China 
Africa 
Explore chapters and articles related to this topic
Pleural disease induced by drugs
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Methysergide, a serotonin antagonist, is used to treat migraine headaches. Significant adverse effects include alopecia, dermatitis, nausea, and coronary and valvular heart disease. Fibrosing mediastinitis and retroperitoneal fibrosis have been recorded in the medical literature since the 1960s. Subsequent reports have documented fibrosis of the pleura, lung, endocardium and pericardium. Pleuropulmonary complications occur in fewer than 1 per cent of patients taking the drug. Most patients present with fever, dyspnoea, weight loss and pleuritic chest pain 1–4 years after initiation of the drug.38 Pleural fluid has been described as serous to bloody with total protein concentrations of 2.0–4.4 g/dL and a low nucleated cell count.39 On pleural biopsy, there was evidence of chronic pleuritis with a mononuclear cell infiltrate with fibroblasts.
Negative pressure wound therapy: device design, indications, and the evidence supporting its use
Published in Expert Review of Medical Devices, 2021
Stephen J. Poteet, Steven A. Schulz, Stephen P. Povoski, Albert H. Chao
Negative pressure wound therapy has had broadening applications over time and continues to evolve. In 1998, Dr. Argenta described using vacuum-assisted devices as a bolster dressing for skin grafts to improve graft survival and quality in challenging anatomic locations, and additional evidence for this technique was published subsequently [8–10]. In the early 2000s, there were descriptions in the literature of the use of NPWT to manage complex (associated with tissue loss or exposure of vital structures) acute soft tissue injuries in both the adult and pediatric populations, including lower extremity injuries with exposed bone and defects from necrotizing infections [11–13]. Additional studies showed utility for NPWT devices in the management of challenging breast wounds and abdominal wall defects including the use of intra-abdominal NPWT dressings as a bridge to definitive fascial closure following trauma and salvage of abdominal dehiscence after hernia repair [14–17]. In a similar way, other practitioners utilized NPWT devices in patients with postoperative sternal wound infection and/or mediastinitis as a bridge between initial debridement and definitive closure[18]. NPWT has also been observed to improve overall survival in patients with mediastinitis following coronary artery bypass grafting when compared to conventional treatment [19,20]. Lastly, a diverse array of investigators have reported use of NPWT in the settings of orthopedic trauma, perineal and gynecologic defects, burn injury, diabetic foot wounds, and head and neck defects [21,22].
Topical negative-pressure wound therapy: emerging devices and techniques
Published in Expert Review of Medical Devices, 2020
Raymund E. Horch, Ingo Ludolph, Wibke Müller-Seubert, Katharina Zetzmann, Theresa Hauck, Andreas Arkudas, Alexander Geierlehner
Mediastinitis, postoperative sternal infection and thoracic instability are all disastrous and potentially fatal complications after open heart surgery increasing the mortality rate up to 50%. NPWT as first-line therapy has shown to reduce early reinfection rates, as well as the numbers of late chronic sternal infections [70]. NPWT is believed to stabilize the thoracic cage after the removal of an infected sternum and improve patients' recovery from systemic and respiratory complications [71,72]. In conjunction with tissue transfer procedures, NPWT showed adequate infection control hence preventing sepsis and hemodynamic instability [73,74]. Negative-pressure therapy applied to sternal wounds prior to tissue transfer can reduce the length of hospital stay, mortality, and flap failure rates compared to conventional wound dressings [75–78]. However, post-sternotomy osteomyelitis still requires adequate staged debridement and systemic antibiotic therapy in addition to NPWT [74–76].
Recent advancements in the minimally invasive management of esophageal perforation, leaks, and fistulae
Published in Expert Review of Medical Devices, 2019
Shirin Siddiqi, Dean P. Schraufnagel, Hafiz Umair Siddiqui, Michael J. Javorski, Adam Mace, Abdulrhman S. Elnaggar, Haytham Elgharably, Patrick R. Vargo, Robert Steffen, Saad M. Hasan, Siva Raja
Factors that influence the incidence of esophageal anastomotic leak include ischemia, the type of anastomosis, location of anastomosis (cervical or intrathoracic), anastomotic technique (hand sewn, stapled or hybrid), type of conduit (stomach, colon or small intestine) and location of the conduit (orthotopic versus heterotopic) [2–4]. Advance age, male gender, emergency surgery, history of smoking or alcohol abuse, obesity, diabetes, renal dysfunction, and cardiovascular disease increase the risk of anastomotic leaks [72]. The clinical presentation can vary from local wound infection, neck or chest pain, vomiting, pneumothorax or subcutaneous emphysema to empyema, mediastinitis, peritonitis or septicemia [11].