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undiagnosed pleural effusion

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https://www.readbyqxmd.com/read/28791245/diagnostic-yield-and-safety-of-closed-needle-pleural-biopsy-in-exudative-pleural-effusion
#1
Govind Singh Rajawat, Supreet Batra, Rajendra Prasad Takhar, Lalit Rathi, Chand Bhandari, Manohar Lal Gupta
BACKGROUND: Closed pleural biopsy was previously considered a procedure of choice in cases of undiagnosed pleural effusion with good efficacy. Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups. OBJECTIVE: The objective of this study was to analyze the diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion and assessment of patients' characteristics with the yield of pleural biopsy...
July 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28702335/an-undiagnosed-pleural-effusion-with-surprising-consequences
#2
A G Casalini, F Cusmano, N Sverzellati, P A Mori, M Majori
We present the case of a 43-year-old Italian woman with a left undiagnosed pleural effusion, which in subsequent months presented a clinically unexpected evolution with the appearance at first of a right wrist tenosynovitis and subsequently a bilateral lung involvement caused by M. Tuberculosis. With this case report, we would like to underline the importance of making a correct diagnosis of any pleural effusion as soon as possible by at least a thoracocentesis. If untreated, tuberculosis may easily disseminate to other organs...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28617941/association-of-immunoglobulin-g4-and-free-light-chain-with-idiopathic-pleural-effusion
#3
Y Murata, K Aoe, Y Mimura-Kimura, T Murakami, K Oishi, T Matsumoto, H Ueoka, K Matsunaga, M Yano, Y Mimura
The cause of pleural effusion remains uncertain in approximately 15% of patients despite exhaustive evaluation. As recently described immunoglobulin (Ig)G4-related disease is a fibroinflammatory disorder that can affect various organs, including the lungs, we investigate whether idiopathic pleural effusion includes IgG4-associated etiology. Between 2000 and 2012, we collected 830 pleural fluid samples and reviewed 35 patients with pleural effusions undiagnosed after pleural biopsy at Yamaguchi-Ube Medical Center...
October 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28482965/the-diagnostic-utility-of-pleural-fluid-adenosine-deaminase-for-tuberculosis-in-a-low-prevalence-area
#4
P Sivakumar, L Marples, R Breen, L Ahmed
BACKGROUND: Pleural fluid adenosine deaminase (pfADA) is not routinely measured in patients with undiagnosed pleural effusion due to limited evidence of its diagnostic utility in areas of low tuberculosis (TB) prevalence. METHODS: We conducted a retrospective consecutive case series analysis of all patients who underwent pfADA testing from 2009 to 2015 at a tertiary service pleural centre in south London. Using receiver operating characteristic (ROC) curve analysis, we identified the optimal threshold at which maximal sensitivity and specificity were achieved...
June 1, 2017: International Journal of Tuberculosis and Lung Disease
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...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28353119/safety-and-feasibility-of-pleural-cryobiopsy-compared-to-forceps-biopsy-during-semi-rigid-pleuroscopy
#6
Vikas Pathak, Ray W Shepherd, Ehab Hussein, Rajiv Malhotra
BACKGROUND: Pleural biopsy is often obtained in patients with undiagnosed exudative pleural effusion during pleuroscopy. Standard forceps have been traditionally used for the biopsy. Cryoprobes are being increasingly used for transbronchial lung biopsy as they obtain larger specimens and have less crush artifact. However, the safety and feasibility of cryoprobe biopsy compared to standard forceps for pleural biopsy has not been fully assessed. OBJECTIVES: The objective of this study was to demonstrate the safety and feasibility of cryoprobe biopsy in the pleural space using semi-rigid pleuroscopy...
June 2017: Lung
https://www.readbyqxmd.com/read/28284315/long-term-outcome-of-patients-with-nonspecific-pleurisy-at-medical-thoracoscopy
#7
Yuan Yang, Yan-Bing Wu, Zhen Wang, Xiao-Juan Wang, Li-Li Xu, Zhao-Hui Tong, Huan-Zhong Shi
BACKGROUND: Medical thoracoscopy is an effective and safe procedure for diagnosing pleural effusions of undetermined causes. But there are still a part of patients with pleural effusions were diagnosed as nonspecific pleurisy when no specific biopsy results were found after undergoing thoracoscopic biopsy. The long-term outcome of these patients is unclear, and anxieties about undiagnosed malignancy persist. METHODS: Between July 2005 and June 2014, medical thoracoscopy using the semi-rigid instrument was performed and pleural biopsy was taken in 833 patients with pleural effusions...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28245530/positive-pleural-cytology-is-an-indicator-for-visceral-pleural-invasion-in-metastatic-pleural-effusions
#8
Marios E Froudarakis, Jerôme Plojoux, Elise Kaspi, Stavros Anevlavis, Sophie Laroumagne, Georgia Karpathiou, Elisa Roca, Daniel Adler, Hervé Dutau, Philippe Astoul
INTRODUCTION: In case of undiagnosed pleural effusions, it is necessary to conduct thoracentesis with pleural fluid (PF) cytology. Yet, sensitivity of PF cytology is widely variable as a result of sample size, experience and preparation method. OBJECTIVES: The aim of this study was to assess whether pleural fluid (PF) cytology is correlated to visceral or parietal pleural invasion as assessed by thoracoscopy in metastatic pleural effusions. METHODS: All records of patients with pleural effusion were reviewed...
