BACKGROUND Fibrinolytic therapy is a time-critical intervention proven to reduce mortality and morbidity in patients with ST-elevation myocardial infarction (STEMI). Limited data exist in South Africa (SA) regarding time to fibrinolytic therapy for STEMI patients and reasons for delayed therapy. OBJECTIVES To establish the proportion of STEMI patients receiving fibrinolytic agents at Steve Bi...

BACKGROUND Pleural infection remains a significant cause of morbidity, mortality, prolonged hospital stay, and increased healthcare costs, despite advances in therapy. Twice daily intrapleural tissue plasminogen activator (tPA)/deoxyribonuclease (DNase) initiated at the time of diagnosis has been shown to significantly improve radiological outcomes and decrease the need for surgery. OBJECTIVE...

Alpha1-antitrypsin (alpha1AT) deficiency is a genetic disorder causing emphysema if serum alpha1AT levels are <570 microg/ml. We have shown that intrapleural administration of an AAV5alpha1AT vector yielded persistent therapeutic alpha1AT serum levels. Since anti-AAV2 and -AAV5 antibodies prevalent in humans may limit the use of these common serotypes in gene therapy, we screened 25 AAV vectors...

OBJECTIVE To present a case of bilateral parapneumonic effusions in a child with Pneumococcal pneumonia and bacteraemia managed aggressively with early thoracotomies. The literature from peer reviewed journals is summarized and the different management strategies are discussed. METHODS Articles and reviews from peer reviewed journals on the management of empyema in children and adults. RESU...

introduction: the precise time of using percutaneous coronary intervention (pci) after fibrinolytic therapy for maximum efficiency and minimum side effects is still undetermined. therefore, the present study was designed to compare the outcome of myocardial infarction (mi) patients who underwent surgical intervention (angiography and pci) within 48 hours of thrombolytic therapy or after that. m...

Background Despite the widespread use of fibrinolytic therapy and the numerous reports on its bleeding complications, spontaneous hemarthrosis following fibrinolytic therapy is quite rare. Case Report We describe in this report a patient with no previous history of articular disease who developed a spontaneous right knee bloody effusion following fibrinolytic therapy using rt-PA for acute ST-el...

TOPIC: Cardiothoracic Surgery TYPE: Medical Student/Resident Case Reports INTRODUCTION: A 79-year-old female status post right lower lobe (RLL) resection one month prior presented with shortness of breath, cough, and fever despite antibiotic therapy. Initial chest CT revealed empyema. Curiously, each administration intrapleural fibrinolytic therapy tissue plasminogen activator (tPA) recombinant...

BACKGROUND The role of drainage, intrapleural fibrinolytics, and/or surgery in the management of thoracic empyema is controversial. OBJECTIVES We aimed to investigate the operational practice of empyema management at our hospital. METHODS Between January 2001 and December 2008, all patients with thoracic empyema were retrieved. After exclusion of patients with malignant effusion, traumatic ...

Today, in spite of the developments in imaging methods and antibiotherapy, childhood pleural empyema is a prominent cause of morbidity and mortality. In recent years, it has been shown that there has been an increase in the frequency of pleural empyema in children, and antibiotic resistance in microorganisms causing pleural empyema has made treatment difficult. Despite the many studies investig...