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Nefrologia : Publicacion Oficial de La... 2013Turbid acellular peritoneal fluid of a non-infectious aetiology is an uncommon entity in peritoneal dialysis and is characterised by a high concentration of...
Turbid acellular peritoneal fluid of a non-infectious aetiology is an uncommon entity in peritoneal dialysis and is characterised by a high concentration of triglycerides in the peritoneal fluid. The most common causes include cancer, lymphatic obstructions, pancreatitis, trauma, and even the use of certain medications such as calcium antagonists. The largest studies concerning this entity have been carried out in patients of Asian descent. We recently diagnosed 4 cases of turbid acellular peritoneal fluid at our institution in relation to the use of calcium antagonists. We reviewed the primary characteristics of these cases and examined the relationship between the use of calcium antagonists and triglyceride levels in the peritoneal fluid of stable patients on peritoneal dialysis during 2010. Of the four patients with turbid acellular peritoneal fluid, 75% were male and 75% were on treatment with manidipine; in all cases, the issue was resolved by suspending medication. Mean triglyceride levels were 314 mg/dl. Mean triglyceride levels in 36 stable patients on peritoneal dialysis were 8.1mg/dl, with a range of 1-35 mg/dl. Mean triglyceride levels in patients with and without calcium antagonist treatment were very similar, at 7.81 mg/dl and 8.6 mg/dl, respectively. We did not observe significant differences in terms of the type of calcium antagonist prescribed. In our experience, we believe that calcium antagonists should be considered as a cause of turbid acellular peritoneal fluid in patients on peritoneal dialysis, in particular manidipine. We do not find it useful to determine triglyceride levels in the peritoneal fluid of asymptomatic patients on treatment with calcium antagonists.
Topics: Adult; Aged; Ascitic Fluid; Calcium Channel Blockers; Female; Humans; Lymph; Male; Middle Aged; Peritoneal Dialysis; Triglycerides
PubMed: 23712225
DOI: 10.3265/Nefrologia.pre2013.Feb.11697 -
Advances in Peritoneal Dialysis.... 2002Cytokines are soluble mediators of the immune system that regulate the response to antigens and microorganisms. In patients on continuous ambulatory peritoneal dialysis...
Cytokines are soluble mediators of the immune system that regulate the response to antigens and microorganisms. In patients on continuous ambulatory peritoneal dialysis (CAPD) who have peritonitis, an inflammatory process exists that must be understood if susceptibility to, and the mechanisms of, complications such as fibrosis and others are to be understood. To that end, we studied 9 CAPD patients with peritonitis. The case series was conducted in Popayán, Colombia, at the RTS Cauca dialysis unit and the University of Cauca hospital, a tertiary health care facility. Peritonitis was diagnosed by standard clinical and laboratory criteria. Using flow cytometry, we measured the percentage production of intracellular cytokines [interleukin-1 alpha (IL-1 alpha), IL-6, IL-12, tumor necrosis factor alpha (TNF alpha), IL-4, and interferon-gamma (IFN-gamma) in T lymphocytes from blood and peritoneal fluid. Among the studied patients, all (100%) produced high levels of IL-1, IL-6, TNF alpha, IL-12, and IL-4 in both fluids (blood: 89% +/- 63% of cells; peritoneal fluid: 81.6% +/- 10.1% of cells). In blood, 25% of patients produced IFN-gamma (mean: 15.7% of cells), showing that 75% of patients had the TH2 pattern, and 25% were close to TH0. In peritoneal fluid, 34% of patients produced IFN-gamma spontaneously (mean: 24.5% of cells), indicating that 66% of patients were TH2, and 34% were close to TH0. After stimulation, expression of cytokines, including IFN-gamma (39% of T cells), was increased, and high production of IL-4 indicated that 25% of patients were TH2, and 75% were TH0. In peritoneal fluid, production of cytokines, including IFN-gamma, was increased, with high production of IL-4, indicating switching from TH2 (34% of patients) to TH0 (66% of patients). Of the studied patients, 35% had a CD4:CD8 ratio < 1.1 in blood, and also produced IL-12 (94.5% of cells) and IFN-gamma (30% of cells), as compared with patients in whom the CD4:CD8 ratio was > 1.2. Patients on CAPD who have peritonitis produce large amounts of pro-inflammatory and TH2 cytokines. More IFN-gamma is produced in peritoneal fluid than in blood, which suggests more inflammation. Immunodeviation TH2 is seen in blood and peritoneal fluid of CAPD patients with peritonitis. Patients with a CD4:CD8 ratio < 1.1 produce more IFN-gamma and IL-12, and are more able to switch from TH2 to TH0.
