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Parapneumonic pleural effusion

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https://www.readbyqxmd.com/read/27866276/manual-intrapleural-saline-flushing-plus-urokinase-a-potentially-useful-therapy-for-complicated-parapneumonic-effusions-and-empyemas
#1
José M Porcel, Horacio Valencia, Silvia Bielsa
PURPOSE: We sought to evaluate the safety profile and effectiveness of manual pleural saline flushing, in addition to urokinase, for managing complicated parapneumonic effusions and empyemas. METHODS: Retrospective comparative review of 23 consecutive patients with complicated parapneumonic effusions or empyemas who received saline flushing plus urokinase through small-bore chest catheters, and 39 who were only treated with fibrinolytics. Both groups had similar baseline characteristics and treatments were mostly protocol-driven...
November 19, 2016: Lung
https://www.readbyqxmd.com/read/27821625/hippocrates-ca-460-375-bc-introducing-thoracotomy-combined-with-a-tracheal-intubation-for-the-parapneumonic-pleural-effusions-and-empyema-thoracis
#2
Gregory Tsoucalas, Markos Sgantzos
Hippocrates was the first physician to describe in accuracy pleural effusion and pneumonia. To treat empyema thoracis he had introduced a combined method of tracheal intubation with a simultaneously thoracotomy. The surgical incision was used for the pus to be progressively drainaged. If the patient was too weak to eat, he had suggested for nutritional mixtures to be administered through an oral-gastric tube. Thus Hippocrates composed in his operating theatre, an icon similar to modern surgical operations.
December 2016: Surgical Innovation
https://www.readbyqxmd.com/read/27709281/stratifying-fibrinolytic-dosing-in-pediatric-parapneumonic-effusion-based-on-ultrasound-grade-correlation
#3
Charles A James, Leah E Braswell, Amir H Pezeshkmehr, Paula K Roberson, James A Parks, Mary B Moore
BACKGROUND: Complicated pleural effusion prolongs the hospital course of pneumonia. Chest tube placement with instillation of fibrinolytic medication allows efficient drain output and decreases hospital stay. OBJECTIVE: To evaluate experience with lower fibrinolytic dose for parapneumonic effusions and to assess potential dose stratification based on a simple ultrasound grading system. MATERIALS AND METHODS: We retrospectively reviewed the medical record to identify children and young adults who received fibrinolytic therapy for parapneumonic effusion and had chest tube placement by an interventional radiology service at a single children's hospital...
October 5, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27648553/therapy-of-645-children-with-parapneumonic-effusion-and-empyema-a-german-nationwide-surveillance-study
#4
Florian J Segerer, Karin Seeger, Anna Maier, Christine Hagemann, Christoph Schoen, Mark van der Linden, Andrea Streng, Markus A Rose, Johannes G Liese
OBJECTIVE: To evaluate the initial management of pediatric parapneumonic effusion or pleural empyema (PPE/PE) with regard to length of hospital stay (LOS). METHODS: Collection of pediatric PPE/PE cases using a nationwide surveillance system (ESPED) from 10/2010 to 06/2013, in all German pediatric hospitals. Inclusion of PPE/PE patients <18 years of age requiring drainage or with a PPE/PE persistence >7 days. Staging of PPE/PE based on reported pleural sonographic imaging...
September 20, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27635382/pasteurella-multocida-pleural-effusion-a-case-report-and-review-of-literature
#5
Sidharth Navin Jogani, Ramesh Subedi, Amit Chopra, Marc A Judson
We describe a man who developed pleural effusion with Pasteurella multocida, and review the reported literature concerning this entity. We identified 21 such cases, including our own. Most patients with P. multocida pleural effusions are immunocompromised and/or have significant co-morbidities. These effusions are typically complicated parapneumonic effusions that are grossly purulent (87%) with a low pleural fluid pH (mean 6.8), high protein (mean 4.8 g/dl) and high LDH (mean 1911 U/L) and low glucose (28...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27625443/thoracoscopic-evaluation-of-129-cases-having-undiagnosed-exudative-pleural-effusions
#6
Chetan Basavaraj Patil, Ramakant Dixit, Rakesh Gupta, Neeraj Gupta, Varna Indushekar
BACKGROUND: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. MATERIALS AND METHODS: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope...
September 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27607885/-decortication-in-pleural-empyema-reasonable-effects-on-lung-function
#7
T Potzger, M Ried, H-S Hofmann
UNLABELLED: Parapneumonic pleural effusion (PPE) occurring in early-stage (stage I) pleural empyema (PE) can be managed by chest tube drainage, which should be performed as soon as possible, to achieve re-expansion of the pulmonary parenchyma. Chronic disease leads to fibrin deposits on both pleural surfaces (stage II), followed by a thickened pleura peel (stage III). A trapped or compressed lung can only be released by surgical decortication, which may be performed with a minimally-invasive approach (video-assisted thoracoscopy) or an open technique (thoracotomy)...
