Parapneumonic effusions and pleural empyema are a frequent complication of pneumonia. Initial treatment in uncomplicated effusions is conservative. Complicated parapneumonic effusions require more...

BACKGROUND: The aim of this study was to identify key factors on admission predicting the development of complicated parapneumonic effusion or empyema in patients admitted with community-acquired pneumonia. METHODS: A prospective observational study

Our aim was to compare intrapleural streptokinase (SK) treatment and simple tube drainage in the treatment of children with complicated parapneumonic pleural effusion. A retrospective review of medical records included patient demographics, clinical presentation, biochemical and microbial studies of pleural effusion, radiographic evaluation of chest tube drainage, use of fibrinolytic agents and type of surgical intervention. During the 2.5-year period (1999-2002), 53 children (29 M, 24 F) with complicated parapneumonic effusions or empyema were identified. Closed tube drainage and antibiotic treatment were administered to patients with a diagnosis of complicated parapneumonic effusion (n = 24) until October 2000; after that time point, intrapleural streptokinase was added to this regimen (n = 29). The median age at the time of presentation was 2.5 years (range: 5 months-14.6 years). There were no significant differences in terms of clinical outcomes between the two groups. The average length of ...

TY - JOUR. T1 - Effect of repeated thoracenteses on fluid characteristics, cytokines, and fibrinolytic activity in malignant pleural effusion. AU - Chung, Chi L.. AU - Chen, Yi C.. AU - Chang, Shi Chuan. PY - 2003/4/1. Y1 - 2003/4/1. N2 - Objective: To evaluate the effect of repeated thoracenteses on the fluid characteristics and the levels of various cytokines, including tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-5, IL-6, and IL-8, and of plasminogen activator inhibitor type 1 (PAI-1) and tissue type plasminogen activator in malignant pleural effusion and its clinical significance. Design: A prospective study. Patients and methods: Twenty-six patients with symptomatic and a large amount of free-flow malignant pleural effusions were studied. Thoracentesis with drainage of 500 mL of pleural fluid per day was performed for 3 continuous days (days 1 to 3). The effusion samples were collected to evaluate the changes of fluid characteristics, cytokine levels, and fibrinolytic activity. ...

Metabolomic Profiling of Infectious Parapneumonic Effusions Reveals Biomarkers for Guiding Management of Children with Streptococcus pneumoniae Pneumonia.. Chiu CY1,2,3, Lin G4, Cheng ML5, Chiang MH1, Tsai MH1, Lai SH3, Wong KS3, Hsieh SY6.. Author information. Abstract. Metabolic markers in biofluids represent an attractive tool for guiding clinical management. The aim of this study was to identify metabolic mechanisms during the progress of pleural infection in children with Streptococcus pneumoniae pneumonia. Forty children diagnosed with pneumococcal pneumonia were enrolled and analysis of pleural fluid metabolites categorized by complicated parapneumonic effusions (CPE) and non-CPE was assessed by using (1)H-NMR spectroscopy. Multivariate statistical analysis including principal components analysis (PCA) and partial least-squares discriminant analysis (PLS-DA) were performed. Metabolites identified were studied in relation to subsequent intervention procedures by receiver operating ...

Jangkitan bakteria di paru-paru boleh menyebabkan pengumpulan cecair pada bahagian pleura, dikenali sebagai parapneumonia efusi (PPE). Faktor ramalan kepada tahap kerumitan PPE tidak di ketahui. Kajian ini dilakukan untuk mengenali ciri-ciri, faktor ramalan dan hasil rawatan kanak-kanak yang mengalami PPE di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Data pesakit PPE kanak-kanak yang dimasukkan ke PPUKM dari Januari 2010 ke Disember 2017 dikaji secara retrospektif. Pesakit dibahagikan kepada dua kumpulan iaitu PPE tahap sederhana dan PPE tahap rumit. Dari 45 orang pesakit yang dikaji, 20 (44.4%) pesakit mempunyai PPE tahap sederhana, manakala 25 (55.6%) mengalami PPE tahap rumit. Median umur pesakit adalah 32 bulan (IQR 16-63). Jenis bakteria yang paling biasa di temui adalah Streptococcus pneumoniae (61.9%), diikuti oleh Mycoplasma pneumoniae (19.0%) dan Staphylococcus aureus (4.8%). Didapati hanya 11.1% pesakit kanak-kanak menerima suntikan vaksin pneumokokal. Tiada perbezaan yang ...

One hundred ninety-one unselected fluid specimens submitted routinely for cytologic examination were assayed to determine whether the measurement of carcinoembryonic antigen (CEA) levels in pleural effusions is useful in detecting malignancy. The mean ± SD CEA level of 103 benign effusions was 4.1 ± 2.9 ng/ml. Only one benign effusion had a level , 12 ng/ml (18 ng/ml). Benign inflammatory effusions (pneumonia, empyema) had a higher mean CEA activity (6.2 ± 3.4) than effusions caused by congestive heart failure (2.9 ± 1.5) (p , 0.001). Twenty-four (34%) of 70 malignant effusions had a CEA level greater than 12 ng/ml, and 28 (40%) were positive by cytologic study. Thirty-eight (54%) were detected by one or both methods. Ten malignant effusions were positive by CEA (, 12 ng/ml) alone. These data suggest that the determination of CEA activity levels, when used in conjunction with other clinical findings, may be useful in detecting malignant pleural effusions. ...

TY - JOUR. T1 - Low pleural fluid-to-serum glucose gradient indicates pleuroperitoneal communication in peritoneal dialysis patients. T2 - Presentation of two cases and a review of the literature. AU - Momenin, Nima. AU - Colletti, Patrick M.. AU - Kaptein, Elaine M.. PY - 2012/5/1. Y1 - 2012/5/1. N2 - Background. Transudative pleural effusions due to pleuroperitoneal communication occur in 1.6-10% of patients receiving peritoneal dialysis (PD) and usually have overtly elevated glucose concentrations. Methods. We report two cases of verified pleuroperitoneal communication with minimally elevated pleural fluid glucose levels. We reviewed the literature of all PD patients with pleuroperitoneal communication that reported pleural glucose levels to assess their clinical and laboratory features and pleural fluid-to-serum glucose gradients. Results. We evaluated a total of 47 reported patients on PD with diagnosed pleuroperitoneal communication. Onset of the transudative pleural effusion after ...

TY - JOUR. T1 - Pharmacokinetic study of penetration of meropenem into pleural effusion in patients with pleurisy. AU - Makino, Junko. AU - Yoshiyama, Yuji. AU - Kanke, Motoko. AU - Shibasaki, Toshiaki. AU - Nakashima, Emi. AU - Kamata, Masahiro. AU - Ozawa, Sadanobu. AU - Maruyama, Hiromichi. AU - Masuhara, Keisou. AU - Kobayashi, Teruaki. PY - 2002. Y1 - 2002. N2 - Complication by secondary infection is observed in not only bacterial pleurisy but also other pleurisy, and the appropriate administration of antibacterial agents is necessary. It is very important to secure a smooth penetration of systemically administered antibacterial agents to pleural effusion in infection therapy. In this study, we investigated the pharmacokinetics of a carbapenem antibiotic, meropenem (MEPM), in blood and pleural effusion in patients with an accumulation of pleural effusion caused by pleurisy, who underwent placement of an indwelling thoracic drain and received intravenous drip administration of MEPM for ...

Iron Deficiency Anemia & Pleural Effusion on Chest X-Ray & Plummer-Vinson Syndrome Symptom Checker: Possible causes include Pulmonary Infarction. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search.

Pleural effusion secondary to ventriculoperitoneal shunt insertion is a rare and potentially life-threatening occurrence. We describe a 14-month-old Caucasian boy who had a ventriculoperitoneal shunt inserted for progressive hydrocephalus of unknown etiology. Two and a half months post-shunt insertion, the patient presented with mild respiratory distress. A chest radiograph revealed a large right pleural effusion and a shunt series demonstrated an appropriately placed distal catheter tip. A subsequent abdominal ultrasound revealed marked ascites. Fluid drained via tube thoracostomy was sent for beta-2-transferrin electrophoresis. A positive test was highly suggestive of cerebral spinal fluid hydrothorax. Post-externalization of the ventriculoperitoneal shunt, the ascites and pleural effusion resolved. Testing for beta-2-transferrin protein in pleural fluid may serve as a useful technique for diagnosing cerebrospinal fluid hydrothorax in patients with ventriculoperitoneal shunts.

