Showing 6 results for Pleura
Z Ahmadinejad, Sh Phyroosbakhsh, Z.n Hatmy, B Bagherian, H Sabery, M Bahador, M Nikzad, M Jamali Zavare, A Hadady, M Hajiabdolbaghi, M Mohraz, M. Rasolinejad, A Soudbakhsh, A Yalda,
Volume 64, Issue 2 (4-2006)
Abstract
Background and Aim: Tuberculous pleural effusion occurs in 30% of patients with tuberculosis (TB). Rapid diagnosis of a tuberculous pleural effusion would greatly facilitate the management of many patients. The purpose of this study was to determine sensitivity, specificity, and predictive values of clinical, laboratory, radiographic findings in patients with tuberculous pleural effusion.
Materials and Methods: The cross sectional study was performed between august 2002 and March 2004 at a referral teaching hospital. Major clinical, laboratory, and radiographic findings were evaluated in 88 cases of pleural effusion, 33 with confirmed TB pleural effusion (TBPE) and 55 with a diagnosis other than TB (NTBPE).
Results: The sensitivity of culture of pleural effusion and tissue were 3% and 9.1% respectively. The mean of adenosine deaminase (ADA) values in TBPE was 36.7 U/L (±18.72), and the mean in the NTBPE was 28.2 U/L (±17.0). Both the sensitivity and specificity of ADA estimation in diagnosing tuberculosis were 55%. The sensitivity of PCR was 3% with specificity of 12.7% (positive predictive value, 50% negative predictive value, 70%). Younger age (p<0.024), positive history of exposure to TB patient (p<0.02), and the combination of fever, weight loss and sweating (p<0.01), were associated with tuberculous pleural effusion. There were also significant association between Positive sputum smear (p<0.001), positive sputum culture (p<0.006), positive pleural biopsy (p<0.001), pleural LDH>200 (p<0.005), pleural lymphocytes>50% (p<0.015) and TBPE.
Conclusions: In our region with a high incidence of tuberculosis, the most frequent cause of exudative pleural effusion is tuberculosis. We suggest that the diagnostic planning of pleural effusion should be determined in each region with a view to the adoption of regionally optimized diagnostic and therapeutic facilities.
Bagheri R, Haghy Sz, Rahim Mb, Attaran D, Silanian Toosi M,
Volume 67, Issue 2 (5-2009)
Abstract
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Background: Pleural
malignant mesothelioma is an uncommon but extremely invasive tumor which
originates from mesothelial cells and usually occures after prolonged exposure
to asbestos. The aim of this study was to clinicopathologically evaluation of 40
patients with pleural malignant mesothelioma and the main factors influencing
their prognosis.
Methods: In this
study patients with definitive diagnosis, who had been followed up for at least
three years were studied based on gender, age presenting symptoms, and
clinicopathological patterns.
Results: Male to
female ratio of the study patients was three to one any the average age of them
was 55 years. Chest pain was the most common symptoms in 34(85%) patients. Most
of the study patients were in Buchard stage I (37/5%) and the epithelial form
was the most common pathological pattern 25(62.5%). 19(47.5%) of cases received
only radiotherapy and chemotherapy. Extrapleural pneumonectomy was performed on
eight (20%) patients, seven (17.5%) patients underwent decortication and
pleurectomy beside adjuvant therapy and 15% of the cases rejected any type of
treatment. Surgical mortality occurred in one patient and the most common surgical
complication was wound infection. The average survival rate was 12±1.2 months and the main factors influencing it
were the patient's physiologic status, pathological form, stage of the disease
and the pattern of pleural involvement.
Conclusions: Because the low survival rate after multimodality invasive treatments in
mesothelioma, aggressive therapeutic methods were recommended in selected
patients
Forouzan Nia Skh, Mirhosseini Sj, Moshtaghion Sh, Abdollahi Mh, Hosseini H, Dehghanizadeh H, Bani Fateme Sa, Hosseini Sm,
Volume 68, Issue 12 (3-2011)
Abstract
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Background: Proper drainage of the mediastinal and pleural spaces following Off-Pump Coronary
Artery Bypass (OPCAB) surgery is essential
for the prevention of pleural and pericardial effusions, cardiac tamponade and
late complications such as constrictive pericarditis. Drainage tubes themselves
may induce some complications which can negatively affect the result of the
surgery. In this study we assessed a new technique for chest drainage following
OPCAB.
Methods: In this clinical trial, 171 patients were
allocated to two groups. In the control group, the drainage technique included
one drain in the left pleural cavity and another in the mediastinum, while in
the case group the drainage technique included one drain in the left plural
and one in the right pleural cavity.
Results: The amount of drainage in the case group was more than the control group (p=0.001).
We found significant reductions in the incidence of arrhythmias in the case
group (p=0.005). While one patient (1.2%)
needed reoperation for bleeding control in the control group, no patients
needed reexploration in the case group (p=0.497).
The duration of hospital (p=0.022) and ICU
(p=0.002) stays was shorter in the case group.
Conclusions: Based
on the results of this study, changing the position of mediastinal drains in
patients undergoing OPCAB surgery and shifting it to
the right pleural cavity, reduces complications, such as arrhythmia and
pericardial effusion, aside from establishing a better drainage.
