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Parapneumonic pleural effusion

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https://www.readbyqxmd.com/read/29221347/safe-administration-of-intrapleural-alteplase-during-pregnancy
#1
Heather Torbic, Hanine Inaty, Siva Raja, Humberto Choi
Instillation of intrapleural (IP) fibrinolytics has been used in patients with complicated parapneumonic pleural effusions to improve fluid drainage and decrease the need for surgical intervention. However, clinical trials have not included certain special populations such as pregnant females and there are currently no published case reports of this practice in this group. We describe the case of a 35-year-old female, G2P1 at 32 weeks of gestation, with a complicated pleural effusion due to influenza pneumonia with superimposed bacterial pneumonia...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29202740/the-pleural-fluid-lactate-dehydrogenase-adenosine-deaminase-ratio-differentiates-between-tuberculous-and-parapneumonic-pleural-effusions
#2
Jinlin Wang, Jun Liu, Xiaohong Xie, Panxiao Shen, Jianxing He, Yunxiang Zeng
BACKGROUND: Although pleural fluid lactate dehydrogenase (LDH) and adenosine deaminase (ADA) levels are often used to distinguish between tuberculous pleural effusion (TPE) and parapneumonic pleural effusion (PPE), this can be challenging as the LDH level may vary from normal to severely increased in PPE and a significantly elevated ADA is frequently measured in both conditions. In this study, we evaluated use of the pleural fluid LDH/ADA ratio as a new parameter to discriminate TPE from PPE...
December 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29124008/rare-complicated-parapneumonic-effusion-mycoplasma-pneumoniae-with-new-onset-lupus-flare-case-report-and-literature-review
#3
Bharat Bajantri, Shaik Danial, Richard Duncalf, Misbahuddin Khaja
Mycoplasma pneumoniae has been associated with respiratory tract infections. Mycoplasma pneumoniae pneumonia-related pleural effusion is rarely reported. Extra-pulmonary abnormalities such as encephalitis, myocarditis, glomerulonephritis, and myringitis have been reported. However pulmonary manifestations in systemic lupus erythematosus include pneumonitis, pleurisy, interstitial lung disease, and thromboembolic disease. We present the case of a 26-year-old male who came for evaluation of fever, cough, and shortness of breath with right-sided chest pain...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29081644/precision-guided-personalized-intrapleural-fibrinolytic-therapy-for-empyema-and-complicated-parapneumonic-pleural-effusions-the-case-for-the-fibrinolytic-potential
#4
Steven Idell, Galina Florova, Sreerama Shetty, Torry Tucker, Richard Idell, Kathy Koenig, Ali Azghani, Najib M Rahman, Andrey Komissarov
Complicated pleural effusions and empyema with loculation and failed drainage are common clinical problems. In adults, intrapleural fibrinolytic therapy is commonly used with variable results and therapy remains empiric. Despite the intrapleural use of various plasminogen activators; fibrinolysins, for about sixty years, there is no clear consensus about which agent is most effective. Emerging evidence demonstrates that intrapleural administration of plasminogen activators is subject to rapid inhibition by plasminogen activator inhibitor-1 and that processing of fibrinolysins is importantly influenced by other factors including the levels and quality of pleural fluid DNA...
July 2017: Clinical Pulmonary Medicine
https://www.readbyqxmd.com/read/29064169/unexpandable-lung-from-pleural-disease
#5
REVIEW
John T Huggins, Fabien Maldonado, Amit Chopra, Najib Rahman, Richard Light
Unexpandable lung is a common complication of malignant pleural effusions and inflammatory pleural diseases, such as pleural infection (e.g. empyema and complicated parapneumonic effusion) and noninfectious fibrinous pleuritis. Unexpandable lung due to pleural disease may be because of an active pleural process, and is referred to as malignant or inflammatory lung entrapment. An unexpandable lung may also be encountered in the setting of remote pleural inflammation resulting in a mature fibrous membrane overlying the visceral pleura preventing full expansion of the lung...
October 24, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28991771/surgical-treatment-of-pleural-empyema-our-results
#6
Goran Kondov, Zoran Spirovski, Irena Kondova-Topuzovska, Anita Kokareva, Risto Colanceski, M Srceva, Borislav Kondov, I Dzikovski, N Toleska-Dimitrovska, Sanja Petrusevska-Marinkovic
Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce morbidity, mortality and duration of hospital stay. Unfortunately, advanced stages of empyema need to use extensive surgery - decortications or thoracoplasty. Early recognition of the parapneumonic effusion and the adequate treatment with thoracentesis or pleural drainage, which is minimally invasive, is possible not to prograde the process and not to become empyema. AIM: To analyze the results of the surgical treatment in patients with empyema treated at Clinic for thoracic surgery...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28938258/pneumococcal-vaccination-and-pneumonia-associated-with-pleural-effusion-in-a-pediatric-population
#7
Enrique Bernaola, Francisco Gil, Mercedes Herranz, Alberto Gil-Setas, Marcela Guevara, Jesus Castilla
OBJECTIVE: The aim was to assess the effect of the non-systematic pneumococcal conjugate vaccine (PCV) on incidence of pneumonia associated with parapneumonic pleural effusion (PPE) in vaccinated and unvaccinated children. METHODS: Cases were patients aged <15 years who had been diagnosed with pneumonia associated with PPE in a tertiary hospital in Navarra (Spain) between 1995 and 2014. The population aged <15 years and covered by the public health service was used as reference...
