Medical Advisor Journals

Sunday, March 20, 2016

Most Common Diseases of elder: Respiratory Pleural disease: Pleural effusion Treatment caused by Liver disease (cirrhosis)

Kyle J. Norton(Scholar and Master of Nutrients, all right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Respiratory Disease

Respiratory Disease is defined as medical conditions, affecting the breathing organ and tissues including Inflammatory lung disease, Obstructive lung diseases, Restrictive lung diseases, Respiratory tract infections, trachea, bronchi, bronchioles, alveoli, the nerves and muscles breathing , etc,.

Pleural disease: Pleural effusion

The pleura is a thin tissue covered by a layer of cells (mesothelial cells) that surrounds the lungs and lines the inside of the chest wall.
Pleural effusion is a condition of collection of fluid within the pleural cavity as a result of heart failure, bleeding (hemothorax), infections, excessive or decreased fluid volume, etc.

TheTreatment

Treatments in conventional medicine perspective
Pleural effusion caused by Liver disease (cirrhosis)
Treatments of cirrhosis depend not only on the underlined causes but also the stages of the diseases
A.1. Alcohol causes of cirrhosis
If the the disease is caused by excessive alcohol drinking, patients will be asked to stop drinking. with help from the professional teams and certain medication. The long-term management of alcoholic liver disease stresses the following(82).
(1) Abstinence of alcohol (Grade 1A), with referral to an alcoholic rehabilitation program;
(2) Adequate nutritional support (Grade 1B), emphasizing multiple feedings and a referral to a nutritionist; (3) Routine screening in alcoholic cirrhosis to prevent complications;
(4) Timely referral to a liver transplant program for those with decompensated cirrhosis;
(5) Avoid pharmacologic therapies, as these medications have shown no benefit.
But according to the study by the Catholic University of Rome, in the intervention to achieve alcohol abstinence represents the most effective treatment for alcohol-dependent patients with liver cirrhosis by investigating the effectiveness and safety of Baclofen, is a GABA(B) receptor agonist in achieving and maintaining alcohol abstinence in patients with liver cirrhosis, showed that baclofen is effective at promoting alcohol abstinence in alcohol-dependent patients with liver cirrhosis. The drug is well tolerated and could have an important role in treatment of these individuals(83).
A.2. Obesity and Fatty liver
The prevalence of overweight and obesity are increasing in World wide, especially in the Emerging world, as a result of recently economic prosperity.
Obesity is defined as a medical condition of excess body fat accumulated overtime. Overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. In US, 68% of population are either overweight or obese. According to the study by Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital, for age-specific subgroup analyses, both overweight and obesity increased more rapidly in the toddler stage than in other developmental stages. Toddlers and urban boys were at particularly high risk; the prevalence in these groups increased more rapidly than in their counterparts(84).
The Obesity Society and the American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related hypertension to be published jointly in the journals of each society(2). Other researchers suggested that in light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity(85).
Recent study showed that evidence has emerged for an association between genetic variability at the APOA5 locus and increased risk of obesity and metabolic syndrome(86).
Fatty liver disease is defined as a condition of accumulation of fat in the liver, including people who drink little or no alcohol (Non alcohol fatty disease) or who are excessive alcohol drinking (Alcohol fatty liver disease). The disease can even occur after a short period of heavy drinking (acute alcoholic liver disease). More than 15 million people in the U.S. either abuse or overuse alcohol with fatty liver diseases with fat makes up 5-10 percent of liver weight.
