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Pleural effusion

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https://www.readbyqxmd.com/read/28433200/the-case-against-performing-pleural-biopsies-for-the-aetiological-diagnosis-of-exudates
#1
J M Porcel
In most cases, the etiological diagnosis of pleural exudates does not require a pleural biopsy. However, when it is considered necessary, the biopsy should seldom be conducted using invasive methods such as thoracoscopy. Two paradigmatic examples are pleural tuberculosis and malignant effusions. In many centres, pleural fluid adenosine deaminase measurement has replaced closed pleural biopsies in the diagnosis of tuberculosis. Similarly, pathological and molecular studies on pleural fluid cell blocks or alternatively, image-guided pleural biopsies have drastically reduced the need for thoracoscopy...
April 19, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#2
Hussnain S Mirza, Gregory Logsdon, Anoop Pulickal, Mark Stephens, Rajan Wadhawan
Point-of-care (POC) ultrasound refers to the use of portable imaging. Although POC ultrasound is widely available to the neonatologists in Australia and Europe, neonatologists in the United States report limited availability. Our objective was to seek the US neonatologists' perception of barriers and prerequisites in adopting POC ultrasound in neonatal intensive care units. An online survey link was sent via e-mail to 3000 neonatologists included in the database maintained by the American Academy of Pediatrics...
April 20, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28430631/loss-of-steroid-hormone-receptors-is-common-in-malignant-pleural-and-peritoneal-effusions-of-breast-cancer-patients-treated-with-endocrine-therapy
#3
Willemijne A M E Schrijver, Karianne Schuurman, Annelot van Rossum, Ton Peeters, Natalie Ter Hoeve, Wilbert Zwart, Paul J van Diest, Cathy B Moelans
Discordance in estrogen receptor alpha (ERα), progesterone receptor (PR), androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) status between primary breast cancers and solid distant metastases ("conversion") has been reported previously. Even though metastatic spread to the peritoneal and pleural cavities occurs frequently and is associated with high mortality, the rate of receptor conversion and the prognostic implications thereof remain elusive.We therefore determined receptor conversion in 91 effusion metastases (78 pleural, 13 peritoneal effusions) of 69 patients by immunohistochemistry (IHC) and in situ hybridization...
February 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28428936/multistate-models-on-pleural-effusion-after-allogeneic-hematopoietic-stem-cell-transplantation
#4
Joohyoung Lee, Dipenkumar Modi, Hyejeong Jang, Joseph P Uberti, Seongho Kim
A multistate model is more complicated than competing risk models and composed of finite number of states and transitions between states. Unlike competing risk models, this model has the ability to assess the effect of occurrence order of time-to-event data. Pleural effusion (PE) is a severe complication that often occurs after allogeneic hematopoietic stem cell transplantation (HSCT). Many patients develop pleural effusion during the first 100 days after allogeneic HSCT and graft-versus-host disease (GVHD) occurs either before or after the development of PE, implying that the occurrence order of PE and GVHD (i...
2017: Open Access Medical Statistics
https://www.readbyqxmd.com/read/28427079/diagnostic-accuracy-of-combinations-of-tumor-markers-for-malignant-pleural-effusion-an-updated-meta-analysis
#5
Yuan Yang, Ya-Lan Liu, Huan-Zhong Shi
BACKGROUND: The role of combinations of tumor markers such as carcinoembryonic antigen (CEA), carbohydrate antigens (CA) 125, 15-3, and 19-9, and CYFRA 21-1 (a fragment of cytokeratin 19) in diagnosing malignant pleural effusion (MPE) has not been clearly established. OBJECTIVES: This meta-analysis was performed to establish the overall diagnostic accuracies of combinations of these pleural fluid tumor markers for MPE. METHODS: The PubMed, Ovid, Embase, Web of Science, and Cochrane bibliographic databases were searched...
