Pleural Effusion

Researchers are evaluating new imaging techniques in adults aged 18 to 85 with lung diseases such as asthma, emphysema, COPD, bronchiectasis, sarcoidosis, pulmonary fibrosis, alpha 1-anti-trypsin deficiency, and lymphangioleiomyomatosis (LAM). The study aims to develop tools for analyzing lung function and structure using hyperpolarized Xenon 129 MRI alongside pulmonary function tests. This research is supported by Western University, Canada. Participants will undergo a series of tests during a one to two-hour visit, including medical history review, vital signs measurement, full pulmonary function testing following American Thoracic Society guidelines, proton MRI, specialized 129-Xe MRI scans using chest coils, and a low-dose thoracic CT scan. The MRI procedure includes monitoring heart rate and oxygen levels, providing hearing protection, and offering supplemental oxygen as needed. These imaging and testing methods help assess lung ventilation, diffusion, and gas exchange. During the study visit, participants will complete pulmonary function tests such as spirometry, plethysmography, and diffusing capacity tests. They will undergo magnetic resonance imaging with hyperpolarized Xenon gas to visualize lung airways and anatomy, along with CT scans matched to MRI breathing maneuvers. Researchers will measure ventilation defect percent (VDP), apparent diffusion coefficients (ADC), and dissolved phase spectroscopy over five years. Participant safety is monitored throughout the visit, and the total study duration includes these assessments and follow-up measures.

Researchers are studying biomarkers from 129Xe gas exchange MRI to understand how they change with different medical interventions. The study focuses on interactions between 129Xe and red blood cells in the lungs. Participants include healthy volunteers and patients with conditions like interstitial lung disease, pulmonary hypertension, acute or chronic pulmonary embolism, anemia, polycythemia, and dyspnea. The study uses hyperpolarized xenon gas inhaled in multiple doses followed by breath holds, alongside oxygen administration. Participants are grouped by treatment: those undergoing transfusion or phlebotomy, patients receiving oxygen for lung-related conditions or healthy volunteers, and those recently diagnosed with acute or chronic pulmonary embolism. Treatments and responses are monitored at baseline and various follow-up points. Participants will undergo MRI scans to measure red blood cell transfer, chemical shifts after oxygen delivery, and changes in red blood cell signal oscillations before and after treatment. The study includes visits up to 3–6 months after interventions to track changes. Researchers also monitor safety and participant adherence throughout the study, which lasts until mid-2028.

Researchers are evaluating postoperative pain in patients undergoing minimally invasive pulmonary lobectomy and/or segmentectomy for resectable non-small cell lung cancer (NSCLC). The study compares the use of small-bore (16F) chest drains to the standard large-bore (24F) chest drains. It aims to determine if smaller chest tubes and earlier removal can reduce pain and improve recovery without compromising safety. This is a prospective randomized controlled trial conducted at a single center. Participants are assigned to one of four groups: small-bore (16F) chest tubes removed early (2 to 6 hours after surgery), small-bore tubes removed at standard time (1 day post-op), large-bore (24F) tubes removed early, or large-bore tubes removed at standard time. The study monitors safety and feasibility of early chest drain removal and compares effects of tube size and timing on postoperative outcomes. During the study, pain levels are assessed multiple times within the first three days after surgery, at discharge, and during follow-ups at 30 and 180 days. Researchers also track analgesic use, duration of drainage, fluid output, hospital stay length, complications, rehospitalization, mortality, chronic pain, and quality of life. Participants can expect detailed monitoring and evaluations throughout hospitalization and at follow-up visits up to six months after surgery.