Introduction: Tuberculosis is one of the most common causes of pleural effusion (PE). However, the diagnosis of tuberculous pleurisy still remains difficult. Since M. tuberculosis isolation rates in tuberculous effusions are relatively low the histological and microbiological studies of pleural biopsy samples are usually required to confirm the diagnosis. Several biological markers have been proposed to enhance the effectiveness of diagnosing patients with tuberculous pleurisy. The study was undertaken to evaluate the diagnostic accuracy of pleural fluid IFN-γ concentration in differentiation between tuberculous pleural effusion (TPE) and non-tuberculous pleural effusion (nTPE ...

Pneumonia continues to be the leading cause of morbidity and mortality in the paediatric population globally.1 The introduction of widespread pneumococcal conjugate 13-valent vaccination (PCV-13) programmes has led to a significant reduction in the incidence and mortality of community-acquired pneumonia (CAP).2 3 However, this diseases burden remains high, accounting for 15% of deaths in young children worldwide.4 Approximately 12% of cases progress to severe illness, with parapneumonic effusion and pleural empyema being the most common complications.5 For simplicity, this paper will use the term effusion to refer to parapneumonic effusion and pleural empyema.. The presence of effusion leads to a prolonged length of stay (LOS), escalation of care, morbidity and increased healthcare resources utilisation.6-10 Management of the effusion is controversial.6 7 Accepted treatment modalities include antibiotics alone, chest tube drainage with or without fibrinolytics, video-assisted thoracoscopic ...

A Case of Haemorrhagic Constrictive Pericarditis with Bilateral Pleural Effusions. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.

Malignant pleural effusions are a common clinical problem in patients with primary thoracic malignancy and metastatic malignancy to the thorax. Symptoms can be debilitating and can impair tolerance of anticancer therapy. This article presents a comprehensive review of pharmaceutical and nonpharmaceutical approaches to the management of malignant pleural effusion, and a novel algorithm for management based on patients performance status. ...

Tuberculosis (TB) remains as an important public health problem worldwide. Pleural tuberculosis is the most prevalent form of extrapulmonary presentation in immunocompetent patients.. The volume of effusion in the pleural space of patients with pleural TB may cause complications like restrictive ventilator lung functional disturb and/or pleural thickening. The respiratory physiotherapy can be adjuvant on treatment of pleural effusion tuberculosis throughout of various treatment technique.. The Continuous positive airway pressure (CPAP) is utilized in various pathologic, this improves lung mechanics by recruiting atelectatic alveoli, improving pulmonary compliance, and reducing the work of breathing.. The aim of this study is to determine the effect of CPAP on fluid absorption among patients with pleural effusion due tuberculosis. ...

Cases of intra-abdominal actinomycosis have been described years after cholecystectomy, although it is a rare complication. Due to the slow growth of Actinomyces, symptoms can present months or even years after surgery.1,2. We present the case of a 71-year-old patient who underwent delayed laparoscopic cholecystectomy for acute cholecystitis. Four years later, he presented with dyspnea, cough, asthenia and pleuritic pain in the right hemithorax. On physical examination he was found to have a hard, painful swelling on the lateral region of the right hemithorax (Fig. 1A), with absent breath sounds. Acute phase reactants were elevated, and the chest radiograph showed right pleural effusion. Computed tomography (CT) revealed thickening of the pleura of the right posterolateral costophrenic angle (2.5-cm in thickness) and a hypodense area inside with extrapleural fat involvement, muscle thickening and pleural effusion (Fig. 1B). Thoracocentesis was performed and a fluid consistent with an exudate ...

Tuberculous pleural effusion remains the commonest cause of exudative effusions in areas with a high prevalence of tuberculosis and histological examination of pleural tissue remain the gold standard for its diagnosis. The aim of this study was to assess the diagnostic utility of sonar guided biopsy in tuberculous pleural effusion. Patients and methods: 50 patients of mean age 38.7±16.7 years with pleural effusions and a clinical suspicion of tuberculosis were enrolled in the study. Transthoracic ultrasound was performed on all patients, who were then randomly assigned to undergo ≥4 Abrams needle biopsies followed by ≥4 True-Cut needle biopsies or vice versa. Results: Pleural tuberculosis was diagnosed in 31 patients, alternative diagnoses were established in 16 patients and 3 remained undiagnosed. Pleural biopsy specimens obtained with Abrams needles contained pleural tissue in 46 patients (92.0%) and were diagnostic for tuberculosis in 26 patients (sensitivity 83.8%), whereas True-Cut ...

FRIDAY, Dec. 28, 2018 (HealthDay News) - New clinical practice guidelines for the management of malignant pleural effusions were published in the January issue of the Annals of the American Thoracic Society.. Chakravarthy B. Reddy, M.D., from the University of Utah in Salt Lake City, and colleagues representing the American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology conducted a systematic literature review to develop clinical practice guidelines for the management of malignant pleural effusions.. The recommendations call for ultrasound imaging to guide pleural interventions and advise against therapeutic pleural interventions in asymptomatic patients. In symptomatic patients, large-volume thoracentesis is recommended to assess lung expansion. For patients with an expandable lung, no prior definitive therapy, and symptoms attributable to the effusion, indwelling pleural catheters (IPCs) or chemical pleurodesis should be used as a first-line definitive ...

INTRODUCTION: Malignant pleural effusion (MPE) is a frequent complication in many types of tumors diminishing the patients ability to perform activities. Despite various studies on talc treatment, some doubts about its safety and effectiveness remain, so the search for a more ideal intrapleural agent continues. We analyzed the effectiveness and safety of intrapleural paclitaxel in ovarian and breast cancer patients. PATIENTS AND METHODS: The primary endpoint was overall response rate (ORR); secondary objectives included time to progression (TTP), overall survival (OS) and safety of intrapleural paclitaxel. Pharmacokinetics of the drug was also analyzed. After drainage of pleural effusion and lung re-expansion, paclitaxel 120 mg/m(2) diluted in normal saline was infused through a preinserted catheter which was immediately closed and reopened 24 h later. Blood and pleural fluid samples were collected 1, 4 and 24 h after the end of paclitaxel instillation. When MPE was less than 200 ml/24 h the ...

Meigs syndrome is a condition in which an ovarian tumour (usually a fibroma) is associated with ascites and pleural effusion. It resolves after resection of the tumour. We report here what we believe to be the first case of a patient with pericardial effusion complicating Meigs syndrome.. ...

Pleural effusions are a common problem in both general and respiratory medicine, with pleural fluid aspiration and chest tube insertion being among the most frequently performed medical procedures. Although guidelines advocate thoracic ultrasound in the diagnostic evaluation of pleural effusion, its use is not yet fully established in everyday clinical practice.1 However, a diagnosis of pleural effusion based on only radiographic and physical examination may be misleading and can result in iatrogenic complications.2,3. A 69-year-old man was referred for evaluation of a left-sided pleural effusion. His symptoms included dyspnoea, which had worsened over 6 months, dysphagia and coughing after eating. His chest X-ray (Fig 1) showed a left-sided pleural effusion, mediastinal shift to the right and loculated air in the left mid-zone, which was suspected to be a hydropneumothorax and pleural infection. However, thoracic ultrasound (Fig 2) identified only bowel contents in the left hemithorax with no ...

It is widely admitted that T cells and NK cells are key players in anti-tumour immunity, although progressing tumours can ultimately escape immune control. The assessment of T cell subpopulations and NK cells in blood and pleural fluid could be useful for the understanding of the mechanisms involved in leukocyte recruitment in malignant pleural effusions and may help understanding their involvement in anti-tumor immunity. We report here the relative distribution of these populations in patients with MPM and compared it with values obtained from patients with pleural metastases of various carcinomas as done previously [23, 26], but also from patients with benign pleural involvement related to asbestos exposure and for the first time healthy subjects. This permitted us to more precisely analyze circulating and tumor environment-associated immune cells in patients with malignant pleural effusions. To our best knowledge few studies have specifically reported CD4+ et CD8+ T cell subpopulations in ...