Topics: Antigens, CD; Antigens, Differentiation, T-Lymphocyte; Ascitic Fluid; CD4-CD8 Ratio; Cells, Cultured; Cytokines; Female; Flow Cytometry; Fluorescent Antibody Technique; Humans; Interleukins; Lectins, C-Type; Lymphocyte Activation; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Th2 Cells; Tumor Necrosis Factor-alpha
PubMed: 12402614
DOI: No ID Found -
Fertility and Sterility Nov 1986Peritoneal fluid (PF) was studied for the presence of endometrial tissue in a consecutive series of 67 women (with documented tubal patency) undergoing diagnostic...
Peritoneal fluid (PF) was studied for the presence of endometrial tissue in a consecutive series of 67 women (with documented tubal patency) undergoing diagnostic laparoscopy, tubal lavage, and hysteroscopy. PF was completely aspirated from the cul-de-sac both before and after uterine irrigation. The PF was then analyzed for the presence of endometrial tissue. In native PF no significant difference in the incidence of endometrial tissue between patients with (19%) and without (11%) endometriosis (P = 0.6) was observed. Refluxed PF, obtained after uterine irrigation, showed a significantly higher incidence of endometrial tissue in women with endometriosis (76%) as compared to controls (42%) (P = 0.03). We propose two models to explain the development of endometriosis. These are not mutually exclusive, may be independent of each other, and may represent two distinct pathophysiologic disease processes.
Topics: Adolescent; Adult; Ascitic Fluid; Endometriosis; Endometrium; Female; Humans
PubMed: 3780999
DOI: 10.1016/s0015-0282(16)49813-4 -
Human Reproduction Update 1996The local environment of peritoneal fluid (PF) surrounding the endometriotic implant is immunologically dynamic and links the reproductive and immune systems. Peritoneal... (Review)
Review
The local environment of peritoneal fluid (PF) surrounding the endometriotic implant is immunologically dynamic and links the reproductive and immune systems. Peritoneal fluid contains a variety of free floating cells, including macrophages, mesothelial cells, lymphocytes, eosinophils and mast cells. Macrophages are attracted to the peritoneal environment more abundantly than any other cell type. These scavengers promote cellular growth and viability through secretion of growth factors and cytokines. It is now becoming evident that cytokines play an important role in reproduction at various levels, including gamete function, fertilization and embryo development, implantation and postimplantation survival of the conceptus. Peritoneal fluid has been shown to affect negatively ovum capture by the fimbria, sperm survival, spermatozoon-oocyte interaction and embryonic development. We have recently identified the presence of two pro-inflammatory chemoattractant cytokines for monocyte/macrophages (MCP-1) and for granulocytes (interleukin-8, IL-8) in the PF. Concentrations of both IL-8 and MCP-1 are not only elevated in PF of women with endometriosis compared to those without endometriosis, but they are related to the severity of the disease. Over the past 70 years, at least a dozen theories have been proposed to explain the histogenesis and aetiology of endometriosis. It appears that the aetiology is multifactorial, and today a composite theory of retrograde menstruation with implantation of endometrial fragments in conjunction with peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis.
Topics: Animals; Ascitic Fluid; Cytokines; Embryonic Development; Endometriosis; Endometrium; Epithelium; Female; Growth Substances; Humans; Macrophages; Male; Mice; Peritoneal Diseases; Prostaglandins; Sperm-Ovum Interactions
PubMed: 15717438
DOI: 10.1093/humupd/2.5.385 -
Gynecological Endocrinology : the... Aug 2008Endometriosis has a wide range of severity but molecular factors associated with variable extension of the disease have not been widely investigated. The present study...
OBJECTIVE
Endometriosis has a wide range of severity but molecular factors associated with variable extension of the disease have not been widely investigated. The present study compares the peritoneal fluid (PF) proteome of 109 women with endometriosis and different disease stage as defined by the American Society for Reproductive Medicine (ASRM).