Chronic subdural hematoma (CSDH) is a common condition often treated by neurosurgical evacuation and drainage of the hematoma. This research aims to compare two drainage methods after surgery: 24 hours of active subperiosteal drainage versus 24 hours of passive subdural drainage. The study is a nationwide, randomized clinical trial conducted across all neurosurgical units in Denmark to evaluate if active drainage is not worse than passive drainage in terms of safety and recurrence. Participants will be adults with symptomatic unilateral CSDH undergoing single burr hole evacuation. Before surgery, patients will be randomly assigned to receive either 24 hours of active subperiosteal drainage or 24 hours of passive subdural drainage. Both drainage methods are already in use, but a direct comparison has not been done. The trial will monitor patients for 90 days post-surgery to assess outcomes. During the study, participants will be evaluated for mortality and recurrence of CSDH requiring reoperation within 90 days. Other assessments include complications related to surgery, length of hospital stay, and functional outcomes measured by the simplified modified Rankin scale. The study uses a double-blind design for patients and statisticians and plans to enroll 354 participants over approximately two years.

Researchers are evaluating hemithoracic intensity-modulated pleural radiation therapy (IMPRINT) to determine if it is a safe treatment option with minimal side effects for people with thymic malignancies that have spread to the lining of the lungs and chest. The study also aims to assess whether this radiation therapy is effective against cancer in these patients. This is a Phase II clinical trial sponsored by Memorial Sloan Kettering Cancer Center. Participants will receive radiation therapy over about 6 weeks, with a total dose of 50.4 Gy given in 28 sessions. There is an option for a higher dose to areas of visible remaining cancer while protecting normal tissues. This treatment targets the affected hemithoracic pleura, the lining of one side of the chest. During the study, participants will be monitored for side effects such as radiation pneumonitis over two years. Researchers will also measure progression-free survival at 12 months to see how well the cancer is controlled. Participants will have regular assessments including lung function tests and kidney function evaluations to ensure safety, with study participation lasting for at least two years of follow-up.

Researchers are evaluating MT027, a CRISPR/Cas9 edited B7H3-specific allogeneic CAR-T cell therapy, in adults with pleural malignant tumors who have previously received standard care. This phase I, open-label, single-arm study aims to assess the feasibility, safety, tolerability, pharmacokinetics, pharmacodynamics, and to determine the recommended dose of MT027 delivered directly into the pleural cavity. Participants must have tumors that overexpress the B7H3 antigen. MT027 is administered by injection into the pleural cavity on day 1 of a 28-day cycle, followed by a 28-day monitoring period for dose-limiting toxicities. If no significant toxicity or disease progression occurs, treatment continues every three weeks with injections on day 1 or 2 of each 21-day cycle. After the first dose, participants stay in the hospital for at least seven days for close monitoring and safety assessments. Dose adjustments or temporary treatment interruptions may be made based on tolerance and adverse events. Participants will receive treatment until intolerable side effects, disease progression, withdrawal, or death. Safety is assessed through adverse event monitoring, including serious events, graft-versus-host disease, cytokine release syndrome, and neurotoxicity over about one year. Follow-up continues for up to 15 years with periodic telephone check-ins. The study includes laboratory tests, clinical evaluations, and tumor antigen testing to monitor treatment effects and participant health throughout the trial.

Researchers are evaluating the use of point-of-care ultrasound (POCUS) to diagnose acute pulmonary edema in adults who come to the emergency department with sudden breathing difficulties and respiratory failure. The study focuses on measuring the respiratory variation in the diameter of the inferior vena cava (IVC) to identify heart-related fluid buildup in the lungs. It also explores whether combining IVC ultrasound with lung and cardiac ultrasound, plus clinical and lab data like hemoglobin and plasma protein changes, improves diagnosis and risk assessment. This is a single-center, prospective observational study enrolling adults aged 18 and older who present with acute dyspnea and respiratory failure. Participants will receive standard clinical evaluations including lab tests and chest imaging, along with ultrasound assessments at admission, one hour later, and when possible, 24 to 48 hours afterward. The study does not involve any experimental treatments but observes and records diagnostic data during routine care. Participants will undergo multiple assessments, including ultrasound scans of the IVC, lungs, and heart, clinical evaluations, and laboratory tests. Researchers will measure the accuracy of IVC diameter changes at admission and after one hour in diagnosing pulmonary edema. They will also analyze early changes in hemoglobin and plasma proteins as indicators of fluid shifts. Clinical outcomes such as hospital admission, need for increased care, and mortality will be tracked, with the overall study period lasting until November 2028.

