2003
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Abstract: Background: Polymorphonuclear elastase (PMN-E) is a neutrophilic marker that has been implicated in acute inflammatory responses. Objectives: To evaluate the accuracy of PMN-E in the diagnosis of complicated pyogenic effusions. Patients and Method: We studied 536 patients with pleural effusion of various etiologies. There were 125 pyogenic bacterial effusions (42 typical parapneumonic, 17 borderline complicated parapneumonic and 66 complicated parapneumonic or empyema), 83 tuberculous, 91 malignant, 42 paramal… Show more

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Cited by 23 publications
(27 citation statements)
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References 18 publications
(27 reference statements)
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“…The pathogenetic mechanisms and clinical implications of pleural pH and glucose level changes have been described previously, although not specifically addressed in the context of tuberculous pleural effusions. In parapneumonic effusions, low pH and glucose content have been known to be related to the fibropurulent process, which leads to complicated parapneumonic effusions and empyema [37, 41]. The inverse correlation between MMP-9 levels and either pH or glucose levels may suggest that MMP-9 is either directly or indirectly involved in the fibropurulent reactions in pleural effusions.…”
Section: Discussionmentioning
confidence: 99%
“…The pathogenetic mechanisms and clinical implications of pleural pH and glucose level changes have been described previously, although not specifically addressed in the context of tuberculous pleural effusions. In parapneumonic effusions, low pH and glucose content have been known to be related to the fibropurulent process, which leads to complicated parapneumonic effusions and empyema [37, 41]. The inverse correlation between MMP-9 levels and either pH or glucose levels may suggest that MMP-9 is either directly or indirectly involved in the fibropurulent reactions in pleural effusions.…”
Section: Discussionmentioning
confidence: 99%
“…No clinical or radiographic findings, however, offer sufficient diagnostic accuracy to establish the need for pleural drainage in patients with parapneumonic effusions [6, 7, 8]. The detection by thoracentesis of intrapleural pus or nonpurulent fluid with a positive Gram stain is accepted as indication for instituting immediate pleural fluid drainage [15].…”
Section: Introductionmentioning
confidence: 99%
“…The data provided by the same group [4] and published in this issue of Respiration provide good evidence that a high pleural PMN-E can be useful for the early diagnosis and management of complicated pyogenic effusions. Although the sensitivity for the effusions not classified with classic markers was 67% at a cutoff point of 3,500 mg/l, if PMN-E was added to the latter the sensitivity rose to 91%, while its overall specificity was 97%.…”
mentioning
confidence: 83%