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1.
Cancer Invest ; 37(9): 440-452, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31530033

RESUMO

Ovarian cancer is the deadliest gynecologic cancer. The large-scale microRNA (miRNA) expression profiling and individual miRNA validation was performed to find potential novel biomarkers for ovarian cancer. The most consistent overexpression of miRs-200b-3p, 135 b-5p and 182-5p was found in both ascitic fluid and tumors and suggests their potential as oncogenes. miR-451a was consistently underexpressed so may be a tumor suppressor. Results were inconsistent for miR-204-5p, which was overexpressed in ascitic fluid but underexpressed in tumor tissue. miR-203a-3p was generally overexpressed but this failed to be proved in independent sample set in tissue validation.


Assuntos
Líquido Ascítico/química , Biomarcadores Tumorais/genética , Perfilação da Expressão Gênica/métodos , MicroRNAs/genética , Neoplasias Ovarianas/genética , Ovário/química , Idoso , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Neoplasias Ovarianas/patologia , Prognóstico
2.
Curr Drug Deliv ; 16(7): 654-662, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31418659

RESUMO

BACKGROUND: Prolonged chemodrug delivery to the tumor site is a prerequisite to maintaining its localised therapeutic concentrations for effective treatment of malignant solid tumors. OBJECTIVE: The current study aims to develop implantable polymeric depots through conventional electrospinning for sustained drug delivery, specifically to the peritoneum. METHODS: Non-woven electrospun mats were fabricated by simple electrospinning of Polydioxanone solution loaded with the chemodrug, Paclitaxel. The implants were subjected to the analysis of morphology, mechanical properties, degradation and drug release in phosphate buffer and patient-derived peritoneal drain fluid samples. In vivo studies were conducted by surgical knotting of these implants to the peritoneal wall of healthy mice. RESULTS: Non-woven electrospun mats with a thickness of 0.65±0.07 mm, weighing ~ 20 mg were fabricated by electrospinning 15 w/v% polymer loaded with 10 w/w% drug. These implants possessing good mechanical integrity showed a drug entrapment efficiency of 87.82±2.54 %. In vitro drug release studies in phosphate buffer showed a sustained profile for ~4 weeks with a burst of 10 % of total drug content, whereas this amounted to >60% in patient samples. Mice implanted with these depots remained healthy during the study period. The biphasic drug release profile obtained in vivo showed a slow trend, with peritoneal lavage and tissues retaining good drug concentrations for a sustained period. CONCLUSION: The results indicate that non-woven electrospun mats developed from biodegradable Polydioxanone polymer can serve as ideal candidates for easily implantable drug depots to address the challenges of peritoneal metastasis in ovarian cancer.


Assuntos
Antineoplásicos Fitogênicos/administração & dosagem , Sistemas de Liberação de Medicamentos , Nanofibras/administração & dosagem , Paclitaxel/administração & dosagem , Polidioxanona/administração & dosagem , Animais , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/farmacocinética , Líquido Ascítico/química , Liberação Controlada de Fármacos , Feminino , Humanos , Injeções Intraperitoneais , Camundongos Endogâmicos BALB C , Nanofibras/química , Neoplasias Ovarianas , Paclitaxel/química , Paclitaxel/farmacocinética , Polidioxanona/química , Polidioxanona/farmacocinética
3.
Ethiop J Health Sci ; 29(3): 383-390, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31447507

