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Arie Oliven - One of the best experts on this subject based on the ideXlab platform.
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The Role of Pleural Fluid-Serum Gradient of Tumor Necrosis Factor-α Concentration in Discrimination Between Complicated and Uncomplicated Parapneumonic Effusion
Lung, 2005Co-Authors: Majed Odeh, Edmond Sabo, Isaac Srugo, B. Makhoul, Arie OlivenAbstract:In a previous preliminary study an excess of tumor necrosis factor-α (TNF) was found in pleural fluid of patients with complicated Parapneumonic Effusion (CPPE), and its levels in pleural fluid of these patients were shown to be significantly higher than those in patients with uncomplicated Parapneumonic Effusion (UCPPE). This larger population study was undertaken to investigate, for the first time, the role of pleural fluid-serum gradient of TNF (TNFgradient) in discrimination between UCPPE and CPPE. Using a commercially available high sensitivity ELISA kit, levels of TNF were measured in serum and pleural fluid of 51 patients with UCPPE and 30 patients with nonempyemic CPPE. The mean ± SEM values of serum TNF (TNFserum), pleural fluid TNF (TNFpf), and TNFgradient in the UCPPE group were 6.65 ± 0.48 pg/mL, 10.85 ± 0.74 pg/mL, and 4.2 ± 0.38 pg/mL respectively, and in the CPPE group they were 7.59 ± 0.87 pg/mL, 54.02 ± 5.43 pg/mL, and 46.43 ± 5.34 pg/mL, respectively. While no significant difference was found between the two groups regarding levels of TNFserum ( p = 0.31), a highly significant difference between these two groups was found regarding levels of TNFpf and TNFgradient ( p < 0.0001 for both variables). A significant correlation was found between levels of TNFserum and levels of TNFpf in the UCPPE group (r = 0.89, p < 0.0001), but not in the CPPE group (r = 0.18, p < 0.33). TNFgradient at an optimal cut-off level of 9.0 pg/mL was found to be a good marker for discrimination between UCPPE and CPPE (sensitivity, 96.7%, specificity, 98%, accuracy, 97.5%, and p < 0.0001). In conclusion, levels of TNFpf but not TNFserum are significantly higher in CPPEs than those in UCPPEs where TNFgradient at an optimal cut-off level of 9.0 pg/mL is a good marker for discrimination between UCPPE and CPPE.
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correlation between polymorphonuclear leukocyte counts and levels of tumor necrosis factor a in pleural fluid of patients with Parapneumonic Effusion
Lung, 2002Co-Authors: Majed Odeh, Edmond Sabo, Isaac Srugo, Arie OlivenAbstract:High concentrations of tumor necrosis factor-a (TNF), as well as excess of polymorphonuclear leukocytes (PMNs), are present in pleural fluid of patients with complicated Parapneumonic Effusion (CPPE). Several studies have shown that PMNs are capable of secreting TNF. However, the correlation between levels of TNF and PMN counts in pleural fluid of patients with Parapneumonic Effusion has not been previously evaluated. This study was undertaken to evaluate this correlation. Using a commercially available high sensitivity ELISA kit, levels of TNF were measured in pleural fluid of patients with UCPPE (n = 22), and CPPE (n = 14), and were compared with PMN count in pleural fluid of these patients. The mean +/- SD values of pleural fluid TNF and PMN count in the UCPPE group the group were 10.15 +/- 6.48 pg/mL and 3,452 +/- 2,878 cells/mm3, respectively, and in the CPPE group the values were 55.51 +/- 29.49 pg/mL and 25,261 +/- 11,733 cells/mm3, respectively. Levels of pleural fluid TNF and PMN counts in the CPPE group were significantly higher than in the UCPPE group (p <0.0001). A significant correlation was found between levels of pleural fluid TNF and PMN counts in the CPPE group (r = 0.57, p = 0.03) and also in the UCPPE group (r = 0.44, p = 0.04). The results of this study indicate that in pleural fluid of patients with UCPPE or CPPE, levels of TNF correlate positively with PMN counts, and PMNs might be an important source of TNF production in pleural fluid of these patients, particularly in those with CPPE.
Majed Odeh - One of the best experts on this subject based on the ideXlab platform.
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diagnostic value of c reactive protein in discrimination between uncomplicated and complicated Parapneumonic Effusion
Diagnostics (Basel Switzerland), 2020Co-Authors: Yana Kogan, Edmond Sabo, Majed OdehAbstract:Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated Parapneumonic Effusion (UCPPE) from complicated Parapneumonic Effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.
