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approach to diagnosis of ascites

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https://www.readbyqxmd.com/read/29692402/indian-childhood-cirrhosis-down-but-not-out-report-of-a-rare-case-with-a-practical-clinicopathological-diagnostic-approach
#1
K Gaur, P Sakhuja, R N Mandal, S Kapoor
Indian childhood cirrhosis is an entity believed to be on the verge of extinction. We present the case of a 13-month-old girl presenting acutely with jaundice, fever, and persistently increasing bilirubin. Investigations revealed direct hyperbilirubinemia, elevated transaminases, anemia, a blood with few schistocytes, positive direct coombs test, and deranged prothrombin time. Viral, autoimmune, and metabolic workup was unremarkable. Ultrasonography showed chronic liver disease, portal hypertension, and ascites...
April 2018: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/29578263/telomere-length-determined-by-the-fluorescence-in-situ-hybridisation-distinguishes-malignant-and-benign-cells-in-cytological-specimens
#2
Y Matsuda, A Suzuki, S Esaka, Y Hamashima, M Imaizumi, M Kinoshita, H Shirahata, Y Kiso, H Kojima, M Matsukawa, Y Fujii, N Ishikawa, J Aida, K Takubo, T Ishiwata, M Nishimura, T Arai
BACKGROUND: Telomeres are tandem repeats of TTAGGG at the end of eukaryotic chromosomes that play a key role in preventing chromosomal instability. The aim of the present study is to determine telomere length using fluorescence in situ hybridisation (FISH) on cytological specimens. METHODS: Aspiration samples (n = 41) were smeared on glass slides and used for FISH. RESULTS: Telomere signal intensity was significantly lower in positive cases (cases with malignancy, n = 25) as compared to negative cases (cases without malignancy, n = 16), and the same was observed for centromere intensity...
March 26, 2018: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/29509634/comparison-of-transjugular-liver-biopsy-and-percutaneous-liver-biopsy-with-tract-embolization-in-pediatric-patients
#3
Sheryl Tulin-Silver, Chrystal Obi, Nishita Kothary, Matthew Lungren
PURPOSE: The aim of the study was to compare safety and efficacy of transjugular liver biopsy (TJLB) and percutaneous liver biopsy (PLB) with tract embolization in pediatric patients with liver disease. MATERIALS AND METHODS: TJLB and PLB between December 2009 and October 2015 were retrospectively reviewed. Primary endpoints were adequate sampling and complication rate. Patient age, weight, coagulation factors, ascites, blood transfusions, adequacy of biopsy sample, number of biopsy samples, and complications were compared...
March 5, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29502362/clinical-impact-of-healthcare-associated-acquisition-in-cirrhotic-patients-with-community-onset-spontaneous-bacterial-peritonitis
#4
Jungok Kim, Cheol-In Kang, Geum-Youn Gwak, Doo Ryeon Chung, Kyong Ran Peck, Jae-Hoon Song
Background/Aims: Healthcare-associated (HCA) infection is a recently suggested new category of community-onset infections. The implications of HCA infections in terms of diagnosis, treatment, and outcomes of spontaneous bacterial peritonitis (SBP) are not well understood. We sought to delineate the differences between community-acquired (CA) SBP and HCA SBP with specific interest in the antimicrobial resistance of causative microorganisms and outcomes. Methods: We conducted a retrospective cohort study of all SBP episodes with positive ascitic culture and/or blood culture from June 2000 to August 2011...
March 5, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29476731/metabolic-causes-of-nonimmune-hydrops-fetalis-a-next-generation-sequencing-panel-as-a-first-line-investigation
#5
Bénédicte Sudrié-Arnaud, Florent Marguet, Sophie Patrier, Jelena Martinovic, Ferielle Louillet, Françoise Broux, Françoise Charbonnier, Hélène Dranguet, Sophie Coutant, Myriam Vezain, Raphaël Lanos, Abdellah Tebani, Maria Fuller, Foudil Lamari, Pascal Chambon, Anne-Claire Brehin, Laetitia Trestard, Isabelle Tournier, Stéphane Marret, Eric Verspyck, Annie Laquerrière, Soumeya Bekri
PURPOSES: Hydrops fetalis is a life-threatening fetal condition, and 85% of all cases are classified as nonimmune hydrops fetalis (NIHF). Up to 15% of NIHF cases may be due to inborn errors of metabolism (IEM), but a large proportion of cases linked to metabolic disorders remains undiagnosed. This lack of diagnosis may be related to the limitations of conventional biological procedures, which involve sequential investigations and require multiple samples and steps. In addition, this approach is time consuming...
