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Complicated parapneumonic effusion

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https://www.readbyqxmd.com/read/28642494/proteome-profiling-reveals-novel-biomarkers-to-identify-complicated-parapneumonic-effusions
#1
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
#2
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...
June 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28474458/accuracy-of-complement-activation-product-levels-to-detect-infected-pleural-effusion-in-rats
#3
Guilherme E Peterson, Samanta S Silva, Sérgio L Amantéa, Patrícia Miorelli, Paulo Sanches, Jane Kulczynski, Eliane Roesch, José Carlos Fraga
BACKGROUND: Pleural empyema is a well-known complication of pneumonia. If treatment is delayed, empyema may increase morbidity and mortality in affected patients. Therefore, the identification of empyema biomarkers in parapneumonic pleural effusion is desirable. Previous research has suggested complement activation products as candidate empyema markers. OBJECTIVE: To compare the levels of complement activation products C3a, C5a, and C5b9 in pleural effusion induced by Staphylococcus aureus (SA), Streptococcus pneumoniae (SP), or turpentine (control)...
June 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28410823/the-case-for-performing-pleural-biopsies-for-the-aetiological-diagnosis-of-exudates-yes
#4
F Rodriguez-Panadero
Pleural biopsies are especially indicated in the following circumstances: a) inconclusive pleural fluid analysis and negative sputum study, if adenosine deaminase (ADA) levels are unavailable; b) suspected multi-resistant tuberculosis; c) a need for differentiating tuberculous pleurisy (if it progresses with neutrophilia) and complicated parapneumonic effusion; d) malignant pleural effusion coexisting with very high ADA levels; e) effusion coexisting with lung cancer and negative pleural cytology; f) suspected mesothelioma; and g) need for implementing re-treatment for patients with relapse after chemotherapy...
April 12, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28370693/computed-tomography-scoring-system-for-discriminating-between-parapneumonic-effusions-eventually-drained-and-those-cured-only-with-antibiotics
#5
José M Porcel, Marina Pardina, Carmen Alemán, Esther Pallisa, Richard W Light, Silvia Bielsa
BACKGROUND AND OBJECTIVE: Due to limited data, we aimed to develop and validate a computed tomography (CT)-based scoring system for identifying those parapneumonic effusions (PPEs) requiring drainage. METHODS: A retrospective review of all patients with PPE who underwent thoracentesis and a chest CT scan before any attempt to place a tube thoracostomy, if applicable, over an 8-year period was conducted. Eleven chest CT characteristics were compared between 90 patients with complicated PPEs (CPPEs), defined as those which eventually required chest drainage, and 60 with non-complicated effusions (derivation sample)...
March 30, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28363363/dexamethasone-for-parapneumonic-pleural-effusion-a-randomized-double-blind-clinical-trial
#6
Alfredo Tagarro, Enrique Otheo, Fernando Baquero-Artigao, María-Luisa Navarro, Rosa Velasco, Marta Ruiz, María Penín, David Moreno, Pablo Rojo, Rosario Madero
OBJECTIVE: To assess whether dexamethasone (DXM) decreases the time to recovery in patients with parapneumonic pleural effusion. STUDY DESIGN: This was a multicenter, randomized, double blind, parallel-group, placebo-controlled clinical trial of 60 children, ranging in age from 1 month to 14 years, with community-acquired pneumonia (CAP) and pleural effusion. Patients received either intravenous DXM (0.25 mg/kg/dose) or placebo every 6 hours over a period of 48 hours, along with antibiotics...
March 28, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28348265/group-g-streptococcus-dysgalactiae-subspecies-equisimilis-the-clinical-significance-of-a-rare-infection-endocarditis-polyarteritis-septic-bursitis-and-pneumonia-with-complicated-parapneumonic-effusion
#7
https://www.readbyqxmd.com/read/28304084/surgical-versus-non-surgical-management-for-pleural-empyema
#8
REVIEW
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28270104/clinical-features-of-community-acquired-adenovirus-pneumonia-during-the-2011-community-outbreak-in-southern-taiwan-role-of-host-immune-response
#9
Ching-Fen Shen, Shih-Min Wang, Tzong-Shiann Ho, Ching-Chuan Liu
BACKGROUND: Human adenovirus 7 (HAdV-7) was responsible for a significant number of fatalities during the 2011 community outbreak in Taiwan. The mechanisms underlying the pathogenesis of severe adenovirus infections in non-immunocompromised individuals remain unclear. Adenovirus pneumonia was associated with pleural effusion in a number of patients from the 2011 outbreak suggesting that similar to bacterial pneumonia, patients diagnosed with adenovirus pneumonia who have pleural effusion are more severely and systemically infected, and may have a more protracted disease course...
