ABSTRACT
Objectives: To evaluate the efficacy of the chest tube drainage [CTD] and the needle aspiration [NA] in the treatment of primary Spontaneous pneumothorax [SP]
Methods: In a randomized controlled trial, seventy patients suffering SP were divided equally into two subgroups, as follows: [A] CTD and [B] NA. The immediate and one-week rate of the treatments was the primary endpoints. Postoperative complications, length of hospital stay and incidence of pneumothorax recurrence during one-year follow up were also recorded
Results: The immediate success of treatment was 68.5% and 54.2% of patients in CTD and NA groups, respectively that showed no significant difference between study groups [P: 0.16]. The complete lung expansion after one week observed in 32 [91.4%] of NA group and 33 [94.2%] patients in CTD group [P: 0.5]. Pneumothorax recurrence was detected in 13 patients [4 in NA and 9 in CTD group] [P: 0.11]. Mean pain intensity was significantly lower in the NA group at the first hour after the procedure, the first postoperative day and the first week after the intervention [P< 0.001]
Conclusion: Needle aspiration [NA] can be applied as a first step treatment in patients with primary SP, considering its advantages
ABSTRACT
BACKGROUND AND OBJECTIVES: Leukocyte and platelet have been found to be associated with metabolic syndrome (MetS). We aimed to determine the usefulness of a novel marker named white blood cell count to mean platelet volume ratio (WMR) for predicting outcomes of non-ST elevation acute coronary syndrome (NSTE-ACS) with or without MetS. SUBJECTS AND METHODS: A total of 331 NSTE-ACS individuals (60±12.5 years, 57.4% male) were enrolled and followed for a median of 24 months. MetS was identified using the National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS: Patients were divided into two groups: high WMR (WMR≥720) and low WMR (WMR<720). Major adverse cardiovascular events (MACE) and MetS rates were significantly greater in the higher WMR group compared to those in the low WMR group (MACE: 14.3% vs. 25%, p=0.014; MetS: 50.9% vs. 75%, p<0.001). MetS was diagnosed in 62.2% of patients. MACE incidence in patients with or without MetS was comparable (p=0.737). Among MetS individuals, patients in the high WMR group had more MACE than the low WMR group (11.2% vs. 26.5%, p=0.007). However, MACE was comparable among non-MetS individuals (p=0.681). In multivariable Cox regression analysis, hazard ratios (HR) of MACE incidence for high-WMR in MetS individuals was 2.616 (95% confidence interval: 1.282–5.339, p=0.008). However, HR of MACE incidence for high WMR in non-MetS individuals was not significant. CONCLUSION: Among NSTE-ACS patients without revascularization therapy, elevated admission WMR was associated with an increased risk of developing composite MACE in MetS individuals but not in non-MetS patients.