September 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28893806/low-dose-intrapleural-alteplase-without-deoxyribonuclease-in-complicated-parapneumonic-effusion-case-series-and-literature-reviews
#8
Carol Lai, Nurashikin Mohammad, Tidi Maharani Hassan, Mohamed Faisal Abdul Hamid
This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28840015/a-review-of-the-management-of-complex-para-pneumonic-effusion-in-adults
#9
REVIEW
Vikas Koppurapu, Nikhil Meena
A complex para-pneumonic effusion is a descriptive term for exudative effusions, which complicate or are likely to complicate the anatomy of the pleural space after pneumonia. We performed an online search was performed using the resources PubMed and Google Scholar to provide an update on the management of such effusions based on review of published literature. Search terms including pleural effusion (PE), parapneumonic effusion, and empyema were used. Relevant studies were identified and original articles were studied, compared and summarized...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28837796/videothoracoscopic-surgery-before-and-after-chest-tube-drainage-for-children-with-complicated-parapneumonic-effusion
#10
Rogerio Knebel, Jose Carlos Fraga, Sergio Luis Amantea, Paola Brolin Santis Isolan
OBJECTIVES: To evaluate the effectiveness of videothoracoscopic surgery in the treatment of complicated parapneumonic pleural effusion and to determine whether there is a difference in the videothoracoscopic surgery outcome before or after the chest tube drainage. METHODS: The medical records of 79 children (mean age 35 months) undergoing videothoracoscopic surgery from January 2000 to December 2011 were retrospectively reviewed. The same treatment algorithm was used in the management of all patients...
August 22, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28836366/lipoteichoic-acid-upregulates-plasminogen-activator-inhibitor-1-expression-in-parapneumonic-effusions
#11
Kai-Ling Lee, Wei-Lin Chen, Ray-Jade Chen, Kevin S Lai, Chi-Li Chung
BACKGROUND AND OBJECTIVE: Parapneumonic effusion (PPE) is commonly caused by Gram-positive bacteria (GPB) and often presents with pleural loculation, which is characterized by overproduction of plasminogen activator inhibitor (PAI)-1. Lipoteichoic acid (LTA), a surface adhesion molecule of GPB, binds to the pleural mesothelium and triggers inflammation. However, the effects of LTA on PAI-1 expression in PPE and underlying mechanisms remain unclear. METHODS: Thirty consecutive patients with PPE were enrolled, including uncomplicated culture negative (CN, n = 11), Gram-negative bacteria (GNB, n = 7) and GPB (n = 12) groups stratified by pleural fluid characteristics and bacteriology, and the effusion PAI-1 levels were measured...
August 23, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28816982/performance-of-procalcitonin-in-diagnosing-parapneumonic-pleural-effusions-a-clinical-study-and-meta-analysis
#12
Chao He, Bo Wang, Danni Li, Huan Xu, Yongchun Shen
BACKGROUND: Parapneumonic pleural effusion (PPE) is a common complication of pneumonia. The accurate diagnosis of PPE remains a challenge. Recent studies suggest that procalcitonin (PCT) emerges as a potential biomarker for PPE. Our study aimed to determine the diagnostic value of PCT for PPE by a clinical study and summarize the overall diagnostic performance of PCT through a meta-analysis. METHODS: Demographic and clinical data of the patients with PPE and controls were collected in our clinical study...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28800935/two-stage-interventional-management-of-tube-thoracostomy-induced-pulmonary-artery-perforation-in-a-patient-with-parapneumonic-pleural-effusion-associated-with-oesophageal-squamous-cell-carcinoma
#13
Anthony Alozie, Andrea Bier, Alexander Kaminski, Bernd Westphal, Thomas Heller, Karlheinz Haunstein
No abstract text is available yet for this article.
July 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28797003/pleural-effusion-in-multiple-myeloma-characteristics-and-practice-patterns
#14
Ja Min Byun, Ki Hwan Kim, In Sil Choi, Jin Hyun Park, Jin-Soo Kim, Dong-Yeop Shin, Youngil Koh, Inho Kim, Sung-Soo Yoon, Hyo Jeong Lim
In many Asian countries battling with the double burden of increasing noninfectious diseases on top of infectious diseases, multiple myeloma (MM) patients presenting with pleural effusion (PE) pose a great diagnostic challenge. Thus, we aimed to analyze the clinical features and practice patterns of such patients. This is a multicenter retrospective study of newly diagnosed MM patients between January 2011 and December 2015. Among 575 MM patients diagnosed during the study period, 80 (13.9%) that were associated with PE were identified and analyzed...
