scholarly journals Pleural Pressure Pulse in Patients with Pleural Effusion: A New Phenomenon Registered during Thoracentesis with Pleural Manometry

2020 ◽  
Vol 9 (8) ◽  
pp. 2396
Author(s):  
Elzbieta M. Grabczak ◽  
Marcin Michnikowski ◽  
Grzegorz Styczynski ◽  
Monika Zielinska-Krawczyk ◽  
Anna M. Stecka ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pulse Rate ◽  
Pressure Pulse ◽  
Systolic Function ◽  
Cross Sectional Study ◽  
Lung Mechanics ◽  
Pleural Pressure ◽  
Pressure Curve ◽  
Cross Sectional ◽  
Cyclic Changes

Pleural manometry enables the assessment of physiological abnormalities of lung mechanics associated with pleural effusion. Applying pleural manometry, we found small pleural pressure curve oscillations resembling the pulse tracing line. The aim of our study was to characterize the oscillations of pleural pressure curve (termed here as the pleural pressure pulse, PPP) and to establish their origin and potential significance. This was an observational cross-sectional study in adult patients with pleural effusion who underwent thoracentesis with pleural manometry. The pleural pressure curves recorded prior to and during fluid withdrawal were analyzed. The presence of PPP was assessed in relation to the withdrawn pleural fluid volume, lung expandability, vital and echocardiographic parameters, and pulmonary function testing. A dedicated device was developed to compare the PPP to the pulse rate. Fifty-four patients (32 women) median age 66.5 (IQR 58.5–78.7) years were included. Well visible and poorly visible pressure waves were detected in 48% and 35% of the patients, respectively. The frequency of PPP was fully concordant with the pulse rate and the peaks of the oscillations reflected the period of heart diastole. PPP was more visible in patients with a slower respiratory rate (p = 0.008), a larger amount of pleural effusion, and was associated with a better heart systolic function assessed by echocardiography (p < 0.05). This study describes a PPP, a new pleural phenomenon related to the cyclic changes in the heart chambers volume. Although the importance of PPP remains largely unknown, we hypothesize that it could be related to lung atelectasis or lower lung and visceral pleura compliance.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

CLINICAL SYMPTOMS, BIOCHEMISTRY AND CYTOLOGY OF PLEURAL, PERITONEAL EFFUSIONS

2016 ◽  
pp. 66-71
Author(s):  
Van Mao Nguyen ◽  
Huyen Quynh Trang Pham
Keyword(s):  
Pleural Effusion ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Malignant Cells ◽  
Sectional Study ◽  
Pleural Effusions ◽  
Cross Sectional ◽  
Breath Sounds ◽  
Peritoneal Effusion ◽  
Neutrophil Leukocytes

Background: The cytology and the support of clinical symptoms, biochemistry for diagnosis of the cases of effusions are very important. Objectives: - To describe some of clinical symptoms and biochemistry of effusions. - To compare the results between cytology and biochemistry by the causes of pleural, peritoneal fluids. Material & Method: A cross-sectional study to describe all of 47 patients with pleural, peritoneal effusions examinated by cytology in the Hospital of Hue University of Medicine and Pharmacy from April 2013 to January 2014. Results: In 47 cases with effusions, pleural effusion accounting for 55.32%, following peritoneal effusions 29.79% and 14.89% with both of them. The most common symptoms in patients with pleural effusions were diminished or absent tactile fremitus, dull percussion, diminished or absent breath sounds (100%), in patients with peritoneal effusions was ascites (95.24%). 100% cases with pleural effusions, 50% cases with peritoneal effusions and 80% cases with pleural and peritoneal effusions were exudates. The percentage of malignant cells in patients with pleural effusions was 26.92%, in peritoneal effusions was 28.57%, in pleural and peritoneal effusions was 42.86%. The percentage of detecting the malignant cells in patients with suspected cancer in the first test was 57.14%, in the second was 9.53% and 33.33% undetectable. Most of cases which had malignant cells and inflammatory were exudates, all of the cases which had a few cells were transudates. Besides, 7.5% cases which had high neutrophil leukocytes were transudates. Conclusion: Cytology should be carry out adding to the clinical examinations and biochemistry tests to have an exact diagnosis, especially for the malignant ones. For the case with suspected cancer, we should repeat cytology test one more time to increase the ability to detect malignant cells. Key words: Effusion, pleural effusion, peritoneal effusion, cytology, biochemistry

scholarly journals Abnormal spirometry after the Fontan procedure is common and associated with impaired aerobic capacity

