scholarly journals Some pleural effusions labeled as idiopathic could be produced by the inhalation of silica

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Silvia Bielsa ◽  
Ana Guitart ◽  
Aureli Esquerda ◽  
Rodrigo Fernández-Pacheco ◽  
Maria Teresa Baranguán ◽  
...  
Keyword(s):  
Silica Nanoparticles ◽  
Pleural Fluid ◽  
Case Series ◽  
Emission Spectrometry ◽  
Pleural Effusions ◽  
Plasma Atomic Emission Spectrometry ◽  
Retrospective Case ◽  
Pleural Biopsy ◽  
Spectrometry Analysis ◽  
Exposed Case

Abstract Objectives Exposure to silica nanoparticles has been associated with pleural effusions (PEs) in animal models and case series. We hypothesized that some PEs labelled as “idiopathic” could, in fact, be secondary to inhalation of silica. Methods A retrospective case control study was designed utilizing a prospectively maintained pleural database. Cases, represented by idiopathic PEs, were matched by age and gender to control patients who had been diagnosed with malignant, cardiac, or infectious PEs. A survey consisting of questions about occupational life and possibility of silica inhalation was conducted. In a subgroup of patients, pleural fluid concentrations of silica were quantified by plasma atomic emission spectrometry analysis. Also, the pleural biopsy of a silica-exposed case was subjected to an energy dispersive X-ray spectroscopy (EDX) to identify the mineral, the size of which was determined by electron microscopy. Results A total of 118 patients (59 cases and 59 controls) completed the survey. There were 25 (42%, 95% CI 31–55%) and 13 (22%, 95% CI 13–34%) silica-exposed workers in case and control groups, respectively. The exposure attributable fraction was 0.62 (95% CI 0.14–0.83). Four of eight exposed cases showed detectable levels of silica in the pleural fluid (mean 2.37 mg/L), as compared to none of 16 tested controls. Silica nanoparticles of 6–7 nm were identified in the pleural biopsy of an exposed case patient. Conclusions It is plausible that some idiopathic PEs could actually be caused by occupational silica inhalation.

scholarly journals Pleural tuberculosis

2016 ◽  
Vol 65 (1) ◽  
Author(s):  
B. Chakrabarti ◽  
P.D.O. Davies
Keyword(s):  
Pleural Fluid ◽  
Diagnostic Yield ◽  
Western World ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Biopsy Specimens ◽  
Tuberculous Pleurisy ◽  
The Impact ◽  
Antituberculous Chemotherapy

Pleural effusions in tuberculosis are commonly seen in young adults as an immunological phenomenon occurring soon after primary infection. However, the epidemiology and demographics of tuberculous pleurisy are changing due to the impact of HIV co-infection and the increasing number of pleural effusions seen as part of re-activation disease. Pleural biopsy for histology and culture is the mainstay of diagnosis with closed needle biopsy adequate in the majority of cases. Techniques such as PCR of biopsy specimens and the role of pleural fluid ADA are still being evaluated as a diagnostic aid. Tuberculous empyema is less commonly seen in the western world and the diagnostic yield from pleural fluid here is greater than in “primary” effusions. Treatment with appropriate antituberculous chemotherapy is generally successful though there is currently insufficient evidence to recommend the routine use of corticosteroids in this condition.

scholarly journals Fast, Nondestructive, and Cost-Effective Methods to Detect Pesticide Residues: A Case Study of Several Repatriated Karuk Tribe Artifacts

2017 ◽  
Vol 31 (1-2) ◽  
pp. 23-33
Author(s):  
Rosene Salmo ◽  
Peter T. Palmer ◽  
Karuk Tribe
Keyword(s):  
Microwave Plasma ◽  
Cost Effective ◽  
Atomic Emission ◽  
Mass Spectrometry Analysis ◽  
Gas Chromatography Mass Spectrometry ◽  
Emission Spectrometry ◽  
Plasma Atomic Emission Spectrometry ◽  
Spectrometry Analysis ◽  
Organic Pesticides

Abstract This study describes the use of three different nondestructive methods to determine whether or not nine artifacts belonging to the Karuk Tribe had been treated with common inorganic and organic pesticide agents. A portable X-Ray Fluorescence analyzer was used to estimate the concentrations of arsenic, mercury, and lead at two different locations on each artifact. Black beads on a necklace were found to contain 2.1% lead and 0.23% arsenic, which can be attributed to the natural composition of the beads. Leather on a drum mallet was found to contain 0.49% lead and 0.10% arsenic, which were due to the pigments used to decorate this item. Microwave Plasma-Atomic Emission Spectrometry analysis of swab samples taken from the surfaces of an elk horn, bow, and musical drum showed nondetectable levels of arsenic and lead. Gas Chromatography/Mass Spectrometry analysis of a second set of swab samples taken from the surface of each artifact showed nondetectable levels of p-dichlorobenzene, naphthalene, dichlorodiphenyltrichloroethane, and other common organic pesticides. These results suggest that these artifacts were not treated with pesticides for preservation purposes, and hence they can be handled, worn, and used as intended.

