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pleural effusions review

Agne Ulyte, Nomeda Valeviciene, Darius Palionis, Simona Kundrotaite, Algirdas Tamosiunas
OBJECTIVE: In cardiac magnetic resonance imaging (CMR), incidental pathological findings are frequently found outside the investigated cardiovascular system. Some of these findings might have clinical implications. The aim of this study was to determine the prevalence of incidental extracardiac findings (ECF) in CMR and their clinical significance. METHODS: A total of 4165 CMR reports from 2009-2012 were retrospectively reviewed for ECF. Two hundred-twenty reports with ECF were found...
September 22, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Atsushi Yamamoto, Yoshiaki Miyasaka, Kazushige Furuya, Hideki Watanabe, Masahiro Maruyama, Haruka Nakada, Atsushi Takano, Masao Hada, Hiroshi Nakagomi, Masao Omata, Toshio Oyama
We herein experienced a case with pseudo-Meigs' syndrome that developed both synchronous and metachronous metastases to the ovary from ascending colon cancer. A 57-year-old female visited a hospital for a 2-month history of abdominal distension and voiding difficulty. Massive pleural effusion on the right side and a small amount of left-sided pleural effusion were detected on CT. She underwent emergent laparotomy due to the severe symptom of abdominal distention. The tumor originated from the left ovary, and left-sided oophorectomy was performed...
December 2016: Surgical Case Reports
A N Aggarwal, R Agarwal, I S Sehgal, S Dhooria, D Behera
OBJECTIVE: To determine the diagnostic accuracy of pleural fluid adenosine deaminase (ADA) in diagnosing tuberculous pleural effusion (TPE) among Indian patients using systematic review and meta-analysis. DESIGN: The PubMed, Embase, IndMED and Cochrane databases and other relevant publications were searched to identify Indian studies evaluating the sensitivity and specificity of ADA in diagnosing TPE. Pooled diagnostic accuracy measures and 95% confidence intervals (95%CI) were generated using a bivariate random-effects model, and examined using forest plots and hierarchical summary receiver operating characteristic (HSROC) curves...
October 2016: International Journal of Tuberculosis and Lung Disease
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
Ahmed A Nassr, Rodrigo Ruano, Jimmy Espinoza, Alireza A Shamshirsaz
BACKGROUND AND OBJECTIVES: Fetal pleural effusions are either primary or secondary to chromosomal or structural fetal abnormalities. In both cases, thoraco-amniotic shunts may be indicated to prevent life-threatening consequences. In this report, we describe a rare complication of shunts and successful in utero management of this complication. We also summarize the prior reports of shunt wrapping around fetal limbs and successful prenatal release of the shunts. DATA SOURCE: Search including PubMed, MEDLINE and EMBASE databases from inception till November 2015 was conducted for cases with shunt entrapment around fetal limbs with or without prenatal management...
October 6, 2016: Fetal Diagnosis and Therapy
Hana Bartáková, Jan Novák, Radek Jakša, Jiří Beneš, Jiří Votruba
Pulmonary infiltration is an infrequent organ involvement in Waldenström's disease (WD). Diffuse infiltration, isolated parenchymatous nodules and pleural effusion are the most common manifestations of WD, while endobronchial mass is extremely rare. We present a case report of a 66-year-old man with a long-standing history of WD, who developed febrile neutropenia after therapy with rituximab, cyclophosphamide and dexamethasone. X-ray and CT scan showed consolidation consistent with right-sided pneumonia. Surprisingly, bronchoscopy revealed an endobronchial tumor obstructing the right lower lobe (RLL) and two smaller granulations...
October 3, 2016: Clinical Respiratory Journal
Sebastián Fernández-Bussy, Gonzalo Labarca, Mario Lanza, Erik Folch, Adnan Majid
The use of thoracic ultrasound as a diagnostic tool in the emergency department, intensive care unit or in patients with pulmonary diseases is increasing steadily. It is used to guide percutaneous tracheostomies, to assess pleural effusions, to rule out pneumothorax, and to guide the placement of endovascular and pleural catheters. It is also useful in the assessment of patients with dyspnea. The aim of this review is to provide the practical and technical basics for the use of this diagnostic tool among internists and specialists in pulmonary diseases...
