Recommended criteria for surgical drainage of parapneumonic effusions include evidence of frank purulence, a glucose level less than 40 mg/dl, a pH of less than 7.00, or an LDH greater than 1,000 IU/L. To test the utility of these criteria, we reviewed the three-year experience of three Rochester, NY, hospitals. We identified 133 patients undergoing thoracentesis for putative parapneumonic effu...

Two hundred consecutive patients with malignant pleural effusion were reviewed. The pathologic etiology of malignant pleurisy was: primary lung cancer in 123 cases; five, mesothelioma; and 72 cases secondary to metastatic tumors. Adenocarcinoma of the lung and mammary cancer were the most frequent tumors causing malignant pleural effusion. The modalities employed in local treatment consisted of...

OBJECTIVE Surgery can only offer palliation in an attempt to slow the progression of malignant pleural mesothelioma (MPM). We want to assess the effectiveness and safety of pleurectomy/decortication in establishing a tissue diagnosis, and controlling pleural fluid accumulation and symptoms in patients with MPM. METHODS We reviewed our pleurectomy results in 100 patients with MPM over a 19 yea...

BACKGROUND Empyema thoracis results from postpneumonic effusion of bacterial origin or trauma. If untreated it may convert to fibro-purulent or an organising stage. METHODS This study was conducted at cardiothoracic unit of Ayub Teaching Hospital Abbottabad from Jan 2008 to Aug 2009. Patients with diagnosis of empyema thoracic were studied. Their clinical features and investigations were reco...

Oxidative stress and excitotoxicity have been implicated in selective striatal vulnerability caused by the mitochondrial toxin, 3-nitropropionic acid (3-NP), which may simulate Huntington's disease in animals and humans. The detailed mechanism of the role of superoxide in striatal vulnerability induced by 3-NP is still unknown. The authors investigated oxidative cellular injury and DNA fragment...

Postpneumonic empyema still remains quite common in developing countries, especially during the hot and humid months. While most cases would respond to antibiotic therapy, needle aspiration and intercostal drainage, few cases require further surgical management. The most common nontubercular etiological agent is Staphylococcus. Tubercular etiology is not uncommon in India, especially due to del...

OBJECTIVES This study aimed to assess the efficacy of thoracotomy and decortication (T/D) in achieving lung re-expansion in patients with Stage III empyema and assess the impact of culture-positive empyema on the outcome of decortication. METHODS This is a retrospective observational study of consecutive patients treated with T/D over a 6-year period. RESULTS A total of 107 consecutive pati...

In patients with pseudomyxoma peritonei or peritoneal mesothelioma, direct extension of disease through the hemidiaphragm may result in an isolated progression of tumor within the pleural space. We monitored the intrapleural and plasma levels of mitomycin C and doxorubicin by HPLC assay in order to determine the pharmacokinetic behavior of this intracavitary use of chemotherapy. Our results sho...

Malignant pleural mesothelioma (MPM) is a primary solid malignancy related to inhalational asbestos exposure. Despite advances in therapy, MPM remains challenging treat with post-treatment survival of only 15% at 5-year. In recent years, extra-pleural pneumonectomy has decreased popularity due high morbidity rate and mortality compared pleurectomy/decortication other therapeutic alternatives. t...

introduction: extreme altitude travel has gained popularity globally for adventurous, scientific, and military endeavors. cerebral venous sinus thrombosis (cvst) at extreme altitude is a rare, covert, and emergent condition requiring immediate intervention. case presentation: a case of cvst masqueraded as high altitude cerebral edema (hace) at 6700 m/22000 ft in karakoram himalayas. atypical ol...