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The article discusses the case of a domestic short-hair cat with abdominal distention. Topics discussed include the results of abdominal radiography, differential diagnosis including pyometra and adenocarcinoma of the pancreas, and ovariohysterectomy and surgical biopsy of the pancreas performed on the cat. Also discussed are the treatment and outcome of the veterinary patient.

Detection of sperm in the peritoneal fluid of animals is unusual and has not been reported in the literature. In this report, we describe the presence of sperm cells in the peritoneal fluid of a two-year-old ram. The ram was presented with dyspnea, reduced rumen contractions, a mild degree of dehydration, cyanotic mucosa, difficulty in standing, and anuria. Ancillary diagnostics, including ultrasonography, radiography, complete blood cell count, and abdominocentesis were performed. In the peripheral blood sample, no blood parasites were observed, although thrombocytosis with toxic neutrophilia, and atypical lymphocytes were seen in the blood smear. In radiographs, urolithiasis was confirmed just on the sigmoid flexure position. Ultrasound examination revealed a distended bladder and large amounts of free fluid within the peritoneal cavity. The electrocardiogram analysis showed the absence of P waves, bradycardia, wide QRS complexes, ST-segment elevation, and tented T waves. In the peritoneal fluid smears, a large number of spermatozoa, and increased inflammatory cells were observed. It was concluded that the trauma or rupture in colliculus seminalis, ductus deferens, or the urethra with urinary stones resulted in leakage of spermatozoa to the peritoneal cavity. To our knowledge, this is the first report of the presence of spermatozoa in the peritoneal fluid of large animals.

Peritoneal effusion is a common event in ovarian cancer (OC) patients. LncRNA H19 and vascular endothelial growth factor (VEGF) are implicated in cancer progression. The study evaluated the curative effect and safety of bevacizumab combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in OC patients with peritoneal effusion and the effect on serum lncRNA H19/VEGF levels. Totally 248 OC patients with peritoneal effusion were treated with intraperitoneal bevacizumab + HIPEC (observation group) or abdominal paracentesis without HIPEC (control group). The clinical efficacy, quality of life, and adverse reactions were evaluated after two treatment cycles. The serum lncRNA H19 and VEGF levels pre-/post-treatment were determined by RT-qPCR and ELISA. The observation group exhibited better clinical efficacy than the control group, evidenced by a higher partial response rate, response rate, and disease control rate. The observation group exhibited reduced physical/cognitive/role/social/emotional function scores and total adverse reactions. LncRNA H19/VEGF levels showed no significant difference between the two groups before treatment but were significantly downregulated in the observation group after treatment. Summarily, intraperitoneal bevacizumab + HIPEC has significant efficacy in treating peritoneal effusion, improves the quality of life, and reduces serum lncRNA H19 and VEGF levels in OC patients, with fewer adverse reactions and higher safety. What is already known on this subject? The utilization of hyperthermic intraperitoneal chemotherapy (HIPEC) as an emerging treatment option for abdominal malignancies has garnered the attention of numerous researchers over the years, which has significant clinical effects on peritoneal effusion in ovarian cancer and can control patients' conditions and improve their signs and symptoms to a certain extent. What do the results of this study add? In this paper, we investigated the efficacy and safety of intraperitoneal bevacizumab combined with hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal effusion in ovarian cancer. Meanwhile, we compared serum lncRNA H19 and VEGF levels before and after treatment. What are the implications of these findings for clinical practice and/or further research? Our findings may provide a clinically worthy method for the treatment of peritoneal effusion in ovarian cancer. The treatment method reduces serum lncRNA H19 and VEGF levels in patients, which provides a theoretical basis for further research. [ABSTRACT FROM AUTHOR]

Detection of sperm in the peritoneal fluid of animals is unusual and has not been reported in the literature. In this report, we describe the presence of sperm cells in the peritoneal fluid of a twoyear-old ram. The ram was presented with dyspnea, reduced rumen contractions, a mild degree of dehydration, cyanotic mucosa, difficulty in standing, and anuria. Ancillary diagnostics, including ultrasonography, radiography, complete blood cell count, and abdominocentesis were performed. In the peripheral blood sample, no blood parasites were observed, although thrombocytosis with toxic neutrophilia, and atypical lymphocytes were seen in the blood smear. In radiographs, urolithiasis was confirmed just on the sigmoid flexure position. Ultrasound examination revealed a distended bladder and large amounts of free fluid within the peritoneal cavity. The electrocardiogram analysis showed the absence of P waves, bradycardia, wide QRS complexes, ST-segment elevation, and tented T waves. In the peritoneal fluid smears, a large number of spermatozoa, and increased inflammatory cells were observed. It was concluded that the trauma or rupture in colliculus seminalis, ductus deferens, or the urethra with urinary stones resulted in leakage of spermatozoa to the peritoneal cavity. To our knowledge, this is the first report of the presence of spermatozoa in the peritoneal fluid of large animals. [ABSTRACT FROM AUTHOR]

