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Pleural effusions

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https://www.readbyqxmd.com/read/28443595/evaluation-of-the-diagnostic-role-of-bedside-lung-ultrasonography-in-patients-with-suspected-pulmonary-embolism-in-the-emergency-department
#1
Hüseyin Acar, Serkan Yılmaz, Elif Yaka, Nurettin Özgür Doğan, Asım Enes Özbek, Murat Pekdemir
BACKGROUND: Despite the existence of detailed consensus guidelines, challenges continue to exist regarding efficient, appropriate and safe imaging methods for the diagnosis of suspected pulmonary embolism. AIMS: This study was conducted to investigate the role of wedge sign, B-lines and pleural effusion seen on bedside lung ultrasound in the diagnosis of pulmonary embolism. STUDY DESIGN: Diagnostic accuracy study. METHODS: During the first evaluation of patients with suspected pulmonary embolism, bedside lung ultrasound was performed, and the B-lines, wedge sign, and pleural effusion were investigated...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28442619/initial-size-of-unilateral-pleural-effusion-determines-impact-of-thoracocentesis-on-oxygenation
#2
Stylianos A Michaelides, George D Bablekos, Antonis Analitis, Avgerinos-Romanos Michailidis, Konstantinos A Charalabopoulos, Nikolaos Koulouris
BACKGROUND: There have been contradicting reports in the literature regarding the impact of pleural fluid aspiration on patients' oxygenation. The aim of this study was to assess the role of the initial size of effusion on post-drainage oxygenation. METHODS: We studied 122 patients, aged (mean±SD) 61.2±16.8 years, with unilateral pleural effusion and no remarkable parenchymal lesion, by determining PaO2, PaCO2 and [A-a] PaO2 just before thoracocentesis (T1), 30 min after its completion (T2) and 48 hours after the procedure (T3)...
April 25, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28441828/-clinical-analysis-of-seven-cases-of-pulmonary-malignant-tumors-in-children
#3
D Xu, Z M Chen, W Z Gu, Y S Wang, M X Huang, L F Tang, Y Y Zhang, Y Jiang
Objective: To understand the clinical manifestation, imaging characteristics and outcomes of pulmonary malignant tumors in children. Method: We retrospectively collected information about seven cases of pulmonary malignant tumors in children in our hospital from Jan 2010 to Dec 2016. The information included clinical manifestation, imaging characteristics, pathologic results, and treatment. Result: (1) All the seven patients firstly visited pediatric internal medicine departments. Symptoms included cough (n=6), dyspnea (n=4), fever (n=2), anorexia (n=2), chest tightness (n=1), chest pain (n=1), lameness (n=1), abdominal distension and constipation (n=1)...
April 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28441375/primary-adrenal-angiosarcoma-a-rare-and-potentially-misdiagnosed-tumor
#4
Ariel Grajales-Cruz, Francis Baco-Viera, Ernesto Rive-Mora, Carlos Ramirez-Tanchez, David Tasso, Norma Arroyo-Portela, Elizabeth Calderon, Ilean Joan Padua-Octaviani, William Caceres-Perkins
A man aged 69 years presented with acute right flank pain secondary to a hemorrhagic large adrenal tumor. En bloc resection was performed to repair the inferior vena cava. Immunoperoxidase levels in the tumor were positive for factor VIII and CD31 and negative for S100, protein Melan-A, CD34, synaptophysin, chromogranin, desmin, muscle specific actin, ETFA (EMA), KRT20 (CK20), CDX2, TTF1, LNPEP (PLAP), inhibin, ?-fetoprotein, CD30, hepatocyte paraffin, and aberrant expression of cytokeratin 7 and pankeratin...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28440918/uremic-pleuritis-a-case-report-and-review-of-recurrent-exudative-pleural-effusions-in-children
#5
Matthew D McGraw, Csaba Galambos, Paul C Stillwell
Despite similar mechanisms driving pleural fluid accumulation, the causes of pleural effusions in children differ significantly from that of adults. When a pleural effusion re-occurs in an adult, literature recommends early thoracentesis, and consideration for pleuroscopy with biopsy to guide the diagnostic evaluation. In children, there is a paucity of literature for guiding management of recurrent exudative pleural effusion. We present an unusual pediatric case of uremic pleuritis with recurrent pericardial and exudative pleural effusions...
April 25, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28440869/massive-pleural-effusion-on-the-contralateral-side-of-a-venous-peripherally-inserted-central-catheter
#6
Selim Sancak, Abdulhamit Tuten, Tulin Gokmen Yildirim, Guner Karatekin
A preterm newborn infant, delivered at 30 weeks of gestation and 965 g birth weight, developed respiratory distress with resistant hypoxia after a central catheter line was inserted via the right venae brachialis on postnatal day 21. Left-sided massive pleural effusion, collapsed left lung with air bronchograms, and bidirectional shunting through reopened ductus arteriosus were detected by targeted neonatal echocardiography. Hydrothorax was drained under sonographic guidance, producing a milky-white fluid biochemically compatible with parenteral nutrition...
April 25, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28433200/the-case-against-performing-pleural-biopsies-for-the-aetiological-diagnosis-of-exudates
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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