Comparison of the Effectiveness of Tetracycline and Minocycline as Pleural Sclerosing Agents in Rabbits

Light, Richard W.; Wang, Nai‐San; Sassoon, Catherine S. H.; Gruer, Steve E.; Vargas, Francisco Suso

doi:10.1378/chest.106.2.577

Cited by 84 publications

(80 citation statements)

References 15 publications

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“…minocycline and OK-432) have been widely used in clinical practice. Minocycline, a derivative of tetracycline, has been shown to be as effective as tetracycline in inducing pleural fibrosis in rabbits [25]. Pleurodesis with minocycline has also been reported as safe and efficacious [26] and OK-432 was shown to be more effective than other pleural sclerosing agents [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of pleurodesis for malignant pleural effusions in breast cancer patients

Hirata¹,

Yonemori

Hirakawa³

et al. 2011

Eur Respir J

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This study retrospectively compared long-term outcomes between two groups of breast cancer patients with malignant pleural effusion (MPE): those receiving only systemic therapy (ST) and those receiving ST following initial pleurodesis (P-ST).We identified 180 breast cancer patients from the National Cancer Center Hospital (Tokyo, Japan) database who had received ST and P-ST as an initial treatment for MPE between 1997 and 2008 for study inclusion. Pleural progression-free survival (PPFS) was defined as the time from ST in the ST group and from pleurodesis in the P-ST group to the first observation of pleural progression or death from any cause.Of the 180 patients, 78 received ST and 102 received P-ST after MPE diagnosis. Median duration of follow-up was 12.7 months (range 0.9-80.1 months). Median PPFS for the ST group and the P-ST group was 4.1 and 8.5 months, respectively. The difference in PPFS between the two groups was statistically significant (p,0.001) and the hazard ratio after adjusting for prognostic factors in the P-ST group relative to the ST group was 0.24.Our results suggest that the efficacy of P-ST may be superior to that of ST alone with respect to local control of pleural effusions in breast cancer patients.

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Section: Discussionmentioning

confidence: 99%

Efficacy of pleurodesis for malignant pleural effusions in breast cancer patients

Hirata¹,

Yonemori

Hirakawa³

et al. 2011

Eur Respir J

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“…This possibility is unlikely since the volume of lidocaine injected was only 0.5 ml and since previous studies with minocycline showed that at the same dose, the pleurodesis with larger volumes was stronger 28 . Finally, the combination of lidocaine with silver nitrate may change the pH.…”

Section: Discussionmentioning

confidence: 98%

Effectiveness of silver nitrate compared to talc slurry as pleural sclerosing agent in rabbits. Influence of concomitant intrapleural lidocaine

et al. 1999

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SUMMARY: The ideal agent for producing pleurodesis has not been identified. Talc, the most commonly used, poses several problems. Another possibility is silver nitrate, which was widely used in the past.Purpose: To determine the influence of the intrapleural instillation of lidocaine in producing a pleurodesis with silver nitrate, to define the effect of lidocaine in the maturation of the collagen fibers, and to confirm that the pleurodesis after silver nitrate is stronger than after talc.Methods: We studied three groups of 8 rabbits. Two groups received 0.5% silver nitrate; in one we had previously injected 0.5 ml of 2% lidocaine. The third group received 400 mg/kg talc (2 ml). The animals were sacrificed 28 days after the injection, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of inflammation and fibrosis. The total amount of pleural collagen and the distribution of thick and thin collagen fibers were quantified. Collagen was identified using picrosirius red stain.Results: In the two groups that received silver nitrate (without lidocaine: 3.5 + 03 and with lidocaine: 3.2 + 0.3), the macroscopic pleurodesis (scale 0 -4) was significantly (p = 0.001) better than that resulting from talc (1.6 + 0.2). The mean degree of pleural fibrosis induced by silver nitrate (3.5 + 0.2) was significantly (p = 0.004) higher than that induced by talc (1.9 + 0.1). The previous instillation of lidocaine resulted in a tendency for decreased amounts of fibrosis (3.1 + 0.4). The mean amount (10 3 mm 2 ) of pleural collagen was significantly (p = 0.009) greater in the rabbits that received silver nitrate (116.9 + 22.7) than in those that received talc (10.7 + 3.4). The injection of lidocaine slightly reduced the collagen (80.1 + 30.3). The distribution of collagen fibers did not differ among the groups.Conclusion: This rabbit model clearly confirms that intrapleural silver nitrate is more effective than talc for producing pleurodesis. The previous intrapleural instillation of lidocaine results in a decreasing trend in the amount of collagen, but does not change the effectiveness of the pleural fusion or modify the process of collagen maturation.

