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[PMID]:29229117
[Au] Autor:Mon RA; Treadwell MC; Berman DR; Day L; Kreutzman J; Mychaliska GB; Perrone EE
[Ad] Endereço:Section of Pediatric Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan; University of Michigan Health System, Fetal Diagnosis and Treatment Center, Ann Arbor, Michigan.
[Ti] Título:Outcomes of fetuses with primary hydrothorax that undergo prenatal intervention (prenatal intervention for hydrothorax).
[So] Source:J Surg Res;221:121-127, 2018 Jan.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary hydrothorax is a congenital anomaly affecting 1 in 10,000-15,000 pregnancies. The natural history of this condition is variable with some fetuses having spontaneous resolution and others showing progression. The associated pulmonary hypoplasia leads to increased perinatal morbidity and mortality. Optimal prenatal intervention remains controversial. METHODS: After obtaining the Institutional Review Board approval, a retrospective review of all patients evaluated for a fetal pleural effusion in the Fetal Diagnosis and Treatment Center at The University of Michigan, between 2006 and 2016 was performed. Cases with secondary etiologies for an effusion or when families decided to pursue elective termination were excluded. RESULTS: Pleural effusions were identified in 175 patients. Primary hydrothorax was diagnosed in 15 patients (8%). The effusions were bilateral in 13/15 cases (86%) and 10/15 (66%) had hydrops at presentation. All 15 patients with primary hydrothorax underwent prenatal intervention. Thoracentesis was performed in 14/15 cases (93%). Shunt placement was performed in 10/15 cases (66%). Shunt migration was seen in four patients (40%) and all of these underwent prenatal shunt replacement. Overall survival was 76%. The rates of prematurity and preterm premature rupture of membranes were 69% and 35%, respectively. CONCLUSIONS: Fetal intervention for the treatment of primary hydrothorax is effective, and it appears to confer a survival advantage. Both the fetuses and the mothers tolerated the procedures well. Preterm labor and preterm premature rupture of membranes remain an unsolved problem. Further studies are needed to understand the mechanisms behind the development of fetal hydrothorax.
[Mh] Termos MeSH primário: Quilotórax/congênito
Terapias Fetais
Toracentese
[Mh] Termos MeSH secundário: Quilotórax/terapia
Feminino
Seres Humanos
Gravidez
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE


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[PMID]:28953667
[Au] Autor:Lian R; Zhang G; Zhang G
[Ad] Endereço:aDepartment of Emergency Medicine bDepartmentof General Surgery, China-Japan Friendship Hospital, Beijing, China.
[Ti] Título:Empyema caused by a colopleural fistula: A case report.
[So] Source:Medicine (Baltimore);96(39):e8165, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATINALE: Empyema is a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. An empyema caused by colo-pleural fistula is a rare but potentially life-threatening condition. PATIENT CONCERNS: We describe a case of 42-year-old man was brought to our Emergency Department for chest pain with dyspnea and fever. DIAGNOSES: The final diagnoses are empyema caused by colo-pleural fistula and colon cancer. INTERVENTIONS: The patient underwent laparotomy surgery, during which a tumor was found in the splenic flexure of the descending colon. The tumor penetrated the colonic serosa and invaded the left side of the diaphragm. A left hemicolectomy was performed. OUTCOMES: After the operation, the patient recovered smoothly and was discharged on postoperative day 14. It's been over 3 years now, CT and colonoscopy assessments show no recurrence or metastasis. LESSONS: This case serves as a reminder to test for pathogens in patients with an unexplained empyema. If normal intestinal bacteria are detected, the empyema may be derived from intestinal disease. In addition, an abdominal examination should be performed in patients with an empyema of unknown origin.
