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1.
Braz. j. med. biol. res ; 54(2): e10462, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153510

ABSTRACT

Infections caused by uncommon and resistant pathogens in unusual sites have been increasingly reported in medical literature. We describe four cases of rare cytological findings and clinical impact for patients. In the first case, Aspergillus sp and Pneumocystis jirovecii were observed in the bronchoalveolar lavage of a patient with severe systemic lupus. In the second and third cases, we describe the presence of Trichomonas sp and Strongyloides sp larvae in samples of pleural and peritoneal fluid, respectively. The fourth report is about a patient with a wrist subcutaneous nodule whose synovial aspiration and cytology revealed the presence of brown septate hyphae. The early identification of the infectious agent in the cytological examination was essential for the introduction and/or re-adaptation of therapy in the four cases described. Patients in this report were immunocompromised with severe comorbidities, conditions often associated with unfavorable clinical outcomes.


Subject(s)
Humans , Animals , Male , Female , Middle Aged , Communicable Diseases/diagnosis , Cytodiagnosis/methods , Pleural Effusion/parasitology , Aspergillus/isolation & purification , Strongyloides/isolation & purification , Strongyloidiasis/diagnosis , Trichomonas/isolation & purification , Trichomonas Infections/diagnosis , Ascitic Fluid/parasitology , Bronchoalveolar Lavage Fluid/microbiology , Fatal Outcome , Pneumocystis carinii/isolation & purification
2.
Rev. cir. (Impr.) ; 72(3): 217-223, jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1115545

ABSTRACT

Resumen Introducción: Es importante mantener programas de vigilancia bacteriana para disminuir resistencia y definir esquemas farmacológicos adecuados. Los pacientes con abdomen agudo representan un grupo microbiológico especial. Objetivos: Hacer una revisión de agentes patógenos en pacientes adultos operados en nuestro Servicio de Urgencia por patología abdominal con líquido libre y analizar los resultados obtenidos de cultivos respecto a las cepas y la susceptibilidad a los antibióticos. Materiales y Método: Estudio de cohorte prospectiva con estadística descriptiva. Se incluyen pacientes consecutivos, mayores de 18 años, operados por abdomen agudo que presentan líquido libre intraperitoneal entre noviembre de 2017 y abril de 2018. Se excluyen casos con terapia antimicrobiana, hospitalización y/o cirugía en los 3 meses previos. Se registran los cultivos positivos, cepas aisladas, susceptibilidad antimicrobiana, datos demográficos y evolución clínica. Resultados: De 63 pacientes 55% fueron hombres, edad promedio 52,2 años. Las patologías más frecuentes fueron de origen apendicular (62%) y de causa entérica (30%). En un 44% el cultivo fue positivo y en 36% con más de un germen. Escherichia coli fue el patógeno más frecuente (64,2%) seguidos de Enterococcus faecium y Streptococcus anginosus (7,1%). De los otros patógenos cultivados sólo se observó resistencia múltiple en un caso aislado de Morganella Morganii. Conclusiones: Estos datos constituyen la realidad microbiológica local en abdomen agudo. La Escherichia Coli sigue siendo el germen más frecuente, debe enfrentarse con profilaxis y tratamiento antibiótico adecuado. Es necesario mantener vigilancia microbiología local para un manejo acorde.


Introduction: It is important to maintain bacterial surveillance programs to decrease resistance and define adequate pharmacological schemes. Patients with abdomen represent a special microbiological group. Objetives: Make a review of pathogens in adult patients operated in our Emergency Service for abdominal pathology with free fluid and analyze the results obtained from cultures with respect to the strains and susceptibility to antibiotics. Materials and Method: Prospective cohort study with descriptive statistics. We include consecutive patients, older than 18 years old, operated on by abdomen who present free intraperitoneal fluid between November 2017 and April 2018. Cases with antimicrobial therapy, hospitalization and/or surgery 3 months prior are excluded. Positive cultures, isolated strains, antimicrobial susceptibility, demographic data and clinical evolution are recorded. Results: Of 63 patients, 55% were men and the average age was 52.2 years. The most frequent pathologies were of appendicular origin (62%) and of enteric origin (30%). In 44% the crop was positive and in 36% with more than one germ. Escherichia coli was the most frequent pathogen (64.2%) followed by Enterococcus faecium and Streptococcus anginosus (7.1%). Of the others, cultivated pathogens have only observed multiple resistance in an isolated case of Morganella Morganii. Conclusions: These data include the local microbiological reality in acute abdomen. Escherichia coli is still the most frequent germ that must be faced with the profile and the appropriate treatment. It is necessary to maintain local microbiology surveillance for a proper management.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Bacterial Infections/drug therapy , Abdomen, Acute/surgery , Abdomen, Acute/complications , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/etiology , Bacterial Infections/prevention & control , Ascitic Fluid , Ciprofloxacin/therapeutic use , Enterococcus faecium/drug effects , Streptococcus anginosus , Escherichia coli/drug effects , Abdomen, Acute/pathology , Metronidazole
3.
Pesqui. vet. bras ; 40(3): 158-164, Mar. 2020. tab
Article in English | ID: biblio-1135602