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“…25 In experiments, minocycline has even been found to be better than tetracycline as a pleural sclerosing agent. 26 Tetracycline pleurodesis is an effective technique to induce a chemical pleurodesis in patients whose pulmonary function impairment precludes definitive surgical treatment. 27 Tetracycline is definitely better than silver nitrate, 28 which was the first chemical used by Spengler in 1906 29 to effect chemical pleurodesis.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Pneumothorax: A Retrospective Study of Twenty-Five Patients and Literature Review

et al. 1996

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We present a retrospective study of 25 patients with spontaneous pneumothorax (three recurrent), comprising 16 Saudis (nine males and seven females) and nine non-Saudis (eight males and one female), seen at the Asir Central Hospital, Abha, over a period of 45 months. Almost one-third of the patients (9/25) had no underlying cause discernible by our investigational facilities (chest x-ray, ultrasonography, computed tomographic scan, and flexible bronchofiberscopy). Underlying pneumonia (three patients), pulmonary tuberculosis (two patients), lung abscess (one patient), and congenital bullae (one patient) constituted the etiology in another third of the spontaneous pneumothorax patients. Other underlying pulmonary diseases precipitating spontaneous pneumothorax in the group included pulmonary fibrosis, metastatic mesothelioma, and immunosuppression in a medulloblastoma patient undergoing chemotherapy with the development of chickenpox. Closed thoracostomy tube drainage was the only method of treatment in 20 out of the 25 patients, with three failures of closed thoracostomy tube drainage needing thoracotomy and resection of blebs/bullae. The only complication was empyema in two of the patients. Two patients were successfully treated conservatively with observation alone. Ann Saudi Med 1996;16(3):249-253. A-N Batouk, S Jastaniah, IA Grillo, TS Malatani, AH Al-Saigh, MY Al-Shehri, B Teklu, A Softah, KA Mohmed Ali, Spontaneous Pneumothorax: a Retrospective Study of Twenty-Five Patients and Literature Review. 1996; 16(3): 249-253 The term pneumothorax was introduced almost two centuries ago by Itard in 1803, and popularized by Laennec in 1819.1 From that time until the mid-1930s, it was thought that all pneumothoraces were secondary to pulmonary tuberculosis.2 Kjaergaard's review of the subject in 1932 highlighted the occurrence of the condition in previously healthy individuals.3 If these "healthy individuals" had been thoroughly studied with modern medical, radiological or endoscopic investigations, they might have been found to have such occult abnormalities as blebs, bullae, or bronchial obstructions. 4 The Asir region of Saudi Arabia is a mountainous territory of about one million people, served by the Asir Central Hospital (ACH), a 450-bed tertiary hospital. Over a period of three years and nine months (1990)(1991)(1992)(1993)(1994), 25 patients were treated for spontaneous pneumothorax (SP) at ACH. As this problem has not been previously reviewed in this part of the world, we are presenting the first 25 adult patients of SP seen in this region and reviewing the literature in light of our experience. Patients and MethodsTwenty-five patients with spontaneous pneumothorax (SP) constitute the subjects of this retrospective study (April .1990 to December 1994. The patients consisted of 16 Saudis and nine non-Saudis seen at ACH, either on direct admission through the Emergency Department or upon referral from neighboring hospitals and admitted or evaluated only as outpatients. The demographics (nationality, sex...

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Comparison of the Effectiveness of Tetracycline and Minocycline as Pleural Sclerosing Agents in Rabbits

Cited by 84 publications

References 15 publications

Efficacy of pleurodesis for malignant pleural effusions in breast cancer patients

Efficacy of pleurodesis for malignant pleural effusions in breast cancer patients

Effectiveness of silver nitrate compared to talc slurry as pleural sclerosing agent in rabbits. Influence of concomitant intrapleural lidocaine

Spontaneous Pneumothorax: A Retrospective Study of Twenty-Five Patients and Literature Review

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