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Showing 4 results for Pleural Effusion
Predictive Values Of Diagnostic Tests In Patients With Tuberculous Pleural Effusion In Iran
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.


Diagnosis of pleural effusion by portable ultrasound and chest radiography in intensive care unit
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
A case report of ovarian fibroids torsion with ascites and pleural effusion: case report
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.

Diagnostic Value of high sensitivity C-reactive protein in Differentiating Transudate and Exudative Fluid in Patients with Pleural Effusion.
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.
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).
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.

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