scholarly journals Pharmacokinetics of Vancomycin Installation in Pleural Cavity—A Clinical Case with Animal Experiments

2021 ◽  
Vol 11 (14) ◽  
pp. 6456
Author(s):  
Soojin Lee ◽  
Hyo Yeong Ahn ◽  
Keunyoung Kim ◽  
Jeong Hun Kim ◽  
Soo Young Moon ◽  
...  
Keyword(s):  
Critically Ill Patients ◽  
Clinical Case ◽  
Multidisciplinary Approach ◽  
Pleural Cavity ◽  
Bronchopleural Fistula ◽  
Animal Experiments ◽  
Efficient Treatment ◽  
Antibiotic Solution ◽  
Mrsa Infection ◽  
Rat Experiments

(1) background: Postpneumonectomy empyema is often observed in patients after a complete pneumonectomy. The management of these cases can be challenging when the condition of patients is complicated by a bronchopleural fistula. A multidisciplinary approach is required to manage these critically ill patients, especially when they are not suitable candidates for surgery; (2–3) Methods & Results: we report a case of successfully treated postpneumonectomy empyema caused by a bronchopleural fistula and pharmacokinetics of vancomycin installation in pleural cavity using rat experiments; (4) Conclusions The experiments provide evidence that irrigation of the pleural cavity with an antibiotic solution containing vancomycin may be an efficient treatment strategy, especially in the case of an MRSA infection in the thickened pleura.

scholarly journals Pharmacist’s role in the system of palliative and hospice care in Ukraine and Poland

2014 ◽  
Vol 83 (4) ◽  
pp. 282-287
Author(s):  
Sofiya Prokip ◽  
Iga Pawłowska ◽  
Bohdan Hromovyk ◽  
Leszek Pawłowski
Keyword(s):  
Multidisciplinary Team ◽  
Multidisciplinary Approach ◽  
Hospice Care ◽  
Multiple Choice Questions ◽  
Drug Management ◽  
Efficient Treatment ◽  
Study Results ◽  
Polish Study ◽  
The Status

Introduction. The efficient pharmacotherapy is an important part of palliative and hospice care, and requires a multidisciplinary approach to the patients. The pharmacist, as the member of the multidisciplinary therapeutic team, is responsible for performing pharmaceutical care, which provides safe and efficient treatment. The aim of the research was to conduct a comparative research about the status of palliative and hospice care and role of the pharmacist (clinical pharmacist) in Ukraine and Poland.Material and methods. It was a questionnaire survey conducted in Ukraine, as well as analysis of information sources associated with this subject. The questionnaire was developed on the basis of similar study conducted in Poland. It consisted of 15 multiple-choice questions addressed to head physicians and doctors in Ukraine. The obtained results were compared to the results of the mentioned above Polish study. Results. Eight head physicians and 22 doctors (30 questionnaires) from 13 palliative and hospice care institutions in Ukraine responded to the survey. It has been found that almost half in Ukraine (43%) believed that the pharmacist should be a mandatory member of a multidisciplinary team, because of his/her significant role in drug management in hospice. Conclusion. A multidisciplinary approach to satisfying of patients' needs in palliative and hospice care has a great significance. Results of the study testify to the importance of including the pharmacists into the multidisciplinary team.

scholarly journals Case Report: COVID-19 Pneumonia Following Left Pneumonectomy for Lung Cancer Complicated by Empyema and Bronchopleural Fistula

2021 ◽  
Vol 8 ◽  
Author(s):  
Alberto Testori ◽  
Veronica M. Giudici ◽  
Marco Alloisio ◽  
Ugo Cioffi
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Statistical Data ◽  
Pulmonary Thromboembolism ◽  
Bronchopleural Fistula ◽  
Case Presentation ◽  
Arterial Thromboembolism ◽  
Left Pneumonectomy

Background: Venous and arterial thromboembolism is commonly reported in critically ill COVID-19 patients, although there are still no definitive statistical data regarding its incidence.Case presentation: we report a case of a patient who fell ill with Covid during hospitalization for a pneumonectomy complicated by empyema and bronchopleural fistula. The patient, despite being cured of COVID, died after 14 days for pulmonary thromboembolism.Conclusion: Our case strengthens the suggestion of adequate thromboprophylaxis in all hospitalized COVID patients and of increasing prophylaxis in critically ill patients even in the absence of randomized studies

scholarly journals А сlinical case report of mediastinal teratoma in an adolescent patient with Klinefelter syndrome