Background: The "international system for reporting serous fluid cytopathology"(TIS) consists of five diagnostic categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of undetermined significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). The study was conducted to reclassify effusion cytology samples according to the newly proposed TIS to calculate the risk of malignancy (ROM) for each category and to conduct performance analysis. Materials and Methods: The study was a retrospective observational study conducted at a tertiary care institution in North India. Clinical data of the cases from June 2013 to July 2021 were retrieved and the cases were reviewed by two cytopathologists. All cases were reclassified according to the proposed TIS system into five categories. Results: A total of 2318 patients were included in the study over a time span of 8 years, and 1614 (69.6%) cases of pleural effusion cytology, 612 (26.4%) cases of peritoneal effusion cytology, and 92 (3.9%) cases of pericardial effusion cytology were included. All effusion cytology smears were recategorized as per TIS guidelines into ND, NFM, AUS, SFM, and MAL with 4 (0.17%), 1756 (75.75%), 12 (0.51%), 57 (2.46%), and 489 (21.11%) cases, respectively, and ROM was 25%, 17.9%, 66.7%, 75.4%, and 96.5%, respectively, for the categories. Conclusion: Besides being a simple, easy, and user-friendly system, TIS has the benefit of risk stratification and ROM for each category. The TIS system proposed a tiered scheme, which places the effusion cytology into well-defined categories, and therefore has lesser chances of false-positive and false-negative cases. [ABSTRACT FROM AUTHOR]

The study aims to identify the morphoclinical and paraclinical elements useful in the diagnosis of FIP, given that the symptoms are sometimes uncharacteristic, varied and often similar to those of other diseases. The morphoclinical features of 32 patients diagnosed with FIP were evaluated. In 26 patients (81.25%), the predominant symptomatology was similar: intermittent fever, loss of appetite, weakness, dyspnoea and physical signs of peritoneal fluid collection. The peritoneal puncture fluid was inflammatory, with numerous large phagocytes (neutrophils and macrophages), lymphocytes and, in some cases, red blood cells. The cell blood count (CBC) showed the existence of normocytic, hypochromic and hypoplastic anaemia and the presence of an active systemic inflammatory process, confirmed by the presence of aggregated platelets and segmented and vacuolated neutrophils in the stained smear May Grunwald Giemsa (MGG). Biochemical blood examination revealed the evolution of a physiopathological syndrome of hepatocytolysis, increased tissue catabolism and haemolytic anaemia. These results confirm that FIP is usually a systemic disease with polymorphic clinical signs, and biochemical blood tests, unlike CBC, have more prognostic value and lower value for suspecting the disease. However, sometimes, lesions and associated clinical signs in a single organ predominate. Thus, in three patients (9.37%), the predominant symptomatology was hepato-digestive with hepatocellular jaundice; one patient had obvious clinical signs of renal failure, one had signs of cortical syndrome, and one patient showed periosteal lesions (granulomatous osteitis). These results indicate that some less common lesions in cats, such as osteitis granulomatous, should be included in the list of FIP lesions.

Background: Serous fluids are commonly produced in many disease conditions and it is relatively easy to collect it. Subjecting it to analysis will help identify the etiology of the disease process and thereby help the clinicians to plan the treatment strategy appropriately. The application of the international system for reporting serous fluid cytology will further make it easy for the clinicians with its simpler terminologies and clear categorization of entities. Materials and method: All effusion samples that were received from 2020 to 2022 were examined and categorized according to international system for reporting serous fluid cytology. Risk of malignancy (ROM) was also calculated. Results: Among 400 cases, 140 (35%) were pleural fluid, 260 (65%) were ascitic fluid. Among 140 pleural fluid, 8 (5.7%) were ND, 121 (86.4%) were NFM, 2 (1.4%) were AUS, 5(3.6%) were SFM and 4 (2.9%) were MAL. Among the 260 peritoneal fluid, 13 (5%), 226 (86.9%), 9 (3.5%), 9 (3.5%), and 3 (1.1%) were reported as ND, NFM, AUS, SFM and MAL respectively. Risk of Malignancy (ROM) calculated for the cases collected in this study were 0% for ND, 0.9% for NFM, 45.5% for AUS, 71.4% for SFM and 100% for MAL. Conclusion: The international system (TIS) for reporting serous fluid cytopathology is very easy to employ and gives high accuracy with clear diagnostic criteria for each category, hence makes it easy to communicate with the clinicians by employing simple terminologies.

