Publications by authors named "Gihan Hettiarachchi"
Background: The principal aim of malignant pleural effusion (MPE) management is to improve health-related quality of life (HRQoL) and symptoms.
Methods: In this open-label randomised controlled trial, patients with symptomatic MPE were randomly assigned to either indwelling pleural catheter (IPC) insertion with the option of talc pleurodesis or chest drain and talc pleurodesis. The primary end-point was global health status, measured with the 30-item European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) at 30 days post-intervention.
Effect of Thoracoscopic Talc Poudrage vs Talc Slurry via Chest Tube on Pleurodesis Failure Rate Among Patients With Malignant Pleural Effusions: A Randomized Clinical Trial.
JAMA
January 2020
Article Synopsis
- Malignant pleural effusion (MPE) is difficult to treat, and while talc pleurodesis is a popular method, there's no consensus on the best way to deliver the talc, leading to varying practices.
- * This study aimed to determine if talc poudrage delivered during thoracoscopy with local anesthesia was more effective than talc slurry via chest tube for inducing pleurodesis.
- * Conducted across 17 UK hospitals, the trial involved 330 participants who were followed for various outcomes, including pleurodesis failure, hospital stay duration, and quality of life indicators.
Study Objectives: Drugs and psychoactive substances can cause sleepiness and when undetected, may lead to over diagnosis of central hypersomnias. We performed urine drug testing using gas chromatography-mass spectrometry in adults undergoing multiple sleep latency testing (MSLT) for a suspected central hypersomnia. We examined how the drug test results modified the treating physician's diagnosis.
View Article and Find Full Text PDFImportance: For treatment of malignant pleural effusion, nonsteroidal anti-inflammatory drugs (NSAIDs) are avoided because they may reduce pleurodesis efficacy. Smaller chest tubes may be less painful than larger tubes, but efficacy in pleurodesis has not been proven.
Objective: To assess the effect of chest tube size and analgesia (NSAIDs vs opiates) on pain and clinical efficacy related to pleurodesis in patients with malignant pleural effusion.