Massive Pleural Effusions and Anasarca After Allogeneic Hematopoietic Cell Transplantation.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4556-4556
Author(s):  
Baldeep Wirk
Keyword(s):  
Bone Marrow ◽  
T Cell ◽  
Pleural Fluid ◽  
Bone Marrow Biopsy ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cell Transplant ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Ventricular Ejection Fraction

Abstract Abstract 4556 A 37 year old male with T cell acute lymphoblastic leukemia with normal cytogenetics 46XY in second complete remission (CR2) after 8 cycles of HyperCVAD and 4 cycles of salvage nelarabine underwent myeloablative conditioning with cyclophosphamide TBI for a matched related donor allogeneic stem cell transplant from his brother. His day+100 bone marrow biopsy showed CR2 and was 100% donor. His post transplant course was unremarkable until he relapsed d+162. The immunosuppression was tapered off rapidly and 2 cycles of nelarabine and a donor lymphocyte infusion (1×107 CD3 cells/kg) were completed by d+254 and CR3 was achieved. He did well until d+608 when he presented with a month long history of dyspnea and recurrent bilateral large pleural effusions (despite multiple large volume thoracenteses) and anasarca including facial edema. He had gained 15 kilograms in 2 weeks. He had no fever, skin rash, sicca syndrome or lichen planus. Chest and abdomen CT showed massive bilateral pleural effusions, but no lung infiltrate, pericardial effusion or ascites or lymphadenopathy. The complete blood count, renal function and liver function tests were normal and there was normal hepatopedal flow in the main portal vein and its branches. The echocardiogram showed a left ventricular ejection fraction of 60% (normal) and there were no vegetations. The serum ANA, anti-Ro and anti-La were negative. The bone marrow biopsy showed no evidence of relapse of T cell ALL. The peripheral blood STR was 100% donor. The pleural fluid was transudative and cytology showed no malignancy. Pleural fluid flow cytometry showed no CD20+ B cells but did show polyclonal T cells with a CD4:CD8 ratio of 0.22. The pleural biopsy showed reactive mesothelial cells with mixed acute and chronic inflammation and no malignancy. Ebstein Barr virus in-situ hybridization and HHV-8 immunohistochemistry was negative on the pleural biopsy. All bacterial, fungal and viral (including CMV, EBV, HSV, adenovirus, VZV, HIV, BK) of the blood, urine and pleural fluid were unremarkable. A random skin biopsy of the forearm showed scleroderma. Methylprednisolone 2 mg/kg iv daily and therapeutic tacrolimus with extracorporeal photoporesis was begun with resolution of the pleural effusions and anasarca two months later. On d+903 he remains in CR3 and is on tapering courses of prednisone and tacrolimus without recurrence of the pleural effusions or anasarca. Conclusion: Isolated sterile pleural effusions with anasarca should be recognized as a rare feature of late onset chronic graft versus host disease so as to allow prompt initiation of immunosuppression. The patient shared the HLA antigens HLA DR15 and HLA DQW6 which are associated with autoimmune disease such as systemic lupus erythematosus suggesting that patients with this HLA combination may be more prone to this presentation. Disclosures: No relevant conflicts of interest to declare.

Telomerase activity in pleural effusions: diagnostic significance.

1998 ◽  
Vol 16 (2) ◽  
pp. 567-573 ◽  
Author(s):  
C T Yang ◽  
M H Lee ◽  
R S Lan ◽  
J K Chen
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Telomerase Activity ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Diagnostic Significance ◽  
Group Iii ◽  
Malignant Pleural Effusions ◽  
Group I ◽  
Group Ii

