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Medicine Sep 2019Malignant pleural effusion (MPE) and tuberculosis pleural effusion (TPE) are 2 kinds of common pleural diseases. Finding efficient and accurate biomarkers to distinguish...
BACKGROUND
Malignant pleural effusion (MPE) and tuberculosis pleural effusion (TPE) are 2 kinds of common pleural diseases. Finding efficient and accurate biomarkers to distinguish the 2 is of benefit to basic and clinical research. In the present study, we carried out the first high-throughput autoantibody chip to screen the beneficial biomarker with samples of MPE and TPE and the corresponding serum.
METHODS
We collected pleural effusion and serum of patients with MPE (n = 10) and TPE (n = 10) who had been in Beijing Chao-Yang hospital from June 2013 to August 2014. Using RayBio Human Protein Array-G2 to measure the concentration of 487 defined autoantibodies.
RESULTS
Fold changes of Bcl-2-like protein 11 (BIM) autoantibody in MPE-serum/TPE-serum and MPE/TPE groups were 10 (P = .019) and 6 (P = .001); for decorin autoantibody, MPE-serum/TPE-serum ratio was 0.6 (P = .029), and MPE/TPE ratio was 0.3 (P < .001).
CONCLUSION
BIM autoantibody is a promising MPE biomarker by high-throughput autoantibody analysis in MPE and TPE.
Topics: Autoantibodies; Bcl-2-Like Protein 11; Biomarkers; Female; High-Throughput Screening Assays; Humans; Male; Middle Aged; Pleural Effusion; Pleural Effusion, Malignant; Tuberculosis, Pleural
PubMed: 31567996
DOI: 10.1097/MD.0000000000017253 -
The Journal of Adolescent Health :... Mar 2023A 17-year-old previously healthy female presented with unilateral chest pain and dyspnea. Chest radiographs demonstrated a unilateral pleural effusion and pneumonia....
A 17-year-old previously healthy female presented with unilateral chest pain and dyspnea. Chest radiographs demonstrated a unilateral pleural effusion and pneumonia. Pleural fluid bacterial cultures were negative; acid-fast cultures grew Mycobacterium tuberculosis. Two months after starting appropriate therapy, she had a recrudescence of symptoms and reaccumulation of the pleural fluid. Her tuberculosis antibiotic regimen was expanded, the effusion drained, and systemic corticosteroids initiated, resulting in rapid clinical improvement. Cultures of the second pleural fluid collection were negative. Her clinical deterioration was due to immune reconstitution inflammatory syndrome (IRIS). IRIS can be seen within the first several months of starting tuberculosis therapy and can result in paradoxical worsening of symptoms or radiographic findings in adolescents who are on the appropriate therapy. IRIS is a diagnosis of exclusion after drug resistance and medication malabsorption, intolerance, and nonadherence are excluded. Therapy includes nonsteroidal anti-inflammatory agents for milder reactions and systemic corticosteroids for more severe IRIS cases.
Topics: Humans; Female; Adolescent; Tuberculosis, Pleural; Mycobacterium tuberculosis; Adrenal Cortex Hormones; Anti-Bacterial Agents; Immune Reconstitution Inflammatory Syndrome
PubMed: 36567181
DOI: 10.1016/j.jadohealth.2022.11.013 -
Seminars in Respiratory and Critical... Jun 2019Pleural effusions are common and associated with high morbidity and mortality. Whereas thoracentesis can assist in achieving a diagnosis or therapy, advances in... (Review)
Review
Pleural effusions are common and associated with high morbidity and mortality. Whereas thoracentesis can assist in achieving a diagnosis or therapy, advances in education and in the technique may prevent morbidity associated with the procedure. Medical thoracoscopy is often useful for undiagnosed effusions, as well as for therapeutic purposes. There is much enthusiasm about techniques for biopsies that extend beyond forceps. These include biopsies using a diathermic knife as well as cryoprobes. Similarly, adhesiolysis or other techniques to improve therapy in multiloculated effusions using medical thoracoscopy are contested. This review attempts to synthesize recent advances and controversies in thoracentesis and medical thoracoscopy as clinicians head into the next decade of treatment.