September 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27529628/microbiological-characteristics-and-predictive-factors-for-mortality-in-pleural-infection-a-single-center-cohort-study-in-korea
#8
Cheol-Kyu Park, Hyoung-Joo Oh, Ha-Young Choi, Hong-Joon Shin, Jung Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yong-Soo Kwon
BACKGROUND: Identification and understanding of the pathogens responsible for pleural infection is critical for appropriate antibiotic treatment. This study sought to determine the microbiological characteristics of pleural infection and to identify potential predictive factors associated with mortality. METHODS: In this retrospective study, we analyzed patient data from 421 cases of parapneumonic effusion. A total of 184 microorganisms were isolated from 164 patients, using two culture systems: a standard method and a method using pairs of aerobic and anaerobic blood culture bottles...
2016: PloS One
https://www.readbyqxmd.com/read/27527890/pleural-effusion-with-negative-culture-a-challenge-for-pneumococcal-diagnosis-in-children
#9
Vinicius Pieta Perez, Juliana Caierão, Gilberto Bueno Fischer, Cícero Armídio Gomes Dias, Pedro Alves d'Azevedo
BACKGROUND: Pneumococcal parapneumonic effusion seems to be increasing in children in the postvaccine era and is frequently associated with negative culture. Due to the low yield of culture, culture-independent tools are evaluated. METHODS: Culture-negative pleural fluid specimens from 38 children with parapneumonic effusion were examined for pneumococcal lytA by quantitative polymerase chain reaction (qPCR) and soluble antigen (C-polysaccharide) using an immunochromatographic test (BinaxNow Streptococcus pneumoniae)...
October 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/27504545/frequency-of-hepatic-hydrothorax-and-its-association-with-child-pugh-class-in-liver-cirrhosis-patients
#10
Amanullah Abbasi, Abdul Rabb Bhutto, Mohammad Tanveer Alam, Muhammad Aurangzaib, Mohammad Masroor
OBJECTIVE: To determine the frequency of hepatic hydrothorax and its association with Child Pugh Class in patients with liver cirrhosis. STUDY DESIGN: Descriptive, analytical study. PLACE AND DURATION OF STUDY: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, (Ward- 7), from June 2012 to May 2013. METHODOLOGY: All patients with established diagnosis of decompensated chronic liver disease were included. Detailed history, thorough physical examination, routine laboratory investigations, chest X-ray and abdominal ultrasound were carried out in all patients to find out the presence of pleural effusion and ascites, respectively...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27499963/the-diagnostic-utility-and-tendency-of-the-soluble-receptor-for-advanced-glycation-end-products-srage-in-exudative-pleural-effusion
#11
Yun Su Sim, Dong Gyu Kim, Tae Rim Shin
BACKGROUND: The soluble receptor for advanced glycation end products (sRAGE) may have an inflammatory or homeostatic function in lung tissue. The aim of this study was to assess the usefulness of sRAGE as a diagnostic marker for exudative pleural effusions, which are common manifestations of a variety of diseases. METHODS: Patients with an undiagnosed pleural effusion were prospectively enrolled between January 2013 and January 2015. Samples of blood and pleural fluid were centrifuged and the supernatant stored at -70 °C...
July 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27488820/pleural-fluid-adenosine-deaminase-serum-c-reactive-protein-ratio-for-the-differentiation-of-tuberculous-and-parapneumonic-effusions-with-neutrophilic-predominance-and-high-adenosine-deaminase-levels
#12
Jaehee Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Chang Ho Kim
PURPOSE: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are usually distinguished by cellular predominance and pleural fluid adenosine deaminase (ADA) levels. However, both diseases may occasionally show similar neutrophilic predominance and high ADA levels. In such cases, the differential diagnosis between TPE and PPE is challenging and has been rarely investigated. METHODS: A retrospective study was conducted on TPE and PPE patients with neutrophilic exudate and pleural fluid ADA levels ≥40 U/L...
August 3, 2016: Infection
https://www.readbyqxmd.com/read/27460398/intrapleural-urokinase-therapy-in-a-neonate-with-pleural-empyema
#13
Lily Myung-Jin Cha, Sunha Choi, Taehwan Kim, Shin Won Yoon
Pleural empyema is rare in neonates, and treatment with systemic antibiotics and tube drainage may fail because of the thick viscous fluid, bacterial products with fibrin deposition, and multiple loculations. Intrapleural fibrinolytic therapy with urokinase is an effective and non-invasive treatment option that avoids surgical intervention, although its use in neonates has not been studied extensively. In this report, we describe the case of a 13-day-old male neonate with Escherichia coli sepsis and pneumonia, which rapidly progressed to parapneumonic effusion and pleural empyema...
