Influence of Environmental Factors on the Primary Spontaneous Pneumotorax

2018 ◽  
Vol 69 (10) ◽  
pp. 2937-2947
Author(s):  
Tiberiu Lunguleac ◽  
Marius Valeriu Hinganu ◽  
Cristina Grigorescu ◽  
Liviu Ciprian Gavril ◽  
Paul Salahoru ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Mechanism Of Action ◽  
Seasonal Variability ◽  
Spontaneous Pneumothorax ◽  
Average Duration ◽  
Statistical Significance ◽  
Pleural Space ◽  
Pleural Effusions ◽  
Treatment Methods ◽  
Duration Of Hospitalization

Pneumothorax is the presence of air between the two pleural effusions, making the pleural space from a virtual cavity to a real one. At present, we are facing a particular phenomenon: trying to establish with certainty the mechanisms underlying the occurrence of primary spontaneous pneumothorax and how to find and implement the best strategies for the application of treatment methods. Considering the classical conception that the incidence of spontaneous pneumothorax has a seasonal variability, we followed its distribution after the season, calendar month, by checking the statistical significance of the data obtained. Regardless of the dynamics factor involved and the likely mechanism of action, it seems to have an influence on the average duration of hospitalization and the length of time elapsed from intervention to discharge.

Pleural Effusions: Diagnostic Considerations

1995 ◽  
Vol 16 (2) ◽  
pp. 79-79
Author(s):  
Jeffrey M. Ewig
Keyword(s):  
Chest Pain ◽  
Pleural Space ◽  
Pleural Effusions ◽  
Pleuritic Chest Pain ◽  
Radiographic Appearance ◽  
Air Bubble ◽  
Presenting Symptoms ◽  
Breath Sounds ◽  
Costophrenic Angle ◽  
Pleural Involvement

The presence of fluid in the pleural space can be seen in a variety of disorders. Presenting symptoms include dyspnea, pleuritic chest pain, and ipsilateral shoulder pain if pleural involvement occurs at the central portion of the diaphragm. Physical examination findings include chest asymmetry, diminished breath sounds, dullness to percussion, and decreased tactile fremitus. In an upright patient, the radiographic appearance of pleural fluid includes blunting of the costophrenic angle, straightening or a more lateral peak of the hemidiaphragm contour, simulation of an elevated hemidiaphragm, or a distance of greater than 2 cm between the gastric air bubble and the lung.

scholarly journals Changing the structure of the hospitalized patients at the Psychiatric clinic Vrapce

2011 ◽  
Vol 139 (suppl. 1) ◽  
pp. 33-35 ◽  
Author(s):  
Petar Bilic ◽  
Ana Ivanis ◽  
Domagoj Vidovic ◽  
Vlado Jukic
Keyword(s):  
Psychiatric Treatment ◽  
Average Duration ◽  
Developed Countries ◽  
International Classification Of Diseases ◽  
Hospitalized Patients ◽  
Personality Change ◽  
Psychiatric Clinic ◽  
New Therapeutic Approaches ◽  
Number Of Patients ◽  
Duration Of Hospitalization

Introduction. Psychiatric treatment in developed countries has significantly changed in the last few decades, with a significant shortening of the duration of hospitalization. Numerous West European countries are undertaking health system reforms to improve treatment efficiency. Objective. The aim of the study was to present the structure of hospitalized patients according to diagnostic categories of International Classification of Diseases and Related Health Problems - 10th Revision (ICD-10), and average duration of hospitalization from 2001 till 2010. Methods. Data was collected from hospital medical charts for the period from 2001 till 2010 on the number of hospitalized patients, diagnosis and duration of hospitalization. Results. Number of hospitalized patients increased by 27% (6309 vs. 8032). Average duration of hospitalization decreased for 45.1% (72.3 vs. 39.7 days), while the number of hospitalized patients decreased from 1284 (20.4%) in 2001 to 995 (12.4%) in 2010, the number of patients hospitalized because of depressive disorder increased from 309 (4.9%) in 2001 to 994 (12.4%) in 2010. The number of patients hospitalized because of enduring personality changes increased from 104 (1.7%) in 2001 to 449 (5.6%) in 2010. Conclusion. In the last decade the number of hospitalized patients suffering from schizophrenia at the Psychiatric Clinic Vrapce decreased, while the number of those suffering from depression and enduring personality change increased. The number of hospitalizations in the observed period increased overall. Observed changes can be explained by new therapeutic approaches, but also by objective social and economic factors and organization of the healthcare system.

