Patients with acquired immune deficiency syndrome (AIDS) do not frequently have pleural complications. However, pneumothorax is a troublesome complication of patients with AIDS. At some medical centres, more than 50% of patients with spontaneous pneumothorax have AIDS. Most patients with spontaneous pneumothorax and AIDS have Pneumocystis carinii infection and necrotic subpleural blebs. The pne...

STUDY OBJECTIVE The emergency management of primary spontaneous pneumothorax is controversial. This evidence-based emergency medicine review evaluates the existing evidence about the efficacy and safety of needle aspiration in comparison to tube thoracostomy for management of primary spontaneous pneumothorax. METHODS We searched MEDLINE, EMBASE, the Cochrane Library, and other databases. We s...

Study objectives: To evaluate the clinical safety, efficacy, and cost of a small indwelling pleural catheter (7F, Turkel Safety Thoracentesis System [Sherwood, Davis, and Geek; St. Louis]) vs repeated needle thoracentesis or closed tube thoracostomy as a means to drain a large-volume pleural effusion. Setting: Inpatients in a tertiary care university teaching hospital in urban Chicago. Design: ...

Background: Primary spontaneous pneumothorax occurs in young, healthy populations, usually males, in the absence of lung disease. Secondary spontaneous pneumothorax occurs in older adults who have underlying lung disease such as COPD, emphysema, or a malignant growth. The estimated incidence of spontaneous pneumothorax is 7.4 to 18 per 100,000 for males and 1.2 to 6 per 100,000 in females. Trad...

OBJECTIVE A prospective randomized study was conducted in order to analyze the role of fibrinolytics in the treatment of complicated parapneumonic effusion. METHODS From 2001 to 2004, 127 consecutive patients were managed for thoracic empyema. In all cases the cause was bacterial pneumonia. Seventy patients were managed with sole tube thoracostomy (group A) and 57 with combination of tube tho...