The objective of this study was to investigate the relationship between serum tumor markers and serous effusion in systemic lupus erythematosus (SLE) patients, thereby contributing preliminary data on the utility of these tumor markers in diagnosing serous effusion. In this retrospective analysis, clinical data of SLE patients were extracted from electronic medical records. This included the levels of serum tumor markers, including pro-gastrin-releasing peptide, neuron-specific enolase (NSE), cytokeratin-19 fragments (CYFRA 21-1), various carbohydrate antigens (CA 153, CA 125, CA 19-9), along with carcinoembryonic antigen, and alpha-fetoprotein. Positivity of tumor markers was established based on serum levels surpassing the upper threshold of the respective reference ranges. This study included 149 eligible patients with SLE, of whom 38 (25.50%) had serous effusion, and the prevalence of pleural, pericardial, and peritoneal effusions was 11.41%, 14.77%, and 6.71%, respectively. The analysis revealed that patients with serous effusion had higher scores on the SLE Disease Activity Index 2000 (SLEDAI 2000) than those without serous effusion. Notably, this disparity remained significant when the serositis score was excluded from the SLEDAI 2000 calculation. The positivity rate and serum levels of CA 125 were higher in patients with serous effusion and pleural effusion. Patients with pericardial effusion demonstrated an elevated CYFRA 21-1 positivity rate and serum CA 125 and CYFRA 21-1 levels compared to patients without pericardial effusion. CA 125 and NSE were higher both in terms of positivity rate and serum levels for patients with peritoneal effusion. Through receiver operating characteristic curve analysis, a moderate relationship was discerned between the conjoined levels of CYFRA 21-1 and CA 125 and the occurrence of pericardial effusion. Additionally, CA 125, NSE, and their combination revealed the moderate diagnostic ability of peritoneal effusion. In summary, this study observed elevated serum levels of various tumor markers in SLE patients exhibiting serous effusion, which is likely attributable to lupus-induced inflammation. These findings suggest that serum tumor markers can be valuable in diagnosing pericardial and peritoneal effusions.

Peritoneal effusion is a common event in ovarian cancer (OC) patients. LncRNA H19 and vascular endothelial growth factor (VEGF) are implicated in cancer progression. The study evaluated the curative effect and safety of bevacizumab combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in OC patients with peritoneal effusion and the effect on serum lncRNA H19/VEGF levels. Totally 248 OC patients with peritoneal effusion were treated with intraperitoneal bevacizumab + HIPEC (observation group) or abdominal paracentesis without HIPEC (control group). The clinical efficacy, quality of life, and adverse reactions were evaluated after two treatment cycles. The serum lncRNA H19 and VEGF levels pre-/post-treatment were determined by RT-qPCR and ELISA. The observation group exhibited better clinical efficacy than the control group, evidenced by a higher partial response rate, response rate, and disease control rate. The observation group exhibited reduced physical/cognitive/role/social/emotional function scores and total adverse reactions. LncRNA H19/VEGF levels showed no significant difference between the two groups before treatment but were significantly downregulated in the observation group after treatment. Summarily, intraperitoneal bevacizumab + HIPEC has significant efficacy in treating peritoneal effusion, improves the quality of life, and reduces serum lncRNA H19 and VEGF levels in OC patients, with fewer adverse reactions and higher safety.Impact statement What is already known on this subject? The utilization of hyperthermic intraperitoneal chemotherapy (HIPEC) as an emerging treatment option for abdominal malignancies has garnered the attention of numerous researchers over the years, which has significant clinical effects on peritoneal effusion in ovarian cancer and can control patients’ conditions and improve their signs and symptoms to a certain extent. What do the results of this study add? In this paper, we investigated the efficacy and safety of intraperitoneal bevacizumab combined with hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal effusion in ovarian cancer. Meanwhile, we compared serum lncRNA H19 and VEGF levels before and after treatment. What are the implications of these findings for clinical practice and/or further research? Our findings may provide a clinically worthy method for the treatment of peritoneal effusion in ovarian cancer. The treatment method reduces serum lncRNA H19 and VEGF levels in patients, which provides a theoretical basis for further research.

Background: The “international system for reporting serous fluid cytopathology”(TIS) consists of five diagnostic categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of undetermined significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). The study was conducted to reclassify effusion cytology samples according to the newly proposed TIS to calculate the risk of malignancy (ROM) for each category and to conduct performance analysis. Materials and Methods: The study was a retrospective observational study conducted at a tertiary care institution in North India. Clinical data of the cases from June 2013 to July 2021 were retrieved and the cases were reviewed by two cytopathologists. All cases were reclassified according to the proposed TIS system into five categories. Results: A total of 2318 patients were included in the study over a time span of 8 years, and 1614 (69.6%) cases of pleural effusion cytology, 612 (26.4%) cases of peritoneal effusion cytology, and 92 (3.9%) cases of pericardial effusion cytology were included. All effusion cytology smears were recategorized as per TIS guidelines into ND, NFM, AUS, SFM, and MAL with 4 (0.17%), 1756 (75.75%), 12 (0.51%), 57 (2.46%), and 489 (21.11%) cases, respectively, and ROM was 25%, 17.9%, 66.7%, 75.4%, and 96.5%, respectively, for the categories. Conclusion: Besides being a simple, easy, and user-friendly system, TIS has the benefit of risk stratification and ROM for each category. The TIS system proposed a tiered scheme, which places the effusion cytology into well-defined categories, and therefore has lesser chances of false-positive and false-negative cases.