RESUMO

Background: The aim of this study was to assess the role of transabdominal ultrasonography in characterizing and determining the etiology of ascites in comparison with laboratory ascitic fluid analysis and other methods used to establish the final diagnosis. Methods: A prospective descriptive study was conducted on 61 patients with ascites attending outpatient department (OPD) or admitted to wards of Tikur Anbesa Specialized Hospital (TASH) and referred to radiology department for imaging from June 2017 to November 2017. Data were collected following the internationally recommended scanning technique in consecutive bases. The data were analyzed using SPSS version 20. The comparison of ultrasound and laboratory findings with final clinical diagnosis was analyzed using Chi-square test (X2). Results: Of 61 patients with ascites enrolled in this study, females were 35(57.4%) with age range of 16 to 75 and mean age of 43.2±14.11. The cause of ascites was established in 59 cases using a combination of clinical, pathological, imaging evidences and tumor markers. However there were two cases who had ascites with indeterminate cause. US suggested the diagnosis in 54(91.5%) patients. Excluding mixed and indeterminate cases, ultrasound characterized ascites correctly as exudate and transudate in 95% cases. Conclusion: Ultrasound has significant accuracy to distinguish transudate and exudate ascites and in suggesting the underlying cause. It can be a valuable method of investigation of ascites in places where CT and MRI are not available, and it is the best complement for laboratory investigations on ascites in suggesting the etiology based on ascitic fluid texture and ancillary findings.


Assuntos
Ascite/diagnóstico por imagem , Ultrassonografia , Adolescente , Adulto , Idoso , Ascite/diagnóstico , Ascite/etiologia , Líquido Ascítico/química , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
4.
Pancreatology ; 19(5): 646-652, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31301995

RESUMO

BACKGROUND & AIM: Ascites in patients with acute pancreatitis (AP) is understudied although recent literature hints at its evident role in the final outcome. This study was planned to study the characteristics of ascites in patients of AP and its effect on the disease course and outcome. METHODS: Consecutive patients of AP were studied and patients with or without ascites were evaluated for the baseline parameters and severity assessment. Ascites was quantified and fluid analyzed for its characteristics. Intraabdominal pressure (IAP) was monitored. The various outcome parameters were compared between the two groups of patients with and without ascites. RESULTS: Of the cohort of 213 patients, 82 (38.5%) developed ascites. Ascites group had significantly higher rates of organ failure (p = 0.001), necrosis (p=<0.001) and higher severity assessment scores. The ascites group had significantly longer hospital and ICU stay and higher ventilator days compared to the non-ascites group. Mortality was also higher in the ascites group (34.1% vs 8.45; p = 0.001). Majority of patients with ascites had moderate to gross ascites (75.6%), low serum ascites albumin gradient (87.8%) with low amylase levels (71.9%). Sub-group analysis in ascites group showed that patients with fatal outcome had higher rates of moderate to gross ascites, higher baseline IAP and lower reduction in IAP after 48 h. Moderate to gross ascites and grades of intra-abdominal hypertension (IAH) were significant predictors of mortality (AUC - 0.76). CONCLUSION: AP patients with ascites have a more severe disease with poorer outcome. Higher degrees of ascites and IAH grades are significant predictors of mortality.


Assuntos
Ascite/patologia , Pancreatite/patologia , Doença Aguda , Adulto , Amilases/metabolismo , Líquido Ascítico/química , Líquido Ascítico/patologia , Estudos de Coortes , Feminino , Humanos , Hipertensão Intra-Abdominal/etiologia , Hipertensão Intra-Abdominal/fisiopatologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pancreatite/mortalidade , Pancreatite/terapia , Paracentese , Valor Preditivo dos Testes , Resultado do Tratamento
5.
Iran J Immunol ; 16(2): 151-162, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31182689

