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In Vivo (Athens, Greece) 2023The management of refractory ascites is critical for the treatment of patients with decompensated cirrhosis. This study aimed to evaluate the feasibility and safety of... (Observational Study)
Observational Study
Changes in Coagulation and Fibrinolytic Factors in Patients With Cirrhotic Refractory Ascites Undergoing Cell-free and Concentrated Ascites Reinfusion Therapy: A Retrospective Observational Study in Japan.
BACKGROUND/AIM
The management of refractory ascites is critical for the treatment of patients with decompensated cirrhosis. This study aimed to evaluate the feasibility and safety of cell-free and concentrated ascites reinfusion therapy (CART) in patients with cirrhosis and refractory ascites, with a focus on changes in coagulation and fibrinolytic factors in ascitic fluid following CART.
PATIENTS AND METHODS
This was a retrospective cohort study including 23 patients with refractory ascites undergoing CART. Serum endotoxin activity (EA) before and after CART and the levels of coagulation and fibrinolytic factors and proinflammatory cytokines in original and processed ascitic fluid were measured. The Ascites Symptom Inventory-7 (ASI-7) scale was used for subjective symptom assessment before and after CART.
RESULTS
Body weight and waist circumference significantly decreased after CART, whereas serum EA did not significantly change after CART. Similar to the previous reports, ascitic fluid concentrations of total protein, albumin, high-density lipoprotein cholesterol, γ-globulin, and immunoglobulin G levels were significantly increased after CART; mild elevations in body temperature and interleukin 6 and tumor necrosis factor-alpha levels in ascitic fluid were also observed. Importantly, the levels of antithrombin-III, factor VII, and X, which are useful for patients with decompensated cirrhosis, were markedly increased in the reinfused fluid during CART. Finally, the total ASI-7 score was significantly lower following CART, compared with the pre-CART score.
CONCLUSION
CART is an effective and safe approach for the treatment of refractory ascites that allows the intravenous reinfusion of coagulation and fibrinolytic factors in the filtered and concentrated ascites.
Topics: Humans; Ascites; Retrospective Studies; Japan; Ascitic Fluid; Liver Cirrhosis
PubMed: 37103093
DOI: 10.21873/invivo.13199 -
World Journal of Gastroenterology Mar 2011Ascites remain the commonest complication of decompensated cirrhosis. Spontaneous bacterial peritonitis (SBP) is defined as the infection of ascitic fluid (AF) in the...
Ascites remain the commonest complication of decompensated cirrhosis. Spontaneous bacterial peritonitis (SBP) is defined as the infection of ascitic fluid (AF) in the absence of a contiguous source of infection and/or an intra-abdominal inflammatory focus. An AF polymorphonuclear (PMN) leucocyte count ≥ 250/mm(3)--irrespective of the AF culture result--is universally accepted nowadays as the best surrogate marker for diagnosing SBP. Frequently the results of the manual or automated PMN count do not reach the hands of the responsible medical personnel in a timely manner. However, this is a crucial step in SBP management. Since 2000, 26 studies (most of them published as full papers) have checked the validity of using leukocyte esterase reagent strips (LERS) in SBP diagnosis. LERS appear to have low sensitivity for SBP, some LERS types more than others. On the other hand, though, LERS have consistently given a high negative predictive value (> 95% in the majority of the studies) and this supports the use of LERS as a preliminary screening tool for SBP diagnosis. Finally, an AF-tailored dipstick has been developed. Within the proper setting, it is set to become the mainstream process for handling AF samples.
Topics: Ascites; Ascitic Fluid; Bacterial Infections; Carboxylic Ester Hydrolases; Female; Humans; Liver Cirrhosis; Male; Peritonitis; Reagent Strips; Sensitivity and Specificity
PubMed: 21448413
DOI: 10.3748/wjg.v17.i9.1091 -
Iranian Journal of Immunology : IJI Jun 2019Endometriosis 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...
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-β1, 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-β1 was increased in endometriosis group (p=0.030). Furthermore, the ratios of IFN-γ/TGF-β1 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.
