Percutaneous transthoracic needle aspiration, lavage and instillation of clindamycin-gentamycin in peripheral pyogenic lung abscess

Lung abscess are defined as localized suppurative necrotizing collection occurring within the pulmonary parenchyma. Some authors emphasized image-guided aspiration of lung abscess before antibiotics use in order to identify the pathogen. Antibiotic lavage is currently widely used in the treatment of patients with peritonitis, but not used previously in lung abscesses. Is to asses the role of percutaneous transthoracic needle aspiration, lavage and instillation of clindamycin-gentamycin on the treatment of peripheral pyogenic lung abscess. Twenty-six patients with peripheral pyogenic lung abscess are included in this study and classified into two groups. Group I received systemic empirical antibiotic, remod-ulated after the result of sputum culture and sensitivity. While group II underwent ultrasound guided percutaneous transthoracic needle aspiration, lavage and local instillation of antibiotics [clindamycin-gentamycin] associated with receiving systemic empirical parentral antibiotics, that were remodulated after the result of aspiration culture and sensitivity. Chest X-ray and chest ultrasound were done pre, post and after intervention by one week and before discharge. There was a statistically significant difference between group I and II as regard duration of systemic antibiotic use, duration of hospital stay, duration of radiological improvement, and size of abscess after intervention. Moreover complications occurred in group I were higher than in group II. Succeeded patients [according to clinical and radiological improvement of lung abscess] were more obvious among group II than group I. Aspirates culture and sensitivity revealed gram negative bacteria and anaerobic microorganisms, which are sensitive to local instillation of antibiotics [clindamycin-gentamycin]. Percutaneous aspiration of peripheral lung abscess has an accurate determination of the causative organisms inside the abscess. The resolution of the abscesses clinically and radiolog-ically was hastened by needle aspiration, lavage and instillation of clindamycin-gentamycin. Early intervention can improve symptoms, decrease morbidity and complications

effect of weight reduction versus reduction mammoplasty on the pulmonary function parameters and leptin level in obese-macromazia subjects

Background: Obese subjects with breast hypertrophy are suffering not only from cosmetic aspects but also negatively affecting the quality of their life so, the aim of this study was to evaluate the effect of weight reduction versus reduction-mammoplasty on pulmonary function parameters and serum-leptin level

Subjects and methods: Forty females with obesity and macromazia were enrolled into the study. They were classified into two groups, group [1] twenty females who were seeking reduction mammoplasty, and group [2] twenty females who refused surgery and were seeking diet-control regimen. Both groups were matched as regards age and body mass index [BMI]. Pulmonary function parameters [FVC%, FEV[1]%, FEV[1]/FVC and PEFR%] and serum leptin level were measured before starting the intervention in both groups and after starting it by three months

Results: Reduction mammoplasty significantly increases FVC% with non-significant improvement regarding BMI and serum leptin level. On the other hand, diet control regimen improves FEV[1]%, FVC%, FEV[1]/FVC and PEFR% with a significant reduction of BMI and serum leptin levels

Conclusion: Reduction mammoplasty can play a role in improving restrictive pulmonary function parameters while diet control regimen has a more significant improvement in both obstructive and restrictive pulmonary function parameters and in the reduction of BMI and serum leptin level in obese subjects with macromazia