PURPOSE To determine the diagnostic value of pleural fluid telomerase activity in distinguishing a malignant from a nonmalignant pleurol effusion in a cohort of patients undergoing thoracentesis. PATIENTS AND METHODS Using a polymerase chain reaction (PCR)-based assay, telomerase activity was examined in the pleural fluid cells obtained from 144 consecutive, unselected patients. According to the final diagnosis achieved, these patients were classified into three groups: group I consisted of 70 malignant pleural effusions diagnosed by either fluid cytology or pleural biopsy, group II consisted of 52 nonmalignant pleural effusions, and another 22 samples were categorized to be suspicious malignant pleural effusions (group III) due to inconclusive results in effusion cytology and percutaneous pleural biopsy, but were strongly suspicious in clinical settings. RESULTS The presence of telomerase activity was observed in 64 of 70 samples in group I (91.4%), three of 52 samples in group II (5.8%), and 20 of 22 samples in group III. All three nonmalignant, telomerase-positive pleural effusion samples in group II were obtained from patients with tuberculosis. As a diagnostic criterion for malignant pleural effusion in group I and group II patients, positive telomerase activity had a sensitivity of 91.4%, a specificity of 94.2%, and a positive and negative predictive value of 0.96 and 0.89, respectively. CONCLUSION Our results indicate that the detection of telomerase activity may be a useful adjunct to cytopathologic methods in the diagnosis of malignant pleural effusions.

scholarly journals Rapid automated determination of adenosine deaminase and lysozyme for differentiating tuberculous and nontuberculous pleural effusions

1996 ◽  
Vol 42 (2) ◽  
pp. 218-221 ◽  
Author(s):  
V Villena ◽  
J A Navarro-Gonzálvez ◽  
C García-Benayas ◽  
J A Manzanos ◽  
J Echave ◽  
...  
Keyword(s):  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Cutoff Values ◽  
Serum Lysozyme ◽  
Automated Procedures ◽  
Automated Determination

Abstract The catalytic concentration of pleural adenosine deaminase (ADA) and the ratio of pleural lysozyme (PL) to serum lysozyme (SL) were measured in consecutive patients (49 tuberculous and 179 nontuberculous) with two automated procedures in a Hitachi 717 analyzer. Using sensitivity and specificity curves, we established cutoff values at 33 U/L for ADA and 1.7 for the PL/SL ratio. The sensitivity of ADA activities for tuberculous effusion was 90%, specificity 85%. Combining ADA with the PL/SL ratio enhanced specificity to 99%. However, high values for ADA and lysozyme ratios are not, alone or in combination, sensitive or specific enough to replace pleural biopsy or culture of pleural fluid for the diagnosis of tuberculous empyema.

scholarly journals Case Report: Indwelling Pleural Catheter Based Management of Refractory Hepatic Hydrothorax as a Bridge to Liver Transplantation

2021 ◽  
Vol 8 ◽  
Author(s):  
Mayurun Selvan ◽  
Hannah Collins ◽  
William Griffiths ◽  
William Gelson ◽  
Jurgen Herre
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Pleural Fluid ◽  
Case Series ◽  
Pleural Effusions ◽  
Hepatic Hydrothorax ◽  
Post Transplantation ◽  
Fluid Removal ◽  
At Home

Introduction: Liver transplantation is the treatment of choice for decompensated liver disease, and by extension for hepatic hydrothorax. Persistent pleural effusions make it challenging for patients to maintain physiological fitness for transplantation. Indwelling pleural catheters (IPCs) provide controlled pleural fluid removal, including peri-operatively. The immune dysfunction of cirrhosis heightens susceptibility to bacterial infection and concerns exist regarding the sepsis potential from a tunnelled drain.Method: Six patients were identified who underwent IPC insertion for hepatic hydrothorax before successful liver transplantation, between November 2016 and November 2017.Results: All patients had recurrent transudative right sided pleural effusions. Mean age was 49 years (range 24–64) and mean United Kingdom Model for End-Stage Liver Disease score was 58. Four patients required correction of coagulopathy before insertion. There were no complications secondary to bleeding. Three patients were taught self-drainage at home of up to 1 litre (L) daily. A protocol was developed to ensure weekly review, pleural fluid culture and drainage of larger volumes in hospital. For every 2–3 L of pleural fluid drained, 100 mls of 20% Human Albumin Solution (HAS) was administered. On average an IPC was in situ for 58 days before surgery and drained 19 L of fluid in hospital. There was a small increase in average BMI (0.2) and serum albumin (2.1 g/L) at transplantation. There was one episode of stage one acute kidney injury secondary to high volume drainage. No further ascitic or pleural procedures were needed while an IPC was in situ. One thoracentesis was required after IPC removal. On average IPCs remained in situ for 7 days post transplantation and drained a further 2 L of fluid. Pleural fluid sampling was acquired on 92% of drainages in hospital. Of 44 fluid cultures, 2 cultured bacteria. Two patients had their IPCs and all other lines removed post transplantation due to suspected infection.Conclusion: Our case series describes a novel protocol and successful use of IPCs in the management of refractory hepatic hydrothorax as a bridge to liver transplantation. The protocol includes albumin replacement during pleural drainage, regular clinical review and culture of pleural fluid, with the option of self-drainage at home.