July 2016: Revista Médica de Chile
Shogo Matsuda, Shuzo Yoshida, Tohru Takeuchi, Yohei Fujiki, Ayaka Yoshikawa, Shigeki Makino
We report the case of a 66-year-old man with seropositive rheumatoid arthritis who developed neurologically asymptomatic rheumatoid meningitis (RM) revealed by MRI. RM worsened and chest CT showed pericardial effusion, pleural effusion, and bilateral consolidation, and his serum C3 level was decreased. We diagnosed systemic rheumatic vasculitis based on these findings. After a review of more than 20 previously reported cases of RM, this is the first case of RM without central nerve system symptoms.
September 23, 2016: Modern Rheumatology
Michelle Oyeka, Suresh Antony
Bacteremia is usually caused by gram-positive organisms such as Staphylococcus aureus or β hemolytic streptococci. While there is a wealth of information that exits for these types of bacteremia, less is available to address bacteremia that is caused by less common bacteria such as Citrobacter. We report an unusual case of Citrobacter braakii bacteremia in a patient with multiple comorbidities that presented to the hospital with cellulitis and pleural effusion. Blood cultures grew Citrobacter braakii. Despite good response to antibiotic treatment, the patient's infection proved to be persistent and he succumbed to the cirrhosis of the liver and subsequent renal failure...
September 20, 2016: Infectious Disorders Drug Targets
Krzysztof Dąbkowski, Andrzej Białek, Maciej Kukla, Janusz Wójcik, Andrzej Smereczyński, Katarzyna Kołaczyk, Tomasz Grodzki, Teresa Starzyńska
Mediastinal pseudocysts are a rare complication of acute pancreatitis. Lack of uniform treatment standards makes the management of this condition a clinical challenge. We report the case of a 43-year-old patient who presented with a left pleural effusion. Pleural fluid revealed a high amylase concentration consistent with a pancreaticopleural fistula. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a disruption of the pancreatic duct with free outflow of contrast medium into the thoracic cavity...
September 13, 2016: Clinical Endoscopy
Pedro David Delgado-López, Antonio Rodríguez-Salazar, Vicente Martín-Velasco, José Manuel Castilla-Díez, Javier Martín-Alonso, Ana Galacho-Harriero, Cecilia Gil-Polo, Elena Araus-Galdós
OBJECTIVE: To describe the specific surgical details and report the lessons learned with a series of patients suffering from spinal tumours that underwent total en bloc spondylectomy (TES). METHODS: A retrospective case series review is presented, together with an analysis of the clinical and technical variables, as well as the outcomes. RESULTS: A total of 10 patients underwent TES (2000-2016) for primary (osteosarcoma, chondrosarcoma, fibrosarcoma and chordoma) and secondary spinal tumours (lung, breast, thyroid, oesophagus, and meningioma metastases)...
September 14, 2016: Neurocirugía
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
Oscar M Crespin, Louis W C Liu, Ambica Parmar, Timothy D Jackson, Jemila Hamid, Eran Shlomovitz, Allan Okrainec
INTRODUCTION: Peroral endoscopic myotomy (POEM) is a novel intervention for the treatment of achalasia, which combines the advantages of endoscopic access and myotomy. The purpose of this study was to perform a systematic review of the literature to evaluate the efficacy and safety of POEM. METHODS: The systematic review was conducted following the PRISMA guidelines. Evidence-Based Medicine Reviews, Cochrane Central Register of Controlled Trials, Ovid MEDLINE (R) including in-process and non-indexed citations were searched for POEM studies using the keywords: esophageal achalasia, POEM, endoscopy, natural orifice surgery, laparoscopic Heller myotomy (LHM), and related terms...
