-
BMC Pulmonary Medicine Jun 2020The collected works of Hippocrates were searched for concepts on the diagnosis, prognosis, and treatment of acute and urgent respiratory diseases, with the objective to... (Review)
Review
BACKGROUND
The collected works of Hippocrates were searched for concepts on the diagnosis, prognosis, and treatment of acute and urgent respiratory diseases, with the objective to trace their origins in the Hippocratic Collection.
METHODS
A scoping review was performed to map out key concepts of acute and severe respiratory diseases in the entire Hippocratic Collection. The digital library Thesaurus Lingua Graeca (TLG) was researched for references in the entire Hippocratic Collection regarding the epidemiology, pathophysiology, prognosis, diagnosis and treatment of acute respiratory diseases; then, the relevant texts were studied in their English translation by the Loeb Classical Library.
RESULTS
Hippocratic physicians followed principles of treatment for pneumonia and pleurisy, still relevant, such as hydration, expectoration, analgesia and prompt mobilisation. Other approaches, including the inhalation of "vapours through tubes" in angina, can be considered as forerunners of modern medical practice. Thoracic empyema was diagnosed by shaking the patient and direct chest auscultation after "applying your ear to his sides". In case of an emergency from upper airway obstruction, urgent insertion of primitive airway equipment, such as a small pharyngeal tube, was applied.
CONCLUSIONS
The main Hippocratic concepts on four still common acute and urgent respiratory diseases -pneumonia, pleurisy, thoracic empyema and upper airway obstruction- were identified and most of them were found to be in agreement with contemporary medical thinking and practice.
Topics: Acute Disease; Airway Obstruction; Diagnosis; Emergencies; Empyema, Pleural; Greece, Ancient; Greek World; History, Ancient; Humans; Physicians; Pleurisy; Pneumonia; Prognosis
PubMed: 32522288
DOI: 10.1186/s12890-020-01193-9 -
Thoracic Cancer Apr 2022Pleural biopsies for investigating the causes of pleurisy are performed through modalities including needle biopsies, local anesthetic thoracoscopic procedures, and...
BACKGROUND
Pleural biopsies for investigating the causes of pleurisy are performed through modalities including needle biopsies, local anesthetic thoracoscopic procedures, and surgery (video-assisted thoracoscopic surgery and open thoracotomy). To date, there have been no large-scale nationwide epidemiological studies regarding pleurisy diagnosed via surgical pleural biopsy. This study examined the epidemiology of pleurisy diagnosed via surgical pleural biopsy in a Japanese nationwide administrative database.
METHODS
We evaluated Japanese Diagnosis Procedure Combination data of 24 173 patients who underwent video-assisted thoracoscopic surgery or open thoracotomy and received a diagnosis of pleurisy between April 2014 and March 2020. In addition to pleurisy diagnoses, the patients' clinical information, including age, sex, smoking status (pack-years), dyspnea grade, length of in-hospital stay, and comorbidities, were extracted from the dataset.
RESULTS
This study included data from 1699 patients. The most frequent causes of pleurisy were neoplastic diseases (55.9%; malignant mesothelioma 22.5%, lung cancer 15.7%, lymphoma 2.5%), followed by infectious diseases (24.0%; tuberculosis 16.2%, parapneumonic pleural effusion 3.6%, empyema 3.5%, nontuberculous mycobacteriosis 0.5%), collagen vascular diseases (2.8%; rheumatoid arthritis 1.3%, immunoglobulin G4-related diseases 0.7%, systemic lupus erythematosus 0.3%), and paragonimiasis (0.1%).
CONCLUSIONS
Neoplastic diseases, including malignant mesothelioma and lung cancer, were frequently and accurately diagnosed as pleurisy via surgical pleural biopsy. The next leading cause was infectious diseases such as mycobacterial infections. Physicians should consider performing surgical biopsy in light of the knowledge regarding the etiology of pleurisy when a definitive diagnosis cannot be made via needle pleural biopsy.
