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Pleural Empyema
Pleural empyema is a collection of pus in the pleural cavity caused by microorganisms, usually bacteria. Often it happens in the context of a pneumonia, injury, or chest surgery. It is one of the various kinds of pleural effusion. There are three stages: exudative, when there is an increase in pleural fluid with or without the presence of pus; fibrinopurulent, when fibrous septa form localized pus pockets; and the final organizing stage, when there is scarring of the pleura membranes with possible inability of the lung to expand. Simple pleural effusions occur in up to 40% of bacterial pneumonias. They are usually small and resolve with appropriate antibiotic therapy. If however an empyema develops additional intervention is required. Signs and symptoms The clinical presentation of both the adult and pediatric patient with pleural empyema depends upon several factors, including the causative micro-organism. Most cases present themselves in the setting of a pneumonia, although up ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hydro-pneumothorax
Hydropneumothorax is defined as the presence of both air and fluid within the pleural space. An upright chest x-ray will show air fluid levels. The horizontal fluid level is usually well defined and extends across the whole length of one of the hemithorax. Signs and symptoms This can be remembered by the 4 'S': straight line dullness, shifting dullness, splash, sound of coin. Causes * Iatrogenic: Introduction of air during pleural fluid The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication be ... aspiration in effusion * Presence of a gas-forming organism * Thoracic trauma Diagnosis Diagnosis can be via CXR. CT is better to outline borders of air fluid levels, however, CT has a greater radiation exposure. Treatment Treatment includes ICD ( intercostal drainage) of fluid and air and tr ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Radiodensity
Radiodensity (or radiopacity) is opacity to the radio wave and X-ray portion of the electromagnetic spectrum: that is, the relative inability of those kinds of electromagnetic radiation to pass through a particular material. Radiolucency or hypodensity indicates greater passage (greater transradiancy) to X-ray photonsNovelline, Robert. ''Squire's Fundamentals of Radiology''. Harvard University Press. 5th edition. 1997. . and is the analogue of transparency and translucency with visible light. Materials that inhibit the passage of electromagnetic radiation are called radiodense or radiopaque, while those that allow radiation to pass more freely are referred to as radiolucent. Radiopaque volumes of material have white appearance on radiographs, compared with the relatively darker appearance of radiolucent volumes. For example, on typical radiographs, bones look white or light gray (radiopaque), whereas muscle and skin look black or dark gray, being mostly invisible (radiolucent). T ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Penicillins
Penicillins (P, PCN or PEN) are a group of β-lactam antibiotics originally obtained from ''Penicillium'' moulds, principally '' P. chrysogenum'' and '' P. rubens''. Most penicillins in clinical use are synthesised by P. chrysogenum using deep tank fermentation and then purified. A number of natural penicillins have been discovered, but only two purified compounds are in clinical use: penicillin G (intramuscular or intravenous use) and penicillin V (given by mouth). Penicillins were among the first medications to be effective against many bacterial infections caused by staphylococci and streptococci. They are still widely used today for different bacterial infections, though many types of bacteria have developed resistance following extensive use. 10% of the population claims penicillin allergies but because the frequency of positive skin test results decreases by 10% with each year of avoidance, 90% of these patients can tolerate penicillin. Additionally, those with p ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pulmonary Aspiration
Pulmonary aspiration is the entry of material such as pharyngeal secretions, food or drink, or stomach contents from the oropharynx or gastrointestinal tract, into the larynx (voice box) and lower respiratory tract, the portions of the respiratory system from the trachea (windpipe) to the lungs. A person may inhale the material, or it may be delivered into the tracheobronchial tree during positive pressure ventilation. When pulmonary aspiration occurs during eating and drinking, the aspirated material is often colloquially referred to as "going down the wrong pipe". Consequences of pulmonary aspiration range from no injury at all, to chemical pneumonitis or pneumonia, to death within minutes from asphyxiation. These consequences depend on the volume, chemical composition, particle size, and presence of infectious agents in the aspirated material, and on the underlying health status of the person. In healthy people, aspiration of small quantities of material is common and ra ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Urokinase
Urokinase, also known as urokinase-type plasminogen activator (uPA), is a serine protease present in humans and other animals. The human urokinase protein was discovered, but not named, by McFarlane and Pilling in 1947. Urokinase was originally isolated from human urine, and it is also present in the blood and in the extracellular matrix of many tissues. The primary physiological substrate of this enzyme is plasminogen, which is an inactive form ( zymogen) of the serine protease plasmin. Activation of plasmin triggers a proteolytic cascade that, depending on the physiological environment, participates in thrombolysis or extracellular matrix degradation. This cascade had been involved in vascular diseases and cancer progression. Urokinase is encoded in humans by the ''PLAU'' gene, which stands for "plasminogen activator, urokinase". The same symbol represents the gene in other animal species. Function The ''PLAU'' gene encodes a serine protease () involved in degradation of t ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Intrapleural Fibrinolysis