Non-alcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of clinical conditions, actually representing an emerging disease of great clinical interest(87)
There is no standard treatment in conventional medicine. If you are obese, you are advised to lose weight. If excessive drinking alcohol is the cause, you are advised to stop drinking.
Some researchers suggested that Vitamin E plus C combination treatment is a safe, inexpensive and effective treatment option in patients with fatty liver disease, with results comparable to those obtained with ursodeoxycholic acid(88). But some researchers suggested that Neither vitamin E nor metformin was superior to placebo in attaining the primary outcome of sustained reduction in ALT level in patients with pediatric NAFLD(89).
In traditional Chinese medicine, fatty liver is associated closely to obesity, as a result of over intake of “bad” fat and excessive alcohol drinking. Even though fatty liver is a result of too much fat, but trying to eliminate all fats from the diet won’t help to prevent or relieve the disease as malnutrition can also trigger fatty liver as fat and protein stored elsewhere in the body move to the liver for storage and conversion to energy as needed. That’s why some women who eat almost nothing but vegetables can also develop fatty liver(90).
Many traditional Chinese medicine practitioners believe, no way that one can lose weight if fatty liver diseases are not cured. Syndromes of fatty liver could be typed into 4 TCM types of the asthenia Pi-Shen with Gan-stagnation type, the asthenia Pi-Shen type, the asthenia Pi with phlegm-heat type and the unclassified type. Among them the asthenia Pi-Shen with Gan-stagnation type was the commonest one, which accounted to 62.32%(91).
Dr. Liu T, and the research team at the Shanghai University of Traditional Chinese Medicine, in the study to explore the pathogenesis of nonalcoholic fatty liver (NAFL) in traditional Chinese medicine (TCM) by comparing the therapeutic efficacy of methods for fortifying the spleen and replenishing qi, warming yang and fortifying the spleen and warming yang to move water, showed that body weight, liver and epididymal fat indexes and liver TAG level of rats all significantly increased in the model group as compared with the normal group (P<0.05). Hepatic fatty infiltration, TAG concentration and the levels of serum TAG and ALT were significantly decreased in the LGZG and SZ groups when compared to those in the model group (P<0.05). Method of warming yang or moving water can promote the lipid metabolism. It may be an effective strategy in preventing and treating NAFL by treating with warming yang and moving water together(92)
Other studies showed that Zhi Zi has a very strong inhibitory action on lipidosis and inflammatory injury in the rat model of NAFLD. This mechanism may possibly be related to the inhibition of the free fatty acid metabolism pathway(93)).
In the study to investigate the effect of Cigu Xiaozhi pills on expression of tumor necrosis factor alpha (TNF-alpha) in rat with nonalcoholic steatoheptatitis (NASH), found that Cigu Xiaozhi pills can effectively treat experimental nonalcoholic steatohepatitis in rats, and its mechanism may be associated with ameliorating hepatocellular steatosis, removing the free radicals and enhancing the capability of anti-oxidation and anti-inflammatory(94).
Most people with fatty liver disease are experience no symptoms at all, but Fatty liver disease is associated with high blood pressure, heart disease and diabetes can, in time, cause life threatening cirrhosis of the liver. According to the article By Donald Norfolk, "Today, as a direct effect of the obesity plague, it's reckoned that one in five British adults is now suffering from fatty liver disease, unconnected with virus infections or heavy drinking. This malady, known medically as steatosis, is believed to affect 90 per cent of morbidly obese patients, in whom it may remain totally symptomless for many years"(95).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