METHODS
PF samples were subjected to two-dimensional gel electrophoresis; protein spots of interest were identified by liquid chromatography tandem mass spectrometry.
RESULTS
Over 470 protein spots were analyzed. One isoform of haptoglobin alpha chain, alpha-1b-glycoprotein and one unknown protein had higher expression in PF of women with ASRM stage I-II endometriosis. Four isoforms of alpha1-antitrypsin, three isoforms of alpha-1b-glycoprotein, one isoform of S100-A8 and serotransferrin had higher expression in PF of women with ASRM stage III-IV disease.
CONCLUSIONS
Several protein isoforms have different expression in PF of women with ASRM stage I-II endometriosis than in those with ASRM stage III-IV disease; most of these molecules are involved in inflammation and immune response.
Topics: Adult; Ascitic Fluid; Disease Progression; Electrophoresis, Gel, Two-Dimensional; Endometriosis; Female; Humans; Menstrual Cycle; Peritoneal Diseases; Proteins; Proteome; Reproductive Medicine; Research Design; Societies, Medical
PubMed: 18850380
DOI: 10.1080/09513590802173824 -
Journal of Gastrointestinal Cancer Jun 2023Molecular analysis of peritoneal fluid in staging laparoscopy of gastric cancer is performed to improve the detection of free intraperitoneal tumor cells. Nevertheless,...
PURPOSE
Molecular analysis of peritoneal fluid in staging laparoscopy of gastric cancer is performed to improve the detection of free intraperitoneal tumor cells. Nevertheless, its significance is controversial, especially in patients with negative cytology but positive molecular analysis. The aim of this study was to analyze the sensitivity of molecular analysis and its prognostic value.
METHODS
A retrospective analysis from April 2011 to October 2019 was performed. Cytology (Cyt) and molecular analysis were analyzed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) of the carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) tumor makers.
RESULTS
During the study period, 138 staging laparoscopies were performed. Macroscopic carcinomatosis was found in 12.3%. Of the remaining 87.7%, 9.9% were Cyt + and 11.6% were Cyt- RT-PCR + . Of the latter, 9 responded to chemotherapy and underwent radical surgery. The sensitivity of cytology and molecular analysis was 0.70 and 0.76, respectively (p = 0.67). The 2-year overall survival (OS) of Cyt- RT-PCR + vs. Cyt + was similar (p = 0.1). The 2-year OS of Cyt-RT-PCR + subgroup who underwent radical surgery vs. Cyt-RT-PCR- patients was similar (p = 0.69), but disease-free survival was shorter in the first group (p = 0.005).
CONCLUSION
Our results show that the sensitivity of molecular analysis is similar to that of cytology. The prognostic value of positive molecular analysis was similar to positive cytology in terms of 2-year overall survival, except in the subgroup of operated patients in whom the overall survival was similar to that of those with a negative molecular analysis, albeit with a shorter disease-free survival.
Topics: Humans; Ascitic Fluid; Stomach Neoplasms; Retrospective Studies; Neoadjuvant Therapy; Carcinoembryonic Antigen; Laparoscopy; Prognosis; Neoplasm Staging; Reverse Transcriptase Polymerase Chain Reaction
PubMed: 35881277
DOI: 10.1007/s12029-022-00846-8 -
Journal of the American Veterinary... Apr 1999To determine whether peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity can be used to differentiate horses with septic peritonitis from...
OBJECTIVE
To determine whether peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity can be used to differentiate horses with septic peritonitis from those with nonseptic peritonitis.
DESIGN
Prospective study.
ANIMALS
46 horses, including 10 healthy horses, 15 horses with septic peritonitis, and 21 horses with nonseptic peritonitis.
PROCEDURE
Peritoneal fluid and blood samples were analyzed for pH, glucose concentration, and lactate dehydrogenase activity. Complete blood cell counts were performed, and peritoneal fluid samples were submitted for bacterial culture.
RESULTS
Horses with septic peritonitis had significantly lower peritoneal fluid pH and glucose concentrations than horses with nonseptic peritonitis and healthy horses. Compared with other tests, serum-to-peritoneal fluid glucose concentration differences > 50 mg/dl had the highest diagnostic use for detection of septic peritonitis. Peritoneal fluid pH < 7.3, glucose concentration < 30 mg/dl, and fibrinogen concentration > 200 mg/dl were also highly indicative of septic peritonitis.