Pneumothorax

2007 ◽  
pp. 161-170
Keyword(s):  
Treatment Response ◽  
Spontaneous Pneumothorax ◽  
Tension Pneumothorax ◽  
Pleural Space ◽  
Response To Therapy ◽  
Primary Spontaneous Pneumothorax ◽  
Acute Presentation ◽  
Secondary Spontaneous Pneumothorax

Definitions 162 Primary spontaneous pneumothorax (PSP) 162 Secondary spontaneous pneumothorax (SSP) 162 Acute presentation 163 Tension pneumothorax 164 Investigations 165 Management 166 Complications 167 Pneumothorax is defined as air in the pleural space. It may occur as a result of trauma or spontaneously, in which case it is further subdivided into primary and secondary. The treatment, response to therapy, and prognosis in these two groups is quite different, and establishing the category is essential....

scholarly journals Study of rs12532, rs8670 Polymorphism of Msh Homeobox 1 (MSX1), rs61754301, rs4904155 Polymorphism of Paired Box Gene 9 (PAX9), and rs2240308 Polymorphism of Axis Inhibitor Protein 2 (AXIN2) Genes in Nonsyndromic Hypodontia

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Krisztina Mártha ◽  
Bernadette Kerekes Máthé ◽  
Valeriu George Moldovan ◽  
Claudia Bănescu
Keyword(s):  
Environmental Factors ◽  
Genetic Background ◽  
Orthodontic Treatment ◽  
Statistical Significance ◽  
Nucleotide Polymorphisms ◽  
Inhibitor Protein ◽  
Single Nucleotide ◽  
Variant Genotype ◽  
Genetic And Environmental Factors ◽  
Age And Sex

The etiology of hypodontia is complex, in which both genetic and environmental factors can be related. The main objective of our study was to contribute to elucidating the genetic background of nonsyndromic hypodontia (NSH). In this order, we selected 97 NSH subjects (70 females and 27 males) from patients referred to orthodontic treatment, and we matched to each NSH subject a control by age and sex. DNA was obtained from epithelial cells from the oral mucosa. Genotyping of the PAX9 (rs4904155 and rs61754301), MSX1 (rs8670 and rs12532), and AXIN2 (rs2240308) SNPs was performed by using TaqMan SNP Genotyping Assays on a real-time PCR system. Single-nucleotide polymorphisms (SNPs) were studied for the whole NSH group and for frontal and lateral agenesis NSH subjects separately. Our results showed that the variant genotype (p=0.0008, OR = 2.9, 95% CI = 1.58–5.3) and variant T allele (p=0.0002, OR = 2.65, 95% CI = 1.6–4.39) of the MSX1 rs8670 SNP increased the risk of hypodontia in the studied population when the whole NSH group was compared with controls. The variant genotype of the MSX1 rs8670 SNP was the most frequent in frontal agenesis; meanwhile in the lateral agenesis NSH group, the AXIN2 rs2240308 SNP showed a higher frequency of the variant genotype, with a trend towards statistical significance. In conclusion, the results of the present study showed that the variant genotype and variant T allele of the MSX1 rs8670 SNP increased the risk of hypodontia in the studied population. The presence of the variant A allele of AXIN2 rs2240308 is associated with frontal agenesis but not with lateral agenesis.

A New Treatment for Unilateral Recurrent Hydrothorax during CAPD

1985 ◽  
Vol 5 (3) ◽  
pp. 180-181 ◽  
Author(s):  
Jannis Vlachojannis ◽  
Ivar Boettcher ◽  
Lothar Brandt ◽  
Wilhelm Schoeppe
Keyword(s):  
Peritoneal Dialysis ◽  
Triamcinolone Acetonide ◽  
Rare Complication ◽  
Pleural Space ◽  
Visceral Pleura ◽  
Pleural Effusions ◽  
Fibrin Adhesive ◽  
Fibrin Adhesion ◽  
Non Invasive ◽  
New Treatment

A 46-year-old woman undergoing CAPD developed a recurring right sided hydrothorax. Instillation of tetracycline HCI and triamcinolone acetonide did not correct the condition. However application of a fibrin adhesive (Tissucol) made it possible to achieve permanent adhesion of the pleural layers. This paper descrubes the method in detail. The development of pleural effusions in patients undergoing peritoneal dialysis, although a rare complication, can lead to the interruption of CAPD (2,3). As treatment, several workers have provoked the adhesion of parietal and visceral pleura by instillation tetracycline HCI or triamcinolone acetonide into the pleural space (6). As this report shows, these approaches failed in one patient and we achieved pennanent correction of this hydrothorax by employing a non-invasive, fibrin-adhesion technique.

