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Medical Ultrasonography Aug 2021Ultrasound (US) is an ideal diagnostic tool for paediatric patients owning to its high spatial and temporal resolution, real-time imaging, and lack of ionizing radiation... (Review)
Review
Ultrasound (US) is an ideal diagnostic tool for paediatric patients owning to its high spatial and temporal resolution, real-time imaging, and lack of ionizing radiation and bedside availability. The lack of superficial adipose tissue and favorable acoustic windows in children makes US the first line of investigation for the evaluation of pleural and chest wall abnormali-ties. Lung parenchyma was previously thought to be inaccessible to ultrasound due to the presence of the air and bony thorax. The change in attitude and growing awareness of the diagnostic possibilities has led to lung ultrasound (LUS) being accepted as a valuable point of care method. In addition, the application of LUS has widened with improvements in technology such as higher resolution transducers, harmonic imaging and contrast-enhanced ultrasound. In the current World Federation of Societies for Ultrasound in Medicine and Biology (WFUMB) paper series the topic will be introduced, the technical requirements explained and the use of ultrasound in the lung and pleura in pediatric patients are discussed.
Topics: Child; Humans; Lung; Pleura; Point-of-Care Systems; Ultrasonography
PubMed: 33626123
DOI: 10.11152/mu-3058 -
Respiratory Medicine Jan 2022Pleuroparenchymal fibroelastosis (PPFE) is a rare, generally idiopathic form of interstitial pneumonia with unique clinical, radiological and histopathological features.... (Review)
Review
Pleuroparenchymal fibroelastosis (PPFE) is a rare, generally idiopathic form of interstitial pneumonia with unique clinical, radiological and histopathological features. It is named after the presence of upper lobe pleural and subjacent parenchymal fibrosis, with accompanying elastic fibers. Although it is usually an idiopathic disease, it has been linked to other co-existent diseases. Diagnostic suspicion of PPFE is based on the identification of typical abnormalities on chest CT scan, which are prevailingly located in the upper lobes, adjacent to the apex of the lungs. Diagnosis can be confirmed by histological analysis, although biopsy is not always feasible. The disease is generally progressive, but not uniformly. The course of the disease is frequently slow and involves a progressive loss of upper lobe volume, which results in platythorax, associated with a significant reduction of body mass. PPFE concomitant to other interstitial lung diseases is associated with a poorer prognosis. The disease occasionally progresses rapidly causing irreversible respiratory insufficiency, which leads to death. Currently, there is no effective pharmacological therapy available, and lung transplantation is the best therapeutic option. The purpose of this review is to draw the attention to PPFE, describe its clinical, radiological and histopathological features, analyze its diagnostic criteria, and provide an update on the management of the disease.
Topics: Humans; Lung; Lung Diseases, Interstitial; Lung Transplantation; Pleura; Tomography, X-Ray Computed
PubMed: 33992495
DOI: 10.1016/j.rmed.2021.106437 -
Respiratory Medicine Jan 2022A sarcoidosis associated pleural effusion (SAPE) is a pleural effusion caused by active granulomatous inflammation from sarcoidosis. We describe the epidemiology,... (Review)
Review
A sarcoidosis associated pleural effusion (SAPE) is a pleural effusion caused by active granulomatous inflammation from sarcoidosis. We describe the epidemiology, clinical features, diagnostic approach, treatment strategies and outcome of this condition. SAPE occurs in approximately 1% of sarcoidosis patients. The condition most commonly occurs at the initial presentation of sarcoidosis or within the first year. Dyspnea is the most common presenting symptom. Although a definitive diagnosis of SAPE requires a pleural biopsy, the diagnosis may be established on the basis of clinical features alone provided that alternative conditions can be reliably excluded. Pleural fluid analysis is essential in establishing the clinical diagnosis of SAPE. Corticosteroids are the drugs of choice for SAPE, and they are usually rapidly effective with courses of therapy often lasting less than two months. SAPE tends to have a low rate of recurrence that appears be to lower than for many other forms of sarcoidosis.
Topics: Biopsy; Exudates and Transudates; Humans; Pleura; Pleural Effusion; Sarcoidosis
PubMed: 34954636
DOI: 10.1016/j.rmed.2021.106723 -
Medicina (Kaunas, Lithuania) Dec 2022: This study was designed to evaluate platelet-rich plasma (PRP) as a method of pleurodesis in a rabbit model. Pleurodesis with PRP was compared against the...
: This study was designed to evaluate platelet-rich plasma (PRP) as a method of pleurodesis in a rabbit model. Pleurodesis with PRP was compared against the gold-standard use of talc. The secondary evaluation assessed the ideal time for achieving pleurodesis. : 25 healthy New Zealand white rabbits were assigned to three groups, as follows: 12 animals in the first and second groups, as well as one animal with no intervention in the final group, which was used as a control. The talc pleurodesis group (baseline) underwent pleurodesis with sterile talc, which is the gold-standard sclerosing agent used for pleurodesis. The PRP group underwent pleurodesis using autologous PRP. The last group had one rabbit with no intervention. A total of 12 rabbits ( = 6 for the talc pleurodesis group and = 6 for the PRP group) were sacrificed 3 days (72 h) after the intervention, and 12 rabbits ( = 6 for the talc pleurodesis group and = 6 for the PRP group) were sacrificed 6 days (144 h) after the intervention. In both the talc and PRP group, FBC and CRP were measured before the intervention and in 3 or 6 days afterwards, respectively. The pleura and the lungs were evaluated histopathologically. : Macroscopically, there were no statistically significant differences between the two groups. In terms of microscopic findings, there were no statistically significant differences in inflammatory reactions provoked in the visceral and parietal pleura between the PRP and talc. In addition, with talc pleurodesis, a foreign-body reaction was observed in about 50% of the cases, which was not observed with PRP. In terms of inflammation between 3 and 6 days, there were no statistically significant differences with PRP, there was only a statistically significant difference between 3 and 6 days regarding the parietal pleura in the talc group. : The instillation of autologous PRP in the pleural cavity shows promise in achieving pleurodesis. The efficacy of PRP as a pleurodesis agent should be examined further.
