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Outcomes in patients with fractured ribs: middle aged at same risk of complications as the elderly.

AIMS: Rib fractures occur in up to 10% of hospitalised trauma patients and are the most common type of clinically significant blunt injury to the thorax. There is strong evidence that elderly patients have worse outcomes compared with younger patients. Evolving evidence suggests adverse outcomes start at a younger age. The aim of this study was to explore the effect of age on outcomes in patients with rib fractures in Northland, New Zealand. METHOD: A two-year retrospective study of patients admitted to any Northland District Health Board hospital with one or more radiologically proven rib fr

Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1215 patients.

OBJECTIVE: To review the technical improvements and changes in management that have occurred over 21 years, which have made the minimally in … infection occurred in 1.4% (17 patients), of whom 4 required surgical drainage (0.4% of the total). Hemothorax occurred in 0.6% (8 patients); 4 during the postoperative period and four occurred late. Postoperative pulmonary function testing has shown significant improvement. A good or excellent anatomic surgical outcome was achieved in 95.8% of patients at t …

Thoracic paravertebral block versus local infiltration anesthesia for percutaneous kyphoplasty to treat osteoporotic vertebral compression fractures combined with intercostal neuralgia: a randomized controlled trial.

BACKGROUND: Percutaneous kyphoplasty (PKP) is an effective treatment for osteoporotic vertebral compression fractures (OVCFs) and provides effective pain relief; however, its efficacy is questionable in patients with thoracic OVCFs combined with intercostal neuralgia (IN). This study aims to compare the efficacy and safety of thoracic paravertebral nerve block (TPVB) and local infiltration (LI) anesthesia for PKP to treat thoracic OVCFs combined with IN. METHODS: Patients with OVCFs combined with IN scheduled to undergo PKP between January 2021 and June 2022 were randomized into the following

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… No postoperative complications, including atelectasis, pneumonia, pneumothorax, hemothorax, or neuraxial complications, such as epidural injection or total spinal anesthesia, were observed in either group. … In this study, no adverse events, such as pneumothorax, hemothorax, epidural spread, or high spinal anesthesia, were observed following TPVB. …

Respiratory and Thoracic Medicine

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Intrapleural Fibrinolytic Therapy With Alteplase for the Management of Multiloculated Malignant Pleural Effusion: A Case Series.

Malignant pleural effusion refers to the presence of fluid in the pleural space due to an underlying malignancy. Malignant pleural effusion is sometimes accompanied by the formation of fibrous adhesions resulting in a multiloculated effusion. This diminishes the efficacy of drainage and makes successful pleurodesis impossible, leaving the patients with severe shortness of breath. In the process of freeing the pleural space from fluid-filled loculations, intrapleural application of fibrinolytic is being investigated as a possible therapeutic approach. Here, we report four cases of adult patient

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… These were hemothorax in three patients, and Pseudomonas aeruginosa empyema in one. Mishra et al. also reported two pleural space infections, one in the IPFT group and one in the placebo group [ 11 ]. In our cases, only one patient experienced acute chest pain shortly after IPFT administration. …

STUDY OF THE PROCESSES OF LIPID PEROXIDATION, THE STATE OF THE ANTIOXIDANT SYSTEM IN PATIENTS WITH POLYTRAUMA AND ALCOHOL ANAMNESIS.

The effectiveness of management of patients with severe combined trauma and alcohol withdrawal syndrome, complicated alcoholic delirium rema … study, 40 patients with polytrauma were examined (thoracic and/or abdominal trauma: rib fractures, hemothorax, pneumothorax, hematomas of the liver or spleen, fractures of the waist and/or upper and/or lower limbs, pelvic fractures), medium severity. During the study, to achieve the goal, the main indicators of the oxidant-antioxidant system in patients wer …

Experience with indwelling pleural catheters in the treatment of recurrent pleural effusions.

Recurrent pleural effusions are frequently encountered in clinical practice. Whether malignant or nonmalignant, they often pose a challenge to the practicing clinician. When they recur, despite optimum medical therapy of the underlying condition and repeated thoracenteses, more invasive definitive approaches are usually required. Since its introduction in 1997, the PleurX catheter became the preferred method to treat recurrent malignant pleural effusions. Since then, a number of publications have documented its utility in managing recurrent nonmalignant pleural effusions. The purpose of this p

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… Catheter-related complications included one hemothorax and one empyema [ Vakil et al. 2010 ]. …

Характеризация и последствия серьезных осложнений после аналоговой гематопоиетической трансплантации стволовых клеток: ретроспективное многоцентральное исследование.

