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Objective: Procalcitonin (PCT) may lead a more rapid and specific result than other infectious markers in the differentation of infectious diseases from those of noninfectious conditions. In several studies, higher pleural fluid PCT levels in parapneumonic effusion (PPE) than other causes of pleural effusion has been found and it has been reported that it is a useful marker in the diagnosis of PPE. The aim of this study is to investigate the role of pleural fluid PCT levels in the diagnosis of PPE. Materials and Methods: Eighty-seven patients with pleural effusion consisting of 26 transudative pelural effusion, 26 malignant pleural effusion (MPE), 24 PPE and 11 tuberculous pleural effusion (TPE) were enrolled in the study. Results: There was no significant difference between the groups for the pleural fluid PCT, serum PCT and pleural fluid PCT/serum PCT ratio. The patients were divided into transudative and exudative groups and there was no difference in the pleural fluid PCT and serum PCT between these two groups. In the PPE group, the correlation between pleural fluid PCT level and pleural fluid albumin, protein, LDH, glucose and ADA was studied and no correlation was found. Conclusion: In our study, in PPE, a diagnostic efficiacy of pleural fluid and serum PCT could not be found.

Objective: Procalcitonin (PCT) may lead a more rapid and specific result than other infectious markers in the differentation of infectious diseases from those of noninfectious conditions. In several studies, higher pleural fluid PCT levels in parapneumonic effusion (PPE) than other causes of pleural effusion has been found and it has been reported that it is a useful marker in the diagnosis of PPE. The aim of this study is to investigate the role of pleural fluid PCT levels in the diagnosis of PPE. Materials and Methods: Eighty-seven patients with pleural effusion consisting of 26 transudative pelural effusion, 26 malignant pleural effusion (MPE), 24 PPE and 11 tuberculous pleural effusion (TPE) were enrolled in the study. Results: There was no significant difference between the groups for the pleural fluid PCT, serum PCT and pleural fluid PCT/serum PCT ratio. The patients were divided into transudative and exudative groups and there was no difference in the pleural fluid PCT and serum PCT between these two groups. In the PPE group, the correlation between pleural fluid PCT level and pleural fluid albumin, protein, LDH, glucose and ADA was studied and no correlation was found. Conclusion: In our study, in PPE, a diagnostic efficiacy of pleural fluid and serum PCT could not be found.

Immunoglobulin G4 (IgG4)-related disease is a systemic fibroinflammatory disorder that can affect almost any tissue. Isolated IgG4 pleural disease is a rare manifestation and, when present, is usually described in patients presenting with dyspnoea. We present a case of asymptomatic isolated IgG4 pleural effusion and highlight that IgG4-related disease should be remembered as a differential diagnosis in patients with pleural effusion and pleural thickening, even if asymptomatic and without any other organ involvement.

Immunoglobulin G4 (IgG4)-related disease is a systemic fibroinflammatory disorder that can affect almost any tissue. Isolated IgG4 pleural disease is a rare manifestation and, when present, is usually described in patients presenting with dyspnoea. We present a case of asymptomatic isolated IgG4 pleural effusion and highlight that IgG4-related disease should be remembered as a differential diagnosis in patients with pleural effusion and pleural thickening, even if asymptomatic and without any other organ involvement.

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in patients admitted to the ICU and a leading cause of mortality in critically ill patients. The rise in antimicrobial resistance threatens current treatment methods, and if not addressed will lead to a significant increase in mortality. Rapid and accurate diagnostic methodologies are needed to combat this issue. To develop and test the potential of these DNA based technologies, we focus here on Staphylococcus aureus as it is a common cause of antimicrobial resistant VAP. The first step in the application of any DNA-based test is the reliable extraction of the bacterial DNA. In this project three DNA extraction methods were compared for accuracy and sensitivity: a commercially available DNA extraction kit, and two methods which use traditional phenol/chloroform methods for DNA purification but differ in their lysis technique; one using physical bead-beating and the other using MetaPolyzyme, a multi-lytic enzyme mix. To test each method’s ability to extract S. aureus, extracted DNA was amplified using qPCR with generic 16S rRNA gene primers and S. aureus specific nuc gene primers to determine the relative quantity of S. aureus within a sample. On pure broth grown cultures the bead-beating method was determined as the most effective and was subsequently developed and optimised for use on pleural fluids provided to us by the NHS. With these more complex materials the use of phase lock gel (PLG) reduced the variability observed when using phenol/chloroform in standard laboratory tubes. Having established the optimal extraction methodology, and alongside control plasmids, the limit of detection was determined for two sets of PCR primers, a generic bacterial 16S set and a S. aureus specific nuc set. The limit of detection of spiked pleural fluids was ~1x104 CFU/ml using the 16S primer set and ~1x103 CFU/ml for the nuc set. As this work is developed further its use in a

