Author: David Arnold

  • Journal Club December 2022

    Journal Club December 2022

    Control of bleeding from intercostal artery laceration.  Sabath BF, et al. Respir Med Case Rep. PMID: 36440304  A case report and management approach for the uncommon (less than 1% of procedures) but important complication of bleeding at thoracoscopy. The authors provide a review of the literature and a video of successful control of bleeding using extra-thoracic…

  • Journal Club November 2022

    Journal Club November 2022

    Subcutaneous octreotide therapy for malignant pleural effusion after pleurodesis with talc powder: a placebo-controlled, triple-blind, randomized trial. Ershadi R, et al. Support Care Cancer. PMID: 36357795 A small but novel RCT from Iran assessing the potential benefit of giving octreotide to patients prior to the administration of talc pleurodesis. The theory being that octreotide might have…

  • Journal Club October 2022

    Journal Club October 2022

    The Biological Role of Pleural Fluid PAI-1 and Sonographic Septations in Pleural Infection: Analysis of a Prospectively Collected Clinical Outcome Study.  Bedawi EO, et al. Am J Respir Crit Care Med. PMID: 36191254 This paper represents a really important advance in pleural diagnostics and our understanding of pleural infection pathophysiology. The investigators analysed pleural fluid samples…

  • Journal Club September 2022

    Journal Club September 2022

    A feasibility randomised trial comparing therapeutic thoracentesis to chest tube insertion for the management of pleural infection: results from the ACTion trial.  Arnold DT, et al. BMC Pulm Med. 2022 PMID: 36042460  A randomised feasibility trial comparing chest tube insertion (standard care) to therapeutic thoracentesis (intervention). The COVID-19 pandemic had a substantial impact on recruitment with…

  • Journal Club August 2022

    Journal Club August 2022

    Birt-Hogg-Dubé syndrome in apparent primary spontaneous pneumothorax patients; results and recommendations for clinical practice.  Sriram JD, et al. BMC Pulm Med. PMID: 36028846 This cohort from the Netherlands examined the prevalence of BHD in patients who had previously presented with apparent primary spontaneous pneumothorax to their centre. 475 apparent spontaneous pneumothorax patients met their inclusion criteria…

  • Journal Club July 2022

    Journal Club July 2022

    Australasian Malignant PLeural Effusion (AMPLE)-3 trial: study protocol for a multi-centre randomised study comparing indwelling pleural catheter (±talc pleurodesis) versus video-assisted thoracoscopic surgery for management of malignant pleural effusion.  Fitzgerald DB, et al. Trials. The protocol for the third in the series of AMPLE trials of malignant pleural disease. This trial aims to establish the…

  • Journal Club June 2022

    Journal Club June 2022

    Ipsilateral and contralateral hemidiaphragm dynamics in symptomatic pleural effusion: The 2nd PLeural Effusion And Symptom Evaluation (PLEASE-2) Study.  Fitzgerald DB, et al. Respirology. PMID: 35672271 This elegant physiology study from Australia follows on from the PLEASE 1 study which focused on the ipsilateral diaphragm movement in patients with pleural effusions and the impact of thoracentesis. PLEASE-2…

  • Journal Club May 2022

    Journal Club May 2022

    Lymphocyte predominance in blood, pleural fluid, and tumour stroma; a prognostic marker in pleural mesothelioma.  De Fonseka D, et al. BMC Pulm Med. PMID: 35501755  Numerous studies have demonstrated that a higher neutrophil to lymphocyte ratio infers a more aggressive tumour and shorter overall survival. This study of 184 patient with mesothelioma diagnosed at thoracoscopy has…

  • Journal Club April 2022

    Journal Club April 2022

    Silver Nitrate-Coated Versus Standard Indwelling Pleural Catheter for Malignant Effusions: The SWIFT Randomized Trial.  Shrager JB, et al. Ann Am Thorac Soc. Devised as a method to increase the rates of pleurodesis following surgery the silver nitrate coated catheter (SNCIPC) was trialled in 20 hospitals in the US and UK. Any studies in malignant pleural…

  • Journal Club March 2022

    Journal Club March 2022

    The bacteriology of pleural infection (TORPIDS): an exploratory metagenomics analysis through next generation sequencing Kanellakis, NI et al. The Lancet Microbe, A hugely impressive body of work from Kanellakis et al using next generation sequencing techniques to examine the pleural fluid from the PILOT study (large observational study of patients with pleural infection). Previous studies…