[Mh] Termos MeSH primário: Colectomia
Colo Descendente
Neoplasias do Colo
Empiema Pleural
Fístula
Cavidade Pleural
[Mh] Termos MeSH secundário: Adulto
Colectomia/efeitos adversos
Colectomia/métodos
Colo Descendente/diagnóstico por imagem
Colo Descendente/patologia
Neoplasias do Colo/complicações
Neoplasias do Colo/patologia
Colonoscopia/métodos
Empiema Pleural/diagnóstico
Empiema Pleural/etiologia
Empiema Pleural/microbiologia
Empiema Pleural/terapia
Enterococcus faecium/isolamento & purificação
Escherichia coli/isolamento & purificação
Fístula/diagnóstico
Fístula/etiologia
Fístula/fisiopatologia
Fístula/cirurgia
Microbioma Gastrointestinal
Seres Humanos
Masculino
Invasividade Neoplásica
Estadiamento de Neoplasias
Cavidade Pleural/diagnóstico por imagem
Cavidade Pleural/patologia
Toracentese/métodos
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008165


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[PMID]:28727272
[Au] Autor:Solari L; Soto A; Van der Stuyft P
[Ad] Endereço:Unit of General Epidemiology and Disease Control, Institute of Tropical Medicine of Antwerp, Antwerp, Belgium.
[Ti] Título:Performance of clinical prediction rules for diagnosis of pleural tuberculosis in a high-incidence setting.
[So] Source:Trop Med Int Health;22(10):1283-1292, 2017 Oct.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Diagnosis of pleural tuberculosis (PT) is still a challenge, particularly in resource-constrained settings. Alternative diagnostic tools are needed. We aimed at evaluating the utility of Clinical Prediction Rules (CPRs) for diagnosis of pleural tuberculosis in Peru. METHODS: We identified CPRs for diagnosis of PT through a structured literature search. CPRs using high-complexity tests, as defined by the FDA, were excluded. We applied the identified CPRs to patients with pleural exudates attending two third-level hospitals in Lima, Peru, a setting with high incidence of tuberculosis. Besides pleural fluid analysis, patients underwent closed pleural biopsy for reaching a final diagnosis through combining microbiological and histopathological criteria. We evaluated the performance of the CPRs against this composite reference standard using classic indicators of diagnostic test validity. RESULTS: We found 15 eligible CPRs, of which 12 could be validated. Most included ADA, age, lymphocyte proportion and protein in pleural fluid as predictive findings. A total of 259 patients were included for their validation, of which 176 (67%) had PT and 50 (19%) malignant pleural effusion. The overall accuracy of the CPRs varied from 41% to 86%. Two had a positive likelihood ratio (LR) above 10, but none a negative LR below 0.1. ADA alone at a cut-off of ≥40 IU attained 87% diagnostic accuracy and had a positive LR of 6.6 and a negative LR of 0.2. CONCLUSION: Many CPRs for PT are available. In addition to ADA alone, none of them contributes significantly to diagnosis of PT.
[Mh] Termos MeSH primário: Adenosina Desaminase/análise
Derrame Pleural/microbiologia
Tuberculose Pleural/diagnóstico
[Mh] Termos MeSH secundário: Biomarcadores/análise
Biópsia por Agulha
Ensaios Enzimáticos Clínicos
Técnicas de Apoio para a Decisão
Seres Humanos
Incidência
Mycobacterium/isolamento & purificação
Peru/epidemiologia
Derrame Pleural/diagnóstico por imagem
Valor Preditivo dos Testes
Radiografia Torácica
Escarro/microbiologia
Toracentese/métodos
Tuberculose Pleural/enzimologia
Tuberculose Pleural/epidemiologia
Tuberculose Pleural/microbiologia
Ultrassonografia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); EC 3.5.4.4 (Adenosine Deaminase)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12932


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[PMID]:28604316
[Au] Autor:Van der Westhuizen HM; Dramowski A
[Ad] Endereço:Department of Global Health, Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town; and TB Proof, Cape Town, South Africa. helene1mari@gmail.com.
