PubMed Health⌕ Search

Biomedical subjects

S S Hurwitz

Publications and source records attributed to S S Hurwitz.

At least 19 recordsLinked to original sources
PubMed1995

Elective pneumonectomy for benign lung disease: modern-day mortality and morbidity.

This retrospective study of elective pneumonectomy for complicated inflammatory lung disease was done to define modern-day mortality and morbidity. One hundred twenty-four patients received elective pneumonectomy. Patient ages ranged from 6 months to 71 years. Past, recurrent, or new pulmonary tuberculosis was present in 107 patients (86.3%). Clinical presentation involved recurrent infections or severe suppurative sequelae (abscess, empyema). Forty-seven patients had chronic hemoptysis and 25 patients had past or recent massive hemoptysis (> 600 ml of hemoptysis fluid within 24 hours). Nutritional deficiencies were common. One hundred six patients (85.5%) had end-stage destroyed lungs. Evaluative bronchoscopy showed inflammatory endobronchial changes in 106 patients (85.5%), bronchial strictures in 4, and indolent endobronchial tumor in 2. Lung separation was by double-lumen tube in 96 patients, single lung-single tube in 6, bronchus blocker in 6, and prone posture in 9. Extrapleural pneumonectomy was done in 83 patients (66.9%). Fifty-seven of these procedures were left sided and 26 were right sided. Standard transpleural pneumonectomy was done in 41 patients (33.1%): 30 left sided and 11 right sided. Nine pneumonectomies were conducted with the patient in the prone position. Four patients had completion pneumonectomy. Hospital mortality was three deaths (2.4%). Morbidity included postpneumonectomy empyema in 19 patients (15.3%). Seven postoperative bronchopleural fistulas occurred. Empyema in most patients was managed by open pleural drainage (thoracostoma) and later space closure. Pneumonectomy proved effective therapy with low mortality but postpneumonectomy empyema posed serious morbidity.

Adolescent↗
PubMed1984

Empyema thoracis--a prospective study on 73 patients.

A prospective study of empyema thoracis was conducted on 73 consecutive patients. The pathogenesis and bacteriological features of the condition and its clinical course and management are recorded and analysed. Pleural cultures revealed that the predominant pathogen was Staphylococcus aureus. Fifty of 65 patients had mixed isolates on pleural culture, with a 4:1 ratio of aerobes to anaerobes. Twenty per cent of the patients had anaerobic empyemas. The underlying lesion was parenchymal lung disease in 37 cases and an infected hemopneumothorax following penetrating injury in 26. The remaining 10 patients developed empyema after pulmonary resection. The empyema resolved completely in 81% of the patients.

Adolescent↗
PubMed1984

Adult respiratory distress syndrome associated with miliary tuberculosis. A case report.

In this report we describe a patient with miliary tuberculosis who presented with the adult respiratory distress syndrome. The diagnostic problems are discussed and the value of transbronchial lung biopsy is emphasized. Our experience with this patient stresses the need for maintaining a high index of suspicion for treatable causes of adult respiratory distress syndrome.

Adult↗
PubMed1983

Superior vena-caval obstruction in urban blacks. A report of 82 cases.

Eighty-two patients with superior vena-caval obstruction (SVCO) were studied retrospectively. Carcinoma of the bronchus was responsible for the syndrome in 60 patients; of the remaining 22 patients, 7 had mediastinal lymphomas, 5 retrosternal goitres, 4 oesophageal cancer, 3 vascular aneurysms, 2 thymic tumours, and 1 granulomatous mediastinitis. Rigid bronchoscopy, scalene node biopsy or aspiration, cervical mediastinoscopy, anterior mediastinotomy, transthoracic needle biopsy and median sternotomy were the procedures used to make a definitive diagnosis. It is noteworthy that in 9 of the 82 patients malignant disease was not the cause of the SVCO. Seven of the remaining 73 patients had lymphoma causing compression of the superior vena cava. A significant proportion (19.5%) of urban Blacks with SVCO had causes other than hopeless bronchogenic carcinoma as the basis for their condition.

Adolescent↗
PubMed1983

Taurolidine instillation as therapy for empyema thoracis. A prospective study of 50 patients.