September 15, 2016: Surgical Endoscopy
Nithin Jayan, Jaya Susan Jacob, Mohan Mathew, Roy Joy Mukkada
BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is a safe and minimally invasive modality regarded as the first-line management of all types of achalasia. POEM is performed under general anesthesia with endotracheal intubation using an orally inserted flexible fiberscope. The aim of this study is to describe the anesthetic management of POEM for achalasia. MATERIAL AND METHODS: A chart review of 21 patients who underwent POEM for achalasia at our center from March 2013 to June 2015 was performed...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Amit Kumar Mittal, Namrata Gupta
In the era of evidence-based medicine, ultrasonography has emerged as an important and indispensable tool in clinical practice in various specialties including critical care. Lung ultrasound (LUS) has a wide potential in various surgical and clinical situations for timely and easy detection of an impending crisis such as pulmonary edema, endobronchial tube migration, pneumothorax, atelectasis, pleural effusion, and various other causes of desaturation before it clinically ensues to critical level. Although ultrasonography is frequently used in nerve blocks, airway handling, and vascular access, LUS for routine intraoperative monitoring and in crisis management still necessitates recognition...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Adriana Lama, Lucía Ferreiro, María E Toubes, Antonio Golpe, Francisco Gude, José M Álvarez-Dobaño, Francisco J González-Barcala, Esther San José, Nuria Rodríguez-Núñez, Carlos Rábade, Carlota Rodríguez-García, Luis Valdés
BACKGROUND: Pseudochylothorax (PCT) (cholesterol pleurisy or chyliform effusion) is a cholesterol-rich pleural effusion (PE) that is commonly associated with chronic inflammatory disorders. Nevertheless, the characteristics of patients with PCT are poorly defined. METHODS: A systematic review was performed across two electronic databases searching for studies reporting clinical findings, PE characteristics, and the most effective treatment of PCT. Case descriptions and retrospective studies were included...
August 2016: Journal of Thoracic Disease
Jaehee Lee, Jae Kwang Lim, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Chang Ho Kim
BACKGROUND: Tuberculous pleural effusion (TPE) exhibits different characteristics according to pleural fluid cellular predominance or whether the pleural fluid is free-flowing or loculated. However, its categorization based on either of these factors alone may be insufficient to properly reflect the heterogeneous manifestation of TPE. We evaluated the characteristics of the four TPE groups classified according to cellular predominance and whether the fluid is free-flowing or loculated...
August 2016: Journal of Thoracic Disease
Sriram Pothapregada, Banupriya Kamalakannan, Mahalaskhmy Thulasingham, Srinivasan Sampath
OBJECTIVE: To study the clinical profile and outcome of dengue fever in children at a tertiary care hospital in Puducherry. MATERIALS AND METHODS: All children (0-12 years of age) diagnosed and confirmed as dengue fever from August 2012 to January 2015 were reviewed retrospectively from hospital case records as per the revised World Health Organization guidelines for dengue fever. The diagnosis was confirmed by NS1 antigen-based ELISA test or dengue serology for IgM and IgG antibodies, and the data were analyzed using SPSS 16...
July 2016: Journal of Global Infectious Diseases
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
Khaled Ali Jadallah, Enas Walid Sarsak, Yara Mohammad Khazaleh, Rawan Mohammad Khair Barakat
We report a case of Budd-Chiari syndrome occurring in a patient with coeliac disease, who presented with symptoms of increased abdominal girth, right upper quadrant pain and shortness of breath for three weeks prior to admission. Initial assessment revealed the presence of moderate ascites, hepatosplenomegaly and right-sided pleural effusion. Further diagnostic work-up established a diagnosis of chronic Budd-Chiari syndrome. Interestingly, complete screening for pro-thrombotic factors was negative. A review of the literature on this association disclosed only 28 similar cases, with the majority of them describing individuals of North African origin...
September 7, 2016: Gastroenterology Report
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