Eleven articles published in the English language between 2004 and 2007 were chosen. The basis of selection of the articles was the impact on daily practice, change in prior thinking of a disease process or specific treatment modality, as well as proper design and execution of the study. 5-Amino-laevulinic
acid with fluorescent light combined with white light may allow further diagnostic yield in undiagnosed
pleural disease. FDG-PET may allow prognostication of patients with pleural
tumors. Utilizing ultrasound by trained Emergency Department physicians is a rapid and effective technique to evaluate non-traumatic
pleural effusions in symptomatic patients. Serum
osteopontin levels may distinguish patients exposed to
asbestos with benign disease from those with pleural
mesothelioma. Administration of
streptokinase in patients with
empyema does not need for surgical drainage, length of
hospital stay, or mortality as compared to conventional treatment with
chest tube drainage and intravenous
antibiotics.
Silver nitrate may be an alternative agent to
talc for producing
pleurodesis. Routine use of graded
talc (50% particles greater than 25 microns) is recommended to reduce the morbidity associated with
talc pleurodesis. Study design does not permit us to conclude that aspiration of
spontaneous pneumothorax is as effective as
chest tube drainage. Pleural
catheter may prove to be an important palliative modality in treating debilitated patients or patients with trapped lung who show symptomatic improvement with drainage; however, at the present time, these
catheters cannot be considered a first line treatment option for patients with
malignant pleural effusion. One of the studies reviewed showed no significant difference in tract
metastasis in patients with
malignant mesothelioma undergoing an invasive pleural procedure with or without irradiation to the procedure site. However, the design of the trial does not allow us to make this conclusion at the present time.