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1.
Eur Respir J ; 15(1): 166-9, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10678640

ABSTRACT

This study was conducted to assess the prevalence of eosinophilia in 358 consecutive samples of pleural fluid (all cases corresponded to first thoracentesis), to review the cause of eosinophilic pleural effusions, and to determine whether the presence of eosinophils increases the likelihood of nonmalignant underlying disorders. Eosinophilic pleural effusions were identified in 45 patients (12.6%): malignant underlying conditions were diagnosed in 11 patients (24.4% with eosinophilic effusions) and benign aetiologies were found in 27 patients. Benign aetiologies included uncomplicated paraneumonic effusion in 10 patients, tuberculosis in seven, complicated paraneumonic in five, liver cirrhosis in three, hydronephrosis in one and pulmonary thromboembolism in one. Seven pleural effusions were idiopathic. There was no difference in the prevalence between eosinophilic and noneosinophilic effusions according to the different diagnoses. With parameters of sensitivity, specificity, pretest and post-test probability and positive and negative predictive values for any prevalence figure using the Bayes' theorem and for any value of eosinophils (both in percentage or absolute numbers) in the pleural fluid (receiver operating characteristic curve) an adequate predictor of benign disease was not found. It is concluded that pleural eosinophilia at the initial thoracentesis cannot be considered as a predictor of an underlying benign disorder.


Subject(s)
Eosinophilia/diagnosis , Pleural Effusion, Malignant/diagnosis , Pleural Effusion/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Eosinophilia/etiology , Eosinophilia/immunology , Eosinophils/immunology , Female , Humans , Leukocyte Count , Male , Middle Aged , Pleural Effusion/etiology , Pleural Effusion/immunology , Pleural Effusion, Malignant/etiology , Pleural Effusion, Malignant/immunology , Predictive Value of Tests , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/immunology
4.
Rev Clin Esp ; 196(3): 157-61, 1996 Mar.
Article in Spanish | MEDLINE | ID: mdl-8650384

ABSTRACT

OBJECTIVE: To study the initial respiratory effects and those observed 18 months later after the inhalation of toxic and irritant substances in textile aerography workers. SUBJECTS: Seventeen patients (14 women and 3 men), with a mean age of 21 years (range: 18-38). METHODS: Initially, pulmonary effects were assessed by pathological (transbronchial biopsy and/or video-thoracoscopy) and functional findings [spirometry with lung volumes and study of diffusion capacity of CO (DLCO)]. Eighteen months later a challenge bronchial test with histamine was performed. RESULTS: Forty-one per cent of patients had pathologic lesions with intraalveolar fibrin, 35% had minimal non-specific lesions, 18% bronchiolitis obliterans with organized pneumonia (BOOP) and 6% pulmonary fibrosis and BOOP. Functional respiratory test showed two patients with a slight restrictive pattern, one patient with very severe restriction and six patients with low DLCO. The challenge tests was positive for 59% of patients. CONCLUSION: After the massive inhalation of irritant and/or toxic substances, patients presented different types of pathological response at pulmonary level. In our workers histological repairing lesions--of high or low degree--were found, BOOP being the lesions observed most frequently, and different patterns of functional involvement. Fifty-nine per cent of cases developed non-specific bronchial hyperreactivity consistent with a reactive airways dysfunction syndrome.


Subject(s)
Lung Diseases/chemically induced , Occupational Diseases/chemically induced , Paint/adverse effects , Solvents/adverse effects , Textile Industry , Adolescent , Adult , Biopsy , Bronchial Hyperreactivity/diagnosis , Cryptogenic Organizing Pneumonia/chemically induced , Cryptogenic Organizing Pneumonia/diagnosis , Cryptogenic Organizing Pneumonia/pathology , Female , Humans , Lung/pathology , Lung Diseases/diagnosis , Lung Diseases/pathology , Male , Occupational Diseases/diagnosis , Occupational Diseases/pathology , Pulmonary Fibrosis/chemically induced , Pulmonary Fibrosis/diagnosis , Pulmonary Fibrosis/pathology , Respiratory Function Tests , Syndrome
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