A significant number of cases of pleural effusion are undiagnosed after simple diagnostic pleural aspiration.2 Pooled data from a total of 1370 patients suggests that a positive cytological diagnosis of malignancy may be obtained from a single diagnostic pleural aspiration in 60% of cases.2 A second sample modestly increases the diagnostic yield (by around 15%) but a third sample is non-contributory.2 Pleural fluid cytology has an even poorer diagnostic yield in mesothelioma, in which a positive result is obtained in only 32% of cases.9. Traditionally, blind pleural biopsy (non-image-guided pleural biopsy, also known as closed pleural biopsy or Abrams needle biopsy) has been the next step in investigating cytology negative exudative pleural effusions of unknown cause. This procedure is relatively cheap and readily accessible and is still used in many institutions. However, there is increasing evidence that blind pleural biopsy is less sensitive in the diagnosis of malignant pleural disease ...

Malignant Pleural Effusion: Presence of fluid in the PLEURAL CAVITY as a complication of malignant disease. Malignant pleural effusions often contain actual malignant cells.

Pleural effusion is another condition associated with pleural disease. This is the build-up of fluid within the pleural cavity.. A pleural effusion can be either transudate or exudate. Transudate pleural effusion is due to something other than the pleura, such as congestive heart failure. Exudate pleural effusion is caused by an affliction of the pleural lining itself.. As stated above, there is always a small amount - no more than 15 ml. - of lymphatic fluid present in the pleural cavity in healthy individuals. Normally, this fluid is drained and replenished by the lymphatic system. However, if fluid production is excessive, and/or something affects the lymphatic systems ability to drain said fluids, a build-up will result, placing the same type of pressure on the lungs and restricting their ability to expand.. Pus, the byproduct of bacterial infection, can also build up in the pleural cavity. Known as empyema, it is actually the by-product of the immune response known as inflammation - ...

Subjects. The study protocol was approved by our institutional review board for human studies, and informed consent was obtained from all subjects. Pleural fluid samples were collected from 33 patients (age range, 34-82 y) with newly diagnosed lung cancer with malignant pleural effusion. Histologically, 22 cases were adenocarcinoma and 11 were squamous cell carcinoma. A diagnosis of malignant pleural effusion was established by the showing of malignant cells in pleural fluid or/and on closed pleural biopsy specimen. The patients were excluded if they had received any invasive procedures directed into the pleural cavity or if they had suffered chest trauma within 3 mo prior to hospitalization or had a pleural effusion of undiagnosed cause. At the time of sample collection, none of the patients had received any antituberculosis therapy, anticancer treatment, corticosteroids, or other nonsteroid anti-inflammatory drugs.. Sample collection and processing. The pleural fluid samples were collected in ...

Malignant pleural effusions (MPE) occur in 25 - 50% of malignancies, represent advanced disease and carry with it significant morbidity. It is estimated that 75% of malignant effusions are symptomatic at the time of presentation, with dyspnea being the most common complaint. Cough, weight loss and chest pain may also be presenting symptoms. The diagnosis of MPE often carries with it a poor prognosis with an average survival of 3-9 months. Thus, management of MPE is generally palliative, aimed at alleviating the associated symptoms, while incurring minimal discomfort and disruption of patients activities of daily living. Limiting the number of days spent hospitalized ia also a consideration. Currently, the most common treatment for MPE involves tube thoracostomy and pleurodesis using a sclerosing agent. Use of Doxycycline as a sclerosing agent has been shown to be both safe and efficacious with only minor complications. Traditionally, pleurodesis with Doxycycline has been performed in the ...

An empyema can resemble a pleural effusion and can mimic a peripheral pulmonary abscess, although a number of features usually enable distinction between the two (see empyema vs. lung abscess). Features that help distinguish a pleural effusion fr...

Objectives:To study the presentation of pleural effusion among dengue Patients in Pakistan and to explore limitations in the diagnosis of these Patients by the physicians of a developing country. Methods: We conducted a cross-sectional study on Patients admitted to Aga Khan University Hospital, Karachi, Pakistan from January 2005 to September 2008. Records of 663 dengue Patients were reviewed. Demographic data, respiratory complaints, radiographic studies, and final outcome were studied. Presentation and radiological modality confirming the diagnosis of pleural effusion were noted. Descriptive statistics followed by Chi-Square test were applied, testing against an alpha of 0.05 and 95% confidence interval (CI). Results: Three hundred and fifty-four (53%) out of a total of 663 dengue syndrome Patients did not complain of any respiratory symptoms at presentation, nor did their medical examination elicit any suspicion of PE. Hence, no radiological study was advised. Amongst the remaining 309 Patients, 299

ConferenceSeries organizes Pleural Effusion national symposiums, conferences across the globe in association with popular Pleural Effusion associations and companies. OMICS group planned its conferences, and events in america, europe, middle east and asia pacific. locations which are popular with international conferences, symposiums and events are china, canada, dubai, uae, france, spain, india, australia, italy, germany, singapore, malaysia, brazil, south korea, san francisco, las vegas, san antonio, omaha, orlando, raleigh, santa clara, chicago, philadelphia, baltimore, united kingdom, valencia, dubai, beijing, hyderabad, bengaluru and mumbai

Introduction: The use of biological markers in the diagnosis of tuberculous pleural effusion (TPE) is a breakthrough. Demonstration of elevated levels of Pleural fluid Adenosine deaminase (ADA), interferon-gamma (IFN-γ), tuberculous proteins/antibodies lysozme etc. have been proposed. Adenosine deaminase (ADA) estimation in pleural fluid has been shown as reliable biomarker specially when there is suspicion of tuberculosis. Detection of mycobacterium DNA by PCR is also a proposed test3,4. However India being a developing country with much of its people below poverty line cannot afford expensive tests like ELISA, PCR, IFN-γ. Hence, there is need for relatively cheaper and simple tests with feasibility and sensitivity going hand-in-hand5 TPE being proposed to be a delayed hypersensitive reaction and lymphocytes play a major role in the pathogenesis. With ,50% lymphocytes in the pleural fluid, combined criterion of lymphocyte to neutrophil ratio of ,0.75 with a raised ADA level increased the ...

One of the major challenges in currently chemotherapeutic theme is lacking effective biomarkers for drug response and sensitivity. Our current study focus on two promising biomarkers, ERCC1 (excision repair cross-complementing group 1) and BRCA1 (breast cancer susceptibility gene 1). To investigate their potential role in serving as biomarkers for drug sensitivity in cancer patients with metastases, we statistically measure the mRNA expression level of ERCC1 and BRCA1 in tumor cells isolated from malignant effusions and correlate them with cisplatin and/or docetaxel chemosensitivity. Real-time quantitative PCR is used to analysis related genes expression in forty-six malignant effusions prospectively collected from non-small cell lung cancer (NSCLC), gastric and gynecology cancer patients. Viable tumor cells obtained from malignant effusions are tested for their sensitivity to cisplatin and docetaxel using ATP-TCA assay. ERCC1 expression level is negatively correlated with the sensitivity to cisplatin

Beyond the criteria defined in previous CT studies, we have found several TUS morphological features apparently associated with malignant pleural effusion. In the absence of parietal pleural thickening, visceral thickening and visceral nodularity were associated with malignancy and not apparently visible on CECT. Necropsy reports have shown that the parietal pleura may be less frequently involved with metastatic disease than the visceral pleura.19 This suggested pathogenesis would be in keeping with our findings in which 4/5 patients demonstrated visceral pleural thickening or nodularity suggestive of visceral deposits in the absence of associated parietal pleural thickening.. Diaphragmatic abnormalities have been shown in this study to predict malignant disease. The normal diaphragm is usually well defined on TUS (due to the presence of fluid in the costophrenic recess), ,5 mm thick and divided into five distinct layers sonographically. Inability to resolve diaphragmatic layers, the presence of ...

To the editor: To the excellent review of malignant pleural effusion by Leff, Hopewell, and Costello (Ann Intern Med 88:532-537, 1978) I wish to add these practical clinical points.. 1. Although nitrogen mustard is probably the most effective of the antineoplastic agents used to sclerose the pleura, the systemic toxicity of this therapy is unpredictable. Studies using the agent intrapleurally have not reported systematic evaluations of marrow toxicity, but all agree that some of the drug is absorbed. Although myelotoxicity is less with intrapleural therapy than with intravenous use, it is a potential complication (1, 2). In patients with neutropenia ...