scholarly journals Sequential dehydration of the phosphate–sulfate association from Gura Dobrogei Cave, Dobrogea, Romania

2021 ◽  
Vol 33 (3) ◽  
pp. 329-340
Author(s):  
Delia-Georgeta Dumitraş ◽  
Ştefan Marincea
Keyword(s):  
Inductively Coupled Plasma ◽  
Atomic Emission ◽  
Optical Methods ◽  
Emission Spectrometry ◽  
Plasma Atomic Emission Spectrometry ◽  
Exothermic Reactions ◽  
Spectrometry Analysis ◽  
Inductively Coupled ◽  
Chemically Induced ◽  
Microbial Action

Abstract. A rich association of primary guano minerals, including taranakite, hydroxylapatite, brushite and gypsum with relicts of illite, kaolinite, alpha (low) quartz and calcite, was identified in the fossil bat guano deposit from Gura Dobrogei Cave, Dobrogea County, Romania. Gypsum and Ca phosphates developed preferentially on the carbonate bedrock or on fallen carbonate blocks in the guano mass, whereas taranakite was identified in the clay-rich, detritic sequences. The mineral species from the cave were characterized by optical methods, scanning electron microscopy, X-ray powder diffraction, Fourier-transform infrared and inductively coupled plasma–atomic emission spectrometry analysis. Chemically induced local dehydration of primary minerals, characterized by low temperatures (up to 100 ∘C or even lower) and critically depending on exothermal reactions in the guano mass, prompted the formation of a secondary association, consisting of francoanellite, bassanite and monetite. Topotactic substitutions were observed in the cases of francoanellite on taranakite, bassanite on gypsum and monetite on brushite. In its turn, ardealite was partially replaced by monetite and bassanite. The sequential dehydration process seems driven by the degradation of organic matter by microbial action and also, presumably, by other exothermic reactions at local scale (e.g., oxidation of ammonia, allogenic pyrite or other organic compounds).

Silicate analysis of carbonated rocks using ICP-AES with calibration by the concentration ratio

2020 ◽  
Vol 86 (5) ◽  
pp. 16-21
Author(s):  
T. A. Karimova ◽  
G. L. Buchbinder ◽  
S. V. Kachin
Keyword(s):  
Inductively Coupled Plasma ◽  
Concentration Ratio ◽  
Total Error ◽  
Atomic Emission ◽  
Emission Spectrometry ◽  
Calibration Error ◽  
Plasma Atomic Emission Spectrometry ◽  
Standard Samples ◽  
Inductively Coupled ◽  
Carbonate Materials

Calibration by the concentration ratio provides better metrological characteristics compared to other calibration modes when using the inductively coupled plasma atomic emission spectrometry (ICP-AES) for analysis of geological samples and technical materials on their base. The main reasons for the observed improvement are: i) elimination of the calibration error of measuring vessels and the error of weighing samples of the analyzed materials from the total error of the analysis; ii) high intensity of the lines of base element; and iii) higher accuracy of measuring the ratio of intensities compared to that of measuring the absolute intensities. Calcium oxide is better suited as a base when using calibration by the concentration ratio in analysis of carbonate rocks, technical materials, slags containing less than 20% SiO2 and more than 20% CaO. An equation is derived to calculate the content of components determined in carbonate materials when using calibration by the concentration ratio. A method of ICP-AES with calibration by the concentration ratio is developed for determination of CaO (in the range of contents 20 – 100%), SiO2 (2.0 – 35%), Al2O3 (0.1 – 30%), MgO (0.1 – 20%), Fe2O3 (0.5 – 40%), Na2O (0.1 – 15%), K2O (0.1 – 5%), P2O5 (0.001 – 2%), MnO (0.01 – 2%), TiO2 (0.01 – 2.0%) in various carbonate materials. Acid decomposition of the samples in closed vessels heated in a HotBlock 200 system is proposed. Correctness of the procedure is confirmed in analysis of standard samples of rocks. The developed procedure was used during the interlaboratory analysis of the standard sample of slag SH17 produced by ZAO ISO (Yekaterinburg, Russia).

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