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Role of steroids in to Pleural effusion

Utkan Sevuk, Erkan Baysal, Rojhat Altindag, Baris Yaylak, Mehmet Sahin Adiyaman, Nurettin Ay, Vahhac Alp, Unal Beyazit
OBJECTIVE: Postpericardiotomy syndrome (PPS), which is thought to be related to autoimmune phenomena, represents a common postoperative complication in cardiac surgery. Late pericardial effusions after cardiac surgery are usually related to PPS and can progress to cardiac tamponade. Preventive measures can reduce postoperative morbidity and mortality related to PPS. In a previous study, diclofenac was suggested to ameliorate autoimmune diseases. The aim of this study was to determine whether postoperative use of diclofenac is effective in preventing early PPS after cardiac surgery...
2015: Vascular Health and Risk Management
V M dos Santos, M M da Silva Zembrzuski, I P Gouvea, N S Nery, L A M dos Santos
We describe the case of a 72-year old male with pleural effusion associated with prostate cancer. There was a previous history of tobacco smoking (pack/year: 47) and of total prostatectomy followed by external beam radiation therapy seven years previously for prostate cancer. Furthermore, he was submitted to orchiectomy plus non-steroidal anti-androgen blockage, in addition to docetaxel-based chemotherapy and prednisone. After the beginning of chemotherapy, a progressive elevation in prostate specific antigen (PSA) levels was observed...
December 2011: West Indian Medical Journal
Alberto Dolara, Silvia Favilli
Controversies in the therapy of congenital complete heart block are reviewed in terms of the timing of pacemaker implantation, the type and complications of pacing and its role in the presence of myocardial dysfunction. Drug treatment may be useful in selected cases in the presence of pleural effusions, ascites and hydrops of the fetus, but have no effect on complete heart block. Administration of fluorinated steroids in anti-Ro antibody-positive mothers with the aim of preventing complete heart block has given controversial results...
June 2010: Journal of Cardiovascular Medicine
Celalettin Ustun, Natasha Savage, Elizabeth Manaloor, Chandra Kunavarapu, Anand Jillella
A 77-year-old man presented with Evans syndrome (ES), hard palate thickening, gastrointestinal (GI) hemorrhage, acute myocardial infarction (AMI) and pleural and pericardial effusions. The patient responded well to emergent ES treatment with high-dose steroids and intravenous immunoglobulin. Investigation revealed lymphoplasmacytic lymphoma (LPL) as well as amyloidosis in the hard palate, lymph nodes, and pericardium. Considering his age, non-myelosuppressive agents were administered, with the exception of dose-reduced cyclophosphamide...
March 2009: Amyloid: the International Journal of Experimental and Clinical Investigation
Fabio José Haddad, Riad Naim Younes, Jefferson Luiz Gross, Daniel Deheinzelin
The purpose of this study was to evaluate the efficacy, safety, and cost of bedside pleurodesis for malignant pleural effusions using talc slurry (TS) or bleomycin (BL) in a prospective randomized trial, and to determine prognosticators for procedure failure. From June 1997 to June 1999 a series of 71 patients entered this trial. They underwent 37 procedures with TS (4 g) and 34 with BL (60 units) via tube thoracostomy. Success was defined as no recurrence of pleural effusion or asymptomatic recurrence of a small amount of effusion...
August 2004: World Journal of Surgery
Stephen J Chapman, Robert J O Davies
Pleural infection is responsible for significant morbidity and mortality worldwide, and its clinical management is challenging. The diagnosis of empyema and tuberculous pleurisy may be difficult, and these conditions may be confused with other causes of exudative pleural effusions. Complicated parapneumonic effusion or empyema may present with 'atypical' clinical features; delays in diagnosis are common and may contribute to the high mortality of these infections. Pleural aspiration is the key diagnostic step; pleural fluid that is purulent or that has a pH < 7...
March 2004: Respirology: Official Journal of the Asian Pacific Society of Respirology
S Garcês, F Araújo, F Rego, J L Ducla Soares, A G Palma Carlos
Capillary leakage Syndrome (CLS) is a rare clinical syndrome, that was first described in 1960, characterized by acute episodes of generalized edema, hemoconcentration, hypoproteinemia and monoclonal gammopathy, in the vast majority of cases. We describe a 39-year-old man with anasarca, bilateral pleural and pericardial effusions, ascites and diffuse alveolo-intersticial edema. Clinical and laboratory findings were consistent with an acute episode of CLS. Treatment with prednisone, furosemide and aminophylline was started, which lead to a gradual improvement in 48 hours...