RESUMO

BACKGROUND: Endometriosis is a chronic inflammatory disease with the growth of endometrial cells out of uterus and in the peritoneal cavity. T cell subsets participate in the establishment and progress of the disease by producing different cytokines. OBJECTIVE: To investigate a group of cytokines related to Th1/Th2/Th17/Treg subsets within both peripheral blood and peritoneal fluid (PF) samples from infertile endometriosis women. METHODS: Peripheral blood and PF samples were collected from 30 infertile endometriosis and 30 non-endometriosis fertile women during laparoscopy. Concentration of cytokines, including TNF-α, IFN-γ, TGF-ß1, IL-4, IL-10, IL-17 and IL-23 were evaluated using ELISA method. RESULTS: Results indicated that the concentration of IFN-γ within serum was significantly reduced in endometriosis group (p=0.001). Regarding PF cytokines, TGF-ß1 was increased in endometriosis group (p=0.030). Furthermore, the ratios of IFN-γ/TGF-ß1 and IL-17/IL-23 were significantly different between endometriosis and non-endometriosis women in serum samples (p<0.001 and p<0.01 respectively). The ratios of TNF-α/IL-10 and IL-17/IL-10 were also significantly different regarding PF samples between the two studied groups (p<0.04 and p<0.03 respectively). Finally, significant correlations were observed between the levels of IL-17 and IL-23, inflammatory and anti-inflammatory cytokines, in both samples and serum to PF inflammatory cytokines. CONCLUSION: Based on the results of the present study, in women with endometriosis, the disturbance of cytokines network might gradually activate the inflammatory responses and tissue repair, resulting in endometriosis development after several years.


Assuntos
Citocinas/imunologia , Endometriose/imunologia , Endométrio/patologia , Infertilidade Feminina/imunologia , Subpopulações de Linfócitos T/imunologia , Adulto , Líquido Ascítico/química , Líquido Ascítico/imunologia , Citocinas/análise , Citocinas/sangue , Endometriose/complicações , Feminino , Humanos , Infertilidade Feminina/complicações , Pessoa de Meia-Idade , Adulto Jovem
7.
Equine Vet J ; 51(6): 727-732, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30854696

RESUMO

BACKGROUND: Strangulating small intestinal disease (SSID) carries a poor prognosis for survival in comparison to other types of colic, particularly if resection is required. Identification of markers which aid early diagnosis may prevent the need for resection, assist with more accurate prognostication and/or support the decision on whether surgical intervention is likely to be successful, would be of significant welfare benefit. OBJECTIVES: To apply an unbiased methodology to investigate the plasma and peritoneal fluid proteomes in horses diagnosed with SSID requiring resection, to identify novel biomarkers which may be of diagnostic or prognostic value. STUDY DESIGN: Prospective clinical study. METHODS: Plasma and peritoneal fluid from horses presented with acute abdominal signs consistent with SSID was collected at initial clinical examination. Samples from eight horses diagnosed with SSID at surgery in which resection of affected bowel was performed and four control horses subjected to euthanasia for orthopaedic conditions were submitted for liquid chromatography tandem mass spectrometry. Protein expression profiles were determined using label-free quantification. Data were analysed using analysis of variance to identify differentially expressed proteins between control and all SSID horses and SSID horses which survived to hospital discharge and those which did not. Significance was assumed at P≤0.05. RESULTS: A greater number of proteins were identified in peritoneal fluid than plasma of both SSID cases and controls, with 123 peritoneal fluid and 13 plasma proteins significantly differentially expressed (DE) between cases and controls (P<0.05, ≥2 fold change). Twelve peritoneal fluid proteins (P<0.036) and four plasma proteins (P<0.05) were significantly DE between SSID horses which survived and those which did not. MAIN LIMITATIONS: A low number of samples were analysed, there was variation in duration and severity of SSID and only short-term outcome was considered. CONCLUSIONS: Changes in peritoneal fluid proteome may provide a sensitive indicator of small intestinal strangulation and provide biomarkers relevant to prognosis.


Assuntos
Líquido Ascítico/química , Doenças dos Cavalos/sangue , Enteropatias/veterinária , Animais , Biomarcadores/sangue , Biomarcadores/química , Feminino , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/patologia , Cavalos , Intestino Delgado/patologia , Masculino , Estudos Prospectivos , Proteoma
8.
Lab Med ; 50(2): 145-149, 2019 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-30169773