Topics: Adult; Ascitic Fluid; Cytokines; Endometriosis; Endometrium; Female; Humans; Infertility, Female; Middle Aged; T-Lymphocyte Subsets; Young Adult
PubMed: 31182689
DOI: 10.22034/IJI.2019.80258 -
Canadian Journal of Veterinary Research... Jan 1989Six healthy adult mares were each given an oral loading dose of ormetoprim(OMP)-sulfadimethoxine (SDM) at a dosage of 9.2 mg of OMP/kg and 45.8 mg of SDM/kg, followed by...
Six healthy adult mares were each given an oral loading dose of ormetoprim(OMP)-sulfadimethoxine (SDM) at a dosage of 9.2 mg of OMP/kg and 45.8 mg of SDM/kg, followed by four maintenance doses of 4.6 mg of OMP/kg and 22.9 mg of SDM/kg, at 24 h intervals. Ormetoprim and SDM concentrations were measured in serum, synovial fluid, peritoneal fluid, cerebrospinal fluid, urine and endometrium. The highest mean serum OMP concentration was 0.92 micrograms/mL 0.5 h after the first dose; the highest mean SDM concentration was 80.9 micrograms/mL 8 h after the first dose. The highest mean synovial fluid concentrations were 0.14 microgram of OMP/mL and 28.5 micrograms of SDM/mL 12 h after the first dose. The highest mean peritoneal fluid concentrations were 0.19 micrograms of OMP/mL 6 h after the first dose and 25.5 micrograms of SDM/mL 8 h after the fifth dose. The highest mean endometrial concentrations were 0.56 micrograms of OMP/g and 28.5 micrograms of SDM/g 4 h after the fifth dose. The mean cerebrospinal fluid concentrations were 0.08 micrograms of OMP/mL and 2.1 micrograms of SDM/mL 5 h after the fifth dose. Mean trough urine drug concentrations were greater than or equal to 0.4 micrograms of OMP/mL and greater than or equal to 172 micrograms of SDM/mL. Two of the mares were each given a single intravenous (IV) injection of OMP and SDM at a dosage of 9.2 mg of OMP/kg and 45.8 mg of SDM/kg. Excitation and muscle fasciculations were observed in both mares after IV administration and all scheduled blood samples could be collected from only one of the two mares.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Animals; Ascitic Fluid; Body Fluids; Drug Combinations; Endometrium; Female; Horses; Pyrimidines; Sulfadimethoxine; Synovial Fluid
PubMed: 2914221
DOI: No ID Found -
Fertility and Sterility Jul 2001To review the literature on the role of cytokines in the pathogenesis of endometriosis and endometriosis-associated infertility. (Review)
Review
OBJECTIVE
To review the literature on the role of cytokines in the pathogenesis of endometriosis and endometriosis-associated infertility.
DESIGN
Pertinent studies were identified by a computer search of MEDLINE. References of selected articles were hand-searched for additional citations.
RESULT(S)
Recent studies suggest that the peritoneal fluid of women with endometriosis contains an increased number of activated macrophages that secrete various local products, such as growth factors and cytokines. Levels of several cytokines were reported to be elevated in the peritoneal fluid of women with endometriosis. Because the peritoneal environment may be controlled by locally regulated factors, cytokines are believed to play a role in the development and progression of endometriosis and endometriosis-associated infertility. A possible pathogenic mechanism links cytokines with endometriosis.
CONCLUSION(S)
Cytokines, which are produced by many cell types including endometriotic tissues, play diverse roles in the pathogenesis of endometriosis and endometriosis-associated infertility. More studies about the specific role of these cells and soluble factors are needed to improve understanding of endometriosis and to develop novel therapies.
Topics: Ascitic Fluid; Cytokines; Endometriosis; Female; Humans; Infertility, Female
PubMed: 11438312
DOI: 10.1016/s0015-0282(01)01816-7 -
British Medical Journal (Clinical... May 1981
Topics: Ascites; Ascitic Fluid; Humans; Methods
PubMed: 6786531
DOI: No ID Found -
Journal of Hepatology Jan 2015
Topics: Ascitic Fluid; DNA; DNA-Binding Proteins; Female; Gene Expression Regulation; Humans; Inflammasomes; Liver Cirrhosis; Macrophages; Male
PubMed: 25308173
DOI: 10.1016/j.jhep.2014.10.003 -
Ethiopian Journal of Health Sciences May 2019The aim of this study was to assess the role of transabdominal ultrasonography in characterizing and determining the etiology of ascites in comparison with laboratory...
