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  1. Article ; Online: Management of Malignant Pleural Effusions

    Villanueva, Andrew G.

    Principles and Practice of Interventional Pulmonology

    Abstract: The development of pleural effusions is a common occurrence in patients with neoplastic disease. In one postmortem study, 15 % of patients who died with malignancies were found to have malignant pleural effusions, and the annual incidence of malignant ... ...

    Abstract The development of pleural effusions is a common occurrence in patients with neoplastic disease. In one postmortem study, 15 % of patients who died with malignancies were found to have malignant pleural effusions, and the annual incidence of malignant pleural effusions (MPE) in the United States is estimated to be >150,000 cases. The presence of a MPE often portends a poor prognosis; the mean survival after the diagnosis of a MPE ranges from 3 to 12 months, depending on the underlying tumor (lung cancer is generally associated with the shortest average survival time). Patients with MPE often have symptoms that impair their quality of life, such as dyspnea, orthopnea, cough, and chest discomfort, some or all of which can be improved with palliative therapeutic measures.
    Keywords covid19
    Publisher PMC
    Document type Article ; Online
    DOI 10.1007/978-1-4614-4292-9_64
    Database COVID19

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  2. Article: The Long-term Prognosis of Patients With the Diagnosis of Nonmalignant Pleural Effusions After Pleuroscopy.

    Mouchantaf, Fares G / Villanueva, Andrew G

    Journal of bronchology & interventional pulmonology

    2009  Volume 16, Issue 1, Page(s) 25–27

    Abstract: Purpose: Several studies have demonstrated the diagnostic yield of medical thoracoscopy (pleuroscopy) in making the diagnosis of malignant pleural effusion (MPE). No previous studies, however, have reported long-term outcomes for patients undergoing ... ...

    Abstract Purpose: Several studies have demonstrated the diagnostic yield of medical thoracoscopy (pleuroscopy) in making the diagnosis of malignant pleural effusion (MPE). No previous studies, however, have reported long-term outcomes for patients undergoing diagnostic pleuroscopy in whom no malignancy was demonstrated either with cytologic examination of pleural fluid or pathologic examination of thoracoscope-guided pleural biopsies. We report the results of long-term follow-up (at least 3 y) of patients with the diagnosis of nonmalignant pleural effusions (NMPEs) after pleuroscopy.
    Methods: One hundred and nineteen patients underwent the procedure between 1994 and 2003 at Lahey Clinic. We report a retrospective review of 25 of those patients diagnosed with NMPE after diagnostic pleuroscopy. All 25 patients underwent thoracoscopic pleural biopsy and cytologic examination of the effusion. Outcomes were assessed using review of the medical records, appointment scheduler, social security death index, and/or telephone conversation with primary care providers.
    Results: Mean age±SD was 68 years (range, 34 to 87 y). Median survival time was estimated at 114 months. Concomitant illness was also evaluated: 40% (n=10) diabetes, 64% (n=16) coronary artery disease, 40% (n=10) congestive heart failure, 20% (n=5) liver disease, 20% (n=5) renal disease, and 36% (n=9) pulmonary disease. Final diagnoses after pleuroscopy most commonly included chronic pleuritis (n=7) and pleural plaques (n=5). Survival was found at 1 year to be 88% (22/25), 3 years 80% (20/25), and 5 years 74.7% (19/25). None of the 25 patients developed subsequent MPE.
    Conclusions: Patients with NMPE after pleuroscopy have a favorable prognosis and are unlikely to be subsequently diagnosed with an MPE.
    Language English
    Publishing date 2009-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2478320-1
    ISSN 1948-8270 ; 1944-6586
    ISSN (online) 1948-8270
    ISSN 1944-6586
    DOI 10.1097/LBR.0b013e318195d7a0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4027: Show issues Location:
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  3. Article: Diffuse pulmonary infiltrates in an old man with chronic lymphocytic leukemia.

    Hosseinnezhad, Alireza / Seguel, Joseph M / Villanueva, Andrew G

    Clinics and practice

    2011  Volume 1, Issue 2, Page(s) e41

    Abstract: An 82-year-old man known case of chronic lymphocytic leukemia (CLL) presented with fever and weakness. He had never received any treatment for his CLL in the past. On admission he was found to be in mild respiratory distress with bilateral crackles and ... ...