June 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29397622/-current-situation-and-prospect-of-breast-cancer-liquid-biopsy
#6
B Zhou, L Xin, L Xu, J M Ye, Y H Liu
Liquid biopsy is a diagnostic approach by analyzing body fluid samples. Peripheral blood is the most common sample. Urine, saliva, pleural effusion and ascites are also used. Now liquid biopsy is mainly used in the area of neoplasm diagnosis and treatment. Compared with traditional tissue biopsy, liquid biopsy is minimally invasive, convenient to sample and easy to repeat. Liquid biopsy mainly includes circulating tumor cells and circulating tumor DNA (ctDNA) detection. Detection of ctDNA requires sensitive and accurate methods...
February 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29379145/just-the-tip-of-the-iceberg-difficulties-in-assessing-and-managing-extreme-obesity-in-routine-clinical-care
#7
Christine Poitou, Margot Denis, Zeina Chakhtoura, Catherine Uzan, Maryam Nikpayam, Jean-Michel Oppert
As obesity prevalence increases worldwide, healthcare professionals are often faced with challenging cases associated with massive obesity. A 33-year-old woman (weight 342 kg, body mass index = 100 kg/m²) presented with respiratory failure, limb edema and ascites. Abdominal CT scan became feasible after initial weight loss and showed a large pelvic mass in contact with the left ovary. The surgical removal performed despite a high-risk profile led to the diagnosis of a giant mucinous borderline tumor whose growth was due to delayed care and responsible for multiple severe complications: sepsis, anemia, esophagitis, constipation, anorexia due to mechanical compression, undernutrition, sarcopenia and lower limb edema contributing to a severe disability...
March 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29377355/gallbladder-agenesis-in-17-dogs-2006-2016
#8
K Sato, M Sakai, S Hayakawa, Y Sakamoto, Y Kagawa, K Kutara, K Teshima, K Asano, T Watari
BACKGROUND: Gallbladder agenesis (GBA) is extremely rare in dogs. HYPOTHESIS/OBJECTIVES: To describe the history, clinical signs, diagnosis, treatment, and outcomes of dogs with GBA. ANIMALS: Seventeen client-owned dogs with GBA. METHODS: Medical records from 2006 through 2016 were retrospectively reviewed. Dogs were included when GBA was suspected on abdominal ultrasonography and confirmed by gross evaluation. Signalment, clinical signs, clinicopathological data, diagnostic imaging, histopathology, treatment, and outcome were recorded...
January 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29374723/low-dose-pressurized-intrathoracic-aerosol-chemotherapy-pitac-as-an-alternative-therapy-for-pleuropulmonary-involvement-in-pseudomyxoma-peritonei
#9
Manuela Robella, Marco Vaira, Alice Borsano, Claudio Mossetti, Michele DE Simone
BACKGROUND/AIM: Pseudomyxoma peritonei (PMP) is a rare disease characterized by mucinous ascites and widespread peritoneal implants. It usually originates from the rupture of an adenoma/adenocarcinoma of the appendix. Although this tumor is only superficially invasive and does not metastasize, it could be a fatal disease. Extra-abdominal spread of PMP is an unusual occurrence with few reports in medical literature. CASE REPORT: A 50-year-old man was diagnosed with PMP according to the findings of thorax and abdomen CT scan and cytologic and histological examinations...
February 2018: Anticancer Research
https://www.readbyqxmd.com/read/29364009/laparoscopic-aproach-in-post-traumatic-chylous-ascites
#10
L Tallón-Aguilar, J A López-Ruiz, C Domínguez-Sánchez, F Pareja-Ciuró, J Padillo-Ruiz
Chylous ascites is a rare condition little reported in literature, with even more exceptional traumatic origin. Its production mechanism is not known exactly but has been attributed to hyperflexion or hyperextension of the spine leading to a rupture of lymph ducts. We present a case of post-traumatic chyloperitoneum in a young patient after abdominal blunt trauma. Conservative treatment should be the first therapeutic option, especially if the origin is traumatic, reserving more aggressive possibilities for cases that do not respond after 15 days, if debt is greater than 1...