ABSTRACT

This study aimed to evaluate the appropriate sites of abdominocentesis for peritoneal fluid collection in cattle and to investigate the time of cell viability in vitro, comparing three methods of sample conservation. Twenty-one healthy cattle (19 females and 2 males) were subjected to a laparocentesis procedure to obtain peritoneal fluid, with punctures in three defined sites: left cranial, right cranial, and right caudal. The total peritoneal fluid collected was divided into three aliquots and maintained under three preservation conditions: room temperature (26°C), refrigeration (4°C), and room temperature (26°C) with the addition of 1µL of 10% formaldehyde per 1mL of peritoneal fluid. The peritoneal fluid analysis performed immediately after collection consisted of: physical examination (color, appearance, volume, and specific gravity), biochemical measures (pH, total protein, fibrinogen, creatinine, and glucose), and cellularity (total and differential counts). The determination of proteins and the examination of cells were repeated in each separate aliquot at two, four, six, and eight hours after harvest. Data were analyzed through repeated measures ANOVA or Friedman test. The harvest was productive in 67% of cattle. The left cranial and the right cranial puncture sites were the most appropriate. Peritoneal fluid analyzed after collection, the total protein concentration ranged from 1.4 to 3.6g/dL, and number of leukocytes ranged from 54 to 1,322 cells/µL; 60 to 95% of leukocytes were lymphocytes. The protein concentration decreased, but the absolute values of leukocytes, lymphocytes, and segmented neutrophils did not change up to eight hours after collection, independent of the maintenance method. Cell lysis was delayed by cooling, and the addition of formaldehyde did not help preserve the integrity of cellular morphology. Laparocentesis is a safe and secure procedure in cattle and maybe more productive when performed in specific sites on the left or right sides of the cranial abdominal wall. Peritoneal fluid samples may be analyzed with reliable results for up to eight hours after collection when kept refrigerated and for up to six hours when kept at room temperature.(AU)


O estudo teve como objetivo avaliar os locais adequados de laparocentese para a colheita de fluido peritoneal de bovinos e estabelecer o tempo de viabilidade celular in vitro, comparando três métodos de conservação. Vinte e um bovinos hígidos (19 fêmeas e 2 machos) foram submetidos ao procedimento de laparocentese para obtenção de fluido peritoneal, com punção em três pontos definidos: cranial esquerdo, cranial direito e caudal direito. O volume total do líquido peritoneal foi dividido em três alíquotas mantidas sob três métodos de conservação: temperatura ambiente (26°C); refrigeração (4°C); e temperatura ambiente (26°C) com adição de 1µL de formol 10% para cada 1mL de líquido peritonial. A análise do líquido peritoneal realizada imediatamente após sua obtenção consistiu em: exames físico (cor, aspecto, volume e densidade); bioquímicos (pH, proteína total, fibrinogênio, creatinina e glicose); e da celularidade (contagens total e diferencial). A determinação de proteínas e o exame da celularidade foram repetidos, em cada alíquota separada, as duas, quatro, seis e oito horas após a colheita. Análise de variâncias de medidas repetidas ou teste de Friedman foram empregados para avaliação ao longo do tempo. A colheita foi produtiva em 67% dos bovinos e os locais de punção craniais esquerdo e direito foram os mais adequados. A concentração de proteína total variou de 1,4 a 3,6g/dL e o número de leucócitos de 54 a 1.322 células/µL, com predomínio de linfócitos (60 a 95% das células) no fluido peritoneal analisado logo após a colheita. A concentração de proteínas diminuiu, mas os valores absolutos de leucócitos, de linfócitos e de neutrófilos segmentados não se modificaram até oito horas após a colheita, independente do método de manutenção das amostras. A lise celular foi retardada pela refrigeração e a adição de formol não contribuiu para preservar a integridade da morfologia celular. A laparocentese é um procedimento seguro e de execução fácil em bovinos sendo mais produtiva quando realizada em locais específicos à esquerda ou à direita craniais da parede abdominal. Amostras de fluido peritoneal podem ser analisadas com resultados confiáveis quando mantidas refrigeradas por até oito horas após a colheita e quando mantidas à temperatura ambiente por até seis horas.(AU)


Subject(s)
Animals , Cattle , Ascitic Fluid/cytology , Ascitic Fluid/chemistry , Punctures/methods , Abdominal Cavity/pathology , Peritonitis/diagnosis
4.
Rev. chil. infectol ; 37(1): 82-84, feb. 2020. graf
Article in Spanish | LILACS | ID: biblio-1092726

ABSTRACT

Resumen Se comunica el caso clínico de un varón, con antecedentes de una cirrosis hepática alcohólica y gota, usuario crónico de antiinflamatorios, incluyendo corticoesteroides. Consultó por una melena secundaria a una úlcera bulbar. Durante su internación presentó fiebre, tratándose con ceftriaxona por un probable foco urinario. Por persistir febril, se realizó una paracentesis diagnóstica. En la muestra de líquido ascítico se observaron larvas de Strongyloides stercoralis. Recibió tratamiento antiparasitario con ivermectina, con buena respuesta clínica. Aunque la infección por S. stercoralis es relativamente frecuente en pacientes con cirrosis hepática alcohólica, la ascitis infectada por Strongyloides corresponde a una forma de presentación infrecuente. Este caso muestra la importancia de la paracentesis diagnóstica en todo paciente con ascitis secundaria a una cirrosis. Es importante considerar la presentación atípica de la infestación por Strongyloides en el contexto del paciente inmunocomprometido, ya que sin tratamiento puede tener una alta mortalidad.