Mohammadreza Kasraei , Hamidreza Abtahi, Niloofar Eyoobi Yazdi, Enayat Safavi, Shahram Firoozbakhsh, Mostafa Mohammady,
Volume 72, Issue 7 (10-2014)
Abstract
Pleural effusion (PE) is common among ICU and acutely ill patients. Traditionally plain chest radiography (CXR) has been done for pleural effusion evaluation in ICU. However, better results have been reported by ultrasound for the diagnosis of this condition in ICU. In this study, we compared two methods of ultrasound and CXR in PE detection in ICU patients. Also we studied the percentage of thoracentesis by physician after detection of PE by ultrasonography or CXR.
Methods: Portable supine CXR and chest ultrasound were done in Thirty-nine non-surgical patients who were admitted to the Medical and General ICUs of Imam Khomeini hospital in Tehran from Oct 2013 to Mar 2014. Ultrasound was done and interpreted by radiologist and CXR by patient' physician. Thoracentesis or CT-scan was used as gold standard for PE diagnosis.
Results: Ultrasound in 29 patients (74.3%) showed PE. In 21 patients thoracentesis was done by patient’s physician and all had PE with mean volume of 447.2(417.6). In 13 of 18 patients without thoracentesis chest CT scan was available. It shows PE in 6 cases (all with positive PE in ultrasonography). CXR in 9 patients (23.1%) was positive for PE and in 30 patients (76.9%) was negative. The ability of chest ultrasound and CXR for diagnosis of PE was significantly different (P= 0.0.1). In 68.9 % of cases that ultrasound was positive, the CXR was negative and only in 34.5% of cases both methods had negative results. The sensitivity, specificity, positive and negative predictive values were 100% (87.1-100), 100% (58.9-100), 100% (87.1-100), 100% (58.9-100) respectively for ultrasonography. For CXR there were 33% (16.6-54.0), 100% (58.9-100), 100% (66.2-100), 28% (12.1-49.4) respectively.
Conclusion: Ultrasonography for diagnosis of pleural effusion in ICU patients has better diagnostic performance than portable CXR
Seyede Houra Mousavi Vahed , Maliheh Afiat, Fahimeh Alizadeh, Anahita Hamidi Laien , Zeynab Khademi, Azin Nikoozadeh,
Volume 77, Issue 2 (5-2019)
Abstract
Background: Ovarian fibroma is the most common benign solid tumor of the ovary. The most common symptoms are abdominal discomfort and pain. Ovarian fibroids are associated with Meigs syndrome in 1% to 10% of cases. The aim of study is report of a case of Meigs syndrome
Case presentation: A 65-year-old menopausal woman who complained of abdominal pain was referred to our academic hospital of Mashhad, Iran, in April 2018. In abdominal examination, a soft mass with size of 200×100 mm, was detected. Also leukocytosis and increase in CRP was observed. Marker CA125 was higher than 200. In CT scan in right adnexa heterogeneous mass 170×100 mm with enhancement was reveled. pleural effusion was reported in the both lungs and collapse of underlying lung tissue in Chest X-ray. Explorative laparotomy was performed. Ascites and inflamed omentum covered the surface of right ovary was detected. The huge solid-cystic hemorrhagic, irregular mass with a specific pedicle that enclosed in the capsule in right adnexa was seen. Right salpingo-oophorectomy was performed. The result of final pathologic was benign proliferative lesions of mitotic fibroblasts were reported according to ovarian fibroma.
Conclusion: In case of accompanying ovarian mass with ascites and pleural effusion, after the exclude of ovarian malignancies, Meigs syndrome should be considered in differential diagnosis.
Mohammad Ranaee, Yaghob Khoshsirat Tomaj , Hemmat Gholinia Ahangar , Mahmood Monadi,
Volume 80, Issue 3 (6-2022)
Abstract
Background: Pleural effusion is the accumulation of fluid in the pleural cavities resulting from an imbalance of fluid production and reabsorption. Early detection of the cause of pleural effusion leads to early treatment and reduces effects on the patient. The most important step in pleural effusion diagnosis is to determine its nature and to determine whether it is transudate or exudate. CRP(C-reactive protein) is an acute-phase protein that is synthesized by hepatocytes during inflammatory states, the highly sensitive type of CRP is more sensitive than the standard CRP test and measures lower levels. It may help differentiate the nature of pleural effusion. The aim of this research was to evaluate the hs-CRP diagnostic value in differentiating the nature of the pleural effusion
Methods: In this descriptive-analytical cross-sectional study, in Rohani hospital of Babol from March 2017 to February 2019, 75 pleural effusion patients, undergoing thoracentesis, the hs-CRP level was measured in their pleural fluid and were compared based on Light´s criteria in two groups of transudates and exudates. Using the ROC curve, the appropriate cut-off point was determined for hs-CRP to differentiate the nature of pleural effusion.
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Results: Out of 75 patients, 45 patients were in the exudative pleural effusion group and 30 patients in the transudative group. The mean of hs-CRP in the exudate group was 18.27±10.74 mg/L and in the transudative group 2.98±2.15 mg/L (p˂0.001). The cut-off point for hs-CRP of pleural fluid was calculated to be 5.94 mg / L, which has a sensitivity of 88.9% and a specificity of 93.3%. This marker was also studied in exudative subgroups, and there was a significant difference between pleural hs-CRP levels in two groups of pleural effusion due to malignancy and Parapneumonic effusion (p=0.011).
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Conclusion: The pleural fluid hs-CRP can be used as a useful marker for differentiating the nature of pleural effusion and differentiating the pleural effusion of transudate and exudate.
