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PubMed1999

[Talc--a standard drug in the treatment of malignant pleural effusion].

Currently, talc is the most effective and widely-used agent for chemical pleurodesis in the treatment of both malignant pleural effusion and pneumothorax. Its popularity has been growing due to the low incidence of side effects, low cost and higher success rate in comparison with other agents (tetracyclines, bleomycin, Corynebacterium parvum). The guidelines for talc pleurodesis are summarized and the history of the Corynebacterium parvum as an agent for chemical pleurodesis is mentioned. Its production in the Czech Republic has been halted due to the increased interest in the talc as a chemical sclerosant.

Humans↗

PubMed2001

Talc pleurodesis: a new technique.

Pleurodesis is a commonly used option in the management of malignant pleural effusion. Although several chemical agents are used talc has only recently been advocated as the sclerosing agent of choice. Talc can be administered via open thoracotomy or tube thoracostomy, but thoracoscopy offers an excellent alternative to these approaches. We describe a new technique of thoracoscopically applied talc pleurodesis that is easy, inexpensive, and reliable.

Humans↗

PubMed1975

Chemical and physical properties of British talc powders.

An examination of bulk talc samples imported into Great Britain has shown that they are extremely variable in their talc mineral content. Major contaminating minerals present with the talc are chlorite, carbonates and quartz. The chemistry of samples examined varied with their mineralogical content which also accounted for observed differences in particle morphology. Tremolite fibres were found in three samples, one of which contained the mineral as a major phase. No other varieties of asbestos were detected.

Asbestos↗

PubMed2002

[Determination of major and minor components in standard talc samples by ICP-AES].

The standard talc sample was fused with Na2CO3 and Na2B4O7 and then the fused disc was dissolved with HCl solution. SiO2, MgO, Al2O3, Fe3O2 and CaO in talc samples were determined simultaneously by ICP-AES. The optimum analytical line with high sensitivity and low spectral interference were carefully chosen. The sources and properties of the interference were discussed. The recoveries for these elements were 98.8%-104.4%, with precision of 0.12%-2.4% RSD (n = 6). The results of major and minor components in talc samples by this method were in agreement with those provided by the standard method.

Aluminum Oxide↗

PubMed1992

Iodized talc pleurodesis for the treatment of pleural effusions.

This prospective study was designed to determine the efficacy of iodized talc pleurodesis in patients with pleural effusions. Thirty-four patients underwent this treatment (three bilaterally) between October 1, 1989, and March 31, 1991. All patients had to have complete or nearly complete lung reexpansion after tube thoracostomy with fluid drainage less than 100 ml in 24 hours. A slurry containing 5 gm of talc and 3 gm of thymol iodide was instilled into the pleural space through the chest tube. Chest tubes were removed after complete reexpansion and clearing of the effusions, usually in 3 to 5 days. The patients' ages ranged from 26 to 88 years (average 50 years). Eighteen patients had lung carcinoma, two had mesothelioma, and one each had carcinoma of the ovary, breast, or anorectum, multiple myeloma, schwannoma, or Hodgkin's lymphoma. Two patients had an unknown adenocarcinoma primary and five other patients had acquired immunodeficiency syndrome. One patient had congestive heart failure. Nineteen patients had left, 12 had right, and three had bilateral pleural effusions. The effusion was serosanguineous in 26 and serofibrinous in eight patients. Serial chest radiography showed complete response in all patients. The period of follow-up ranged from 1 to 21 (average 4.9) months, with no recurrences. Twenty-three patients have died during the follow-up period, and there was no sign that reaccumulated pleural effusion existed in any, despite clinical evidence of systemic tumor progression. These observations indicate that intrapleural instillation of a slurry of iodized talc is a safe, adequate, and effective treatment for control of neoplastic or benign pleural effusions.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Comparison of two protocols of conscious analgosedation in video-assisted talc pleurodesis.

