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Intrapleural fibrinolytic therapy for pleural infections: Outcomes from a cohort study.
Ann Acad Med Singap
December 2024
Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.
Introduction: Pleural infections are a significant cause of mortality. Intrapleural fibrinolytic therapy (IPFT) utilising alteplase and dornase is a treatment option for patients unsuitable for surgery. The optimal dose of alteplase is unknown, and factors affecting treatment success in an Asian population are unclear.
View Article and Find Full Text PDFPhase I clinical trial testing the dose escalation and expansion of Pressurized IntraThoracic Hyperthermic Aerosol Cisplatin administration (PITHAC) for the management of pleural carcinosis.
Cancer Treat Res Commun
December 2024
Division of Thoracic Surgery, University Hospital of Lausanne, Rue du Bugnon 46 1011, Lausanne, Switzerland. Electronic address:
Background: Pleural carcinosis originates from various cancers. Its management consists in systemic therapies combined to dyspnea relief procedures. Prior studies have tested hyperthermic intrathoracic chemotherapy to treat pleural carcinosis with interesting patient survival results.
View Article and Find Full Text PDFCan Intrapleural Tissue Plasminogen Activator and Deoxyribonuclease Be Used to Treat Persistent Hemothorax After Robotic Lobectomy?
Cureus
November 2024
Cardiothoracic Surgery, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Hemothorax is a serious complication following thoracic surgery, often resulting from vessel injury or rib fractures, and is typically managed with chest tube drainage. Persistent or loculated hemothorax, referred to as retained hemothorax, may require more invasive interventions, such as thoracotomy. Although the intrapleural administration of tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) has shown promise in managing pleural infections, its use for hemothorax remains controversial due to bleeding risks.
View Article and Find Full Text PDFIntratumoral Treatment in Lung Cancer: Is It Time to Move Towards Clinical Practice?
Cancers (Basel)
November 2024
Medical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy.
According to a modern view, cancer no longer follows a purely mechanistic model. Rather, a tumor is conceived as a more complex structure, composed of cancer cells, the activities of which may interact and reshape the so-called tumor microenvironment (TME), leading to preservation of specific tumoral niches and promoting the survival of tumoral stem cells. : Therapeutic strategies must deal with this unique cancer architecture in the near future by widening their range of activities outside the cancer cells and rewiring a TME to ensure it is hostile to cancer growth.
View Article and Find Full Text PDFArticle Synopsis
- - A 45-year-old male underwent thoracotomy for empyema and received several doses of intrapleural rtPA, a clot-dissolving medication.
- - To ensure safe administration of regional anesthesia, the acute pain service conducted a ROTEM test, revealing normal clotting parameters and no significant effects from the rtPA.
- - The findings allowed for a successful single-shot paravertebral block and subsequent thoracic epidural, demonstrating ROTEM's effectiveness in assessing coagulation status in patients treated with rtPA.
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