March 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29360196/expression-of-micrornas-in-the-ascites-of-patients-with-peritoneal-carcinomatosis-and-peritonitis
#11
Philipp Schindler, Juozas Kupcinskas, Simonas Juzenas, Jurgita Skieceviciene, Violeta Salteniene, Christian Schulz, Jochen Weigt, Peter Malfertheiner, Alexander Link
BACKGROUND: Peritoneal carcinomatosis (PCA) has a prognostic role in patients with gastrointestinal cancers. The differential diagnosis may be challenging due to the low sensitivity of cytology. Although microRNAs (miRNAs) have been a focus of various specimens and diseases, to the best of the authors' knowledge only limited knowledge exists regarding ascites. Herein, the authors systematically evaluated preanalytical factors and the potential of miRNAs as biomarkers of ascites. METHODS: The authors prospectively analyzed samples from patients with PCA, spontaneous bacterial peritonitis (SBP), and portal hypertension (no SBP/PCA)...
January 23, 2018: Cancer Cytopathology
https://www.readbyqxmd.com/read/29315697/fractional-excretion-of-urea-a-simple-tool-for-the-differential-diagnosis-of-acute-kidney-injury-in-cirrhosis
#12
Kavish R Patidar, Le Kang, Jasmohan S Bajaj, Daniel Carl, Arun J Sanyal
Current approaches to determine the cause of acute kidney injury (AKI) in patients with cirrhosis are suboptimal. The aim of this study was to determine the utility of fractional excretion of urea (FEUrea) for the differential diagnosis of AKI in cirrhotic patients. A retrospective analysis was performed in patients (n=50) with cirrhosis and ascites admitted with AKI. Using adjudicated etiology assessment as the reference standard, receiver operating curves (ROC) and optimal cutoff, sensitivity (Sn) and specificity (Sp) for the diagnosis of prerenal azotemia (PRA), type 1 hepatorenal syndrome (HRS) and acute tubular necrosis (ATN) was derived...
January 8, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29313804/endolymphatic-balloon-occluded-retrograde-abdominal-lymphangiography-boral-and-embolization-borale-for-the-diagnosis-and-treatment-of-chylous-ascites-technique-and-experience-in-three-patients
#13
Ravi N Srinivasa, Joseph J Gemmete, Matthew L Osher, Jeffrey Forris Beecham Chick
PURPOSE: To describe endolymphatic balloon-occluded retrograde abdominal lymphangiography (BORAL) and embolization (BORALE) for diagnosis and treatment of chylous ascites in patients with previously unidentifiable leakage site or failed lymphatic embolization. MATERIALS AND METHODS: Two (66%) men and one (33%) woman with mean age of 52 years (range: range: 14-79 years) presented with chylous ascites and underwent BORAL or BORALE between March 2016 and February 2017...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29274599/bowel-obstruction-in-obturator-hernia-a-challenging-diagnosis
#14
L Conti, E Baldini, P Capelli, C Capelli
INTRODUCTION: The obturator hernia is a rare pelvic hernia that often comes in the shape of bowel obstruction caused by the presence of an intestinal segment, more often ileum, passing trough the obturator foramen of the pelvic wall (Fig. 1). This type of hernia accounts for 0.5-1.4% of all hernias. CASE PRESENTATION: We report the clinical case of a 84-year-old woman with no previous surgical interventions, who went to the emergency room complaining of vomit and nausea, bowels closed to gas and stool, which she had experienced for three previous days...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29217440/endolymphatic-balloon-occluded-retrograde-abdominal-lymphangiography-boral-and-embolization-borale-for-the-diagnosis-and-treatment-of-chylous-ascites-approach-technical-success-and-clinical-outcomes
#15
Ravi N Srinivasa, Joseph J Gemmete, Matthew L Osher, Anthony N Hage, Jeffrey Forris Beecham Chick