[Ti] Título:When students become patients: TB disease among medical undergraduates in Cape Town, South Africa.
[So] Source:S Afr Med J;107(6):475-479, 2017 May 24.
[Is] ISSN:0256-9574
[Cp] País de publicação:South Africa
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Medical students acquire latent tuberculosis (TB) infection at a rate of 23 cases/100 person-years. The frequency and impact of occupational TB disease in this population are unknown. METHODS: A self-administered questionnaire was distributed via email and social media to current medical students and recently graduated doctors (2010 - 2015) at two medical schools in Cape Town. Individuals who had developed TB disease as undergraduate students were eligible to participate. Quantitative and qualitative data collected from the questionnaire and semi-structured interviews were analysed with descriptive statistics and a framework approach to identify emerging themes. RESULTS: Twelve individuals (10 female) reported a diagnosis of TB: pulmonary TB (n=6), pleural TB (n=3), TB lymphadenitis (n=2) and TB spine (n=1); 2/12 (17%) had drug-resistant disease (DR-TB). Mean diagnostic delay post consultation was 8.1 weeks, with only 42% of initial diagnoses being correct. Most consulted private healthcare providers (general practitioners (n=7); pulmonologists (n=4)), and nine underwent invasive procedures (bronchoscopy, pleural fluid aspiration and tissue biopsy). Substantial healthcare costs were incurred (mean ZAR25 000 for drug-sensitive TB, up to  ZAR104 000 for DR-TB). Students struggled to obtain treatment, incurred high transport costs and missed academic time. Students with DR-TB interrupted their studies and experienced severe side-effects (hepatotoxicity, depression and permanent ototoxicity). Most participants cited poor TB infection-control practices at their training hospitals as a major risk factor for occupational TB. CONCLUSIONS: Undergraduate medical students in Cape Town are at high risk of occupationally acquired TB, with an unmet need for comprehensive occupational health services and support.
[Mh] Termos MeSH primário: Doenças Profissionais/epidemiologia
Estudantes de Medicina/estatística & dados numéricos
Tuberculose/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Antituberculosos/efeitos adversos
Broncoscopia
Doença Hepática Induzida por Substâncias e Drogas/etiologia
Diagnóstico Tardio
Depressão/induzido quimicamente
Feminino
Custos de Cuidados de Saúde
Transtornos da Audição/induzido quimicamente
Seres Humanos
Masculino
Doenças Profissionais/diagnóstico
Doenças Profissionais/tratamento farmacológico
Doenças Profissionais/economia
Licença Médica
África do Sul/epidemiologia
Inquéritos e Questionários
Toracentese
Tuberculose/diagnóstico
Tuberculose/tratamento farmacológico
Tuberculose/economia
Tuberculose dos Linfonodos/diagnóstico
Tuberculose dos Linfonodos/tratamento farmacológico
Tuberculose dos Linfonodos/economia
Tuberculose dos Linfonodos/epidemiologia
Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico
Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico
Tuberculose Resistente a Múltiplos Medicamentos/economia
Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
Tuberculose Pleural/diagnóstico
Tuberculose Pleural/tratamento farmacológico
Tuberculose Pleural/economia
Tuberculose Pleural/epidemiologia
Tuberculose Pulmonar/diagnóstico
Tuberculose Pulmonar/tratamento farmacológico
Tuberculose Pulmonar/economia
Tuberculose Pulmonar/epidemiologia
Tuberculose da Coluna Vertebral/diagnóstico
Tuberculose da Coluna Vertebral/tratamento farmacológico
Tuberculose da Coluna Vertebral/economia
Tuberculose da Coluna Vertebral/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antitubercular Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.7196/SAMJ.2017.v107i6.12260


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[PMID]:28554579
[Au] Autor:Kim H; Shyn PB; Wu L; Levesque VM; Khorasani R; Silverman SG
[Ad] Endereço:Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.