The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication between the membranes, and also to create a pressure gradient. The serous membrane that covers the surface of the lung is the visceral pleura and is separated from the outer membrane the parietal pleura by just the film of pleural fluid in the pleural cavity. The visceral pleura follows the fissures of the lung and the root of the lung structures. The parietal pleura is attached to the mediastinum, the upper surface of the diaphragm, and to the inside of the ribcage. Structure In humans, the left and right lungs are completely separated by the mediastinum, and there is no communication between their pleural cavities. Therefore, in cases of a unilateral pneumothorax, the contralateral lung will remain functioning normally unless there ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Mucolytic
Mucoactive agents are a class of chemical agents that aid in the clearance of mucus or sputum from the upper and lower airways, including the lungs, bronchi, and trachea. Mucoactive drugs include expectorants, mucolytics, mucoregulators, and mucokinetics. These medications are used in the treatment of respiratory diseases that are complicated by the oversecretion or inspissation of mucus. These drugs can be further categorized by their mechanism of action. Mechanism of action Mucoactive agents - expectorants – include mucolytics, secretolytics and mucokinetics (also called secretomotorics) * Mucolytics – thin (reduce the viscosity of) mucus * Secretolytics – increase airway water or the volume of airway secretions * Mucokinetics – increase mucociliary transport (clearance) and transportability of mucus by cough * Mucoregulators – suppress underlying mechanisms of mucus hypersecretion Alternatively, attacking the affinity between secretions and the biological surface ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Fibrinolytic
Fibrinolysis is a process that prevents blood clots from growing and becoming problematic. Primary fibrinolysis is a normal body process, while secondary fibrinolysis is the breakdown of clots due to a medicine, a medical disorder, or some other cause.Dugdale, David et al.Primary or secondary fibrinolysis, Medline Plus. Retrieved 7 August 2011. In fibrinolysis, a fibrin clot, the product of coagulation, is broken down. Its main enzyme plasmin cuts the fibrin mesh at various places, leading to the production of circulating fragments that are cleared by other proteases or by the kidney and liver. Physiology Plasmin is produced in an inactive form, plasminogen, in the liver. Although plasminogen cannot cleave fibrin, it still has an affinity for it, and is incorporated into the clot when it is formed. Tissue plasminogen activator (t-PA) and urokinase are the agents that convert plasminogen to the active plasmin, thus allowing fibrinolysis to occur. t-PA is released into the blood ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Polymerase Chain Reaction
The polymerase chain reaction (PCR) is a method widely used to rapidly make millions to billions of copies (complete or partial) of a specific DNA sample, allowing scientists to take a very small sample of DNA and amplify it (or a part of it) to a large enough amount to study in detail. PCR was invented in 1983 by the American biochemist Kary Mullis at Cetus Corporation; Mullis and biochemist Michael Smith, who had developed other essential ways of manipulating DNA, were jointly awarded the Nobel Prize in Chemistry in 1993. PCR is fundamental to many of the procedures used in genetic testing and research, including analysis of ancient samples of DNA and identification of infectious agents. Using PCR, copies of very small amounts of DNA sequences are exponentially amplified in a series of cycles of temperature changes. PCR is now a common and often indispensable technique used in medical laboratory research for a broad variety of applications including biomedical research ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Sensitivity And Specificity
''Sensitivity'' and ''specificity'' mathematically describe the accuracy of a test which reports the presence or absence of a condition. Individuals for which the condition is satisfied are considered "positive" and those for which it is not are considered "negative". *Sensitivity (true positive rate) refers to the probability of a positive test, conditioned on truly being positive. *Specificity (true negative rate) refers to the probability of a negative test, conditioned on truly being negative. If the true condition can not be known, a " gold standard test" is assumed to be correct. In a diagnostic test, sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives. For all testing, both diagnostic and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensitivities will mean lower specificities and vice versa. If the goal is to return the ratio at w ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Sputum Culture
A sputum culture is a test to detect and identify bacteria or fungi that infect the lungs or breathing passages. Sputum is a thick fluid produced in the lungs and in the adjacent airways. Normally, fresh morning sample is preferred for the bacteriological examination of sputum. A sample of sputum is collected in a sterile, wide-mouthed, dry, leak-proof and break-resistant plastic-container and sent to the laboratory for testing. Sampling may be performed by sputum being expectorated (produced by coughing), induced (saline is sprayed in the lungs to induce sputum production), or taken via an endotracheal tube with a protected specimen brush (commonly used on patients on respirators) in an intensive care setting. For selected organisms such as Cytomegalovirus or "Pneumocystis jiroveci" in specific clinical settings (immunocompromised patients) a bronchoalveolar lavage might be taken by an experienced pneumologist. If no bacteria or fungi grow, the culture is negative. If organi ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Blood Culture
A blood culture is a medical laboratory test used to detect bacteria or fungi in a person's blood. Under normal conditions, the blood does not contain microorganisms: their presence can indicate a bloodstream infection such as bacteremia or fungemia, which in severe cases may result in sepsis. By culturing the blood, microbes can be identified and tested for resistance to antimicrobial drugs, which allows clinicians to provide an effective treatment. To perform the test, blood is drawn into bottles containing a liquid formula that enhances microbial growth, called a culture medium. Usually, two containers are collected during one draw, one of which is designed for aerobic organisms that require oxygen, and one of which is for anaerobic organisms, that do not. These two containers are referred to as a ''set'' of blood cultures. Two sets of blood cultures are sometimes collected from two different blood draw sites. If an organism only appears in one of the two sets, it is m ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
