Disease relevance of Pleurodesis

• DESIGN: A prospective comparison of cytologic examinations and pleural biopsy results, survival, and response to chemical pleurodesis with tetracycline in patients with normal-pH (7.30 or greater) and low-pH (less than 7.30) malignant pleural effusions [1].
• Spontaneous pneumothorax: comparison of simple drainage, talc pleurodesis, and tetracycline pleurodesis [2].
• Pleurodesis for refractory pleural effusion in systemic lupus erythematosus [3].
• Acute respiratory failure after pleurodesis with doxycycline [4].
• Chest pain was a common complaint after minocycline pleurodesis, but the total doses of requested analgesics were comparable in both groups [5].

High impact information on Pleurodesis

• Low-dose bleomycin (30 mg) is as effective as the usual dose of bleomycin (60 mg) for pleurodesis [6].
• PURPOSE: To compare bleomycin pleurodesis and immunotherapy with intrapleural interferon alfa-2b (IFN) in the palliation of malignant pleural effusions [7].
• After the operation, patients were randomly assigned to additional minocycline pleurodesis (103 patients) or to observation (99 patients) [8].
• We conclude that increased pleural fibrinolytic activity is associated with failure of pleurodesis, despite significant inhibitory activity of PAI in all groups [9].
• CONCLUSIONS: TGFbeta2 can induce effective pleurodesis and remains effective in the presence of high dose parenteral corticosteroids [10].

Chemical compound and disease context of Pleurodesis

• Chemical pleurodesis in malignant pleural effusions: a randomised prospective study of mepacrine versus bleomycin [11].
• Prospective randomized trial of silver nitrate vs talc slurry in pleurodesis for symptomatic malignant pleural effusions [12].
• Effects of additional minocycline pleurodesis after thoracoscopic procedures for primary spontaneous pneumothorax [5].
• Tamoxifen therapy and tetracycline pleurodesis were successful in stopping the progressive course and controlling the chylothorax [13].
• STUDY OBJECTIVE: Expert consensus recommends testing pleural fluid for pH to assist the selection of patients with malignant pleural effusions for pleurodesis [14].

Biological context of Pleurodesis

• This report presents the cases of three patients with serious zinc chloride inhalation and ARDS, the last of whom survived after prolonged intensive care, videothoracoscopic excision of emphysema bullae, and recurrent chemical pleurodesis [15].
• Disruption of the thoracic duct occurred with the high intrathoracic pressures generated by the Valsalva maneuver used by the patient during labor to "push." No evidence of other trauma or malignancy were found and the patient did well after use of total parenteral nutrition, thoracotomy with thoracic duct ligation, and pleurodesis [16].
• To obtain further insight into the inflammatory process that causes pleurodesis, the cellular kinetics in the pleural space after the administration of talc was studied, along with its relation to chemokine concentrations in the pleural fluid [17].
• In view of the high bioavailability and the large doses used for pleural sclerosing (pleurodesis) in patients, neurological disease and psychiatric disturbances that predispose to CNS toxicity should be considered as contraindications to intrapleural quinacrine [18].
• A case of intrathoracic extramedullary hematopoiesis with massive pleural effusion: successful pleurodesis with intrapleural minocycline [19].

Anatomical context of Pleurodesis

• There was a spectrum of results with tetracycline, but with the concentrated tetracycline solution (group D) histologic examination showed uniform pleurodesis and thickening of the pleura [20].
• In conclusion, the present model describes the establishment of pleurodesis by aluminum hydroxide, which thwarts the normal chest wall mechanical profile without inducing any changes in the underlying lungs [21].
• This study evaluated the extracellular matrix (collagen and elastic fibers) in pleurodesis induced by intrapleural talc (TL) or silver nitrate (SN) [22].
• Mechanism of tetracycline-hydrochloride-induced pleurodesis. Tetracycline-hydrochloride-stimulated mesothelial cells produce a growth-factor-like activity for fibroblasts [23].

Associations of Pleurodesis with chemical compounds

• MAIN RESULTS: The 20 patients with low-pH malignant effusions had a significantly greater positivity on initial pleural fluid cytologic evaluation, a shorter mean survival, and a poorer response to tetracycline pleurodesis compared with 40 patients with normal-pH malignant effusions [1].
• Since 1983 intrathoracic instillation of the anti-malaria drug mepacrine has been used to achieve pleurodesis [11].
• Immunosuppressive treatment, diet, and underwater seal drainage led to a diminished volume of pleural fluid and pericardial fluid and to a diminished concentration of triglyceride in them; pleurodesis with tetracycline was then performed [24].
• Chemical pleurodesis with mitoxantrone in the management of malignant effusions [25].
• They can be divided into 2 major groups: systemic therapy (immunosuppressive therapy, plasmapheresis, and intravenous immunoglobulin) and local therapy (intrapleural steroid injections, pleurodesis with talc or tetracycline, and pleurectomy) [26].

Gene context of Pleurodesis

• Furthermore, MMP-9 levels were variable; in fact, in some patients they were high at the beginning of treatment, in others they increased a few days after pleurodesis induction [27].
• The levels of u-PA in patients who did not respond to chemical pleurodesis were significantly higher than those who had complete response (p=0.0001) [28].
• RESULTS: At day 14, the pleurodesis score of the TGF-beta2 group (7.7+/-0.6) was similar to that of the talc (7.0+/-1.7) group and significantly higher than that of the bleomycin group (3.3+/-2.3; P < 0.05) [29].
• The aims of the present study were to compare: (i) the effectiveness of TGF-beta2, talc and bleomycin in producing pleurodesis in sheep; (ii) the acute side-effects and systemic TGF-beta levels following the intrapleural administration of these agents; and (iii) histological changes after intrapleural injections of these agents [29].
• Intrapleural instillation of TNF appears to be an effective method for achieving pleurodesis with relatively few side-effects and can be successful even after other methods have failed [30].

Analytical, diagnostic and therapeutic context of Pleurodesis

• Prospective randomized comparison of thoracoscopic talc poudrage under local anesthesia versus bleomycin instillation for pleurodesis in malignant pleural effusions [31].
• Tube thoracostomy with chemical pleurodesis using doxycycline or bleomycin is the mainstay of current treatment and is about 85% effective [32].
• The recurrence rate of open thoracotomy with pleural abrasion was 12.5% (3 of 24 episodes), which was not lower than that of thoracostomy tube drainage with chemical pleurodesis using tetracycline (recurrence rate, 18.8%) (p > 0.5) [33].
• When pleurodesis is attempted in rabbits with intrapleural doxycycline, the insertion of a chest tube will prevent hemothorax and lead to a better pleurodesis [34].
• RESULTS: The mean macroscopic pleurodesis score of the diclofenac group was 2.16 +/- 0.40 compared with 2.83 +/- 0.40 in the control group (p = .027) [35].

References