ЦЕЛЬ: Описание клинических характеристик и методов лечения, а также выявление факторов, связанных с результатами лечения пациентов, нуждающихся в интенсивной терапии (ИКУ) после аналоговой трансплантации стволовых клеток (ASCT). DESIGN: Многоцентральное ретроспективное когортное исследование. Вечеринка: Eight Университетско-больничное отделение во Франции с января 2013 и июль 2023. ПАТИЕНТЫ: Взрослые (постоянные)≥ 18 (сроки поступления в СИС 90 через несколько дней после выдерживания ASCT. Возражения: нет. ИЗМЕРЕНИЯ И ОСНОВНЫЕ РЕЗУЛЬТАТЫ: 6,342 Получатели ACCT, 355 (В тыс.5.6%) требовался допу

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… disseminated intravascular coagulation ( n = 2), autoimmune hemolytic anemia ( n = 2) f Bleeding sites included the gastrointestinal tract ( n = 16), central nervous system (n = 9), deep muscle or connective tissue ( n = 8), surgical site ( n = 6), diffuse suffusion ( n = 6), urinary tract ( n = 2), hemothorax … disseminated intravascular coagulation ( n = 2), autoimmune hemolytic anemia ( n = 2) f Bleeding sites included the gastrointestinal tract ( n = 16), central nervous system (n = 9), deep muscle or connective tissue ( n = 8), surgical site ( n = 6), diffuse suffusion ( n = 6), urinary tract ( n = 2), hemothorax …

Ultrasound-guided central venous catheterization in cancer patients improves the success rate of cannulation and reduces mechanical complications: a prospective observational study of 1,978 consecutive catheterizations.

BackgroundA central venous catheter (CVC) currently represents the most frequently adopted intravenous line for patients undergoing infusional chemotherapy and/or high-dose chemotherapy with hematopoietic stem-cell transplantation and parenteral nutrition. CVC insertion represents a risk for pneumothorax, nerve or arterial punctures. The aim of this prospective observational study was to explore the safety and efficacy of CVC insertion under ultrasound (US) guidance and to confirm its utility in clinical practice in cancer patients.MethodsConsecutive adult patients attending the oncology-hemat

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… In this large series of 1,978 CVC insertional performed procedures in 1,660 consecutive patients suffering from cancer in different phases of their disease, none of the patients experienced major complications (pneumotorax, hemothorax, nerve lesions). …

Osteoporotic vertebral fractures: an update.

INTRODUCTION: Osteoporotic vertebral fractures (OVFs) are the most common type of fragility fractures. They have a significant and usually detrimental impact on the patient's functional status and mortality rate, constituting a substantial burden for the patients, their families, and the healthcare system. This narrative review aims to summarize the current knowledge of osteoporotic vertebral fractures and secondary fracture prevention. METHODS: A comprehensive literature search was conducted across major medical databases, including PubMed, Scopus, and Web of Science. Relevant studies, guide

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… More serious complications are rare and include neurologic deficits resulting from nerve injury, fractures of the rib, sternum or pedicle, pulmonary embolus, hemothorax, pneumothorax, or cement embolism [ 48 ]. …

Surgical treatment in malignant pleural effusion.

Malignant pleural effusion can be described as the presence of exudate in the pleural space, accompanied by the detection of cancer cells in pleural fluid or tissue, which is the indicator of the disease in its advance stages, and survival time of these patients ranges between 3 and 12 months. Treatment options for malignant pleural effusion vary from observation in asymptomatic patients to pleurectomies or even extrapleural pneumonectomies in severe cases.

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… Development of spontaneous hemothorax has been detected in a patient with an RCC resulting from metastatic involvement and invasion of the intercostal vessels.[ 33 - 36 ] To date, surgery is most commonly preferred for localized metastases, as there is no effective chemotherapy for RCCs other than interferon …

Пространственное картирование оси AA-PGE2-EP при множественных повреждениях склероза.

