Abstract:
:The bacillary population described in tuberculous pleuritis is small, and its most likely pathogenetic mechanism is essentially immunologic. This explains why, until now, the diagnostic identification of tuberculous pleuritis (TP) has been based on the presence of granulomas in pleural biopsy. Correcting this diagnostic deficiency through other parameters related to the specific pathogenetic mechanism has been widely studied. The determination of the levels of adenosine deaminase (ADA) in pleural fluid offers high performance in its discriminating capacity to identify TP (sensitivity 87 to 100%, specificity 81 to 97%). Adenosine deaminase expresses the sum of two isoenzymes (ADA1 and ADA2). ADA1 is ubiquitous in all cells, including lymphocytes and monocytes, whereas ADA2 is found only in monocytes. Analysis and determination of these isoenzymes have shown that ADA in TP increases particularly at the expense of ADA2 and that the ADA1 /ADAp activity ratio improves performance in terms of sensitivity, specificity, and efficacy (100%, 92 to 97%, and 98%, respectively) in correcting all false-negative and false-positive results except 1 to 9% of nonlymphoproliferative malignancies. Only the high performance of ADA in the identification of TP allows it to be assumed that pleural biopsy can be obviated, especially in patients aged less than 35 years of age or having a lymphocyte-to-neutrophil proportion of more than 0.75 in regions of high prevalence. Quick determination and low cost justify its routine use in exudates. The ADA1 /ADAp activity ratio improves performance even more and could be used in cases with uncertain diagnoses or in regions with low prevalence of tuberculosis.
journal_name
Curr Opin Pulm Medjournal_title
Current opinion in pulmonary medicineauthors
Pérez-Rodriguez E,Jiménez Castro Ddoi
10.1097/00063198-200007000-00002keywords:
subject
Has Abstractpub_date
2000-07-01 00:00:00pages
259-66issue
4eissn
1070-5287issn
1531-6971journal_volume
6pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Lung cancer is the leading cause of cancer mortality in men and women. Most patients present with advanced disease and face significant morbidity, with many reporting distressing symptoms throughout the course of their illness. The purpose of this review is to highlight the recent studies that support...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3283620e76
更新日期:2013-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Smoking is a major risk factor for lung cancer, which is the leading cause of cancer-related deaths both in the USA and worldwide. Chronic obstructive pulmonary disease and emphysema are comorbid conditions often found in lung cancer patients. The inflammatory pathways that link chronic obstructive pu...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32832c975a
更新日期:2009-07-01 00:00:00
abstract::The author describes a current status of nuclear imaging in interstitial lung disease. A number of tests have been proposed for the evaluation of disease activity. The only one that is used in many centers, however, is 67Ga scan. If the goal is the evaluation of functional impairment, 99mTc-penta-acetic acid aerosol m...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199709000-00010
更新日期:1997-09-01 00:00:00
abstract:PURPOSE OF REVIEW:A small percentage of asthma exacerbations are linked with infection by an atypical bacterium, such as Chlamydia pneumoniae or Mycoplasma pneumoniae. These bacteria also have been proposed to cause occult chronic lower airway inflammation and to initiate nonatopic asthma in adults. Consequently, the l...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200401000-00003
更新日期:2004-01-01 00:00:00
abstract::The diagnosis, staging, and follow-up of lung cancer is a clinical and therapeutic challenge. Recent radiographic advances are critical to the management of patients with lung cancer. This review focuses on state-of-the-art chest imaging modalities, including plain radiography, computed tomography; magnetic resonance ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-07-01 00:00:00
abstract::The nontuberculous mycobacteria (NTM), especially Mycobacterium avium complex, are being recognized with increasing frequency as clinical pathogens, not only as a cause of disseminated disease in patients with AIDS but also as a cause of chronic lung disease in patients without AIDS. These infections have traditionall...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199703000-00010
更新日期:1997-03-01 00:00:00
abstract::Although influenza activity throughout the world has been relatively low during the past year, epidemics of influenza A, in particular, which are caused by new virus variants, continue to be a major public health problem. Widespread vaccination is the only rational measure that can be used for the prevention of illnes...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200205000-00010
更新日期:2002-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) and lung cancer are the leading causes of morbidity and mortality worldwide. The current research is focused on identifying the common and disparate events involved in epigenetic modifications that concurrently occur during the pathogenesis of COPD and lung...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3283477533
更新日期:2011-07-01 00:00:00
abstract::A gamma-scintigraphic study was carried out in 13 healthy individuals to compare the lung deposition of budesonide from a novel multidose dry powder inhaler (MDPI; Novolizer) with that from the Pulmicort Turbuhaler, and to assess the degree of flow rate dependence of the Novolizer. Median whole lung depositions for th...
