Post-Biopsy Pneumothorax Incidence in Patients Treated with Biosentry™ Plug Device.

INTRODUCTION: This study aimed to determine if the Biosentry™ Plug Device (BPD), a prophylactic sealant used to prevent pneumothorax after lung biopsies, reduced post-lung biopsy pneumothorax rates, and other complications compared to no device utilization. METHODS: This single institution, retrospective cohort study included patients who received a lung biopsy in the Department of Interventional Radiology from May 1, 2015 to August 31, 2017. Data such as sex, race, ethnicity, chronic obstructive pulmonary disease status, degree of lung bullae if present, smoking status, and use of BPD were recorded. Decisions to use BPD were based on operator preference. A chi squared analysis was used with a p value greater than 0.05 considered significant. RESULTS: The study included 521 patients who underwent a lung biopsy during the study timeframe. Of these, 74 (14.2%) received the BPD, while 447 (85.8%) did not. One-hundred ninety (36.4%) had a pneumothorax within one month of the lung biopsy. Of the total 190 that experienced pneumothorax, 36.7% of non-BPD biopsies resulted in pneumothorax, while 35.1% of BPD biopsies resulted in pneumothorax (p value = 0.7970; degrees of freedom = 1). CONCLUSIONS: These findings indicated that BPD may not reduce pneumothorax incidence nor limit the severity of complications in patients.

Assessing societal impacts when planning restoration of large alluvial rivers: a case study of the Sacramento River project, California.

Studies have shown that ecological restoration projects are more likely to gain public support if they simultaneously increase important human services that natural resources provide to people. River restoration projects have the potential to influence many of the societal functions (e.g., flood control, water quality) that rivers provide, yet most projects fail to consider this in a comprehensive manner. Most river restoration projects also fail to take into account opportunities for revitalization of large-scale river processes, focusing instead on opportunities presented at individual parcels. In an effort to avoid these pitfalls while planning restoration of the Sacramento River, we conducted a set of coordinated studies to evaluate societal impacts of alternative restoration actions over a large geographic area. Our studies were designed to identify restoration actions that offer benefits to both society and the ecosystem and to meet the information needs of agency planning teams focusing on the area. We worked with local partners and public stakeholders to design and implement studies that assessed the effects of alternative restoration actions on flooding and erosion patterns, socioeconomics, cultural resources, and public access and recreation. We found that by explicitly and scientifically melding societal and ecosystem perspectives, it was possible to identify restoration actions that simultaneously improve both ecosystem health and the services (e.g., flood protection and recreation) that the Sacramento River and its floodplain provide to people. Further, we found that by directly engaging with local stakeholders to formulate, implement, and interpret the studies, we were able to develop a high level of trust that ultimately translated into widespread support for the project.