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Pleural Effusion

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1. Pleural effusion

Pleural effusion Pleural effusion - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Pleural effusion Last reviewed: February 2019 Last updated: February 2019 Summary Patients predominantly present with breathlessness, but cough and pleuritic chest pain can be a feature. The aetiology of the pleural effusion determines other signs and symptoms. Postero-anterior chest x-ray will show an effusion of >200 mL of fluid (...) . An ultrasound, chest computed tomography scan, or lateral decubitus study indicates whether the fluid is free-flowing or loculated, and whether or not septations are present. Aspiration and evaluation of the pleural fluid with biochemistry, cytology, and culture determines the nature of the effusion. Treatment is based on the nature of the effusion and underlying condition. Therapeutic thoracentesis with nearly complete removal of the fluid collection alleviates dyspnoea and cough in most circumstances

2019 BMJ Best Practice

2. Indwelling pleural catheters for the management of malignant pleural effusions

Indwelling pleural catheters for the management of malignant pleural effusions Indwelling pleural catheters for the management of malignant pleural effusions Indwelling pleural catheters for the management of malignant pleural effusions HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Indwelling pleural catheters for the management (...) of malignant pleural effusions. Lansdale: HAYES, Inc.. Directory Publication. 2016 Authors' objectives The purpose of indwelling pleural catheters (IPCs) is to allow for the intermittent drainage of accumulated fluid from the lungs that can occur as a complication of advanced malignancy, causing dyspnea, cough, and/or chest pain that lead to a decreased quality of life (QOL) and reduced functional ability. Controversy: The main controversy surrounding the use of IPCs are their effectiveness compared

2017 Health Technology Assessment (HTA) Database.

3. Distinguishing tuberculosis pleural effusion from parasitic pleural effusion using pleural fluid characteristics: A case control study. (PubMed)

Distinguishing tuberculosis pleural effusion from parasitic pleural effusion using pleural fluid characteristics: A case control study. Tuberculosis pleural effusion (TPE) and parasitic pleural effusion (PPE) present with similar clinical manifestations. We evaluated the pleural fluid features of TPE and PPE.A total of 76 patients with pleuritis, including 25 patients with TPE and 51 patients with PPE were retrospectively studied. Pleural fluid was sent for analyses of protein, cytology, cell (...) the study groups in terms of the ADA level of the pleural fluid (P > .05).When the results of pleural fluid testing reveal marked eosinophilia and a low proportion of lymphocytes, physicians should consider a diagnosis of PPE, especially for patients who live in or have traveled to endemic areas.

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2019 Medicine

5. Pleural effusion

Pleural effusion Pleural effusion - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Pleural effusion Last reviewed: February 2019 Last updated: February 2019 Summary Patients predominantly present with breathlessness, but cough and pleuritic chest pain can be a feature. The aetiology of the pleural effusion determines other signs and symptoms. Postero-anterior chest x-ray will show an effusion of >200 mL of fluid (...) . An ultrasound, chest computed tomography scan, or lateral decubitus study indicates whether the fluid is free-flowing or loculated, and whether or not septations are present. Aspiration and evaluation of the pleural fluid with biochemistry, cytology, and culture determines the nature of the effusion. Treatment is based on the nature of the effusion and underlying condition. Therapeutic thoracentesis with nearly complete removal of the fluid collection alleviates dyspnoea and cough in most circumstances

2018 BMJ Best Practice

6. Management of Malignant Pleural Effusions:

Management of Malignant Pleural Effusions: AMERICANTHORACICSOCIETY DOCUMENTS ManagementofMalignantPleuralEffusions An Of?cial ATS/STS/STR Clinical Practice Guideline David J. Feller-Kopman*, Chakravarthy B. Reddy*, Malcolm M. DeCamp, Rebecca L. Diekemper, Michael K. Gould, Travis Henry, Narayan P. Iyer, Y. C. Gary Lee, Sandra Z. Lewis, Nick A. Maskell, Najib M. Rahman, Daniel H. Sterman, Momen M. Wahidi, and Alex A. Balekian; on behalf of the American Thoracic Society, Society of Thoracic (...) patientoutcomes. Keywords: pleural effusion; malignant; palliation; pleurodesis; pleural catheter Contents Summary of Recommendations Introduction Methods Recommendations for Speci?c Treatment Questions PICO 1: In Patients with Known or Suspected MPE, Should Thoracic Ultrasound Be Used to Guide Pleural Interventions? PICO 2: In Patients with Known or Suspected MPE Who Are Asymptomatic, Should Pleural Drainage Be Performed? PICO3:ShouldtheManagement of Patients with Symptomatic Known or Suspected MPE Be Guided

