       Document 0516
 DOCN  M9610516
 TI    AIDS-related spontaneous pneumothorax. Risk factors and treatment.
 DT    9601
 AU    Metersky ML; Colt HG; Olson LK; Shanks TG; Pulmonary Division,
       University of Connecticut Health Center,; Farmington, USA.
 SO    Chest. 1995 Oct;108(4):946-51. Unique Identifier : AIDSLINE MED/96010149
 AB    OBJECTIVE: To define risk factors and optimum therapy for AIDS-related
       spontaneous pneumothorax (PTX). DESIGN: Case-control study. SETTING:
       Tertiary care center. PATIENTS: Thirty-five patients with AIDS who
       developed spontaneous PTX between January 1, 1988 and December 31, 1991,
       of whom 27 (77.1%) did so in the setting of Pneumocystis carinii
       pneumonia (PCP). Forty-one patients who were diagnosed as having PCP and
       did not develop PTX served as the control group. RESULTS: Using logistic
       regression, a history of cigarette smoking, aerosolized pentamidine
       treatment, and the observation of pneumatoceles by chest radiography
       were associated with an increased risk of PTX. Although not associated
       with an increased risk of occurrence of PTX, the use of systemic
       corticosteroids for PCP treatment was associated with a longer
       requirement for chest tube drainage. Although chest tube drainage alone
       was often successful, chemical and surgical pleurodesis was often
       effective in treating prolonged air leaks and was associated with a
       lower incidence of recurrent PTX, although this difference did not
       achieve statistical significance (p = 0.07). CONCLUSIONS: Patients at
       high risk of developing AIDS-related spontaneous PTX can be identified.
       Systemic corticosteroids may increase the risk of morbidity from
       AIDS-related PTX. Chemical and surgical pleurodesis may be of value in
       short-term treatment and in reducing the risk of recurrence.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  AIDS-Related
       Opportunistic Infections/COMPLICATIONS  Case-Control Studies
       Comparative Study  Female  Human  *HIV-1  Logistic Models
       Lung/RADIOGRAPHY  Male  Pneumonia, Pneumocystis carinii/COMPLICATIONS
       Pneumothorax/*ETIOLOGY/RADIOGRAPHY/THERAPY  Retrospective Studies  Risk
       Factors  Treatment Outcome  CLINICAL TRIAL  JOURNAL ARTICLE  RANDOMIZED
       CONTROLLED TRIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