February 28, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28158976/the-role-of-serum-procalcitonin-in-establishing-the-diagnosis-and-prognosis-of-pleural-infection
#9
Giles Dixon, Adriana Lama-Lopez, Oliver J Bintcliffe, Anna J Morley, Clare E Hooper, Nick A Maskell
BACKGROUND: Bacterial pleural infection requires prompt identification to enable appropriate investigation and treatment. In contrast to commonly used biomarkers such as C-reactive protein (CRP) and white cell count (WCC), which can be raised due to non-infective inflammatory processes, procalcitonin (PCT) has been proposed as a specific biomarker of bacterial infection. The utility of PCT in this role is yet to be validated in a large prospective trial. This study aimed to identify whether serum PCT is superior to CRP and WCC in establishing the diagnosis of bacterial pleural infection...
February 3, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28039396/systematic-review-and-meta-analysis-of-vascular-endothelial-growth-factor-as-a-biomarker-for-malignant-pleural-effusions
#10
Eleftheria Fafliora, Chrissi Hatzoglou, Konstantinos I Gourgoulianis, Sotirios G Zarogiannis
Conventional methods may fail to identify the cause of pleural effusion (PE), thus establishing reliable biomarkers is deemed necessary. This study aimed at examining the role of vascular endothelial growth factor (VEGF) as a biomarker in the differentiation between malignant and benign PEs in adults. A comprehensive literature search in PubMed (Medline), Scopus (ELSEVIER), and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted using keywords. We included studies that evaluated pleural and/or serum levels of VEGF among patients presenting with undiagnosed PE and the association between these levels and the final diagnosis...
December 2016: Physiological Reports
https://www.readbyqxmd.com/read/28025056/nonmalignant-pleural-effusions-a-prospective-study-of-356-consecutive-unselected-patients
#11
Steven P Walker, Anna J Morley, Louise Stadon, Duneesha De Fonseka, David T Arnold, Andrew R L Medford, Nick A Maskell
BACKGROUND: Pleural effusion secondary to a nonmalignant cause can represent significant morbidity and mortality. Nonmalignant pleural effusion (NMPE) is common, with congestive heart failure representing the leading cause. Despite this, there are limited data on mortality risk and associated prognostic factors. METHODS: We recruited 782 consecutive patients presenting to a pleural service between March 2008 and March 2015 with an undiagnosed pleural effusion. Further analysis was conducted in 356 patients with NMPE...
May 2017: Chest
https://www.readbyqxmd.com/read/27997741/advances-in-pleuroscopy
#12
REVIEW
Stavros Anevlavis, Marios E Froudarakis
OBJECTIVES: To describe the technique of pleuroscopy, its clinical uses such as diagnosis of exudative pleural effusion, treatment of pleural infection, treatment of pneumothorax, and diagnosis and pleurodesis of malignant pleural mesothelioma. Also to describe the newer techniques developed such as minothoracoscopy, semirigid thoracoscopy, narrow band imaging pleuroscopy, infrared pleuroscopy, autofluorescence pleuroscopy. DATA SOURCE: We searched the pubmed the last decade for publications with the key words pleuroscopy, medical thoracoscopy, pneumothorax and pleuroscopy, malignant pleural mesothelioma, minothoracoscopy, semirigid thoracoscopy, autofluorescence pleuroscopy...
December 20, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27931685/evaluation-of-different-laboratory-methods-for-rapid-diagnosis-of-tuberculous-pleurisy
#13
Safaa Amer, Azza El Hefnawy, Nashwa Abdel Wahab, Hadir Okasha, Amira Baz
BACKGROUND/OBJECTIVE: Tuberculous pleurisy is a diagnostic challenge due to its nonspecific clinical presentation, paucibacillary nature of the effusion together with the inefficiency of conventional laboratory methods motivating the evaluation of variable diagnostic strategies. METHODS: Using thoracoscopy, the pleural cavity of 50 patients with undiagnosed exudative pleural effusion were fully examined and biopsy specimens of affected parietal pleura were taken under direct vision...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27766798/to-study-efficacy-of-medical-thoracoscopy-in-undiagnosed-pleural-effusions
#14
Sachin S Dole, Gauri P Godbole, Himanshu S Pophale
BACKGROUND: Medical thoracoscopy has received interest in recent past for diagnostic as well as therapeutic uses. In this study we describe our experience with diagnostic medical thoracoscopy in pleural effusions of undiagnosed etiology. OBJECTIVE: 1.To detect diagnostic yield of medical thoracoscopy in pleural effusions of unknown etiology. 2.To find complication rate in these patients. METHODOLOGY: In a retrospective analysis of thoracoscopic procedures performed between March 2011 and December 2014, diagnostic yield and complications of thoracoscopic pleural biopsy for achieving a diagnosis in undiagnosed pleural effusions were evaluated...