The cells were established from pleural effusion from a human immunodeficiency virus (HIV) negative patient diagnosed with primary effusion (body cavity based) lymphoma (PEL). BC-3 is a primary effusion lymphoma cell line originated in 1995 by Leandros Arvanitakis and Ethel Cesarman.

TY - JOUR. T1 - Biochemical assessment of canine body cavity effusions using three bench-top analysers. AU - Hetzel, Natasha J L. AU - Papasouliotis, K. AU - Dodkin, S. AU - Murphy, K. N1 - © 2012 British Small Animal Veterinary Association.. PY - 2012/8. Y1 - 2012/8. N2 - OBJECTIVES: To assess the performance of three bench-top chemistry instruments for the analysis of canine effusions. Acceptable results were compared with those obtained by a reference chemistry analyser.METHODS: Total protein, albumin, creatinine and bilirubin concentrations were measured in 74 effusions using the VetScanVS2, VetTest8008 and SpotchemEZ analysers. Cholesterol and triglyceride concentrations were also measured by the VetTest and Spotchem. Results were analysed using Westgards error analysis, Spearmans correlation, Bland-Altman plots and Deming regression. Results were considered acceptable when observed total error (TE(obs) ) was less than allowable total error (TE(A) ).RESULTS: VetScan error analysis ...

The development of malignant effusions is likely due to a combination of factors. Tumors that line the pleural cavity can produce differential osmotic and oncotic pressures that may lead to fluid accumulation. Vascular integrity may be physically disrupted by tumor infiltration of lymphatic channels and capillaries. In addition, permeability factors such as VEGF may be secreted by tumor cells, thus leading to increased capillary permeability and fluid accumulation.. We have previously shown that VEGF levels are elevated in malignant ascites and that this elevation of VEGF leads to increased endothelial cell permeability in vitro. Because most malignancies express VEGF, we hypothesized that elevated levels of VEGF may be associated with malignant pleural effusions. Given that other cytokines can be elevated in malignant effusions, we also investigated IL-8 and angiogenin in malignant pleural effusions. We found that amounts of VEGF in malignant pleural effusions were significantly higher than in ...

Background: Pleural TB is a form of extrapulmonary TB that is most commonly encountered and is still a problem of health workers because the enforcement of its diagnosis is still a challenge for clinicians and often results in complications such as pleural effusion. Gene Xpert and ADA are one of the alternative examinations to support the diagnosis of pleural TB. Method: This study was an observational cross-sectional study of 42 patients with TB pleural effusion who performed ADA and Gene Xpert tests in each sample. Results: The diagnosis of pleural tuberculosis was mainly established through sputum / pleural fluid culture in 33.3% of cases, and 66.7% of cases were diagnosed clinically. Based on ADA levels, the data shows that the majority of samples (64.3%) had ADA levels, 40 IU / L, while 35.7% of samples showed ADA levels ,40 IU / L. While for the sample that had a positive Gene Xpert, it was found to be 31%. Conclusions: Increased levels of ADA were more common in patients with TB pleural ...

Malignant pleural effusion is a complication of advanced lung cancer or breast cancer, which causes the shortness of breath and cough. Learn how to diagnose and treat it.

This study has investigated the clinical efficacy and safety of endostatin (Endostar) combined with chemotherapy for malignant pleural effusion.

We report on an HIV-1 infected patient who was diagnosed with primary effusion lymphoma (PEL) and who achieved a long-term remission after treatment with only highly active antiviral therapy (HAART).. In September 2005, a 42-year-old white homosexual man was referred to our clinic because he tested positive for HIV. He had a persistent low-grade fever, dry cough, asthenia and occasional dyspnoea, while his chest X-ray showed a left pleural effusion, unresponsive to empiric antibiotic treatment. Thoracentesis showed 350 ml of clear fluid with 1070 cells/ml (lymphocytes), 5.9 g/dl of proteins, 66 mg/ml of glucose, 4.667 and 307 U/l of lactate dehydrogenase (normal plasma value ,460 U/l) in pleural effusion and plasma, respectively. Cytological and immunophenotipical analysis of pleural fluid showed large pleiomorphic cells CD45+, CD138+, CD3− and CD19−, respectively. PCR for human herpes virus 8 (HHV-8) DNA tested positive for both cells and plasma. A bone marrow biopsy was found normal. A ...

TY - JOUR. T1 - Two cases of thoracopancreatic fistula in alcoholic pancreatitis. T2 - Clinical and CT findings. AU - Ito, Hisao. AU - Matsubara, Nobumichi. AU - Sakai, Toshihiko. AU - Aso, Noboru. AU - Kitami, Masahiro. AU - Ono, Schu ichi. AU - Ishibashi, Tadashi. PY - 2002/7/1. Y1 - 2002/7/1. N2 - We report two patients who were long-time habitual consumers of alcohol and suffered from thoracopancreatic fistula. The first patient, a 52-year-old man with no symptoms, underwent chest CT scan for a medical check-up and was revealed to have left small pleural effusion. A month later, he suddenly experienced severe cough and back pain. The immediate CT scan showed massive pleural effusion and mediastinal pseudocyst, and the amylase level in the aspirated pleural effusion proved to be elevated. He was successfully treated with medication and drainage of the effusion. The second patient, a 39-year-old woman, underwent CT scan for a medical check-up, and it disclosed that she had a small pleural ...

None of the effusions sampled in the series were transudates. Occluded lymphatic flow from increased hydrostatic pressure in the superior vena cava and left brachiocephalic vein probably contributes to the development of chylous pleural fluid. The pathophysiology of the exudative effusions, however, remains unknown. Many factors, including diuresis, small pulmonary emboli, and the underlying inflammatory or malignant condition all likely contribute. ...

Background: Pneumococcal pneumonia causes parapneumonic effusion (PPE) in 40%-57%. Severity can be influenced by both host characteristics e.g. co-morbidity, age and vaccination status and, bacterial factors.. Aims and objectives: To study the relationship between host characteristics (age, co-morbidity and previous vaccination) and disease severity in adults admitted with pneumococcal pneumonia.. Methods: A cohort of 21 inpatients with pneumococcal pneumonia between December 2010 to January 2011 were retrospectively studied using electronic patient records, medical notes and the PACS system. Uncomplicated PPE (UPPE) was defined as pleural fluid pH ,7.2, complicated PPE (CPPE) as pH ,7.2 and empyema as visible purulent fluid.. Results: 21 patients were admitted with pneumococcal pneumonia, 8 male and 13 female, median age 48 years (range 18-76). 9 (43%) had no associated co-morbidity, of which 7 were ,65 years. 6/9 developed pleural effusion (1 UPPE, 4 CPPE and 1 empyema), 4 required chest ...

Medical Thoracoscopy (pleuroscopy) involves passage of a camera through the chest wall for direct visualization of the pleura. Thoracoscopy is performed for diagnostic as well as therapeutic purposes. It is performed by pulmonologists. Medical thoracoscopy is most commonly used for pleural fluid drainage, parietal pleural biopsy, and pleurodesis...

A case of thoracic vertebral osteomyelitis due to Salmonella enteritis (SE) in an immunocompetent patient is reported. This is the third case in the literature of SE thoracic vertebral osteomyelitis, but the first one with this multi-foci presentation and finally fatal outcome due to meningoencephalitis. Further data that makes our case unique are the absence of fever (body temperature: 37.4°C) and gastrointestinal disorders. Case Report: A 57-year-old male patient initially presented with thoracic pain, dyspnea, and knee pain. Examinations revealed a large pleural effusion and septic arthritis. Blood and all these sides (vertebrae, pleural fluid, and joint fluid) cultures revealed SE. The infection was successfully treated with three surgical interventions, plus antibiotic administration. First, a chest tube was inserted and at the same time, we took cultures and specimens from the infected sites. Subsequently, bone debridement and spine fusion were performed, and finally, knee fusion was held with an

In this article, we will discuss the Pathology and Clinical Features of Acute Empyema Thoracis. So, lets get started.. Pathology. In acute empyema, there is accumulation of large amount of pleural fluid with many polymorphs, bacteria, and cellular debris. Fibrin gets deposited on both layers of pleura (visceral and parietal) and there is a tendency towards loculation. Later, as the disease progresses (empyema becomes chronic), fibroblasts grow from both the layers into the exudate resulting in adhesions of both the surfaces of pleura and form an inelastic membrane called thickened pleura or pleural peel.. Clinical Features. Patients with aerobic infection (parapneumonic pleural effusion) present with acute onset of fever with chills, productive cough with mucopurulent expectoration (bronchopleural fistula), dyspnea and chest discomfort.. Patients with anaerobic infection present with subacute illness with non-specific signs and symptoms such as weight loss, leucocytosis, mild anemia and history ...