RESUMO

BACKGROUND: Chemistry testing is requested for body fluid (BF) specimens despite the lack of assays approved by the US Food and Drug Administration (FDA). The criteria for categorizing fluids as transudate or exudate are not validated across analyzers. OBJECTIVE: To compare BF chemical analysis and classification by different analyzers. METHODS: We analyzed 10 pleural and 18 peritoneal fluids with corresponding plasma specimens using the Vitros 5,1 FS; Abbott ARCHITECT ci8200; and Roche Modular P platforms. Total protein (TP) and lactate dehydrogenase (LDH) were measured for pleural fluids. Light's criteria were applied. Albumin was measured for peritoneal specimens, and the plasma-ascites-albumin gradient was calculated. RESULTS: TP results showed agreement. The Vitros LDH assay produced higher fluid:plasma ratios. Classification by Light's criteria resulted in 1 discrepancy (ARCHITECT). Albumin results showed agreement. There were 2 discrepant gradient interpretations (Vitros). CONCLUSIONS: These data suggest that analyses of pleural and peritoneal fluids using these platforms are diagnostically interchangeable.


Assuntos
Líquido Ascítico/química , Testes de Química Clínica/métodos , Testes de Química Clínica/normas , Derrame Pleural/metabolismo , Albuminas/análise , Humanos , Valores de Referência , Reprodutibilidade dos Testes , Albumina Sérica/análise
9.
Res Vet Sci ; 125: 421-424, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29113645

RESUMO

Intra-vitam diagnosis of feline infectious peritonitis (FIP) is a challenge for veterinary diagnosticians, since there are no highly specific and sensitive assays currently available. With the aim to contribute to fill this diagnostic gap, a total of 61 effusions from cats with suspected effusive FIP were collected intra-vitam for detection of feline coronavirus (FCoV) antibodies and RNA by means of indirect immunofluorescence (IIF) assay and real-time RT-PCR (qRT-PCR), respectively. In 5 effusions there was no evidence for either FCoV RNA or antibodies, 51 and 52 specimens tested positive by IIF and qRT-PCR, respectively, although antibody titres≥1:1600, which are considered highly suggestive of FIP, were detected only in 37 effusions. Three samples with high antibody levels tested negative by qRT-PCR, whereas 18 qRT-PCR positive effusions contained no or low-titre antibodies. qRT-PCR positive samples with low antibody titres mostly contained low FCoV RNA loads, although the highest antibody titres were detected in effusions with CT values>30. In conclusion, combining the two methods, i.e., antibody and RNA detection would help improving the intra-vitam diagnosis of effusive FIP.


Assuntos
Anticorpos Antivirais/química , Líquido Ascítico/virologia , Coronavirus Felino/imunologia , Peritonite Infecciosa Felina/virologia , RNA Viral/química , Animais , Líquido Ascítico/química , Gatos , Coronavirus Felino/genética , Peritonite Infecciosa Felina/imunologia , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Reação em Cadeia da Polimerase Via Transcriptase Reversa/veterinária
10.
Methods Mol Biol ; 1897: 125-133, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30539441

RESUMO

There is limited information regarding the biobanking of pleural and peritoneal fluids that might supplement storage of pulmonary and thoracic tissue biospecimens. Such fluids are sometimes collected for clinical analyses and may have uses that obviate or supplement tissue samples. There has been a growing interest in using liquid biopsies as they are less invasive and may be amenable to analyses that guide targeted therapies. Integrating cytology and biobanking approaches, we describe techniques that may be used for collecting and banking pleural and peritoneal fluids.


Assuntos
Líquido Ascítico/química , Bancos de Espécimes Biológicos , Manejo de Espécimes/métodos , Humanos , Bancos de Tecidos/tendências
11.
Vet Surg ; 48(2): 152-158, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30588637