AIM: Video-assisted thoracoscopy surgery (VATS) is classically performed using general anesthesia with a double-lumen endotracheal tube to allow collapse of the operated lung. However, according to our opinion, the risks of general anesthesia with one-lung ventilation could be accepted when major thoracic operation is planned, but it should be avoided or kept at minimum when performing less invasive procedures such as video-assisted talc pleurodesis. In this paper, 2 different protocols are described in order to demonstrate the effectiveness and safety of Monitored Anesthesia Care (MAC) for performing VATS talc pleurodesis. METHODS: We studied 65 neoplastic patients ASA III-IV who underwent video-assisted pleurodesis with talc nebulization. They were randomized into 2 homogenous groups: Group 1, received midazolam (0.015-0.030 mg/kg) and sufentanil (0.15-0.20 microg/kg); Group 2, received midazolam (0.15-0.2 mg/kg) and continuous remifentanil infusion 0.5-1 microg/kg/min in the first minute, followed by 0.05 microg/kg/min. Local anesthesia with 0.2% ropivacaine was employed before the thoracoscopic trocar was inserted in both groups. Intraoperative standard monitoring required ECG, heart rate, non-invasive blood pressure, transcutaneous carbon dioxide and oxygen saturation. Consciousness status has been evaluated by Ramsey scale, while pain intensity by VAS scale. RESULTS: No statistically significant fluctuations were observed for mean arterial pressure, heart rate, SpO(2), tCO(2), VAS and Ramsey score. No postoperative complications and hospital mortality occurred. CONCLUSIONS: Both the protocols offer an efficient control of analgosedation with a minimum incidence of intraoperative and postoperative side effects. Anyway, the titration of the drug is very important.

Adult↗

PubMed2005

[Intractable pneumothorax successfully treated by talc slurry pleurodesis and video-assisted thoracoscopic surgery in a patient with idiopathic pulmonary fibrosis].

Pneumothorax associated with idiopathic pulmonary fibrosis (IPF) is intractable and often fatal because the patients are usually under a long-term steroid therapy, and are associated with severely impaired lung function. Further, pneumothorax itself recurs frequently, and acute exacerbation of IPF may develop after a surgical intervention. Here, we describe a case of intractable pneumothorax developed in a patient with IPF who was successfully treated with repeated talc pleurodesis combined with video-assisted thoracoscopic surgery under local anesthesia. A 67-year-old male with IPF who was under a long-term treatment with steroid, developed right-sided pneumothorax. A chest drainage tube was placed in the right pleural cavity, and repeated pleurodesis with minocycline or fibrinogen was challenged, but the outcome turned out to be unsuccessful. Then, talc slurry was applied repeatedly, resulting in a high-grade fever associated with reactive accumulation of pleural effusion. However, air leakage did not cease completely despite the eight-times pleurodesis with talc using 16 g in total. Finally, video-assisted thoracoscopic surgery under local anesthesia was undertaken and the pulmonary fistula was successfully closed.

Aged↗

PubMed1985

Disseminated talc granulomatosis. An unusual finding in a patient with acquired immunodeficiency syndrome and fatal cytomegalovirus infection.

The association of disseminated magnesium silicate talc granulomatosis and acquired immunodeficiency syndrome is reported in a male homosexual who used intravenous drugs and who died of overwhelming cytomegalovirus (CMV) infection. Autopsy findings included widespread deposition of talc crystals in the lungs, liver, lymph nodes, bone marrow, and spleen. Typical CMV inclusions were seen in the lungs, kidneys, adrenal glands, gastrointestinal tract, and right eye. There was no evidence of malignancy. Analysis of peripheral blood neutrophil function revealed impaired chemotaxis and chemokinesis, but opsonophagocytosis had remained normal. The CMV infection in the small bowel was extensive and resulted in severe destruction of the muscularis propria and neural plexi, leading to marked dilatation and persistent diarrhea. The terminal course was marked by intractable hypotension, pneumonitis, and malnutrition, which could be attributed respectively to CMV involvement of the adrenal glands, lungs, and small bowel. The etiology and possible role of systemic talc granulomatosis in the development of immunosuppressive illness is reported herein.

Acquired Immunodeficiency Syndrome↗

PubMed1988

Systemic talc granulomatosis associated with disseminated histoplasmosis in a drug abuser.

A 32-year-old intravenous drug abuser was found to have systemic talc granulomatosis and disseminated histoplasmosis. The clinicopathologic findings of this case support the hypothesis that the patient was predisposed to disseminated histoplasmosis by repeated intravenous talc administration. The effects of silica, a close relative of talc, on macrophages and the role of macrophages in recovery from Histoplasma capsulatum infection are described.

Adult↗

PubMed1984

Effects of talc on the rat ovary.