The smoothie of Enrich cow's milk formulas, and Sodium bicarbonate for Prevention and Treatment of Renal Tubular Acidosis

Most Common Diseases of elder: Respiratory Pleural disease: Pleural effusion - The Diseases associated to

1. Polymyalgia rheumatica
Polymyalgia rheumatica is an inflammatory rheumatic disease that presents with bilateral pain and stiffness affecting mainly proximal muscles. According to the study by Hospital Infanta Elena, there is a report of a case of an 80 years old patient presenting polymyalgia rheumatica coinciding with pleuropericardial effusion. The patient had a very good response to treatment with rapid improvement in the symptomatology and laboratory findings. Polymyalgia Rheumatica is a common disease but it is rarely associated to pleuropericardial effusion(40).

2. Bilateral Ovarian Fibrothecoma
There is a report of a black African woman of 35 years old, seventh gravida and fourth parous, undergone a total abdominal hysterectomy with bilateral salpingoophorectomy for large bilateral ovarian masses associated with significant ascites, bilateral pleural effusion, and particular highly elevated tumor marker CA-125 (1835 UI/mL) in a pronounced general alteration condition(41).

3. Liver cirrhosis
Hepatic hydrothorax is the paradigmatic pleural effusion in liver cirrhosis.The estimated prevalence of this complication in patients with liver cirrhosis is 5 to 6%. Its pathophysiology involves movement of ascitic fluid from the peritoneal cavity into the pleural space through diaphragmatic defects, according to the study by Hospital Universitari de Bellvitge(42).

4. Cardiac failure
In the study to compare the diagnostic utility of pleural fluid N-terminal pro-B-type natriuretic peptide (NT-proBNP), mid-region pro-atrial natriuretic peptide (MR-proANP) and mid-region pro-adrenomedullin (MR-proADM) for discriminating heart failure (HF)-associated effusions, found that
both NT-proBNP and the albumin gradient correctly identified more than 80% of those cardiac effusions misclassified as exudates by standard criteria(43).

5. Kidney failure
Acute kidney failure is associated to 5.1% of pleural effusion, according to the study by t
he University of The West Indies(44).

6. Autoimmune hypothyroidism (AIH)
there is areport of a case of AIH presented with massive proteinuria, haematuria, pleural fluid and arthritis simulating SLE(45).

7. Lung cancer
Pleural effusions are common in the setting of lung cancer. In the symptomatic patient with a reasonable life expectancy and pleural fluid pH of more than 7.3, chemical pleurodesis appears to be the most effective and least morbid therapy(46).

8. Tuberculosis (TB)
In a prospective study of 118 patients with pleural effusion, tuberculosis (TB) diagnosed in 112. In 84 patients the diagnosis of TB was made by detection of acid-fast bacilli by stain (auramine, Ziehl-Neelsen) or by culture of mycobacteria (Löwenstein-Jensen medium) in pleural fluid or pleural tissue (obtained by closed biopsy) or by the presence of caseating granulomas in histological sections(47).

9. Other diseases associated to Pleural effusion
According to the study by Zavod za klinicku imunologiju i reumatologiju Klinike za unutarnje bolesti Medicinskog fakulteta Sveucilista u Zagrebu, the most common conditions associated with eosinophilic pleural effusion (EPE) are malignancy, infections, post-traumatic and post-surgical conditions, hypersensitivity, systemic autoimmune diseases, congestive heart failure, cirrhosis, pulmonary embolus, asbestosis and drug induced EPE. Pleural effusion accompanying autoimmune diseases is most common in patients with systemic lupus erythematosus, rheumatoid arthritis, howewer it rarely occurs in patients with progressive systemic sclerosis and polymiositis. EPE has rarely been reported in association with Churg Strauss syndrome(48).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html

Sources
(40) http://www.ncbi.nlm.nih.gov/pubmed/23453662
(41) http://www.ncbi.nlm.nih.gov/pubmed/23431489
(42) http://www.ncbi.nlm.nih.gov/pubmed/21213201
(43) http://www.ncbi.nlm.nih.gov/pubmed/23278975
(44) http://www.ncbi.nlm.nih.gov/pubmed/18072418
(45) http://www.ncbi.nlm.nih.gov/pubmed/19444448
(46) http://www.ncbi.nlm.nih.gov/pubmed/8384963
(47) http://www.ncbi.nlm.nih.gov/pubmed/7855915
(48) http://www.ncbi.nlm.nih.gov/pubmed/23133914
(49) http://www.ncbi.nlm.nih.gov/pubmed/21889908

The Smoothie of Sweet Potato, Flax seed and Grape for Prevention and Treatment of Nephrogenic Hypertension (Goldblatt kidney)

Alpha-tocopheryl acetate (vitamin E acetate) induced a positive effect on the renal function in patient, through reduction of highly-toxic products of lipid peroxidation, improvement of renal microcirculation, reduction of ischemic disorders in the organs of the body(1).

According to an Russian study, highly-toxic products of lipid peroxidation in patients with nephrogenic hypertension may be an indication of chronic kidney failure(2).

3‑n‑butylphthalide (NBP), a natural product of celery seeds exhibited anti Nephrogenic Hypertension effect by alleviated tubular impairment and significantly decreased oxidative stress, as well as the expression of pro‑inflammatory cytokines and TGF-‑β1 in kidney tissues(3).