RESUMO

OBJECTIVE: To determine the ability of plasma and peritoneal creatine kinase (CK) to predict the presence of a strangulating lesion in horses presented for colic. STUDY DESIGN: Prospective clinical study. ANIMALS: Ten healthy control horses and 61 clinical colic cases. METHODS: Creatine kinase activity was measured in peritoneal fluid and plasma of 10 healthy horses and 61 horses presenting for colic (40 horses with nonstrangulating lesions and 21 horses with strangulating lesions). Information on other blood and peritoneal fluid variables, signalment, results from the physical examination, outcome, requirement for surgery, and lesion location and type were retrieved from the medical records of horses presenting for colic. RESULTS: A peritoneal CK cutoff level of 16 IU/L yielded a sensitivity of 95.2% and a specificity of 84.6% (positive predictive value [PPV] = 76.9% and negative predictive value [NPV] = 97%, respectively) for predicting a strangulating lesion. A peritoneal lactate cutoff level of 3.75 mmol/L yielded a sensitivity of 81% and a specificity of 92% (PPV = 85% and NPV = 90%, respectively) for predicting a strangulating lesion. CONCLUSION: Peritoneal CK concentration was a sensitive indicator of the presence of a strangulating lesion in horses presenting with colic, whereas peritoneal lactate concentration was a more specific indicator. CLINICAL SIGNIFICANCE: Measuring CK in peritoneal fluid may be a useful adjunct to clinical case presentation to accelerate the diagnosis and definitive treatment of horses presenting with strangulating intestinal lesions, thereby improving their outcome.


Assuntos
Líquido Ascítico/química , Cólica/veterinária , Creatina Quinase/química , Doenças dos Cavalos/cirurgia , Animais , Biomarcadores/química , Cólica/cirurgia , Constrição Patológica/veterinária , Creatina Quinase/metabolismo , Feminino , Cavalos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos
12.
Ann Agric Environ Med ; 25(4): 587-592, 2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30586986

RESUMO

INTRODUCTION: Data on the possible role of peritoneal fluid free radical-mediated oxidative damage in the pathogenesis of endometriosis still remains inconsistent. The aim of the study was to determine iron metabolism markers and their influence on oxidative stress arameters in the peritoneal fluid of women with endometriosis. MATERIAL AND METHODS: 110 women with endometriosis and 119 patients with benign ovarian cysts were included in the study. All visible peritoneal fluid was aspirated during laparoscopy from the anterior and posterior cul-de-sacs. under direct vision to avoid blood contamination. Haemoglobin, iron, total oxidative status, and total antioxidant status were measured using standard colourimetric kits. RESULTS: Haemoglobin, iron levels, as well as total oxidative status values were significantly higher, whereas total antioxidant status values were significantly lower in the peritoneal fluid of patients with endometriosis, in comparison to the reference groups. No differences were observed in peritoneal fluid concentrations of all parameters measured in relation to the phase of the menstrual cycle. CONCLUSIONS: Peritoneal fluid of women with endometriosis is characterized by disrupted iron metabolism. This is most likely related to an increased number of erythrocytes in the peritoneal cavity of endometriotic women, which leads to a higher concentration of haemoglobin in this environment. Impaired iron homeostasis may have a significant influence on the pathophysiology of peritoneal endometriosis by the direct impact of haemoglobin derivatives and/or formation of the pro-inflammatory and pro-oxidative environment. Peritoneal cavity oxidative stress occurs predominantly in women in advanced stages of the disease.


Assuntos
Líquido Ascítico/química , Endometriose/metabolismo , Ferro/metabolismo , Estresse Oxidativo , Adolescente , Adulto , Líquido Ascítico/metabolismo , Biomarcadores/análise , Feminino , Hemoglobinas/metabolismo , Humanos , Laparoscopia , Pessoa de Meia-Idade , Cistos Ovarianos/metabolismo , Cavidade Peritoneal/fisiologia , Adulto Jovem
13.
Rev. lab. clín ; 11(4): 209-216, oct.-dic. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-176919