Abstract Male patient, with a history of alcoholic cirrhosis frequent user of anti-inflammatory drugs including corticosteroids. He consulted for digestive bleeding secondary to a bulbar ulcer. During the admission, he had fever and antibiotic treatment with ceftriaxone is started, for a urinary infection. Fever persisted for 48 hours, so a diagnostic paracentesis was made: Strongyloides stercoralis larvae were seen in the direct microscopic exam. The patient started antiparasitic treatment with ivermectin. He was discharged and did not returned for follow up. Although infection with S. stercoralis is relatively common in patients with alcoholic liver cirrhosis, ascites infected with Strongyloides corresponds to an infrequent form of presentation. This case shows the importance of diagnostic paracentesis in every cirrhotic patient. It is important to consider atypical presentation of Strongyloides infection in the immunocompromised host, considering it could be fatal without treatment.


Subject(s)
Humans , Animals , Male , Strongyloidiasis/complications , Strongyloidiasis/physiopathology , Strongyloidiasis/drug therapy , Strongyloides stercoralis/isolation & purification , Liver Cirrhosis/etiology , Liver Cirrhosis/parasitology , Liver Cirrhosis/drug therapy , Ascites/parasitology , Ivermectin/therapeutic use , Ascitic Fluid/parasitology , Treatment Outcome , Antiparasitic Agents/therapeutic use
5.
Article in English | WPRIM | ID: wpr-762455

ABSTRACT

BACKGROUND: Anti-carbohydrate antibody responses, including those of anti-blood group ABO antibodies, are yet to be thoroughly studied in humans. Because anti-ABO antibody-mediated rejection is a key hurdle in ABO-incompatible transplantation, it is important to understand the cellular mechanism of anti-ABO responses. We aimed to identify the main human B cell subsets that produce anti-ABO antibodies by analyzing the correlation between B cell subsets and anti-ABO antibody titers. METHODS: Blood group A-binding B cells were analyzed in peritoneal fluid and peripheral blood samples from 43 patients undergoing peritoneal dialysis and 18 healthy volunteers with blood group B or O. The correlation between each blood group A-specific B cell subset and anti-A antibody titer was then analyzed using Pearson's correlation analysis. RESULTS: Blood group A-binding B cells were enriched in CD27⁺CD43⁺CD1c− B1, CD5⁺ B1, CD11b⁺ B1, and CD27⁺CD43⁺CD1c+ marginal zone-B1 cells in peripheral blood. Blood group A-specific B1 cells (P=0.029 and R=0.356 for IgM; P=0.049 and R=0.325 for IgG) and marginal zone-B1 cells (P=0.011 and R=0.410 for IgM) were positively correlated with anti-A antibody titer. Further analysis of peritoneal B cells confirmed B1 cell enrichment in the peritoneal cavity but showed no difference in blood group A-specific B1 cell enrichment between the peritoneal cavity and peripheral blood. CONCLUSIONS: Human B1 cells are the key blood group A-specific B cells that have a moderate correlation with anti-A antibody titer and therefore constitute a potential therapeutic target for successful ABO-incompatible transplantation.


Subject(s)
Antibodies , Antibody Formation , Ascitic Fluid , B-Lymphocyte Subsets , B-Lymphocytes , Healthy Volunteers , Humans , Immunoglobulin M , Peritoneal Cavity , Peritoneal Dialysis
6.
Einstein (Säo Paulo) ; 18: eAO5294, 2020. tab, graf
Article in English | LILACS | ID: biblio-1090061

ABSTRACT

ABSTRACT Objective To analyze and compare the expression of Toll-like receptors by regulatory T cells present in the peritoneal fluid of patients with and without endometriosis. Methods Regulatory T cells were isolated from peritoneal fluid of women with and without endometriosis, collected during surgery, and mRNA was extracted for analysis of Toll-like receptors expression by reverse-transcriptase polymerase chain reaction. Results Patients with endometriosis presented regulatory T cells expressing a larger number and variety of Toll-like receptors when compared to regulatory T cells from patients in the Control Group. Toll-like receptor-1 and Toll-like receptor-2 in regulatory T cells were expressed in both groups. All other expressed Toll-like receptors types were only found in regulatory T cells from the Endometriosis Group. Conclusion Patients with endometriosis had peritoneal regulatory T cells expressing various Toll-like receptors types.


RESUMO Objetivo Analisar e comparar a expressão de receptores do tipo Toll por células T reguladoras presentes no líquido peritoneal de pacientes com endometriose. Métodos Células T reguladoras foram isoladas do líquido peritoneal de mulheres com e sem endometriose, coletadas durante a cirurgia, e o RNAm foi extraído para análise da expressão de receptores do tipo Toll por reação em cadeia da polimerase com transcriptase reversa. Resultados Pacientes com endometriose apresentaram células T reguladoras expressando maior número e variedade de Toll por células quando comparadas com T reguladoras de pacientes do Grupo Controle. Receptores do tipo Toll-1 e receptores do tipo Toll-2 foram expressos em ambos os grupos. Todos os outros tipos de receptores Toll foram encontrados expressos apenas em células T reguladoras do grupo com endometriose. Conclusão Pacientes com endometriose apresentaram células T reguladoras peritoneais expressando vários tipos de receptores tipo Toll.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Ascitic Fluid/pathology , T-Lymphocytes, Regulatory/chemistry , Endometriosis/pathology , Endometrium/pathology , Toll-Like Receptors/analysis , Reference Values , Ascitic Fluid/immunology , Body Mass Index , Case-Control Studies , T-Lymphocytes, Regulatory/immunology , Statistics, Nonparametric , Reverse Transcriptase Polymerase Chain Reaction , Endometriosis/immunology , Endometrium/immunology , Visual Analog Scale
7.
Biol. Res ; 53: 13, 2020. tab, graf
Article in English | LILACS | ID: biblio-1100919

