  
Ease Of Use ◽  
High Rate ◽  
Sclerosing Agent

Introduction: Pleurodesis is a procedure to achieve symphysis between the two layers of pleura aimed at preventing the accumulation of either air or fluid in the pleural space. In Nepal, intrapleural instillation of the chemical sclerosing agent is more commonly done as thoracoscopy facility is not easily available. However, iodopovidone is rarely used for this purpose in Nepal. The study aims to find the prevalence of success using iodopovidone as the chemical sclerosing agent. Methods: The study included cases undergoing pleurodesis over a two-year period. The clinicodemographic data, diagnosis, treatment effect and treatment response were analyzed. The treatmentresponse was graded as Treatment Success (Complete Response or Partial Response) and TreatmentFailure. Results: Pleurodesis was done in a total of 54 cases. Of those, 39 cases were Secondary SpontaneousPneumothorax, 11 were Malignant Pleural Effusion, 3 were Primary Spontaneous Pneumothorax,and 1 was a case of Hepatic Hydrothorax. Among Secondary Spontaneous Pneumothorax, Pleurodesis was successful in 37 (95%) out of 39 cases, with 35 (90%) having a Complete Response and 2 (5%)having a Partial Response while 2 (5%) had Treatment failure. Among Malignant Pleural Effusion,treatment success was achieved in 6 (55%) out of 11, whereas 5 (45%) failed the treatment. The commonest complication was burning sensation, and the commonest pain scale was “distressing.” Conclusions: This study highlights the safety and ease of use of iodopovidone as an agent forchemical pleurodesis. It confirms the high rate of success of pleurodesis in cases of pneumothoraxas found in other studies. In contrast, the success rate is understandably lower in cases of MalignantPleural effusion.

Clinical results of recombinant adenoviral human p53 gene in treatment of malignant pleural effusions caused by advanced lung cancers.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19026-e19026
Author(s):  
Yong He
Keyword(s):  
Lung Cancer ◽  
Pleural Effusion ◽  
Partial Response ◽  
Malignant Pleural Effusion ◽  
P53 Gene ◽  
Complete Response ◽  
Advanced Lung Cancer ◽  
Karnofsky Performance Scale ◽  
Complete Disappearance ◽  
Radio Therapy

e19026 Background: Management of the malignant pleural effusion caused by advanced or recurrent lung cancer is a big challenge for clinicians due to multiple reasons: patients’ poor conditions, resistance to chemo- or radio-therapy, intolerance to an aggressive treatment, et al. This report presents a new safe treatment for controlling this type of tough conditions. Methods: Fifty-six patients, 39 males and 17 females with an average age of 64.2 years old were included in this study. All these patients had either a lung cancer in advanced stage or a recurrent cancer after a radical tumorectomy, with malignant pleural effusion. After draining most of the effusion fluid, the patients received intra-cavity infusion of rAed-p53 once per week for 4 weeks, at dose of 2×1012 viral particles (VP) diluted into 300 ml of saline solution. The complete response is defined as the complete disappearance of pleural or peritoneal fluid and negative cytologic findings for >4 weeks, and the partial response is defined as a decrease over 50% of the fluid without the need of drainage and negative cytologic findings for >4 weeks. Results: Participants were followed up for a median time of 15 month. Fifty patients (26.8%) achieved a complete response (CR) and 23 (41.1%) achieved a partial response (PR). The overall response rate is 67.9%. Patients’ quality of life, assessed by using Karnofsky performance scale (KPS) scores, was improved by an average of 27.2. The one-year of overall survival rate was 48.2% with a median survival time of 11.0 months. There were no serious side effects observed except for self-limited fever found in 82.6% of the cases. Conclusions: Intra-cavity infusion of rAd-p53 is a safe and effective method for controlling the malignant pleural effusion for patients with advanced lung cancer and in a poor condition, especially for those who can’t tolerate the standard treatments.

Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study

2021 ◽  
pp. 1-6
Author(s):  
Ediz Vuruskan ◽  
Hakan Ercil ◽  
Umut Unal ◽  
Ergun Alma ◽  
Hakan Anil ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Partial Response ◽  
Medical Treatment ◽  
Predictive Factors ◽  
Treatment Success ◽  
Complete Response ◽  
Response To Treatment ◽  
Factors Affecting ◽  
Success Of Treatment ◽  
Functioning Kidney

<b><i>Introduction:</i></b> The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension. <b><i>Methods:</i></b> Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated. <b><i>Results:</i></b> Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 ± 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (<i>p</i> = 0.071, <i>p</i> = 0.973, respectively), but the increase in age and hypertension duration (<i>p</i> = 0.030 and <i>p</i> &#x3c; 0.001, respectively) and the presence of metabolic syndrome (<i>p</i> = 0.002) significantly decreased the complete response rates. <b><i>Conclusions:</i></b> Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.

scholarly journals Experience of lodopovidone Pleurodesis at A Tertiary Care Hospital in Peshawar

1969 ◽  
Vol 11 (3) ◽  
pp. 123-127
Author(s):  
Muhammad Umar ◽  
Zia Ul Haq ◽  
Imtiaz Khan ◽  
Anila Basit ◽  
Amin Ul Haq ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
Chemical Pleurodesis ◽  
Effective Agent ◽  
Age Range ◽  
Recurrent Pleural Effusion

Background: Chemical pleurodesis is used for the management of malignant /recurrent pleural effusion and pneumothorax.Malignant pleural effusion is diagnosed on histopathology or malignant cells in pleural fluid. Pneumothorax is diagnosed by chestradiograph. Pleurodesis can be performed surgically or by using medical agents. Various pleurodesis agents have been used e.g.Tetracycline.Bleomycin. Talc and lodopovidone with different success and complications rates.Objective: This study was conducted to know the efficacy and safety of lodopovidone as pleurodesis agent in themanagement of pleural effusion (malignant/recurrent) and recurrent pneumothorax.Material and Methods: This was a descriptive study conducted at department of Pulmonology Lady Reading HospitalPeshawar from February 2018 to May 2019.Results:A Total of 213 patients were included in the study, among which 120 (56.3%) were males and 93 (43.6%) werefemales. Age range was from 20 to 83 years. One hundred and thirty eight patients (74.8%) had malignant pleural effusion and75 (35.2%) had recurrent pneumothorax. The success rate with lodopovidone pleurodesis was 85 % (181) as a whole with afailure rate of 13 %( 28) in pleural effusion and 2 %( 4) in pneumothorax. Chest pain (65.7%) was the most common side effectfollowed by fever (24.4%) and dyspnea (12.2%).No serious side effects were observed in this study.Conclusion: lodopovidone is easily available, safer, cheaper and effective agent for chemical pleurodesis in pneumothorax,malignant/recurrent pleural effusion.Keywords: Pleurodesis, lodopovidone. Malignant, Pleural Effusion, Pneumothorax.

The efficacy of doxycycline as a pleural sclerosing agent in malignant pleural effusion: A prospective study

Respirology ◽  
1996 ◽  
Vol 1 (1) ◽  
pp. 69-72 ◽  
Author(s):  
C PULSIRIPUNYA ◽  
P YOUNGCHAIYUD ◽  
R PUSHPAKOM ◽  
N MARANETRA ◽  
A NANA ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Prospective Study ◽  
Malignant Pleural Effusion ◽  
Sclerosing Agent ◽  
A Prospective Study

scholarly journals Pure Red Cell Aplasia and Carcinoma

Blood ◽  
1971 ◽  
Vol 37 (5) ◽  
pp. 594-597 ◽  
Author(s):  
A. B. S. MITCHELL ◽  
G. PINN ◽  
G. D. PEGRUM
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Complete Response ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Red Cell Aplasia ◽  
Autoimmune Mechanism

Abstract A patient presented with pure red cell aplasia, which responded to corticosteroids. Thirteen months later, a malignant pleural effusion developed, with subsequent death from adenocarcinomatosis. The reports of cases in which pure red cell aplasia has been associated with carcinomata are reviewed. An autoimmune mechanism can be postulated in these circumstances, and the complete response to corticosteroids in the present case would support this hypothesis.