Topics: Rabbits; Animals; Pleurodesis; Talc; Pleura; Lung; Platelet-Rich Plasma
PubMed: 36557044
DOI: 10.3390/medicina58121842 -
Ultraschall in Der Medizin (Stuttgart,... Feb 2023Diseases of the respiratory system are among the main problems of premature patients in the neonatal intensive care unit. Radiography of the thorax is the gold standard...
Diseases of the respiratory system are among the main problems of premature patients in the neonatal intensive care unit. Radiography of the thorax is the gold standard of imaging. This results in high cumulative radiation exposure with potential negative long-term consequences. Ultrasound examination of thoracic structures represents a promising radiation-free and ubiquitously available alternative.A healthy, ventilated lung can only be imaged via artifacts, since total reflection of the sound waves occurs due to the high impedance difference between tissue and air-filled lung. Pathologies of pleura and subpleural lung tissue lead to changes in the acoustic properties of the tissue and thus to variations in the artifacts that can be imaged. The main sonographic characteristics of pulmonary pathology are: pleural line abnormalities, increased B-lines and comet-tail artifacts, lung consolidations, a visible pulmonary pulse, pleural sliding abnormalities, and visualization of effusions. Deviations from normal sonographic findings can be assigned to specific underlying pathophysiologies, so that conclusions about the disease can be drawn in conjunction with the clinical symptoms.
Topics: Infant, Newborn; Humans; Lung; Lung Diseases; Pleura; Ultrasonography; Diagnosis, Differential
PubMed: 36075237
DOI: 10.1055/a-1885-5664 -
PloS One 2022Pleural mesothelial cells are the predominant cell type in the pleural cavity, but their role in the pathogenesis of pleural diseases needs to be further elucidated. 3D...
Pleural mesothelial cells are the predominant cell type in the pleural cavity, but their role in the pathogenesis of pleural diseases needs to be further elucidated. 3D organotypic models are an encouraging approach for an in vivo understanding of molecular disease development. The aim of the present study was to develop a 3D organotypic model of the pleural mesothelium. Specimens of human pleura parietalis were obtained from patients undergoing surgery at the University Hospital Leipzig, Germany. 3D co-culture model of pleura was established from human pleural mesothelial cells and fibroblasts. The model was compared to human pleura tissue by phase-contrast and light microscopy, immunochemistry and -fluorescence as well as solute permeation test. Histological assessment of the 3D co-culture model displayed the presence of both cell types mimicking the morphology of the human pleura. Vimentin and Cytokeratin, PHD1 showed a similar expression pattern in pleural biopsies and 3D model. Expression of Ki-67 indicates the presence of proliferating cells. Tight junctional marker ZO-1 was found localized at contact zones between mesothelial cells. Each of these markers were expressed in both the 3D co-culture model and human biopsies. Permeability of 3D organotypic co-culture model of pleura was found to be higher for 70 kDa-Dextran and no significant difference was seen in the permeability for small dextran (4 kDa). In summary, the presented 3D organoid of pleura functions as a robust assay for pleural research serving as a precise reproduction of the in vivo morphology and microenvironment.
Topics: Humans; Pleura; Coculture Techniques; Dextrans; Pleural Diseases; Pleural Cavity
PubMed: 36454800
DOI: 10.1371/journal.pone.0276978 -
Respirology (Carlton, Vic.) Feb 2021
Topics: Humans; Lasers; Pleura; Pleural Neoplasms; Thoracoscopy
PubMed: 33251664
DOI: 10.1111/resp.13982 -
Anaesthesia Dec 2017
Topics: Nerve Block; Pleura
PubMed: 29130282
DOI: 10.1111/anae.14108 -
RoFo : Fortschritte Auf Dem Gebiete Der... Sep 2019
Topics: Adolescent; Ambulatory Care; Child; Child, Preschool; Critical Care; Emergency Service, Hospital; Female; Humans; Infant; Lung; Male; Pleura; Pleuropneumonia; Sensitivity and Specificity; Thoracic Diseases; Thoracic Wall; Ultrasonography
PubMed: 31430775
DOI: 10.1055/a-0943-1123 -
BMJ Case Reports Mar 2021A 31-year-old female physician was diagnosed with bilateral pneumothorax a day after her acupuncture treatment. Her body mass index was 16.9 and she did not have a prior...
A 31-year-old female physician was diagnosed with bilateral pneumothorax a day after her acupuncture treatment. Her body mass index was 16.9 and she did not have a prior history of respiratory disease or smoking. Acupuncture needles may easily reach the pleura around the end of the suprascapular angle of the levator scapulae muscle where the subcutaneous tissue is anatomically thin. In our patient, the thickness between the epidermis and the visceral pleura in this area was only 22 mm as confirmed by an ultrasound scan. Although she felt chest discomfort 30 min after the procedure, she assumed the symptom to be a reaction to the acupuncture. In light of our case, we advise practitioners to select appropriate acupuncture needles for patients based on the site of insertion and counsel them regarding the appearance of symptoms such as chest pain and dyspnoea immediately after the procedure.
Topics: Acupuncture Therapy; Adult; Dyspnea; Female; Humans; Needles; Pleura; Pneumothorax
PubMed: 33649032
DOI: 10.1136/bcr-2020-241510