Topics: Biopsy; Humans; Lung Neoplasms; Mesothelioma, Malignant; Pleural Effusion; Pleurisy; Thoracic Surgery, Video-Assisted
PubMed: 35243795
DOI: 10.1111/1759-7714.14368 -
QJM : Monthly Journal of the... Feb 2018Cardiac tamponade is a rare but life-threatening complication of systemic lupus erythematosus (SLE).
BACKGROUND
Cardiac tamponade is a rare but life-threatening complication of systemic lupus erythematosus (SLE).
AIMS/OBJECTIVES
To describe incidence, risk factors and treatment of cardiac tamponade in a large cohort of Indian patients with SLE.
METHODS
This retrospective study was conducted at the Department of Rheumatology, IPGMER, Kolkata, India from May 2014 to December 2016 on admitted patients with SLE. Lupus-related serositis was diagnosed after excluding other causes, such as infection, malignancy or heart failure.
RESULTS
Of 409 patients with SLE, pericarditis was diagnosed in 25.4% (104/409) and cardiac tamponade in 5.9% (24/409). Tamponade was the presenting feature of SLE in 50% (12/24). Tamponade occurred in 77.8% (14/18) of large effusions and in 11.63% (10/86) of small-to-moderate effusions. The commonest autoantibody in serum and pericardial fluid was anti-nucleosme antibody. Large pericardial effusion (>20 mm) (Odd's ratio (OR): 93.2, 95% confidence interval (CI): 11.1-782.5, P < 0.001) predicted tamponade. In the subset of patients with small-to-moderate sized pericardial effusion, tamponade was associated with pleuritis (OR: 44.5, 95% CI: 1.6-1243, P = 0.025), anti-nucleosome antibody (OR: 42.9, 95% CI: 1.6-1176, P = 0.026) and size of pericardial effusion (OR: 1.36, 95% CI: 1.04-1.76, P = 0.025). Repeated pericardiocentesis was required in 3 patients and one needed surgical intervention. Immunosuppressives used were: prednisolone with monthly intravenous cyclophosphamide (in 33.33%) and intravenous methylprednisolone with monthly cyclophosphamide (in 50%).
CONCLUSIONS
Pleuritis, anti-nucleosome antibody and size of pericardial effusion predicted development of tamponade. High dose immunosuppression (methylprednisolone and IV cyclophosphamide) alleviated need for surgery in majority.
Topics: Adolescent; Adult; Antibodies, Antinuclear; Biomarkers; Cardiac Tamponade; Combined Modality Therapy; Female; Humans; Immunosuppressive Agents; Lupus Erythematosus, Systemic; Male; Nucleosomes; Pericardial Effusion; Pericardiocentesis; Pericarditis; Pleurisy; Retrospective Studies; Risk Factors; Young Adult
PubMed: 29048543
DOI: 10.1093/qjmed/hcx195 -
Naunyn-Schmiedeberg's Archives of... Aug 2021Crotamine is a polypeptide toxin isolated from rattlesnake venom. Although several studies have been developed identifying many biological effects of isolated crotamine,...
Crotamine is a polypeptide toxin isolated from rattlesnake venom. Although several studies have been developed identifying many biological effects of isolated crotamine, none of them evaluated its acute toxicity, antinociceptive, and anti-inflammatory activities through oral administration. All in vivo experiments from this study were performed in mice. The up-and-down procedure and hippocratic screening were carried out to evaluate possible pharmacological and toxic effects. Antinociceptive and anti-inflammatory activities of this toxin were evaluated using acetic acid-induced abdominal writhing, formalin-induced pain assays, croton oil-induced ear edema, and carrageenan-induced pleurisy. Crotamine did not cause lethality or signs of intoxication up to the maximum dose tested (10.88 mg/kg). The number of contortions was reduced significantly by 34, 57, and 74% at the oral doses of 0.08, 0.16, and 0.32 mg/kg, respectively. At the dose of 0.16 mg/kg, crotamine decreases pain time-reactivity at neurogenic phase by 45% and at inflammatory phase by 60%. Also, crotamine elicited antiedematogenic activity through the attenuation of the croton oil-induced ear edema by 77%. In the carrageenan-induced pleurisy, the leukocyte, neutrophil, and mononuclear cell migration to the lesion site were reduced by 52%, 46%, and 59%, respectively. Altogether, crotamine demonstrated in vivo antinociceptive and anti-inflammatory effect through acute oral administration, generating an anti-migratory mechanism of action at non-toxic doses.