2014 ◽  
Vol 307 (1) ◽  
pp. H110-H117 ◽  
Author(s):  
Alexander R. Opotowsky ◽  
Michael J. Landzberg ◽  
Michael G. Earing ◽  
Fred M. Wu ◽  
John K. Triedman ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Aerobic Capacity ◽  
Minute Ventilation ◽  
Fontan Procedure ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Lung Mechanics ◽  
Cross Sectional ◽  
Exercise Limitation ◽  
Physiological Relevance

Impaired exercise capacity is common after the Fontan procedure and is attributed to cardiovascular limits. The Fontan circulation, however, is also distinctively vulnerable to unfavorable lung mechanics. This study aimed to define the prevalence and physiological relevance of pulmonary dysfunction in patients with Fontan physiology. We analyzed data from the Pediatric Heart Network Fontan Cross-Sectional Study to assess the prevalence and pattern of abnormal spirometry in Fontan patients (6–18 yr old) and investigated the relationship between low forced vital capacity (FVC) and maximum exercise variables, including peak O2consumption (V̇o2peak), among those who demonstrated adequate effort ( n = 260). Average ages at the time of exercise testing and Fontan completion were 13.2 ± 3.0 and 3.5 ± 2.2 yr old, respectively. Aerobic capacity was reduced (V̇o2peak: 67.3 ± 15.6% predicted). FVC averaged 79.0 ± 14.8% predicted, with 45.8% having a FVC less then the lower limit of normal. Only 7.8% demonstrated obstructive spirometry. Patients with low FVC had lower V̇o2peak(64.4 ± 15.9% vs. 69.7 ± 14.9% predicted, P < 0.01); low FVC independently predicted lower V̇o2peakafter adjusting for relevant covariates. Among those with V̇o2peak< 80% predicted ( n = 204/260), 22.5% demonstrated a pulmonary mechanical contribution to exercise limitation (breathing reserve < 20%). Those with both low FVC and ventilatory inefficiency (minute ventilation/CO2production > 40) had markedly reduced V̇o2peak(61.5 ± 15.3% vs. 72.0 ± 14.9% predicted, P < 0.01) and a higher prevalence of pulmonary mechanical limit compared with patients with normal FVC and efficient ventilation (36.1% vs. 4.8%). In conclusion, abnormal FVC is common in young patients after the Fontan procedure and is independently associated with reduced exercise capacity. A large subset has a pathologically low breathing reserve, consistent with a pulmonary mechanical contribution to exercise limitation.

scholarly journals A study to know the various causes of pleural effusion and role of pleural fluid adenosine deaminase enzyme in tuberculous pleural effusion

2020 ◽  
Vol 8 (4) ◽  
pp. 1231
Author(s):  
Avdhesh Kumar ◽  
Brijesh Kumar ◽  
Sanjay Kumar Verma ◽  
Anand Kumar ◽  
R. K. Mathur ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Common Cause ◽  
Tuberculous Pleural Effusion ◽  
Mdr Tb ◽  
The Mean ◽  
The Difference

Background: India has the maximum burden of both non MDR tuberculosis (TB) and Multidrug-Resistant (MDR) TB, as per data reported in Global TB Report 2018 and tuberculosis is remains one of the most common cause of pleural effusions.Methods: This was a cross-sectional study conducted in Department of Respiratory Diseases and a total of 110 patients with pleural effusion were included in the study, which were enrolled for treatment from July 2018 to June 2019.Results: One hundred and ten patients with pleural effusion were enrolled during the study period. There were 65 males (59%) and 45 (40.9%) females.  The overall mean age for males and females were 44.4±18.84 years (35-87 years) and 38.28±17.66 years (35-87 years) respectively. Tuberculous Pleural Effusion group (TPE) seen in 82 patients. Right sided pleural effusion (69.5 %) were more common than left sided (30.4 %). In TPE group the mean pleural fluid ADA level were 86.41±38.08 IU/L (range: 14-195 IU/L). The Malignant Pleural Effusion (MPE) group included 21 patients. In MPE group the mean pleural fluid ADA level were 34.10±32.88 IU/L (range: 8-144 IU/L). The difference in pleural fluid ADA levels between TPE and MPE group was statistically highly significant.Conclusions: Tuberculous pleural effusion was the most common cause of pleural effusion in present study and observed in 74.5% cases.