ABSTRACT

BACKGROUND: Gallbladder cancer (GBC) is the most common tumor of the biliary tract. The incidence of GBC shows a large geographic variability, being particularly frequent in Native American populations. In Chile, GBC represents the second cause of cancer-related death among women. We describe here the establishment of three novel cell lines derived from the ascitic fluid of a Chilean GBC patient, who presented 46% European, 36% Mapuche, 12% Aymara and 6% African ancestry. RESULTS: After immunocytochemical staining of the primary cell culture, we isolated and comprehensively characterized three independent clones (PUC-GBC1, PUC-GBC2 and PUC-GBC3) by short tandem repeat DNA profiling and RNA sequencing as well as karyotype, doubling time, chemosensitivity, in vitro migration capability and in vivo tumorigenicity assay. Primary culture cells showed high expression of CK7, CK19, CA 19-9, MUC1 and MUC16, and negative expression of mesothelial markers. The three isolated clones displayed an epithelial phenotype and an abnormal structure and number of chromosomes. RNA sequencing confirmed the increased expression of cytokeratin and mucin genes, and also of TP53 and ERBB2 with some differences among the three cells lines, and revealed a novel exonic mutation in NF1. The PUC-GBC3 clone was the most aggressive according to histopathological features and the tumorigenic capacity in NSG mice. CONCLUSIONS: The first cell lines established from a Chilean GBC patient represent a new model for studying GBC in patients of Native American descent.


Subject(s)
Humans , Animals , Male , Middle Aged , Antigens, Tumor-Associated, Carbohydrate/genetics , Indians, South American/genetics , Gallbladder Neoplasms/genetics , Ascitic Fluid/metabolism , Tumor Cells, Cultured , Carcinogenicity Tests , Chile , DNA Fingerprinting , Tumor Suppressor Protein p53/genetics , Cisplatin/pharmacology , Mice, Inbred NOD , Clone Cells/drug effects , Clone Cells/metabolism , Sequence Analysis, RNA , Receptor, ErbB-2/genetics , Genes, erbB-2/genetics , Gene Expression Profiling , Cell Line, Tumor/drug effects , Cell Line, Tumor/metabolism , Deoxycytidine/analogs & derivatives , Deoxycytidine/pharmacology , Epithelial Cells/metabolism , Keratin-19/genetics , Keratin-7/genetics , Carcinogenesis/genetics , Gallbladder Neoplasms/metabolism , Antineoplastic Agents/pharmacology
8.
Arq. bras. med. vet. zootec. (Online) ; 71(3): 869-877, May-June 2019. tab
Article in English | ID: biblio-1011305

ABSTRACT

The objective of this study was to determine the frequency of different categories of specific and general classification in canine cavitary effusions (CE), as well as their association with the underlying etiologies. The laboratorial and clinical data from 304 cases of canine CE were retrospectively assessed. In 32.9% (100 cases), at least one of the specific classification categories was established, with a subtotal predominance of neoplasia (42%), bacterial serositis (24%) and hemorrhage (16%). Neoplasia was confirmed by effusion cytology in 57.5% of the cases with histopathological confirmation. From the cases in which the specific classification was not obtained, 35.8% were classified as modified transudate, 30.4% as pure transudate, 21.1% % as exudate and 12.7% was not included in any general category. The most common causes of effusion among these cases were hypoproteinemia and/or hipoalbuminemia (HPHA) (25.8%), hepatopathy (22.5%), cardiac insufficiency (15.5%) and cytologically undetected cases of neoplasia (12.4%). In conclusion, HPHA, hepatopathy and neoplasia represents important etiologies for canine CE development. Classification of effusions, solely based on [TP] and TNCC, might be an inaccurate diagnostic tool of effusions. New laboratorial classification methods for canine CE should be researched.(AU)


O objetivo deste estudo foi determinar a frequência de diferentes categorias de classificação específica e geral em efusões cavitárias (EC) caninas, bem como sua associação com as etiologias subjacentes. Os dados laboratoriais e clínicos de 304 casos de EC canina foram avaliados retrospectivamente. Em 32,9% (100 casos), pelo menos uma das categorias específicas de classificação foi estabelecida, com predomínio subtotal de neoplasia (42%), serosite bacteriana (24%) e hemorragia (16%). A neoplasia foi confirmada pela citologia da efusão em 57,5% dos casos com confirmação histopatológica. Dos casos em que a classificação específica não foi obtida (204 casos), 35,8% foram classificados como transudato modificado, 30,4% como transudato puro, 21,1% como exsudato e 12,7% não foram incluídos em nenhuma categoria geral. As causas mais comuns de efusão nestes casos foram hipoproteinemia e/ou hipoalbuminemia (HPHA) (25,8%), hepatopatia (22,5%), insuficiência cardíaca (15,5%) e casos de neoplasia citologicamente não detectados (12,4%). Em conclusão, HPHA, hepatopatia e neoplasia representam importantes etiologias para o desenvolvimento da EC canina. A classificação geral de efusões, baseada exclusivamente em proteína e celularidade, pode ser uma ferramenta diagnóstica imprecisa. Novos métodos de classificação laboratorial para ECs caninas devem ser pesquisados.(AU)