2018 American Thoracic Society

7. Tunnelled Catheters for the Management of Pleural Effusion: Clinical Effectiveness

Tunnelled Catheters for the Management of Pleural Effusion: Clinical Effectiveness Latex-safe Catheters for Patients Requiring Urinary Catheterization: Safety | CADTH.ca Find the information you need Latex-safe Catheters for Patients Requiring Urinary Catheterization: Safety Latex-safe Catheters for Patients Requiring Urinary Catheterization: Safety Published on: November 7, 2016 Project Number: RB1035-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

8. Discriminating Tuberculous Pleural Effusion from Malignant Pleural Effusion Based on Routine Pleural Fluid Biomarkers, Using Mathematical Methods (PubMed)

Discriminating Tuberculous Pleural Effusion from Malignant Pleural Effusion Based on Routine Pleural Fluid Biomarkers, Using Mathematical Methods The differential diagnosis of tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) is difficult because the biochemical profiles are similar. The present study aimed to differentiate TPE from MPE, using a decision tree and a weighted sparse representation-based classification (WSRC) method, based on the best combination of routine (...) pleural effusion fluid biomarkers.The routine biomarkers of pleural fluid, including differential cell count, lactate dehydrogenase (LDH), protein, glucose and adenosine deaminase (ADA), were measured in 236 patients (100 with TPE and 136 with MPE). A Sequential Forward Selection (SFS) algorithm was employed to obtain the best combination of parameters for the classification of pleural effusions. Moreover, WSRC was compared to the standard sparse representation-based classification (SRC

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2017 Tanaffos

9. Diagnostic Accuracy of Interleukin-27 between Tuberculous Pleural Effusion and Malignant Pleural Effusion: A Meta-Analysis.

Diagnostic Accuracy of Interleukin-27 between Tuberculous Pleural Effusion and Malignant Pleural Effusion: A Meta-Analysis. The concentration assay of pleural effusion interleukin-27 (IL-27) has raised concern for diagnosing tuberculous pleurisy. Compared with malignant pleural effusion (MPE), the concentration of IL-27 in tuberculous pleural effusion (TPE) increased significantly. Accurate differentiating diagnosis is essential for choosing treatment for pleural effusion.The present meta

2018 Respiration; international review of thoracic diseases

10. Effect of an Indwelling Pleural Catheter vs Talc Pleurodesis on Hospitalization Days in Patients With Malignant Pleural Effusion: The AMPLE Randomized Clinical Trial. (PubMed)

Effect of an Indwelling Pleural Catheter vs Talc Pleurodesis on Hospitalization Days in Patients With Malignant Pleural Effusion: The AMPLE Randomized Clinical Trial. Indwelling pleural catheter and talc pleurodesis are established treatments for malignant pleural effusions among patients with poor prognosis.To determine whether indwelling pleural catheters are more effective than talc pleurodesis in reducing total hospitalization days in the remaining lifespan of patients with malignant (...) pleural effusion.This open-label, randomized clinical trial included participants recruited from 9 centers in Australia, New Zealand, Singapore, and Hong Kong between July 2012 and October 2014; they were followed up for 12 months (study end date: October 16, 2015). Patients (n = 146) with symptomatic malignant pleural effusion who had not undergone indwelling pleural catheter or pleurodesis treatment were included.Participants were randomized (1:1) to indwelling pleural catheter (n = 74) or talc

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2017 JAMA

11. Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion. (PubMed)

Pleural IFN-γ release assay combined with biomarkers distinguished effectively tuberculosis from malignant pleural effusion. Tuberculosis (TB) remains a major public health concern on a global scale, especially in developing nations. So far, no formal guidelines are available for the diagnosis and treatment of tuberculosis pleurisy. The diagnosis of TB is worsened by the immense difficulty in differential determination of tuberculosis pleural effusion (TPE) and malignant pleural effusion (MPE (...) ). The purpose of this investigation is to assess the differential diagnostic efficiencies of the pleural IFN-γ release assay (IGRA) and widely-used biochemical parameters in the distinction analysis of TPE and MPE.A cohort of 222 patients with pleural effusion was examined, comprising of 143 TPE and 58 MPE patients. The patients were examined with IGRA, and the widely-used biomarkers in the pleural effusion and peripheral blood.Our results show that the TPE patients have significantly higher M. tuberculosis

