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pleural effusion guidelines

Oliver J Bintcliffe, Gary Y C Lee, Najib M Rahman, Nick A Maskell
The evidence base concerning the management of benign pleural effusions has lagged behind that of malignant pleural effusions in which recent randomised trials are now informing current clinical practice and international guidelines.The causes of benign pleural effusions are broad, heterogenous and patients may benefit from individualised management targeted at both treating the underlying disease process and direct management of the fluid. Pleural effusions are very common in a number of non-malignant pathologies, such as decompensated heart failure, and following coronary artery bypass grafting...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
Rana Khazar Al-Zoubi, Mouhanna Abu Ghanimeh, Ashraf Gohar, Gary A Salzman, Osama Yousef
Hepatic Hydrothorax (HH) is defined as a pleural effusion greater than 500 ml in association with cirrhosis and portal hypertension. It is an uncommon complication of cirrhosis, most frequently seen in association with decompensated liver disease. The development of HH remains incompletely understood and involves a complex pathophysiological process with the most acceptable explanation being the passage of the ascetic fluid through small diaphragmatic defects. Given the limited capacity of the pleural space, even the modest pleural effusion can result in significant respiratory symptoms...
August 31, 2016: Hospital Practice (Minneapolis)
Matthew F Covington, Gagandeep Choudhary, Ryan J Avery, Elizabeth A Krupinski, Phillip H Kuo
OBJECTIVE: Nuclear imaging can confirm pleuroperitoneal shunt as the cause of pleural effusion. No society guidelines exist for scintigraphic pleuroperitoneal shunt detection. Our institutional protocol was evaluated to determine optimal imaging time points for shunt detection. METHODS: Pleuroperitoneal shunt studies over 4 years were blindly reviewed by 2 nuclear radiologists. Data from blinded review included presence or absence of pleuroperitoneal shunt, laterality of shunt and time points for shunt detection...
October 2016: Clinical Nuclear Medicine
Suhendro Suwarto, Leonard Nainggolan, Robert Sinto, Bonita Effendi, Eppy Ibrahim, Maulana Suryamin, R Tedjo Sasmono
BACKGROUND: There are several limitations in diagnosing plasma leakage using the World Health Organization (WHO) guidelines of dengue hemorrhagic fever. We conducted a study to develop a dengue scoring system to predict pleural effusion and/or ascites using routine laboratory parameters. METHODS: A prospective observational study was carried out at Cipto Mangunkusumo Hospital and Persahabatan Hospital, Jakarta, Indonesia. Dengue-infected adults admitted on the third febrile day from March, 2010 through August, 2015 were included in the study...
2016: BMC Infectious Diseases
Kazuki Nabeshima, Shinji Matsumoto, Makoto Hamasaki, Tomoyuki Hida, Toshiaki Kamei, Kenzo Hiroshima, Tohru Tsujimura, Kunimitsu Kawahara
Because most of malignant pleural mesothelioma (MPM) patients first present with pleural effusion, detection of mesothelioma cells on effusion smears is critical for early diagnosis. Recently, accumulating evidence indicating that the cytological diagnosis of MPM supported by ancillary techniques is as reliable as that based on histopathology has led to new guidelines for the cytopathologic diagnosis of MPM. Based on the guidelines, a combination of cytomorphological criteria and verification by ancillary techniques is required for the cytologic diagnosis of MPM...
September 2016: Diagnostic Cytopathology
James Milne, Paul Atkinson, David Lewis, Jacqueline Fraser, Laura Diegelmann, Paul Olszynski, Melanie Stander, Hein Lamprecht
INTRODUCTION: Point of care ultrasound (PoCUS) has become an established tool in the initial management of patients with undifferentiated hypotension. Current established protocols (RUSH and ACES) were developed by expert user opinion, rather than objective, prospective data. PoCUS also provides invaluable information during resuscitation efforts in cardiac arrest by determining presence/absence of cardiac activity and identifying reversible causes such as pericardial tamponade. There is no agreed guideline on how to safely and effectively incorporate PoCUS into the advanced cardiac life support (ACLS) algorithm...
2016: Curēus
Rosanel Amaro, Adamantia Liapikou, Catia Cilloniz, Albert Gabarrus, Francesc Marco, Jacobo Sellares, Eva Polverino, Javier Garau, Miquel Ferrer, Daniel M Musher, Antoni Torres
In patients with pneumococcal community-acquired pneumonia (CAP), the risk factors for bacteraemia and its impact on outcomes are not fully elucidated. We aimed to compare characteristics of patients with blood-culture-positive versus blood-culture-negative pneumococcal CAP, and to characterise bacteraemic serotypes.We describe a prospective, observational study on nonimmunocompromised patients with pneumococcal CAP, from 1996 to 2013. We define severe pneumonia according to American Thoracic Society/Infectious Diseases Society of America guidelines...
