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Rodríguez Torres J, Cabrera Martos I, López López L, Torres Sánchez I, Granados Santiago M, Valenza MC. Psychological distress at hospital admission is related to symptoms severity and health status in malignant pleural effusion patients. Eur J Cancer Care (Engl) 2019; 29:e13212. [PMID: 31880035 DOI: 10.1111/ecc.13212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 12/09/2022]
Abstract
OBJECTIVE The incidence and associated healthcare costs of malignant pleural effusion (MPE) are expected to rise, but there is limited evidence about which factors affect patients' prognosis. So, the aim of this study was to determine whether psychological distress at hospital admission is associated with symptom severity and health status in patients with MPE. METHODS A longitudinal observational prospective cohort study was carried out in the Pulmonology Service of the Granada University Hospital Complex in Granada, Spain. Patients diagnosed with MPE were included and evaluated at hospital admission, at discharge and at one month after discharge. Outcome measures included symptom severity (i.e. dyspnoea, pain and cough) and health status (functionality and self-perceived health status). RESULTS Significant differences were found in symptoms and the health status, with worse results in the group with psychological distress at discharge. One month after discharge, MPE patients with psychological distress exhibited greater symptoms, including more cough and dyspnoea (p < .05). Moreover, these patients showed worse functionality (p < .05) and self-perceived health status (p < .05). CONCLUSION Psychological distress is an important factor to take into account in patients with MPE. The presence of psychological distress appears to increase the symptoms and is associated with worse health status after hospitalisation.
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Affiliation(s)
- Janet Rodríguez Torres
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Cabrera Martos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López López
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Torres Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - María Granados Santiago
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Pleural fluid due to papillary thyroid cancer. Oncol Lett 2019; 18:962-966. [PMID: 31289575 DOI: 10.3892/ol.2019.10383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/14/2019] [Indexed: 11/05/2022] Open
Abstract
We report herein a rare case of massive pleural effusion caused by papillary thyroid cancer, which was accompanied by multiple pulmonary metastasis. A 91-year-old male patient presented with shortness of breath due to massive right pleural fluid. Cytological specimens, which were obtained from pleural fluid by thoracentesis, and was consistent with that observed in surgically resected thyroid cancer 6-year previously. Immunocytochemical staining of the cells was positive for cytokeratin (CK)-7, CK-19, and positive for thyroglobulin. Massive pleural fluid due to a metastatic from papillary thyroid cancer is very rare but may develop in long-term survivors with this disease as observed in this case.
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Shi J, Li P, Zhou L, Qi S, Wang B, Li D, Duan L, Chen WX, Xia J, Zou L, Yang S. Potential biomarkers for antidiastole of tuberculous and malignant pleural effusion by proteome analysis. Biomark Med 2019; 13:123-133. [PMID: 30791695 DOI: 10.2217/bmm-2018-0200] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AIM To investigate novel potential biomarkers for antidiastole of tuberculous pleural effusion (TPE) from malignant pleural effusion (MPE). MATERIALS & METHODS iTRAQTM-coupled LC-MS/MS were applied to analyze the proteome of TPE and MPE samples. The candidate proteins were verified by enzyme-linked immunosorbent assay. RESULTS A total of 432 differential proteins were identified. Enzyme-linked immunosorbent assay revealed significantly higher levels of fibronectin (FN) and cathepsin G (CTSG) in MPE than in TPE, but lower levels of leukotriene-A4 hydrolase (LTA4H). The receiver operator characteristic values were 0.285 for FN, 0.64 for LTA4H, 0.337 for CTSG and 0.793 for a combination of these candidate markers. CONCLUSION FN, LTA4H and CTSG were identified as potential biomarkers to differentiate TPE from MPE and their combination exhibited higher diagnostic capacity.