Биоактивные липидные посредники (ДМ), получаемые из полиненасыщенных жирных кислот (ПУФА), являются ключевыми молекулами как инициирования, так и разрешения подстрекательских реакций. Предыдущие выводы свидетельствуют о том, что дисрегулируемый баланс LM, особенно в рамках арахидонической кислоты (АА), может способствовать реакции на нарушение разрешения и последующей хронической нейроинфламмации при множественном склерозе (МС). Однако на сегодняшний день местный биосинтез и сигнализация ММ в мозге людей с MS (PwMS) остаются неисследованными. Поэтому в этом исследовании мы впервые наметили рас

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… a MSI, IHC(COX2), mRNA NNC989 71 F 7:50 Lung carcinoma n/a FF n/a MSI, IHC (COX2), mRNA NNC999 74 M 10:20 Euthanasia n/a FF n/a IHC (COX2), mRNA NNC227 93 M 6:00 Cachexia, cerebrovascular accident/kidney failure n/a FF n/a mRNA NNC254 75 F 5:40 Cachexia n/a FF n/a mRNA NNC275 82 F 5:10 Pneumonia by hemothorax … a MSI, IHC(COX2), mRNA NNC989 71 F 7:50 Lung carcinoma n/a FF n/a MSI, IHC (COX2), mRNA NNC999 74 M 10:20 Euthanasia n/a FF n/a IHC (COX2), mRNA NNC227 93 M 6:00 Cachexia, cerebrovascular accident/kidney failure n/a FF n/a mRNA NNC254 75 F 5:40 Cachexia n/a FF n/a mRNA NNC275 82 F 5:10 Pneumonia by hemothorax …

Challenges and Advances in Managing Thrombocytopenic Cancer Patients.

Cancer patients have varying incidence, depth and duration of thrombocytopenia. The mainstay of managing severe chemotherapy-induced thrombocytopenia (CIT) in cancer is the use of platelet transfusions. While prophylactic platelet transfusions reduce the bleeding rate, multiple unmet needs remain, such as high residual rates of bleeding, and anticancer treatment dose reductions/delays. Accordingly, the following promising results in other settings, antifibrinolytic drugs have been evaluated for prevention and treatment of bleeding in patients with hematological malignancies and solid tumors. I

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… Several case reports showed favorable bleeding outcomes with TXA in the management of bleeding from malignant mesothelioma with hemothorax [ 46 ], hemoptysis due to bronchogenic carcinoma [ 47 ] and DIC after a prostatic biopsy [ 48 ]. … Tranexamic acid treatment of hemothorax in two patients with malignant mesothelioma. Chest. 1991;100:847–848. doi: 10.1378/chest.100.3.847. 47. Kaufman B., Wise A. Antifibrinolytic therapy for haemoptysis related to bronchial carcinoma. Postgrad. Med. …

A single institution experience for the management of recurrent pleural effusions with tunneled pleural catheter and its evolution.

BackgroundIndwelling tunneled pleural catheters (TPCs) are increasingly being used to treat recurrent pleural effusions. There is also an increased interest in early pleurodesis in order to prevent infectious complications. We studied the time to removal and other outcomes for all the TPCs placed at our institution.MethodsAfter institutional review board approval, records of patients who had had a TPC placed between July 2009 and June 2016 were reviewed; the catheters were placed in an endoscopy suite or during pleuroscopy with or without a sclerosant. The catheters were drained daily or less

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… to removal (days) mean (range) | 57 (24 –372) | 22 (15–28) | 14 (8–28) | 19 (7–31) | 28 (19–39) | 5 (2–5) Thoracentesis after removal | 2 | 3 | 2 | 1 | 0 | 0 Pleuroscopy/ video-assisted thoracoscopic surgery | 1 | 2 | 2 | 1 | 1 | 0 Complications | | | | | | Infections | 2 | 1 | 0 | 0 | 0 | 0 Hemothorax …

A Monocentric Analysis of Implantable Ports in Cancer Treatment: Five-Year Efficacy and Safety Evaluation.

BACKGROUND: Daily clinical practice requires repeated and prolonged venous access for delivering chemotherapy, antibiotics, antivirals, parenteral nutrition, or blood transfusions. This study aimed to investigate the performance and the safety of totally implantable vascular access devices (TIVADs) over a 5-year follow-up period through a standardized well-trained surgical technique and patient management under local anesthesia. METHODS: In a retrospective, observational, and monocentric study, 70 patients receiving POLYSITE® TIVADs for chemotherapy were included. The safety endpoints focused

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… Perioperative complications include cardiac arrhythmia, accidental arterial injury, hemothorax, pneumothorax, and, rarely, air embolism [ 1 ]. …

T-Cell-Based Cellular Immunotherapy of Multiple Myeloma: Current Developments.

