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Search Results: 1 - 10 of 718 matches for " pleural effusion "
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Aetiology and Demographic Attributes of Common Pleural Collections in an African Population  [PDF]
Ezekiel O. Ogunleye, Martins O. Thomas, Olugbenga O. Olusoji
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.47066

Background: Fluids collect in the pleural space under different conditions and they are of different types. Detailed study of demographic attributes and aetiology of pleural collections has not been well reported in Africa. Aims and Objectives: This study was conducted to determine the demographic attributes and aetiology of common pleural space fluid collections. Methods: The sample population consisted of referrals received via clinics, admission through the emergency centre and wards. We noted their biodata, hospital identification numbers, ages and gender and other relevant parameters. Data analysis was done with special interest in gender-based diseases like ovarian carcinoma prostatic carcinoma and the like. Results: There were 372 patients over a 55-month period. The M:F ratio was 1:1 approximately. The combined mean age was 37.8 ± 0.92 years at 95% confidence interval. Their distribution was negatively skewed and it was leptokurtic. The age bracket of 20 - 49 had 65.6% of cases. There was gender based disparity in ages. Discussion: Malignant effusions constituted majority of sample size and the right side was consistently affected more often than the left side. Conclusion: Advanced malignancies are the commonest causes of pleural effusion. There is ongoing epidemiologic transition of diseases as the burden of non-communicable diseases is now juxtaposed with that of communicable diseases in Africa.

Pleural effusion: presentation, causes and treatment outcome in a resource limited area, Ethiopia  [PDF]
Mekonnen Desalew, Amare Amanuel, Alemu Addis, Hurissa Zewdu, Ali Jemal
Health (Health) , 2012, DOI: 10.4236/health.2012.41004
Abstract: Back ground: Pleural effusion is a common clinical problem with different causes. Objective: To demonstrate clinical features and outcome of pleural effusion. Methods: Prospective descriptive study was conducted involving 110 patients with pleural effusion admitted to a resource limited hospital in Ethiopia. Results: Males and females were almost equally represented. Cough, fever and weight loss were prominent presenting symptoms accounting 90, 77.3 and 77.3 percent respectively. Right side effusion was the common presentation 50 (45.5%). Forty (37.4%) patients had HIV infection among 107 tested. Tuberculosis was the commonest cause 78 (70.9%) followed by parapneumonic effusion 36 (32.7%) and empyema 27 (24.5%). Malignant pleural effusion was detected only in one patient. Eighty one (73.6%) improved from their illness and 7 (6.4%) died. Lympocytic pleural effusion found to be associated with tuberculosis (OR = 3.942 (1.527 - 10.179), P = 0.005. There were no associations between HIV infection, anemia, elevated ESR and side of pleural effusion with tuberculosis. Conclusion: Tuberculosis was the leading cause of pleural effusion in our setup even though etiologic diagnosis was difficult. Strengthening the laboratory and pathology services in the area is strongly recommended.
Gastric Malrotation Relieved by Pleural Effusion Drainage  [PDF]
Guy Dori, Rawi Hazzan, Gregori Kushner
Case Reports in Clinical Medicine (CRCM) , 2014, DOI: 10.4236/crcm.2014.34047

Mr M., 55-year-old, with metastatic adenocarcinoma of lung (stage IV) was admitted to the hospital after an earlier visit to oncology, where he presented with abdominal pain and distention suspected of having ascites for the first time. After performing abdominal CT and gastric passage film, it was hypothesized that clinical manifestation was related to gastric malrotation. The latter was forced by the huge left pleural effusion. Draining the pleural effusion may be complicated by a trapped lung, an adverse effect where the lung does not expand post drainage. After considering the palliative therapeutic options the effusion was drained, the stomach recoiled to its anatomical position, gastric malrotation was relieved, and the patient resumed oral nutrition. Though gastric malrotation due to a huge, malignant left pleural effusion is rare, it should be considered as more patients are being treated for lung cancer.

