Needle aspiration may reduce the need for a chest tube, however, the effectiveness and safety of both invasive procedures have not been fully studied. Prevention
A preventative procedure (thoracotomy or thoracoscopy with pleurodesis) may be recommended after an episode of pneumothorax, with the intention to prevent recurrence. Evidence on the most effective treatment is still conflicting in some areas, and there is variation between treatments available in Europe and the US. Not all episodes of pneumothorax require such interventions; the decision depends largely on estimation of the risk of recurrence. These procedures are often recommended after the occurrence of a second pneumothorax. Surgery may need to be considered if someone has experienced pneumothorax on both sides ("bilateral"), sequential episodes that involve both sides, or if an episode was associated with pregnancy. Epidemiology
The annual age-adjusted incidence rate (AAIR) of PSP is thought to be three to six times as high in males as in females. Fishman cites AAIRs of 7.4 and 1.2 cases per 100,000 person-years in males and females, respectively. Significantly above-average height is also associated with increased risk of PSP – in people who are at least 76 inches (1.93 meters) tall, the AAIR is about 200 cases per 100,000 person-years. Slim build also seems to increase the risk of PSP.The risk of contracting a first spontaneous pneumothorax is elevated among male and female smokers by factors of approximately 22 and 9, respectively, compared to matched non-smokers of the same sex.
Nevertheless, the failure to irrefutably demonstrate infectivity following intracerebral inoculation with urine from transmissible spongiform encephalopathy (TSE)-infected hosts suggests that the risk associated with products derived from urine is merely theoretical.Recombinant gonadotropins have to a large degree replaced hMG in fertility treatments. The recombinant process allows for the production of pure FSH or LH not "contaminated" by other proteins that may be present after urinary extraction. While some head-on studies seem not to suggest that "pure FSH" gives better results than hMG, others claim that recombinant FSH is more efficient and reduces costs. A Cochrane Collaboration analysis did not reveal major differences in clinical outcomes when comparing urinary versus recombinant FSH.The Practice Committee of the American Society for Reproductive Medicine reported: “Compared with earlier crude animal extracts, modern highly purified urinary and recombinant gonadotropin products have clearly superior quality, specific activity, and performance.