Background: Cytologic specimens often represent the initial diagnostic material for tubo‐ovarian neoplasms resulting from therapeutic paracentesis for patients presenting with high‐volume ascites. However, subtyping and immunohistochemical (IHC) characterization, which have implications in preoperative management and downstream ancillary testing, are not routinely performed in many institutions. This study aims to perform cytohistologic correlation of commonly used IHC stains to establish their reliability in peritoneal fluids/washing specimens. Methods: A retrospective search of the laboratory information systems was performed to identify peritoneal fluid/washing specimens involved by borderline or malignant epithelial tubo‐ovarian neoplasms and concurrent/subsequent surgical resection specimens. Cell blocks and tissue were stained for PAX8, WT‐1, p53, p16, Napsin‐A, estrogen receptor, and progesterone receptor, and staining between cytological and surgical specimens was compared. Results: A total of 56 case pairs were included, with the following final diagnoses on histological examination: 37 high‐grade serous carcinomas, eight clear cell carcinomas, one endometrioid adenocarcinoma, two low‐grade serous carcinomas, and eight serous borderline tumors. There was perfect cytohistologic correlation for PAX8 (Lin's concordance correlation coefficient [LINCCC] = 1.00) and WT‐1 (LINCCC = 1.00), substantial/good correlation for p53 (LINCCC = 0.96), p16 (LINCCC = 0.93), napsin‐A (LINCCC = 0.91) and ER (LINCCC = 0.77), and moderate correlation for PR (LINCCC = 0.54). Conclusions: Immunohistochemical correlation between peritoneal fluid and surgical resection specimens for tubo‐ovarian neoplasms is high. Common subtypes of tubo‐ovarian carcinomas can be reliably distinguished on fluids using IHC. Cytohistologic correlation of immunohistochemistry (IHC) in tubo‐ovarian neoplasms is high. Common subtypes can be reliably distinguished on fluids using IHC. [ABSTRACT FROM AUTHOR]

IntroductionThe clinical manifestations of paragonimiasis are diverse and non-specific, and can easily lead to misdiagnosis. We aimed to analyze the clinical manifestations, laboratory features, treatment, and clinical outcome of children with paragonimiasis in order to improve recognition of this disease and avoid misdiagnosis.MethodsChildren diagnosed with paragonimiasis from August 2016 to July 2022 were included in the study. Information on population informatics, medical history, and laboratory features was extracted from case data. The clinical features of paragonimiasis were retrospectively analyzed.ResultsA total of 45 children were included in this study. All children had, at least, one risk factor. The clinical features mainly included fever, cough, pleural effusion, peritoneal effusion, and subcutaneous nodules. The main imaging findings were alveolar exudation, peritoneal effusion, pleural thickening, and local nodules. The “tunnel sign” finding on computed tomography (CT)/magnetic resonance imaging (MRI) was helpful in establishing the diagnosis of paragonimiasis. After praziquantel treatment, most of the children improved, and one child with cerebral paragonimiasis experienced sequelae.ConclusionMost children with paragonimiasis have a good prognosis, but few children can experience sequelae. Avoidance of untreated water and raw food is a simple, feasible, and effective preventive measure.

Dagninet Alelign,1 Gemechu Ameya,2 Munira Siraj1 1Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Kotebe Metropolitan University, Addis Ababa, EthiopiaCorrespondence: Dagninet Alelign Tel +251 931-155-573Email dagninet.alelign@gmail.comBackground: Ascitic fluid plays a critical role in the microbiological diagnosis of peritonitis. Drug-resistant bacterial infection of the peritoneal cavity is becoming a public health threat. However, data on bacterial profile and antimicrobial-resistant pattern of isolates from the ascitic fluid are scarce. Thus, this study was aimed to assess drug-resistant bacteriological profiles and factors associated with peritonitis in southern Ethiopia.Methods: An institutional-based cross-sectional study was conducted from March 2019 to December 2019. A semi-structured questionnaire was used to collect socio-demographic and clinical data. A total of 147 ascitic fluid samples were aseptically collected and inoculated onto blood agar, MacConkey agar, and chocolate agar. The inoculated culture media were incubated aerobically and micro-aerobically at 37°C for 48 hrs. Bacterial identification was done by standard protocols and the antimicrobial susceptibility testing by Kirby Bauer’s disk diffusion method. Logistic regression was used to identify the associated factors with bacterial peritonitis.Results: Of the total study participants, the overall magnitude of bacterial peritonitis was 19.05% with a total of 30 bacterial isolates. Majority of the isolates were Gram negative bacteria with predominant species E. coli 36.67% followed by Gram positive S. aureus 13.33%. The multidrug resistant isolates accounts about 43.3% while a quarter of isolated S. aureus were methicillin resistant. The bacterial peritonitis was associated with recent history of surgery [AOR = 8.724, 95% CI: (2.688– 28.314)], hospitalization more than seven days [AOR = 8.990, 95% CI: (2.755– 29.342)], cirrhosis [AOR = 2.751, 95% CI: (1.109– 6.822)] and alcoholism [AOR = 5.802, 95% CI: (1.948– 17.285)].Conclusion: Nearly half of the isolated bacteria were observed to be MDR, and this may alarm all healthcare workers and policymakers. Thus, continuous surveillance of antimicrobial resistance patterns along with associated factors is essential for regular monitoring of transmission of drug-resistant bacteria and the emergence of antibiotic resistance.Keywords: antimicrobial resistance, ascitic fluid, bacteriological profile, peritoneal effusion, southern Ethiopia

Quiz regarding the cytological analysis of peritoneal effusion in a patient with a history of myeloproliferative neoplasm. [ABSTRACT FROM AUTHOR]