Thoracoscopy: Outstanding Interventional Modality in Diagnosis of Pleural Nosologies  [PDF]
I. Sotiriou, N. Siddique
Open Journal of Respiratory Diseases (OJRD) , 2014, DOI: 10.4236/ojrd.2014.44016
Abstract: Thoracoscopy is a well established invasive method for the diagnosis and management of pleural nosologies. The role and the impact that this procedure exerts in settings alongside the diagnostic yield in pleural malignancies are unquestionable. New insights and novel techniques promise an even greater future towards the usefulness of this technique in interventional pneumonology. This is a short review highlighting the principles and novel aspects in the evolutionary progress of pleuroscopy.
Diagnostic and Prognostic Value of Survivin in Pleural Effusion  [PDF]
Yongfang Xu, Changqing Xu, Falin Zhao, Gang Chen, Weiluo Sun
Advances in Lung Cancer (ALC) , 2018, DOI: 10.4236/alc.2018.72002
Abstract: Background: Survivin is an inhibitor of apoptosis that may be a novel diagnostic and prognostic marker of cancer. Our study is to investigate the diagnostic and prognostic value of survivin for pleural effusions. Methods: Sixty-five pleural effusion patients were enrolled prospectively. Pleural effusion samples were examined for survivin level by ELISA. Pleural effusions were divided into three groups: Group I, malignant pleural effusion (MPE) (n = 36); Group II, tuberculous pleurisy (TPE) (n = 18); and Group III, transudative pleural effusion (n = 11). The accuracy of diagnosis and the correlation between survivin level and survival in malignant pleural effusions (MPE) were analyzed. Results: Survivin level was 320.50 ± 228.24 pg/ml in MPE, 328.35 ± 146.79 pg/ml in TPE and 318.87 ± 208.39 pg/ml in transudative pleural effusion respectively. ROC curves for MPE versus TPE were analyzed, area under the ROC curve was 0.419, and for the cutoff value of 254.85 pg/ml sensitivity was 44.4% and specificity 55.6%. Survivin had no discriminative power in differentiating exudative effusions of MPE from non-MPE (p = 0.648). There was no correlation between survivin level and age, sex. However, statistically significant difference was found between primary lung carcinoma (238.66 ± 48.19 pg/ml) and extra-pulmonary metastatic carcinomas (435.09 ± 320.62 pg/ml) according to survivin level (p = 0.033). Survivin levels can distinguish patients who had poor prognosis (median survival 96 days) and those who had good prognosis (median survival 206 days) in MPE. Conclusio
Persistence of Pleural Effusions and Empyemas after Pneumococcal Conjugate Vaccine Implementation in Uruguay  [PDF]
Miguel Estevan, Luis Martínez, Edith Arreisengor, Maria Hortal
World Journal of Vaccines (WJV) , 2012, DOI: 10.4236/wjv.2012.24024
Abstract: In Uruguay a post pneumococcal conjugate vaccine implementation surveillance of hospitalized children with pneumonia showed an increase of complicated pneumonias, while uncomplicated pneumonias decreased. Out of 151 pleural effusions, 62 were empyemas requiring drainage, the rest of cases were treated with antibiotics with a favorable outcome. Patient’s vaccinated status varied. Pneumococcal etiology was poorly documented. The few identified sero-types were 1 and 3, a fact that urges PCV13 use for their control.
Description of Prescribing Practices of Intrapleural Tissue Plasminogen Activator and Intrapleural DNase Administration at a Tertiary Academic Medical Center  [PDF]
Heather Torbic, Gaspar Hacobian, Nahal Beik
Pharmacology & Pharmacy (PP) , 2014, DOI: 10.4236/pp.2014.59099

Objectives: To describe the prescribing practices, preparation and administration techniques of intrapleural (IP) tissue plasminogen activator (t-PA) and IP DNase in patients at a tertiary academic medical center. Methods: Adult patients receiving IP t-PA and IP DNase between January 1-December 31, 2012 were retrospectively evaluated. Patients were included if they received IP t-PA and/or IP DNase for a pleural infection and were excluded if they received IP t-PA or IP DNase for chest tube clearance. Results: A total of 197 doses of IP t-PA and IP DNase received amongst 30 patients were included. The mean age of the patients included was 62 years old with 50% of the patients being female. Of the 30 patients included, 18 patients (60%) received both IP t-PA and IP DNase and 12 patients (40%) received only IP t-PA. The median dose of IP t-PA received was 4 mg (IQR 2-10) and the median dose of IP DNase received was 5 mg (IQR 5-5). Systemic antibiotics were administered to 77% of patients prior to IP t-PA or IP DNase administration. Improved pleural effusion drainage was reported in 70% of patients. Increased pain in the chest cavity during administration of IP t-PA or IP DNase was reported in 7% of patients. Conclusion: The majority of patients at our institution received concomitant IP t-PA and IP DNase after systemic therapy for treatment of pleural infections had been attempted. Administration of IP t-PA and IP DNase demonstrated improved drainage of pleural infections with minimal harm to patients.