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The Role of Pleural Fluid-Serum Gradient of Tumor Necrosis Factor-α Concentration in Discrimination Between Complicated and Uncomplicated Parapneumonic Effusion
Lung, 2005Co-Authors: Majed Odeh, Edmond Sabo, Isaac Srugo, B. Makhoul, Arie OlivenAbstract:In a previous preliminary study an excess of tumor necrosis factor-α (TNF) was found in pleural fluid of patients with complicated Parapneumonic Effusion (CPPE), and its levels in pleural fluid of these patients were shown to be significantly higher than those in patients with uncomplicated Parapneumonic Effusion (UCPPE). This larger population study was undertaken to investigate, for the first time, the role of pleural fluid-serum gradient of TNF (TNFgradient) in discrimination between UCPPE and CPPE. Using a commercially available high sensitivity ELISA kit, levels of TNF were measured in serum and pleural fluid of 51 patients with UCPPE and 30 patients with nonempyemic CPPE. The mean ± SEM values of serum TNF (TNFserum), pleural fluid TNF (TNFpf), and TNFgradient in the UCPPE group were 6.65 ± 0.48 pg/mL, 10.85 ± 0.74 pg/mL, and 4.2 ± 0.38 pg/mL respectively, and in the CPPE group they were 7.59 ± 0.87 pg/mL, 54.02 ± 5.43 pg/mL, and 46.43 ± 5.34 pg/mL, respectively. While no significant difference was found between the two groups regarding levels of TNFserum ( p = 0.31), a highly significant difference between these two groups was found regarding levels of TNFpf and TNFgradient ( p < 0.0001 for both variables). A significant correlation was found between levels of TNFserum and levels of TNFpf in the UCPPE group (r = 0.89, p < 0.0001), but not in the CPPE group (r = 0.18, p < 0.33). TNFgradient at an optimal cut-off level of 9.0 pg/mL was found to be a good marker for discrimination between UCPPE and CPPE (sensitivity, 96.7%, specificity, 98%, accuracy, 97.5%, and p < 0.0001). In conclusion, levels of TNFpf but not TNFserum are significantly higher in CPPEs than those in UCPPEs where TNFgradient at an optimal cut-off level of 9.0 pg/mL is a good marker for discrimination between UCPPE and CPPE.
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correlation between polymorphonuclear leukocyte counts and levels of tumor necrosis factor a in pleural fluid of patients with Parapneumonic Effusion
Lung, 2002Co-Authors: Majed Odeh, Edmond Sabo, Isaac Srugo, Arie OlivenAbstract:High concentrations of tumor necrosis factor-a (TNF), as well as excess of polymorphonuclear leukocytes (PMNs), are present in pleural fluid of patients with complicated Parapneumonic Effusion (CPPE). Several studies have shown that PMNs are capable of secreting TNF. However, the correlation between levels of TNF and PMN counts in pleural fluid of patients with Parapneumonic Effusion has not been previously evaluated. This study was undertaken to evaluate this correlation. Using a commercially available high sensitivity ELISA kit, levels of TNF were measured in pleural fluid of patients with UCPPE (n = 22), and CPPE (n = 14), and were compared with PMN count in pleural fluid of these patients. The mean +/- SD values of pleural fluid TNF and PMN count in the UCPPE group the group were 10.15 +/- 6.48 pg/mL and 3,452 +/- 2,878 cells/mm3, respectively, and in the CPPE group the values were 55.51 +/- 29.49 pg/mL and 25,261 +/- 11,733 cells/mm3, respectively. Levels of pleural fluid TNF and PMN counts in the CPPE group were significantly higher than in the UCPPE group (p <0.0001). A significant correlation was found between levels of pleural fluid TNF and PMN counts in the CPPE group (r = 0.57, p = 0.03) and also in the UCPPE group (r = 0.44, p = 0.04). The results of this study indicate that in pleural fluid of patients with UCPPE or CPPE, levels of TNF correlate positively with PMN counts, and PMNs might be an important source of TNF production in pleural fluid of these patients, particularly in those with CPPE.
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Role of tumor necrosis factor-α in the differential diagnosis of Parapneumonic Effusion
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2000Co-Authors: Majed Odeh, Edmond Sabo, I Arie Oliven, Isaac SrugoAbstract:Abstract Objective: This study was undertaken to investigate the role of tumor necrosis factor-α (TNF-α) in discriminating between uncomplicated Parapneumonic Effusion (UCPPE) and complicated Parapneumonic Effusion (CPPE). Method: Using a commercially available high sensitivity enzyme-linked immunosorbent assay (ELISA) kit, concentrations of TNF were measured in the serum (TNFs) and pleural fluid (TNFpf) of 21 patients with Parapneumonic Effusion (PPE), 13 patients with UCPPE, and 8 patients with nonempyemic CPPE. Results: No significant difference in values of TNF concentration was found between the group with UCPPE and that with CPPE (P > 0.05). Concentration levels of TNFpf were significantly higher in the group with CPPE than in that with UCPPE (P = 0.0008). Levels of TNF in pleural fluid were significantly higher than in serum in both groups (P Conclusions: The results of this study indicate that TNFpf, and particularly TNFr, may be helpful in discriminating between UCPPE and CPPE. However, further studies are needed in a larger population to confirm these findings.