[Ti] Título:Wall suction-assisted image-guided thoracentesis: a safe alternative to evacuated bottles.
[So] Source:Clin Radiol;72(10):898.e1-898.e5, 2017 Oct.
[Is] ISSN:1365-229X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To compare the safety of evacuated bottle-assisted thoracentesis with wall suction-assisted thoracentesis. MATERIALS AND METHODS: An institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study of 161 consecutive patients who underwent 191 evacuated bottle-assisted thoracenteses from 1 January 2012 to 30 September 2012, and 188 consecutive patients who underwent 230 wall suction-assisted thoracenteses from 1 January 2013 to 30 September 2013 was conducted. All procedures used imaging guidance. Primary diagnosis, age, gender, total fluid volume removed, and adverse events (AE) up to 30 days post-procedure were recorded and graded using Common Terminology Criteria for Adverse Events 4.0 (CTCAE) . RESULTS: Overall AE rates were 42.9% (82/191) for the evacuated bottle group and 19.6% (45/230) for the wall suction group (p<0.0001). Grade I AE occurred more commonly in the evacuated bottle group than in the wall suction group, [41.9% (80/191) and 18.3% (42/230)], respectively (p<0.0001). No significant differences were observed in grade 2 [0.5% (1/191) and 0% (0/230), p=0.45] or grade 3 AE [0.5% (1/191) and 1.3% (3/230), p=0.63] between the evacuated bottle and wall suction groups, respectively. No grade 4 or 5 AE occurred. Excluding transient chest pain and cough, there was no statistical difference in overall AE rate between the evacuated bottle and wall suction groups [11% (21/191) and 8.3% (19/230), p=0.4]. CONCLUSION: Image-guided thoracentesis performed with wall suction is safe when compared to evacuated bottles. The use of wall suction, in comparison to evacuated bottles, may decrease the incidence of transient chest pain or cough.
[Mh] Termos MeSH primário: Derrame Pleural/terapia
Toracentese/instrumentação
Toracentese/métodos
Ultrassonografia de Intervenção
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Derrame Pleural/diagnóstico por imagem
Estudos Retrospectivos
Sucção
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE


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[PMID]:28489618
[Au] Autor:Brydges R; Stroud L; Wong BM; Holmboe ES; Imrie K; Hatala R
[Ad] Endereço:R. Brydges is assistant professor, Department of Medicine, University of Toronto, and scientist, Wilson Centre, University Health Network, Toronto, Ontario, Canada. L. Stroud is assistant professor, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. B.M. Wong is associate professor, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. E.S. Holmboe is senior vice president for milestones development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. K. Imrie is immediate past president, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada. R. Hatala is associate professor, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
[Ti] Título:Core Competencies or a Competent Core? A Scoping Review and Realist Synthesis of Invasive Bedside Procedural Skills Training in Internal Medicine.
[So] Source:Acad Med;92(11):1632-1643, 2017 Nov.
[Is] ISSN:1938-808X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Invasive bedside procedures are core competencies for internal medicine, yet no formal training guidelines exist. The authors conducted a scoping review and realist synthesis to characterize current training for lumbar puncture, arthrocentesis, paracentesis, thoracentesis, and central venous catheterization. They aimed to collate how educators justify using specific interventions, establish which interventions have the best evidence, and offer directions for future research and training. METHOD: The authors systematically searched Medline, Embase, the Cochrane Library, and ERIC through April 2015. Studies were screened in three phases; all reviews were performed independently and in duplicate. The authors extracted information on learner and patient demographics, study design and methodological quality, and details of training interventions and measured outcomes. A three-step realist synthesis was performed to synthesize findings on each study's context, mechanism, and outcome, and to identify a foundational training model. RESULTS: From an initial 6,671 studies, 149 studies were further reduced to 67 (45%) reporting sufficient information for realist synthesis. Analysis yielded four types of procedural skills training interventions. There was relative consistency across contexts and significant differences in mechanisms and outcomes across the four intervention types. The medical procedural service was identified as an adaptable foundational training model. CONCLUSIONS: The observed heterogeneity in procedural skills training implies that programs are not consistently developing residents who are competent in core procedures. The findings suggest that researchers in education and quality improvement will need to collaborate to design training that develops a "competent core" of proceduralists using simulation and clinical rotations.