Pleural Effusions: Pathophysiology and Management

1994 ◽  
Vol 28 (7-8) ◽  
pp. 894-903 ◽  
Author(s):  
Carlota O. Andrews ◽  
Mary Lea Gora
Keyword(s):  
Adverse Effects ◽  
English Language ◽  
Treatment Options ◽  
Cost Effective ◽  
Underlying Disease ◽  
Pleural Space ◽  
Pleural Effusions ◽  
Medline Search ◽  
Sclerosing Agents ◽  
Study Selection

OBJECTIVE: To review the pathophysiology and management of pleural effusions, including available agents for pleural sclerosis. DATA SOURCES: A MEDLINE search (1966 to present) was performed that included clinical studies in the English language involving the pathophysiology and management of pleural effusions; references used in those articles were screened for additional published information. STUDY SELECTION: All clinical trials were considered for potential inclusion in the review. DATA SYNTHESIS: Pleural effusion is an accumulation of fluid in the pleural space that results when homeostatic forces that control the flow into and out of the area are disrupted. The management of transudative pleural effusions is primarily directed at treatment of the underlying disease. There are several treatment options for pleural effusions, including chemical pleurodesis. Many of the trials that examine the use of talc, bleomycin, and doxycycline have poorly described study designs and end points, with inconsistent evaluation of patients. Each agent is considered to be generally effective and safe, with fever and pain as the most frequently reported adverse effects. The use of talc requires sterilization, and many clinicians use general anesthesia with instillation, which increases the risk associated with the procedure. Bleomycin is generally safe; however, it should not be used in doses exceeding 40 mg/m2. Only uncontrolled trials support the use of doxycycline; however, it provides an effective, safe, and relatively inexpensive alternative. CONCLUSIONS: Pleural effusions are defined as an accumulation of fluid in the pleural space. Treatment is generally palliative. Intrapleural administration of talc, bleomycin, and doxycycline are effective sclerosing agents for treatment of recurrent, symptomatic pleural effusions. Although the most cost-effective agent has not been determined, doxycycline is an inexpensive alternative to bleomycin, and may have fewer adverse effects than talc.

Role of aquaporin water channels in pleural fluid dynamics

2000 ◽  
Vol 279 (6) ◽  
pp. C1744-C1750 ◽  
Author(s):  
Yuanlin Song ◽  
Baoxue Yang ◽  
Michael A. Matthay ◽  
Tonghui Ma ◽  
A. S. Verkman
Keyword(s):  
Pleural Fluid ◽  
Water Transport ◽  
Water Channels ◽  
Pleural Space ◽  
Parietal Pleura ◽  
Pleural Effusions ◽  
Wild Type ◽  
Rt Pcr ◽  
Fluid Accumulation ◽  
Osmotic Equilibration

Continuous movement of fluid into and out of the pleural compartment occurs in normal chest physiology and in pathophysiological conditions associated with pleural effusions. RT-PCR screening and immunostaining revealed expression of water channel aquaporin-1 (AQP1) in microvascular endothelia near the visceral and parietal pleura and in mesothelial cells in visceral pleura. Comparative physiological measurements were done on wild-type vs. AQP1 null mice. Osmotically driven water transport was measured in anesthetized, mechanically ventilated mice from the kinetics of pleural fluid osmolality after instillation of 0.25 ml of hypertonic or hypotonic fluid into the pleural space. Osmotic equilibration of pleural fluid was rapid in wild-type mice (50% equilibration in <2 min) and remarkably slowed by greater than fourfold in AQP1 null mice. Small amounts of AQP3 transcript were also detected in pleura by RT-PCR, but osmotic water transport was not decreased in AQP3 null mice. In spontaneously breathing mice, the clearance of isosmolar saline instilled in the pleural space (∼4 ml · kg−1· h−1) was not affected by AQP1 deletion. In a fluid overload model produced by intraperitoneal saline administration and renal artery ligation, the accumulation of pleural fluid (∼0.035 ml/h) and was not affected by AQP1 deletion. Finally, in a thiourea toxicity model of acute endothelial injury causing pleural effusions and lung interstitial edema, pleural fluid accumulation in the first 3 h (∼4 ml · kg−1· h−1) was not affected by AQP1 deletion. These results indicate rapid osmotic equilibration across the pleural surface that is facilitated by AQP1 water channels. However, AQP1 does not appear to play a role in clinically relevant mechanisms of pleural fluid accumulation or clearance.

