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https://www.readbyqxmd.com/read/29323536/high-positive-end-expiratory-pressure-renders-spontaneous-effort-non-injurious
#1
Caio C A Morais, Yukiko Koyama, Takeshi Yoshida, Glauco M Plens, Susimeire Gomes, Cristhiano L A S Lima, Ozyres P Ramos, Sérgio M Pereira, Naomasa Kawaguchi, Hirofumi Yamamoto, Akinori Uchiyama, João B Borges, Marcos F Vidal Melo, Mauro R Tucci, Marcelo B P Amato, Brian P Kavanagh, Eduardo L V Costa, Yuji Fujino
RATIONALE: In ARDS, atelectatic 'solid-like' lung tissue impairs transmission of negative 'swings' in pleural pressure (Ppl) resulting from diaphragmatic contraction. The localization of more negative Ppl proportionally increases dependent lung stretch by drawing gas either from other lung regions, e.g., non-dependent lung (Pendelluft) or from the ventilator. Lowering of the level of spontaneous effort and/or converting solid-like to fluid-like lung might render spontaneous effort non-injurious...
January 11, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29323086/a-rare-case-of-shewanella-putrefaciens-bacteremia-in-a-patient-of-road-traffic-accident
#2
Ritesh Ranjan, Priti Chowdhary
Shewanella putrefaciens rarely causes human infection. These are mostly found in environment and food stuffs. Shewanella are often found in mixed culture. It has been implicated in cellulitis, otitis media, and septicemia. It may be found in respiratory tract, urine, feces, and pleural fluid. There is no definite guideline for therapeutic option. In general, these are susceptible to various antimicrobial agents but are often resistant to penicillin and cephalothin. We report a rare case of bacteremia by S. putrefaciens in a patient of head injury with polytrauma after a road traffic accident...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29322942/purulent-pericarditis-an-unusual-complication-of-pneumococcal-pneumonia-a-case-report
#3
Ghizlane Zoulati, Ramatou Yèya Maïga, Rachid Kerzaz, Ghita Yahyaoui, Mustapha Harandou, Mustapha Mahmoud
Purulent pericarditis has become rare since the advent of antibiotics. Among the involved germs, S. pneumoniae remains the most implicated pathogen to evoke in principle, especially that prescription of systematic antibiotics for any febrile condition can considerably mask the clinical picture. A 36-year-old pregnant woman was visiting the emergency department for dyspnea and flu-like syndrom that had been going on for a week. The chest X-ray showed a white lung on the left and the transthoracic ultrasound revealed a pericardial effusion, resulting in pericardial drainage and pleural puncture that allows the evacuation of a purulent fluid...
January 11, 2018: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29321967/teratoma-as-unusual-cause-of-chest-pain-hemoptysis-and-dyspnea-in-a-young-patient
#4
Irena Hammen, Achhe Lal Yadav
A 16-year-old girl presented with intermittent left chest pain and breathlessness on exertion for last 4 months with one episode of haemoptysis. There has been loss of appetite and weight loss of 4 kg over a period of 1 month. A chest radiograph revealed a large mass like opacity with pleural effusion in the left lung field. Computerized Tomography scanning (CT scanning) and Positron Emission Tomography/Computerized Tomography scanning (PET/CT scanning) demonstrated a 7 cm round, cystic lesion in the anterior mediastinum...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29321929/pleuritis-associated-with-primary-sjogren-syndrome
#5
Chiaki Hosoda, Yusuke Hosaka, Kai Ryu, Akira Kinoshita, Keisuke Saito, Kazuyoshi Kuwano
We herein present a case of a 71-year-old woman with primary Sjogren's syndrome (SjS), who developed bilateral pleural effusion and ground glass opacity during treatment with low-dose prednisolone. The pleural effusion and bronchoalveolar lavage fluid revealed elevation of lymphocytes. Thoracoscopic pleural biopsy showed infiltration of lymphocytes with no evidence of other diseases, confirming SjS-related pleuritis. Therefore, we initiated 20 mg prednisolone and pleural effusion was rapidly resolved. Our results indicate that SjS can be rarely complicated with pleuritis...