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2019 BMC Infectious Diseases

12. Pleural amyloidosis with recurrent pleural effusion and pulmonary embolism: A case report. (PubMed)

Pleural amyloidosis with recurrent pleural effusion and pulmonary embolism: A case report. Clinical and radiologic manifestations of pleural amyloidosis are non-specific. And it can easily be missed or misdiagnosed. Meanwhile, few studies document amyloidosis presenting with pulmonary infarcts at the same time. Hereby, we report a case of immunoglobulin light chain amyloidosis (AL) pleural amyloidosis with pulmonary embolism rarely reported.A 66-year-old male patient who suffered recurrent (...) pleural effusion for more than 6 months and coughed for 2 months was admitted to hospital for clear diagnosis and treatment. He was previously engaged in a job which exposed him to dust and talcum powder for a long time. He underwent right thoracentesis and anti-infective treatment before admission. The patient's cough and shortness of breath were slightly relieved. He still experienced pleural effusion and had symptoms of cough and shortness of breath.Chest X-ray demonstrated bilateral pleural

2019 Medicine

13. Diagnostic value of soluble mesothelin-related peptides in pleural effusion for malignant pleural mesothelioma: An updated meta-analysis. (PubMed)

Diagnostic value of soluble mesothelin-related peptides in pleural effusion for malignant pleural mesothelioma: An updated meta-analysis. Soluble mesothelin-related peptide (SMRP) is a widely studied tumor marker for diagnosing malignant pleural mesothelioma (MPM). This study discussed the diagnostic value of SMRPs in pleural effusion (PE) for MPM.Medline, Embase, Web of Science, and Cochrane library system were systematically searched on the data of SMRPs in PE for MPM diagnosis. Pooled

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2019 Medicine

14. Metabonomics by proton nuclear magnetic resonance in human pleural effusions: A route to discriminate between benign and malignant pleural effusions and to target small molecules as potential cancer biomarkers. (PubMed)

Metabonomics by proton nuclear magnetic resonance in human pleural effusions: A route to discriminate between benign and malignant pleural effusions and to target small molecules as potential cancer biomarkers. Cytopathology is a noninvasive and cost-effective method for detecting cancer cells in pleural effusions (PEs), although in many cases, the diagnostic performance is hindered by the paucity of significant cells or the lack of clear morphological criteria. This study presents the results (...) of an omics approach to improving the diagnostic performance of PE cytology.Metabolic profiling with proton nuclear magnetic resonance (1 H-NMR) was performed for 92 PEs (44 malignant cases of 8 different cancers and 48 benign cases of 7 nonneoplastic conditions). Light's criteria were used to further classify PEs as transudates or exudates, and 1 H-NMR spectroscopy was used to differentiate malignant pleural effusions (mPEs) from benign pleural effusions (bPEs).1 H-NMR metabolic analysis showed clearly

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2017 Cancer

15. Vascular endothelial growth factor and protein level in pleural effusion for differentiating malignant from benign pleural effusion (PubMed)

Vascular endothelial growth factor and protein level in pleural effusion for differentiating malignant from benign pleural effusion Pleural effusion is associated with multiple benign and malignant conditions. Currently no biomarkers differentiate malignant pleural effusion (MPE) and benign pleural effusion (BPE) sensitively and specifically. The present study identified a novel combination of biomarkers in pleural effusion for differentiating MPE from BPE by enrolling 75 patients, 34 with BPE (...) and 41 with MPE. The levels of lactate dehydrogenase, glucose, protein, and total cell, neutrophil, monocyte and lymphocyte counts in the pleural effusion were measured. The concentrations of interleukin (IL)-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-α, interferon γ, transforming growth factor-β1, colony stimulating factor 2, monocyte chemoattractant protein-1 and vascular endothelial growth factor (VEGF) were detected using cytometric bead arrays. Protein and VEGF levels

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2017 Oncology letters

16. Effect of percutaneous radiofrequency ablation after thoracoscopic pleurodesis for treating non‐small cell lung cancer patients with malignant pleural effusion and/or pleural dissemination (PubMed)