Hemolymphangioma is a congenital malformation of blood vessels and lymphatic vessels, commonly found in the head, neck, and subcutaneous, rarely in the viscera and extremely rarely in the liver. In this case, a 6-year-old boy was found to have abdominal distension for more than 2 months with no other obvious symptoms. Physical examination revealed a large abdominal mass that was hard and not mobile. Laboratory tests found no obvious abnormity. Preoperative ultrasound and CT showed a huge cystic and solid-cystic tumor in the abdomen with close relationship to the right lower margin of the liver and fluid accumulation in the abdominopelvic cavity. The preliminary diagnoses were a malignant tumor of embryonic origin and undifferentiated sarcoma. Liver tumor resection was performed in our hospital, and the postoperative pathology was diagnosed as hepatic hemolymphangioma. The patient recovered well after surgery. It is easy to diagnose a large abdominal mass in a child as a malignant tumor of the liver and delay the treatment—no obvious symptoms, no obvious abnormalities in laboratory tests, and imaging shows a multiocular cystic lesion with clear borders and no invasion of blood vessels, indicating that the possibility of this disease should be considered. The tumor has an abnormal rich blood supply, and preoperative imaging evaluation clearly shows the vascular pathway and blood supply status to help optimize the surgical plan.

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Objective: To evaluate the use of a veterinary point‐of‐care urine culture system (POCUCS) for the diagnosis of septic peritonitis. Design: Prospective feasibility study performed between August 2017 and April 2018. Setting: Private referral hospital. Animals: Twenty samples of naturally occurring canine peritoneal effusion collected via aseptic abdominocentesis. Procedures: Point‐of‐care urine culture systems were inoculated and incubated according to manufacturer's instructions. The presence of bacterial growth, estimation of colony‐forming units/mL of bacteria, and organism identification were recorded. Bacterial growth and organism identification on POCUCS were compared to an aerobic culture performed at a commercial microbiology laboratory. Serial dilution and subsequent culture on a POCUCS of a confirmed Escherichia coli infected peritoneal effusion and negative control sample were performed to determine the lowest concentration of bacteria detectable. Results: There were 10 septic and 10 aseptic samples of peritoneal effusion confirmed by aerobic laboratory culture. Of the 10 culture‐positive samples, 8 were culture‐positive on the POCUCS. The sensitivity and specificity of the POCUCS for the detection of bacteria in peritoneal effusion were 80.0% and 100%, respectively. The POCUCS lowest limit of detectable bacteria in peritoneal effusion was 1000 CFUs/mL. Conclusions: The POCUCS evaluated in this study was less sensitive and less rapid for diagnosing septic peritonitis than blood glucose to peritoneal effusion glucose ratio and plasma lactate to peritoneal effusion glucose ratio. This POCUCS is not recommended as a tool for diagnosing septic peritonitis. [ABSTRACT FROM AUTHOR]

Background: There is disagreement in the literature about the proportion of neutrophils expected in canine transudates. A cutoff of <30% neutrophils has been recommended for distinguishing transudates from exudates, but its validity has not been established. Objective: The aim of this study was to evaluate differential cell counts in canine effusions and analyze the percentage and number of neutrophils in transudates and exudates. Methods: Effusion data were obtained retrospectively from 263 dogs with pleural or peritoneal effusion. Low‐protein transudates, high‐protein transudates, and exudates were classified using the total protein (TP) concentration and total nucleated cell count (TNCC). Differential percentages and absolute neutrophil counts were compared by the effusion type and underlying etiology. Results: Low‐protein transudates (n = 63), high‐protein transudates (n = 84), and exudates (n = 77) had a median (range) of 35% (0%‐100%), 59% (0%‐100%), and 90% (50%‐98%) neutrophils (P <.0001). All effusions with <50% neutrophils were transudates, but 53% of transudates had ≥50% neutrophils, and 69% had ≥30%. Median neutrophil counts were 62/µL (0‐892/µL), 538/µL (0‐4550/µL), and 45 590/µL (5400‐496 800/µL) in low‐protein transudates, high‐protein transudates, and exudates, respectively (P <.0001). Neutrophil counts correlated with TNCC (r2 = 0.99), such that using neutrophil cutoffs did not affect effusion classifications in most cases. Neutrophil percentages and counts were higher in effusions from dogs with uroabdomen and sepsis (P <.01); neutrophil counts were lower in dogs with hepatic insufficiency (P <.0001). Uroabdomen usually caused low‐protein, high‐neutrophil exudates. Conclusions: Although effusions with <50% neutrophils are transudates, most transudates and exudates have ≥50% neutrophils, limiting the diagnostic usefulness of % neutrophils for classifying effusions. Absolute neutrophil cutoffs did not notably improve effusion classification but could warrant future studies. [ABSTRACT FROM AUTHOR]