journal_title:Current opinion in pulmonary medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2001-04-01 00:00:00
abstract:PURPOSE OF REVIEW:To examine the recent advancements of the epidemiology, pathophysiology, clinical characteristics, radiographic studies, diagnostic modalities, treatment, and prognosis of pulmonary hypertension in sarcoidosis. RECENT FINDINGS:A large retrospective study found 73.8% of patients with sarcoidosis liste...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328273bc5c
更新日期:2007-09-01 00:00:00
abstract:PURPOSE OF REVIEW:This article aims to review the most recent proteomic findings in tissue and biological fluids and application of new technologies for the study of interstitial lung diseases. RECENT FINDINGS:New insights into lung cell biology as well as novel pathogenetic pathways of different interstitial lung dis...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32832ea4f2
更新日期:2009-09-01 00:00:00
abstract::Pulmonary embolism occurs in more than 175,000 patients each year in the United States. The objectives of treatment are to prevent death from the existing embolus, to prevent death and morbidity from recurrent pulmonary embolism, and to prevent morbidity from recurrent deep-vein thrombosis. For patients with adequate ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199907000-00007
更新日期:1999-07-01 00:00:00
abstract::There has been increased recognition of the importance of inflammatory cells and their products in the pathogenesis of asthma. From this recognition has evolved a number of new approaches to treat the various components of the asthmatic inflammatory response. Nonselective anti-inflammatory agents such as cyclosporine ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199701000-00006
更新日期:1997-01-01 00:00:00
abstract::Recently, with radiology some advances have been made in the care of patients with interstitial lung disease, predominately through the use of high-resolution computed tomography. This technique is helpful not only in the diagnosis of interstitial lung disease, but also in patient follow-up and management. Other techn...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章
doi:10.1097/00063198-199909000-00002
更新日期:1999-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Heparin-induced thrombocytopenia is a severe side effect of treatment with unfractionated heparin. The relation of low-molecular-weight heparin to heparin-induced thrombocytopenia is less well understood. This review will summarize what is known about the similarities and differences between thrombocy...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000174232.78219.03
更新日期:2005-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Pleural effusions are frequent in the context of acute idiopathic pericarditis and following pericardiotomy, but they have seldom been characterized. This review summarizes their most relevant clinical features. RECENT FINDINGS:In acute idiopathic pericarditis, pleural effusions tend to be left-sided...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000383
更新日期:2017-07-01 00:00:00
abstract::Bronchial carcinoids and hamartomas are, respectively, the most common malignant and benign unusual primary lung neoplasms. These tumors are often asymptomatic but can cause central airway obstruction. Helical computed tomographic and radionuclide scintigraphic advances in their detection and evolution, together with ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200107000-00012
更新日期:2001-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to highlight seminal and current literature that informs our understanding of the clinical and investigative utility of biomarkers in asthma. Biomarkers derive from a variety of sources [bronchiolar lavage (BAL), sputum, exhaled breath, and blood], and have widely variant...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32831de235
更新日期:2009-01-01 00:00:00
abstract::Wheezing in infants and children presents a difficult differential diagnosis contingent on the presenting symptoms and age of the child. A determination of the anatomy of the lower airway, combined with allergic, infectious, and noninfectious irritants, is requisite to a complete evaluation. The intervention strategie...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199901000-00009
更新日期:1999-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) is one of the most prevalent and increasing health problems in the elderly on a worldwide scale. The management of COPD in older patients presents practical diagnostic and treatment issues, which are reviewed with reference to the stable stage of the diseas...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000410747.20958.39
更新日期:2011-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This review presents recent advances in the study of the depression that is so often co-morbid with chronic obstructive pulmonary disease. The discussion includes prevalence, etiology, impact and management. RECENT FINDINGS:Efforts continue to find a reliable prevalence rate for co-morbid depression ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000208450.50231.c6
更新日期:2006-03-01 00:00:00
abstract::It is usually assumed that upper airway pressure receptors mediate the reflexes involved in sleep apneas, but many other receptors may be involved, including those responding to chemical stimuli. The reflexes to upper airway negative pressure have been further studied, and the timing of their inputs shown to be import...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199811000-00013
更新日期:1998-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Regions of the neocortex most strongly activated during waking exhibit increased sleep intensity during subsequent sleep. The novel concept that aspects of sleep homeostasis are determined locally in the cortex contrasts with the established views that global changes in neocortical activity during sle...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32833eec92
更新日期:2010-11-01 00:00:00
abstract:PURPOSE OF REVIEW:To discuss pros and cons of anticoagulant treatment in the presence of symptomatic distal deep vein thrombosis. RECENT FINDINGS:Available data are responsible for a lack of consensus regarding treatment of distal deep vein thrombosis. SUMMARY:One standard diagnostic approach of suspected deep vein t...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32830460ea
更新日期:2008-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Accurate diagnosis of interstitial lung diseases (ILDs) can be challenging, and a substantial percentage of ILD patients remain unclassifiable even after thorough assessment by an experienced multidisciplinary team. In this review, we summarize the recent literature on the definition, prevalence, diag...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000509
更新日期:2018-09-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review was to evaluate the consequence of obstructive sleep apnea (OSA) in pulmonary hypertension by reviewing the current literature and understanding potential pathophysiological mechanisms. RECENT FINDINGS:Small studies have suggested a high prevalence of comorbid OSA in those ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000206
更新日期:2015-11-01 00:00:00
abstract::Chronic airway inflammation is considered responsible for symptoms and disorders of airway function associated with asthma. This process is the target of anti-inflammatory therapy, so a number of standardized, noninvasive techniques have been developed to assess it. More recent approaches include the measurement of ex...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200201000-00005
更新日期:2002-01-01 00:00:00
abstract::Chronic obstructive pulmonary disease is the fourth leading cause of death in the United States, affecting approximately 10% of all adults. Several articles published during the past year contributed significantly to our understanding of the complicated management of this disease. New information concerning bronchodil...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199603000-00011
更新日期:1996-03-01 00:00:00
abstract:PURPOSE OF REVIEW:This review highlights recent developments in liver disease associated with cystic fibrosis. RECENT FINDINGS:The broad spectrum of hepatobiliary problems in cystic fibrosis includes specific alterations ascribable to the underlying defect as well as lesions of iatrogenic origin or that reflect the ef...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3282f10a16
更新日期:2007-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Coal mine workers are at risk for a range of chronic respiratory diseases including coal workers' pneumoconiosis, diffuse dust-related fibrosis, and chronic obstructive pulmonary disease. The purpose of this review is to describe coal mining processes and associated exposures to inform the diagnostic ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000251
更新日期:2016-03-01 00:00:00