Topics: Administration, Oral; Analgesics; Animals; Anti-Inflammatory Agents; Carrageenan; Crotalid Venoms; Disease Models, Animal; Dose-Response Relationship, Drug; Edema; Male; Mice; Pain; Pleurisy; Toxicity Tests, Acute
PubMed: 34014349
DOI: 10.1007/s00210-021-02103-4 -
Scandinavian Journal of Surgery : SJS :... Jun 2018The development of pleural infection may imply a worse state of health and prognosis. The objective of this study was to ascertain the long-term survival and causes of...
BACKGROUND AND AIMS
The development of pleural infection may imply a worse state of health and prognosis. The objective of this study was to ascertain the long-term survival and causes of death after pleural infections and to compare them to those of matched controls.
MATERIAL AND METHODS
Altogether 191 patients treated for pleural infections at a single University Hospital between January 2000 and December 2008 and 1910 age- and gender-matched controls were included. Survival data and the causes of death for non-survivors were obtained from national databases and compared between the groups.
RESULTS
The etiology of pleural infection was pulmonary infection in 70%, procedural complication in 9%, trauma in 5%, malignancy in 4%, other in 7%, and unknown in 5% of patients. The course of treatment was surgical in 82%, drainage only in 12%, and conservative in 5% of included patients. The median follow-up time was 11 years. Mortality rates were 8.4% versus 0.8% during the first 90 days, p < 0.001, and 46.6% versus 24.5% overall, p < 0.001, in patients and controls, respectively. Mortality was significantly higher in patients with pulmonary infection, procedural complication, or malignancy as the etiology of pleural infection. In multivariable analysis, advanced age, previous malignancies, institutional care, alcoholism, and malignant etiology for the infection were associated with inferior survival. Deaths caused by malignancies, respiratory diseases, and digestive diseases were significantly more common in patients than in controls.
CONCLUSION
Long-term survival in patients with pleural infections is significantly inferior to that of age and gender-matched controls.
Topics: Adult; Aged; Case-Control Studies; Cause of Death; Empyema, Pleural; Female; Humans; Male; Middle Aged; Pleurisy; Prognosis; Survival Rate
PubMed: 29121816
DOI: 10.1177/1457496917738868 -
Inflammopharmacology Feb 2023Advances have been made in the search for new multi-target modulators to control pain and inflammation. Therefore, compound...
Advances have been made in the search for new multi-target modulators to control pain and inflammation. Therefore, compound 3,5-di-tert-butyl-4-hydroxyphenyl)(4-methylpiperazin-1-yl)methanone (LQFM202) was synthesised and evaluated. First, in vitro assays were performed for COX-1, COX-2, and 5-LOX enzymes. Subsequently, adult female Swiss albino mice treated orally with LQFM202 at doses of 25-200 mg/kg were subjected to acetic acid-induced writhing, formalin-induced pain, carrageenan-induced hyperalgesia, carrageenan- or zymosan-induced paw oedema, or pleurisy. LQFM202 inhibited COX-1, COX-2, and LOX-5 (IC = 3499 µM, 1565 µM, and 1343 µM, respectively). In acute animal models, LQFM202 (50, 100, or 200 mg/kg) decreased the amount of abdominal writhing (29%, 52% and 48%, respectively). Pain in the second phase of the formalin test was reduced by 46% with intermediate dose. LQFM202 (100 mg/kg) reduced the difference in nociceptive threshold in all 4 h evaluated (46%, 37%, 30%, and 26%, respectively). LQFM202 (50 mg/kg) decreased the carrageenan-oedema from the second hour (27%, 31% and 25%, respectively); however, LQFM202 (100 mg/kg) decreased the carrageenan-oedema in all hours evaluated (35%, 42%, 48% and 50%, respectively). When using zymosan, LQFM202 (50 mg/kg) decreased the oedema in all hours evaluated (33%, 32%, 31% and 20%, respectively). In the carrageenan-pleurisy test, LQFM202 (50 mg/kg) reduced significantly the number of polymorphonuclear cells (34%), the myeloperoxidase activity (53%), TNF-α levels (47%), and IL-1β levels (58.8%). When using zymosan, LQFM202 (50 mg/kg) reduced the number of polymorphonuclear and mononuclear cells (54% and 79%, respectively); and the myeloperoxidase activity (46%). These results suggest antinociceptive and anti-inflammatory effects of LQFM202.