Subject(s)
Animals , Dogs , Pericardial Effusion/pathology , Pericardial Effusion/veterinary , Pleural Effusion/pathology , Pleural Effusion/veterinary , Ascitic Fluid/pathology , Dog Diseases , Exudates and Transudates
9.
Mali méd. (En ligne) ; 34(2): 18-22, 2019. ilus
Article in French | AIM | ID: biblio-1265739

ABSTRACT

Introduction : Les ascites métastatiques cancéreuses sont caractérisées par la présence de cellules cancéreuses métastatiques dans le liquide péritonéal. Elles sont fréquentes à un stade avancé des cancers. Il s'agissait de déterminer la contribution de la cytologie au diagnostic et à l'évaluation du pronostic des ascites métastatiques dans le service d'Anatomie et Cytologie Pathologiques du CHU du Point G. Matériel et méthode : Notre étude s'est étendue de Janvier 2013 à Décembre 2015; soit une période de 3 ans. Elle était rétrospective et prospective incluant tous les patients dont l'étude cytologique des liquides d'ascitea mis en évidence des cellules malignes. Le dossier médical des patients a été exploité pour la recherche du site primitif et du diagnostic histologique éventuel et le suivi. Résultats : Sur 213 examens cytologiques de liquide d'ascite; 61 étaient malins, soit un taux de 28,64%. La tranche d'âge la plus répresentée était de 46 à 60 ans avec un âge moyen de 53,7 ± 14,7 ans. Le sexe féminin était dominant avec un taux de 66%. La profession la plus fréquente était les ménagères soit un taux de 50,82%. Le siège primitif le plus fréquent était l'ovaire (26%). Il était suivi par le foie et l'estomac avec respectivement 20% et 18%. L'ascite a été le signe révélateur du cancer dans 36% des cas. Elle était isolée dans 78%. Après 6 mois de suivi, le taux de mortalité était 75,6%. Conclusion : L'examen cytologique constitue un examen paraclinique dans le diagnoticdes ascites métastatiques cancéreuses


Subject(s)
Ascites/diagnosis , Ascitic Fluid , Cell Biology , Mali , Neoplasms , Prognosis
10.
Zagazig univ. med. j ; 25(3): 317-325, 2019. tab
Article in English | AIM | ID: biblio-1273853

ABSTRACT

Background: Spontaneous Bacterial Peritonitis (SBP) is the most frequent bacterial infection in cirrhotic patients with ascites. The mortality rate in those patients ranges from 40-70%.Aim: to assess level of serum and ascetic fluid polymorph nuclear leucocytes (PMN), high sensitive C reactive protein (hs-CRP) in patients with SBP before and after treatment. Methods: A cohort study was done on 114 patients SBP admitted in the Internal Medicine, Faculty of Medicine, Zagazig University during the period from December 2017 to September 2018. All patients were subjected to full history taking, thorough clinical examination, routine laboratory investigation, ultrasonography and ascitic fluid sampling. They was followed up for 5 days from starting treatment by parenteral third generation cephalosporin and peripheral blood (PMN), serum (hs-CRP), ascitic fluid PMN and hs-CRP were measured again.Results: the largest percentage of the patients were male, had posthepatitic C cirrhosis and child C score. There was statistically non-significant difference between antibiotic responders and non-responders regarding peripheral blood PMN before or five days after antibiotic use. There was statistically non-significant difference in ascitic fluid PMN, serum and ascitic fluid hs-CRP before treatment while the difference is significant between both groups regarding them five days after treatment. Percent change in serum hs-CRP was equal to that of ascitic fluid PMN. Percent change in ascitic fluid hs-CRP was comparable to that of ascitic fluid PMN. Conclusion: Serum and ascitic fluid hs-CRP level can be considered as alternative prognostic markers in cirrhotic patients with SBP


Subject(s)
Ascitic Fluid , C-Reactive Protein/metabolism , Egypt , Peritonitis , Peritonitis/diagnosis , Prognosis
11.
Article in English | WPRIM | ID: wpr-787201

ABSTRACT

A differential diagnosis of ascites is always challenging for physicians. Peritoneal tuberculosis is particularly difficult to distinguish from peritoneal carcinomatosis because of the similarities in clinical manifestations and laboratory results. Although the definitive diagnostic method for ascites is to take a biopsy of the involved tissues through laparoscopy or laparotomy, there are many limitations in performing biopsies in clinical practice. For this reason, physicians have attempted to find surrogate markers that can substitute for a biopsy as a confirmative diagnostic method for ascites. CA 125, which is known as a tumor marker for gynecological malignancies, has been reported to be a biochemical indicator for peritoneal tuberculosis. On the other hand, the sensitivity of serum CA 125 is low, and CA 125 may be elevated due to other benign or malignant conditions. This paper reports the case of a 66-year-old male who had a moderate amount of ascites and complained of dyspepsia and a febrile sensation. His abdominal CT scans revealed a conglomerated mass, diffuse omental infiltration, and peritoneal wall thickening. Initially, peritoneal tuberculosis was suspected due to the clinical symptoms, CT findings, and high serum CA 125 levels, but non-specific malignant cells were detected on cytology of the ascitic fluid. Finally, he was diagnosed with primary malignant peritoneal mesothelioma after undergoing a laparoscopic biopsy.