RESUMO

Los laboratorios clínicos son frecuentemente requeridos para la identificación de líquidos corporales de los que se desconoce su origen. La información bibliográfica con respecto a la identificación de líquidos biológicos de procedencia incierta es escasa. El objetivo de este documento es actualizar los conocimientos sobre aquellos constituyentes útiles como marcadores para la identificación y diferenciación de estos líquidos. Se abordan aspectos como la identificación de una punción lumbar traumática o de líquido cefalorraquídeo en fístulas, la identificación de un derrame quiloso o pseudoquiloso, de secreción biliar, pancreática, gastroesofágica o de orina en las cavidades serosas así como del líquido amniótico


Clinical laboratories are regularly requested to analyze unusual body fluids of unknown origin. There is little in the literature about the identification of body fluids of uncertain origin. The purpose of this document is to perform an updated review on those constituents that may be useful as markers for identifying and diferentiating these unusual fluids. A review is presented on aspects such as the identification of a traumatic lumbar puncture or a cerebrospinal fluid leakage, the identification of a chylous or pseudochylous effusion, leakage of bile, pancreatic fluid, gastroesophageal fluid, or urine, in the serous cavities, as well as the amniotic fluid


Assuntos
Humanos , Secreções Corporais/química , Testes de Química Clínica/métodos , Técnicas de Laboratório Clínico/métodos , Líquido Cefalorraquidiano/química , Líquido Ascítico/química , Bile/química , Líquido Amniótico/química , Relatório de Pesquisa
14.
Semin Respir Crit Care Med ; 39(5): 566-577, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30485887

RESUMO

Gastrointestinal (GI) bleeding and ascites are two significant clinical events that frequently present in critically ill patients with chronic liver failure or decompensated cirrhosis. GI bleeding in patients with cirrhosis, particularly portal hypertensive-associated bleeding, carries a high short-term mortality (15-25%) and requires early initiation of a vasoactive agent and antibiotics as well as timely endoscopic management. Conservative transfusion strategies and adequate airway protection are also imperative to assist in bleeding control. The presence of ascites among hospitalized cirrhotics requires early analysis of ascitic fluid to diagnose spontaneous bacterial peritonitis and initiate appropriate antibiotics and albumin to reduce patients' high associated mortality rates of greater than 25%. Appropriate utilization of portal decompression using transjugular intrahepatic portosystemic shunt placement for selected patients with failure to control bleeding or ascites and early consideration for liver transplantation referral is critical to improve patient survival. This review will aim to elucidate the current strategies for the management of critically ill patients with chronic liver failure presenting with GI bleeding or ascites.


Assuntos
Ascite/terapia , Cuidados Críticos , Hemorragia Gastrointestinal/terapia , Cirrose Hepática/complicações , Falência Hepática/complicações , Ascite/etiologia , Ascite/mortalidade , Líquido Ascítico/química , Líquido Ascítico/citologia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Humanos , Hipertensão Portal/complicações , Peritonite/diagnóstico , Peritonite/microbiologia , Peritonite/terapia , Derivação Portossistêmica Transjugular Intra-Hepática
15.
J Hepatobiliary Pancreat Sci ; 25(11): 508-517, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30328297

RESUMO

BACKGROUND: The mechanism of infected postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy (PD) is undefined. Drain amylase has been used to predict POPF, whereas little data are available about the value of drain fluid culture. The aim was to investigate the incidence, risk factors and association with surgical outcomes of positive drainage culture (PDC) after PD. METHODS: A single-center retrospective analysis was conducted of prospectively collected data from patients who underwent PD between January 2005 and December 2015. Drain fluid samples were obtained for microbiological analysis after surgery. Risk factors for PDC were evaluated, and its influence on surgical outcomes was explored. RESULTS: Of 768 patients, 261 (34%) had PDC during the postoperative period. Among them, a total of 434 isolates were yielded. One hundred and seven (24.7%) were Gram-positive, 283 (65.2%) Gram-negative, and 44 (10.1%) fungi. Multivariate analysis revealed that body mass index (BMI) ≥25 kg/m2 , preoperative chemoradiation and intra-operative red blood cell transfusion were independent risk factors for PDC. PDC was associated with higher incidences of complications including POPF, major complications and reoperation, but with no correlation between the day of PDC and complications. BMI ≥25 kg/m2 , early PDC (≤3 days), main pancreatic duct <3 mm, and soft pancreas were revealed as independent predictors for POPF. There was a correlation between type of microorganisms and complications. CONCLUSION: Considering the correlation between PDC and postoperative complications, preventive measures are crucial to improve outcomes after PD. Whether antibiotic treatment for early PDC will alter the clinical course of POPF needs further evaluation.