Sonographic Evaluation of Pleural Effusion  [PDF]
Ajit Kumar Reddy, Sandeep Ballal Kaup, Annitha Elavarasi Jayamohan, Prakash Manikka Lakshmanan, Krishnappa Nasappa, Antony Jean
Open Journal of Medical Imaging (OJMI) , 2017, DOI: 10.4236/ojmi.2017.73008
Abstract: Background: Although at times small amounts of pleural fluid is detected on the lateral decubitus chest radiograph, this may be impossible to obtain in severely ill patients. Because of its ready availability and ability for bedside imaging, ultrasonography has become a crucial imaging modality not only in detecting the presence of pleural fluid but also as a guide to aspiration. Aims: To sonographically determine the nature of pleural effusions. To analyze predictability of both benign and malignant pleural effusions and to study statistical value of various ultrasound characteristics in differentiating exudative and transudative as well as benign and malignant effusions in correlation with thoracocentesis. Material and Methods: Sonographic feature as well as fluid cytology was evaluated. Following categorization into exudates or transudate as well as benign or malignant the diagnosis was then correlated biochemically. Results: Transudates were anechoic, while an anechoic effusion may be either a transudate or an exudate. Complex septation, internal echoes, thickened pleura or homogeneously echogenic patterns were always exudates. Sonographic findings of pleural nodules and associated parenchymal lesions in the lung and liver were indicative of malignancy. Conclusions: Ultrasound in addition to being highly sensitive for pleural effusion also aided in characterizing the nature and minimizing the complications during thoracocentesis. Pleural effusions were categorized into exudates and transudate as well as benign and malignant with a certain degree of confidence based on sonographic findings.
Manejo práctico del derrame pleural
Porcel-Pérez,J. M.;
Anales de Medicina Interna , 2002, DOI: 10.4321/S0212-71992002000400011
Abstract: there are many different diseases that can be associated with pleural effusions. when a pleural effusion is discovered, two questions need to be answered: 1) is the effusion a transudate or is it an exudate?, and 2) if the effusion is an exudate, what is the disease responsible for its production?. answers to these questions can be obtained in more than two-thirds of patients testing the pleural fluid by diagnostic thoracentesis. the remainder may require watchful waiting until resolution or further diagnostic procedures, either non-invasive (radiologic imaging) or invasive (bronchoscopy, pleural biopsy, thoracoscopy).
The diagnostic significance and the assessment of the value of vascular endothelial growth factor as a marker for success of chemical pleurodesis in malignant pleural effusion  [PDF]
Dalokay Kilic, Alper Findikcioglu, Goknur Alver, Tolga Tatar, Hakan Akbulut, Ahmet Hatipoglu
Journal of Biomedical Science and Engineering (JBiSE) , 2011, DOI: 10.4236/jbise.2011.43030
Abstract: Differential diagnosis of pleural effusion is an important issue, since the treatment modalities and prognosis strictly depend on early and correct diagnosis of the underlying etiology. We assessed the efficacy of vascular endothelial growth factor (VEGF) in the differential diagnosis of patients with malignant and non-malignant pleural diseases. And also is assessed of the VEGF as a marker for success of chemical pleurodesis in malignant pleural effusion. Pleural effusions of 40 patients with a mean age of 55 (range, 26 to 78 years) were examined. A total of 20 patients had malignant pleural effusion; malignant mesothelioma (n=7), lung cancer (n=5) and metastatic malignancies (n=8). Twenty patients had benign pleural effusion; fibrinous pleuritis (n=6), tuberculosis (n=3) empyema (n=5), congestive heart failure (n=3), and acute pancreatitis (n=3). Definitive diagnosis was obtained in all cases with blind or open pleural biopsy, and cytological examination. VEGF levels were determined by enzyme-linked immunosorbent assay. The VEGF level of pleural effusion was comparably higher in the malignant group. The mean level of VEGF in patients with malignant pleural effusions (21.7 ± 1.8 ng/ml) was significantly (P <0.001) higher than that of (13.2 ± 1.5 ng/ml) non-malignant effusions. No significant difference was found regarding the VEGF levels and histological types in malignant pleural effusions. Negative correlation was observed between success rate of pleurodesis and VEGF level of pleural effusion (p= 0.015). The measurement of VEGF levels in pleural effusion may be useful to differentiate malignant from nonmalignant pleural effusions. VEGF level may also be an important prognostic marker for effective treatment of the patients who had malignant pleural effusions with pleurodesis. It is important issue in here whether VEGF could be useful in prognostication of outcome of chemical pleurodesis or not.
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