Topics: Humans; Pleural Effusion; Thoracentesis; Thoracoscopy; Tuberculosis, Pleural
PubMed: 31525816
DOI: 10.1055/s-0039-1694034 -
QJM : Monthly Journal of the... Sep 2019
Topics: Adult; Antitubercular Agents; Biopsy, Fine-Needle; Chest Pain; Drainage; Empyema, Tuberculous; Fever; Humans; Male; Mycobacterium tuberculosis; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Pleural
PubMed: 30847490
DOI: 10.1093/qjmed/hcz060 -
Revista Clinica Espanola Mar 2021This work aims to investigate the diagnostic accuracy of a nucleic acid amplification test (FluoroType MTB®) in pleural fluid (PF) and sputum to diagnose tuberculous...
OBJECTIVES
This work aims to investigate the diagnostic accuracy of a nucleic acid amplification test (FluoroType MTB®) in pleural fluid (PF) and sputum to diagnose tuberculous pleural effusion (TPE). We also analyzed the increase in diagnostic accuracy of a second FluoroType MTB® test on a second thoracentesis sample when the first was negative.
METHODS
We conducted a prospective single-center study that included 207 patients with pleural effusion (31 tuberculous and 176 due to other causes). Of the 31 cases of TPE, 21 (68%) were confirmed histologically or microbiologically; the other cases were considered probable.
RESULTS
The operational characteristics of FluoroType MTB® in PF for identifying tuberculosis were a sensitivity of 13%, a specificity of 99%, a positive likelihood ratio of 11, and a negative likelihood ratio of 0.9. The diagnostic efficacy data for sputum samples were 21%, 91%, 2.4, and 0.9, respectively. PF and sputum cultures in solid and liquid media had greater sensitivity (36% and 31%, respectively). A second FluoroType MTB® test in PF was negative for 24 patients who had TPE and for whom the first FluoroType MTB® test was also negative. Only two (6.5%) patients with TPE had a confirmed diagnosis based exclusively on the positive results of the FluoroType MTB® in PF.
CONCLUSION
Due to its low sensitivity, the FluoroType MTB® test in PF has a limited role in diagnosing tuberculous pleurisy.
Topics: Exudates and Transudates; Humans; Mycobacterium tuberculosis; Pleural Effusion; Prospective Studies; Tuberculosis, Pleural
PubMed: 33998461
DOI: 10.1016/j.rceng.2020.04.010 -
Deutsches Arzteblatt International Dec 2018
Topics: Aged; Antitubercular Agents; Exudates and Transudates; Humans; Image-Guided Biopsy; Male; Pleural Effusion; Thoracentesis; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Pleural
PubMed: 30722838
DOI: 10.3238/arztebl.2018.0839 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: To improve early diagnosis of drug-resistant superbacteria and interrupt the ways of its formation through molecular technological and surgical methods.
OBJECTIVE
The aim: To improve early diagnosis of drug-resistant superbacteria and interrupt the ways of its formation through molecular technological and surgical methods.
PATIENTS AND METHODS
Materials and methods: The operated patients were divided into two groups: group 1 - 351 (51.25 %) patients, who were operated with the use of minimally invasive technologies, and this was the main group; group 2 - 334 (48.75 %) patients who were operated on open wide thoracotomy, which was the comparison group. Among 351 patients in the main group, in 301 - acute pleural tuberculous empyema was detected, and in 50 - chronic one. Among patients in the comparison group, acute pleural empyema was observed in 284 patients and chronic in 50 patients.
RESULTS
Results: According to our data, video thoracoscopy is a highly informative method of diagnosis of pleural effusions, detection of pleural tuberculous empyema in the first, second and third stages of its development.