BACKGROUND: To describe endolymphatic balloon-occluded retrograde abdominal lymphangiography (BORAL) and embolization (BORALE) for diagnosis and treatment of chylous ascites in patients with previously unidentifiable leakage site or failed lymphatic embolization. METHODS: Two (66%) men and 1 (33%) woman with mean age of 52 years (range: 14-79 years) presented with chylous ascites and underwent BORAL or BORALE between March 2016 and February 2017. Patients presented with chylous ascites (n = 3) and with renal cell carcinoma after left nephrectomy and lymph node dissection (n = 1), metastatic Merkel cell carcinoma after left nephrectomy and adrenalectomy (n = 1), and heart transplantation after failed Fontan procedure (n = 1)...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29076695/broad-ligament-haematoma-following-normal-vaginal-delivery
#16
Faiza Ibrar, Azra Saeed Awan, Touseef Fatima, Hina Tabassum
A 37-year-old, patient presented in emergency with history of normal vaginal delivery followed by development of abdominal distention, vomiting, constipation for last 3 days. She was para 4 and had normal vaginal delivery by traditional birth attendant at peripheral hospital 3 days back. Imaging study revealed a heterogeneous complex mass, ascites, pleural effusion, air fluid levels with dilatation gut loops. Based upon pelvic examination by senior gynaecologist in combination with ultrasound; a clinical diagnosis of broad ligament haematoma was made...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28892178/review-article-the-diagnostic-approach-and-current-management-of-chylous-ascites
#17
REVIEW
B Lizaola, A Bonder, H D Trivedi, E B Tapper, A Cardenas
BACKGROUND: Chylous ascites is rare, accounting for less than 1% of cases. An appropriate and stepwise approach to its diagnosis and management is of key importance. AIM: To review the current diagnostic approach and management of chylous ascites. METHODS: A literature search was conducted using PubMed using the key words 'chylous', 'ascites', 'cirrhosis', 'pathophysiology', 'nutritional therapy', 'paracentesis", "transjugular intrahepatic portosystemic shunt" and "TIPSS'...
November 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28876707/-initial-management-of-new-onset-ascites-in-patient-with-cirrhosis
#18
Léon Finci, Stéphane Mouraux, Judith Knuchel, Laurent Bochatay
Ascites is the most frequent complication of cirrhosis and represents a significant change for the patient because the impact on mortality and quality of life is important. The management of a patient with initial onset of ascites includes a full history, a clinical exam and complementary analysis. This systematic approach allows an etiologic diagnosis. The aim of this article is to review the etiologies encountered in the initial onset of ascites in patient suffering from cirrhosis, to help the diagnosis and start initial management...
September 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28818214/treatment-outcomes-and-risk-factors-for-bowel-infarction-in-patients-with-acute-superior-mesenteric-venous-thrombosis
#19
Hyung-Kee Kim, Deokbi Hwang, Sujin Park, Jong-Min Lee, Seung Huh
OBJECTIVE: The prognosis of acute superior mesenteric venous thrombosis (SMVT) remains obscure. We aimed to investigate the treatment outcomes and possible risk factors for bowel infarction in these patients. METHODS: We retrospectively included 66 patients with acute SMVT between January 2002 and June 2016. Each patient underwent contrast-enhanced computed tomography as part of the initial diagnosis. The standard protocol for management included a nonsurgical approach with early anticoagulation and selective exploration...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28812198/laparoscopic-colectomy-reduces-complications-and-hospital-length-of-stay-in-colon-cancer-patients-with-liver-disease-and-ascites
#20
Kevin Y Pei, David T Asuzu, Kimberly A Davis
BACKGROUND: Ascites increases perioperative complications and risk of death, but is not an absolute contraindication for colectomy in patients with colon cancer. It remains unclear whether postoperative risks can be minimized using a laparoscopic versus open approach. METHODS: Data were retrospectively analyzed from 2152 patients with ascites who underwent laparoscopic or open partial colectomy with diagnosis of colon cancer from 2005 to 2013 using the American College of Surgeons National Surgical Quality Improvement Program database...
March 2018: Surgical Endoscopy
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