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in patients admitted to the ICU and a leading cause of mortality in critically ill patients. The rise in antimicrobial resistance threatens current treatment methods, and if not addressed will lead to a significant increase in mortality. Rapid and accurate diagnostic methodologies are needed to combat this issue. To develop and test the potential of these DNA based technologies, we focus here on Staphylococcus aureus as it is a common cause of antimicrobial resistant VAP. The first step in the application of any DNA-based test is the reliable extraction of the bacterial DNA. In this project three DNA extraction methods were compared for accuracy and sensitivity: a commercially available DNA extraction kit, and two methods which use traditional phenol/chloroform methods for DNA purification but differ in their lysis technique; one using physical bead-beating and the other using MetaPolyzyme, a multi-lytic enzyme mix. To test each method’s ability to extract S. aureus, extracted DNA was amplified using qPCR with generic 16S rRNA gene primers and S. aureus specific nuc gene primers to determine the relative quantity of S. aureus within a sample. On pure broth grown cultures the bead-beating method was determined as the most effective and was subsequently developed and optimised for use on pleural fluids provided to us by the NHS. With these more complex materials the use of phase lock gel (PLG) reduced the variability observed when using phenol/chloroform in standard laboratory tubes. Having established the optimal extraction methodology, and alongside control plasmids, the limit of detection was determined for two sets of PCR primers, a generic bacterial 16S set and a S. aureus specific nuc set. The limit of detection of spiked pleural fluids was ~1x104 CFU/ml using the 16S primer set and ~1x103 CFU/ml for the nuc set. As this work is developed further its use in a

Introduction:Pleural effusion is the most common pleural disorder. It refers to excessive or abnormal accumulation of fluid in the pleural space. It is a commonly occurring medical problem caused by various pathological conditions. To treat patients appropriately, it is important to establish an accurate etiological diagnosis. Material and Method: This is an observational study conducted at a tertiary health care center. The pleural effusion was assessed clinically, biochemically, bacteriologically, cytologically, and histopathologically. Result: Tuberculosis was the most common etiology, followed by malignancy. A pleural biopsy was done in 70 patients. Pleural tissue was obtained in 65 cases. On histopathology,Malignancy was diagnosed in 15, tuberculosis in 35, and non-specific inflammation in 13 cases. Out of 35 histological proven tuberculosis cases, 26 cases had adenosine de-aminase (ADA) more than 70 u/l. Conclusion:Every pleural effusion is not due to tuberculosis but can be due to other causes, malignancy should always be excluded. Pleural fluid cytology and biopsy can give a definite diagnosis in a significant number of cases of pleural effusion. Tuberculosis is still the most common cause of pleural effusion followed by malignancy.

Introduction:Pleural effusion is the most common pleural disorder. It refers to excessive or abnormal accumulation of fluid in the pleural space. It is a commonly occurring medical problem caused by various pathological conditions. To treat patients appropriately, it is important to establish an accurate etiological diagnosis. Material and Method: This is an observational study conducted at a tertiary health care center. The pleural effusion was assessed clinically, biochemically, bacteriologically, cytologically, and histopathologically. Result: Tuberculosis was the most common etiology, followed by malignancy. A pleural biopsy was done in 70 patients. Pleural tissue was obtained in 65 cases. On histopathology,Malignancy was diagnosed in 15, tuberculosis in 35, and non-specific inflammation in 13 cases. Out of 35 histological proven tuberculosis cases, 26 cases had adenosine de-aminase (ADA) more than 70 u/l. Conclusion:Every pleural effusion is not due to tuberculosis but can be due to other causes, malignancy should always be excluded. Pleural fluid cytology and biopsy can give a definite diagnosis in a significant number of cases of pleural effusion. Tuberculosis is still the most common cause of pleural effusion followed by malignancy.

Cellular analysis of body fluids, including cerebrospinal fluid and serous fluids, provides essential information in the differential diagnosis. Improper techniques and inaccurate results may lead to the under or over-diagnosis of disorders such as meningitis and peritoni

Alangium lamarkii (Alangiaceae) is commonly known as

Alangium lamarkii (Alangiaceae) is commonly known as

BACKGROUND: Hyaluronan may be used as a marker for malignant mesothelioma, thus indicating its mesodermal origin. METHODS: The sensitivity as a diagnostic test of three different methods for hyaluronan analyses of pleural fluid was examined in patients with biopsy-verified malignant pleural mesothelioma. RESULTS: A quantitative high-performance liquid-chromatography (HPLC) method was performed on fluids from 43 patients. Using a cutoff level of 100 mg/l, higher levels were noted in 30 (70%) patients, with a median value of 220 mg/l (mean, 560 mg/l; range, 20-6600 mg/l). An identical median value (220 mg/l) was obtained with a radioassay method when simultaneously performed on paired samples from 21 patients (correlation coefficient, 0.91). A qualitative precipitation test using 0.5% cetylpyridinium chloride combined with a quantitative viscosimetric method was significantly less sensitive (P < 0.01). CONCLUSION: Hyaluronan analyses is beneficial in distinguishing malignant mesothelioma if methods such as the evaluated HPLC or radioassay with a sensitivity of 70% toward mesothelioma are used and other known causes of elevated content are considered.