Assuntos
Líquido Ascítico/microbiologia , Infecções Intra-Abdominais/microbiologia , Pancreatopatias/cirurgia , Fístula Pancreática/microbiologia , Pancreaticoduodenectomia/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amilases/análise , Líquido Ascítico/química , Drenagem , Feminino , Humanos , Infecções Intra-Abdominais/etiologia , Infecções Intra-Abdominais/prevenção & controle , Infecções Intra-Abdominais/terapia , Masculino , Pessoa de Meia-Idade , Fístula Pancreática/etiologia , Fístula Pancreática/prevenção & controle , Fístula Pancreática/terapia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
17.
Fertil Steril ; 110(4): 767-777.e5, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30196975

RESUMO

OBJECTIVE: To characterize the peritoneal fluid (PF) sphingolipid profile in endometriosis-associated infertility (EAI), and to assess the plausible functional role(s) of ceramides in oocyte maturation potential. DESIGN: Retrospective case-control study and in vitro mouse oocyte study. SETTING: University-affiliated hospital and university laboratory. SUBJECTS: Twenty-seven infertile patients diagnosed with endometriosis and 20 infertile patients who did not have endometriosis; BALB/c female mice. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): PF sphingolipid concentrations. Number of metaphase II (MII) mouse oocytes. RESULT(S): Liquid chromatography-tandem mass spectrometry revealed 11 significantly elevated PF sphingolipids in infertile women with severe endometriosis compared with infertile women without endometriosis (change >50%, false discovery rate ≤10%). Logistic regression analysis identified three very-long-chain ceramides potentially associated with EAI. Functional studies revealed that very-long-chain ceramides may compromise or induce murine MII oocyte maturation. The oocyte maturation effects induced by the very long-chain ceramides were triggered by alterations in mitochondrial superoxide production in a concentration-dependent manner. Scavenging of mitochondrial superoxide reversed the maturation effects of C24:0 ceramide. CONCLUSION(S): EAI is associated with accumulation of PF very-long-chain ceramides. Mouse studies demonstrated how ceramides affect MII oocyte maturation, mediating through mitochondrial superoxide. These results provide an opportunity for direct functional readout of pathophysiology in EAI, and future therapies targeted at this sphingolipid metabolism may be harnessed for improved oocyte maturation.


Assuntos
Líquido Ascítico/metabolismo , Ceramidas/metabolismo , Endometriose/metabolismo , Infertilidade Feminina/metabolismo , Oócitos/metabolismo , Adulto , Animais , Líquido Ascítico/química , Estudos de Casos e Controles , Proliferação de Células/fisiologia , Ceramidas/análise , Cromatografia Líquida/métodos , Endometriose/diagnóstico , Feminino , Humanos , Infertilidade Feminina/diagnóstico , Espectrometria de Massas/métodos , Camundongos , Camundongos Endogâmicos BALB C , Oócitos/química , Estudos Retrospectivos
18.
Rev. chil. cir ; 70(4): 367-372, ago. 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-959398

RESUMO

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.


