Chest Tube Drainage of the Pleural Space: A Concise Review for Pulmonologists

Porcel, Jose M. The Korean Academy of Tuberculosis and Respiratory 2018 Tuberculosis and Respiratory Diseases Vol.81 No.2

Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (${\leq}14F$) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains. Chest tube insertion should be guided by imaging, either bedside ultrasonography or, less commonly, computed tomography. The so-called trocar technique must be avoided. Instead, blunt dissection (for tubes >24F) or the Seldinger technique should be used. All chest tubes are connected to a drainage system device: flutter valve, underwater seal, electronic systems or, for indwelling pleural catheters (IPC), vacuum bottles. The classic, three-bottle drainage system requires either (external) wall suction or gravity ("water seal") drainage (the former not being routinely recommended unless the latter is not effective). The optimal timing for tube removal is still a matter of controversy; however, the use of digital drainage systems facilitates informed and prudent decision-making in that area. A drain-clamping test before tube withdrawal is generally not advocated. Pain, drain blockage and accidental dislodgment are common complications of small-bore drains; the most dreaded complications include organ injury, hemothorax, infections, and re-expansion pulmonary edema. IPC represent a first-line palliative therapy of malignant pleural effusions in many centers. The optimal frequency of drainage, for IPC, has not been formally agreed upon or otherwise officially established.

Fuzzy Linguistic Recommender Systems for the Selective Diffusion of Information in Digital Libraries

Porcel, Carlos,Ching-Lopez, Alberto,Bernabe-Moreno, Juan,Tejeda-Lorente, Alvaro,Herrera-Viedma, Enrique Korea Information Processing Society 2017 Journal of information processing systems Vol.13 No.4

The significant advances in information and communication technologies are changing the process of how information is accessed. The internet is a very important source of information and it influences the development of other media. Furthermore, the growth of digital content is a big problem for academic digital libraries, so that similar tools can be applied in this scope to provide users with access to the information. Given the importance of this, we have reviewed and analyzed several proposals that improve the processes of disseminating information in these university digital libraries and that promote access to information of interest. These proposals manage to adapt a user's access to information according to his or her needs and preferences. As seen in the literature one of the techniques with the best results, is the application of recommender systems. These are tools whose objective is to evaluate and filter the vast amount of digital information that is accessible online in order to help users in their processes of accessing information. In particular, we are focused on the analysis of the fuzzy linguistic recommender systems (i.e., recommender systems that use fuzzy linguistic modeling tools to manage the user's preferences and the uncertainty of the system in a qualitative way). Thus, in this work, we analyzed some proposals based on fuzzy linguistic recommender systems to help researchers, students, and teachers access resources of interest and thus, improve and complement the services provided by academic digital libraries.

Fuzzy Linguistic Recommender Systems for the Selective Diffusion of Information in Digital Libraries

( Carlos Porcel ),( Alberto Ching-lpez ),( Juan Bernabe-moreno ),( Alvaro Tejeda-lorente ),( Enrique Herrera-viedma ) 한국정보처리학회 2017 Journal of information processing systems Vol.13 No.4

The significant advances in information and communication technologies are changing the process of how information is accessed. The internet is a very important source of information and it influences the development of other media. Furthermore, the growth of digital content is a big problem for academic digital libraries, so that similar tools can be applied in this scope to provide users with access to the information. Given the importance of this, we have reviewed and analyzed several proposals that improve the processes of disseminating information in these university digital libraries and that promote access to information of interest. These proposals manage to adapt a user`s access to information according to his or her needs and preferences. As seen in the literature one of the techniques with the best results, is the application of recommender systems. These are tools whose objective is to evaluate and filter the vast amount of digital information that is accessible online in order to help users in their processes of accessing information. In particular, we are focused on the analysis of the fuzzy linguistic recommender systems (i.e., recommender systems that use fuzzy linguistic modeling tools to manage the user`s preferences and the uncertainty of the system in a qualitative way). Thus, in this work, we analyzed some proposals based on fuzzy linguistic recommender systems to help researchers, students, and teachers access resources of interest and thus, improve and complement the services provided by academic digital libraries.

Chest Tube Drainage of the Pleural Space: A Concise Review for Pulmonologists

( Jose M. Porcel ) 대한결핵 및 호흡기학회 2018 Tuberculosis and Respiratory Diseases Vol.81 No.2

Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains. Chest tube insertion should be guided by imaging, either bedside ultrasonography or, less commonly, computed tomography. The so-called trocar technique must be avoided. Instead, blunt dissection (for tubes >24F) or the Seldinger technique should be used. All chest tubes are connected to a drainage system device: flutter valve, underwater seal, electronic systems or, for indwelling pleural catheters (IPC), vacuum bottles. The classic, three-bottle drainage system requires either (external) wall suction or gravity (“water seal”) drainage (the former not being routinely recommended unless the latter is not effective). The optimal timing for tube removal is still a matter of controversy; however, the use of digital drainage systems facilitates informed and prudent decision-making in that area. A drain-clamping test before tube withdrawal is generally not advocated. Pain, drain blockage and accidental dislodgment are common complications of small-bore drains; the most dreaded complications include organ injury, hemothorax, infections, and re-expansion pulmonary edema. IPC represent a first-line palliative therapy of malignant pleural effusions in many centers. The optimal frequency of drainage, for IPC, has not been formally agreed upon or otherwise officially established.

Characterization and evaluation of liver fibrosis grade in patients with chronic hepatitis B virus infection and normal transaminases

( San Juan Lopez Cristina ),( Casado Martin Marta ),( Gonzalez Sanchez Mercedes ),( Porcel Martin Almudena ),( Hernandez Martinez Alvaro ),( Vega Saenz Jose Luis ),( Parron Carreno Tesifon ) 대한간학회 2018 Clinical and Molecular Hepatology(대한간학회지) Vol.24 No.4

Backgrounds/Aims: The objective of our study was to determine the epidemiological, laboratory, and serological characteristics of patients with chronic hepatitis B virus (HBV) infection and normal transaminases. The study also aimed to evaluate liver damage by measuring the liver fibrosis (LF) grade and to identify possible factors associated with the presence of fibrosis. Methods: A retrospective observational study was conducted in patients with chronic HBV infection and classified as inactive carriers or immune-tolerant. Epidemiological variables of age, sex, immigrant, alcohol consumption, and body mass index (BMI), as well as virological variables (HBV DNA) and transaminase level were collected throughout the follow-up. The LF grade was evaluated by transient elastography. The cutoff value for significant fibrosis (SF) was liver stiffness ≥7.9 kPa. Results: A total of 214 patients were included in the analysis, and 62% of them had a BMI ≥25 kg/㎡. During follow-up, 4% of patients showed transaminase elevation (<1.5 times normal). Most patients had a viral DNA level <2,000 IU/mL (83%). Data on LF were available in 160 patients; of these, 14% had SF, 9% F3, and 6% F4. The variables associated with the presence of SF were transaminase alteration during follow-up, as 23% of patients with SF had elevated transaminases versus 3% of patients without SF (P<0.005), and BMI, as the vast majority of patients with SF (88%) had a BMI ≥25 kg/㎡ versus 56% of patients without SF (P<0.05). Conclusions: In patients with chronic HBV infection and normal transaminases, liver damage does not seem to be related to DNA levels, alcohol consumption, or immigrant status. SF seems to be associated with transaminase alteration during follow-up and elevated BMI. It is therefore recommended to measure LF grade with validated non-invasive methods in such patients. (Clin Mol Hepatol 2018;24:384-391)