The Indian journal of chest diseases & allied sciences
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To assess the role of multidetector spiral CT in patients with blunt chest trauma. ⋯ Multidetector computed tomogram is the modality of choice for rapid assessment of emergency chest trauma patients.
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Sepsis is the leading cause of hospital admissions, morbidity and mortality. Treating sepsis is expensive resulting in consumption of major health care resources. ⋯ Further, it is thought that combination of these strategies in the form of "bundles" can further improve the outcome. Concerted utilisation of the "sepsis bundles" is likely to improve outcome of this serious disorder.
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Indian J Chest Dis Allied Sci · Oct 2008
Derivation of a prognostic equation to predict in-hospital mortality and requirement of invasive mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease.
Predicting in-hospital mortality and formulating a scoring system derived from predictors of mortality may aid prognostication. ⋯ Serum creatinine and sodium at admission are independent predictors of mortality for patients admitted with AECOPD. The equation derived from these two variables is a simple and useful method for predicting outcome.
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This review will focus on anatomical and aetiologic factors as well as the conservative and operative therapy of chylothorax. ⋯ A prompt diagnosis is needed to start treatment of the underlying cause. Treatment can be divided into conservative and surgical interventions. There are no evidence-based guidelines to assist in the management of this disease. Initial conservative therapy includes intercostal decompression of the pleural effusion along with nutritional support in the form of total parenteral nutrition, and reduction of chylous formation with somatostatin. Surgical interventions include thoracic duct ligation, pleuroperitoneal shunt and percutaneous embolisation.
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Indian J Chest Dis Allied Sci · Jul 2008
ReviewIntrapleural fibrinolytic therapy in complicated parapneumonic effusion and empyema: present status.
Pneumonia remains one of the commonest community- and hospital-acquired infection despite the advent of potent antimicrobial agents. A significant number of patients with pneumonia develop parapneumonic effusions. The parapneumonic effusion may be "simple" consisting of free-flowing, clear exudative fluid which almost resolves completely with antibiotics alone. ⋯ Intrapleural instillation of fibrinolytic agents has been found to be a useful adjunctive therapy in various small uncontrolled and randomised trials. After a recent and first large multicentre trial which showed that this therapy does not have any significant effect in reducing mortality and need for surgery in patients with pleural infection, the role of intrapleural fibrinolytics has become more controversial. In view of this, there is a need to re-define its role especially in the developing countries.