Isaac Srugo - One of the best experts on this subject based on the ideXlab platform.
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The Role of Pleural Fluid-Serum Gradient of Tumor Necrosis Factor-α Concentration in Discrimination Between Complicated and Uncomplicated Parapneumonic Effusion
Lung, 2005Co-Authors: Majed Odeh, Edmond Sabo, Isaac Srugo, B. Makhoul, Arie OlivenAbstract:In a previous preliminary study an excess of tumor necrosis factor-α (TNF) was found in pleural fluid of patients with complicated Parapneumonic Effusion (CPPE), and its levels in pleural fluid of these patients were shown to be significantly higher than those in patients with uncomplicated Parapneumonic Effusion (UCPPE). This larger population study was undertaken to investigate, for the first time, the role of pleural fluid-serum gradient of TNF (TNFgradient) in discrimination between UCPPE and CPPE. Using a commercially available high sensitivity ELISA kit, levels of TNF were measured in serum and pleural fluid of 51 patients with UCPPE and 30 patients with nonempyemic CPPE. The mean ± SEM values of serum TNF (TNFserum), pleural fluid TNF (TNFpf), and TNFgradient in the UCPPE group were 6.65 ± 0.48 pg/mL, 10.85 ± 0.74 pg/mL, and 4.2 ± 0.38 pg/mL respectively, and in the CPPE group they were 7.59 ± 0.87 pg/mL, 54.02 ± 5.43 pg/mL, and 46.43 ± 5.34 pg/mL, respectively. While no significant difference was found between the two groups regarding levels of TNFserum ( p = 0.31), a highly significant difference between these two groups was found regarding levels of TNFpf and TNFgradient ( p < 0.0001 for both variables). A significant correlation was found between levels of TNFserum and levels of TNFpf in the UCPPE group (r = 0.89, p < 0.0001), but not in the CPPE group (r = 0.18, p < 0.33). TNFgradient at an optimal cut-off level of 9.0 pg/mL was found to be a good marker for discrimination between UCPPE and CPPE (sensitivity, 96.7%, specificity, 98%, accuracy, 97.5%, and p < 0.0001). In conclusion, levels of TNFpf but not TNFserum are significantly higher in CPPEs than those in UCPPEs where TNFgradient at an optimal cut-off level of 9.0 pg/mL is a good marker for discrimination between UCPPE and CPPE.
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correlation between polymorphonuclear leukocyte counts and levels of tumor necrosis factor a in pleural fluid of patients with Parapneumonic Effusion
Lung, 2002Co-Authors: Majed Odeh, Edmond Sabo, Isaac Srugo, Arie OlivenAbstract:High concentrations of tumor necrosis factor-a (TNF), as well as excess of polymorphonuclear leukocytes (PMNs), are present in pleural fluid of patients with complicated Parapneumonic Effusion (CPPE). Several studies have shown that PMNs are capable of secreting TNF. However, the correlation between levels of TNF and PMN counts in pleural fluid of patients with Parapneumonic Effusion has not been previously evaluated. This study was undertaken to evaluate this correlation. Using a commercially available high sensitivity ELISA kit, levels of TNF were measured in pleural fluid of patients with UCPPE (n = 22), and CPPE (n = 14), and were compared with PMN count in pleural fluid of these patients. The mean +/- SD values of pleural fluid TNF and PMN count in the UCPPE group the group were 10.15 +/- 6.48 pg/mL and 3,452 +/- 2,878 cells/mm3, respectively, and in the CPPE group the values were 55.51 +/- 29.49 pg/mL and 25,261 +/- 11,733 cells/mm3, respectively. Levels of pleural fluid TNF and PMN counts in the CPPE group were significantly higher than in the UCPPE group (p <0.0001). A significant correlation was found between levels of pleural fluid TNF and PMN counts in the CPPE group (r = 0.57, p = 0.03) and also in the UCPPE group (r = 0.44, p = 0.04). The results of this study indicate that in pleural fluid of patients with UCPPE or CPPE, levels of TNF correlate positively with PMN counts, and PMNs might be an important source of TNF production in pleural fluid of these patients, particularly in those with CPPE.
