Necessity of routine chest roentgenography after thoracentesis

Article Abstract:

Chest X rays to detect entry of air may not be necessary after every thoracentesis procedure. A thoracentesis is a diagnostic procedure in which the chest wall is pierced. Researchers reviewed charts on 110 patients who had 174 thoracenteses. All had follow-up X rays. There were nine incidents of pneumothorax, in which air enters the chest. Chest X rays identified eight. Of these, five were suspected and three were small and did not produce complications. In the ninth case, a moderately sized pneumothorax was diagnosed by chest X ray three days later. Several factors greatly increased the likelihood of pneumothorax: aspirating air during the procedure, having a repeat procedure, having the doctor suspect pneumothorax, and having a history of radiation therapy of the chest. Using these criteria as risk markers, chest X rays would not have been needed for 110 procedures and one pneumothorax would have been missed. In the other 64 cases, X-rays would have diagnosed eight cases of pneumothorax.

Usage, Complications and side effects, Paracentesis, Diagnosis, Radioscopic, Radioscopic diagnosis, Chest, Thoracentesis

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Prophylaxis against gallstone formation with ursodeoxycholic acid in patients participating in a very-low-calorie diet program

Article Abstract:

The use of ursodeoxycholic acid may substantially reduce the risk of gallstone formation in patients enrolled in an intense weight loss program. Ursodeoxycholic acid is a naturally occurring chemical produced in the liver that dissolves gallstones. Rapid weight loss is a risk factor for gallstone formation. Researchers administered doses of ursodeoxycholic acid to 788 overweight patients enrolled in a 16 week low calorie, low fat, liquid protein diet. Dieters were divided into four dose groups, including one control group. Ultrasound images were taken at the beginning of the study, at 8 weeks, and at 16 weeks to determine gallstone formation. Gallstones formed in 28% of the control group, in 8% of the patients receiving a 300 milligram per day (mg/d) dose, in 3% of those treated with a 600 mg/d dose, and in 2% of the patients taking a 1200 mg/d dose. The optimal dose seems to be 600 mg/d. Side effects were minimal and easily treatable.

Health aspects, Evaluation, Prevention, Gallstones, Low-calorie diet, Low calorie diet, Ursodiol

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