Researchers are conducting a study called Acutelines, a large data and biobank project at the University Medical Center Groningen in the Netherlands. It focuses on patients with a wide range of acute medical conditions who present to the Emergency Department. The goal is to improve how acute diseases are recognized and treated, understand their outcomes, and support personalized medicine by collecting detailed clinical data, imaging, and biomaterials over time. Participants have their medical information, including demographics, health status, medical history, vital signs, diagnostic tests, and treatments, systematically collected. Biomaterials such as blood, urine, feces, and hair are gathered from patients who meet certain severity criteria. Data collection occurs during hospital admission, including continuous monitoring, and continues with follow-ups at 3 months, 1 year, 2 years, and 5 years after the initial emergency visit. Throughout the study, various assessments are performed, such as quality of life, physical functioning, mental health, symptoms, and hospital length of stay. Researchers collect data on mortality and other health outcomes for up to 50 years. The study uses digital tools to automate data capture and integrates information from multiple healthcare sources. Participants will be monitored closely during hospitalization and at scheduled intervals afterward to help improve understanding and treatment of acute diseases.

Dyspnea, or shortness of breath, is a common and urgent problem in the Emergency Department that requires quick and accurate diagnosis to ensure timely treatment. Researchers are evaluating whether point-of-care ultrasound (POCUS), performed by emergency medicine specialists and residents with limited ultrasound training, can improve diagnostic accuracy for patients with dyspnea compared to routine assessments. This study focuses on several important diagnoses such as heart failure, pneumonia, pulmonary embolism, and exacerbations of chronic lung diseases. In this prospective observational study, specially trained emergency physicians will use a structured ultrasound protocol to examine the lungs, heart, and inferior vena cava of adult patients presenting with severe dyspnea or low oxygen levels. After an initial routine clinical assessment, the physician will estimate the likelihood of key diagnoses. Following this, a certified colleague will perform POCUS and share the results, allowing the initial physician to update their diagnostic estimates. Additional tests like chest imaging and blood markers will also be collected as part of routine care. Participants will be adults arriving with serious respiratory distress or hypoxia in the Emergency Department. Researchers will compare the diagnostic accuracy before and after POCUS by reviewing the final discharge diagnosis. Outcome measures include sensitivity and specificity of diagnoses such as heart failure and pneumonia. Safety is monitored by ensuring no delay in urgent care, and all patients will undergo routine clinical testing. The study aims to improve diagnostic tools for emergency doctors and enhance patient care during acute breathlessness episodes.

Researchers are comparing the pain relief effects of a multiple mid-transverse process to pleura (MTP) block with patient-controlled analgesia (PCA) using morphine in adults with idiopathic scoliosis undergoing posterior spinal fusion surgery. The study addresses the challenges of managing postoperative pain and hospitalization length in this group. Regional anesthesia techniques like epidural analgesia and paravertebral blocks, enhanced by ultrasound guidance, have become important in multimodal pain management. The MTP block and erector spinae plane (ESP) block are newer methods being evaluated for postoperative pain control. Participants are randomly assigned to one of two groups. One group receives multiple MTP blocks after anesthesia induction. The other group uses intravenous PCA with morphine, starting with a loading dose before surgery ends, followed by patient-controlled doses with specified lockout intervals and background infusion rates. This randomized, double-blind trial compares these two pain management approaches during and after surgery. Throughout the study, researchers monitor pain levels 24 hours after surgery as the primary outcome. They also track intraoperative fentanyl use, timing of first rescue analgesia, total morphine use, blood pressure and heart rate every 15 minutes during surgery, patient satisfaction, and any complications within 24 hours postoperatively. The overall goal is to better understand and improve pain control strategies in scoliosis surgery patients.