The Impact of Gravity versus Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: the GRAVITAS Multicenter Randomized Controlled Trial.

The Impact of Gravity versus Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: the GRAVITAS Multicenter Randomized Controlled Trial. Chest. 2019 Nov 08;: Authors: Lentz RJ, Shojaee S, Grosu HB, Rickman OB, Roller L, Pannu JK, DePew ZS, Debiane LG, Cicenia JC, Akulian J, Walston C, Sanchez TM, Davidson KR, Jagan N, Ahmad S, Gilbert C, Huggins JT, Chen H, Light RW, Yarmus L, Feller-Kopman D, Lee H, Rahman NM, Maldonado F, Interventional Pulmonary Outcomes Group Abstract BACKGROUND: Thoracentesis can be accomplished by active aspiration or drainage with gravity. We investigated whether gravity drainage could protect against negative-pressure related complications, such as chest discomfort, re-expansion pulmonary edema or pneumothorax, compared to active aspiration. METHODS: This prospective, multicenter single blinded randomized controlled trial allocated patients with large free-flowing effusions estimated ≥ 500 mL 1:1 to active aspiration or gravity drainage. Patients rated chest discomfort on 100 mm visual analog scales before, during, and after drainage. Thoracentesis was halted at complete evacuation or for persistent chest discomfort, intractable cough, or other complication. The primary outcome was overall procedural chest discomfort scored five minutes post-procedure. Secondary outcomes included measures of discomfort and breathlessness through 48 hours post-procedure. RESULTS: One hundred forty-two patients we...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research

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By SAURABH JHA, MD Slumdog TB No one knows who gave Rahul Roy tuberculosis. Roy’s charmed life as a successful trader involved traveling in his Mercedes C class between his apartment on the plush Nepean Sea Road in South Mumbai and offices in Bombay Stock Exchange. He cared little for Mumbai’s weather. He seldom rolled down his car windows – his ambient atmosphere, optimized for his comfort, rarely changed. Historically TB, or “consumption” as it was known, was a Bohemian malady; the chronic suffering produced a rhapsody which produced fine art. TB was fashionable in Victorian Britain...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Artificial Intelligence Health Tech Saurabh Jha TB tuberculosis Source Type: blogs
Discussion The respiratory system is a complex system. The upper airways must remain patient. The lower airways must interface with the vascular system. The musculoskeletal system must provide mechanical function and the central nervous system must provide overall control. Respiratory failure occurs when the overall system cannot support the body’s necessarily ventilation, oxygenation or both. Children are at higher risk of respiratory failure. They have few intrinsic lung parenchyma problems, but have very small airways that increase the airflow resistance by themselves but then have to contend with problems such as...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
ConclusionThis case illustrates the difficulties physicians in low-resource settings face in the diagnosis and treatment of TES and the importance of a high index of suspicion as well as a multidisciplinary approach in patient care.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Conclusion: In this case report, a 28-year-old male was treated for thoracic Pott's disease that proved to be metastatic lung adenocarcinoma. To avoid such misdiagnoses in the future, physicians should better differentiate spinal TB from other malignancies that may affect the spine. This study underscores the importance of obtaining at least a chest X-ray in any patient with suspected Pott's disease, irrespective of age, to help rule out lung cancer or other pathologies. PMID: 31768288 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
Conclusion: Because of the risk of complications, which make surgical management more difficult, surgical resection of BC is recommended, whatever the age of discovery.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Thoracic surgery Source Type: research
This study investigate the effectiveness of radial endobronchial ultrasound – transbronchial biopsy (R-EBUS-TBB) with thin bronchoscope in peripheral lung lesions. We compared the diagnostic yields and complication rates of REBUS-TBB with CT-PTNB in a total of 199 patients with peripheral lung lesions. Of the total 199 men, 120 were men and the mean age was 67.6 ± 12.5 years. The left upper lobe was 61 (30.7%) and right upper lobe was 59 (29.6%). 68.8% of the 137 confirmed cases were diagnosed as malignant. The diagnotic accuracy of R-EBUS-TBB in 56 patients was lower than CT-PTNB in 179 patients with statisti...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Conclusions: SPM should be considered in the differential diagnosis of acute chest pain in adolescents. Asthma patients may necessitate prolonged hospital stay and require careful surveillance, eliminating complications that may influence outcome.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric respiratory epidemiology Source Type: research
ConclusionsThe integrated clinical safety data indicated that RM-1929 PIT treatment had a favorable safety profile with no unexpected safety concerns.Clinical trial identificationNCT02422979.Legal entity responsible for the studyRakuten Medical, Inc.FundingRakuten Medical, Inc.DisclosureJ.M. Johnson: Advisory / Consultancy: Foundation Medicine; Research grant / Funding (institution): BMS; Research grant / Funding (institution): Merck; Research grant / Funding (institution): AstraZeneca. J.M. Curry: Research grant / Funding (institution): AstraZeneca. S.T. Kochuparambil: Shareholder / Stockholder / Stock options, Full / Par...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
We report an unusual case of extensive subcutaneous emphysema, pneumomediastinum, and pneumopericardium identified in an otherwise healthy U.S. Marine who was enrolled in the Marine Corps School of Infantry. His training regimen included prolonged periods of yelling and elevation changes during sustained hiking through hilly terrain. The patient presented to the Fast Track with normal vital signs but complained of dyspnea, cough, and subjective fevers. Although he lacked a history of trauma, he was found to have pneumopericardium, pneumomediastinum, and subcutaneous emphysema without pneumothorax. He was admitted to the ge...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Smoke-measuring smart shirts, breath sound analyzing algorithms, and smart inhalers pave the way of pulmonology and respiratory care into the future. As the number of patients suffering from asthma, COPD, or lung cancer due to rising air pollution and steady smoker-levels will unfortunately not decrease any time soon, we looked around what technology can do to help both patients and caregivers. The results are breathtaking. Attacks of breathlessness are too common The diseases which pulmonologists and respiratory care specialists attempt to fight are among the most common conditions in the modern world – and t...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Artificial Intelligence Future of Medicine Health Sensors & Trackers AI asthma cancer cancer treatment care COPD diagnostics inhaler lung lung cancer management medical specialty pulmonology respiratory respiratory care Source Type: blogs
More News: Cough | Pneumothorax | Respiratory Medicine | Thoracentesis