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 (X).
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.
Topics: Adolescent; Adult; Aged; Ascites; Ascitic Fluid; Female; Humans; Male; Middle Aged; Prospective Studies; Ultrasonography; Young Adult
PubMed: 31447507
DOI: 10.4314/ejhs.v29i3.11 -
Cancer Chemotherapy and Pharmacology Jul 2020In this exploratory study, the effect of postprocedural flushing with crystalloids after oxaliplatin-based hyperthermic intraperitoneal chemotherapy (HIPEC) on platinum... (Clinical Trial)
Clinical Trial
PURPOSE
In this exploratory study, the effect of postprocedural flushing with crystalloids after oxaliplatin-based hyperthermic intraperitoneal chemotherapy (HIPEC) on platinum concentrations in peritoneal tissue, blood, and drain fluid was studied. Interpatient variability in oxaliplatin pharmacokinetics and the relation between platinum concentration in peritoneal fluid and platinum exposure in tissue and blood was explored.
METHODS
Ten patients with peritoneal carcinomatosis of colorectal origin were treated with HIPEC including postprocedural flushing, followed by ten patients without flushing afterwards. Tissue, peritoneal fluid, blood, and drain fluid samples were collected for measurement of total and ultrafiltered platinum concentrations.
RESULTS
Peritoneal tissue concentration and systemic ultrafiltered platinum exposure showed large inter individual variability, ranging from 65 to 1640 µg/g dry weight and 10.5 to 28.0 µg*h/ml, respectively. No effect of flushing was found on geometric mean platinum concentration in peritoneal tissue (348 vs. 356 µg/g dry weight), blood (14.8 vs. 18.1 µg*h/ml), or drain fluid (day 1: 7.6 vs. 7.7 µg/ml; day 2: 1.7 vs. 1.9 µg/ml). The platinum concentration in peritoneal fluid at the start of HIPEC differed twofold between patients and was positively correlated with systemic exposure (p = .04) and peak plasma concentration (p = .04).
CONCLUSION
In this exploratory study, no effect was found for postprocedural flushing on platinum concentrations in peritoneal tissue, blood, or drain fluid. BSA-based HIPEC procedure leads to large interpatient variability in platinum exposure in all compartments. The study was registered at ClinicalTrials.gov on 7 December 2017 under registration number NCT03364907.
Topics: Aged; Aged, 80 and over; Ascitic Fluid; Drainage; Female; Humans; Hyperthermic Intraperitoneal Chemotherapy; Male; Middle Aged; Oxaliplatin; Peritoneal Neoplasms; Sodium Chloride; Tissue Distribution
PubMed: 32594200
DOI: 10.1007/s00280-020-04107-y -
Analytical and Bioanalytical Chemistry Oct 2022We developed and validated a liquid chromatography high-resolution mass spectrometry method for the absolute quantification of 51 steroids for clinical analysis of human...
We developed and validated a liquid chromatography high-resolution mass spectrometry method for the absolute quantification of 51 steroids for clinical analysis of human serum and, for the first time, peritoneal fluid. Data acquisition was performed in both targeted and untargeted mode simultaneously, thus allowing the accurate and precise quantification of the main components of the classical steroid pathways (17 steroids) as well as the analysis of 34 additional non-classical steroids. For targeted analysis, validation was performed according to FDA guidelines, resulting, among other parameters, in accuracy < 13% RSD and precision < 10% relative error, for both inter- and intra-day validation runs. By establishing steroid-specific response factors, the calibration curves of the targeted analytes can be extended to untargeted analytes. This approach opens novel possibilities for the post hoc analysis of clinical samples as the data can be examined for virtually any steroid even after data acquisition, enabling facile absolute quantification once a standard becomes available. We demonstrate the applicability of the approach to evaluate the differences in steroid content between peripheral serum and peritoneal fluid across the menstrual cycle phases, as well as the effect of the synthetic gestagen dienogest on the steroid metabolome.
Topics: Ascitic Fluid; Chromatography, High Pressure Liquid; Chromatography, Liquid; Humans; Progestins; Steroids; Tandem Mass Spectrometry
PubMed: 35043262
DOI: 10.1007/s00216-022-03881-3