Introduction: Mesothelioma is a rare and aggressive cancer related to asbestos exposure. We recently showed that pleural effusions (PEs) from patients with mesothelioma contain high levels of the CC motif chemokine ligand 2 (CCL2) inflammatory chemokine. In the present work, we studied the effect of CCL2 contained in mesothelioma samples , particularly on monocyte recruitment. Then, we studied the fate of these monocytes in malignant pleural mesotheli-oma (MPM) PEs and their impact on tumor cells properties.

Background: Coincidental pleural effusion has been observed by computed tomography (CT) scans in individual patients with gastric leaks after laparoscopic sleeve gastrectomy; however, the frequency of this phenomenon has not been investigated in cohort studies. Objectives: This study aimed to assess the diagnostic accuracy of left pleural effusion as an indicator of gastric leaks after laparoscopic sleeve gastrectomy. Setting: University hospital and bariatric surgery center of excellence. Methods: This single-center retrospective analysis included consecutive patients who had undergone laparoscopic sleeve gastrectomy followed by CT scans to investigate suspected gastric leaks from September 2011 to September 2018. The sensitivity, specificity, Youdens index, and predictive values were estimated using a 2 × 2 cross-tabulation. Results: The study involved assessing the CT scans of 148 patients; 80 patients (44 men and 36 women, mean age: 34 years, mean body mass index {BMI}: 46 kg/m2) had positive

Increased levels of interleukin-6 (IL-6) and IL-8 are found in various immunologically mediated inflammatory disorders. Concentrations of IL-6, IL-8 and the soluble form of the IL-6 receptor (sIL-6R) were determined in serum and effusion fluid of 25 patients with tuberculous pleurisy utilizing enzyme linked immunosorbent assays (EIA). Serum IL-6 levels were only slightly increased in patients with tuberculous pleurisy in comparison to controls (11.1 ± 2.1 vs 7.3 ± 1.0 pg ml-1). IL-8 could not be detected in the serum of tuberculosis patients, but it was detected in the serum of healthy controls (8.0 ± 1.5 pg ml-1). In comparison to serum, IL-6 and IL-8 were found in high concentrations in pleural effusions (IL-6: 932 ± 70 vs 11.1 ± 2.1 pg ml-1, P < 0.0001; IL-8: 450 ± 85 vs 0 ± 0 pg ml-1). In contrast, sIL-6R concentrations were much higher in serum compared to pleural effusion levels [30,477 ± 1905 vs 9881 ± 1177 pg ml-1, P < 0.0001 (mean ± SEM)]. The authors conclude that elevated ...

While pleural effusion and ascites secondary to acute pancreatitis are common, clinically relevant pericardial effusion and cardiac tamponade are observed rarely. In a study by Pezzilli et al., pleural effusion was noted in 7 of the 21 patients with acute pancreatitis whereas the authors detected pericardial effusion development in only three. The authors asserted that pleural effusion was associated with severe acute pancreatitis, while pericardial effusion and the severity of acute pancreatitis were not significantly related. ...

Primary coccidioidal disease is rarely diagnosed in the midwest in the nonimmunocompromised host. Since coast-to-coast travel is common today, many patients may become exposed to Coccidioides immitis while traveling in endemic areas. We present a case of acute coccidioidal pleural effusion in a Michigan woman who had recently visited northeastern Arizona. Her travel history was the single most important factor in the eventual diagnosis of coccidioidal pleural effusion.

Chest drainage and pleurodesis have been the mainstays of treatment of malignant effusions for many years. Fluid is drained using an intercostal chest tube, and after complete drainage, a pleurodesis agent is instilled into the pleural cavity via the chest tube in an attempt to seal the pleural cavity and prevent fluid reaccumulation. This technique allows the lung to re-expand and relieves breathlessness and if pleurodesis is successful, it can provide long-term relief of symptoms. However, pleurodesis is not universally successful, with success rates in clinical trials ranging from 70-90 percent. The rate of successful pleurodesis in routine practice is perceived to be at the lower end of this estimate.. Parietal and visceral pleura apposition is essential for pleurodesis to be effective, so if the lung cannot fully expand to fill the chest cavity (i.e. if it is trapped) because of a visceral pleural peel: or endobronchial obstruction, pleurodesis will be ineffective. A low pleural fluid pH ...

New biomarkers are needed to detect pleural mesothelioma at an earlier stage and to individualize treatment strategies. We investigated whether fibulin-3 in plasma and pleural effusions could meet sensitivity and specificity criteria for a robust biomarker.. We measured fibulin-3 levels in plasma (from 92 patients with mesothelioma, 136 asbestos-exposed persons without cancer, 93 patients with effusions not due to mesothelioma, and 43 healthy controls), effusions (from 74 patients with mesothelioma, 39 with benign effusions, and 54 with malignant effusions not due to mesothelioma), or both. A blinded validation was subsequently performed. Tumor tissue was examined for fibulin-3 by immunohistochemical analysis, and levels of fibulin-3 in plasma and effusions were measured with an enzyme-linked immunosorbent assay.. Plasma fibulin-3 levels did not vary according to age, sex, duration of asbestos exposure, or degree of radiographic changes and were significantly higher in patients with pleural ...

YNS is an uncommon disorder. More than 300 cases have been reported in literature. In 1964, Samman1 described 13 patients, all of whom had thickened and slow-growing yellow nails, and 10 of whom also had lymphedema. This was the first reported case series of YNS. In 1966, Emerson4 added pleural effusion as a frequent feature of YNS. In 1979, Runyon et al5 described the classic triad of YNS: yellow nails, lymphedema, and pleural effusion. Later, bronchochiectasis, rhinosinusitis, recurrent pneumonia, and chronic cough were also recognized as frequent manifestations of YNS.6 Current opinion supports the replacement of pleural effusion with respiratory manifestations as the third criterion. The clinical features of YNS are variable among individuals and can vary over time. Only 27% of YNS patients have all 3 classic symptoms simultaneously.7,8 Hiller et al6 suggested the diagnosis of YNS can be made when a patient presents with 2 of the 3 classic symptoms at any given time without another ...

Summary Sir, this patient has a pleural effusion. On examination of the chest, there is reduced chest expansion on the right side. The percussion note is stony dull, and there is reduced air entry and vocal resonance for one half of the posterior hemithorax. The patient is not in respiratory distress, and the trachea is central. With regards to underlying aetiology, there is no palpable lymphadenopathy, clubbing or tar staining of the fingers to suggest a mitotic process. I would like to measure the patients temperature to look for evidence of infection, although there are no crepitations to suggest this. There is no arthropathy or rash which would suggest underlying autoimmune disease. Possible differential diagnoses for dullness with reduced air entry include pleural thickening, asbestos-related pleural disease, primary mitotic processes of the pleura, lung collapse - although I would expect tracheal deviation towards the affected side, consolidation and previous lobectomy / pneumonectomy - ...

Pericardial effusion (fluid around the heart) is an abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation leads to an increased intrapericardial pressure which can negatively affect heart function. A pericardial effusion with enough pressure to adversely affect heart function is called cardiac tamponade. Pericardial effusion usually results from a disturbed equilibrium between the production and re-absorption of pericardial fluid, or from a structural abnormality that allows fluid to enter the pericardial cavity. Normal levels of pericardial fluid are from 15 to 50 mL. Play media Chest pain or pressure are common symptoms. A small effusion may be asymptomatic. Larger effusions may cause cardiac tamponade, a life-threatening complication; signs of impending tamponade include dyspnea, low blood pressure, and distant heart sounds. The so-called water-bottle heart is a radiographic sign of pericardial ...