Assuntos
Humanos , Masculino , Adulto Jovem , Tuberculose Gastrointestinal/diagnóstico , Tuberculose Gastrointestinal/enzimologia , Peritonite Tuberculosa/diagnóstico , Peritonite Tuberculosa/enzimologia , Tuberculose Gastrointestinal/cirurgia , Peritonite Tuberculosa/cirurgia , Líquido Ascítico/química , Radiografia Torácica , Tomografia Computadorizada por Raios X , Adenosina Desaminase/análise , Diagnóstico Diferencial
19.
Minerva Anestesiol ; 84(12): 1369-1376, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29991219

RESUMO

BACKGROUND: Decision to start an anti-fungal therapy in intra-abdominal candidiasis (IAC) is complex. Yeast culture, considered the gold standard, suffers from a delayed response time and exposes the patient to delayed introduction of anti-fungal therapy. We sought to evaluate the performance and feasibility of measuring 1,3-ß-D-glucan (1,3-BDG) in the peritoneal fluid (PF) for the diagnosis of IAC. METHODS: We analyzed retrospectively all PF obtained during abdominal surgery for critically ill adult patients presenting intra-abdominal infections. For each PF sample, direct examination, bacterial and fungal culture, fungal PCR and 1,3-BDG measurements were performed. The diagnostic performance of each technique and the Peritonitis score were calculated considering the positive yeast culture as the reference. The levels of 1,3-BDG were compared between IAC and non-IAC patients. RESULTS: During an 8-month period in 2016, 33 PF samples were recovered. Median (interquartile range) SAPS 2 and SOFA scores were 44 (9-94) and 9 (4-15), respectively. There were seven cases of IAC, 14 of bacterial peritonitis and 12 of undocumented peritonitis. All IAC cases were secondary peritonitis, with a 1,3-BDG level of 1461 (325-5000) versus 224 (68-1357) pg/mL in the non-IAC group (P=0.03). When the 1,3-BDG level was ≤310 pg/mL, its negative predictive value was 100%. CONCLUSIONS: In secondary peritonitis, a peritoneal measurement of 1,3-BDG ≤310 pg/mL could rule out IAC.


Assuntos
Líquido Ascítico/química , Candidíase/diagnóstico , beta-Glucanas/análise , Abdome , Idoso , Estudos de Coortes , Estado Terminal , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Retrospectivos
20.
G Chir ; 39(4): 215-222, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30039788

RESUMO

OBJECTIVE: The aim of this study was to neutralize acidic pH using an alkaline dialysate for continuous ambulatory peritoneal dialysis (CAPD) in mice with peritoneal carcinomatosis (PC) and to investigate the change of the pH level in the acidic fluid along with its effects on liver oxidative stress, liver and kidney histopathology and the lifespan of the body. MATERIALS AND METHODS: A total of 38 mice were randomly divided into 4 groups.PC development was inhibited by intraperitoneal injection of Ehrlich tumor cells in all mice in each group. RESULTS: In the group-1 receiving CAPD, the pH levels of acidic liquid were higher; and the levels of liver TBARS were lower with higher reduced glutathione levels. Histopathological damage in group-1 was less than in group-2. In Group 3 receiving CAPD, the average lifespan extended by 10.4%. The average lifespan extended by 26.1%. CONCLUSION: This study indicated that applying CAPD with alkaline dialysate in PC contributed to the neutralization of acidosis of the intraperitoneal acid structure;had favorable effects on oxidative stress markers in liver tissue; prevented histopathological injury in liver and kidney tissues, and extended the life span of the body in mice. As this is a simple, inexpensive, and easily available method, larger studies are warranted to evaluate its effects.


Assuntos
Líquido Ascítico/química , Carcinoma de Ehrlich/terapia , Soluções para Diálise/uso terapêutico , Diálise Peritoneal Ambulatorial Contínua/métodos , Neoplasias Peritoneais/terapia , Animais , Carcinoma de Ehrlich/metabolismo , Carcinoma de Ehrlich/patologia , Soluções para Diálise/química , Glutationa/análise , Concentração de Íons de Hidrogênio , Fígado/química , Masculino , Camundongos , Estresse Oxidativo , Neoplasias Peritoneais/metabolismo , Neoplasias Peritoneais/patologia , Distribuição Aleatória , Substâncias Reativas com Ácido Tiobarbitúrico/análise
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