Topics: Animals; Mice; Female; Analgesics; Carrageenan; Cyclooxygenase 2; Peroxidase; Zymosan; Anti-Inflammatory Agents; Pain; Inflammation; Pleurisy; Piperazines; Edema; Plant Extracts
PubMed: 36443517
DOI: 10.1007/s10787-022-01103-x -
Annals of Palliative Medicine Sep 2020Recently, the combination of clinical and pleural fluid data can be used to calculate a score which helps facilitate differential diagnosis between tuberculous pleuritis...
BACKGROUND
Recently, the combination of clinical and pleural fluid data can be used to calculate a score which helps facilitate differential diagnosis between tuberculous pleuritis (TBP) and No-TBP effusions. However, a reliable determination of adenosine deaminase (ADA) remains difficult to obtain in Thailand. Therefore, the aim of our study was set out to develop a scoring which makes use of clinical and pleural fluid data.
METHODS
A retrospective study involved 15 patients with TBP and 41 patients with no-TBP. The clinical and pleural fluid data of all patients from January 1, 2011, 32 to December 31, 2014, were collected. The diagnostic sensitivity, specificity, positive and negative predictive value were calculated.
RESULTS
The parameters were superior in detecting TBP, including the ADA ≥17.5 U/L, In scoring I [ADA ≥40 U/L, age The high pleural fluid ADA, high scores model 1, high scores model 2, lower RBC, and no previous history of cancer may help to categorize patients into probable TBP for further clinical decisionmaking.35 years, temperature ≥37.8 ℃, and RBC The high pleural fluid ADA, high scores model 1, high scores model 2, lower RBC, and no previous history of cancer may help to categorize patients into probable TBP for further clinical decisionmaking.5×109 /L] as ≥1.5 points, and scoring II [no previous history of cancer, age The high pleural fluid ADA, high scores model 1, high scores model 2, lower RBC, and no previous history of cancer may help to categorize patients into probable TBP for further clinical decisionmaking.35 years, temperature ≥37.8 ℃ RBC The high pleural fluid ADA, high scores model 1, high scores model 2, lower RBC, and no previous history of cancer may help to categorize patients into probable TBP for further clinical decisionmaking.5×109 /L, pleural protein ≥50 g/L, and LDH ratio ≥2.2] as ≥4.5 points, since the area under curve (AUC) 74.0%, 74.0%, and 81.0%, sensitivity 73.3%, 73.3%, and 71.4%, and specificity 68.7%, 62.5%, and 71.1%, respectively). Moreover, no previous history of cancer and lower RBC The high pleural fluid ADA, high scores model 1, high scores model 2, lower RBC, and no previous history of cancer may help to categorize patients into probable TBP for further clinical decisionmaking.5×109 /L indicated sensitivity (90.6% and 65.5%), and specificity (70.0% and 44.4%), respectively. Summated scores of ≥5 points in model 1 and ≥6 points in model 2 yielded measures of sensitivity (46.7% and 57.1%), and specificity (84.4% and 80.5%), respectively.
CONCLUSIONS
The high pleural fluid ADA, high scores model 1, high scores model 2, lower RBC, and no previous history of cancer may help to categorize patients into probable TBP for further clinical decisionmaking.
Topics: Adenosine Deaminase; Adult; Humans; Pleural Effusion; Pleurisy; Retrospective Studies; Tuberculosis, Pleural
PubMed: 32921071
DOI: 10.21037/apm-19-394 -
Phytotherapy Research : PTR May 2022Oxidative stress and inflammation play important roles in pleurisy. Leonurine (Leo) has been confirmed to exert antioxidative and antiinflammatory effects in many...