September 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Saad Ahmad, Hina K Jamali, Fahad Waqar, David M Harris
Cardiac tamponade is a common and often life-threatening process, which is typically associated with a pericardial effusion or, in rare cases, with a large pleural effusion. Theoretically, as reported in only a single prior case, it can be caused by extrinsic compression from tense ascites. We present a case in which dynamic inferior wall collapse was secondary to increased abdominal pressure from tense ascites. This phenomenon may be more common than previously diagnosed, especially in patients with liver disease...
2016: Cardiology
Kyoung Jin Kim, Kang Won Lee, Ju Hee Choi, Jang Wook Sohn, Min Ja Kim, Young Kyung Yoon
OBJECTIVE AND IMPORTANCE: Infective endocarditis involving the tricuspid valve is an uncommon condition, and a consequent haemothorax associated with pulmonary embolism is extremely rare. Particularly, there are no guidelines for the management of this complication. We describe a rare case of pulmonary embolism and infarction followed by a haemothorax due to infective endocarditis of the tricuspid valve caused by Streptococcus sanguinis. CLINICAL PRESENTATION: A 25-year-old man with a ventricular septal defect (VSD) presented with fever...
August 2016: Acta Clinica Belgica
Katsuya Kato, Kenichi Gemba, Nobukazu Fujimoto, Keisuke Aoe, Yukio Takeshima, Kouki Inai, Takumi Kishimoto
PURPOSE: The purpose of this study was to clarify the characteristic findings of mesothelioma at the time of diagnosis, and determine precautions and guidelines for diagnosing mesothelioma early in imaging studies. MATERIALS AND METHODS: Overall, 327 patients with pleural mesothelioma were selected from 6030 patients who died of mesothelioma between 2003 and 2008 in Japan. Their imaging findings were examined retrospectively. RESULTS: Plaques were found in 35 % of computed tomography (CT) scans...
June 2016: Japanese Journal of Radiology
Zhuo Wang, Guoguang Xia, Ling Lan, Fayong Liu, Yanxun Wang, Baoyue Liu, Yi Ding, Li Dai, Yunjian Zhang
OBJECTIVE: Pleural effusion is rarely observed in patients with multiple myeloma (MM). Myeloma cell infiltration or invasion to the pleura is very rare. This study aimed to investigate the clinical characteristics of pleural effusion in patients with MM. METHODS: We retrospectively reviewed the medical records of patients diagnosed with pleural effusion, MM, and pleural effusion with MM between 2004 and 2014 at Beijing Jishuitan Hospital. The present study included patients with pleural effusion who underwent cytological, bacteriological, biochemical and other testing...
2016: Internal Medicine
Dharmesh Patel
In the modern management of pleural diseases, thoracoscopy has a clear advantage over closed pleural biopsy. By way of its high yield, both in malignant pleural disease and pleural Tuberculosis - the two commonest cause of undiagnosed pleural effusion, thoracoscopy has the added advantage of faster symptom relief and offering effective pleurodesis. This makes it an attractive diagnostic and therapeutic procedure of choice and features high in the algorithms of many international guidelines on the approach to pleural diseases...
November 2015: Lung India: Official Organ of Indian Chest Society
Elias Jabbour, Dinara Makenbaeva, Melissa Lingohr-Smith, Jay Lin
BACKGROUND: The National Comprehensive Cancer Network (NCCN) guidelines state that based on toxicity profiles, 1 second-generation tyrosine kinase inhibitor (TKI) indicated for first-line therapy (ie, dasatinib, nilotinib) may be preferred over the other for treatment of chronic myelogenous leukemia (CML) patients with certain comorbidities. This study assessed the prevalence of comorbid conditions relevant to TKI treatment choice among CML patients in the US real-world setting. PATIENTS AND METHODS: Patients who had CML and initiated TKI treatment were identified from the MarketScan Commercial and Medicare databases (January 1, 2006, to June 30, 2013)...
December 2015: Clinical Lymphoma, Myeloma & Leukemia
Massimiliano Cantinotti, Raffaele Giordano, Giovanni Volpicelli, Shelby Kutty, Bruno Murzi, Nadia Assanta, Luna Gargani
Respiratory complications are common causes of morbidity and the need of repeated X-ray examinations after cardiac surgery. Ultrasound of the chest, including the lung parenchyma, has been recently introduced as a new tool to detect many pulmonary abnormalities. Despite this, the use of lung ultrasound (LUS) in adult and congenital cardiac surgery remains limited. In particular, lung ultrasound has been mainly used in the evaluation of pleural effusion (PLE), but no consensus exists on methods to quantify the volume of the effusion...