Objective: To observe the clinical efficacy of acupuncture combined with Chinese medicinal therapy in the treatment of malignant peritoneal effusion in ovarian cancer and its effects on peritoneal effusion and Karnofsky Performance Status (KPS). Methods: A total of 62 cases of patients with malignant peritoneal effusion caused by ovarian cancer were recruited and divided into an observation group and a control group by using a random number table method, with 31 cases in each group. All of the patients should be treated with intraperitoneal perfusion chemotherapy. Patients in the control group were treated with Chinese medicinal treatment. The Chinese medicinal formula included Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill), Jiu Wei Qiang Huo Tang (Nine Ingredients Notopterygium Decoction) and Ji Jiao Li Huang Wan Jia Jian (Stephaniae Tetrandra, Zanthoxyli, Lepidii and Rhubarb Variant Pill). Patients in the observation groups were treated with acupuncture treatment on the basis of the control group. The two groups were treated for one month. The clinical efficacy, number of times of peritoneal effusion drainage, change of KPS score and the incidence of adverse reactions in the two groups were compared and analyzed. Results: The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). The number of times of peritoneal effusion drainage of the observation group was less than that of the control group, and the difference was statistically significant (P < 0.05). Before treatment, there was no significant difference in the overall score of clinical symptoms between the two groups (P > 0.05). After treatment, the overall score of clinical symptoms in the two groups decreased to some extent comparing with that before treatment respectively, and the differences were statistically significant (P < 0.05). Moreover, the observation group was lower than the control group, and the difference was statistically significant (P < 0.05). Before treatment, there was no significant difference in the KPS score between the two groups (P > 0.05). After treatment, the KPS score of the two groups increased to some extent comparing with that before treatment respectively, and the differences were statistically significant (P < 0.05). Moreover, the KPS score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). The incidence rate of adverse reactions of the observation group was lower than that of the control group, and the difference was statistically significant (P < 0.05). Conclusions: The curative efficacy of acupuncture combined with Chinese medicinal therapy in the treatment of malignant peritoneal effusion in ovarian cancer was obvious. The therapy could improve the clinical symptoms of patients, decrease number of times of peritoneal effusion drainage and improve the quality of life of patients. Moreover, the therapy had relatively high safety. [ABSTRACT FROM AUTHOR]

Introduction: Our aim was to investigate the stability of clinically relevant analytes in pleural and peritoneal fluids stored in variable time periods and variable storage temperatures prior to analysis. Materials and methods: Baseline total proteins (TP), albumin (ALB), lactate dehydrogenase (LD), cholesterol (CHOL), triglycerides (TRIG), creatinine (CREA), urea, glucose and amylase (AMY) were measured using standard methods in residual samples from 29 pleural and 12 peritoneal fluids referred to our laboratory. Aliquots were stored for 6 hours at room temperature (RT); 3, 7, 14 and 30 days at - 20°C. At the end of each storage period, all analytes were re-measured. Deviations were calculated and compared to stability limits (SL). Results: Pleural fluid TP and CHOL did not differ in the observed storage periods (P = 0.265 and P = 0.170, respectively). Statistically significant differences were found for ALB, LD, TRIG, CREA, urea, glucose and AMY. Peritoneal fluid TP, ALB, TRIG, urea and AMY were not statistically different after storage, contrary to LD, CHOL, CREA and glucose. Deviations for TP, ALB, CHOL, TRIG, CREA, urea and AMY in all storage periods tested for both serous fluids were within the SL. Deviations exceeding SL were observed for LD and glucose when stored for 3 and 7 days at - 20°C, respectively. Conclusions: TP, ALB, CHOL, TRIG, CREA, urea and AMY are stable in serous samples stored up to 6 hours at RT and/or 30 days at - 20°C. Glucose is stable up to 6 hours at RT and 3 days at - 20°C. The stability of LD in is limited to 6 hours at RT. [ABSTRACT FROM AUTHOR]

Background: Hemorrhagic rupture of a hepatic cyst is rare. To date, very few cases have been reported in the literature. Case Report: A patient with a history of a suspected liver hydatid cyst presented to the emergency department with abdominal pain and fever. She was admitted with the presumptive diagnosis of acute cholecystitis. During hospitalization, the patient presented with hemodynamic instability and abrupt worsening of the abdominal pain. The abdominal angio-chemotherapy scan showed an abundant free peritoneal effusion and an apparent effacement of the anterior wall of a hepatic cyst of 16 cm. The patient underwent an exploratory laparotomy, deroofing of the cyst, and peritoneal lavage. The anatomopathological results showed a simple hepatic cyst. Discussion: Hemorrhagic rupture of simple hepatic cysts is a life-threatening complication and, although rare, should be included in the differential diagnosis of sudden abdominal pain in patients with a history of simple hepatic cysts.

