scholarly journals Intrapleural Streptokinase in Parapneumonic / Complicated Pleural Effusion/Empyema: Experience in Dhaka Shishu (Children) Hospital

2020 ◽  
Vol 44 (2) ◽  
pp. 104-108
Author(s):  
Md Shakibur Rahman ◽  
Probir Kumar Sarkar ◽  
Khandakar Ashikur Zaman ◽  
Nabila Akand ◽  
Md Kamruzzaman
Keyword(s):  
Pleural Effusion ◽  
Complete Resolution ◽  
Standard Treatment ◽  
Pleural Cavity ◽  
Parapneumonic Effusion ◽  
Empyema Thoracis ◽  
Tube Drainage ◽  
Advanced Stages ◽  
Chest Tube Drain ◽  
Good Success Rate

Background: Parapneumonic effusion/complicated pleural effusion/empyema thoracis in children causes significant morbidity. Standard treatment of pleural effusion includes tube drainage and antibiotics. But the tube drainage often fails. Intrapleural Streptokinase has been used in empyema thoracis as well as complicated pleural effusion with good success rate. Though its efficacy is documented in Western literatures and textbooks, there are no clinical trials in children has been reported from Bangladesh. Objectives: We evaluated the efficacy of intra-pleural Streptokinase in the management of Parapneumonic effusion / complicated pleural effusion/ empyema thoracis even in advanced stages. Patients and Methods: A total of 3 patients with parapneumonic effusion requiring intercostal tube drainage, aged 4 year 6 month to twelve years were included in the study who were admitted in Pediatric respiratory medicine unit in Dhaka Shishu (Children) Hospital. Intercostal chest tube drain was given in all patients and inj: Streptokinase (10,000 units/kg/dose) was instilled into the pleural cavity and kept the Streptokinase for 4 hour in pleural cavity. Response was assessed by clinical outcome, after unclamping and serial chest ultrasounds and subsequent chest radiography. Results: Streptokinase enhanced drainage of pleural fluid and complete resolution of effusion in all the 3 patients. Conclusions: Intrapleural Streptokinase is the preferred treatment for treating pediatric empyema/parapneumonic effusion/complicated pleural effusion even in advanced stages and can avoid surgery. Bangladesh J Child Health 2020; VOL 44 (2) :104-108

scholarly journals Videothoracoscopy in Pleural Empyema Following Methicillin-ResistantStaphylococcus aureus(MRSA) Lung Infection

2009 ◽  
Vol 9 ◽  
pp. 723-728 ◽  
Author(s):  
Duilio Divisi ◽  
Giovanna Imbriglio ◽  
Roberto Crisci
Keyword(s):  
Carbon Dioxide ◽  
Pleural Effusion ◽  
Complete Resolution ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Lung Infection ◽  
Cardiac Insufficiency ◽  
Parapneumonic Effusion ◽  
Thoracostomy Tube ◽  
Therapeutic Procedures

Our study shows the different therapeutic procedures in 64 patients with pleural effusion due to MRSA pneumonia. The thoracostomy tube associated with pleural washing was decisive in 10 simple effusion patients. Video-assisted thoracic surgery allowed a complete resolution of the disease in 22 complex parapneumonic effusion patients. In 20 of 32 patients with frank pus in the pleural cavity, the videothoracoscopic insufflation of carbon dioxide (CO2) before thoracotomy facilitated the dissection of the lung tissue. In 12 patients, this approach was not applied because of cardiac insufficiency. Videothoracoscopy and decortication after thoracotomy ensured the recovery of functions.

Intrapleural Alteplase in a Patient with Complicated Pleural Effusion

2003 ◽  
Vol 37 (3) ◽  
pp. 376-379 ◽  
Author(s):  
Charlotte A Walker ◽  
Mary Beth Shirk ◽  
Marva M Tschampel ◽  
James A Visconti
Keyword(s):  
Pleural Effusion ◽  
Chest Tube ◽  
Pleural Cavity ◽  
Surgical Intervention ◽  
Chest Tube Drainage ◽  
Tube Drainage ◽  
X Ray ◽  
Case Summary ◽  
Chest X Ray ◽  
Intrapleural Administration

OBJECTIVE: To report the intrapleural use of alteplase in a patient diagnosed with complicated pleural effusion (CPE). CASE SUMMARY: A 62-year-old white woman admitted with respiratory distress and hypotension developed a right-sided multi-loculated pleural effusion. Thoracentesis and chest tube drainage were not successful in resolving the effusion. In an attempt to increase the drainage of the pleural effusion, alteplase 16 mg was administered into the pleural cavity via the chest tube on 6 consecutive days. As a result, the volume drained from the patient's chest tube increased, there was improvement on the chest X-ray, and she did not require surgical intervention. DISCUSSION: While streptokinase and urokinase have been shown to be useful adjuncts to chest tube drainage in the treatment of complicated pleural effusion and empyema, there have been no reports on the use of intrapleural alteplase. This report demonstrates that intrapleural administration of alteplase is a useful adjunct to tube drainage in resolving CPE. CONCLUSIONS: This patient's CPE resolved when intrapleural alteplase was used as an adjunct to chest tube drainage and antibiotics. Controlled trials need to be conducted to investigate fully the efficacy, dosing, and safety of intrapleural alteplase in the treatment of patients with CPE and empyema.

