Comparing Pleural Fluid Removal Volume and Oxygenation Change in Therapeutic Thoracentesis: Is There a Relationship?

Background: During therapeutic thoracentesis (TT), pleural fluid is typically drained to completion. Fluid removal improves oxygenation, and the amount of fluid removed is directly associated with the risk of serious complications. A relationship between the amount of fluid removed during TT and the change in oxygenation has not been found in the literature. A direct relationship was hypothesized in this study. Differences in the change in oxygenation between sexes, age, and pre-procedure oxygen support were secondarily hypothesized. This information would assist in the guidance of future TT protocols. Methods: Subjects of this retrospective cohort study were males and females aged 26-74 years. Of the 166 patients who underwent inpatient TT between February 4, 2020, and December 10, 2022, at Berkshire Medical Center (BMC), 16 met the inclusion criteria. They were identified using CPT codes in the electronic medical record (EMR). Demographics, amount of fluid removed, and type of oxygen support were recorded. Pre and post-TT arterial oxygen partial pressure (PaO2) and fraction of inspired oxygen (FiO2) values were collected to calculate the P/F, a metric for oxygenation status. T-test and correlation coefficient were calculated to analyze the change in the P/F ratio versus the amount of pleural fluid removed. Correlation coefficients or ANOVA were calculated to compare oxygenation changes to sex, age, and supplemental oxygen types. Results: There was no statistical significance (p=0.87) in the linear relationship between the amount of pleural fluid drained (mean=660 mL, range=150-1500 mL) and the change in oxygenation (mean=162, range=34-300). There were no statistically significant differences in oxygenation changes between sex (p=0.60), age (p=0.81), or types of oxygen support pre-procedure (p=0.07). There was a statistically significant difference in pre and post-procedure P/F ratio (p\u3c0.001). Discussion: We found a statistically significant change in oxygenation before and after TT, with no evidence of a direct relationship between amount of fluid removed and improvement in oxygenation. There were no complications when removing up to 1500 mL of fluid. A protocol that halts pleural fluid drainage once it is complete or when the amount removed reaches 1500 mL, whichever occurs first, may be optimal

Promoting Optimism: An Interprofessional Approach to Treating Long Covid-19 via Telehealth

A poster entitled: Promoting Optimism: An Interprofessional Approach to Treating Long Covid-19 via Telehealth The objective is to approach a case of chronic illness using an interprofessional team in order to collaboratively and positively address the holistic needs of a patient as a result of long-haul COVID-19https://dune.une.edu/cecespring2022/1008/thumbnail.jp

Mapping current research trends on neuromuscular risk factors of non-contact ACL injury.

The aim of this systematic review was (i) to identify neuromuscular markers that have been predictive of a primary non-contact ACL injury, (ii) to assess whether proposed risk factors have been supported or refuted in the literature from cohort and case-control studies, and (iii) to reflect on the body of research that aims at developing field based tools to assess risk through an association with these risk factors. Electronic searches were undertaken, of PubMed, SCOPUS, Web of Science, CINAHL and SPORTDiscus examining neuromuscular risk factors associated with ACL injury published between January 1990 and July 2015. The evidence supporting neuromuscular risk factors of ACL injury is limited where only 4 prospective cohort studies were found. Three of which looked into muscular capacity and one looked into muscular activation patterns but none of the studies found strong evidence of how muscular capacity or muscular activation deficits are a risk factor for a primary non-contact ACL injury. A number of factors associated to neural control and muscular capacity have been suggested to be related to non-contact ACL injury risk but the level of evidence supporting these risk factors remains often elusive, leaving researchers and practitioners uncertain when developing evidence-based injury prevention programs

Incidental detection of benign metastasizing leiomyoma in asymptomatic female

Benign metastasizing leiomyoma (BML) is a rare finding of histologically benign smooth muscle tumors in extrauterine locations, most commonly the lungs. We report a case of BML found incidentally on pre-operative imaging in a 42-year-old patient. BML is found in premenopausal women with a history of leiomyoma and, often, hysterectomy. As in our case, the metastatic pulmonary nodules are not hypermetabolic on 18F-fluorodeoxyglucose Positron emission tomography/computed tomography. BML may be clinically malignant or asymptomatic. Since the imaging appearance of BML simulates metastatic disease of more malignant etiology, awareness of its multimodality imaging appearance and presentation can aid in diagnosis