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At least 343 records · Page 19Linked to original sources
PubMed1984

Management of acute illness in cats.

Pleural effusions can cause dyspnea and cyanosis, and are caused by cardiomyopathy, pyothorax, FIP, FeLV-related disease and trauma. Thoracentesis is used to obtain fluid samples for cytologic examination and culture. Radiographs made after thoracentesis may reveal the cause. Lymphosarcoma causes a sterile exudate containing neoplastic cells. Congestive cardiomyopathy causes a transudate or modified transudate. The sterile exudate of FIP has a proteinaceous background on cytologic examination. The exudate of pyothorax is septic. Treatment depends on the cause but generally includes thoracentesis and supportive care. Cardiomyopathy causes dyspnea, cyanosis, murmurs, gallop rhythms and other arrhythmias. Radiography reveals a globoid heart in the congestive form and a "valentine-shaped" heart in the hypertrophic form. Treatment of congestive cardiomyopathy involves use of furosemide, but is usually unrewarding. Hypertrophic cardiomyopathy is treated with propranolol. Fever may be caused by infection, immune-mediated disease, neoplasia and unknown causes. Treatment is aimed at removal of the underlying cause.

Acute Disease↗
PubMed2002

[Practical management of pleural effusion].

There are many different diseases that can be associated with pleural effusions. When a pleural effusion is discovered, two questions need to be answered: 1) is the effusion a transudate or is it an exudate?, and 2) if the effusion is an exudate, what is the disease responsible for its production?. Answers to these questions can be obtained in more than two-thirds of patients testing the pleural fluid by diagnostic thoracentesis. The remainder may require watchful waiting until resolution or further diagnostic procedures, either non-invasive (radiologic imaging) or invasive (bronchoscopy, pleural biopsy, thoracoscopy).

Diagnosis, Differential↗
PubMed1990

The serum-effusion albumin gradient in the evaluation of pleural effusions.

The objective of the study was to compare the serum-effusion albumin gradient (serum albumin level minus pleural effusion albumin level) to Light's traditional criteria (pleural fluid/serum total protein ratio greater than 0.5, pleural fluid/serum LDH ratio greater than 0.6, and pleural fluid LDH greater than 200 U/L) for identifying exudative pleural effusions. The design included prospective measurement of the serum-effusion albumin gradient and Light's criteria in patients with pleural effusions in an inpatient ward in a military teaching hospital. Fifty-nine consecutive patients with pleural effusions who were undergoing diagnostic or therapeutic thoracentesis in whom the etiology of the effusion could be determined were studied. Serum and pleural effusion fluid chemistries were measured in order to determine both the serum-effusion albumin gradient and Light's criteria. Using an albumin gradient of 1.2 g/dl or less to indicate exudates and greater than 1.2 g/dl to indicate transudates, 57 of the 59 patients (41 exudates; 18 transudates) were correctly classified. Two patients with malignant effusions were misclassified as having transudates. Although Light's criteria correctly identified all of the exudates, five patients with congestive heart failure were misclassified as exudates. Four of these patients had had previous diuretic therapy, and all had a clinical response to further diuretic therapy. We conclude that although Light's criteria for exudates are very sensitive, an albumin gradient of 1.2 g/dl or less tends to be more specific, especially in cases of chronic congestive heart failure.

Adult↗
PubMed2000

Rapid diagnosis of infectious pleural effusions by use of reagent strips.

Reagent strips have not yet been tested for use in the diagnosis of infectious pleural effusions. A reagent strip was used to evaluate 82 patients with pleural effusions: 20 patients had transudative effusions, 35 had infectious exudative effusions (empyema in 14 and parapneumonic effusion in 21), and 27 had noninfectious exudative effusions. Pleural fluid protein, as evaluated by the reagent strip, proved accurate for the detection of exudative effusions (sensitivity, 93.1%; specificity, 50%; positive predictive value, 84.3%; negative predictive value, 71.5%; odds ratio [OR], 6.77; and 95% confidence interval [CI], 1.87-24). The reagent strip leukocyte esterase test effectively detected infectious exudative effusions (sensitivity, 42.8%; specificity, 91.3%; positive predictive value, 88.2%; negative predictive value, 51.2%; OR, 4.46; and 95% CI, 1.2-16.4). Pleural pH was significantly predicted by the reagent strip but was of no assistance in categorization of exudative effusions as infectious or noninfectious. Compared with physical, laboratory, and microbiological data, the reagent strip was as accurate for estimation of percentages of infectious and noninfectious exudative effusions. Thus, reagent strips may be a rapid, easy-to-use, and inexpensive technique for discriminating transudative from exudative pleural effusions and for categorizing exudative pleural effusions as infectious or noninfectious.

Adult↗
PubMed1960

Microexudates from cells grown in tissue culture.

Cellular substrata of known molecular structure and measurable dimensions can be constructed as transferred films from Langmuir troughs or as adsorbed films. In addition, large molecules in culture media form measurable adsorbates. With the techniques of ellipsometry and surface chemistry it is possible to characterize and measure (within +/- 3A) as a function of several parameters a microexudate of molecular dimensions deposited when tissue cultured cells contact certain substrata. The selective attraction of substratum and cell for microexudate has been determined, and the time course of deposition in Eagle's medium is characterized by a rapid initial accretion of material. During this period, microexudate can diffuse several cell diameters and cannot be detected in the culture medium. In Eagle's medium the cells cannot be detached from glass surfaces by versene or trypsin unless the surface of cell or substratum is coated with certain molecules. Trypsin becomes adsorbed to cell surfaces, continues to be enzymatically active on the surface, and digests protein components of microexudate and substratum. Microexudate appears to be a complex mosaic of molecules (including protein) synthesized within or on the surfaces of cells and secreted by cells or transferred from their surfaces to specific substrata. It is proposed that this mosaic plays, on the molecular level, a significant role in cell-to-cell interactions, cell locomotion and adhesion, and the selective application and spreading of cells on various surfaces.

Cell Communication↗