July 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27401931/risk-factors-for-local-complications-in-children-with-community-acquired-pneumonia
#14
Katarzyna Krenke, Marta Krawiec, Grażyna Kraj, Joanna Peradzynska, Agnieszka Krauze, Marek Kulus
AIM: The aim of this study was to evaluate the factors that could predict the development of local complications (parapneumonic effusion/pleural empyema, necrotizing pneumonia, and lung abscess) in children with community-acquired pneumonia (CAP). METHODS: Demographic, clinical, and laboratory data were prospectively collected and compared in children with noncomplicated and complicated CAP. RESULTS: Two-hundred and three patients aged from 2 months to 17 years were enrolled...
July 12, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27401009/development-and-validation-of-the-comples-score-for-differentiating-between-tuberculous-effusions-with-low-pleural-ph-or-glucose-and-complicated-parapneumonic-effusions
#15
Luis Corral-Gudino, Alberto García-Zamalloa, Cristina Prada-González, Silvia Bielsa, Duckens Alexis, Jorge Taboada-Gómez, Pilar R Dos-Santos-Gallego, María A Alonso-Fernández, Jose M Porcel
BACKGROUND: The frequency of "complicated" pleural effusions (CPE) (i.e., pleural fluid pH ≤ 7.2 and/or glucose ≤60 mg/dL) of tuberculous origin (CTPE) is not well reported. This study aims to quantify their prevalence, and develop a score to differentiate CTPE from complicated parapneumonic effusions (CPPE). METHODS: Retrospective analysis of databases from three Spanish hospitals which included patients with CTPE and CPPE. Forty percent of the study population served to generate a scoring system (COMPLES, COMplicated PLeural Effusion Score) that was further validated in the remaining 60 %...
October 2016: Lung
https://www.readbyqxmd.com/read/27374670/atypical-pleural-fluid-profiles-in-tuberculous-pleural-effusion-sequential-changes-compared-with-parapneumonic-and-malignant-pleural-effusions
#16
Chang Ho Kim, So Yeon Lee, Yong Dae Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Jaehee Lee
Objective Although tuberculous pleural effusion (TPE) is commonly characterized by lymphocytic predominance and high adenosine deaminase (ADA) levels, it may present with neutrophilic predominance or low ADA levels, which are more commonly found in parapneumonic effusion (PPE) or malignant pleural effusion (MPE), respectively. A few studies have observed that the atypical pleural fluid profiles of these cases of TPE may resolve at follow-up thoracentesis. However, these observations were incompletely analyzed and lacked comparison with proper control groups...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27296817/etiology-of-parapneumonic-effusion-and-pleural-empyema-in-children-the-role-of-conventional-and-molecular-microbiological-tests
#17
Katarzyna Krenke, Ewa Sadowy, Edyta Podsiadły, Waleria Hryniewicz, Urszula Demkow, Marek Kulus
BACKGROUND: An increasing incidence of parapneumonic effusion and pleural empyema (PPE/PE) has been reported in recent studies. As only few data on etiology of PPE/PE in Central Europe have been reported, we undertook a study on the etiology of PPE/PE in children, using both standard culture and molecular techniques. METHODS: This prospective study was conducted between June 2011 and December 2013. Consecutive children with PPE/PE complicating community acquired pneumonia, who required diagnostic/therapeutic thoracentesis were included...
July 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27282206/c-reactive-protein-in-pleural-fluid-does-it-help-predict-complicated-parapneumonic-effusions
#18
L Ferreiro, L Valdés
No abstract text is available yet for this article.
October 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27194820/the-diagnostic-value-of-the-pleural-fluid-c-reactive-protein-in-parapneumonic-effusions
#19
Shimon Izhakian, Walter G Wasser, Benjamin D Fox, Baruch Vainshelboim, Mordechai R Kramer
Purpose. The aim of this study was to evaluate the sensitivity of pleural C-reactive protein (CRP) biomarker levels in identifying parapneumonic effusions. Methods. A single-center, retrospective review of 244 patients diagnosed with pleural effusions was initiated among patients at the Rabin Medical Center, Petah Tikva, Israel, between January 2011 and December 2013. The patients were categorized into 4 groups according to their type of pleural effusion as follows: heart failure, malignant, post-lung transplantation, and parapneumonic effusion...
2016: Disease Markers
https://www.readbyqxmd.com/read/27161381/factors-influencing-pleural-drainage-in-parapneumonic-effusions
#20
J M Porcel, H Valencia, S Bielsa
OBJECTIVE: The identification of parapneumonic effusions (PPE) requiring pleural drainage is challenging. We aimed to determine the diagnostic accuracy of radiological and pleural fluid findings in discriminating between PPE that need drainage (complicated PPE (CPPE)) and those that could be resolved with antibiotics only (uncomplicated PPE (UPPE)). SUBJECTS AND METHODS: A retrospective review of 641 consecutive PPE, of which 393 were categorized as CPPE and 248 as UPPE...
May 6, 2016: Revista Clínica Española
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