Two hundred and four patients with pleural effusion were studied to investigate the utility of Light's criteria and pleural fluid cholesterol level (pCHOL) in the identification of exudative pleural effusion (EPE) and transudative pleural effusion (TPE). There were 48 TPE, 56 tumor, 47 tuberculous, 30 metapneumonic and 23 miscellaneous patients. A value > or = 54 mg/dl for pCHOL and > or = 0.32 for the pleura/serum cholesterol ratio (p/sCHOL) showed sensitivity (S) and specificity (Sp) of 95.5% and 91.6% for pCHOL, and 97.4% and 91.6% for p/sCHOL, respectively. Combined pCHOL and/or p/sCHOL showed a S of 98.7% and Sp of 89.5%. Light's criteria achieved a S of 100% and Sp of 64.5%. Combined pCHOL and p/sCHOL revealed a similar accuracy to Light's criteria in EPE diagnosis but was found to be more exact in TPE diagnosis.

Adult↗

PubMed1993

[Tetracycline pleurodesis for treatment of malignant pleural effusions. Retrospective study of 91 cases].

BACKGROUND: Malignant pleural effusions (MPE) are a common complication in patients with advanced neoplasms. Even though no large series confirming this exist, tetracycline pleurodesis has become the therapy of choice. The aim of this retrospective study was to evaluate its efficacy, adverse effects and possible factors predicting the success of the method. METHODS: Between 1985 through 1991, 91 patients with cytologically or histologically confirmed MPE were treated with 1,000-1,500 mg tetracycline pleurodesis. There were 49 females and 42 males, with a mean age of 59 years. The most common malignancies were lung, breast and unknown primary carcinomas. 85% patients complained of dyspnea and the volume of the effusion was moderate in half the cases. 12 variables were analyzed in relation with the probability of response through chi 2 test; survival and recurrence times were calculated with Kaplan and Meier's method. RESULTS: 73 patients were evaluable, with a 67% response rate (22 complete, 27 partial). Time to relapse was significantly higher for partial responses (mean 112 days) than for failures (mean 33 days). 37 patients presented mild complications (pain and fever). Karnofsky performance status (70% or greater), size of the effusion (small or moderate), chest radiograph (only effusion) and pleural LDH (600 U/l or less) attained favourable prognostic significance. Median survival was reached at 6 months. CONCLUSIONS: Tetracycline pleurodesis is an effective and well-tolerated paliative treatment for MPE. Along with other known parameters (pleural pH and glucose levels), Karnofsky performance status, size of the effusion, chest radiograph and pleural LDH allow to predict its results and optimize its indications.

Adult↗

PubMedDate not supplied

[Electrocardiogram in isolated transposition of the great vessels. Analysis of 8 cases with anatomic study and bibliographic review].

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Blood Vessels↗

PubMedDate not supplied

[Comparison of the rapidity of action of dry-powder inhaler vs pressurized aerosol terbutaline].

The speed of bronchodilatation with terbutaline administered through the Turbuhaler system and the same drug administered through a pressurized liquid aerosol device was compared in 9 patients with reversible air flow obstruction. On 2 consecutive days, terbutaline 0.5 mg in aerosol or dry-powder form (Turbuhaler) was administered after baseline spirometric measurements were taken. Spirometry was repeated at 15, 45 and 90 s and at 3, 5, 10, 15, 30, 60 and 120 min after administration of the drug. Both forms of presentation produced approximately 50% of their maximum effect within the first 45 s; 80% of the patients in the dry-powder group reached the mean of maximum FEV1 increase at 10 min, while 83% in the pressurized-aerosol-device group did so. The maximum increase was reached at 52 (54) min with the Turbuhaler and at 69 (50) min for the aerosol. The difference in speed of effect for the two pharmaceutical forms were not statistically significant. The administration of terbutaline in powder form (Turbuhaler) was as fast and effective in achieving bronchodilatation as was the aerosol form.

Administration, Inhalation↗

PubMedDate not supplied

[Fiber bronchoscopy in lung cancer: relationship between radiology, endoscopy, histology and diagnostic value in a series of 1801 cases].

A retrospective analysis of 1,801 patients with primary pulmonary neoplasm diagnosed by fiber bronchoscopy between 1977 and 1992 was carried out in order to determine the relation between chest X-rays and endoscopic and histological findings, as well as to assess the diagnostic usefulness of the various endoscopic techniques used. Central tumors numbered 1,598 and peripheral ones 203. The largest tissue classification was squamous (39%) and the most common X-ray finding was pulmonary mass (40%). Endoscopy showed neoplastic infiltration in 49% of the cases and endobronchial tumor in 27%. X-rays showing pulmonary mass, hilar involvement and atelectasis were more often associated with infiltration, tumor and necrosis and with a small-cell tissue type. Bronchial biopsy gave the best diagnostic results in these cases. In cases of solitary pulmonary nodule and pleural effusion, on the other hand, normal endoscopic results with non-specific changes or extrapulmonary involvement, predominated, with adenocarcinoma and non-small cell tissue types. Transbronchial biopsy, especially with radioscopic monitoring, was most useful in these cases. We conclude that chest X-rays and endoscopic results can be used to predict the most likely tissue type in lung cancer and that they can serve as guides for the choice of diagnostic technique.

Adenocarcinoma↗