March 7, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28229836/-fibrinolytics-in-the-treatment-of-complicated-pleural-effusions
#10
Ana Coelho, Margarida Coelho, Joana Pereira, Vasco Lavrador, Lurdes Morais, Fátima Carvalho
INTRODUCTION: The treatment of complicated pleural parapneumonic effusions with intrapleural instillation of fibrinolytics, has shown similar results as surgical treatment. The present study aimed to evaluate the results of the use of intrapleural instillation of fibrinolytics in the treatment of complicated pleural parapneumonic effusions, in patients followed in our hospital. MATERIAL AND METHODS: A retrospective review of all the patients (aged between one month and 18 years) diagnosed with complicated parapneumonic effusions, which had chest drain insertion with intrapleural instillation of fibrinolytic, between January 2005 and December 2013, was undertaken...
November 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28215651/behaviour-of-nucleated-cells-in-various-types-of-pleural-effusion
#11
L Ferreiro, T Pereiro, E San José, M E Toubes, J Suárez-Antelo, J M Álvarez Dobaño, F J González Barcala, N Rodríguez Núñez, A Lama, L Valdés
INTRODUCTION: To know the behavior of cellular components of pleural fluid can help focus the differential diagnosis of a pleural effusion. Our objective was to assess their composition in different types of pleural effusions and assess whether it provides relevant clinical information. PATIENTS AND METHODS: Observational, cross-sectional and retrospective study in which the cellular components of pleural effusions of different etiology were analyzed. Pleural effusions were classified as neutrophilic, lymphocytic (≥50% of each one of them), eosinophilic (≥10%) or mesothelial (>5%) and were grouped into six diagnostic categories RESULTS: 1...
February 16, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28192581/necrotizing-pneumonia
#12
Elitsa V Nicolaou, Allison H Bartlett
Necrotizing pneumonia refers to the development of necrosis, liquefication, and cavitation of the lung parenchyma from an infectious pathogen. Nearly 4% of all community-acquired pneumonias are necrotizing, although studies retrospectively evaluating the incidence have found it to be increasing during the past 20 years. Common presenting symptoms include fever, tachypnea, and cough, and most of those afflicted also develop complications such as parapneumonic effusions, empyemas, or bronchopleural fistulae. When compared to age-matched controls with parapneumonic effusions or severe pneumonias without a necrotizing component, those with necrotizing pneumonia have been shown to have more elevated white blood cell counts and inflammatory markers that take longer to normalize, a longer duration of symptoms despite initiation of therapy, and a longer hospital stay...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28164581/evaluation-of-pleural-fluid-lactate-for-diagnosis-and-management-of-parapneumonic-pleural-effusion
#13
Jose D Santotoribio, Hiba Alnayef-Hamwie, Paula Batalha-Caetano, Santiago Perez-Ramos, Maria J Sanchez Del Pino
BACKGROUND: The aim was to measure the accuracy of pleural fluid lactate concentration for diagnosis of parapneumonic pleural effusion (PPE) and to discriminate between uncomplicated (UPPE) and complicated PPE (CPPE). METHODS: Pleural fluid lactate was measured in patients with pleural effusion. Patients were classified into two groups according to the etiology of pleural effusion: PPE and NOT PPE. RESULTS: We studied 173 patients. Thirty patients were PPE (10 UPPE and 20 CPPE) and 143 were NOT PPE...
September 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28137493/prehospital-nsaids-use-prolong-hospitalization-in-patients-with-pleuro-pulmonary-infection
#14
Ourania S Kotsiou, Sotirios G Zarogiannis, Konstantinos I Gourgoulianis
OBJECTIVE: Nonsteroidal anti-inflammatory drug (NSAID) pre-hospitalization consumption might affect the course of pneumonia. We opted to assess the potential effects of pre-hospitalization use of NSAIDs in patients with pleuropulmonary infection in the context of the duration of hospitalization. METHODS: A prospective observational study of 57 consecutive patients with a diagnosis of pneumonia and parapneumonic pleural effusion was conducted. The exact medication history the previous fifteen days was recorded...