CLINICAL IMPLICATIONS
Peritoneal fluid pH and glucose concentration can be used to assist in the identification of horses with septic peritonitis. These measurements can provide an early indication of sepsis, especially if cytologic evaluation of peritoneal fluid is unavailable or results are equivocal and peritoneal fluid bacterial culture results are pending.
Topics: Animals; Ascitic Fluid; Blood Cell Count; Blood Glucose; Fibrinogen; Glucose; Horse Diseases; Horses; Hydrogen-Ion Concentration; L-Lactate Dehydrogenase; Peritonitis; Prospective Studies
PubMed: 10200799
DOI: No ID Found -
BMC Medicine Jan 2020Endometriosis is a gynaecological condition characterised by immune cell infiltration and distinct inflammatory signatures found in the peritoneal cavity. In this study,...
BACKGROUND
Endometriosis is a gynaecological condition characterised by immune cell infiltration and distinct inflammatory signatures found in the peritoneal cavity. In this study, we aim to characterise the immune microenvironment in samples isolated from the peritoneal cavity in patients with endometriosis.
METHODS
We applied mass cytometry (CyTOF), a recently developed multiparameter single-cell technique, in order to characterise and quantify the immune cells found in peritoneal fluid and peripheral blood from endometriosis and control patients.
RESULTS
Our results demonstrate the presence of more than 40 different distinct immune cell types within the peritoneal cavity. This suggests that there is a complex and highly heterogeneous inflammatory microenvironment underpinning the pathology of endometriosis. Stratification by clinical disease stages reveals a dynamic spectrum of cell signatures suggesting that adaptations in the inflammatory system occur due to the severity of the disease. Notably, among the inflammatory microenvironment in peritoneal fluid (PF), the presence of CD69 T cell subsets is increased in endometriosis when compared to control patient samples. On these CD69 cells, the expression of markers associated with T cell function are reduced in PF samples compared to blood. Comparisons between CD69 and CD69 populations reveal distinct phenotypes across peritoneal T cell lineages. Taken together, our results suggest that both the innate and the adaptive immune system play roles in endometriosis.
CONCLUSIONS
This study provides a systematic characterisation of the specific immune environment in the peritoneal cavity and identifies cell immune signatures associated with endometriosis. Overall, our results provide novel insights into the specific cell phenotypes governing inflammation in patients with endometriosis. This prospective study offers a useful resource for understanding disease pathology and opportunities for identifying therapeutic targets.
Topics: Ascitic Fluid; Endometriosis; Female; Flow Cytometry; Humans; Prospective Studies; T-Lymphocytes
PubMed: 31907005
DOI: 10.1186/s12916-019-1470-y -
Acta Obstetricia Et Gynecologica... Mar 2005
Topics: Adult; Ascitic Fluid; Case-Control Studies; Endometriosis; Enzyme-Linked Immunosorbent Assay; Female; Humans; Interleukin-16; Lymphocyte Activation; Statistics, Nonparametric
PubMed: 15715540
DOI: 10.1111/j.0001-6349.2005.00679.x -
Antimicrobial Agents and Chemotherapy Feb 1981Simultaneous peritoneal fluid and serum gentamicin assays were performed at 1- or 4-h intervals after the intravenous administration of gentamicin (3 to 5 mg/kg per day)...
Simultaneous peritoneal fluid and serum gentamicin assays were performed at 1- or 4-h intervals after the intravenous administration of gentamicin (3 to 5 mg/kg per day) during nine episodes of spontaneous bacterial peritonitis in cirrhotic patients. Mean peritoneal fluid levels were 4.2 micrograms/ml, whereas simultaneous mean serum levels were 6.1 micrograms/ml (mean percent diffusion into ascites of 67.8%). Three additional patients with uninflamed ascites demonstrated lower levels of diffusion. Regression analysis revealed a positive correlation between simultaneous serum and peritoneal fluid levels. We conclude that diffusion of gentamicin from serum into peritoneal fluid during spontaneous peritonitis is therapeutically adequate if sufficient serum levels are maintained.
Topics: Ascitic Fluid; Gentamicins; Humans; Peritonitis; Time Factors
PubMed: 7347563
DOI: 10.1128/AAC.19.2.312