T-cell-based cellular therapy was first approved in lymphoid malignancies (B-cell acute lymphoblastic leukemia and large B-cell lymphoma) and expanding its investigation and application both in hematological and non-hematological malignancies. Two anti-BCMA (B cell maturation antigen) CAR (Chimeric Antigen Receptor) T-cell therapies have been recently approved for relapsed and refractory multiple myeloma with excellent efficacy even in the heavily pre-treated patient population. This new therapeutic approach significantly changes our practice; however, there is still room for further investiga

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… There were dose limiting toxicities such as cardiomyopathy, spontaneous hemothorax, coagulopathy and one progressive MM with candidemia septic shock [ 21 ]. The ORR was 48% across all cohorts, and the dose with the highest efficacy was 1 × 10 8 –5 × 10 8 CAR T-BCMA cells with an ORR 55% [ 21 ]. … The most commonly reported off-target adverse event is cytopenias, which is reported in the vast majority of patients with less frequent, severe complications such as major bleeding including gastrointestinal, cerebral and hemothorax [ 14 , 21 ]. …

Pleural effusion aetiology, presentation, treatment and outcome in haematological diseases: a review.

BACKGROUND AND AIM: Pleural effusions (PE) can complicate the course of hematologic disorders (HD) and may arise in the form of malignant PE or as a consequence of non-neoplastic complications. While a certain amount of data has been published regarding infectious and iatrogenic HD-associated PE (HPE), no comprehensive review regarding the other types of HPE has ever been conducted. To address this issue, we performed a systematic review of the literature regarding HPE, focusing on the clinical and chemical characteristics of PE, therapeutic approaches and ì outcomes at the one-year follow-up.

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… Acta Cytol 1998 42 5 1116 20 9755667 10.1159/000332098 Aessopos A Tassiopoulos S Farmakis D Extramedullary hematopoiesis-related pleural effusion: the case of beta-thalassemia Ann Thorac Surg 2006 81 6 2037 43 16731126 10.1016/j.athoracsur.2006.01.026 Kupferschmid JP Shahian DM Villanueva AG Massive hemothorax …

Complication Avoidance in Surgical Management of Vertebral Column Tumors.

The surgical management of spinal tumors has grown increasingly complex as treatment algorithms for both primary bone tumors of the spine and metastatic spinal disease have evolved in response to novel surgical techniques, rising complication rates, and additional data concerning adjunct therapies. In this review, we discuss actionable interventions for improved patient safety in the operative care for spinal tumors. Strategies for complication avoidance in the preoperative, intraoperative, and postoperative settings are discussed for approach-related morbidities, intraoperative hemorrhage, wo

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… Anterior approaches may require traversing the pleura, requiring chest tube placement after surgery to avoid pneumo- or hemothorax. …

Research progress on bleeding risk assessment models in anticoagulant therapy.

Balancing thromboembolic prevention against bleeding complications remains a critical challenge in anticoagulant therapy. While established bleeding risk assessment models (RAMs) such as HAS-BLED and HEMORR2HAGES were initially developed for warfarin-treated patients, their applicability to non-vitamin K antagonist oral anticoagulant (NOAC) users and venous thromboembolism (VTE) populations remained uncertain. This review synthesized recent advancements in bleeding risk stratification for atrial fibrillation (AF) and VTE patients, focusing on model performance, drug-specific adaptations, and e

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… Among them, six (4.3%) experienced bleeding complications after anticoagulation therapy, including mild hematuria or microscopic hematuria (32.2%), mild gastrointestinal bleeding (10.7%), moderate epistaxis (10.7%), and severe hemothorax. …

Acute and Chronic Respiratory Failure in Cancer Patients

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… infiltration Lymphangitic spread Leukostasis Peri-engraftment syndrome Idiopathic pneumonia syndrome Pericardial effusion Congestive heart failure Coronary artery disease Thromboembolic disease Alveolar hemorrhage Tumor emboli Veno-occlusive disease Pulmonary hypertension Obesity Pleural effusion Malignant Hemothorax … Lymphangitic spread Leukostasis Peri-engraftment syndrome Idiopathic pneumonia syndrome | Pericardial effusion Congestive heart failure Coronary artery disease | Thromboembolic disease Alveolar hemorrhage Tumor emboli Veno-occlusive disease Pulmonary hypertension | Obesity Pleural effusion Malignant Hemothorax …