scholarly journals Frequency and Types of Parapneumonic Effusion in Pleural Fluid Specimen

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mohammad Sajjad ◽  
Naseeb ur Rehman Shah ◽  
Sami Ullah Khan ◽  
Asim Muhammad ◽  
Shabir Hussain ◽  
...  

Background: Parapneumonic effusion (PPE) is exudative pleural effusion resulting from community acquired pneumonia or lungabscess. In USA about one million people develop PPE annually. The better outcome of PPE depends on early diagnosis andtimely management.Objective: The aim of this study was to see the frequency and types of parapneumonic effusion in pleural fluid specimen usingdifferent laboratory parameters in pneumonia patients.Material and Methods: This study was conducted in Shah Noor Medical laboratory in Bannu KPK. Pakistan. Pleural fluidspecimen were collected from both public and private sectors hospitals of the territory. A total of 422 pleural effusions werecollected. These fluid were analysed for transudate, exudate with possible causes. The PPE were subtyped into simple,complicated and empyema on the basis of color, PH value, ratio of blood and fluid glucose level, total protein level, total anddifferential leukocyte count of fluid, Gram's stain and culture for presence or absence of bacteria. The pleural fluid color wasexamined for subjective grades of turbidity i.e. mild, moderate and marked for simple, complicated and empyema respectively. PHcut off value was 7.2 for simple and complicated PPE, glucose cut off value of 52mg/dl for simple and complicated PPE. Gram'sstain and culture was performed by using conventional Gram's stain and different culture media for differention of simple fromcomplicated PPE and emyema. Inclusion criteria was all pleural effusions either exudative or transudative. Exclusion criteria wasinsufficient pleural fluid. The data was collected and analysed for frequencies with percentages and mean with standard deviationusing SPSS version 20.Results: In this study a total of 422 pleural fluid out of which 77(18.24%) PPE cases were analysed. The age range was from11-80 years with mean age of 54.34±9.22 years. Amongst these PPE 41 were from males patients and 36 from femalepatients. Simple PPE were 21(27.30%), complicated PPE 37(48.05%) and empyema were 29(37.7%).Conclusion: The laboratory parameters for differentiation of different types of parapneumonic effusion have significant role indifferentiation and management of different types of PPE and must be analysed in laboratory to separate the subtypes and guidethe physician about using non invasive and invasive management modalities.

2005 ◽  
Vol 2005 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Saadet Akarsu ◽  
A. Nese Citak Kurt ◽  
Yasar Dogan ◽  
Erdal Yilmaz ◽  
Ahmet Godekmerdan ◽  
...  

The aim is to examine whether the changes in pleural fluid interleukin (IL)-1β, IL-2, IL-6, and IL-8 levels were significant in differential diagnosis of childhood pleural effusions. IL-1β, IL-2, IL-6, and IL-8 levels in pleural fluids of all 36 patients were measured. The levels of IL-1β, IL-2, IL-6, and IL-8 in pleural fluids were statistically significantly higher in the transudate group compared with those of the exudate group. The levels of IL-1β, IL-6, and IL-8 were also found to be statistically significantly higher in the empyema group compared with both the parapneumonic and the tuberculous pleural effusion groups. The levels of IL-2 and IL-6 were detected to be statistically significantly higher in the tuberculous pleural effusion group in comparison with those of the parapneumonic effusion group. The results showed that pleural fluids IL-1β, IL-2, IL-6, and IL-8 could be used in pleural fluids exudate and transudate distinction.


PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 131-141 ◽  
Author(s):  
Sanja Petrusevska Marinkovic ◽  
Irena Kondova Topuzovska ◽  
Milena Stevanovic ◽  
Ankica Anastasovska

Abstract Introduction: Parapneumonic effusions, as a complication of community-acquired pneumonia (CAP), usually have a good course, but they sometimes progress into complicated parapneumonic effusion (CPPE) and empyema, thus becoming a significant clinical problem. Aim: To review clinical and radiological features, as well as diagnostic and therapeutic options in parapneumonic effusions. Material and methods: The analysis included 94 patients with parapneumonic effusion hospitalized at the University Infectious Diseases Clinic in Skopje during a 4 year period. Out of 755 patients with CAP, 175 (23.18%), had parapneumonic effusion. Thoracentesis was performed in 94 (53.71%) patients, 50 patients were with uncomplicated parapneumonic effusions (UCPPE) and 44 with complicated parapneumonic effusions (CPPE). Results: More patients (59.57%) were male; the average age was 53.82±17.5 years. The most common symptoms included: fever (91; 96.81%), cough (80; 85.11%), pleuritic chest pain (68; 72.34%), dyspnea (65; 69.15%). Alcoholism was the most common comorbidity registered in 12 (12.77%) patients. Macroscopically, effusion was yellow and clear in most cases (36; 38.29%). Localization of pleural effusion was often in the left costophrenic angle (53; 56.38%) and ultrasonographic non-septated complex. Between the two groups of effusions there was a significant difference between the ERS, WBC and CRP in serum and CRP in pleural fluid. Statistical difference existed in terms of days of hospitalization with a longer hospital stay for patients with CPPE (p <0.0001). Conclusion: Patients with parapneumonic effusion have the symptoms of acute respiratory infection and frequent accompanying diseases. Future diagnostic and therapeutic treatment depends on pleural fluid features and imaging lung findings.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Neda Dalil Roofchayee ◽  
Majid Marjani ◽  
Neda K. Dezfuli ◽  
Payam Tabarsi ◽  
Afshin Moniri ◽  
...  

AbstractPatients with tuberculous pleural effusion (TPE) or malignant pleural effusions (MPE) frequently have similar pleural fluid profiles. New biomarkers for the differential diagnosis of TPE are required. We determined whether cytokine profiles in the PE of patients could aid the differential diagnosis of TPE. 30 patients with TPE, 30 patients with MPE, 14 patients with empyema (EMP) and 14 patients with parapneumonic effusion (PPE) were enrolled between Dec 2018 and 2019. The levels of interleukin (IL)-6, IL-18, IL-27, CXCL8, CCL-1 and IP-10 were determined in PE by ELISA along with measurements of adenosine deaminase (ADA). The best predictors of TPE were combined ADA.IL-27 [optimal cut-off value = 42.68 (103 U ng/l2), sensitivity 100%, specificity 98.28%], ADA [cut off value 27.5 (IU/l), sensitivity 90%, specificity 96.5%] and IL-27 [cut-off value = 2363 (pg/ml), sensitivity 96.7%, specificity 98.3%, p ≤ 0.0001]. A high level of IL-6 [cut-off value = 3260 (pg/ml), sensitivity 100%, specificity 67.2%], CXCL8 [cut-off value = 144.5 (pg/ml), sensitivity 93.3%, specificity 58.6%], CCL1 [cut-off value = 54 (pg/ml), sensitivity 100%, specificity 70.7%] and IP-10 [cut-off value = 891.9 (pg/ml), sensitivity 83.3%, specificity 48.3%] were also predictive of TPE. High ADA.IL-27, ADA and IL-27 levels differentiate between TPE and non-TPE with improved specificity and diagnostic accuracy and may be useful clinically.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Adel Salah Bediwy ◽  
Hesham Galal Amer

Background. Use of small-bore pigtail catheter is a less invasive way for draining pleural effusions than chest tube thoracostomy. Methods. Prospectively, we evaluated efficacy and safety of pigtail catheter (8.5–14 French) insertion in 51 cases of pleural effusion of various etiologies. Malignant effusion cases had pleurodesis done through the catheter. Results. Duration of drainage of pleural fluid was 3–14 days. Complications included pain (23 patients), pneumothorax (10 patients), catheter blockage (two patients), and infection (one patient). Overall success rate was 82.35% (85.71% for transudative, 83.33% for tuberculous, 81.81% for malignant, and 80% for parapneumonic effusion). Nine cases had procedure failure, five due to loculated effusions, and four due to rapid reaccumulation of fluid after catheter removal. Only two empyema cases (out of six) had a successful procedure. Conclusion. Pigtail catheter insertion is an effective and safe method of draining pleural fluid. We encourage its use for all cases of pleural effusion requiring chest drain except for empyema and other loculated effusions that yielded low success rate.