Well-Differentiated Papillary Mesothelioma Involving the Peritoneal and Pleural Cavities: Successful Treatment by Local and Systemic Administration of Carboplatin

2000 ◽  
Vol 86 (5) ◽  
pp. 419-421 ◽  
Author(s):  
Ken-ichi Shukunami ◽  
Shin-ya Hirabuki ◽  
Mitsuo Kaneshima ◽  
Naoyuki Kamitani ◽  
Fumikazu Kotsuji
Keyword(s):  
Pleural Effusion ◽  
Successful Treatment ◽  
Standard Treatment ◽  
Pleural Cavity ◽  
Systemic Administration ◽  
Menopausal Woman ◽  
Rare Form ◽  
Post Menopausal Woman ◽  
Well Differentiated ◽  
Post Menopausal

Well-differentiated papillary mesothelioma (WDPM) of the peritoneum is a rare form of epithelial mesothelioma. It usually shows an indolent course and no standard treatment is available. Only a few cases of WDPM in the pleural cavity have been reported. We report on a 56-year-old post-menopausal woman who presented with ascites and right pleural effusion. Laparotomy followed by biopsy established the presence of WDPM in the peritoneum and pleural cavity. The patient was successfully treated with local and systemic administration of carboplatin.

scholarly journals Papillary Thyroid Carcinoma with Malignant Pleural Effusion: Dilemma of Etiology

2010 ◽  
Vol 1 (2) ◽  
pp. 117-119 ◽  
Author(s):  
Arvind Krishnamurthy ◽  
KT Siddappa
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Pleural Effusion ◽  
Thyroid Carcinoma ◽  
Distant Metastasis ◽  
Malignant Pleural Effusion ◽  
Standard Treatment ◽  
Pleural Cavity ◽  
Published Data ◽  
Papillary Thyroid

Abstract Papillary carcinomas of thyroid generally have an indolent course with metastatic disease in less than 5% of patients. Common sites of distant metastasis include lung and bone. A presentation with malignant pleural effusion is exceedingly rare with only a handful of cases reported in literature. We present a case and discuss the treatment of a patient presenting of papillary thyroid cancer with a relapse of the disease in the pleural cavity. There are no standard treatment recommendations in this setting in view of paucity of published data from literature.

Clinico-bacteriological Profile and Outcome of Empyema Thoracis in Children at a Tertiary Care Hospital of Central Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Atanu Pan ◽  
Debarshi Jana
Keyword(s):  
Ct Scan ◽  
Broad Spectrum ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Diagnostic Tools ◽  
High Morbidity ◽  
Care Hospital ◽  
Empyema Thoracis ◽  
First Line ◽  
Tube Drainage

Background: Empyema thoracis (ET) is a serious infection of the pleural space. Despite the availability of broad spectrum antibacterial, improved vaccination coverage and better diagnostic tools, Empyema Thoracis remains associated with high morbidity worldwide. Delay   in   early   diagnosis,   failure   to institute   appropriate   antimicrobial   therapy,   multidrug resistant   organisms,   malnutrition,   comorbidities,   poor health  seeking  behaviour  and  high treatment  cost  burden contribute  to  increased  morbidity  in  children. The available  treatment  options  include  intravenous broad-spectrum antibiotics  either  alone  or  in  combination  with surgical  procedure  (thoracocentesis,  chest  tube  drainage, fibrinolytic  therapy,  decortications  with  video  assistedthoracoscopic surgery (VATS) and open drainage. Methods: Fifty Children between 1 month to 16 years admitted in the Pediatrics Ward, PICU of College of Medical Sciences, Bharatpur,Nepal. Data analysis was done by SPSS 24.0. Results: Present study found that according to blood culture, 3(6.0%) patients had enterococcus, 40(80.0%) patients had no growth, 2(4.0%) patients had pseudomonas, 4(8.0%) patients had staphylococcus and 1(2.0%) patients had streptococcus. We found that 20(40.0%) patients had done CT scan thorax, 30(60.0%) patients had not done CT scan thorax and 32(64.0%) patients had Amoxiclav first line antibiotic and 18(36.0%) patients had Ceftriaxone first line antibiotic. Conclusions: Suitable antibiotics and prompt chest tube drainage is an effective method of treatment of childhood empyema, especially in resource-poor settings. Majority of the patients progress on this conservative management and have good recovery on follow up.  

scholarly journals PERIOPERATIVE CHEMOTHERAPY IN LOCALLY ADVANCED GASTRIC CANCER

2013 ◽  
Vol 50 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Thales Paulo BATISTA ◽  
Candice Amorim de Araujo Lima SANTOS ◽  
Gustavo Fernandes Godoy ALMEIDA
Keyword(s):  
Gastric Cancer ◽  
Therapeutic Strategy ◽  
Multimodal Therapy ◽  
Standard Treatment ◽  
Treatment Options ◽  
Locally Advanced ◽  
Special Focus ◽  
Perioperative Chemotherapy ◽  
Locally Advanced Gastric Cancer ◽  
Advanced Stages