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Affiliation(s)
- Jing Shi
- Department of Laboratory Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Pu Li
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China
| | - Lijin Zhou
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China
| | - Suwen Qi
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements & Ultrasound Imaging, Department of Biomedical Engineering, School of Medicine, Shenzhen University, Shenzhen 518060, PR China
| | - Bo Wang
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China
| | - Dandan Li
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China
| | - Liang Duan
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China
| | - Wei Xian Chen
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China
| | - Jirong Xia
- Department of Laboratory Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Lin Zou
- Department of Laboratory Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Shuangshuang Yang
- Department of Laboratory Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
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Angelico G, Ieni A, Caltabiano R, Zeppa P, Tuccari G. Aquaporin-1 expression in fluoro-edenite-induced mesothelioma effusions: An approach by cell-block procedure. Cytopathology 2018; 29:455-460. [PMID: 29873855 DOI: 10.1111/cyt.12583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Aquaporin 1 (AQP-1) is a water channel protein found in cell membranes, whose expression has been considered an independent favourable prognostic factor in pleural malignant mesothelioma (MM). The aim of this study was to evaluate the expression of AQP-1 and its prognostic value in a series of pleural MM effusions, from a geographical area with high concentrations of fluoro-edenite (FE). METHODS We selected 25 MM cases from Biancavilla (Italy), an area with high environmental concentrations of FE. Cytological samples, cell-blocks (CB), clinical and follow-up data were available for all cases. Immunohistochemistry for calretinin, CK5/6, WT1, CK7 and TTF1 was used on CB sections to confirm the cytological diagnosis of MM. Immunohistochemistry for AQP-1 was performed and high expression was defined when ≥50% of tumour cells showed linear and circumferential membranous staining. RESULTS The cohort included 16 men and nine women (median age: 67.5 years; range: 49-88 years). The median survival was 14 months (range 1.5-60 months), with a significant value (P = 0.006). All cases have been histologically confirmed and classified as epithelioid (16 cases), biphasic (seven cases) and sarcomatoid (two cases). AQP-1 high expression has been observed in 16 cases. Comparing AQP-1 high expression to the survival of corresponding patients, a significant association with a slight increased overall survival of 12 months has been demonstrated. Nine patients with a AQP-1 score less than 50% showed a shorter median overall survival (7 months). CONCLUSIONS AQP-1 high expression is detectable on cytological samples of FE-induced MM with a prognostic value.
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Affiliation(s)
- G Angelico
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Unit of Pathological Anatomy, University of Messina, AOU Policlinico G. Martino, Messina, Italy
| | - A Ieni
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Unit of Pathological Anatomy, University of Messina, AOU Policlinico G. Martino, Messina, Italy
| | - R Caltabiano
- Department "G.F. Ingrassia", Section of Pathologic Anatomy, University of Catania, Catania, Italy
| | - P Zeppa
- Pathological Anatomy, AOU San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - G Tuccari
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Unit of Pathological Anatomy, University of Messina, AOU Policlinico G. Martino, Messina, Italy
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Bertolaccini L, Viti A, Paiano S, Pomari C, Assante LR, Terzi A. Indwelling Pleural Catheters: A Clinical Option in Trapped Lung. Thorac Surg Clin 2016; 27:47-55. [PMID: 27865327 DOI: 10.1016/j.thorsurg.2016.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Malignant pleural effusion (MPE) symptoms have a real impact on quality of life. Surgical approach through video-assisted thoracic surgery provides a first step in palliation. In patients unfit for general anesthesia, awake pleuroscopy represents an alternative. Sclerosing agents can be administered at the bedside through a chest tube. Ideal treatment of MPE should include adequate long-term symptom relief, minimize hospitalization, and reduce adverse effects. Indwelling pleural catheter (IPC) allows outpatient management of MPE through periodic ambulatory fluid drainage. IPC offers advantages over pleurodesis in patients with poor functional status who cannot tolerate pleurodesis or in patients with trapped lungs.
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Affiliation(s)
- Luca Bertolaccini
- Thoracic Surgery Unit, Sacro Cuore Don Calabria Research Hospital - Cancer Care Center, Via Don Angelo Sempreboni 5, Negrar, Verona 37024, Italy.