2020 ◽  
Vol 19 (4) ◽  
pp. 143-149
Author(s):  
S. S. Saliyeva ◽  
R. Z. Boranbayeva ◽  
B. M. Zhumadullayev ◽  
K. E. Khairov ◽  
E. V. Krivenko ◽  
...  
Keyword(s):  
Clinical Case ◽  
Multidisciplinary Approach ◽  
Klinefelter Syndrome ◽  
Malignant Tumors ◽  
Complete Removal ◽  
Cell Tumor ◽  
Growing Teratoma Syndrome ◽  
Mediastinal Teratoma ◽  
Mature Type ◽  
Derivatives Of

Teratoma is a germ cell tumor, which consists of derivatives of three germ layers and has various malignant potentials – from benign mature forms to immature embryonic forms with a somatic type of malignancy. Even the mature type of teratoma is biologically unpredictable providing for an ability to grow locally with invasion. Necessity for complete removal of tumors, wherever they are located, is explained by the fact that there is a risk of a possible development of growing teratoma syndrome or transformation into malignant tumors. This article describes the clinical case of growing teratoma syndrome of mediastinal localization in a teenager with Klinefelter syndrome, also as an example of the multidisciplinary approach of pediatric oncologists, surgeons, radiotherapists and pathomorphologists in decision-making for optimal treatment. The patients' parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.

scholarly journals Multidisciplinary approach in intensive care of massive obstetric blood loss: a clinical case

2017 ◽  
Vol 0 (7.86) ◽  
pp. 101-105
Author(s):  
V.A. Sedinkin ◽  
А.М. Dokunina ◽  
V.О. Drozdova ◽  
E.V. Маksimova ◽  
М.N. Palega ◽  
...  
Keyword(s):  
Intensive Care ◽  
Blood Loss ◽  
Clinical Case ◽  
Multidisciplinary Approach

scholarly journals Bubbles in the Box: Recurrent Pneumothorax From Bronchopleural Fistula in Rheumatoid Arthritis

2019 ◽  
Vol 7 ◽  
pp. 232470961986055 ◽  
Author(s):  
Ahmed Taha ◽  
Randa Hazam ◽  
Jim Tseng ◽  
Lusine Nahapetyan ◽  
Masoud Alzeerah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lung Disease ◽  
Pleural Cavity ◽  
Bronchopleural Fistula ◽  
Pulmonary Nodules ◽  
Fistula Formation ◽  
First Case ◽  
Pulmonary Manifestations ◽  
Parenchymal Lung Disease ◽  
Parenchymal Lung

When considering rheumatoid arthritis (RA)-associated pulmonary diseases, interstitial lung disease and pleural disease are the most common RA-associated pulmonary manifestations while spontaneous pneumothorax and bronchopleural fistula (BPF) are among the extremely rare ones. To the best of our knowledge, all the previous reports of RA-associated BPFs were attributed to peripherally located pulmonary nodules that necrotized, burst into the pleural cavity, and eventually lead to the fistula formation. However, we hereby present the first case of BPF in an RA patient that formed in the absence of any underlying rheumatic pulmonary nodules. Additionally, our patient was on chronic methotrexate therapy, and there are no data in the literature that suggest methotrexate-induced parenchymal lung disease can predispose to BPF formation. Our report is the first to introduce a probe to further investigate this association.

scholarly journals Use of a Low-Molecular-Weight Heparinoid (Danaparoid Sodium) for Continuous Renal Replacement Therapy in Intensive Care Patients

2001 ◽  
Vol 7 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Edelgard Lindhoff-Last ◽  
Christoph Betz ◽  
Rupen Bauersachs
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Infusion Rate ◽  
Efficient Treatment ◽  
Intensive Care Patients

The purpose of this study was to evaluate the efficacy and safety of danaparoid in the treatment of critically ill patients with acute renal failure and suspected heparin-induced thrombocytopenia (HIT) needing renal replacement therapy (RRT). We conducted a retrospective analysis of 13 consecutive intensive care patients with acute renal failure and suspected HIT who were treated with danaparoid for at least 3 days during RRT. In eight patients, continuous venovenous hemofiltration was performed. The mean infusion rate of danaparoid was 140 ± 86 U/hour. Filter exchange was necessary every 37.5 hours. In five patients, continuous venovenous hemodialysis was used. A bolus injection of 750 U danaparoid was followed by a mean infusion rate of 138 ± 122 U/hour. Filters were exchanged every 24 hours. In 7 of 13 patients, even a low mean infusion rate of 88 ± 35 U/hour was efficient. Mean anti-Xa (aXa) levels were approximately 0.4 ± 0.2 aXa U/mL. Persistent thrombocytopenia despite discontinuation of heparin treatment was observed in 9 of 13 patients, owing to disseminated intravascular coagulation (DIC). HIT was confirmed by an increase in platelet count and positive heparin-induced antibodies in 2 of 13 patients. No thromboembolic complications occurred, but major bleeding was observed in 6 of 13 patients, which could be explained by consumption of coagulation factors and platelets due to DIC in 5 of 6 patients. Nine of 13 patients died of multiorgan failure or sepsis, or both. In none of these patients was the fatal outcome related to danaparoid treatment. In critically ill patients with renal impairment and suspected HIT, a bralus injection of 750 U danaparoid followed by a mean infusion rate of 50 to 150 U/hour appears to be a safe and efficient treatment option when alternative anticoagutation is necessary.