Fifty patients with chronic empyema thoracis, without bronchopleural fistula, were treated by drainage and twice-daily instillations of 2% taurolidine (Taurolin; Continental Ethicals) for 14 days. No antibiotics were used. Forty-three patients completed the treatment and 7 were withdrawn from the trial, 3 because of evidence of bronchopleural fistula and 1 each because of pain during instillation, associated chest-wall cellulitis, an unexplained, acute epilepsy-like episode during instillation, and inadvertent administration of antibiotics. All 43 patients who completed the trial showed an excellent clinical response with control of the local and systemic toxic effects of sepsis. A rapid falling-off in the volume and purulence of pleural drainage fluid was noted. Twenty-four of the 43 patients (55,8%) were rendered bacteriologically sterile by the treatment. Instillation of 2% taurolidine was therefore an effective form of monotherapy in cases of chronic empyema thoracis without bronchopleural fistula.

Adolescent↗
PubMed1983

Massive hemoptysis. Review of 123 cases.

Case histories of 123 patients with massive hemoptysis were reviewed. The causes of hemorrhage were active pulmonary tuberculosis (47), bronchiectasis (37), chronic necrotizing pneumonia (11), lung abscess (six), lung cancer (six), bronchovascular fistula (five), primary pulmonary fungal infection (four), and miscellaneous (seven). Conservative management was used in 66 patients, with 21 deaths (31.8%). Surgical management was used in 34 patients, with six deaths (17.6%). Endobronchial iced saline lavage was used in 23 patients, with one death. All patients treated by lavage stopped bleeding, and further therapy, either surgical (five) or medical (18), was given as appropriate. The early control of tracheobronchial hemorrhage by endoscopic means is an effective though transitory holding procedure. The unpredictability of massive hemoptysis is underscored by eight deaths from sudden, engulfing hemorrhage in seemingly stable patients awaiting endoscopy or operation.

Adolescent↗
PubMed1982

Giant chondromatous hamartoma of the first rib. A case report.

Primary rib tumours uncommon in children and their diagnosis and management pose unique problems. The majority of these growths arise from cartilage and are malignant. Chondrosarcoma of varying histological gradations is the common tumour. The distinction between benign and malignant tumours is seldom clear-cut. We describe the presentation, management and pathological features in a child with a gaint chondromatous hamartoma of the first rib.

Adolescent↗
PubMed1982

Early decortication for the disorganized pleural space.

Early decortication is advocated for the disorganized pleural space. This series reviews 85 patients operated on for haemothorax and empyema as a result of penetrating chest trauma (61 cases), blunt chest trauma (2), post-pneumonic empyema (15), tuberculous empyema (4) and chronic pneumothorax (2). The aetiology, surgical technique and results are discussed. In 83% of cases there was complete clinical recovery and radiological re-expansion of the affected lung.

Adolescent↗
PubMed1982

Empyema and the urban black.

Fifty consecutive Black patients with thoracic empyema were studied retrospectively. The causes of the empyema were penetrating thoracic trauma (27 cases), lung abscess (10), post-aspiration pulmonary disease (4), and pulmonary and pleural tuberculosis (4); a miscellaneous group of 5 patients had empyema complicating an infected pulmonary cyst, a hepatic amoebic abscess, necrotic pulmonary lymphoma, thoracic actinomycosis and blunt thoracic trauma. Fourteen patients had bronchopleural fistulas. Patients were treated by closed-tube thoracostomy drainage alone (6 cases), rib resection and drainage (36), pulmonary decortication alone (3), and pulmonary decortication in association with a thoracic operative procedure (5). Results of treatment were good in the majority of patients with empyema (41), in 7 cases results were poor, and 2 patients died. Serious underlying pulmonary disease was responsible for treatment failure. Empyema in the urban Black is associated with prolonged morbidity and severe social consequences.

Adolescent↗
PubMed1980

Management of massive haemoptysis with the rigid bronchoscope and cold saline lavage.

Twelve successive patients with massive haemoptysis were treated by emergency rigid bronchoscopy and lavage of the bleeding lung with cold saline. All patients stopped bleeding during the procedure and all blood and clot was evacuated from the accessible airways. The bleeding source was localised to a lobe in seven cases, and lateralised in the remaining five patients. Five patients had a second haemorrhage during that hospital stay and cold saline lavage again terminated it. Further therapy, either surgical or medical was based on information obtained during the respite from haemorrhage achieved with this technique. There was no hospital mortality in the series.

Adult↗