The dog didn't bark

Our plain-English summary of The dog didn't bark, by V. Acton (The Journal of Thoracic and Cardiovascular Surgery, 2013).

The study

• Author: V. Acton
• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2013;146(4):990
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This was a short letter to the editor, not a research study, and it reported no new data. The author was responding to an article in the same journal on outcome and prognostic factors of pleural mesothelioma after surgical diagnosis and/or pleurodesis, which the author said again illustrated the universally lethal course of the disease. The author estimated that over the last 60 years hundreds of thousands of young patients worldwide had undergone prophylactic pleurodesis, typically for recurrent spontaneous pneumothorax. The author noted that these patients had then risked the 'normal' exposure to asbestos fibers suffered by the general population. The author pointed out that a different paper, by Middleton and colleagues, stated that no documented cases of pleural malignancy after instillation of talc exist, and called this extraordinary. Rather than drawing a conclusion, the author raised a question: should a young individual with evidence of asbestos-related pleural disease also be free to consider pleurodesis to prevent later development of mesothelioma? The letter did not present any study testing this idea.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: letter to the editor (commentary); no original data
• Who was studied: No group was studied. The letter discussed, by the author's own estimate, hundreds of thousands of young patients worldwide who had undergone prophylactic pleurodesis over the last 60 years, typically for recurrent spontaneous pneumothorax.
• Exposure: Prophylactic pleurodesis, and the 'normal' general-population exposure to asbestos fibers that the author said these patients then risked. No fiber type was named.
• The authors' conclusion: The author drew no firm conclusion. The author asked whether a young individual with evidence of asbestos-related pleural disease should also be free to consider pleurodesis to prevent subsequent development of mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Related studies

• Thoracoscopic palliative treatment of malignant pleural effusions: results in 273 patients — K. Arapis, R. Caliandro, et al. (2006)
• Outcome and prognostic factors of pleural mesothelioma after surgical diagnosis and/or pleurodesis — M. Baud, S. Strano, et al. (2013)
• MesoTRAP: a feasibility study that includes a pilot clinical trial comparing video-assisted thoracoscopic partial pleurectomy decortication with indwelling pleural catheter in patients with trapped lung due to malignant pleural mesothelioma designed to address recruitment and randomisation uncertainties and sample size requirements for a phase III trial — C. Matthews, C. Freeman, et al. (2019)
• Video-assisted management of malignant pleural effusion in breast carcinoma — R. Gasparri, F. Leo, et al. (2006)
• Reply to the editor — M. Baud, P. Forgez, et al. (2013)
• Persistent lung expansion after pleural talc poudrage in non-surgically resected malignant pleural mesothelioma — O. Rena, R. Boldorini, et al. (2015)

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