April 21, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28426471/advances-in-the-management-of-malignant-pleural-effusion
#6
Labib G Debiane, David E Ost
PURPOSE OF REVIEW: The current review describes the latest evidence in the management of malignant pleural effusions (MPE). RECENT FINDINGS: Daily drainage of indwelling pleural catheters achieved auto-pleurodesis at a higher rate compared with every-other-day drainage [0.47 vs. 0.24; difference in proportion of 0.23; 95% confidence interval (CI) 0.08-0.38; P = 0.003]. In patients with MPE undergoing talc pleurodesis, a large multicenter randomized clinical trial found that pain control with opiates vs...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28426470/identification-and-management-of-pleural-effusions-of-multiple-aetiologies
#7
Steven Walker, Nick Maskell
PURPOSE OF REVIEW: Historically, pleural effusions have been attributed to a single cause. There is growing recognition that a substantial proportion of pleural effusions may have more than one underlying cause. The purpose of this review is to summarise recent findings regarding the diagnosis and treatment of effusions secondary to more than one aetiology. RECENT FINDINGS: A recent prospective study identified that 30% of pleural effusions had more than one underlying aetiology...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28426468/indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax
#8
Kevin P Haas, Alexander C Chen
PURPOSE OF REVIEW: Hepatic hydrothorax is a complication of end-stage liver disease that may have significant associated morbidity. Sodium restriction and diuretic therapy are the mainstays of treatment, though up to a quarter of patients will become refractory to this and will require a pleural drainage procedure. Thoracentesis, transjugular intrahepatic portosystemic shunt, and chemical pleurodesis all have variable success rates and associated complications in the management of hepatic hydrothorax...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#9
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28425045/soluble-triggering-receptor-expressed-on-myeloid-cell-1-strem-1-a-potential-biomarker-for-the-diagnosis-of-infectious-diseases
#10
REVIEW
Changlin Cao, Jingxian Gu, Jingyao Zhang
Sensitive and useful biomarkers for the diagnosis and prognosis of infectious diseases have been widely developed. An example of these biomarkers is triggering receptor expressed on myeloid cell-1 (TREM-1), which is a cell surface receptor expressed on monocytes/macrophages and neutrophils. TREM-1 amplifies inflammation by activating the TREM-1/DAP12 pathway. This pathway is triggered by the interaction of TREM-1 with ligands or stimulation by bacterial lipopolysaccharide. Consequently, pro-inflammatory cytokines and chemokines are secreted...
April 19, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28423705/addition-of-bevacizumab-for-malignant-pleural-effusion-as-the-manifestation-of-acquired-egfr-tki-resistance-in-nsclc-patients
#11
Tao Jiang, Aiwu Li, Chunxia Su, Xuefei Li, Chao Zhao, Shengxiang Ren, Caicun Zhou, Jun Zhang
This study aimed to investigate the role of bevacizumab in patients with advanced non-small cell lung cancer (NSCLC) who had developed acquired resistance to EGFR-TKIs therapy that manifested as malignant pleural effusion (MPE). In total, 86 patients were included. 47 patients received bevacizumab plus continued EGFR-TKIs and 39 patients received bevacizumab plus chemotherapy. The curative efficacy rate for MPE in bevacizumab plus EGFR-TKIs group was significantly higher than that in bevacizumab plus chemotherapy group (89...
March 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28423035/genetic-profiling-of-putative-breast-cancer-stem-cells-from-malignant-pleural-effusions
#12
Verena Tiran, Stefanie Stanzer, Ellen Heitzer, Michael Meilinger, Christopher Rossmann, Sigurd Lax, Oleksiy Tsybrovskyy, Nadia Dandachi, Marija Balic
A common symptom during late stage breast cancer disease is pleural effusion, which is related to poor prognosis. Malignant cells can be detected in pleural effusions indicating metastatic spread from the primary tumor site. Pleural effusions have been shown to be a useful source for studying metastasis and for isolating cells with putative cancer stem cell (CSC) properties. For the present study, pleural effusion aspirates from 17 metastatic breast cancer patients were processed to propagate CSCs in vitro...
2017: PloS One
https://www.readbyqxmd.com/read/28417478/point-of-care-lung-sonography-an-audit-of-1150-examinations
#13
Giuseppe Francesco Sferrazza Papa, Michele Mondoni, Giovanni Volpicelli, Paolo Carlucci, Fabiano Di Marco, Elena Maria Parazzini, Francesca Reali, Giulia Michela Pellegrino, Paola Fracasso, Simone Sferrazza Papa, Livio Colombo, Stefano Centanni
OBJECTIVES: Point-of-care lung sonography has theoretical usefulness in numerous diseases; however clinical indications and the impact of this technique have not been fully investigated. We aimed to describe the current use of point-of-care lung sonography. METHODS: A 2-year prospective observational study was performed by pulmonologists in an Italian university hospital. Techniques, indications, consequences of lung sonography, and barriers to the examination were analyzed...
