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PubMed1991

[Surfactant substitution in very small premature infants].

In addition to the established treatment of neonatal respiratory distress syndrome by oxygen supplementation, artificial ventilation and thermoneutrality, substitution of surfactant offers a new therapeutic perspective. Up to now, either artificial mixtures of surface active components or surfactant extracts from minced animal lungs, lung lavage fluid, or human amniotic fluid have been used in controlled trials of prophylactic and rescue surfactant treatment. Meta-analysis of controlled prevention trials including about 2,400 preterm infants shows decreased mortality (21% in controls, 9.5% in infants treated with natural preparations, p less than 0.001; 17% in controls, 11% in infants treated with artificial preparations, p less than 0.001) and fewer complications of artificial ventilation (pneumothorax: 24 vs. 7.2% with natural preparations, p less than 0.001; 20 vs. 15% with artificial preparations, p less than 0.05). In rescue studies on more than 1,900 preterm infants, natural surfactant preparations decreased complications of artificial ventilation such as pulmonary interstitial emphysema and pneumothorax (32 vs. 13%, p less than 0.001). Although the immediate effect of artificial preparations is mild, the incidence of pneumothorax also could be reduced (30 vs. 19%, p less than 0.001). Mortality could be reduced by 1/3 with natural (31 vs. 20%, p less than 0.001) and with artificial preparations (23 vs. 16%, p less than 0.01). The incidence of bronchopulmonary dysplasia and intracerebral hemorrhage, however, did not drop significantly. Severe adverse side effects of this treatment seem to be rare. There are, however, potential hazards of surfactant substitution. Its use should be restricted to fully staffed and equipped neonatal intensive care units.

Combined Modality Therapy↗
PubMed1993

[The strategy for curing open pulmonary tuberculosis in a short period].

The new approaches to short-term cure of open pulmonary tuberculosis imply intensification of etiotropic therapy with the emphasis on its bactericidal potential, introduction of pneumothorax as early as the treatment week 3, initiation of early surgery. Intravenous drug administration needs breaks in its course to make mycobacteria surviving after the previous dose sensitive to the antibiotics. Such intermittent regimens are beneficial for the patients as they contribute to better tolerance, to reducing total drug dosage, to earlier discharge from hospital for outpatient after treatment. Out of 1190 patients treated for 6.5 months according to the above principles cavern healing was achieved in 1106 (93%).

Aftercare↗
PubMed1994

Diagnostic use of inadvertent pneumothorax after CT-guided percutaneous lung biopsy.

Previous studies using artificially induced pneumothorax and post-pneumothorax computed tomography (pCT) have shown that 100% of cancers that fall away from the mediastinum or chest wall are contained within the visceral pleura at that site. This patient demonstrates how an unintentional, postbiopsy pneumothorax can be used to show that a peripheral carcinoma of the lung does not invade the mediastinum.

Aged↗