CONCLUSION
Conclusions: The introduction of modern molecular-geneticand surgical technologies will allow to accurately establish the etiology process, to conduct the identification of pathogen microorganisms and to determine the phenotymetric and genotytypical sensitivity of bacteria to Antimycobacterial drugs. Such diagnostics will promote effective treatment of patients who are already infected with persistent strains of bacteria and viruses.
Topics: Humans; Empyema, Tuberculous; Superinfection; Thoracoscopy; Empyema, Pleural; Tuberculosis; Bacteria
PubMed: 36591773
DOI: 10.36740/WLek202211216 -
Chest Oct 2021Comprehensive US epidemiologic data for adult pleural disease are not available.
BACKGROUND
Comprehensive US epidemiologic data for adult pleural disease are not available.
RESEARCH QUESTION
What are the epidemiologic measures related to adult pleural disease in the United States?
STUDY DESIGN AND METHODS
Retrospective cohort study using Healthcare Utilization Project databases (2007-2016). Adults (≥ 18 years of age) with malignant pleural mesothelioma, malignant pleural effusion, nonmalignant pleural effusion, empyema, primary and secondary spontaneous pneumothorax, iatrogenic pneumothorax, and pleural TB were studied.
RESULTS
In 2016, ED treat-and-discharge (T&D) visits totaled 42,215, accounting for charges of $286.7 million. In 2016, a total of 361,270 hospitalizations occurred, resulting in national costs of $10.1 billion. A total of 64,174 readmissions contributed $1.16 billion in additional national costs. Nonmalignant pleural effusion constituted 85.5% of ED T&D visits, 63.5% of hospitalizations, and 66.3% of 30-day readmissions. Contemporary sex distribution (male to female ratio) in primary spontaneous pneumothorax (2.1:1) differs from older estimates (6.2:1). Decadal analyses of annual hospitalization rates/100,000 adult population (2007 vs 2016) showed a significant (P < .001) decrease for malignant pleural mesothelioma (1.3 vs 1.09, respectively), malignant pleural effusion (33.4 vs 31.9, respectively), iatrogenic pneumothorax (17.9 vs 13.9, respectively), and pleural TB (0.20 vs 0.09, respectively) and an increase for empyema (8.1 vs 11.1, respectively) and nonmalignant pleural effusion (78.1 vs 100.1, respectively). Empyema hospitalizations have high costs per case ($38,591) and length of stay (13.8 days). The mean proportion of readmissions attributed to a pleural cause varied widely: malignant pleural mesothelioma, 49%; malignant pleural effusion, 45%; nonmalignant pleural effusion, 31%; empyema, 27%; primary spontaneous pneumothorax, 27%; secondary spontaneous pneumothorax, 27%; and iatrogenic pneumothorax, 20%. Secondary spontaneous pneumothorax had the shortest time to readmission in 2016 (10.3 days, 95% CI, 8.8-11.8 days).
INTERPRETATION
Significant epidemiologic trends and changes in various pleural diseases were observed. The analysis identifies multiple opportunities for improvement in management of pleural diseases.
Topics: Adolescent; Adult; Aged; Empyema; Female; Health Care Coalitions; Health Expenditures; Hospitalization; Humans; Incidence; Male; Mesothelioma, Malignant; Middle Aged; Patient Readmission; Pleural Diseases; Pleural Effusion; Pleural Effusion, Malignant; Pleural Neoplasms; Pneumothorax; Tuberculosis, Pleural; United States; Young Adult
PubMed: 34023322
DOI: 10.1016/j.chest.2021.05.026 -
The European Respiratory Journal May 2017
Topics: Humans; Pleural Effusion; Pleurisy; Tuberculosis, Pleural
PubMed: 28546275
DOI: 10.1183/13993003.00356-2017 -
The European Respiratory Journal May 2017
Topics: Humans; Pleural Effusion; Pleurisy; Tuberculosis, Pleural
PubMed: 28546270
DOI: 10.1183/13993003.02472-2016