Subject(s)
Aged , Ascites , Ascitic Fluid , Biomarkers , Biopsy , CA-125 Antigen , Carcinoma , Diagnosis, Differential , Dyspepsia , Hand , Humans , Laparoscopy , Laparotomy , Male , Mesothelioma , Methods , Peritoneum , Peritonitis, Tuberculous , Sensation , Tomography, X-Ray Computed
12.
Chinese Acupuncture & Moxibustion ; (12): 1294-1298, 2019.
Article in Chinese | WPRIM | ID: wpr-781791

ABSTRACT

OBJECTIVE@#To observe the clinical efficacy of adjuvant therapy of moxibustion combined with formula for peritoneal effusion of ovarian malignant tumors.@*METHODS@#Sixty patients with peritoneal effusion of ovarian malignant tumors were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the control group were treated with intravenous infusion of paclitaxel liposome at the first day and cisplatin at the 2nd to 4th day, 21 days as a course of treatment, and 4 courses were given. Based on the treatment of the control group, the patients in the observation group were treated by moxibustion combined with formula. Moxibustion was applied at Mingmen (GV 4), Pishu (BL 20), Shenshu (BL 23), Shenque (CV 8), Guanyuan (CV 4), Zigong (EX-CA 1), Zhongwan (CV 12), Shuifen (CV 9), Qihai (CV 6) and Zhongji (CV 3), each acupoint for 30 min, once a day for 12 weeks. formula was taken twice orally, one dose a day, 2 weeks as a course of treatment, and 6 courses were given. The levels of , , and / in peripheral blood were measured before and after 12-week treatment in the two groups. The changes of peritoneal effusion volume and Karnofsky performance status scale (KPS) score before and after treatment were compared between the two groups, and the clinical efficacy of the two groups was evaluated.@*RESULTS@#The symptom improvement rate was 96.7% (29/30) and overall effective rate was 86.7% (26/30) in the observation group, which were significantly superior to those in the control group [80.0% (24/30) and 56.7% (17/30), 0.05), and the increase in the observation group was significantly higher than that in the control group (<0.05). After treatment, the volume of peritoneal effusion in the two groups was decreased (<0.01), and the reduced volume in the observation group was higher than that in the control group (<0.05). After treatment, KPS scores were increased significantly in both two groups (<0.01), and the increase in the observation group was higher than that in the control group (<0.05). The incidence rate of adverse reactions in the observation group was lower than that in the control group [23.3% (7/30) vs 53.3% (16/30), <0.05].@*CONCLUSION@#Moxibustion combined with formula could effectively improve the immune function, reduce the volume of peritoneal effusion, improve the symptom improvement rate, overall effective rate and the quality of life, and reduce the incidence of adverse reactions in chemotherapy of patients with peritoneal effusion of ovarian malignant tumors.


Subject(s)
Acupuncture Points , Ascitic Fluid , Humans , Moxibustion , Neoplasms , Quality of Life
14.
Article in English | WPRIM | ID: wpr-761553

ABSTRACT

A differential diagnosis of ascites is always challenging for physicians. Peritoneal tuberculosis is particularly difficult to distinguish from peritoneal carcinomatosis because of the similarities in clinical manifestations and laboratory results. Although the definitive diagnostic method for ascites is to take a biopsy of the involved tissues through laparoscopy or laparotomy, there are many limitations in performing biopsies in clinical practice. For this reason, physicians have attempted to find surrogate markers that can substitute for a biopsy as a confirmative diagnostic method for ascites. CA 125, which is known as a tumor marker for gynecological malignancies, has been reported to be a biochemical indicator for peritoneal tuberculosis. On the other hand, the sensitivity of serum CA 125 is low, and CA 125 may be elevated due to other benign or malignant conditions. This paper reports the case of a 66-year-old male who had a moderate amount of ascites and complained of dyspepsia and a febrile sensation. His abdominal CT scans revealed a conglomerated mass, diffuse omental infiltration, and peritoneal wall thickening. Initially, peritoneal tuberculosis was suspected due to the clinical symptoms, CT findings, and high serum CA 125 levels, but non-specific malignant cells were detected on cytology of the ascitic fluid. Finally, he was diagnosed with primary malignant peritoneal mesothelioma after undergoing a laparoscopic biopsy.