Purpose: This study aimed to elucidate the factors that affect the dynamics of blood D-dimer in ovarian hyperstimulation syndrome (OHSS)., Methods: We retrospectively reviewed medical records from two hospitals and extracted data obtained during assisted reproductive technology and OHSS treatment. Blood D-dimer levels during hospitalization were plotted against body weight. Other factors possibly related to blood D-dimer levels were also analyzed., Results: The analysis included 10 patients with OHSS admitted between January 2013 and June 2023. In all patients, blood D-dimer levels increased significantly when they convalesced from OHSS and lost weight. None of the patients showed clinical signs of thrombosis, which was confirmed using imaging tests in 8 of 10 patients. Two patients underwent cell-free and concentrated ascites reinfusion therapy (CART), and their blood D-dimer levels increased dramatically after the procedure., Conclusion: Weight change and CART are associated with blood D-dimer dynamics in OHSS. Our results show that elevated blood D-dimer levels in patients with OHSS do not always represent the presence of thrombosis. Reinfusion of pooled D-dimer in ascites may explain the D-dimer surge during the recovery phase or after CART in these patients. Our study provides new perspectives on the clinical implications of D-dimer during OHSS., Competing Interests: The authors declare no conflicts of interest for this article., (© 2024 The Authors. Reproductive Medicine and Biology published by John Wiley & Sons Australia, Ltd on behalf of Japan Society for Reproductive Medicine.)

The International System for Reporting Serous Fluid Cytopathology (TIS) classifies serous effusions into five categories: non-diagnostic (ND), negative for malignancy (NFM), atypia of unknown significance (AUS), suspicious for malignancy (SFM) and malignant (MAL). The main objectives of this classification comprise the establishment of a universal code of communication between cytopathologists and clinicians and histopathologists, as well as between different laboratories worldwide, paving the way for the setting of clinical management guidelines based on the risk of malignancy assessment for each diagnostic category. We retrieved the total number of pleural and peritoneal effusion cases of our department for the three-year time period between 2018 and 2020, yielding a total of 528 and 500 cases, respectively. We then proceeded to reclassify each specimen according to TIS guidelines and calculate the risk of malignancy (ROM) for each category by searching each patients’ histology records, medical history and clinical follow-up. For pleural effusions, 3 (0.57%) cases were classified as ND, 430 (81.44%) cases as NFM, 15 (2.84%) as AUS, 15 (2.84%) as SFM and 65 (12.31%) as MAL. ROM amounted to 0%, 5.3%, 33.33%, 93.33% and 100% for each category, respectively. As far as peritoneal effusions are concerned, 6 (1.2%) were categorized as ND with ROM estimated at 16.66%, 347 (69.4%) as NFM (ROM = 9%), 13 (2.6%) as AUS (ROM = 38.46%), 12 (2.4%) as SFM (ROM = 83.33%) and 122 (24.4%) as MAL (ROM = 100%). Our results underline the utility of the current classification, both as a means of communication between doctors of different specialties and as general guidelines for the further clinical management of patients.

Introduction: Our aim was to investigate the stability of clinically relevant analytes in pleural and peritoneal fluids stored in variable time periods and variable storage temperatures prior to analysis. Materials and methods: Baseline total proteins (TP), albumin (ALB), lactate dehydrogenase (LD), cholesterol (CHOL), triglycerides (TRIG), creatinine (CREA), urea, glucose and amylase (AMY) were measured using standard methods in residual samples from 29 pleural and 12 peritoneal fluids referred to our laboratory. Aliquots were stored for 6 hours at room temperature (RT); 3, 7, 14 and 30 days at - 20°C. At the end of each storage period, all analytes were re-measured. Deviations were calculated and compared to stability limits (SL). Results: Pleural fluid TP and CHOL did not differ in the observed storage periods (P = 0.265 and P = 0.170, respectively). Statistically significant differences were found for ALB, LD, TRIG, CREA, urea, glucose and AMY. Peritoneal fluid TP, ALB, TRIG, urea and AMY were not statistically different after storage, contrary to LD, CHOL, CREA and glucose. Deviations for TP, ALB, CHOL, TRIG, CREA, urea and AMY in all storage periods tested for both serous fluids were within the SL. Deviations exceeding SL were observed for LD and glucose when stored for 3 and 7 days at - 20°C, respectively. Conclusions: TP, ALB, CHOL, TRIG, CREA, urea and AMY are stable in serous samples stored up to 6 hours at RT and/or 30 days at - 20°C. Glucose is stable up to 6 hours at RT and 3 days at - 20°C. The stability of LD in is limited to 6 hours at RT. [ABSTRACT FROM AUTHOR]