    Abstract An 82-year-old man known case of chronic lymphocytic leukemia (CLL) presented with fever and weakness. He had never received any treatment for his CLL in the past. On admission he was found to be in mild respiratory distress with bilateral crackles and had markedly elevated white blood count (WBC) (137 K/uL with 93% lymphocytes). His respiratory status deteriorated necessitating non-invasive ventilatory support. Chest computed tomography (CT) scan revealed bilateral diffuse ground glass opacities, so broad spectrum antibiotic therapy was initiated. Despite that, he remained febrile and cultures were all negative. Chest x-rays showed progressive worsening of diffuse alveolar opacities. Bronchoalveolar lavage (BAL) was negative for infectious etiologies, however flow cytometry of the fluid was consistent with CLL. Chemotherapy with chlorambucil was started. Although most of the pulmonary infiltrates in CLL patients are due to infectious causes, leukemic cells infiltration should be considered as well in CLL patients with respiratory symptoms who do not respond appropriately to standard antimicrobial regimen.
    Language English
    Publishing date 2011-05-31
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2605724-4
    ISSN 2039-7283 ; 2039-7275
    ISSN (online) 2039-7283
    ISSN 2039-7275
    DOI 10.4081/cp.2011.e41
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Lung injury following thoracoscopic talc insufflation: experience of a single North American center.

    Gonzalez, Anne V / Bezwada, Vishnu / Beamis, John F / Villanueva, Andrew G

    Chest

    2010  Volume 137, Issue 6, Page(s) 1375–1381

    Abstract: Background: Thoracoscopic talc insufflation (TTI) has been used to obliterate the pleural space and prevent recurrent pleural effusions or pneumothorax. Reports of acute pneumonitis and ARDS after the use of talc raised concern about its safety. ... ...

    Abstract Background: Thoracoscopic talc insufflation (TTI) has been used to obliterate the pleural space and prevent recurrent pleural effusions or pneumothorax. Reports of acute pneumonitis and ARDS after the use of talc raised concern about its safety. Differences in particle size of various talc preparations may explain the variable occurrence of pneumonitis. We sought to determine the incidence of lung injury after TTI over a 13-year period at our institution.
    Methods: Patients who underwent TTI between January 1994 and July 2007 were identified from a prospectively maintained logbook. The talc used was commercially available sterile talc (Sclerosol). The hospital course was reviewed in detail, and all cases of respiratory insufficiency were examined with regard to onset, suspected cause, and outcome. Talc-related lung injury was defined as the presence of new infiltrates on chest radiograph and increased oxygen requirements, with no other identifiable trigger than talc exposure.
    Results: A total of 138 patients underwent 142 TTIs for recurrent pleural effusions or spontaneous pneumothorax. TTI was performed most frequently for malignant pleural effusions (75.5% of effusions). The median dose of talc was 6 g (range, 2-8 g). Dyspnea with increased oxygen requirements developed within 72 h postprocedure for 12 patients. Four patients (2.8%) had talc-related lung injury, and talc exposure may have contributed to the respiratory deterioration in four additional patients.
    Conclusions: We report the occurrence of lung injury after TTI using the only talc approved by the US Food and Drug Administration. These results reinforce previous concerns regarding the talc used for pleurodesis in North America.
    MeSH term(s) Acute Lung Injury/chemically induced ; Acute Lung Injury/diagnostic imaging ; Aged ; Female ; Humans ; Insufflation/adverse effects ; Male ; Particle Size ; Pleural Effusion/diagnostic imaging ; Pleural Effusion/drug therapy ; Pleurodesis/adverse effects ; Pneumonia/chemically induced ; Pneumonia/diagnostic imaging ; Pneumothorax/diagnostic imaging ; Pneumothorax/drug therapy ; Prospective Studies ; Recurrence ; Survival Rate ; Talc/adverse effects ; Thoracoscopy/adverse effects ; Tomography, X-Ray Computed
    Chemical Substances Talc (14807-96-6)
    Language English
    Publishing date 2010-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1378/chest.09-2020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ui III Zs.45: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Zs.MO 349: Show issues

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