Health-Related Quality of Life (Hrqol) in Patients With Alpha1-Antitrypsin (Aat) Deficiency and Effect of Augmentation Therapy: Preliminary Results

Chung, Karen; Borrego, Matthew E.; Short, Jennifer; Kristofek, Loretta; Buelow, Nancye; Gelmont, David

doi:10.1378/chest.128.2.690

Cited by 29 publications

(23 citation statements)

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“…Loculated and free-flowing pleural effusion exhibit many distinct features that are clinically important [33], which may impact the subsequent analysis of pleural fluid samples collected from different locules [34]. In the present study, cell blocks were non-diagnostic in 5 out of the 10 patients with pleural loculations and in 5 out of 25 patients without pleural loculations.…”

Section: Discussionmentioning

confidence: 58%

Diagnostic Utility of Pleural Fluid Cell Block versus Pleural Biopsy Collected by Flex-Rigid Pleuroscopy for Malignant Pleural Disease: A Single Center Retrospective Analysis

et al. 2016

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BackgroundSome trials recently demonstrated the benefit of targeted treatment for malignant disease; therefore, adequate tissues are needed to detect the targeted gene. Pleural biopsy using flex-rigid pleuroscopy and pleural effusion cell block analysis are both useful for diagnosis of malignancy and obtaining adequate samples. The purpose of our study was to compare the diagnostic utility between the two methods among patients with malignant pleural disease with effusion.MethodsData from patients who underwent flex-rigid pleuroscopy for diagnosis of pleural effusion suspicious for malignancy at the National Cancer Center Hospital, Japan between April 2011 and June 2014 were retrospectively reviewed. All procedures were performed under local anesthesia. At least 150 mL of pleural fluid was collected by pleuroscopy, followed by pleural biopsies from the abnormal site.ResultsThirty-five patients who were finally diagnosed as malignant pleural disease were included in this study. Final diagnoses of malignancy were 24 adenocarcinoma, 1 combined adeno-small cell carcinoma, and 7 malignant pleural mesothelioma (MPM), and 3 metastatic breast cancer. The diagnostic yield was significantly higher by pleural biopsy than by cell block [94.2% (33/35) vs. 71.4% (25/35); p = 0.008]. All patients with positive results on cell block also had positive results on pleural biopsy. Eight patients with negative results on cell block had positive results on pleural biopsy (lung adenocarcinoma in 4, sarcomatoid MPM in 3, and metastatic breast cancer in 1). Two patients with negative results on both cell block and pleural biopsy were diagnosed was sarcomatoid MPM by computed tomography-guided needle biopsy and epithelioid MPM by autopsy.ConclusionPleural biopsy using flex-rigid pleuroscopy was efficient in the diagnosis of malignant pleural diseases. Flex-rigid pleuroscopy with pleural biopsy and pleural effusion cell block analysis should be considered as the initial diagnostic approach for malignant pleural diseases presenting with effusion.

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Section: Discussionmentioning

confidence: 58%

Diagnostic Utility of Pleural Fluid Cell Block versus Pleural Biopsy Collected by Flex-Rigid Pleuroscopy for Malignant Pleural Disease: A Single Center Retrospective Analysis

et al. 2016

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“…IL-1 induces mesothelial cells to release transforming growth factor (TGF- β ) which is one of the most potent fibrogenic agents ever discovered [13]. This second stage called fibrinopurulent phase is characterized by positive microbial cultures and the effusion now is referred to as “complicated” (Figure 1).…”

Section: Pathophysiology Of a Parapneumonic Effusionmentioning

confidence: 99%

Management of Infectious Processes of the Pleural Space: A Review

2012

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Pleural effusions can present in 40% of patients with pneumonia. Presence of an effusion can complicate the diagnosis as well as the management of infection in lungs and pleural space. There has been an increase in the morbidity and mortality associated with parapneumonic effusions and empyema. This calls for employment of advanced treatment modalities and development of a standardized protocol to manage pleural sepsis early. There has been an increased understanding about the indications and appropriate usage of procedural options at clinicians' disposal.