[Mh] Termos MeSH primário: Competência Clínica
Medicina Interna/educação
[Mh] Termos MeSH secundário: Artrocentese/educação
Cateterismo Venoso Central
Seres Humanos
Paracentese/educação
Punção Espinal
Toracentese/educação
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE
[do] DOI:10.1097/ACM.0000000000001726


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[PMID]:28350729
[Au] Autor:Krackov R; Rizzolo D
[Ad] Endereço:Rachel Krackov is an independent researcher, registered vascular specialist, and PA educator in point-of-care ultrasound in Orlando, Fla. Denise Rizzolo is an assistant clinical professor in the Pace completion program in New York City, and an associate professor in the PA program at Kean University in Union, N.J. The authors have disclosed no potential conflicts of interest, financial or otherwise.
[Ti] Título:Real-time ultrasound-guided thoracentesis.
[So] Source:JAAPA;30(4):32-37, 2017 Apr.
[Is] ISSN:1547-1896
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Clinicians commonly see patients with pleural effusions requiring thoracentesis. The latest evidence-based guidelines for thoracentesis recommend real-time ultrasound guidance for the safest outcomes from this procedure. This article reviews real-time ultrasound guidance for thoracentesis to help referring clinicians understand the technique and the guidelines for the performance of thoracentesis.
[Mh] Termos MeSH primário: Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos
Pleura/patologia
Derrame Pleural/patologia
Toracentese/métodos
[Mh] Termos MeSH secundário: Drenagem/métodos
Seres Humanos
Ultrassonografia de Intervenção/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1097/01.JAA.0000508210.40675.09


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[PMID]:28209662
[Au] Autor:Cornes MP; Chadburn AJ; Thomas C; Darby C; Webster R; Ford C; Gama R
[Ad] Endereço:Department of Clinical Chemistry New Cross Hospital, Wolverhampton, UK.
[Ti] Título:The impact of between analytical platform variability on the classification of pleural effusions into exudate or transudate using Light's criteria.
[So] Source:J Clin Pathol;70(7):607-609, 2017 Jul.
[Is] ISSN:1472-4146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Light's criteria are ratios of pleural fluid to serum total protein (TP), pleural fluid to serum lactate dehydrogenase (LDH) and pleural fluid LDH to the upper reference limit for serum LDH. They are used to classify pleural effusions into an exudate or transudate when pleural fluid protein is 25-35 g/L. We evaluated the impact of between analytical platforms on the classification of pleural effusions using Light's criteria. METHODS: Light's criteria were used to classify pleural effusions with fluid TP between 25 and 35 g/L into exudate and transudate. LDH and TP were analysed using an Abbott ARCHITECT c16000 analyser using a lactate to pyruvate method for LDH and two Roche Cobas 800 c702 analysers, one using a lactate to pyruvate method (laboratory B) and one a lactate to pyruvate method (laboratory C). RESULTS: Eighty-three paired serum and pleural fluid samples were analysed. Of these, 44 samples had a pleural fluid TP between 25 and 35 g/L and were classified according to Light's criteria. Classification of pleural fluid into transudate or exudate using different analytical platforms was 82% concordant. The LDH ratio and TP ratio were similar in laboratory B and laboratory C, but these were respectively lower (p<0.001) and higher (p<0.001) than those at laboratory A. CONCLUSIONS: Although Light's criteria are ratios, which should minimise interassay variability, we report 18% discordance between different analytical platforms. The discordance was largely due to the performance of LDH and to a lesser extent protein assays in pleural fluid. Laboratories should be aware that assays may perform differently in serum and pleural fluid.
