Sara Martins

Complicated pleural effusion in children – Therapeutical approach

Pediatric management of complicated pleural effusion (CPE) remains controversial. Different approaches include antibiotics and chest tube drainage alone or the use of fibrinolitics, videothorascoscopy (VTC) and surgical decortication through thoracotomy. The aim of the present study was to review, evaluate and update technical approach to CPE. We retrospectively reviewed the clinical files of children admitted to the Pediatric Respiratory Ward between 1992 and 2003 with the diagnosis of CPE. Twenty-five patients were included [15 male (60%)]. Mean (+/-SD) age was 37,4 (+/-37,0) months. Bacteria were identified in 17/25 (68%) [S. aureus in 6/17 (35%), St. pneumoniae in 5/17 (29%)], 16/17 (94%)in the pleural fluid. Twenty-five children were treated with antibiotics and thoracocentesis (100%). Chest tube drainage was required in 22/25 (88%) with mean (+/-DP) duration of 14,2 (+/-7,8) days. Fibrinolitics were employed in 1 only case and surgical decortication in 11/25 (44%). One patient (4%) was submitted to primary VTC. Median length of stay was 30,4 (+/-15,1) days and no deaths were recorded. Center skills in CPE management are critical on the choice of the technique and the timing of approach. This seems to influence immediate prognosis.

Radiation in 1.5 GeV and 12 GeV Laser Wakefield Acceleration Stages from PIC Simulations

A massivelly parallel post‐processing radiation diagnostic for PIC codes is presented, which is then used to study the main features of the radiation from single LWFA stages (1.5 GeV and 12 GeV). This diagnostic also allows to examine radiation signatures associated with the physics of self‐injection.