scholarly journals Laboratory Profiles of Pleural effusion Collected from Children: Experience at a Tertiary Care Hospital in Bangladesh

2013 ◽  
Vol 5 (1) ◽  
pp. 26-27
Author(s):  
Mahmudul Hasan ◽  
Md Rafiqul Islam ◽  
Abdul Matin ◽  
Ranjit Ranjan Roy ◽  
Md Abdullah Yusuf ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Medical College ◽  
Almost All

Background: Pleural effusion occurs in many reasons. Laboratory tests are necessary to find out the causes. Objective: This study was an attempt to know the laboratory findings of pleural effusion. Methodology: This cross-sectional study of thirty (30) admitted cases with pleural effusion confirmed by chest radiography and aspiration of pleural fluid from one (1) year to twelve (12) years age of either sex were collected purposively. This study was carried out from July 2009 to February 2010 in the Department of Pediatrics at Rajshahi Medical College Hospital. All information were recorded in pre tested semi structured questionnaire. Results: Color of pleural fluid was straw in 56.7%, clear in 30.0%, blood stained in 13.3%. In this study, lymphocyte predominance among 56.7% cases, acid fast bacilli in 3.3% cases and raised protein of more than 3gm/dl and sugar less then 60mg/dl in 93.3% cases in pleural fluid. Conclusion: In almost all cases protein is raised and sugar is less in pleural fluid. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16201 J Shaheed Suhrawardy Med Coll, 2013;5(1):26-27

scholarly journals Initial clinical and laboratory profiles to predict pediatric dengue infection severity

2018 ◽  
Vol 57 (6) ◽  
pp. 303
Author(s):  
Natharina Yolanda ◽  
Harris Alfan
Keyword(s):  
Pleural Effusion ◽  
Dengue Infection ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
Inclusion Criteria ◽  
Spontaneous Bleeding ◽  
Cross Sectional ◽  
Clinical Profiles ◽  
Patient Presentation

Background. In dengue infection, it is difficult to differentiate mild and severe dengue prior to its critical phase. Ability to identify risk factors for severe dengue form patients’ initial presentation would help decrease the need of hospitalization, increase physicians’ awareness, and improve outcome.Objective. To predict pediatric dengue infection severity based on initial patient characteristics, routine clinical and laboratory profiles. Methods. This was a cross-sectional study based on medical records of children with dengue infection in Atma Jaya Hospital, Jakarta. Inclusion criteria were children aged 1 – 18 years old with proven dengue infection, hospitalized in Atma Jaya Hospital during January – December 2016. Clinical profiles and laboratory parameters at the time of patient presentation were extracted and analyzed in relationship with dengue severity. Result. Data collected was 110 patients with mean age 9.5 years old. Initial clinical profiles that significantly related to severe dengue were: age ≤5 years old (OR = 0.113, p = 0.001), hepatomegaly (OR = 2.643, p = 0.035), pleural effusion (OR = 9.545, p = 0.000), platelet ≤125,000/uL (OR = 0.201, p = 0.025), hyponatremia (OR = 10.139, p = 0.000) and AST >135 u/L (OR = 5.112, p = 0.014). Gender, duration of fever, additional symptoms, spontaneous bleeding, blood pressure, pulse pressure, hematocrit, leucocyte, random blood glucose, calcium, and ALT were not related significantly to dengue severity.Conclusion. Physician should be cautious in pediatric dengue patients presented in age younger than 5 years old, with hepatomegaly and/or pleural effusion, platelet below 125,000/uL, hyponatremia, and AST more than three times upper normal limit. These patients have higher risk of severe dengue than patients without those findings.

scholarly journals Health Status and Predictors of Hypertension, Blood Pressure, and Pulse Rate of Jamaicans During the Covid-19 Pandemic

