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CMAJ : Canadian Medical Association... Mar 2018
Review
Topics: Diagnosis, Differential; Exudates and Transudates; Humans; Pleural Effusion
PubMed: 29530870
DOI: 10.1503/cmaj.170420 -
Respiratory Medicine Oct 2019A chylothorax, also known as chylous pleural effusion, is an uncommon cause of pleural effusion with a wide differential diagnosis characterized by the accumulation of... (Review)
Review
A chylothorax, also known as chylous pleural effusion, is an uncommon cause of pleural effusion with a wide differential diagnosis characterized by the accumulation of bacteriostatic chyle in the pleural space. The pleural fluid will have either or both triglycerides >110 mg/dL and the presence of chylomicrons. It may be encountered following a surgical intervention, usually in the chest, or underlying disease process. Management of a chylothorax requires a multidisciplinary approach employing medical therapy and possibly surgical intervention for post-operative patients and patients who have failed medical therapy. In this review, we aim to discuss the anatomy, fluid characteristics, etiology, and approach to the diagnosis of a chylothorax.
Topics: Antineoplastic Agents, Hormonal; Chylothorax; Diagnosis, Differential; Exudates and Transudates; Humans; Lymphography; Lymphoscintigraphy; Octreotide; Pleural Effusion; Postoperative Period; Radiography, Thoracic; Suction; Thoracentesis; Thoracic Duct; Tomography, X-Ray Computed; Triglycerides
PubMed: 31454675
DOI: 10.1016/j.rmed.2019.08.014 -
American Family Physician Jul 2014Pleural effusion affects more than 1.5 million people in the United States each year and often complicates the management of heart failure, pneumonia, and malignancy....
Pleural effusion affects more than 1.5 million people in the United States each year and often complicates the management of heart failure, pneumonia, and malignancy. Pleural effusion occurs when fluid collects between the parietal and visceral pleura. Processes causing a distortion in body fluid mechanics, such as in heart failure or nephrotic syndrome, tend to cause transudative effusions, whereas localized inflammatory or malignant processes are often associated with exudative effusions. Patients can be asymptomatic or can present with cough, dyspnea, and pleuritic chest pain. Dullness to percussion on physical examination suggests an effusion; chest radiography can confirm the diagnosis. Thoracentesis may be indicated to diagnose effusion and relieve symptoms. Ultrasound guidance is preferred when aspirating fluid. Routine assays for aspirated fluid include protein and lactate dehydrogenase levels, Gram staining, cytology, and pH measurement. Light's criteria should be used to differentiate exudative from transudative effusions. Additional laboratory assays, bronchoscopy, percutaneous pleural biopsy, or thoracoscopy may be required for diagnosis if the initial test results are inconclusive.
Topics: Diagnosis, Differential; Exudates and Transudates; Humans; Pleural Effusion
PubMed: 25077579
DOI: No ID Found -
American Family Physician Apr 2006The first step in the evaluation of patients with pleural effusion is to determine whether the effusion is a transudate or an exudate. An exudative effusion is diagnosed... (Review)
Review
The first step in the evaluation of patients with pleural effusion is to determine whether the effusion is a transudate or an exudate. An exudative effusion is diagnosed if the patient meets Light's criteria. The serum to pleural fluid protein or albumin gradients may help better categorize the occasional transudate misidentified as an exudate by these criteria. If the patient has a transudative effusion, therapy should be directed toward the underlying heart failure or cirrhosis. If the patient has an exudative effusion, attempts should be made to define the etiology. Pneumonia, cancer, tuberculosis, and pulmonary embolism account for most exudative effusions. Many pleural fluid tests are useful in the differential diagnosis of exudative effusions. Other tests helpful for diagnosis include helical computed tomography and thoracoscopy.
Topics: Adult; Biopsy; Bronchoscopy; Diagnosis, Differential; Exudates and Transudates; Humans; Pleural Effusion; Thoracoscopy; Tomography, X-Ray Computed
PubMed: 16623208
DOI: No ID Found -
Journal of Wound Care Sep 2017
Topics: Biomarkers; Biopsy; Exudates and Transudates; Humans; Wounds and Injuries
PubMed: 28880751
DOI: 10.12968/jowc.2017.26.Sup9.S3 -
Deutsches Arzteblatt International Sep 2019
Topics: Exudates and Transudates; Humans; Pleural Effusion
PubMed: 32048592
DOI: 10.3238/arztebl.2019.0615b -
Burns : Journal of the International... Feb 2015The burn wound exudate represents the burn tissue microenvironment. Extracting information from the exudate relating to cellular components, signaling mediators and... (Review)
Review
INTRODUCTION
The burn wound exudate represents the burn tissue microenvironment. Extracting information from the exudate relating to cellular components, signaling mediators and protein content can provide much needed data relating to the local tissue damage, depth of the wound and probable systemic complications. This review examines the scientific data extracted from burn wound exudates over the years and proposes new investigations that will provide useful information from this underutilized resource.