scholarly journals An improved method of delivering a sclerosing agent for the treatment of malignant pleural effusion

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tim N. Beck ◽  
Alexander Y. Deneka ◽  
Louis Chai ◽  
Colin Kanach ◽  
Priya Johal ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Improved Method ◽  
Sclerosing Agent

First Asia-Pacific Co-Operative Multicenter Multiple Myeloma Clinical Trial: Preliminary Results of the “dtZ”/“DAZZLE” Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4940-4940
Author(s):  
Gerrard Teoh ◽  
Kihyun Kim ◽  
Alok Srivastava ◽  
Vasant Pai ◽  
Sung-Soo Yoon ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Partial Response ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Osteonecrosis Of The Jaw ◽  
High Rate ◽  
Asia Pacific ◽  
Hematopoietic Stem ◽  
Asian Patients ◽  
Tract Infections

Abstract Abstract 4940 Introduction Many physicians have anecdotally reported that Asian patients with multiple myeloma (MM) are frequently unable to tolerate full doses of dexamethasone (Dex) and/or thalidomide (Thal). Unfortunately, co-operative clinical studies from the Asia-Pacific countries are presently lacking and the effective dose of the Dex/Thal combination in Asians is unknown. Since higher doses of zoledronic acid (Zol) have been shown to exert an anti-MM effect in pre-clinical models of MM, we investigated whether higher frequency dosing of Zol combined with lower doses of Dex/Thal could be an effective and better tolerated regimen in Asian patients. Moreover, since attainment of very good partial response (VGPR), near complete response (nCR) or complete response (CR) prior to autologous hematopoietic stem cell transplantation (AHSCT) correlates with good outcome in MM, we wanted to determine if this lower-dose Dex/Thal with higher-frequency dosing Zol regimen could be a good preparative regimen in transplant-eligible patients. Patients and Methods In this international co-operative multicenter phase II non-randomized single arm study in previously untreated patients with MM (n=44), all patients received up to 6 cycles of three-weekly Dex/Thal/Zol (or “dtZ”). Doses of Dex ranged from 20 mg weekly to 20 mg four times a week; and doses of Thal ranged from 50 mg weekly to 100 mg every night. Zol 4 mg was given three-weekly. Response was graded using Blade's criteria. Results The study population included 67.3% Oriental (Korean and Chinese), 30.8% Indian and 1.9% Malay patients. 15.4% of patients were ISS stage I, 61.5% stage II and 23.1% stage III prior to treatment. 39 (88.6%) patients demonstrated at least a partial response (PR); and 23 (52.3%) of patients achieved VGPR (18.2%), near nCR (15.9%) or CR (18.2%). The fastest time to VGPR/nCR/CR was 1 cycle. Most patients tolerated treatment very well and were managed in the outpatient clinic. Sepsis was the most frequently reported grade 3 or 4 toxicity – 8 (18.2%) patients developed bronchopneumonia, and 3 (6.8%) gastrointestinal or urinary tract infections. 1 (2.3%) patient was suspected of having pulmonary embolism. There were 4 (9.1%) deaths – 3 from severe sepsis and 1 from an unknown cause. Importantly, there were no reports of peripheral neuropathy, osteonecrosis of the jaw (ONJ) or end stage renal failure. In fact, there was an overall 2.4% improvement in the median creatinine clearance time (CCT). Finally, the percentage of CD34 stem cells was not adversely affected by treatment with dtZ. Conclusions The dtZ regimen appears to be an effective and well-tolerated treatment regimen for Asian patients with newly-diagnosed MM. The high rate of VGPR/nCR/CR will greatly facilitate AHSCT in transplant-eligible patients. Judicious use of low-dose Thal has abrogated the numerous side-effects associated with Thal and greatly improved patient tolerance. Even though Zol is administered at a higher frequency, it is not associated with worsening of renal function or ONJ. Infections are the most frequent and worrisome complications of treatment. These are likely to be related to the dose of Dex. Accordingly, it is probably wise to further lower the dose of Dex in future studies. (This study is registered with NIH PRS # 00263484.) Disclosures No relevant conflicts of interest to declare.

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