2019 ◽  
pp. 1-12
Author(s):  
Paul Andrew Bourne ◽  
◽  
Vincent M.S. Peterkin ◽  
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Health Status ◽  
Research Design ◽  
Pulse Rate ◽  
Cross Sectional Study ◽  
Least Square ◽  
Unhealthy Lifestyle ◽  
Cross Sectional Survey ◽  
Cross Sectional

The objectives of the current research are to examine Jamaicans’ health status, pulse rate, body mass index (BMI), hypertension, and factors influencing 1) hypertension, 2) blood pressure, and 3) pulse rate, during COVID-19. A cross-sectional survey using associational research design by way of convenience sampling was used to conduct this research. This study examined correlation of age, gender, BMI, hypertension, and blood pressure among Jamaicans age ranging from 15 to 85 and above. Cross–sectional study and associational research design were used to collect data for the period of June to August 2020. The study demonstrated that hypertension is significantly predicted by gender, age, and pulse rate one─Omnibus tests of model (χ2(4) =138.947, P < 0.0001, -2Ll=2098.67) and Wald statistic being 90.161, P < 0.0001, and the variance in model 10.8% (Nagelkerke R2). Furthermore, ordinary least square (OLS) regression can be used to model pulse rate (bpm) for Jamaicans (F [4, 1676] =17.236, P < 0.0001), with the model explaining 4.0% of the variance in pulse rate of Jamaicans. Gender, BMI and Hypertensive emerged as the factors that determine the pulse rate of Jamaicans. Diastolic & systolic blood pressure were determined by age, weight, and pulse rate, with age being the most significant predictor. The risk of hypertension was higher among population groups who were overweight and obese. Gender was found to correlate with blood pressure and hypertension; female participants were more likely to be hypertensive than the male participants. BMI measurement should be recommended as a simple and effective predictor of hypertension in public health strategies. There is empirical evidence that can be used to establish that Jamaicans health status has worsen since March 10, 2020, and that Covid-19 has brought with it unhealthy lifestyle practices, which are pending public health challenges come 2021 and beyond.

scholarly journals PERBANDINGAN NILAI TEKANAN DARAH, DENYUT NADI, DAN VOLUME PARU PELAKU SHALAT TAHAJUD DENGAN YANG TIDAK TAHAJUD PADA SISWA BINA SISWA SMA PLUS CISARUA, LEMBANG

2021 ◽  
Vol 3 (1) ◽  
pp. 22
Author(s):  
Yuda Putra Disastra ◽  
Reni Farenia ◽  
A. Fauzi Yahya
Keyword(s):  
Blood Pressure ◽  
Pulse Rate ◽  
Lung Volume ◽  
Pressure Pulse ◽  
Forced Expiratory Volume ◽  
Male Students ◽  
Cross Sectional ◽  
Mind And Body ◽  
The Mean ◽  
Cross Sectional Design

Tahajud is qiyammul lail or sunnah muakad in Islam, which is both spiritual and physical practice that integrating mind and body. Tahajud regularly has been showed the improvement of neuropsychoendocrinology sistem, relaxing muscle of breathing, and might be influencing cardiovasculae function. The aim of this study was to compare the effect of tahajud on blood pressure, pulse rate, and lung volume. Observational analytic study with cross-sectional design was conducted from June – October 2013, using direct measurement to compare calues of blood pressure, pulse rate, and lung volume (forced volume capacity – FVC and forced expiratory volume in 1 second) between tahajud and non-tahajud prayers. Fourty two male students at Bina Siswa SMA Plus Cisarua, Lembang included in this study as volunteer subjects after informed consent. The result are the mean difference for pulse rate (-2,29 ± 8,69 vs 5,38 ± 0,27; p=0,001), forced volume capacity (-0,04 ± 0,27 vs 0,37 ± 0,27; p=0,012), systolic blood pressure (-2(-22,30) vs 0(-20,30); p=0,64), diastolic blood pressure (0(-20,20) vs 0(-20,20); p=0,22), and forced expiratory volume in 1 second (2,64 ± 0,64 vs 2,23 ± 0,38; p=0,22). This study concluded that tahajud regularly provided improvement in value of cardiopulmonary system especially in pulse rate and FVC.

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