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Spatial Multiobjective Optimization of Agricultural Conservation Practices using a SWAT Model and an Evolutionary Algorithm
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[Hemothorax - a conservative approach in a patient with multiple comorbidities]
Vera Frazão Vieira1, Catarina Faria1, Maria do Rosário Barroso2
1Assistente Medicina Interna, Medicina Interna 2, Centro Hospitalar Leiria, Leiria, Portugal.
Summary
A massive hemothorax in an elderly patient was successfully treated with fibrinolysis via a thoracic drain. This life-saving intervention, tissue plasminogen activator, resolved the condition when other methods failed, leading to patient recovery.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Thoracic Surgery
Background:
- Elderly patient with multiple comorbidities presented with community-acquired pneumonia and pleural effusion.
- History of fall with chest trauma preceded symptom onset and diagnosis.
Observation:
- Massive hemothorax was diagnosed, initially unresponsive to standard treatments.
- Patient's clinical status progressively worsened despite antibiotics and antipyretics.
- Surgical intervention was deemed unsuitable by a multidisciplinary team.
Findings:
- Fibrinolysis using tissue plasminogen activator administered through a thoracic drain was performed as a life-saving measure.
- The procedure was successful and without complications.
- Complete drainage of hemothorax was achieved, leading to patient recovery.
Implications:
- Intrapleural fibrinolysis can be an effective alternative to surgery for managing massive hemothorax in complex patients.
- This case highlights the successful application of tissue plasminogen activator in a challenging clinical scenario.
- Non-surgical management of hemothorax may improve outcomes and reduce risks in elderly patients with comorbidities.
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