Subject(s)
Aged , Ascites , Ascitic Fluid , Biomarkers , Biopsy , CA-125 Antigen , Carcinoma , Diagnosis, Differential , Dyspepsia , Hand , Humans , Laparoscopy , Laparotomy , Male , Mesothelioma , Methods , Peritoneum , Peritonitis, Tuberculous , Sensation , Tomography, X-Ray Computed
15.
Article in English | WPRIM | ID: wpr-760364

ABSTRACT

The goals of this study were, first, to evaluate the feasibility of inducing gastric perforation with 99% alcohol injection after electrocautery (EA-method), and, second, to observe “enhanced peritoneal stripe sign (EPSS)” and other lesions upon induction of gastric perforation. Six clinically normal beagle dogs were prepared for gastric perforation using endoscopy. After gastric perforation, EPSS and other lesions on ultrasonography were observed eventually (at 0 h, 3 h, day 1, day 2, day 3, day 4, day 5, and day 6). We graded the EPSS depending on its width and number. EPSS was observed until day 4 of the examination in all the 6 dogs. The grades of EPSS were the highest at 3 h and declined gradually. Peritoneal effusion was observed in all dogs at 3 h and on day 1. Regional bright mesenteric fat was confirmed in all dogs on days 3 and 4. In conclusion, gastric perforation can be induced by EA-method. EPSS and peritoneal effusion appear at a very early stage, and regional bright mesenteric fat was identified on days 3 and 4 in almost all dogs with gastric perforation.


Subject(s)
Animals , Ascitic Fluid , Dogs , Electrocoagulation , Endoscopy , Pneumoperitoneum , Ultrasonography
16.
Rev. chil. cir ; 70(4): 367-372, ago. 2018. ilus
Article in Spanish | LILACS | ID: biblio-959398

ABSTRACT

Resumen Introducción: La tuberculosis abdominal es un problema reemergente, y es una de las enfermedades transmisibles más importante en todo el mundo. A pesar de las expectativas acerca de su erradicación en países en desarrollo, ha sido recientemente declarada de nuevo como una patología de emergencia mundial. Con el aumento de su incidencia y prevalencia, su forma abdominal es una de las presentaciones de afectación extrapulmonar más comunes. Objetivo: Dado que la tuberculosis puede afectar diversos órganos, tiene una amplia gama y gran espectro de signos y síntomas que dificultan su diagnóstico y retrasan el tratamiento. Por esto, se realiza esta revisión de tema, concentrándonos en que el alto índice de sospecha debe ser un factor importante en el diagnóstico precoz, para que una vez establecido, se pueda iniciar el tratamiento ayudando a prevenir y disminuir las altas tasas de morbilidad y mortalidad evidenciadas en la actualidad. Caso Clínico: Paciente joven con presencia de ascitis secundaria a tuberculosis abdominal confirmada por una biopsia y el aumento de la adenosin deaminasa en el líquido peritoneal. Se describen los principales hallazgos clínicos, paraclínicos, estudios imagenológicos y tratamiento.


Introduction: Abdominal tuberculosis is a reemerging problem and is one of the most important communicable diseases in the world. Despite expectations about the eradication in developing countries, it has recently been re-declared as a global emergency pathology. The increased incidence and prevalence shows an abdominal shape as one of the most common extrapulmonary involvement presentations. Objective: Since tuberculosis can affect various organs, it has a wide range and spectrum of signs and symptoms that make diagnosis difficult and delay treatment. Therefore, this review of the topic is done, concentrating on the fact that the high suspicion index should be an important factor in the early diagnosis. Treatment can be initiated helping to prevent and reduce high morbidity and mortality rates. Case Report: We present a case of a young patient with ascites secondary to abdominal tuberculosis confirmed by biopsy and increased adenosine deaminase in the peritoneal fluid. The main clinical findings, paraclinic, imaging studies and treatment are described.


Subject(s)
Humans , Male , Young Adult , Tuberculosis, Gastrointestinal/diagnosis , Tuberculosis, Gastrointestinal/enzymology , Peritonitis, Tuberculous/diagnosis , Peritonitis, Tuberculous/enzymology , Tuberculosis, Gastrointestinal/surgery , Peritonitis, Tuberculous/surgery , Ascitic Fluid/chemistry , Radiography, Thoracic , Tomography, X-Ray Computed , Adenosine Deaminase/analysis , Diagnosis, Differential
17.
Cambios rev. méd ; 17(1): 48-51, ene. - 2018. ^etab
Article in Spanish | LILACS | ID: biblio-981099

ABSTRACT

Introducción. El tratamiento adecuado de la cavidad peritoneal en la peritonitis secundaria constituye una preocupación permanente de los cirujanos y es primordial en el manejo integral del paciente. Objetivo. Evaluar los resultados de lavar la cavidad abdominal frente al secado peritoneal en los casos de peritonitis secundaria, por apendicitis aguda perforada. Material y métodos. Estudio observacional retrospectivo en el Servicio de Cirugía General del Hospital de Especialidades Carlos Andrade Marín, período enero 2016 a diciembre 2017. Se incluyeron 301 historias clínicas de pacientes con diagnóstico de apendicitis aguda perforada. El objetivo principal del estudio fue evaluar las complicaciones presentadas con cada uno de los procedimientos quirúrgicos empleados. Resultados. Los registros de 301 pacientes, 212 (70,4%) sometidos a lavado peritoneal y 89 (29,6%) a secado del peritoneo. La frecuencia de complicaciones entre los grupos estudiados fue similar, no hubo diferencias significativas. La única variable significativa fue el tiempo operatorio (OR 1,01, p<0,005). Conclusiones. No se encontraron diferencias significativas con el tipo de manejo de cavidad en pacientes con peritonitis secundaria a apendicitis aguda perforada (lavado versus secado de cavidad) en cuanto a complicaciones posoperatorias. El lavado peritoneal requirió un tiempo quirúrgico mayor al secado de la cavidad.