February 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28079399/safety-and-efficacy-of-tissue-plasminogen-activator-and-dnase-for-complicated-pleural-effusions-secondary-to-abdominal-pathology
#15
Adnan Majid, Sebastian Ochoa, Sumit Chatterji, Sebastian Fernandez-Bussy, Fayez Kheir, Estefania Rivera, George Cheng, Erik Folch
RATIONALE: Exudative pleural effusions may arise secondary to inflammation of intra-abdominal structures. Pleural space loculations can complicate these effusions, preventing adequate chest tube drainage and leading to consideration of surgical intervention. Previous studies have demonstrated that intrapleural administration of tissue plasminogen activator (tPA) combined with human recombinant DNase can improve fluid drainage and reduce surgery for patients with loculated parapneumonic effusions; however, the efficacy of this treatment has not been evaluated for complicated pleural effusions attributed to intra-abdominal inflammation...
March 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28054135/-community-acquired-pneumonia
#16
S Poetter-Lang, C J Herold
CLINICAL ISSUE: The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters. STANDARD RADIOLOGICAL METHODS: For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. METHODICAL INNOVATIONS: Based on the evaluation of the different radiological patterns as well as their extent and distribution, a rough allocation to so-called pathogen groups as well as a differentiation between viral and bacterial infections are possible; however, because different pathogens cause different patterns an accurate correlation is not feasible by relying purely on imaging...
January 2017: Der Radiologe
https://www.readbyqxmd.com/read/27993288/diagnosis-of-complicated-parapneumonic-effusion-by-pleural-ph-measurement-is-jeopardized-by-inadequate-physician-knowledge-and-guideline-discordant-laboratory-practice
#17
Lauren Ng, Eli Dabscheck, Mark Hew
Pleural fluid pH is a crucial determinant of complicated parapneumonic effusion diagnosis and the need for drainage. It is best measured by blood gas analyzer. We examined whether physicians were aware of this, and whether their laboratories measured pleural pH according to their expectations. Only 53% of physicians understood the need for blood gas analyzer measurements, only 50% of laboratories used blood gas analyzers, and only 35% of physicians correctly identified the method performed in their laboratory...
January 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/27984384/mixing-it-up-coadministration-of-tpa-dnase-in-complicated-parapneumonic-pleural-effusions-and-empyema
#18
Raju Bishwakarma, Shiwan Shah, Luba Frank, Wei Zhang, Gulshan Sharma, Shawn P E Nishi
BACKGROUND: A recent randomized controlled trial showed 12 serial doses of tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) is safe and effective in managing complicated parapneumonic pleural effusions and empyema (CPEE). However, this regimen is laborious, requiring trained personnel to open/close the chest tube 8 times daily for 3 days. We present our observational data using a simplified regimen of coadministered tPA/DNase. MATERIALS AND METHODS: This is a retrospective observational study of patients who received coadministered tPA/DNase for CPEE from January 2012 to April 2015 at the University of Texas Medical Branch...
January 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/27883327/the-role-of-serum-coagulation-factors-in-the-differential-diagnosis-of-patients-with-pneumonia-and-parapneumonic-effusion
#19
Sanja Petrusevska Marinkovic, Irena Kondova Topuzovska, Zvonko Milenkovic, Biserka Kaeva
The aim of this study was to identify the participations of the serum coagulations and fibrinolysis factors that contribute to the differential diagnosis of the patients with community-acquired pneumonia (CAP) without effusion, uncomplicated parapneumonic effusion (UCPPE) and complicated parapneumonic effusion (CPPE). The coagulations system is fundamental for the maintenance of homeostasis, and contributes to the inflammatory process responsible for CAP and the parapneumonic effusion. The factors of coagulations and fibrinolysis participate in the cellular proliferation and migration as in the synthesis of the inflammatory mediators...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27866276/manual-intrapleural-saline-flushing-plus-urokinase-a-potentially-useful-therapy-for-complicated-parapneumonic-effusions-and-empyemas
#20
José M Porcel, Horacio Valencia, Silvia Bielsa
PURPOSE: We sought to evaluate the safety profile and effectiveness of manual pleural saline flushing, in addition to urokinase, for managing complicated parapneumonic effusions and empyemas. METHODS: Retrospective comparative review of 23 consecutive patients with complicated parapneumonic effusions or empyemas who received saline flushing plus urokinase through small-bore chest catheters, and 39 who were only treated with fibrinolytics. Both groups had similar baseline characteristics and treatments were mostly protocol-driven...
February 2017: Lung
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