February 2016: Interactive Cardiovascular and Thoracic Surgery
Borut Gersak, Theodor Fischlein, Thierry A Folliguet, Bart Meuris, Kevin H T Teoh, Simon C Moten, Marco Solinas, Antonio Miceli, Peter J Oberwalder, Manfredo Rambaldini, Gopal Bhatnagar, Michael A Borger, Denis Bouchard, Olivier Bouchot, Stephen C Clark, Otto E Dapunt, Matteo Ferrarini, Guenther Laufer, Carmelo Mignosa, Russell Millner, Philippe Noirhomme, Steffen Pfeiffer, Xavier Ruyra-Baliarda, Malakh Shrestha, Rakesh M Suri, Giovanni Troise, Anno Diegeler, Francois Laborde, Marc Laskar, Hani K Najm, Mattia Glauber
OBJECTIVES: After a panel process, recommendations on the use of sutureless and rapid deployment valves in aortic valve replacement were given with special respect as an alternative to stented valves. METHODS: Thirty-one international experts in both sutureless, rapid deployment valves and stented bioprostheses constituted the panel. After a thorough literature review, evidence-based recommendations were rated in a three-step modified Delphi approach by the experts...
March 2016: European Journal of Cardio-thoracic Surgery
Heidi L Frankel, Andrew W Kirkpatrick, Mahmoud Elbarbary, Michael Blaivas, Himanshu Desai, David Evans, Douglas T Summerfield, Anthony Slonim, Raoul Breitkreutz, Susanna Price, Paul E Marik, Daniel Talmor, Alexander Levitov
OBJECTIVE: To establish evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the ICU and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck, and extremities. METHODS: The Grading of Recommendations, Assessment, Development and Evaluation system was used to determine the strength of recommendations as either strong or conditional/weak and to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and thus generating six "grades" of recommendation (1A-1B-1C-2A-2B-2C)...
November 2015: Critical Care Medicine
Sara Matani, J Rush Pierce
We report a case of bilateral chylothorax without evidence of chylous fistula in a 62-year-old man following total laryngectomy and bilateral selective neck dissection for laryngeal cancer. Chylous fistulae, a well-known complication of neck dissection, occurs following 1% to 2% of these surgeries. On rare occasions, the chyle leak may communicate with the pleural space, resulting in chylothorax. This is a rare but potentially life-threatening complication. Bilateral chylothorax following neck dissection is even rarer, with less than 25 cases reported in the literature...
April 2015: Journal of Investigative Medicine High Impact Case Reports
Gilda da Cunha Santos, Mauro Ajaj Saieg
The results from molecular assays can be affected significantly by the preanalytic condition of cytologic samples. The authors review current knowledge on the use of cytologic samples for epidermal growth factor receptor (EGFR) mutation testing in non-small cell lung cancer with a focus on preanalytic parameters. A systematic electronic search of the MEDLINE database was performed to identify original articles that reported the use of cytologic samples for EGFR molecular analysis and included a minimum of 100 samples...
November 2015: Cancer Cytopathology
R W Dal Negro, L Bonadiman, P Turco
BACKGROUND: Several comorbidities frequently affect COPD progression. Aim of the study was to assess the prevalence of main comorbidities by gender and disease severity in a cohort of COPD patients referring for the first time to a specialist institution. METHODS: The study was a non-interventional, cross-sectional investigation carried out via automatic and anonymous selection from the institutional data base over the period 2012-2015. Inclusion criteria were: subjects of both sex aged ≥40 years; diagnosis of COPD according to GOLD guidelines 2014; the availability of a complete clinical record file...
2015: Multidisciplinary Respiratory Medicine
Rosa T Roldán, María Elena P Torres, Daniel M Gallardo, Marisol C Arias, Fernando P Saldías
BACKGROUND: Day hospitals can reduce health care costs without increasing the risks of patients with lower respiratory tract infection. AIM: To report the experience of a respiratory day hospital care delivered to adult patients with community-acquired pneumonia (CAP) in a public hospital. MATERIAL AND METHODS: During the fall and winter of 2011 and 2012, adult patients with CAP of intermediate risk categories were assessed in the emergency room, their severity was stratified according to confusion, respiratory rate, blood pressure, 65 years of age or older (CRB-65) score and the Chilean CAP Clinical Guidelines, and were admitted to the respiratory day hospital...
April 2015: Revista Médica de Chile
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