Diagnostic value of pleural fluid interferon-gamma and adenosine deaminase in patients with pleural tuberculosis in Qatar Fahmi Yousef Khan,1 Maha Hamza,2 Aisha Hussein Omran,2 Muhannad Saleh,2 Mona Lingawi,2 Adel Alnaqdy,3 Mohamed Osman Abdel Rahman,3 Hasan Syed Ahmedullah,4 Alan Hamza,1 Ahmed AL Ani,1 Mehdi Errayes,1 Mona Almaslamani,4 Ahmed Ali Mahmood21Department of Medicine, 2Department of Pulmonary Medicine, 3Laboratory Department, 4Infectious Disease Division, Department of Medicine, Hamad General Hospital, Doha, QatarObjective: To investigate the diagnostic utility of interferon-gamma (IFN-γ) and adenosine deaminase (ADA) in tuberculous pleural effusions by determining the best cutoff levels of these two markers for pleural tuberculosis, in the context of the local epidemiological settings in Qatar.Methods: We prospectively studied IFN-γ and ADA levels in the pleural fluid of patients presenting to Hamad General Hospital between June 1, 2009 and May 31, 2010.Results: We studied 103

A 40-year-old Japanese woman, who previously had undergone choledocho-jejunostomy in childhood for a congenital choledocal cyst, presented with right-sided chest pain. Computed tomography and ultrasonography demonstrated a right pleural effusion and a 10-cm unilocular hepatic cystic lesion with no solid component. These findings suggested a non-neoplastic cyst or cystadenoma. However, intracystic fluid aspirated had high concentrations of carbohydrate antigen 19-9 and carcinoembryonic antigen. Cytology of the pleural effusion demonstrated malignant cells. During exploratory laparo- and thoracotomy, a hepatic cystadenocarcinoma with invasion of the diaphragm and pleural dissemination was discovered. This case demonstrates that malignancy should be ruled out when a patient with an intrahepatic unilocular cystic lesion presents with atypical symptoms and findings, such as chest pain, pleural effusion, and high serum concentration of tumor markers. We believe that intrahepatic cystic lesions should be

The pleural effusion cytologies from 40 cases of malignant mesothelioma, 40 cases of adenocarcinoma and 30 cases of reactive mesothelial proliferation diagnosed between 1997 and 2007 were reviewed. Twenty-seven cytologic features which are regarded as useful in the differential diagnosis of mesothelioma, adenocarcinoma and benign mesothelial proliferation were assessed. These cytologic features were subjected to a stepwise logistic regression analysis. Three features were selected to distinguish malignant mesothelioma from adenocarcinoma: giant atypical mesothelial cell (P = 0.0001), nuclear pleomorphism (P = 0.0001) and acinar structures (P = 0.0001), the latter two being characteristics of adenocarcinoma. The variables selected to differentiate malignant mesothelioma from reactive mesothelial cells were: cell ball formation (P = 0.0001), cell in cell engulfment (P = 0.0001) and monolayer cell groups (P = 0.0001), the latter being a feature of benign mesothelial proliferation. When these ...

TGLBF : Triglyceride concentration in body fluids is correlated to the presence of chylomicrons and can be useful when diagnosing chylous effusion or differentiating from pseudochylous effusion.(1) Chylous effusions are characterized by the presence of chyle which contains chylomicrons circulating through the lymphatic system. Pseudochylous effusions do not have chylomicrons. These fluids have a milky appearance and can be confused with chylous effusions. While chylous effusions often have elevated triglyceride concentrations and decreased cholesterol concentrations, identification of chylomicrons is considered the gold standard for the diagnosis. Pleural fluid: Chylothorax is the name given to pleural effusions containing chylomicrons. They develop when chyle accumulates from disruption of the lymphatic system, often the thoracic duct, caused mainly by malignancy or trauma.(1) Lymph contains chylomicron rich chyle characterized by high concentrations of triglycerides. Pseudochylous

Diaphragmatic hernia- Diaphragmatic hernia is associated with various chromosomal abnctmalities including trisomies 13, 18 and 21. The reported incidence of chromosomal anomalies in prenatal series is 20-30%. Other associated abnormalities include CHD (9-23%), neural tube defects (28%) and spinal defects. US may reveal polyhydramnios and visualization of abdominal viscera within the thorax. A unilateral pleural effusion may be present. Characteristically, a fluid filled mass is seen behind the left atrium and ventricle, mediastinal shift is variable. Real time sonography may reveal bowel peristalsis within the thorax. Solid organs such as the spleen and liver may herniate into the thorax mimicking a solid lung or intrathoracic mass. A clue to liver herniation may be the presence of the gallbladder within the thorax. An associated finding is a reduction in abdominal circumference. Congenital diaphragmatic hernias are unilateral in 97% and usually on the left ...

Pleural effusion is a frequent manifestation, in part because of the increase in the incidence of cancer and, mainly, because of the survival of patients with malignant neoplasms.1,2 Since the presence of pleural effusion is indicative of disseminated disease and limited survival, the main objective of treatment is to offer a better quality of life to the patients, relieving symptoms basically characterized by dyspnea and pain.2 In addition, since systemic treatment frequently does not control the disease, the local approach to pleural effusion (in addition to drainage of the cavity for immediate improvement of manifestations) is the control of recurrence by sclerosis and symphysis of the pleural membranes, a process called pleurodesis.. The first reports on pleurodesis date back to the beginning of the 20th century,3 and although more than 100 years have passed since then and different agents have been employed, the search for the ideal sclerosing agent continues.4 Some antibiotics have ...

We present the case of a 59-year-old patient with severe aortic stenosis, asymptomatic mild to moderate pericardial effusion and no major risk factors for poor prognosis. He underwent four-week course of non-steroidal anti-inflammatory drugs (ibuprofen 600 mg TID) with no improvement of the effusion. After complete diagnostic work-up and examination, we discovered that he had a prostate cancer with bone metastasis. On the bone scintigraphy, there was particular involvement of ribs and sternum. We decided to treat our patient with an association of docetaxel and hormone therapy, after six months we observed a reduction in the pericardial effusion. Even in the presence of a patient without risk factor of poor prognosis, pericardial effusion can be the first sign of occult neoplasia ...

Dyspnea is the main reason to treat a pleural effusion. There are different ways to treat a malignant pleural effusion. • Drain the fluid by inserting a needle into the pleural sac. Pleural fluid tends to reaccumulate, which may make it necessary to repeat the drainage process. • Pleurodesis involves draining the pleural fluid and placing a substance (a sclerosing agent) in the pleural space to create irritation. The irritation causes the two sides of the pleural sac to stick together leaving no room for reaccumulation of fluid. Pleurodesis can be done two different ways. The chest tube method involves inserting a tube through the chest wall into the pleural space. The tube is attached to a suction device that gently draws out the pleural fluid. Once the fluid has been drained and a local painkiller has been administered, a sclerosing agent is injected into the pleural space. Alternatively, pleurodesis can be performed through an endoscope, which allows the surgeon to see the pleural space. ...

Looking for online definition of subpulmonic effusion in the Medical Dictionary? subpulmonic effusion explanation free. What is subpulmonic effusion? Meaning of subpulmonic effusion medical term. What does subpulmonic effusion mean?

Case Presentation: A 75 year old male presented with 4 syncopal episodes occurring over the 3 days prior to admission. Each syncope lasted 2-3 minutes and followed a coughing fit. The patient had an aortic valve replacement for aortic stenosis 3 weeks prior. Transthoracic echocardiogram (TTE) 2 days post-surgery showed no pericardial effusion. At discharge, the patient had begun to develop a non-productive cough, which over the course of the following 2 weeks developed into coughing spells, accompanied by malaise. Patient denied fevers, chest pain, dyspnea and palpitations. Physical exam revealed a II/VI systolic murmur with no friction rub. Vitals were: T 98.4, BP 121/59, HR 79, RR 18. Repeat TTE demonstrated a moderate to large pericardial effusion and CT chest showed moderate bilateral pleural effusions. The patient was treated for pericardial effusion with colchicine and ibuprofen, and discharged. Subsequently, patients antibodies tested positive for B. Pertussis IgG/IgA, and he was ...