October 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27660485/streptococcus-pneumoniae-sepsis-as-the-initial-presentation-of-systemic-lupus-erythematosus
#15
Ilknur Erdem, Senay Elbasan Omar, Ridvan Kara Ali, Hayati Gunes, Aynur Eren Topkaya
OBJECTIVE: Infections are among the most important causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE) but are rare initial presentation of the disease. Therefore, in this study, we describe a case of Streptococcus pneumoniae sepsis in a young woman with previously undiagnosed SLE. CASE REPORT: A 23-year-old female patient was admitted to our outpatient clinic complaining of high fever (40°C), chills, fatigue, generalized myalgia, and cough with brown sputum for 5 days...
2016: International Journal of General Medicine
https://www.readbyqxmd.com/read/27625443/thoracoscopic-evaluation-of-129-cases-having-undiagnosed-exudative-pleural-effusions
#16
Chetan Basavaraj Patil, Ramakant Dixit, Rakesh Gupta, Neeraj Gupta, Varna Indushekar
BACKGROUND: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. MATERIALS AND METHODS: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope...
September 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27499963/the-diagnostic-utility-and-tendency-of-the-soluble-receptor-for-advanced-glycation-end-products-srage-in-exudative-pleural-effusion
#17
Yun Su Sim, Dong Gyu Kim, Tae Rim Shin
BACKGROUND: The soluble receptor for advanced glycation end products (sRAGE) may have an inflammatory or homeostatic function in lung tissue. The aim of this study was to assess the usefulness of sRAGE as a diagnostic marker for exudative pleural effusions, which are common manifestations of a variety of diseases. METHODS: Patients with an undiagnosed pleural effusion were prospectively enrolled between January 2013 and January 2015. Samples of blood and pleural fluid were centrifuged and the supernatant stored at -70 °C...
July 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27499957/a-potential-role-for-vegf-in-the-diagnostic-approach-of-pleural-effusions
#18
Aggeliki Psatha, Demosthenes Makris, Theodora Kerenidi, Zoe Daniil, Theodoros Kiropoulos, Konstantinos Gourgoulianis
BACKGROUND: Vascular endothelial growth factor (VEGF) may play a role in pleural fluid formation, as it represents a potent inducer of capillary permeability. We aimed to investigate the diagnostic utility of VEGF levels in pleural fluid and serum in patients with pleural effusions with initially negative diagnostic work up. METHODS: Seventy-one patients with exudative lymphocytic pleural effusions undiagnosed after initial diagnostic work up were enrolled in this prospective study and their clinical course was followed up to 24 months...
July 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27435923/a-multiplexed-cytokeratin-analysis-using-targeted-mass-spectrometry-reveals-specific-profiles-in-cancer-related-pleural-effusions
#19
Dominik Domanski, Anna Perzanowska, Michal Kistowski, Grzegorz Wojtas, Agata Michalak, Grzegorz Krasowski, Michal Dadlez
Pleural effusion (PE), excess fluid in the pleural space, is often observed in lung cancer patients and also forms due to many benign ailments. Classifying it quickly is critical, but this remains an analytical challenge often lengthening the diagnosis process or exposing patients to unnecessary risky invasive procedures. We tested the analysis of PE using a multiplexed cytokeratin (CK) panel with targeted mass spectrometry-based quantitation for its rapid classification. CK markers are often assessed in pathological examinations for cancer diagnosis and guiding treatment course...
July 2016: Neoplasia: An International Journal for Oncology Research
https://www.readbyqxmd.com/read/27238172/a-case-of-systemic-melioidosis-unravelling-the-etiology-of-chronic-unexplained-fever-with-multiple-presentations
#20
Srujana Mohanty, Gourahari Pradhan, Manoj Kumar Panigrahi, Prasanta Raghab Mohapatra, Baijayantimala Mishra
Melioidosis, caused by the environmental saprophyte, Burkholderia pseudomallei, is an important public health problem in Southeast Asia and Northern Australia. It is being increasingly reported from other parts, including India, China, and North and South America expanding the endemic zone of the disease. We report a case of systemic melioidosis in a 58-year-old diabetic, occupationally-unexposed male patient, who presented with chronic fever, sepsis, pneumonia, pleural effusion and subcutaneous abscess, was undiagnosed for long, misidentified as Pseudomonas aeruginosa infection elsewhere, but was saved due to correct identification of the etiologic agent and timely institution of appropriate therapy at our institute...
2016: Pneumonologia i Alergologia Polska
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