Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion.

BACKGROUND: Closed pleural biopsy was previously considered a procedure of choice in cases of undiagnosed pleural effusion with good efficacy. Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups. OBJECTIVE: The objective of this study was to analyze the diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion and assessment of patients' characteristics with the yield of pleural biopsy. DESIGN: This was a cross-sectional study. SETTINGS: This study was conducted at Institute of Respiratory Diseases, SMS Medical College, Jaipur, a tertiary care center of West India. PATIENTS AND METHODS: A total of 250 cases of pleural effusion were evaluated with complete pleural fluid biochemical, microbiological, and cytological examination. Out of these 250 patients, 59 were excluded from the study as the diagnosis could be established on initial pleural fluid examination. The remaining (191) patients were considered for closed pleural biopsy with Abrams pleural biopsy needle. MAIN OUTCOME MEASURES: The main outcome measure was diagnostic yield in the form of confirming diagnosis. RESULTS: Out of the 191 patients with exudative lymphocytic pleural effusion, 123 (64.40%) were diagnosed on the first pleural biopsy. Among the remaining 68 patients, 22 patients had repeat pleural biopsy with a diagnostic yield of 59.9%. The overall pleural biopsy could establish the diagnosis in 136 (71.20%) patients with pleural effusion. The most common diagnosis on pleural biopsy was malignancy followed by tuberculosis. CONCLUSIONS: Closed pleural biopsy provides diagnostic yield nearly comparative to thoracoscopy in properly selected patients of pleural effusions. In view of good yield, low cost, easy availability, and very low complication rate, it should be used routinely in all cases of undiagnosed exudative lymphocytic pleural effusion. LIMITATIONS: There was no comparison with a similar group undergoing thoracoscopic pleural biopsy.

Right ventricular thrombus with pulmonary artery aneurysm in a young male: A rare presentation of Behçet's disease.

We describe an adolescent patient presenting with hemoptysis. Detailed clinical work up of the patient showed right ventricular thrombus and bilateral pulmonary artery aneurysms along with the prescribed criteria for the diagnosis of Behcet's disease. Younger age of the patient was another distinctive feature of this case. Six months of therapy with cyclophosphamide and prednisolone resulted in near complete clinicoradiological response.

Pharmacophore identification and 3D-QSAR studies in N-(2-benzoyl phenyl)-L-tyrosines as PPAR gamma agonists.

The identification of pharmacophore and three dimensional quantitative structure-activity studies have been performed on a set of N-(2-Benzoylphenyl)-L-tyrosine for their PPARgamma agonist activity by using the logico-structural based software Apex 3D-which describes the properties and distribution of primary and secondary biophore sites in the three dimensional space. Among several models, two models of comparable probability were selected on the basis of R(2)>0.60, chance 0.20. These models showed a good correlation between the observed and predicted biological activity both for training and test sets.

Development of 3D-QSAR models in cyclic ureidobenzenesulfonamides: human beta3-adrenergic receptor agonist.

Pharmacophoric mapping based on 3D-QSAR studies is performed on sixteen cyclic ureidobenzenesulfonamides for their beta(3)-adrenergic receptor agonistic activity. The best 3D-QSAR model (with r(2)=0.877) which described the properties and distributions of 5-biophoric and 2-secondary biophoric sites, showed a good correlation between the observed and predicted activity both in training and test.