METHOD
A literature review was conducted using the electronic database PubMed to search for literature pertaining to burn wound or blister fluid analysis. Key words included burn exudate, blister fluid, wound exudate, cytokine burn fluid, subeschar fluid, cytokine burns, serum cytokines. 32 relevant articles were examined and 29 selected as relevant to the review. 3 papers were discarded due to questionable methodology or conclusions. The reports were assessed for their affect on management decisions and diagnostics. Furthermore, traditional blood level analysis of these mediators was made to compare the accuracy of blood versus exudate in burn wound management. Extrapolations are made for new possibilities of burn wound exudate analysis.
RESULTS
Studies pertaining to burn wound exudate, subeschar fluid and blister fluid analyses may have contributed to burn wound management decisions particularly related to escharectomies and early burn wound excision. In addition, information from these studies has the potential to impact on areas such as healing, scarring, burn wound conversion and burn wound depth analysis.
CONCLUSION
Burn wound exudate analysis has proven useful in burn wound management decisions. It appears to offer a far more accurate reflection of the burn wound pathophysiology than the traditional blood/serum investigations undertaken in the past. New approaches to diagnostics and treatment efficacy assessment are possible utilizing data from this fluid. Burn wound exudate is a useful, currently under-utilized resource that is likely to take a more prominent role in burn wound management.
Topics: Bandages; Burns; Cicatrix; Cytokines; Exudates and Transudates; Humans; Wound Healing
PubMed: 24986597
DOI: 10.1016/j.burns.2014.06.002 -
Ugeskrift For Laeger May 2014
Topics: Contraindications, Procedure; Exudates and Transudates; Humans; Paracentesis; Pleural Effusion
PubMed: 25351901
DOI: No ID Found -
Scientific Reports Jul 2022Plant survival during environmental stress greatly affects ecosystem carbon (C) cycling, and plant-microbe interactions are central to plant stress survival. The release...
Plant survival during environmental stress greatly affects ecosystem carbon (C) cycling, and plant-microbe interactions are central to plant stress survival. The release of C-rich root exudates is a key mechanism plants use to manage their microbiome, attracting beneficial microbes and/or suppressing harmful microbes to help plants withstand environmental stress. However, a critical knowledge gap is how plants alter root exudate concentration and composition under varying stress levels. In a greenhouse study, we imposed three drought treatments (control, mild, severe) on blue grama (Bouteloua gracilis Kunth Lag. Ex Griffiths), and measured plant physiology and root exudate concentration and composition using GC-MS, NMR, and FTICR. With increasing drought severity, root exudate total C and organic C increased concurrently with declining predawn leaf water potential and photosynthesis. Root exudate composition mirrored the physiological gradient of drought severity treatments. Specific compounds that are known to alter plant drought responses and the rhizosphere microbiome mirrored the drought severity-induced root exudate compositional gradient. Despite reducing C uptake, these plants actively invested C to root exudates with increasing drought severity. Patterns of plant physiology and root exudate concentration and composition co-varied along a gradient of drought severity.
Topics: Droughts; Exudates and Transudates; Microbiota; Plant Roots; Plants; Poaceae; Rhizosphere
PubMed: 35869127
DOI: 10.1038/s41598-022-16408-8 -
Current Opinion in Pulmonary Medicine Jul 2019The causes of exudative pleural effusions are diverse and frequently remain unclear despite exhaustive examinations. Recently recognized IgG4-related disease (IgG4-RD)... (Review)
Review
PURPOSE OF REVIEW
The causes of exudative pleural effusions are diverse and frequently remain unclear despite exhaustive examinations. Recently recognized IgG4-related disease (IgG4-RD) is a fibroinflammatory disorder that can affect nearly any organ including the lungs. This review will focus on the involvement of IgG4 in exudative pleural effusion of unknown cause.
RECENT FINDINGS
IgG4 is found to be involved in a proportion of patients with undiagnosed pleural effusions. Pleural involvement in IgG4-RD can be seen in isolation or association with other organ disease. Pleural thickening and/or effusion are common clinical features of IgG4-related pleural lesions, and this condition is histologically characterized by a lymphoplasmacytic infiltrate enriched in IgG4-positive plasma cells in the pleura. Although the pathogenesis of IgG4-RD is poorly understood, there is a growing body of evidence that indicates an antigen-driven process requiring T-cell and B-cell interaction in which autoantibodies, plasmablasts, follicular helper T cells and CD4+ cytotoxic T lymphocytes participate.
SUMMARY
The possibility of IgG4-related pleural lesion should be considered in patients with pleural effusion of unexplained cause when lymphoplasmacytic infiltration is seen in a pleural biopsy specimen. This condition is responsive to systemic steroid therapy.
Topics: Biopsy; Diagnosis, Differential; Exudates and Transudates; Humans; Immunoglobulin G4-Related Disease; Pleura; Pleural Effusion
PubMed: 30883447
DOI: 10.1097/MCP.0000000000000581