Exposure of rat ovaries to talc was accomplished by intrabursal injection. As early as 1 and up to 18 months after treatment, the ovaries and associated tissue were cystic in appearance; these changes were the result of bursal distention. Histologically the ovarian tissue was decreased in amount and spread as a remnant on the inner wall of the bursa. In four to 10 treated animals but in no controls, focal areas of papillary change were noted in the surface epithelium of the ovary. Polarized light and electron microscope microanalysis confirmed the presence of talc in the surface epithelium, ovarian cortex, and connective tissue matrix of the bursa. Although the changes in the ovarian surface may be related to direct effects of talc exposure, it is postulated that these changes might also be related to constant exposure to the high concentrations of steroid hormones which have undoubtedly accumulated in the intrabursal space.

Animals↗

PubMed1983

Adult respiratory distress syndrome following intrapleural instillation of talc.

After intrapleural instillation of talc for sclerosis of malignant pleural effusions, dyspnea occurred in three patients, progressed gradually over 72 hours, and culminated in acute respiratory failure characterized by bilateral diffuse pulmonary infiltrates with normal pulmonary artery occlusion pressures. Two patients recovered and one died. The chronological similarity of the sequence of fever, dyspnea, and respiratory failure in the absence of documented infection or other conditions that predispose to the adult respiratory distress syndrome (ARDS) suggests that intrapleural talc may have induced the syndrome in these patients through unknown mechanisms. This experience emphasizes that other agents are preferable for initial attempts to promote pleural symphysis in the palliation of recurrent malignant effusions. When talc is used in patients who are unresponsive to tetracycline, we suggest clinical monitoring for respiratory compromise for 72 hours after the procedure.

Adult↗

PubMed1980

Effects of inhaled asbestos, asbestos plus cigarette smoke, asbestos-cement and talc baby powder in hamsters.

Chronic exposure of hamsters to chrysotile asbestos resulted in severe asbestosis in all animals and in increased mortality; concomitant exposure to cigarette smoke did not affect type or severity of asbestotic lesions. Chronic exposure to asbestos-cement dust increased the number of macrophages and ferruginous bodies. Exposure to talc baby powder caused no significant changes. Deposition of talc particles in the lungs was demonstrated by X-ray fluorescence and X-ray diffraction and by a study with neutron-activated talc. No malignant tumours were observed in any of these studies.

Animals↗

PubMed1981

[Indications for intrapleural talc under pleuroscopic control in malignant recurrent pleural effusions. Based on 26 cases (author's transl)].

A review of ten years' experience of talc pleurodesis applied to the treatment of permanently recurrent carcinomatous pleural effusions. Twenty six patients aged between 35 and 83 years, suffering from metastatic pleural effusions, underwent pleuroscopy with local anaesthesia followed by powdering with talc, then suction drainage. There were 8 failures (30%), including 4 early deaths and 4 survivals of less than 4 months with no reduction in the effusion. Three results proved to be poor because of early extra-thoracic metastases (11.5%). There were 15 useful results, with drying up without return of the effusion and comfortable survival for 3 months to 7 years, including 8 of more than a year. These figures, somewhat unfavourable in comparison with those found in the recent literature (up to 90% useful results) were biased by the inclusion of patients who were in fact beyond help (excessive age, markedly impaired general condition, too advanced pleuro-pulmonary lesions, multiple metastases) which represent classical contraindications to the use of the talc technique. It emphasizes the best indications, based upon a sufficiently long life expectancy, good local pleuro-pulmonary state, the virtual restriction of malignant disease to the pleura, residual therapeutic possibilities-all conditions frequently found in cases of pleural carcinomatosis of mammary origin.

Adult↗

PubMedDate not supplied

A meta-analytical approach examining the potential relationship between talc exposure and ovarian cancer.

The concern that use of talc or talc-containing substances in the perineal region of women may subject them to an increased risk for ovarian cancer has become an important issue in the study of ovarian cancer. The purpose of this paper is to examine whether this concern, heightened by several epidemiological studies purporting to show an increased risk, is valid. Epidemiological studies examining the possibility of this relationship are reviewed, and meta-analyses of their results are performed. The conclusion reached herein is that the evidence regarding the risk of ovarian cancer associated with talc exposure is equivocal, and further examination of the relationship is required before a sound conclusion can be made.

Adult↗

PubMed1995

[Spontaneous pneumothorax. Results of pleural talc therapy using thoracoscopy].