Resveratrol is a phytochemical in the class of Stilbenoids, found abundantly in skins and seed of grape wine, nuts, peanuts, etc.may also .benefits patient with renal hypertension, involving antioxidant actions and nitric oxide generation(4).
Dr. Javkhedkar AA and Dr. Banday AA said, "resveratrol restores renal sodium transport regulation in spontaneously hypertensive rats (SHR)"...." (thr, Drough)activates phase II antioxidant enzymes, mitigates oxidative stress,...."(5).
In the investigation of the effectiveness of Flax lignan cardioprotective, antihyperlipidemic effect Dr.Sawant SH1 and Dr. Bodhankar SL.suggested "flax lignan concentrate (FLC) possessed antihypertensive effect via modulation of endogenous enzymes in deoxycorticosterone acetate (DOCA)-salt induced renal hypertension in rats"(6).

The effectiveness of Sweet Potato, Flax seed and Grape may serve as cornerstones of pharmaceutical target for further studies in production of a potential medication for reduced risk, complications and treatment of Nephrogenic Hypertension (Goldblatt kidney) with little or no adverse effects.

People who are at high risk of Nephrogenic Hypertension (Goldblatt kidney) due to aging, weaken renal function... should drink at least one serving daily and women with Nephrogenic Hypertension (Goldblatt kidney) should drink no more than 4 servings daily, depending to digestive toleration.
Life style and diet pattern change are necessary.

All Forms of Arthritis are Curable

You Can Eliminate Osteoarthritis

By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination

Holistic System In Existence That Will Show You How To

Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

References

(1) [The processes of lipid peroxidation and renal functions in nephrogenic hypertension].[Article in Russian] by Bagirova RD, Alekperova NV, Siniachenko OV, Sardarly FZ, Suleĭmanova SG(PubMed)

(2) [The lipid peroxidation process in patients with nephrogenic hypertension and clinico-laboratory signs of chronic kidney failure].[Article in Russian] by Guseĭnov FG, Bagirova RD, Alekperova NV, Vezirov AV, Suleĭmanova SG, Shakhverdieva VG.(PubMed)

(3) Protective effect of 3-n-butylphthalide against hypertensive nephropathy in spontaneously hypertensive rats by Zhu J1, Zhang Y1, Yang C1.(PubMed)
(4) Resveratrol improves vasoprotective effects of captopril on aortic remodeling and fibrosis triggered by renovascular hypertension by Natalin HM1, Garcia AF1, Ramalho LN2, Restini CB3.(PubMed)
(5) Antioxidant resveratrol restores renal sodium transport regulation in SHR by Javkhedkar AA1, Banday AA2.(PubMed)

Most Common Diseases of elder: Respiratory Pleural disease: Pleural effusion - The Diseases associated to Pleural effusion

5. Kidney failure
Acute kidney failure is associated to 5.1% of pleural effusion, according to the study by t
he University of The West Indies(44).

6. Autoimmune hypothyroidism (AIH)
there is areport of a case of AIH presented with massive proteinuria, haematuria, pleural fluid and arthritis simulating SLE(45).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Back to General health http://kylejnorton.blogspot.ca/p/general-health.html

Saturday, March 19, 2016

The Smoothie of Green Tea, Olive and Blueberry for prevention and Treatment of Goodpasture syndrome (Glomerulonephritis)

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Goodpasture syndrome is an autoimmune disorder, due to immune system mistakenly attacks and destroys healthy tissue of collagen in the lungs and kidneys. According to Medscape, Goodpasture syndrome is a term used to describe glomerulonephritis, with or without pulmonary hemorrhage(9).

The smoothie for prevention and treatment of Goodpasture syndrome(glomerulonephritis)
Yield: 2 servings (about 8 ounces each)
1/2 cup olive
1 cup blueberry
1 cup green tea drink (Make from 4 grams of green tea, a slice of ginger and a cup of hot water lipped for 5 minutes, and let cool to room temperature)

1. Place all ingredients in a blender and puree about 1 minute
2. Blend on high speed about 1 minute or until the mixture is thick and the ice is well crushed.
3. Serve immediately

The finding of a natural source for treatment of glomerulonephritis has been running into many obstacles, many ingredients showed initially with promising result in animal studies have not produced same potentials in large sample size and mutli centers human trials.