February 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29320326/mediastinal-and-pleural-mr-imaging-practical-approach-for-daily-practice
#6
Constantine A Raptis, Sebastian R McWilliams, Kristy L Ratkowski, Jordi Broncano, Daniel B Green, Sanjeev Bhalla
Radiologists in any practice setting should be prepared to use thoracic magnetic resonance (MR) imaging for noncardiac and nonangiographic applications. This begins with understanding the sequence building blocks that can be used to design effective thoracic MR imaging protocols. In most instances, the sequences used in thoracic MR imaging are adapted from protocols used elsewhere in the body. Some modifications, including the addition of electrocardiographic gating or respiratory triggering, may be necessary for certain applications...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29318136/pleural-tuberculosis-medical-thoracoscopy-greatly-increases-the-diagnostic-accuracy
#7
Angelo Gianni Casalini, Pier Anselmo Mori, Maria Majori, Miriam Anghinolfi, Enrico Maria Silini, Letizia Gnetti, Federica Motta, Sandra Larini, Sara Montecchini, Roberta Pisi, Adriana Calderaro
Our objective was to evaluate the efficacy of a standardised work-up in the diagnosis of pleural tuberculosis (TB) that included fibreoptic bronchoscopy and medical thoracoscopy. A consecutive series of 52 pleural TB patients observed during the period 2001-2015 was evaluated retrospectively. 20 females, mean (range) age 39.7 (18-74) years, and 32 males, mean (range) age 45.75 (21-83) years, were included (28 non-EU citizens (53.8%)). The diagnosis of TB infections was established by identification (using stains, culture or molecular tests) of Mycobacterium tuberculosis in the pleura, sputum and/or bronchial specimens, or by evidence of caseous granulomas on pleural biopsies...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29316379/reactive-histiocytic-proliferation-in-the-pleural-fluid-mimicking-metastatic-signet-ring-adenocarcinoma
#8
Fatima Mir, Anam Naumaan, Hussein Alnajar, Arlen Brickman, Vijaya Reddy, Ji-Weon Park, Paolo Gattuso
Reactive nodular and diffuse histiocytic proliferations of mesothelial and non-mesothelial lined sites have been sporadically reported in the literature. However, there is no cytologic literature describing this process. We report a case of reactive histiocytic proliferation mimicking a metastatic signet ring adenocarcinoma in pleural fluid from a 33-year-old white male. Ancillary studies such as immunohistochemistry should be used to elucidate the cell of origin and avoid diagnostic errors.
January 8, 2018: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#9
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29303294/-ultrasound-examination-of-the-chest-in-the-hands-of-the-clinical-physician
#10
Vratislav Sedlák, Vladimír Koblížek, Rastislav Šimek
Implementation of ultrasound into clinical medicine is current trend in many subspecialties of internal medicine. Remarkable development and use of this technology is currently present in intensive care and respiratory medicine. This review summarizes current knowledge and nomenclature of artefacts and findings in clinical chest ultrasound. It describes ultrasound-based approach in a differential diagnostic algorithm of acute severe dyspnoea. Chest ultrasound should be a standard knowledge of chest physician...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29297807/disseminated-protothecosis-in-a-ruwenzori-long-haired-fruit-bat-rousettus-lanosus
#11
Brian G Stockinger, Alan R Doster
An adult male Ruwenzori long-haired fruit bat ( Rousettus lanosus) presented for lethargy and unthriftiness. Physical examination revealed cranial alopecia, mandibular ulceration, and dehydration. Supportive care and antibiotic therapy were initiated. The bat was found dead 3 days after presentation. Necropsy revealed alopecia on the head and body, exposed dried bone on the rostral tip of the mandible, and excessive clear pleural fluid. Lungs were congested and contained miliary white foci disseminated randomly throughout the parenchyma...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29297451/cxcr3-ligands-in-pleural-fluid-as-markers-for-the-diagnosis-of-tuberculous-pleural-effusion
#12
W Chung, Y Jung, K Lee, J Park, S Sheen, K Park
SETTING: A tertiary care academic medical centre. OBJECTIVE: To evaluate the clinical usefulness of C-X-C motif chemokine receptor 3 (CXCR3) ligands in tuberculous pleural effusion (TPE). DESIGN: We recruited 336 patients with pleural effusion due to various causes. Concentrations of interferon-gamma (IFN-γ) and the CXCR3 ligands CXCL9 and CXCL11 were determined using enzyme immunoassays; adenosine deaminase (ADA) activity was measured in pleural fluid and serum...
December 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29285395/paradoxical-response-to-osimertinib-therapy-in-a-patient-with-t790m-mutated-lung-adenocarcinoma
#13
Shinichiro Okauchi, Hajime Osawa, Kunihiko Miyazaki, Mio Kawaguchi, Hiroaki Satoh
A 'paradoxical response' to cancer treatment is a term used to describe the emergence of unexpected new lesions and the progression of existing lesions, despite appropriate and effective therapy. 'Pseudo-progression' is a phenomenon in which lymphocytes activated by an immune checkpoint inhibitor accumulate in a tumor and expand its shadow, mimicking enlargement of the primary lesion or development of a new metastatic lesion. Patients receiving cancer chemotherapy may respond differently to treatment, by exhibiting a response, deterioration, or the simultaneous occurrence of both...