The aim of this retrospective study is to evaluate the advantage of thoracoscopy and the efficacy of talcage in the treatment of spontaneous pneumothorax (SP). Two hundred cases have been analyzed with a follow-up of 1 to 8 years after the occurrence of the disorder. The ratio man/woman is 4/1. One hundred and forty two pneumothorax are considered as being of idiopathic origin and 58 are associated to bronchopneumopathy, with a mean age of 33 and 56 years, respectively. The percentage of smokers is 69.5% with a mean smoking of 14 packets/years. The endoscopic aspect of pleura is either normal (30%) or shows adhesions (23.5%), blebs (17%) or bullaes (29.5%). Thoracoscopy allowed talc poudrage in 191 patients and allowed to indicate the need for surgery in nine patients. The immediate success rate of talcage is 93.7%. In the group of immediate failure (6.3%), unexpected bullous structures (8/12) are found at tomodensitometry (TDM), as well as during surgery. Late recurrence is reported in 2 cases (1%) at 20 and 25 months. Radiological sequelaes are minimum (9%). Lung function testing in patients with idiopathic pneumothorax (n = 64) shows, before talc poudrage, signs of pulmonary hyperdistension (total lung capacity (TLC) at 116% of predicted values), reflecting the illness pathology, 3 months after talcage a discrete restrictive syndrome (TLC 93%) and one year after the partial recovery of the lost volume (TLC 105%). Tomodensitometry revealed to be complementary to thoracoscopy in secondary SP and very instructive in idiopathic SP after immediate failure of talc poudrage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

Talc granuloma of the uterus.

A 40-year-old woman presented with acute obstructive lung disease. She was treated with steroids and achieved a good response. However, she had two previous pelvic operations with histological findings of uterine serosal caseating granulomas presenting in the latter operation. Antituberculosis (TB) prophylaxis was suggested due to the suspicion of TB reactivation under steroid management. Investigation for TB infection or exposure was negative while revision of the histological slides disclosed talc granulomas. Although talc granuloma is reported in starch powder gloves which should not contain talc, it is still very uncommon.

Adult↗

PubMed2001

Assessment of the Surface Heterogeneity of Talc Materials.

The hydrophobic and hydrophilic components of the surface of talc materials in aqueous solution were determined using ionic surfactants and their polar headgroup adsorption isotherms. The hydrophilic and hydrophobic surface areas are inferred from the amount of probe molecule adsorbed and the structure of the adsorbed layer. Natural dispersion of talc shows at 298 K a pH of 9.4 and the electrophoretic measurements indicate that the particles are negatively charged. The hydrophilic surface area is estimated from the adsorption of benzyltrimethylammonium ions (BTMA(+)) through electrostatic interactions as supported by the increase of divalent ions in the bulk phase and the decrease in the exothermic displacement enthalpy. It was also observed from the adsorption isotherm of benzene sulfonate anions that the density of positive surface sites is very low and is thus neglected. The adsorption of an anionic surfactant essentially occurs through dispersive interactions between the nonpolar organic tail of the molecule and the hydrophobic surface. Furthermore, some assumptions on the structure of dodecyl sulfate surfactant aggregates at the interface allow the hydrophobic part of the talc particles to be estimated. The cationic surfactant adsorption has been investigated and found to corroborate the hydrophilic and hydrophobic area values first obtained. Copyright 2001 Academic Press.

Journal Article↗

PubMed2006

Ultrasonic studies on polystyrene/styrene butadiene rubber polymer blends filled with glass fiber and talc.

The compatibility of solid blends: PS/SBR, PS/SBR filled with glass fiber and PS/SBR filled with talc were studied using ultrasonic pulse echo technique. Measurements were carried out at room temperature (298 K) and a frequency of 3 MHz. The ultrasonic velocity for the compressional wave and that for shear wave have been measured to obtain the elastic moduli data by knowing of density. The variation of ultrasonic wave velocities and elastic moduli with weight percent of the blend was found to be linear in PS/SBR blend, indicating some degree of compatibility but the drawback of elastic moduli indicate incompatibility of the system blend, while it deviates from linearity in blends of PS/SBR filled with glass fiber and talc but the increase in elastic moduli indicates that there is an increase in degree of compatibility between PS and SBR due to adding of glass fiber or talc. The ultrasonic absorptions for longitudinal wave in the temperature range from 298 to 423 K in the studied system were measured using ultrasonic pulse echo technique. Typical results showing the temperature dependence of the ultrasonic absorption at frequencies of 1, 2, 3 and 5 MHz are illustrated for all samples of the different compositions. The study of compositional and temperature dependence of the ultrasonic absorption in the present studied blends reveals the same behavior of the compatibility degree of the blends. Density data of the blends confirmed the ultrasonic results. Also the correlation between hardness and elastic moduli for the present blend systems has been studied.

Journal Article↗