| | - Andrea Viti
- Thoracic Surgery Unit, Sacro Cuore Don Calabria Research Hospital - Cancer Care Center, Via Don Angelo Sempreboni 5, Negrar, Verona 37024, Italy
| | - Simona Paiano
- Thoracic Endoscopy Unit, Sacro Cuore Don Calabria Research Hospital - Cancer Care Center, Via Don Angelo Sempreboni 5, Negrar, Verona 37024, Italy
| | - Carlo Pomari
- Thoracic Endoscopy Unit, Sacro Cuore Don Calabria Research Hospital - Cancer Care Center, Via Don Angelo Sempreboni 5, Negrar, Verona 37024, Italy
| | - Luca Rosario Assante
- Thoracic Endoscopy Unit, Sacro Cuore Don Calabria Research Hospital - Cancer Care Center, Via Don Angelo Sempreboni 5, Negrar, Verona 37024, Italy
| | - Alberto Terzi
- Thoracic Surgery Unit, Sacro Cuore Don Calabria Research Hospital - Cancer Care Center, Via Don Angelo Sempreboni 5, Negrar, Verona 37024, Italy
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Khalil M, Shoukri AM. Thoracoscopic tetracycline poudrage for pleurodesis in malignant pleural effusion. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2016. [DOI: 10.4103/1687-8426.184358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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ENFOQUE DIAGNÓSTICO EN EL PACIENTE CON DERRAME PLEURAL. REVISTA MÉDICA CLÍNICA LAS CONDES 2015. [DOI: 10.1016/j.rmclc.2015.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Malignant pleural effusion: Relationship between thoracoscopic findings and type of malignancy. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2015. [DOI: 10.1016/j.ejcdt.2014.11.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Wajda A, Engström H, Persson HL. Medical Talc Pleurodesis: Which Patient with Cancer Benefits Least? J Palliat Med 2014; 17:822-8. [DOI: 10.1089/jpm.2013.0591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Aldona Wajda
- Division of Pulmonary Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Department of Respiratory Medicine UHL, Centre of Surgery and Oncology, County Council of Östergötland, Linköping, Sweden
| | - Helena Engström
- Division of Pulmonary Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Department of Respiratory Medicine UHL, Centre of Surgery and Oncology, County Council of Östergötland, Linköping, Sweden
| | - H. Lennart Persson
- Division of Pulmonary Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Department of Respiratory Medicine UHL, Centre of Surgery and Oncology, County Council of Östergötland, Linköping, Sweden
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Briones-Gómez A, Modesto-Alapont M, Muñoz-Moya MA, Martínez-Tomás R, Cases-Viedma E. Insertion of a metallic guide-wire in the pleural cavity as a complication in tunneled indwelling pleural catheter placement. Arch Bronconeumol 2014; 51:206-7. [PMID: 24935626 DOI: 10.1016/j.arbres.2014.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 04/13/2014] [Accepted: 04/15/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Andrés Briones-Gómez
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, España.
| | - Manuel Modesto-Alapont
- Unidad de Neumología, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, España
| | - Manuel A Muñoz-Moya
- Unidad de Neumología, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, España
| | - Raquel Martínez-Tomás
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Enrique Cases-Viedma
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, España
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Villena Garrido V, Cases Viedma E, Fernández Villar A, de Pablo Gafas A, Pérez Rodríguez E, Porcel Pérez JM, Rodríguez Panadero F, Ruiz Martínez C, Salvatierra Velázquez Á, Valdés Cuadrado L. Recommendations of Diagnosis and Treatment of Pleural Effusion. Update. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.arbr.2014.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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12
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Villena Garrido V, Cases Viedma E, Fernández Villar A, de Pablo Gafas A, Pérez Rodríguez E, Porcel Pérez JM, Rodríguez Panadero F, Ruiz Martínez C, Salvatierra Velázquez A, Valdés Cuadrado L. Recommendations of diagnosis and treatment of pleural effusion. Update. Arch Bronconeumol 2014; 50:235-49. [PMID: 24698396 DOI: 10.1016/j.arbres.2014.01.016] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 01/13/2014] [Accepted: 01/14/2014] [Indexed: 10/25/2022]
Abstract
Although during the last few years there have been several important changes in the diagnostic or therapeutic methods, pleural effusion is still one of the diseases that the respiratory specialist have to evaluate frequently. The aim of this paper is to update the knowledge about pleural effusions, rather than to review the causes of pleural diseases exhaustively. These recommendations have a longer extension for the subjects with a direct clinical usefulness, but a slight update of other pleural diseases has been also included. Among the main scientific advantages are included the thoracic ultrasonography, the intrapleural fibrinolytics, the pleurodesis agents, or the new pleural drainages techniques.