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Role of tumor necrosis factor-α in the differential diagnosis of Parapneumonic Effusion
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2000Co-Authors: Majed Odeh, Edmond Sabo, I Arie Oliven, Isaac SrugoAbstract:Abstract Objective: This study was undertaken to investigate the role of tumor necrosis factor-α (TNF-α) in discriminating between uncomplicated Parapneumonic Effusion (UCPPE) and complicated Parapneumonic Effusion (CPPE). Method: Using a commercially available high sensitivity enzyme-linked immunosorbent assay (ELISA) kit, concentrations of TNF were measured in the serum (TNFs) and pleural fluid (TNFpf) of 21 patients with Parapneumonic Effusion (PPE), 13 patients with UCPPE, and 8 patients with nonempyemic CPPE. Results: No significant difference in values of TNF concentration was found between the group with UCPPE and that with CPPE (P > 0.05). Concentration levels of TNFpf were significantly higher in the group with CPPE than in that with UCPPE (P = 0.0008). Levels of TNF in pleural fluid were significantly higher than in serum in both groups (P Conclusions: The results of this study indicate that TNFpf, and particularly TNFr, may be helpful in discriminating between UCPPE and CPPE. However, further studies are needed in a larger population to confirm these findings.
Araceli Escobar-rojas - One of the best experts on this subject based on the ideXlab platform.
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Risk factors associated to surgical treatment of Parapneumonic Effusion and empyema
European Respiratory Journal, 2013Co-Authors: Renata Báez-saldaña, Héctor Molina-corona, María Elena Martínez-rendón, Araceli Santillán-martínez, Araceli Escobar-rojasAbstract:Introduction Currently there is no clear data to define the point at which a patient with Parapneumonic Effusion and empyema should proceed to surgical intervention and little is known about its associated risk factors. Objective To identify risk factors associated to surgical treatment in patients with Parapneumonic Effusion and empyema. Material and Methods Prospective cohort of consecutive patients with Parapneumonic Effusion and empyema. Variables recorded: clinical characteristics, pleural fluid features, risk categorization for a poor outcome in patients with Parapneumonic Effusions and empyema, surgical treatment as outcome and its associated risk factors. Results 217 patients were included, of these 52 (24%) had parapeumonic Effusion and 165 (76%) had empyema. 163 (75.11%) were men, 72 (33.17%) had diabetes. 100 cases (46%) had two or more loculations, 32 of these cases did not proceed to surgical treatment. 116 (53.45%) were risk category 4 and 105 (48.38%) required surgical treatment. Mutivariate analysis revealed an increasing likelihood for surgical treatment with two or more loculations OR 2.94(IC 95% 1.54-5.63 p=0.001), more than 12000 leukocytes RM 2.30(IC 95% 1.23-4.31 p=0.009), diabetes RM 2.23(IC 95% 1.12–4.46 p=0.023), risk categorization for a poor outcome in empyema RM 9.59(IC 95% 1.12–8.23 p=0.000) and age RM 0.98(IC 95% 0.96–0.99 p=0.046). Conclusions Surgical treatment decision is based on local protocols, institutional experience and individual case management with a flexible sequence of procedures.However, two or more loculations, risk categorization for a poor outcome in Parapneumonic Effusion and empyema, diabetes and leukocytosis are good predictors for surgical treatment.
Changphone Fung - One of the best experts on this subject based on the ideXlab platform.
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clinical and microbiological characteristics of community acquired thoracic empyema or complicated Parapneumonic Effusion caused by klebsiella pneumoniae in taiwan
European Journal of Clinical Microbiology & Infectious Diseases, 2010Co-Authors: Yitsung Lin, Teli Chen, L K Siu, Shihfen Hsu, Changphone FungAbstract:Klebsiella pneumoniae is the major cause of community-acquired pyogenic infections in Taiwan and is becoming an increasing problem in acute thoracic empyema. This study evaluated the clinical and microbiological characteristics of community-acquired thoracic empyema or complicated Parapneumonic Effusion caused by K. pneumoniae in Taiwanese adults treated during the period 2001-2008 at a tertiary medical center. All clinical isolates were examined for capsular serotypes K1/K2, and pulsed-field gel electrophoresis (PFGE) was performed on strains of the same serotype. K. pneumoniae was the most frequent cause of community-acquired thoracic empyema or complicated Parapneumonic Effusion. It was associated with high mortality (32.4%) and was an independent risk factor for fatal outcome. Diabetes mellitus, liver cirrhosis, and bronchogenic carcinoma were independent risk factors for K. pneumoniae infection. Serotypes K1 (9/37, 24.3%) and K2 (13/37, 35.1%) were the prevalent strains but did not predispose patients to poor outcome compared with other non-K1/K2 serotypes. There was no major cluster of isolates found among serotype K1/K2 strains. In summary, physicians should be aware of the risk factors for thoracic empyema or complicated Parapneumonic Effusion caused by K. pneumoniae and the associated high mortality, and monitor these patients more closely.