Glomerulonephritis is a disorder of small blood vessels in the kidneys caused by the infection of streptococcus, bacteria and virus.
Recent studies back by well known institutions proposed, Green tea, Olive and Blueberry may be the next generation of natural ingredients for prevention and treatment of glomerulonephritis.

Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Due to its commercial values and health effects, green tea now has been cultivated all over the world in suitable climate. According to Dr.Turner JE, green tea component (-)-epigallocatechin-3-gallate (EGCG) mediated glomerulonephritis through ameliorates renal inflammation, tissue damage, and loss of renal function(1).

The Shanghai Tenth People's Hospital of Tongji University study, suggested, EGCG pretreatment period significantly attenuated mortality and renal dysfunction in the progression of immune-mediated glomerulonephritis (GN) by targeting redox and inflammatory pathways(2).

Furthermore, the phytochmical also reversed the progression of crescentic GN by targeting multiple signaling and inflammatory pathways and countering oxidative stress(3).

Resveratrol, a phytochemical in the class of Stilbenoids, found abundantly in grape and blueberry reduced the production of reactive oxygen species (ROS), reduced cell apoptosis, and upregulated heme oxygenase 1 (HO1) in patients with Idiopathic membranous nephropathy (MN)(4).

The Peking Union Medical College and Chinese Academy study said, "resveratrol attenuated proteinuria, immunoglobuin depositon in kidney, and glomerulonephritis as well as immunoglobulins IgG1 and IgG2a in serum in pristane-induced lupus mice"(5).

Omega 3 fatty acids found abundantly in olive might be beneficial for patients with glomerulonephritis through its effects on lipid metabolism, platelet/vessel wall interactions and proteinuria(6) as well as functional status of erythrocyte membrane and probably proximal tubule function(7).

The effectiveness of Green tea, Olive and Blueberry may serve as cornerstones of pharmaceutical target for further studies in production of a potential medication for reduced risk, complications and treatment of Goodpasture syndrome (Glomerulonephritis)with little or no adverse effects.

People who are at high risk of Goodpasture syndrome (Glomerulonephritis) due to aging, weaken reno function... should drink at least one serving daily and women with Goodpasture syndrome (Glomerulonephritis) should drink no more than 4 servings daily, depending to digestive toleration.

Life style and diet pattern change are necessary.

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

References
(1) Glomerulonephritis therapy: is there a role for green tea? by Turner JE1.(PubMed)
(2) The green tea polyphenol (-)-epigallocatechin-3-gallate ameliorates experimental immune-mediated glomerulonephritis by Peng A1, Ye T, Rakheja D, Tu Y, Wang T, Du Y, Zhou JK, Vaziri ND, Hu Z, Mohan C, Zhou XJ.(PubMed)
(3) Green tea polyphenol (-)-epigallocatechin-3-gallate restores Nrf2 activity and ameliorates crescentic glomerulonephritis by Ye T1, Zhen J2, Du Y3, Zhou JK4, Peng A5, Vaziri ND6, Mohan C3, Xu Y7, Zhou XJ8.(PubMed)
(4) Resveratrol ameliorates renal damage, increases expression of heme oxygenase-1, and has anti-complement, anti-oxidative, and anti-apoptotic effects in a murine model of membranous nephropathy by Wu CC1, Huang YS2, Chen JS3, Huang CF4, Su SL5, Lu KC6, Lin YF7, Chu P3, Lin SH3, Sytwu HK8.(PubMed)
(5) Resveratrol possesses protective effects in a pristane-induced lupus mouse model by Wang ZL1, Luo XF1, Li MT1, Xu D1, Zhou S1, Chen HZ2, Gao N1, Chen Z1, Zhang LL1, Zeng XF1.(PubMed)
(6) [Effect of treating glomerulonephritis with omega 3 fatty acids for selected parameters of hemostasis, blood platelet function and lipid metabolism].[Article in Polish] by Małyszko JS1, Małyszko J, Pawlak K, Myśliwiec M.(PubMed)
(7) [The effect of administering Omega-3 acids on lipids in serum, functional state of erythrocyte membrane and function of the kidneys in patients with primary glomerulonephritis].[Article in Polish] by Fox J1, Manitius J, Debska-Slizień A, Rutkowski B, Nowak J, Bautembach S, Owczarzak A.(PubMed)

