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Pneumothorax progresses quickly in newborns and can lead to death. This study collected data prospectively over a 2-year period on risk factors, clinical course and prognostic factors of newborn cases diagnosed and treated for pneumothorax. Thirty patients were evaluated for risk factors including concurrent disease, method and duration of chest drainage, oxygen saturation and mechanical ventilation. Pneumothorax developed mostly in male and mature infants during the first 48 h following birth; risk factors included concurrent respiratory distress syndrome and meconium aspiration. Mechanical ventilation was undertaken in 18 (60%) of the patients. Closed-tube drainage was used in 28 (93%) of the patients. Nine out of 10 patients (90%) whose oxygen saturation remained < 90% died. Thus, pneumothorax may develop during the neonatal period, especially in the presence of risk factors, and neonates with < 90% oxygen saturation, despite treatment, have a high mortality rate.

Introduction: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs., Materials and Methods: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) patients with an isolated rib fracture (RF1) (n = 50, 23.4%), 2) patients with two rib fractures (RF2) (n = 53, 24.8%), and 3) patients with more than two rib fractures (RF3) (n = 111, 51.9%). The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion), and co-existing injuries to other systems., Findings: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (p<0.05). Co-existing injuries to other systems were 24% in group RF1, 23.2% in group RF2, and 52.6% in group RF3 (p<0.05). Two patients (4%) in group RF1, 2 patients (3.8%) in group RF2, and 5 patients (4.5%) in group RF3 (total n = 9; 4.2%) died., Conclusion: Patients with any number of rib fractures should be carefully screened for co-existing injuries in other body systems and hospitalized to receive proper treatment.

Objective: To review the medical records of patients with active pulmonary tuberculosis (TB) and pyo-pneumothorax (PPT)., Subjects and Methods: Medical records of 17 patients (14 male, 3 female, mean age 23.8 years, range 20-52) with PPT and active pulmonary tuberculosis at Gulhane Military Medical Academia Haydarpasa Training Hospital, Istanbul, Turkey, were reviewed from January 1998 to December 2002. The patients were treated with chest tube drainage and chemotherapy. Intrapleural fibrinolytic agents or irrigation was not performed., Results: Pleural fluid samples were available in 14 patients and the mean levels of LDH, protein and glucose in the pleural fluid were 1,767 +/- 944 U/l, 5.2 +/- 1.4 g/dl and 31.7 +/- 22.6 mg/dl, respectively. Mycobacterium tuberculosis was detected in the pleural effusion of 3 patients. The duration of chest tube drainage was longer in cases who underwent open drainage (p = 0.014). At the end of the treatment period 10 patients developed pleural thickening, 4 of them underwent decortication and pneumonectomy was also done in 1 patient. The development of pleural thickening was related to the level of pleural fluid glucose (p = 0.04)., Conclusion: This study shows that while taking care of patients with pulmonary TB the physician must be aware of the complication of PPT and that adequate chemotherapy and drainage must be duly performed.