Effect of percutaneous radiofrequency ablation after thoracoscopic pleurodesis for treating non‐small cell lung cancer patients with malignant pleural effusion and/or pleural dissemination The purpose of this study was to retrospectively evaluate percutaneous radiofrequency ablation (RFA) combined with palliative thoracoscopic pleurodesis (TP) for malignant pleural effusion and/or pleural disseminated non-small cell lung cancer (NSCLC), diagnosed by thoracoscopy.The study was composed of 40 (...) patients with primary NSCLC with malignant pleural effusion and/or pleural dissemination recognized for the first time during thoracoscopic exploration. Twenty patients received TPR (TP plus RFA group), while the remaining 20 patients who underwent TP (TP group) represented the control. We evaluated technical success, safety, initial response rate, progression-free survival (PFS), and overall survival (OS).No procedure-related deaths or major complications occurred in any of the 22 ablation procedures

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2016 Thoracic cancer

17. Outcomes of bevacizumab combined with chemotherapy in lung adenocarcinoma‐induced malignant pleural effusion (PubMed)

Outcomes of bevacizumab combined with chemotherapy in lung adenocarcinoma‐induced malignant pleural effusion VEGF is critical in the pathogenesis of malignant pleural effusion (MPE). To understand the clinical benefits of antiangiogenic agents, the efficacy of chemotherapy containing bevacizmab was investigated in patients with lung adenocarcinoma-induced MPE.The data of lung adenocarcinoma patients with MPE treated with bevacizumab plus chemotherapy on day 1, every three weeks, for ≤ 6 (...)  cycles was retrospectively collected. Patients who achieved a response or stable disease were administered bevacizumab as maintenance therapy until progression. The primary outcomes of the study were MPE response rate (RR), MPE control rate, and pleural progression-free survival (PPFS), while the secondary outcomes were PFS, overall survival (OS), changes to the lung volume and thoracic cage, and safety profiles.A total of 21 cases were collected, and all were evaluable for response, including 15

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2018 Thoracic cancer

18. Complete response of pleural effusions caused by extramedullary hematopoiesis to low-dose, single fraction palliative radiation therapy: Case report and literature review (PubMed)

Complete response of pleural effusions caused by extramedullary hematopoiesis to low-dose, single fraction palliative radiation therapy: Case report and literature review 30202814 2019 02 26 2452-1094 3 3 2018 Jul-Sep Advances in radiation oncology Adv Radiat Oncol Complete response of pleural effusions caused by extramedullary hematopoiesis to low-dose, single fraction palliative radiation therapy: Case report and literature review. 463-466 10.1016/j.adro.2018.04.012 Gits Hunter C HC

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2018 Advances in radiation oncology

19. Intrapleural combination therapy with lobaplatin and erythromycin for non‐small cell lung cancer‐mediated malignant pleural effusion (PubMed)

Intrapleural combination therapy with lobaplatin and erythromycin for non‐small cell lung cancer‐mediated malignant pleural effusion Malignant pleural effusion is a common complication of non-small cell lung cancer (NSCLC); however, treatment options remain limited. This study evaluated the safety and efficacy of sequential intrapleural therapy with lobaplatin and erythromycin for NSCLC-mediated malignant pleural effusion.Fifty-six patients with NSCLC complicated with malignant pleural (...) effusion were recruited for a prospective single-arm study from December 2014 to 2016; one patient dropped out. In addition to conventional systemic chemotherapy, lobaplatin and erythromycin were intrapleurally injected into subjects. Short and long-term responses were analyzed. The concentration of ultrafilterable platinum in the pleural effusion and plasma were detected at different time points. Incidences of severe adverse reactions were observed.In the 55 evaluable patients, the effective rate

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2018 Thoracic cancer

20. Well‐controlled pleural effusion indicated pseudoprogression after immunotherapy in lung cancer: A case report (PubMed)

Well‐controlled pleural effusion indicated pseudoprogression after immunotherapy in lung cancer: A case report Squamous cancer (SqCC) of the lung has a poor prognosis. With the advent of immunotherapy, prognosis has tended to improve; however, pseudoprogression poses a challenge to the management of immunotherapy. Herein, we discuss the case of a 47-year-old heavy smoker with advanced SqCC. The patient had recurrent disease after initial successful control of the tumor by concurrent (...) radiochemotherapy, together with ample pleural effusion. Pleural effusion was well controlled with systematic nivolumab and intra-thoracic recombinant endostatin; however with simultaneous deterioration of performance and tumor progression. Nivolumab was maintained with the addition of nab-paclitaxel. The combination soon led to a partial response and rapid improvement of the patient's performance. During treatment of this case, we advocated the early control of pleural effusion as an indicator

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2018 Thoracic cancer

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