December 2002: Allergie et Immunologie
Sergio Sartori, Roberto Galeotti, Nunzio Calia, Malvina Gualandi, Ingrid Nielsen, Lucio Trevisani, Piercarlo Ceccotti, Vincenzo Abbasciano
OBJECTIVE: To report 2 cases in which abdominal sonography played a useful role in diagnosing sarcoidosis with early nodular hepatosplenic manifestations. METHODS: In the first case, an asymptomatic woman with increased liver enzyme values underwent sonography, which showed multiple hypoechoic nodules in the liver and spleen. Computed tomography confirmed the hepatosplenic findings and showed micronodular infiltrates of both lung fields, without hilar and mediastinal lymphadenopathy...
September 2002: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
J J Disa, A W Smith, M H Bilsky
Reoperation for malignant disease of the cervicothoracic spine can lead to compromised wound healing secondary to poor tissue quality from previous operations, heavily irradiated beds, and concomitant steroid therapy. Other complicating factors include exposed dura and spinal implants. Introducing well-vascularized soft tissue to obliterate dead space is critical to reliable wound healing. The purpose of this study was to determine the efficacy of the trapezius turnover flap in the management of these complex wounds...
October 2001: Annals of Plastic Surgery
T S Fröde-Saleh, J B Calixto
OBJECTIVES: Experiments were designed to determine whether or not inhibitors of NF-Kappa B (NF-kappaB) exhibit antiinflammatory effects when assessed in carrageenan-induced pleural inflammation in the mouse. MATERIAL AND METHODS: Adult mice of both sexes received pyrrolidine dithiocarbamate (PDTC) or sulfasalazine administered intraperitoneal by at several time points before intrapleural injection of carrageenan (1%) and the exudation and the total and differential cells were analysed...
July 2000: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
C H Lee, W J Wang, R S Lan, Y H Tsai, Y C Chiang
A prospective, double-blind, randomized study of the role of corticosteroids in the treatment of tuberculous pleurisy was performed in 40 patients. All patients received adequate antituberculosis chemotherapy (isoniazid, 300 mg/day; rifampin, 450 mg/day; ethambutol, 20 mg/kg/day) for more than nine months. They were randomly assigned to take prednisolone 0.75 mg/kg/day orally or placebo for the initial treatment, which was tapered gradually for the next two to three months. Twenty-one were treated with steroids and 19 were given a placebo...
December 1988: Chest
P F Barnes, R L Modlin, D D Bikle, J S Adams
We used tuberculous pleuritis as a model to study the compartmentalization and potential immunoregulatory role of 1,25-dihydroxyvitamin D [1,25-(OH)2-D] in human granulomatous disease. In tuberculous pleuritis, mean concentrations of total 1,25-(OH)2-D were elevated in pleural fluid, compared to blood (67 pg/ml vs. 35 pg/ml). Concentrations of albumin, protein and 25-hydroxyvitamin D (25-OH-D) were lower in pleural fluid than blood, suggesting that accumulation of binding proteins does not explain the transpleural gradient of 1,25-(OH)2-D...
May 1989: Journal of Clinical Investigation
C W White, P Ghezzi
Rats injected with interleukin-1 (10 micrograms) and tumor necrosis factor (10 micrograms) and then exposed continuously to hyperoxia (greater than 99% O2, 1 atm) survived longer, had increased lung reduced/oxidized glutathione ratios, smaller pleural effusions, less pulmonary hypertension and improved arterial blood gases. The percentage of animals surviving for 72 hours in hyperoxia increased from 8% to 94%. Although relatively small increases in glutathione redox cycle enzymes occurred four and sixteen hours following cytokine injection, dramatic increases in all major antioxidant enzymes including superoxide dismutase, glucose-6-phosphate dehydrogenase, glutathione reductase, glutathione peroxidase, and catalase had occurred following 72 hours of exposure to hyperoxia...
1989: Biotherapy
D W Morgan, C Anderson, K Meyers, J Coffey, K Moody, A Welton
The pleural exudate from rats treated intrapleurally with zymosan contains phospholipase A2 (PLA2) activity which is Ca2(+)-independent and optimally active at a neutral pH. This PLA2 activity was found in approximately equal amounts in both the cellular and extracellular fractions of the exudate. The Ca2(+)-independency of the PLA2's in the pleural exudate distinguishes them from plasma PLA2's and this suggests that the source of the exudate PLA2's is not plasma. The appearance of PLA2 activity in zymosan-induced pleural exudate correlates temporally with increases in exudate volume and pleural cell number...
1990: Advances in Experimental Medicine and Biology
A H Khan
Late pericarditis following myocardial infarction, cardiac surgery, or trauma is referred to as postmyocardial infarction syndrome (PMIS) or postcardiotomy syndrome (PCS), respectively. The term postcardiac injury syndrome (PCIS) is used to encompass both these entities. PCIS is characterized by fever, pleuropericardial pain, pericarditis, and pulmonary involvement. Abnormal laboratory findings include leukocytosis, high sedimentation rate, and chest x-ray abnormalities of pleural effusion with or without pulmonary infiltrates...
February 1992: Clinical Cardiology
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