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“…However, the TBPE is now believed to be the consequence of direct infection of the pleural space by paucibacillary MTB related to serial immunologic responses by various pro-inflammatory cytokines based on recent studies131323334. After inoculation of MTB into pleural space, TBPE is initially developed as a result of rapid neutrophilic inflammatory reaction and followed by a CD4 + -lymphocyte driven immunologic response of delayed hypersensitivity response over time131.…”

Section: Discussionmentioning

confidence: 99%

“…Loculation of pleural fluid is not an uncommon feature of inflammatory exudates including TBPE and parapneumonic PE, and is considered to be an intense intra-pleural inflammation resulting in fibrin deposit and subsequent adhesions in the pleural space1533. In TBPE, this may be caused by elevation of the release of pro-inflammatory cytokines such as tumor necrosis factor α, interleukin 1β, transforming growth factor β1, and vascular endothelial growth factor in response to pleural infection with MTB3337.…”

Section: Discussionmentioning

confidence: 99%

“…In TBPE, this may be caused by elevation of the release of pro-inflammatory cytokines such as tumor necrosis factor α, interleukin 1β, transforming growth factor β1, and vascular endothelial growth factor in response to pleural infection with MTB3337. Since it was demonstrated that loculated TBPE causes pulmonary impairment by residual pleural thickening, most studies have concentrated on reducing the sequelae of TBPE.…”

Section: Discussionmentioning

confidence: 99%

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Loculated Tuberculous Pleural Effusion: Easily Identifiable and Clinically Useful Predictor of Positive Mycobacterial Culture from Pleural Fluid

Kim

Chang

et al. 2017

Tuberc Respir Dis

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BackgroundIsolation of M. tuberculosis (MTB) is required in cases of Tuberculous pleural effusion (TBPE) for confirming diagnosis and successful therapy based on drug sensitivity test. Several studies have focused on predictors of MTB culture positivity in TBPE. However, the clinical role of loculated TBPE as a predictor of MTB cultivation from TBPE remains unclear. The aim of this study was to examine possible predictors including loculation of TBPE of MTB culture positivity in TBPE.MethodsWe retrospectively examined associations between clinical, radiological, microbiological, and laboratory characteristics and positive MTB culture from TBPE to determine a potent predictor of culture positivity.ResultsFrom January 2011 to August 2015, 232 patients with TBPE were identified. Of these, 219 were finally analyzed. Among them, 69 (31.5%) were culture positive for MTB in TBPE and 86 (39.3%) had loculated TBPE. In multivariate logistic regression analysis, the loculation of TBPE was independently associated with culture positivity for MTB in TBPE (adjusted odds ratio [OR], 40.062; 95% confidence interval [CI], 9.355–171.556; p<0.001). In contrast, the lymphocyte percentage of TBPE (adjusted OR, 0.934; 95% CI, 0.899–0.971; p=0.001) was inversely associated with culture positivity for MTB in TBPE.ConclusionIn clinical practice, identification of loculation in TBPE is easy, reliable to measure, not uncommon and may be helpful to predict the possibility of positive mycobacterial culture.

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Health-Related Quality of Life (Hrqol) in Patients With Alpha1-Antitrypsin (Aat) Deficiency and Effect of Augmentation Therapy: Preliminary Results

Cited by 29 publications

References 0 publications

Diagnostic Utility of Pleural Fluid Cell Block versus Pleural Biopsy Collected by Flex-Rigid Pleuroscopy for Malignant Pleural Disease: A Single Center Retrospective Analysis

Diagnostic Utility of Pleural Fluid Cell Block versus Pleural Biopsy Collected by Flex-Rigid Pleuroscopy for Malignant Pleural Disease: A Single Center Retrospective Analysis

Management of Infectious Processes of the Pleural Space: A Review

Loculated Tuberculous Pleural Effusion: Easily Identifiable and Clinically Useful Predictor of Positive Mycobacterial Culture from Pleural Fluid

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