[Mh] Termos MeSH primário: Exsudatos e Transudatos/metabolismo
L-Lactato Desidrogenase/metabolismo
Derrame Pleural/classificação
Proteínas/metabolismo
[Mh] Termos MeSH secundário: Técnicas de Laboratório Clínico/métodos
Seres Humanos
Toracentese/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Proteins); EC 1.1.1.27 (L-Lactate Dehydrogenase)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE
[do] DOI:10.1136/jclinpath-2016-204142


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[PMID]:28182812
[Au] Autor:Thong XY; Lee LY; Chia DA; Wong YC; Biswas A
[Ad] Endereço:Department of Paediatrics, Yong Loo Lin School of Medicine, National University Singapore, Singapore.
[Ti] Título:Management and Outcomes of Fetal Hydrops in a Tertiary Care Centre in Singapore.
[So] Source:Ann Acad Med Singapore;46(1):4-10, 2017 Jan.
[Is] ISSN:0304-4602
[Cp] País de publicação:Singapore
[La] Idioma:eng
[Ab] Resumo:: Fetal hydrops is a serious condition which can be caused by immune and non-immune aetiologies. We aimed to review the management of fetal hydrops at our hospital. : A retrospective review of all cases of fetal hydrops diagnosed in our institution from 2006 to 2013 was carried out. : Out of the 30 cases of fetal hydrops diagnosed antenatally, 17 were cases of Bart's hydrops which were all terminated in-utero. Of the remaining 13 cases, 11 cases consisted of non-immune causes of hydrops. Planned antenatal interventions including in-utero blood transfusions (n = 4) and thoracentesis (n = 5) as well as planned caesarean deliveries (n = 11) were performed in the majority of cases. Postnatal neonatal intensive care with interventions including chest drainage and transfusions were also performed. A majority, 92%, of the cases survived the perinatal period following a variable length of hospital stay ranging from a week to 3 months. : Management of fetal hydrops is complex. Close coordination between the obstetric and neonatal teams was the key to good short-term survival of neonates with antenatally diagnosed hydrops, as it allows timely antenatal intervention and anticipation of potential perinatal complications.
[Mh] Termos MeSH primário: Transfusão de Sangue
Cesárea
Terapias Fetais
Hidropisia Fetal/terapia
Toracentese
[Mh] Termos MeSH secundário: Aborto Induzido
Gerenciamento Clínico
Drenagem
Feminino
Hemoglobinas Anormais
Seres Humanos
Hidropisia Fetal/sangue
Hidropisia Fetal/etiologia
Recém-Nascido
Unidades de Terapia Intensiva Neonatal
Gravidez
Diagnóstico Pré-Natal
Estudos Retrospectivos
Singapura
Taxa de Sobrevida
Centros de Atenção Terciária
Talassemia alfa/sangue
Talassemia alfa/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hemoglobins, Abnormal); 9056-09-1 (hemoglobin Bart's)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170221
[Lr] Data última revisão:
170221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170210
[St] Status:MEDLINE


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[PMID]:28178732
[Au] Autor:Thampy E; Cherian SV
[Ad] Endereço:Department of Internal Medicine, University of Texas Health Science Center at Houston, USA.
[Ti] Título:The unexpandable lung.
[So] Source:N Z Med J;130(1449):64-66, 2017 Jan 27.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Mh] Termos MeSH primário: Pulmão/microbiologia
Mycobacterium tuberculosis/isolamento & purificação
Tuberculose Pulmonar/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Antituberculosos/uso terapêutico
Diagnóstico Diferencial
Seres Humanos
Pulmão/diagnóstico por imagem
Masculino
Radiografia Torácica
Toracentese
Tuberculose Pulmonar/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antitubercular Agents)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170209
[St] Status:MEDLINE



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