Craniofacial approaches to large juvenile angiofibromas

2011 ◽  
Vol 8 (1) ◽  
pp. 71-78 ◽  
Author(s):  
M. Yashar S. Kalani ◽  
Maziyar A. Kalani ◽  
Samuel Kalb ◽  
Felipe C. Albuquerque ◽  
Cameron G. McDougall ◽  
...  
Keyword(s):  
Average Duration ◽  
Karnofsky Performance Scale ◽  
Preoperative Embolization ◽  
Large Juvenile ◽  
Csf Leakage ◽  
Scale Scores ◽  
Duration Of Hospitalization ◽  
Performance Scale ◽  
Related Mortality

Object Craniofacial approaches provide excellent exposure to lesions in the anterior and middle cranial fossae. The authors review their experience with craniofacial approaches for resection of large juvenile nasopharyngeal angiofibromas. Methods Between 1992 and 2009, 22 patients (all male, mean age 15 years, range 9–27 years) underwent 30 procedures. These cases were reviewed retrospectively. Results Gross-total resection of 17 (77%) of the 22 lesions was achieved. The average duration of hospitalization was 8.2 days (range 3–20 days). The rate of recurrence and/or progression was 4 (18%) of 22, with recurrences occurring a mean of 21 months after the first resection. All patients underwent preoperative embolization. Nine patients (41%) developed complications, the most common of which was CSF leakage (23%). The average follow-up was 27.7 months (range 2–144 months). The surgery-related mortality rate was 0%. Based on their mean preoperative (90) and postoperative (90) Karnofsky Performance Scale scores, 100% of patients improved or remained the same. Conclusions The authors' experience shows that craniofacial approaches provide an excellent avenue for the resection of large juvenile nasopharyngeal angiofibromas, with acceptable rates of morbidity and no deaths.

Pleurodesis with Iodized Talc for Malignant Effusions Using Pigtail Catheters

1998 ◽  
Vol 32 (7-8) ◽  
pp. 739-742 ◽  
Author(s):  
Robert L Thompson ◽  
Jonathan C Yau ◽  
Ronald F Donnelly ◽  
Debra J Gowan ◽  
Frederick RK Matzinger
Keyword(s):  
Pleural Effusion ◽  
Tertiary Care ◽  
Pleural Space ◽  
Pigtail Catheter ◽  
Pleural Effusions ◽  
Talc Pleurodesis ◽  
Malignant Pleural Effusions ◽  
Kaplan Meier ◽  
A Prospective Study ◽  
The Cost

OBJECTIVE: To assess the efficacy of using an iodized talc slurry as a sclerosing agent instilled into the pleural space via a 12-French pigtail catheter for controlling malignant pleural effusions. DESIGN: A prospective study in which patients were followed until their death. SETTING: A university-affiliated tertiary-care teaching hospital. PATIENTS: Medical oncology patients admitted with symptomatic malignant pleural effusions were considered for iodized talc pleurodesis. MAIN OUTCOME MEASURES: The control of pleural effusion. Treatment failure was defined as any reaccumulation of fluid in the pleural space. RESULTS: Fifteen patients were treated for a total of 17 instillations. The median follow-up on all patients until death was 6 months (range 1–20). The most frequent adverse effect in the study group was pleuritic chest pain (60%). The probability of control of effusion, as determined by the method of Kaplan–Meier, was 81% (SEM 9.7%). The cost of preparing 5 g of iodized talc was $4.32 (US). CONCLUSIONS: Iodized talc slurry instilled through a small-bore pigtail catheter is a safe, economical, and effective treatment for malignant pleural effusion.

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