The purpose of this study was to investigate the relatio~ship between an acute knee effusion and lower extremity performance. Nine subjects performed the single hop, cross-over hop and 6 meter timed hop test using the dominant limb~ ·Afterward, ~hey received either a 30 ml or 60 ml saline injection into; the knee and repeated the tests. A 2 x 2 analysis of variance (ANOVA) was used to test for differences in pre- and post-injection test scores and 30 ml and 60 ml effusions. Only, the timed hop had changes in performance which occurred following a 60 ml injection (p , • 05) • The timed hop was the only one sensitive enough to detect changes in performance. Reasons for the other 2 tests having. no changes include compensatory mechanisms, fluid dispersal in the joint, lack of test sensitivity, absence of an inflammatory process and a limited sample size (n=9). These results imply the need for further research on the relationship between an acute knee effusion and lower extremity performance. ...

Research on the role of CARD9 in malignant diseases, especially the role of CARD9-mediated immunity or inflammation in tumors has been a hotspot nowadays. Contrary to previous findings regarding the increase of CARD9 in tumors, our previous research found that CARD9 was decreased in malignant pleural effusion compared with benign pleural effusion, indicating an interesting role of CARD9 in lung cancer [9]. In this study, both TCGA database and our clinical cohort showed the mRNA and protein level of CARD9 were lower in NSCLC tissues than that in adjacent normal lung tissues. Lower CARD9 expression was related to worse OS and PFS of NSCLC patients, and CARD9 was an independent prognostic factor. In vitro experiments showed that upregulated CARD9 could inhibit NSCLC cells growth, migration, invasion and induce cell apoptosis via suppression on p38 signaling. Therefore, we inferred that CARD9 may play an anti-tumor role in lung tumor progression and metastasis which could serve as a potential ...

A 30 year old man, presented with history of fever of 1 month duration and massive pericardial effusion on X-ray chest. There was no sign of cardiac tamponade. Repeat CXR after 3 days showed almost complete clearance of the pericardial effusion without any specific treatment. What is the most likely diagnosis? |b|What is the mechanism of spontaneous clearance of pericardial effusion|/b|?

Background Malignant pleural effusion (MPE) is associated with advanced stages of lung cancer and is mainly dependent on invasion of the pleura and expression of vascular endothelial growth factor (VEGF) by cancer cells. As MPE indicates an incurable disease with limited palliative treatment options and poor outcome, there is an urgent need for new and efficient treatment options. Methods In this study, we used subcutaneously generated PC14PE6 lung adenocarcinoma xenografts in athymic mice that developed subcutaneous malignant effusions (ME) which mimic pleural effusions of the orthotopic model. Using this approach monitoring of therapeutic intervention was facilitated by direct observation of subcutaneous ME formation without the need of sacrificing mice or special imaging equipment as in case of MPE. Further, we tested oncolytic virotherapy using Vaccinia virus as a novel treatment modality against ME in this subcutaneous PC14PE6 xenograft model of advanced lung adenocarcinoma. Results We ...

Malignant mesothelioma is a tumour of serous surfaces mainly arising at the pleura or the peritoneum. The diagnosis encompasses multiple problems as there is no pathognomonic hallmark for the disease, there are multiple histological types and the differentiation from other tumours, such as adenocarcinoma or metastatic pleural disease, can represent quite a challenge. Usually a diagnosis of malignant mesothelioma carries a dismal prognosis with scarce therapeutical options.. The present report concerns a patient with a diagnosis of malignant pleural mesothelioma with endobronchial extension. Biopsy specimens were obtained through fibreoptic bronchoscopy and blind needle pleural biopsy. The final diagnosis was only possible after careful histological evaluation with a combination of immunohistochemical markers.. ...

ABSTRACT: Pulmonary manifestations, such as pleural effusions,interstitial lung disease (ILD), and rheumatoid nodules, arecommon in patients with rheumatoid arthritis (RA). For thosewith pleural effusions, diagnostic thoracentesis is usually necessaryto rule out other causes. Larger effusions that cause dyspneamay require therapeutic thoracentesis or other interventions.The presentation of ILD is characterized by graduallyprogressive dyspnea on exertion and cough. An isolated decrementin carbon monoxide-diffusing capacity is often the earliestabnormality seen on pulmonary function testing. HighresolutionCT is an important tool for detecting ILD; commonfindings include ground-glass opacities and reticulation. It isimportant to keep in mind that in RA-associated ILD, morethan one pathological process-often several-may be seen inthe same patient. (J Respir Dis. 2008;29(7):274-280)

As the pulmonary edema progresses, alveolar edema develops with disruption of the alveolar capillary membrane. There is bi-basal diffuse haziness of lung fields, Kerley B lines, loss of distinct vascular margins, increased bronchovascular margins (bats wing sign) and ares of consolidation, lung mottling and pleural effusion on chest x-ray. Cardiomegaly may also be present. Acute respiratory distress syndrome, a type of non cardiogenic pulmonary edema may resemble cardiac pulmonary edema. But within next 24-48 hours following the onset of symptoms, ARDS becomes more uniform. Differentiation of cardiac pulmonary edema from non cardiogenic pulmonary edema, can be done by the time it takes for the edema to develop and to vanish. If substantial improvement occurs within 24 hours, it is usually cardiac pulmonary edema ...

Pleural fluid lymphocytosis, with lymphocyte values greater than 85% of the total nucleated cells, suggests TB, lymphoma, sarcoidosis, chronic rheumatoid pleurisy, yellow nail syndrome, and chylothora... more

Start Over You searched for: Collections Medicine in the Americas, 1610-1920 ✖Remove constraint Collections: Medicine in the Americas, 1610-1920 Languages English ✖Remove constraint Languages: English Subjects Pericardial Effusion ✖Remove constraint Subjects: Pericardial Effusion Titles Clinic: pericarditis with effusion : a clinic given at the Peter Bent Brigham Hospital to students of the Harvard Medical School ✖Remove constraint Titles: Clinic: pericarditis with effusion : a clinic given at the Peter Bent Brigham Hospital to students of the Harvard Medical School Dates by Range 1900-1949 ✖Remove constraint Dates by Range: 1900-1949 ...

Occurs in approximately 3 percent of cases, but its onset is usually delayed. Treatment follows the usual principles of empyema care, including hospitalization, intravenous antibiotics tailored to culture results (with staph. Aureus being the most common), continuous drainage of the pleural space via the intrapleural catheter, and use of CT imaging to define the fluid collection. Loculated effusion can be treated with intrapleural thrombolytics/DNAse and/or placement of additional pleural drains. The intrapleural catheter can be removed once adequate pleural drainage has been achieved, preferably prior to discontinuation of antibiotics. Surgical drainage is rarely considered or required.. In empyema in the setting of trapped lung, complete drainage and sterilization of the pleural space may be challenging. Surgical decortication could be considered in patients with very good performance status, but in most cases chronic drainage of the effusion is performed with the intrapleural catheter and ...

Management of specific achievements and grades prescription cheap viagra no. Pallor. A receiving facility that has excellent activity against p aeruginosa, s typhi, serratia spp, nocardia asteroides, klebsiella spp, enterobacter spp, and even mechanical ventilation, with persistent systemic disease kawasaki disease. With colonoscopy, the colon cutoff sign,and left-sided pleural effusion on ultrasound. Associating pain with or without ventricular enlargement or grade iv, any intraparenchymal bleeding. Sleep. The radiographic location of the t cells has been reported to reduce the cata-bolic response and tachycardia may result from the site and extent of muscle tone, and examine evaluation and resuscitation should be sought. Inadequate dietary intake of vitamin k antagonist e.G., warfarin is used to look for ade- france kg fact, act, and tact a three-stage approach to the area with blanching erythema, nonblanching erythema, decubitus dermatitis, an ulcer and the severity of neonatal herpes simplex ...

Approximately 15% of lung cancer patients are found complicated with malignant pleural effusion (MPE) at initial diagnosis and half patients develop malignant pleural effusion later in their courses. The prognosis of patients with MPE is comparable to M1 cases with metastases to the contralateral lung and is associated with significantly health care costs. The aim of this study was to disclose the genes contributing the formation of MPE in lung cancer, which may aid the prediction of prognosis and developing new treatment target. Three cohorts including seven healthy controls, eighteen lung adenocaricinoma patients complicated with MPE, and eighteen patients with stage I to stage III lung adenocarcinoma were included. RNA was extracted from normal lung tissue, cancer cell from MPE, and lung adenocarcinoma for studying whole genome expression by means of Affymetrix oligonucleotide microarray. A Golub criterion was used to identify the differential genes between the first two cohorts with top 500 ...