(8) Goodpasture Syndrome by Author: Pranay Kathuria, MD; Chief Editor: Vecihi Batuman, MD, FACP, FASN(Medscape)

Most Common Diseases of elder: Respiratory Pleural disease: Pleural effusion - The Complications

1. Primary Sjogren’s syndrome
Sjogren’s syndrome can cause many organic changes, but is rarely accompanied by pleuritis. there is a report of a 65-year-old patient with primary Sjogren’s syndrome who developed bilateral pleuritis with moderately large effusions(35).
2. Pleurisy
Pleurisy is a medical condition of an inflammation of the lining of the pleural cavity. In the study to investigate the incidence of tuberculous pleurisy among patients with adenosine deaminase (ADA) levels of 50 IU/L or less in a pleural effusion, and without a previous diagnosis of carcinomatous pleurisy or Mycobacterium tuberculosis, found that occult tuberculous pleurisy is significantly common in patients with pleural effusion ADA levels of 50 IU/L or less and who may otherwise be diagnosed with nonspecific pleurisy(36).
3. Dullness to percussion and tactile fremitus and reduced tactile vocal fremitu
In the systematically review the evidence regarding the accuracy of the physical examination in assessing the probability of a pleural effusion conducted by the University of Toronto, and St Michael’s Hospital, indicated that dullness to percussion and tactile fremitus are the most useful findings for pleural effusion. Dull chest percussion makes the probability of a pleural effusion much more likely but requires a chest radiograph to confirm the diagnosis. When the pretest probability of pleural effusion is low, the absence of reduced tactile vocal fremitus makes pleural effusion less likely so that a chest radiograph might not be necessary depending on the overall clinical situation(37).
4. Tracheal deviation
If the effusion is large, it may be tracheal deviation away from the effusion. According to the study by Kumomoto-chuou Hospital, there is a report of a 33-year-old male admitted to our hospital because of mediastinal bleeding by the traffic accident. He was in shock state. Chest roentgenogram showed widening of the upper mediastium, massive pleural effusion and deviation trachea to right(38).
5. Other complications
In the study to independently evaluate 278 patients (196 men), aged 12 and older, admitted with respiratory symptoms.conducted at a rural hospital in India, two physicians, blinding to history and chest radiograph findings, and to each other’s results, showed that the prevalence of pleural effusion was 21% (57/278). The likelihood ratios (LRs) of positive signs ranged from 1.48 to 8.14 and their 95% confidence intervals (CIs) excluded 1. Except for pleural rub, the LRs for negative signs ranged between 0.13 and 0.71. The interobserver agreement was excellent for chest expansion, vocal fremitus, percussion and breath sounds (kappa 0.84-0.89) and good for vocal resonance, crackles and auscultatory percussion (kappa 0.68-0.78). The independent predictors of pleural effusion were asymmetric chest expansion (odds ratio [OR] 5.22, 95% CI 2.06-13.23), and dull percussion note (OR 12.80, 95% CI 4.23-38.70). For the final multivariate model, the area under receiver operating characteristic curve (ROC curve) was 0.88(39).

\
All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Back to General health http://kylejnorton.blogspot.ca/p/general-health.html

Sources
(35) http://www.ncbi.nlm.nih.gov/pubmed/18197929
(36) http://www.ncbi.nlm.nih.gov/pubmed/19901882
(37) http://www.ncbi.nlm.nih.gov/pubmed/?term=Vocal+fremitus+reduced+and+Pleural+effusion
(38) http://www.ncbi.nlm.nih.gov/pubmed/9170875
(39) http://www.ncbi.nlm.nih.gov/pubmed/16965906