2017: Acta Haematologica
https://www.readbyqxmd.com/read/28781127/evolution-of-practice-in-the-management-of-parapneumonic-effusion-and-empyema-in-children
#15
D Griffith, M Boal, T Rogers
AIM: To assess the evolution in management of children with parapneumonic effusion and empyema in a tertiary referral centre. METHOD: We conducted a retrospective case note review of paediatric patients with parapneumonic effusion, pleural effusion and pleural empyema between December 2006 and December 2015. Digital database searches were performed to identify demographic data, referring hospital, radiological and microbiological investigations. Length of stay and morbidity were analysed...
July 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28767771/parapneumonic-pleural-effusion-early-versus-late-thoracoscopy
#16
Rodrigo Romualdo Pereira, Cristina Gonçalves Alvim, Cláudia Ribeiro de Andrade, Cássio da Cunha Ibiapina
Objective: To evaluate the best time to perform thoracoscopy for the treatment of complicated parapneumonic pleural effusion in the fibrinopurulent phase in patients ≤ 14 years of age, regarding the postoperative evolution and occurrence of complications. Methods: This was a retrospective comparative study involving patients with parapneumonic pleural effusion presenting with septations or loculations on chest ultrasound who underwent thoracoscopy between January of 2000 and January of 2013...
July 31, 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28673835/when-should-parapneumonic-pleural-effusions-be-drained-in-children
#17
REVIEW
Gilberto Bueno Fischer, Helena Teresinha Mocelin, Cistiano Feijó Andrade, Edgar E Sarria
Pneumonia is an important health problem in children, and parapneumonic pleural effusion (PPE) is a frequent complication. There is no standard strategy for treating PPE, reflected in the few international guidelines that have been published on the issue. Compared to adults, there is no consensus on the utility of pleural fluid analysis in paediatric PPE. This is because of the lack of good evidence either in favour or against it and the risks of procedural sedation for acquiring pleural fluid for analysis to guide management...
June 1, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28642494/proteome-profiling-reveals-novel-biomarkers-to-identify-complicated-parapneumonic-effusions
#18
Kuo-An Wu, Chih-Ching Wu, Chi-De Chen, Chi-Ming Chu, Li-Jane Shih, Yu-Ching Liu, Chih-Liang Wang, Hsi-Hsien Lin, Chia-Yu Yang
Patients with pneumonia and parapneumonic effusion (PPE) have elevated mortality and a poor prognosis. The aim of this study was to discover novel biomarkers to help distinguish between uncomplicated PPE (UPPE) and complicated PPE (CPPE). Using an iTRAQ-based quantitative proteomics, we identified 766 proteins in pleural effusions from PPE patients. In total, 45 of these proteins were quantified as upregulated proteins in CPPE. Four novel upregulated candidates (BPI, NGAL, AZU1, and calprotectin) were selected and further verified using enzyme-linked immunosorbent assays (ELISAs) on 220 patients with pleural effusions due to different causes...
June 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28626910/intravenous-and-intracavitary-use-of-contrast-enhanced-ultrasound-in-the-evaluation-and-management-of-complicated-pediatric-pneumonia
#19
Annamaria Deganello, Vasileios Rafailidis, Maria E Sellars, Aikaterini Ntoulia, Kleanthi Kalogerakou, Gary Ruiz, David O Cosgrove, Paul S Sidhu
Pediatric pneumonia can be complicated by necrotizing pneumonia or a parapneumonic effusion either in the form of an empyema or a clear effusion. Ultrasonography (US) and computed tomography represent well-established modalities for evaluation of complicated pediatric pneumonia. Contrast-enhanced ultrasound (CEUS) was recently introduced and is gaining increasing acceptance in pediatric imaging. In this case series, we present our initial experience with both intravenous and intracavitary use of CEUS in children with complicated pneumonia...
September 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28579346/combined-spontaneous-bacterial-empyema-and-peritonitis-in-cirrhotic-patients-with-ascites-and-hepatic-hydrothorax
#20
Anwar Mohamed, Mohammed Atef, Ayman Alsebaey, Mahmoud Musa Elhabshy, Mohsen Salama
BACKGROUND AND STUDY AIMS: Spontaneous bacterial empyema (SBEM) is an underestimated condition in patients with ascites and hepatic hydrothorax with a high mortality. This study aimed to find whether spontaneous bacterial peritonitis (SBP) is a prerequisite for SBEM. PATIENTS AND METHODS: 3000 HCV-related cirrhotic patients with ascites and hydrothorax were screened for the presence of SBP (ascitic fluid neutrophils >250/mm(3)) and SBEM (positive pleural fluid culture and neutrophils >250/mm(3) or negative pleural fluid culture and neutrophils >500/mm(3) with no evidence of pneumonia/parapneumonic effusion on chest radiograph or CT)...
June 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
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