Introduction. The adequate treatment of the peritoneal cavity in peritonitis is a primary concern in the comprehensive management of the patient. Objective. To compare the results of thoroughly washing the peritoneal cavity vs simply just drying the peritoneal cavity in cases of secondary peritonitis due to acute perforated appendicitis. Materials and methods. A retrospective observational study was carried out in the General Surgery Department at Carlos Andrade Marín Specialties Hospital, from January 2016 until December 2017. The study main end-point was assessing the postoperative complication between peritoneal lavage versus cavity drying. Results. The records of 301 patients, 212 (70.4%) who underwent peritoneal lavage and 89 (29.6%) with just drying the peritoneum. The frequency of complications between both groups did not reach statistical significance. The only significant variable was the operative time (OR 1.01, p<0.005). Conclusions. No statistically significant differences were found with the type of cavity management in patients with peritonitis secondary to perforated appendicitis (lavage versus cavity drying). Peritoneal lavage required more time than cavity drying.


Subject(s)
Humans , Appendicitis , Peritoneal Cavity , Peritonitis , Peritoneal Lavage , Ascitic Fluid
18.
Article in English | WPRIM | ID: wpr-713411

ABSTRACT

Large-volume paracentesis-induced intraperitoneal hemorrhage due to pseudoaneurysm formation is rarely reported. Here, we present a 56-year-old man with alcoholic liver cirrhosis admitted for massive ascites. Large-volume paracentesis was performed. Three days later, he became pale and complained of dyspnea and abdominal distention with hypotension. Percutaneous iliac angiography revealed contrast media leakage from a branch of the left circumflex iliac artery with pseudoaneurysm. He was successfully treated with microcoil embolization. Several days later, ascitic fluid increased and large-volume paracentesis was performed again. Two days later, his hemoglobin level suddenly decreased. An abdominal computed tomography scan showed new active bleeding at the left lower lateral peritoneal cavity, just anterior to the metalic coils. Percutaneous iliac angiography revealed contrast media extravasation from a branch of the left inferior epigastric artery with formation of collateral vessel. Percutaneous embolization was successfully performed again. After coil embolization, there were no further bleeding episodes.


Subject(s)
Aneurysm, False , Angiography , Ascites , Ascitic Fluid , Contrast Media , Dyspnea , Embolization, Therapeutic , Epigastric Arteries , Extravasation of Diagnostic and Therapeutic Materials , Hemorrhage , Humans , Hypotension , Iliac Artery , Liver Cirrhosis , Liver Cirrhosis, Alcoholic , Middle Aged , Paracentesis , Peritoneal Cavity
19.
Neonatal Medicine ; : 196-201, 2018.
Article in English | WPRIM | ID: wpr-718042

ABSTRACT

Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various problems, including mechanical, infectious, and thrombotic complications in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extravasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chyloperitoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperitoneum develops in newborns with an indwelling catheter. UVC positions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.


Subject(s)
Abdominal Cavity , Ascitic Fluid , Catheterization , Catheters , Catheters, Indwelling , Chylous Ascites , Heart , Humans , Infant, Newborn , Liver , Lung , Parenteral Nutrition, Total , Triglycerides
20.
Intestinal Research ; : 467-474, 2018.
Article in English | WPRIM | ID: wpr-715879

ABSTRACT

BACKGROUND/AIMS: Early diagnosis of peritoneal metastases in patients with colorectal cancer (CRC) can influence patient prognosis. The aim of this study was to identify the clinical significance of carcinoembryonic antigen (CEA) in peritoneal fluid detected during operation in stage I–III CRC patients. METHODS: Between April 2009 and April 2015, we reviewed medical records from a total of 60 stage I–III CRC patients who had peritoneal fluid collected during operation. Patients who had positive cytology in the assessment of peritoneal fluid were excluded. We evaluated the values of CEA in peritoneal fluid (pCEA) to predict the long-term outcomes of these patients using Kaplan-Meier curves and Cox regression models. RESULTS: The median follow-up duration was 37 months (interquartile range, 21–50 months). On receiver operating characteristic analysis, pCEA had the largest area under the curve (0.793; 95% confidence interval, 0.635–0.950; P=0.001) with an optimal cutoff value of 26.84 (sensitivity, 80.0%; specificity, 76.6%) for predicting recurrence. The recurrence rate was 8.1% in patients with low pCEA ( < 26.84 ng/mL, n=37), and 52.2% in patients with high pCEA (≥26.84 ng/mL, n=23). In multivariate Cox regression analysis, high pCEA (≥26.84 ng/mL) was a risk factor for poor cancer-free survival (CFS) in stage I–III patients. CONCLUSIONS: In this study, we determined that high pCEA (≥26.84 ng/mL) detected during operation was helpful for the prediction of poor CFS in patients with stage I–III CRC.


Subject(s)
Ascitic Fluid , Carcinoembryonic Antigen , Colorectal Neoplasms , Early Diagnosis , Follow-Up Studies , Humans , Medical Records , Neoplasm Metastasis , Prognosis , Recurrence , Risk Factors , ROC Curve , Sensitivity and Specificity
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