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1.
Rev. patol. respir ; 22(1): 9-13, ene.-mar. 2019. ilus, tab
Article in Spanish | IBECS | ID: ibc-185691

ABSTRACT

Introducción. El derrame pleural es una patología muy frecuente que requiere técnicas invasivas para el diagnóstico etiológico. La videotoracoscopia médica (VM), bajo sedación y con anestesia local, consiste en la exploración de la cavidad pleural introduciendo una óptica a través de la pared torácica, se puede realizar en todos los pacientes permitiendo una exploración de la pleura y con menos limitaciones que otros procedimientos. Métodos. Se trata de un estudio retrospectivo y descriptivo, que analiza los pacientes con derrame pleural tipo exudado a los que se les realizó una TM, en un hospital de tercer nivel. El periodo de estudio es entre enero de 2014 y diciembre de 2015. Criterios de inclusión: pacientes con derrame pleural tipo exudado sin causa conocida, con al menos una toracocentesis previa y una biopsia pleural cerrada. Un total de 144 pacientes cumplieron criterios de inclusión. Se analizaron: edad, sexo, neoplasia previa, cantidad de líquido drenado, histología, pleurodesis con talco, colocación de catéter permanente, complicaciones y mortalidad en 30 días. Resultados. La edad media de los pacientes es de 69.29 años (± 11.38). La mayoría son hombres (70,83%). Se obtuvo diagnóstico en 134 (95.13%), y se realizó pleurodesis en 73 (50.69%). Las neoplasias fueron la causa más frecuente de derrame, en un total de 99 pacientes; seguido de la hiperplasia mesotelial y la tuberculosis, en 15 y 12 pacientes respectivamente. No se observó mortalidad perioperatoria. Conclusión. En nuestro estudio la TM es una técnica eficaz y segura para el diagnóstico y tratamiento del derrame pleural tipo exudado


Introduction. Pleural effusion is a very frequent disease requiring invasive techniques for the etiologic diagnoses. Pleuroscopy, performed with sedation and local anesthesia, consists in the exploration of the pleural cavity by introducing an optic through the chest wall, and it can be done in every patient, allowing a pleural exploration with fewer complications than other proceedings. Methods. Retrospective study of patients with exudative pleural effusion with a pleuroscopy performed in a third level hospital, from January 2014 and December 2015. Inclusion criteria were patients with exudative pleural effusion of unknown cause, with at least one thoracentesis performed and a pleural biopsy. A total of 144 patients met inclusion criteria. Data analyzed were age, gender, history of previous malignancy, amount of drained pleural liquid, histology, pleurodesis, permanent catheter drainage, complications and 30 days mortality. Results. Mean age was 69.29 years (± 11.38). Most of the patients were male (70,83%). A diagnosis was achieved in 134 (95.13%) of cases, and pleurodesis was performed in 73 (50.69%) patients. Malignancy was the most frequent cause of pleural effusion, in a total number of 99 patients; followed by mesothelium hyperplasia and tuberculosis, in 15 and 12 patients respectively. No perioperative mortality was observed. Conclusion. In this study, the medical pleuroscopy has demostrated to be safe and effective in the diagnoses and treatmetn of patients with exudative pleural effusion


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Pleural Effusion/diagnosis , Pleural Effusion/surgery , Thoracoscopy/methods , Treatment Outcome , Retrospective Studies , Pleural Effusion/etiology
2.
Rev Med Suisse ; 9(370): 199-202, 2013 Jan 23.
Article in French | MEDLINE | ID: mdl-23413650

ABSTRACT

The knowledge in internal medicine is constantly and so rapidly evolving that practices have to be updated and adjusted to recent scientific rules, in order to improve quality and efficiency in the day to day activities. Residents in the Service of internal medicine of the Lausanne University present several relevant papers published in 2012, whose results are susceptible to change the daily hospital practices. From modest impacts to real revolution, a variety of subjects are discussed in the perspective of evidence based medicine.


Subject(s)
Cardiovascular Diseases/therapy , Lung Diseases/therapy , Cardiovascular Diseases/diagnosis , Critical Pathways , Humans , Internal Medicine , Pyelonephritis/drug therapy , Sepsis/therapy , Status Epilepticus/drug therapy , Stroke/prevention & control
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