April 18, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28416960/medical-thoracoscopy-in-pleural-disease-experience-from-a-one-center-study
#14
Soo Jung Kim, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young Sik Park
BACKGROUND: Medical thoracoscopy (MT) is a minimally invasive, endoscopic procedure for exploration of the pleural cavity under conscious sedation and local anesthesia. MT has been performed at the Seoul National University Hospital since February 2014. This paper summarizes the findings and outcomes of MT cases at this hospital. METHODS: Patients who had undergone MT were enrolled in the study. MT was performed by pulmonologists, using both rigid and semi-rigid thoracoscopes...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28416936/reentrance-of-azygos-vein-into-azygos-fissure-after-pneumothorax
#15
Onur Taydas, Zeynep Atceken, Orhan Macit Ariyurek
Empty azygos fissure implies dislocation of the azygos vein to the mediastinal side of the right upper lobe from azygos fissure, which is usually secondary to pneumothorax, pleural effusion, parenchymal fibrosis, vertebral collapse or persistent vomiting. We are presenting here a case where a separated azygos vein in CT and radiography images was noted. Moreover, in the follow-up images, it appeared that the complete reexpansion of the right lung resulted in reentrance of the azygos vein into azygos fissure in its native position...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28414673/purulent-pericarditis-due-to-an-infected-pacemaker-lead
#16
Teresa Backes
INTRODUCTION: Intravenous drug users have a substantially increased risk of infective endocarditis, especially in the setting of implanted cardiac devices. Purulent pericarditis is a rare occurrence that can occur iatrogenically or through direct or hematogenous spread. CASE DESCRIPTION: A 75 year old man with a past medical history significant for hepatitis C, IV drug abuse, and sick sinus syndrome status post pacemaker was brought in by EMS with a chief complaint of diaphoresis and chest pain...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413685/empyema-associated-with-campylobacter-curvus-infection
#17
Yukihiro Horio, Yoshiki Shiraishi, Nobuo Watanabe, Shigeaki Inoue, Tadashi Imanishi, Koichiro Asano
We report the first case of thoracic empyema associated with Campylobacter curvus infection. A 65-year-old woman with a history of bronchiectasis presented with acute cough and phlegm. The patient reported dyspnoea and left chest pain accompanied by left pleural effusion, despite treatment with sitafloxacin. Curved Gram-negative rods, eventually identified as C. curvus using 16S ribosomal RNA- and atpA-specific polymerase chain reaction (PCR) and sequencing, were cultured in anaerobic condition of pleural effusion together with Peptostreptococci...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28413650/clinical-features-of-hemodialysis-patients-treated-for-hepatocellular-carcinoma-comparison-between-resection-and-radiofrequency-ablation
#18
Atsushi Hiraoka, Takashi Kumada, Kojiro Michitaka, Hidenori Toyoda, Toshifumi Tada, Koichi Takaguchi, Kunihiko Tsuji, Ei Itobayashi, Daichi Takizawa, Masashi Hirooka, Yohei Koizumi, Hironori Ochi, Koji Joko, Yoshiyasu Kisaka, Yuko Shimizu, Kazuto Tajiri, Joji Tani, Tatsuya Taniguchi, Akiko Toshimori, Shinichi Fujioka
There is no consensus regarding which therapeutic option is better and/or safer for treating hemodialysis (HD) patients with hepatocellular carcinoma (HCC). The present study compared surgical resection (Hx) and radiofrequency ablation (RFA) with regard to therapeutic efficacy in HD patients with HCC. Of 108 HD patients with naïve HCC treated at 15 institutions between 1988 and 2014 enrolled in the present study, 58 fulfilled the up-to-7 criteria [7 as the sum of the size of the largest tumor (cm) and the number of tumors] and were treated with Hx (n=23) or RFA (n=35); their clinical features, complications and prognosis were assessed...
April 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28413082/primary-sj%C3%A3-gren-syndrome-with-pleural-effusion
#19
Lucía Ferreiro, Esther San José, Juan Suárez-Antelo, Luis Valdés
No abstract text is available yet for this article.
April 13, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28411293/safe-and-effective-bedside-thoracentesis-a-review-of-the-evidence-for-practicing-clinicians
#20
REVIEW
Richard Schildhouse, Andrew Lai, Jeffrey H Barsuk, Michelle Mourad, Vineet Chopra
BACKGROUND: Physicians often care for patients with pleural effusion, a condition that requires thoracentesis for evaluation and treatment. We aim to identify the most recent advances related to safe and effective performance of thoracentesis. METHODS: We performed a narrative review with a systematic search of the literature. Two authors independently reviewed search results and selected studies based on relevance to thoracentesis; disagreements were resolved by consensus...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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