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Affiliation(s)
- Victoria Villena Garrido
- Servicio de Neumología, Fundación Investigación, Hospital Universitario 12 de Octubre, CIBERES, Madrid, España.
| | | | | | | | | | | | | | | | | | - Luis Valdés Cuadrado
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
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Ried M, Hofmann HS. The treatment of pleural carcinosis with malignant pleural effusion. DEUTSCHES ARZTEBLATT INTERNATIONAL 2013; 110:313-8. [PMID: 23720697 DOI: 10.3238/arztebl.2013.0313] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pleural carcinosis is caused by tumors of the chest (e.g., lung and breast cancer) or elsewhere in the body (e.g., ovarian carcinoma) that metastasize to the visceral and/or parietal pleura. Recurrent malignant pleural effusion due to pleural carcinosis is one of the most common findings in oncology. It affects about 56 000 patients per year in Germany alone. METHODS This review is based on pertinent literature retrieved by a selective search of the Medline database (key words: malignant pleural effusion, pleural carcinosis) and on the authors' clinical experience. RESULTS Although many retrospective studies have been published, there has been only one randomized controlled trial of treatment, in which permanent pleural catheters were compared with talcum pleurodesis. Patients with pleural carcinosis have a median survival of less than 12 months. Many are suffering from progression of their underlying disease, with generalized tumor involvement; thus, the symptomatic treatment of pain and dyspnea is often the main therapeutic issue. The underlying tumor, usually an adenocarcinoma, can be diagnosed either by histology or by cytology. The main complication is progressive respiratory failure. The treatment is palliative, rather than curative. The main approaches are drainage of the effusion (by thoracocentesis or with permanent pleural catheters) and pleurodesis (obliteration of the pleural space by causing the visceral and parietal pleura to adhere to each other). CONCLUSION Pleural carcinosis with symptomatic malignant pleural effusion is treated palliatively. The appropriate treatment in each case should be determined through discussion with the patient, with the goal of improving the patient's quality of life.
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Affiliation(s)
- Michael Ried
- Department of Thoracic Surgery, University Hospital Regensburg, Regensburg, Germany.
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Hunt BM, Farivar AS, Vallières E, Louie BE, Aye RW, Flores EE, Gorden JA. Thoracoscopic Talc Versus Tunneled Pleural Catheters for Palliation of Malignant Pleural Effusions. Ann Thorac Surg 2012; 94:1053-7; discussion 1057-9. [DOI: 10.1016/j.athoracsur.2012.01.103] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 01/08/2012] [Accepted: 01/11/2012] [Indexed: 11/26/2022]
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Abstract
Pleurodesis aims to obliterate the pleural space by producing extensive adhesion of the visceral and parietal pleura, in order to control relapse of either pleural effusions (mostly malignant) or pneumothorax. A tight and complete apposition between the two pleural layers is a necessary condition to obtain a successful pleurodesis, but--besides this mechanical aspect--there are many biological mechanisms that appear to be common to most of the sclerosing agents currently used. Following intrapleural application of the sclerosing agent, diffuse inflammation, pleural coagulation-fibrinolysis imbalance (favoring the formation of fibrin adhesions), recruitment and subsequent proliferation of fibroblasts, and collagen production are findings in the pleural space. The pleural mesothelial lining is the primary target for the sclerosant and plays a pivotal role in the whole pleurodesis process, including the release of several mediators like interleukin-8, transforming growth factor-β and basic fibroblast growth factor. When the tumor burden is high, normal mesothelial cells are scarce, and consequently the response to the sclerosing agent is decreased, leading to failure of pleurodesis. Also, the type of tumor in the pleural cavity may also affect the outcome of pleurodesis (diffuse malignant mesothelioma and metastatic lung carcinomas have a poorer response). There is general agreement that talc obtains the best results, and there are also preliminary experimental studies suggesting that it can induce apoptosis in tumor cells and inhibit angiogenesis, thus contributing to a better control of the malignant pleural effusion. There is concern about complications (possibly associated with talc but other agents as well) related to systemic inflammation and possible activation of the coagulation cascade. In order to prevent extrapleural talc dissemination, large-particle talc is recommended. Although it could--to some degree--interfere with the mechanisms leading to pleurodesis and a carefully balanced clinical decision has therefore to be made, prophylactic treatment with subcutaneous heparin is recommended during hospitalization (immediately before and after the pleurodesis procedure).
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Affiliation(s)
- Francisco Rodriguez-Panadero
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, and CIBER Enfermedades Respiratorias, Sevilla, Spain.
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