Oxidative stress and inflammation play important roles in pleurisy. Leonurine (Leo) has been confirmed to exert antioxidative and antiinflammatory effects in many preclinical experiments, but these effects have not been studied in pleurisy. The aim of this study was to explore the therapeutic effect and mechanism of Leo in a carrageenan (CAR)-induced pleurisy model. In this study, we found that the increase of reactive oxygen species (ROS), myeloperoxidase (MPO), and malondialdehyde (MDA) and decrease of glutathione (GSH) induced by CAR could be reversed by the treatment of Leo. Leo effectively reduced the levels of proinflammatory cytokines interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and the percentages of mature macrophages and increased the levels of antiinflammatory cytokines (IL-10). Furthermore, Western blotting revealed that Leo significantly activated the Nrf2 pathway to restrain the thioredoxin-interacting protein/NOD-like receptor protein 3 (TXNIP/NLRP3) and nuclear factor kappa-B (NF-κB) pathways. However, the protective effect of Leo was significantly weakened in Nrf2-deficient mice. These results indicate that Leo confers potent protection against CAR-induced pleurisy by inhibiting the TXNIP/NLRP3 and NF-κB pathways dependent on Nrf2, which may serve as a promising agent for attenuating pleurisy.
Topics: Animals; Carrageenan; Carrier Proteins; Gallic Acid; Mice; NF-E2-Related Factor 2; NF-kappa B; NLR Family, Pyrin Domain-Containing 3 Protein; Pleurisy; Thioredoxins
PubMed: 35285100
DOI: 10.1002/ptr.7437 -
Internal Medicine (Tokyo, Japan) Apr 2023
Topics: Humans; Pleural Diseases; Pneumothorax; Pleurisy; Social Isolation
PubMed: 36047122
DOI: 10.2169/internalmedicine.0333-22 -
Journal of Ethnopharmacology Jul 2021The population uses the aqueous extract as tea from leaves of Ocimum selloi Benth. (alfavaca) for pain and inflammation issues. This study is motivated by a lack of data...
ETHNOPHARMACOLOGICAL RELEVANCE
The population uses the aqueous extract as tea from leaves of Ocimum selloi Benth. (alfavaca) for pain and inflammation issues. This study is motivated by a lack of data about inflammation properties of O. selloi.
AIM OF THE STUDY
This study investigated the chemical composition and anti-inflammatory activity, in mice models, of the aqueous extract (OSAE) and essential oil (OSEO) obtained from leaves of O. selloi.
MATERIALS AND METHODS
The antioxidant activity and total phenolic content were evaluated for samples, although chemical composition was obtained by U-HPLC-DAD-ESI-MS for OSAE and GC-MS for OSEO. OSAE and OSEO were tested orally at doses of 30, 100 and 300 mg/kg at the carrageenan-induced pleurisy and paw edema, also mechanical hyperalgesia, in mice.
RESULTS
Four glycosylated flavonoids and one organic acid were identified in OSAE, and nine substances in OSEO, the two majoritarian are E-anethole and methyl chavicol. Oral treatments with OSAE and OSEO significantly inhibited the carrageenan-induced pleurisy in female Swiss mice, besides OSAE and OSEO significantly prevented paw edema (after 1, 2, and 4 h), mechanical hyperalgesia (after 3 and 4 h), and cold hyperalgesia 3 h after carrageenan model in male Swiss mice. The dose of 300 mg/kg of OSEO reduced cold hyperalgesia 4 h after carrageenan.
CONCLUSION
The results evidenced the anti-inflammatory, anti-edematogenic, anti-hyperalgesic, and anti-nociceptive potentials of both materials obtained from leaves of O. selloi, mainly OSAE, supporting the popular use of this species.
Topics: Animals; Anti-Inflammatory Agents; Antioxidants; Carrageenan; Dexamethasone; Disease Models, Animal; Edema; Female; Hyperalgesia; Leukocytes; Male; Mice; Ocimum; Oils, Volatile; Phenols; Plant Extracts; Plant Leaves; Pleurisy; Solutions
PubMed: 33892069
DOI: 10.1016/j.jep.2021.114136