2018 ◽  
Vol 2 (1) ◽  
pp. 29-36
Author(s):  
Ali Muhammad ◽  
Zahoor Ul Haq ◽  
Imad Khan

This study uses Pakistan Social and Living Measurement Survey 2016 to study gender discrimination in school enrollment across the four provinces of Pakistan using bi-variate analysis. Results show that there is highly significant difference between male and female education in rural areas (x^2=4940.50 and p<0.05). Analysis indicate that gender disparity in enrollment is significantly higher in low income households (x^2=115.468 and P<0.05). The study also showed that as compared to male, fewer female are enrolled in both public and private sectors. Hence, socio-economic factors play important role in making decision about children enrollment in different types of school. The study recommends that government to take appropriate steps to reduce gender discrimination in school enrollment by offering subsidy on female education in the country.


2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.


Robotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 53
Author(s):  
Luiz F. P. Oliveira ◽  
António P. Moreira ◽  
Manuel F. Silva

The development of robotic systems to operate in forest environments is of great relevance for the public and private sectors. In this sense, this article reviews several scientific papers, research projects and commercial products related to robotic applications for environmental preservation, monitoring, wildfire firefighting, inventory operations, planting, pruning and harvesting. After conducting critical analysis, the main characteristics observed were: (a) the locomotion system is directly affected by the type of environmental monitoring to be performed; (b) different reasons for pruning result in different locomotion and cutting systems; (c) each type of forest, in each season and each type of soil can directly interfere with the navigation technique used; and (d) the integration of the concept of swarm of robots with robots of different types of locomotion systems (land, air or sea) can compensate for the time of executing tasks in unstructured environments. Two major areas are proposed for future research works: Internet of Things (IoT)-based smart forest and navigation systems. It is expected that, with the various characteristics exposed in this paper, the current robotic forest systems will be improved, so that forest exploitation becomes more efficient and sustainable.


Author(s):  
Nazli Gormeli Kurt ◽  
Servan Gokhan ◽  
Ozcan Erel ◽  
Celal Gunes ◽  
Ahmet Fatih Kahraman ◽  
...  

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2798
Author(s):  
Maria Alba Sorolla ◽  
Anabel Sorolla ◽  
Eva Parisi ◽  
Antonieta Salud ◽  
José M. Porcel

Liquid biopsy is emerging as a promising non-invasive diagnostic tool for malignant pleural effusions (MPE) due to the low sensitivity of conventional pleural fluid (PF) cytological examination and the difficulty to obtain tissue biopsies, which are invasive and require procedural skills. Currently, liquid biopsy is increasingly being used for the detection of driver mutations in circulating tumor DNA (ctDNA) from plasma specimens to guide therapeutic interventions. Notably, malignant PF are richer than plasma in tumor-derived products with potential clinical usefulness, such as ctDNA, micro RNAs (miRNAs) and long non-coding RNAs (lncRNAs), and circulating tumor cells (CTC). Tumor-educated cell types, such as platelets and macrophages, have also been added to this diagnostic armamentarium. Herein, we will present an overview of the role of the preceding biomarkers, collectively known as liquid biopsy, in PF samples, as well as the main technical approaches used for their detection and quantitation, including a proper sample processing. Technical limitations of current platforms and future perspectives in the field will also be addressed. Using PF as liquid biopsy shows promise for use in current practice to facilitate the diagnosis and management of metastatic MPE.


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