Objective To establish a modified dual liver transplantation rat model. Methods Based on the classic donor Y-shaped double iliac vein recanalization of bilateral liver grafts and portal vein and bile duct of the recipients, the dual liver transplantation rat model was modified by increasing the rat body mass, increasing the right lower lobe of the right graft, appropriate bile duct length, trimming Y-shaped blood vessels, and "triangular" anastomosis. The operation time, cold ischemia time, warm ischemia time and anhepatic phase of dual liver transplantation were recorded. The incidence of postoperative complications of the recipients was observed. The survival rates of the recipients at postoperative 7 and 30 d were calculated. Results The operation time of dual liver transplantation in rat was (114±7) min, the cold ischemia time was (36±3) min, the warm ischemia time was (9.7±1.6) min, and the anhepatic phase was (19.9±2.2) min, respectively. The incidence of postoperative complications in the recipient rats was 31% (5/16) including 2 cases of peritoneal effusion, 1 case of hemorrhage, 1 case of bile leakage and 1 case of respiratory obstruction. The postoperative 7- and 30-d survival rates of the recipient rats were 81%(13/16)、56%(9/16), respectively. Conclusions The modified technique can establish a stable dual liver transplantation rat model, which deserves widespread application. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the relationship between serum tumor markers and serous effusion in systemic lupus erythematosus (SLE) patients, thereby contributing preliminary data on the utility of these tumor markers in diagnosing serous effusion. In this retrospective analysis, clinical data of SLE patients were extracted from electronic medical records. This included the levels of serum tumor markers, including pro-gastrin-releasing peptide, neuron-specific enolase (NSE), cytokeratin-19 fragments (CYFRA 21-1), various carbohydrate antigens (CA 153, CA 125, CA 19-9), along with carcinoembryonic antigen, and alpha-fetoprotein. Positivity of tumor markers was established based on serum levels surpassing the upper threshold of the respective reference ranges. This study included 149 eligible patients with SLE, of whom 38 (25.50%) had serous effusion, and the prevalence of pleural, pericardial, and peritoneal effusions was 11.41%, 14.77%, and 6.71%, respectively. The analysis revealed that patients with serous effusion had higher scores on the SLE Disease Activity Index 2000 (SLEDAI 2000) than those without serous effusion. Notably, this disparity remained significant when the serositis score was excluded from the SLEDAI 2000 calculation. The positivity rate and serum levels of CA 125 were higher in patients with serous effusion and pleural effusion. Patients with pericardial effusion demonstrated an elevated CYFRA 21-1 positivity rate and serum CA 125 and CYFRA 21-1 levels compared to patients without pericardial effusion. CA 125 and NSE were higher both in terms of positivity rate and serum levels for patients with peritoneal effusion. Through receiver operating characteristic curve analysis, a moderate relationship was discerned between the conjoined levels of CYFRA 21-1 and CA 125 and the occurrence of pericardial effusion. Additionally, CA 125, NSE, and their combination revealed the moderate diagnostic ability of peritoneal effusion. In summary, this study observed elevated serum levels of various tumor markers in SLE patients exhibiting serous effusion, which is likely attributable to lupus-induced inflammation. These findings suggest that serum tumor markers can be valuable in diagnosing pericardial and peritoneal effusions., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Zaheda Khan,1 Kathryn Gates,2 Stephen A Simpson,31Emergency and Critical Care, Animal Specialty and Emergency Center, Los Angeles, CA, 2Emergency and Critical Care, Advanced Critical Care, Emergency and Specialty Services, Culver City, CA 3Emergency and Critical Care, Southern California Veterinary Specialty Hospital, Irvine, CA, USA Abstract: We described the diagnosis and successful treatment of pleural and peritoneal effusion secondary to liver lobe torsion in a dog. A 12-year-old female spayed Borzoi dog was referred for heart failure. Emergency room thoracic and abdominal ultrasound showed a large volume of pleural effusion with mild peritoneal effusion and an abdominal mass. Pleural fluid analysis classified the effusion as exudative. A complete ultrasound revealed mild peritoneal effusion and decreased blood flow to the right liver lobe. Other causes of bicavitary effusion were ruled out based on blood work, ultrasound, echocardiogram, and computed tomography. The patient was taken to surgery and diagnosed with caudate liver lobe torsion and had a liver lobectomy. At the 2-week postoperative recheck, the patient was doing well and there was complete resolution of the pleural effusion. Liver lobe torsion is a rare occurrence in dogs and can be difficult to diagnose. Clinical signs are nonspecific for liver lobe torsion and patients may present in respiratory distress with significant pleural fluid accumulation. When assessing patients with pleural and peritoneal effusion, liver lobe torsion should be considered as a differential diagnosis.Keywords: pleural effusion, peritoneal effusion, hepatic torsion

Although very few reports exist in the dog, formation of spermatocele and sperm granuloma appear to be the reported complications of vasectomy. Given the numerous extracellular and phagocytosed spermatozoa observed in the abdominal fluid, it is reasonable to conclude that spermatozoa were at least a factor (if not the primary factor) driving the inflammation and formation of peritoneal effusion in this patient. Sperm granuloma in the dog: complication of vasectomy. [Extracted from the article]

Preeclampsia is defined as new onset hypertension and proteinuria after 20 weeks of gestation and complicates approximately 2-8% of all pregnancies. Release of vasoconstrictive agents, endothelial damage, hyperpermeability of the capillaries and microangiopathic haemolysis involves the basic pathophysiology. It has variable clinical presentation. Here, we report a case of severe preeclampsia who developed postpartum massive ascites and pleural effusion. Primigravid patient was admitted to our clinic at 35 weeks of gestation with very high blood pressure. In biochemical analysis, Alanine aminotransferase (ALT) was 401 U/L, Aspartate aminotransferase (AST) was 292 U/L. An emergency caesarean section was performed because of fetal distress. On the 2nd post-operative day, abdominal distension and severe abdominal pain occurred. On the 3rd post-operative day, her abdominal distension increased and Ultrasonography (USG) revealed massive ascites. Abdominal drainage was performed and albumin infusion was administered. On postoperative day 4, she still had abdominal distension and concomitant respiratory distress. Computed Tomography (CT) showed ascites and bilateral pleural effusion. Her complaint regressed on the following days.