January 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29285236/intrapleural-targeted-therapies-anti-vegf-and-anti-egfr-in-the-model-of-malignant-pleural-effusion
#14
Milena Marques Pagliarelli Acencio, Juliana Puka, Vanessa Adélia Alvarenga, Vanessa Martins, Mariana Lombardi Peres de Carvalho, Evaldo Marchi, Vera Luiza Capelozzi, Lisete Ribeiro Teixeira
Rationale: Malignant pleural effusion has few options of treatment and drugs administrated by different routes can lead to a less permissive microenvironment for the development of malignant pleural disease. Objectives: To analyze therapies administered intrapleurally in malignant pleural disease and to study EGFR and KRAS mutations in adenocarcinoma. Methods: Mice received LLC cells and were treated intrapleurally with anti-VEGF, anti-EGFR, anti-VEGF+anti-EGFR or saline...
December 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/29284881/postoperative-chylothorax-of-unclear-etiology-in-a-patient-with-right-sided-subclavian-central-venous-catheter-placement
#15
Samie Asghar, Faisal Shamim
A young male underwent decompressive craniotomy for an intracerebral bleed. A right-sided subclavian central venous catheter was placed in the operating room after induction of anesthesia. Postoperatively, he was shifted to Intensive Care Unit (ICU) for mechanical ventilation due to low Glasgow coma scale. He had an episode of severe agitation and straining on the tracheal tube in the evening same day. On the 2nd postoperative day in ICU, his airway pressures were high, and chest X-ray revealed massive pleural effusion on right side...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29274462/performance-of-the-bact-alert-virtuo-microbial-detection-system-for-the-culture-of-sterile-body-fluids-a-prospective-multi-centered-study
#16
Rosemary C She, Marc G Romney, Willson Jang, Tamar Walker, James K Karichu, Sandra S Richter
OBJECTIVES: Continuous monitoring blood culture systems are commonly used for sterile body fluid cultures. In this multi-center study, we evaluated the performance of the new generation BacT/Alert Virtuo system compared to the BacT/Alert 3D and conventional culture for the recovery of microorganisms from sterile body fluids. METHODS: Peritoneal, cerebrospinal, pericardial, pleural, and synovial fluids from adult patients submitted for culture were collected from three different centers...
December 20, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29261631/ventriculopleural-shunt-dysfunction-due-to-a-loculated-pleural-collection-demonstrated-on-spect-ct-imaging
#17
Jeremy Szajer, Roberto Russo, Robert Mansberg
A 35-year-old woman presented with increasing drowsiness on a background of childhood meningitis and hydrocephalus managed with a ventriculopleural shunt. Her cerebral CT and chest radiograph were unchanged from previous imaging and did not identify significant pathology. Because of clinical suspicion of cerebrospinal fluid shunt dysfunction, she was referred for a cerebrospinal fluid shunt study, which demonstrated tracer accumulation within a loculated pleural collection in the left costophrenic recess.
December 19, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29261577/description-of-particle-size-distribution-and-behavior-of-talc-preparations-commercially-available-within-the-united-states
#18
Christopher R Gilbert, Benjamin R Furman, David J Feller-Kopman, Philippe Haouzi
BACKGROUND: Widespread use of talc pleurodesis remains controversial for many providers concerned by adverse events such as respiratory failure, which are sometimes fatal. Particle talc size has been implicated in these adverse effects, mainly on the basis of animal studies utilizing large amounts of talc or in observational studies performed on different continents with different talc preparations and doses. Our aim was to determine the particle size and distribution of only the commercially available US-talc preparations and whether the fluid content can affect this distribution...
January 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29260693/-chylothorax
#19
Mikkel Hvass, Jens Lundby Fransen, Jens Meldgaard Bruun
Chylothorax is a rare condition caused by obstruction or disruption of the lymphatic branches draining the lower body and gastrointestinal tract. Chylothorax is characterized by the presence of lymphatic fluid with triglycerides and chylomicrons in the pleural cavity. The diagnosis is confirmed, when the level of triglycerides is above 1.24 mmol/l (i.e. 110 mg/dl). Aetiologically, chylothorax can be divided into traumatic or non-traumatic, and this separation is of pathophysiological importance, since the treatment should be individualized aiming at the underlying cause of the condition...
December 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29249857/symptomatic-fluid-drainage-tunneled-peritoneal-and-pleural-catheters
#20
REVIEW
Tony Ha, David C Madoff, David Li
Malignant ascites and pleural effusion are significant contributors to patient symptoms such as shortness of breath, abdominal distension, and nausea in the setting of cancer. There are numerous methods employed to control such symptoms such as serial drainages, pleurodesis, and tunneled drainage catheters. Tunneled drainage catheters are a safe, effective, and a minimally invasive procedure to palliate the symptoms of malignant ascites and pleural effusion.
December 2017: Seminars in Interventional Radiology
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