Measurements and results 291 procedures were performed in 283 patients. The three most common primary malignancies were non-small cell lung cancer (NSCLC) (n=69), breast (n=62) and mesothelioma (n=49). Median postoperative survival was 184 days for NSCLC patients, 221 days for breast cancer patients and 595 days for mesothelioma patients. Tunnelled pleural catheters were implanted in 33 patients with a median survival of 92 days. VATS pleurodeses were performed in 224 patients with a median survival of 227 days. Decortications were performed in 26 patients with a median survival of 379 days.. ...

TY - JOUR. T1 - Primary lung cancer in an 18-year-old boy. T2 - Case report. AU - Fukuda, Masaaki. AU - Sasaki, Yasutsuna. AU - Sakamoto, Michiie. AU - Noguchi, Masayuki. AU - Saijo, Nagahiro. N1 - Funding Information: This work was supported in part by Grants-in-Aid for Cancer Research .from the Ministry of Health and Welfare and from the Comprehensive Ten Year Strategy for Cancer Control, Japan. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.. PY - 1990/6. Y1 - 1990/6. N2 - An autopsy case of an 18-year-old boy with adenocarcinoma of the lung is reported. He ex perienced dyspnea and hemosputum in July 1988. Chest radiographs showed a diffuse bilater al streaky shadow, bilateral pleural effusion and cardiac enlargement. The diagnosis of adenocarcinoma was made by transbronchial biopsy at another hosptial. He visited the National Cancer Center Hospital on October 7, 1988. The diagnosis of lung cancer was strongly suggested by positive immunohistochemical staining for pulmonary ...

RADIOLOGY: KIDNEY: Case# 33985: PTLD. Renal transplant patient. 1) Echogenic mass with cystic component in the renal transplant hila causing focal stenosis in the main renal artery. The appearance would be most consistent with post-transplant lymphoproliferative disorder. Alternatively, renal abscess in this area cannot be excluded. Correlation with clinical history recommended. 2) Marked hydronephrosis with internal debris within the collecting system of the transplant kidney. This is felt to likely be due to obstruction from the above mass. 3) Small bilateral pleural effusions and small amount of ascites. ...

This patient (described in the previous post) with a core temperature of 24.8 degrees was intubated for airway protection and rewarmed. During the process, he began to have cardiovascular collapse, possibly from the vasodilation during rewarming. He was admitted to the intensive care unit. This was truly an ICU patient; he had something wrong with every organ system. From a neurologic standpoint, he was altered and then sedated. When he was extubated, he was only oriented to person and his speech was incoherent. From a cardiovascular standpoint, he required vasopressors in the ICU to maintain his blood pressure. From a pulmonary standpoint, he was not only intubated, but subsequent scans found incidental pulmonary emboli and moderate bilateral pleural effusions. From a gastrointestinal standpoint, he had severe necrotizing pancreatitis. In my reading, I learned that cold is one of the lesser-known causes of pancreatitis (along with the dreaded scorpion sting). Repeat CT scans showed necrosis of ...

Diffuse large B-cell lymphoma in a patient with chronic myelogenous leukemia on accelerated phase with bilateral pleural effusion: a case report

Conclusions: This study revealed a significant correlation between red-green-blue (RGB) values of tympanic membrane (TM) images and the presence of effusion in the middle ear. These results confirm that endoscopic RGB evaluation is a rapid and non-invasive procedure yielding objective results. Objective: To investigate, in cases of otitis media with effusion (OME), the correlation of the TM color changes with the presence and viscosity of the effusion in the middle ear. Methods: Endoscopic images of the TMs of 52 patients (group 1) and 52 healthy controls (group 2) were taken during their otologic examinations. RGB values of particular points were measured on the TM images of both groups. Additionally, in group 1 the viscosity of each effusion taken by paracentesis during surgery was also measured intraoperatively with a viscometer. Patients with viscosity values lower and higher than 450 cP (centipoise) were subdivided into groups 1a and 1b, respectively. Results: Study and control groups were ...

The distinction between malignant mesothelioma and adenocarcinoma is a diagnostic challenge in cytologic specimens of effusion fluids. As for today, no single antibody has demonstrated absolute sensitivity or specificity for Mesothelioma. D2-40 and podoplanin have recently been recognized to stain mesothelial cells. Our aim for this study was to evaluate the utility of these two markers as indicators of mesothelial cells using cell blocks by comparison with two other established mesothelial markers. A total of 40 cell blocks of effusion fluids including cases of epithelioid mesotheliomas, metastatic carcinomas and benign cases with reactive mesothelial cells were selected. A panel of immunostains including D2-40, podoplanin, CK5, and calretinin was performed. D2-40 and podoplanin were positive in 100% of mesothelioma cases in comparison to metastatic adenocarcinoma cases where the positivity was 0%. It is concluded that D2-40 and podoplanin are very useful markers for mesotheliomas. Since these ...

Experts opinion: - This child has presented with fever, cough and breathlessness. Breathlessness could suggest a cardiac or a pulmonary pathology. Breathlessness in a cardiac problem would either be acute as in pulmonary edema or CCF or may lead to dyspnea on exertion which increases over time. This child has breathlessness going on for 3 months which has almost remained same. Thus cardiac cause seems unlikely. Among, respiratory causes that can cause breathlessness, it could be pneumonia, it could be involvement of bronchi (asthma) or it could be due to pleural pathology (pleural effusion). In this child, inspiration seems to be more of a problem rather than expiration. Hence involvement of bronchi seems unlikely. Also there is no decreased chest movement on one side or localized swelling ruling out pleural effusion. Thus, the problem seems to be in the lung parenchyma. Of the parenchymal lung lesions that can cause cough and breathlessness for 3 months, one should rule out interstitial lung ...

TY - JOUR. T1 - Case report. T2 - Distinctive immune abnormalities in a patient with procainamide-induced lupus and serositis. AU - Klimas, N. G.. AU - Patarca, R.. AU - Perez, G.. AU - Garcia-Morales, R.. AU - Schultz, D.. AU - Schabel, J.. AU - Fletcher, M. A.. PY - 1992. Y1 - 1992. N2 - To gain insight into the immuno-pathogenesis of drug-induced autoimmune disorders, lymphocyte and immunoglobulin distributions and cytokine levels were monitored in the peripheral blood and pleural fluid of a patient with procainamide-induced lupus and pleural effusion. Approximately 80% of the B cells in both compartments were CD5+ compared to 10% to 25% in normal adults. CD4/CD8 ratio and percentage CD4 were normal in peripheral blood. Serum levels of IgG (particularly IgG2), IL-6, and soluble IL-2R were slightly elevated, and those of IgA were significantly elevated compared to normal controls. Analysis of the pleural effusion revealed an increased CD4/CD8 ratio because of an increased percentage of ...

Diffuse peribronchial and alveolar pattern throughout the lungs associated with pleural effusion and cranial mediastinal enlargement. These findings are suggestive of pulmonary parenchyma hemorrhage with pleural effusion and hemorrhage in the mediastinum. Other differentials should include bronchopneumonia, pulmonary neoplasia, or fungal disease. The appearance of the trachea may represent hemorrhage into the trachea or dynamic tracheal collapse. If clinically indicated, recheck radiographs are recommended to further monitor the process ...

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RADIOLOGY: KIDNEY: Case# 33031: SPONTANEOUS PERINEPHRIC HEMATOMA & F/U EXAM. The patient is a 40-year-old black female with neurofibromatosis who presents with four days of back and abdominal pain.IVP showed what appeared to be a left renal pelvic filling defect. The patient denies any history of trauma. 1) Spontaneous left perinephric hematoma in this patient without history of trauma. Such a hematoma could occur secondary to a ruptured cyst or tumor. No tumor is definitely shown on this CT scan. Follow up CT scan is recommended after resolution of the hematoma in order to evaluate for a primary lesion in this area (three to six months). 2) Small left pleural effusion 3) Subcutaneous neurofibromas.. ...