scholarly journals Transpleural Сontralateral Occlusion of the Left Main Bronchus Stump in a Patient with Bronchopleural Fistula and Chronic Pleural Empyema

2021 ◽  
Vol 14 (3) ◽  
pp. 216-220
Author(s):  
Alexey Nikolaevich Lednev ◽  
Alexey Aleksandrovich Pechetov ◽  
Sergey Sergeevich Karchakov ◽  
Maksim Aleksandrovich Makov
Keyword(s):  
Pleural Cavity ◽  
Main Bronchus ◽  
Bronchopleural Fistula ◽  
Pleural Empyema ◽  
Bronchial Tree ◽  
Bronchial Stump ◽  
Anatomical Features ◽  
Chronic Empyema ◽  
The Right ◽  
Methods Of Treatment

Bronchopleural fistula (BPF) is a pathological communication between the bronchial tree and the pleural cavity, the most common complication of anatomical lung resection.BPF rarely closes spontaneously and almost always requires surgical or bronchoscopic interventions.The main methods of treatment are sanitation of the pleural cavity with the development of empyema and re-occlusion of the bronchial stump. The development of this complication in the postoperative period is accompanied by an increase in hospitalization time, a high risk of chronic pleural empyema, exacerbation of chronic diseases and death. The mortality rate ranges from 18 to 67%. Most often, BPF is manifested after removal of the right lung (8-13%), compared with the left side (1-5%), which is due to the anatomical features of the main bronchus.The presented clinical case describes a non-standard surgical approach in the treatment of bronchopleural fistula and chronic empyema of the residual pleural cavity in a young patient.

scholarly journals Assessment of oral health literacy of principal caregivers and its association with dental caries in Mexican disabled pediatric patients

2021 ◽  
Vol 2 (3) ◽  
pp. 151-157
Author(s):  
Julio Carlos Garnica-Palazuelos ◽  
Mercedes Bermúdez ◽  
Juan Luis Cota-Quintero ◽  
Gerardo Bueno-Acuña ◽  
Sandra Santana-Delgado ◽  
...  
Keyword(s):  
Clinical Case ◽  
Multidisciplinary Approach ◽  
Speech Therapy ◽  
Pediatric Patients ◽  
Open Bite ◽  
Mixed Dentition ◽  
Oral Health Literacy ◽  
Anterior Open Bite ◽  
Tongue Thrust ◽  
Maxillary Deficiency

Open bite can be defined as an absence of occlusion, most frequently located in the anterior region of dental arches and its etiology is multifactorial. We present a clinical case of an 8 years and 10 months child presenting an anterior open bite (AOB) with transverse maxillary deficiency caused by tongue thrust during mixed dentition. The malocclusion was corrected by means of a McNamara expander with a palatal crib jointly with the association of speech therapy for tongue repositioning, and otolaryngology to treat adenoid hypertrophy due to its correlation with AOB. The multidisciplinary approach was effective in correcting the malocclusion with stable results after 2 years post-treatment.

scholarly journals Abscess of the right iliopsoas muscle: rare disease and difficulties in its diagnosis

2020 ◽  
Vol 179 (2) ◽  
pp. 63-67
Author(s):  
S. V. Stolov ◽  
M. Yu. Kabanov ◽  
K. V. Semencov ◽  
T. Yu. Yamshchikova ◽  
O. V. Makarova ◽  
...  
Keyword(s):  
Rare Disease ◽  
Inflammatory Disease ◽  
Clinical Case ◽  
Multidisciplinary Approach ◽  
Iliopsoas Muscle ◽  
The Right

The article presents the clinical case of an abscess of the iliopsoas muscle (iliopsoitis), a rare abdominal infectious and inflammatory disease that required a multidisciplinary approach in the diagnosis of this pathology in a multidisciplinary hospital.

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