Gastric cancer is one of the most common cancers and a main cause of cancer-related death worldwide, since the majority of patients suffering of this malignancy are usually faced with a poor prognosis due to diagnosis at later stages. In order to improve treatment outcomes, the association of surgery with chemo and/or radiotherapy (multimodal therapy) has become the standard treatment for locally advanced stages. However, despite several treatment options currently available for management of these tumors, perioperative chemotherapy has been mainly accepted for the comprehensive therapeutic strategy including an appropriated D2-gastrectomy. This manuscript presents a (nonsystematic) critical review about the use of perioperative chemotherapy, with a special focus on the drugs delivery.

scholarly journals The Differential Diagnostic Values of Cytokine Levels in Pleural Effusions

2005 ◽  
Vol 2005 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Saadet Akarsu ◽  
A. Nese Citak Kurt ◽  
Yasar Dogan ◽  
Erdal Yilmaz ◽  
Ahmet Godekmerdan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Parapneumonic Effusion ◽  
Pleural Effusions ◽  
Tuberculous Pleural Effusion ◽  
Cytokine Levels ◽  
Diagnostic Values

The aim is to examine whether the changes in pleural fluid interleukin (IL)-1β, IL-2, IL-6, and IL-8 levels were significant in differential diagnosis of childhood pleural effusions. IL-1β, IL-2, IL-6, and IL-8 levels in pleural fluids of all 36 patients were measured. The levels of IL-1β, IL-2, IL-6, and IL-8 in pleural fluids were statistically significantly higher in the transudate group compared with those of the exudate group. The levels of IL-1β, IL-6, and IL-8 were also found to be statistically significantly higher in the empyema group compared with both the parapneumonic and the tuberculous pleural effusion groups. The levels of IL-2 and IL-6 were detected to be statistically significantly higher in the tuberculous pleural effusion group in comparison with those of the parapneumonic effusion group. The results showed that pleural fluids IL-1β, IL-2, IL-6, and IL-8 could be used in pleural fluids exudate and transudate distinction.

Pleural tumours

2010 ◽  
pp. 3534-3539
Author(s):  
Robert J.O. Davies ◽  
Y.C. Gary Lee
Keyword(s):  
Pleural Effusion ◽  
Case History ◽  
Pleural Cavity ◽  
Solitary Fibrous Tumour ◽  
Pleural Effusions ◽  
Old Chinese ◽  
Benign Tumours

Case History—A 54 yr old Asian man, and a 19 yr old Chinese man, both with pleural effusions. Case History—A 68 yr old man with a pleural effusion. Benign tumours are rare in the pleural cavity, with solitary fibrous tumour of the pleura, the most frequent of these rarities....

Heparan sulfate chains contribute to the anticoagulant milieu in malignant pleural effusion

Thorax ◽  
2019 ◽  
Vol 75 (2) ◽  
pp. 143-152 ◽  
Author(s):  
Emilia Hardak ◽  
Eli Peled ◽  
Yonatan Crispel ◽  
Shourouk Ghanem ◽  
Judith Attias ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Pleural Effusion ◽  
Heparan Sulfate ◽  
Tumour Cell ◽  
Malignant Pleural Effusion ◽  
Pleural Cavity ◽  
Therapeutic Option ◽  
Factor Xa ◽  
Pleural Effusions ◽  
Cell Proliferation Inhibition

BackgroundWhile malignant pleural effusion (MPE) is a common and significant cause of morbidity in patients with cancer, current treatment options are limited. Human heparanase, involved in angiogenesis and metastasis, cleaves heparan sulfate (HS) side chains on the cell surface.AimsTo explore the coagulation milieu in MPE and infectious pleural effusion (IPE) focusing on the involvement of heparanase.MethodsSamples of 30 patients with MPE and 44 patients with IPE were evaluated in comparison to those of 33 patients with transudate pleural effusions, using heparanase ELISA, heparanase procoagulant activity assay, thrombin and factor Xa chromogenic assays and thromboelastography. A cell proliferation assay was performed. EMT-6 breast cancer cells were injected to the pleural cavity of mice. A peptide inhibiting heparanase activity was administered subcutaneously.ResultsLevels of heparanase, factor Xa and thrombin were significantly higher in exudate than transudate. Thromboelastography detected almost no thrombus formation in the whole blood, mainly on MPE addition. This effect was completely reversed by bacterial heparinase. Direct measurement revealed high levels of HS chains in pleural effusions. Higher proliferation was observed in tumour cell lines incubated with exudate than with transudate and it was reduced when bacterial heparinase was added. The tumour size in the pleural cavity of mice treated with the heparanase inhibitor were significantly smaller compared with control (p=0.005).ConclusionsHS chains released by heparanase form an anticoagulant milieu in MPE, preventing local thrombosis and enabling tumour cell proliferation. Inhibition of heparanase might provide a therapeutic option for patients with recurrent MPE.

Sign in / Sign up

Export Citation Format

Share Document