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Pericardial Fluid (pericardial + fluid)
Selected AbstractsBiochemical Analysis of Pericardial Fluid and Whole Blood in Dogs with Pericardial EffusionJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2005Armelle M. de Laforcade Studies evaluating pericardial fluid analysis in dogs to determine the etiology of pericardial effusions have yielded conflicting results. The purpose of this prospective study was to compare acid-base status, electrolyte concentrations, glucose, and lactate of pericardial fluid to peripheral blood from dogs with pericardial effusion and to compare these variables between dogs with neoplastic and nonneoplastic pericardial effusion. Acid-base status, electrolyte concentrations, glucose, hematocrit, urea nitrogen, and lactate concentrations were evaluated in peripheral blood samples and in pericardial effusion samples of 41 client-owned dogs with pericardial effusion. Common abnormal findings in the peripheral blood of dogs with pericardial effusion included hyperlactatemia (n = 38 [of 41]; 93%), hyponatremia (n = 25/41; 61%), hyperglycemia (n = 13/41; 32%), and hypermagnesemia (n = 13/41; 32%). Bicarbonate, sodium, ionized calcium, glucose, and hematocrit were all significantly lower in the pericardial fluid compared with peripheral blood, whereas lactate, chloride, and PCO2 were significantly higher in the pericardial fluid. When comparing the concentrations of variables in the pericardial fluid of dogs with neoplasia (n = 28) to those without neoplasia (n = 13), pH, bicarbonate, and chloride were significantly lower in dogs with neoplasia, whereas lactate, hematocrit, and urea nitrogen were significantly higher in the pericardial fluid of dogs with neoplasia. The difference between peripheral and pericardial glucose concentrations was significantly larger in dogs with neoplasia than in dogs without neoplasia. Although differences between variables in dogs with neoplastic and nonneoplastic pericardial effusion were documented, clinical relevance is likely limited by the degree of overlap between the 2 groups. [source] Prehospital Ultrasound by Paramedics: Results of Field TrialACADEMIC EMERGENCY MEDICINE, Issue 6 2010William Heegaard MD Abstract Objectives:, The objective was to determine if 9-1-1 paramedics trained in ultrasound (US) could adequately perform and interpret the Focused Assessment Sonography in Trauma (FAST) and the abdominal aortic (AA) exams in the prehospital care environment. Methods:, Paramedics at two emergency medical services (EMS) agencies received a 6-hour training program in US with ongoing refresher education. Paramedics collected US in the field using a prospective convenience methodology. All US were performed in the ambulance without scene delay. US exams were reviewed in a blinded fashion by an emergency sonographer physician overreader (PO). Results:, A total of 104 patients had an US performed between January 1, 2008, and January 1, 2009. Twenty AA exams were performed and all were interpreted as negative by the paramedics and the PO. Paramedics were unable to obtain adequate images in 7.7% (8/104) of the patients. Eighty-four patients had the FAST exam performed. Six exams (6/84, 7.1%) were read as positive for free intraperitoneal/pericardial fluid by both the paramedics and the PO. FAST and AA US exam interpretation by the paramedics had a 100% proportion of agreement with the PO. Conclusions:, This pilot study shows that with close supervision, paramedics can adequately obtain and interpret prehospital FAST and AA US images under protocol. These results support a growing body of literature that indicates US may be feasible and useful in the prehospital setting. ACADEMIC EMERGENCY MEDICINE 2010; 17:624,630 © 2010 by the Society for Academic Emergency Medicine [source] Extramedullary granulocytic sarcoma of the skin, mediastinum, and pericardiumINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2008Mohammad Diab MD A 27-year-old man, with a past history of developmental delay, presented on 18 November 2005 for the evaluation of an acute onset of multiple red,violaceous nodules on the head, neck, and trunk of 5 days' duration. The patient had no associated fever, chills, weight loss, night sweats, chest pain, dyspnea, lymphadenopathy, or organomegaly. He had no previous history of malignancies. A biopsy indicated a diagnosis of leukemia cutis (Fig. 1). His initial complete blood count (CBC) was within normal limits. The 2-week follow-up revealed enlargement of the previous lesions and the development of new lesions (Fig. 2). By the third week, the patient had developed dyspnea, but with normal breath sounds and oxygen saturation. Chest computed tomography demonstrated a mediastinal mass measuring 16 × 5.2 cm and pericardial thickening (Fig. 3). The diagnosis of granulocytic sarcoma of the skin lesion and mediastinal mass was established on the basis of immunohistochemical stains, with positivity to CD43 and Leder's preparation and negativity to CD3, CD4, CD5, CD8, CD10, CD20, CD23, CD30, CD34, CD56, bcl-1, terminal deoxynucleotidyl transferase (TdT), and granzyme. The bone marrow was negative for malignant cells. CBC and chemistry panel were all normal. Nevertheless, the patient experienced increased dyspnea and developed a pericardial effusion which required a pericardial window. Cytology of the pericardial fluid was consistent with granulocytic sarcoma. Once the diagnosis of granulocytic sarcoma was established, the patient started a regimen of cytarabine, daunorubicin, and etoposide. Despite this, the skin lesions and mediastinal mass showed minimal response. Repeat computed tomography showed a mediastinal mass measuring 14.5 × 4.4 cm. The patient's respiratory status required intubation and, 2 weeks later, his family requested that he be withdrawn from life support. Figure 1. Immature myelocytic infiltrate in the dermis (hematoxylin and eosin, ×4) Figure 2. Clinical image of granulocytic sarcoma Figure 3. Computed tomography of the chest illustrating mediastinal pericardial involvement [source] Spontaneous "Cardiomegaly" Following PericardiectomyJOURNAL OF CARDIAC SURGERY, Issue 6 2009Jeffrey B. Geske M.D. Chest x-ray revealed development of interval "cardiomegaly." Bedside echocardiography revealed a large accumulation of pericardial fluid despite absence of pericardium. Diagnostic and therapeutic mediastinocentesis was performed and confirmed the diagnosis of mediastinal hemorrhage. Subsequent to pericardiectomy, mediastinal hemorrhage can masquerade as cardiomegaly and may require urgent intervention. [source] A case of POEMS syndrome with high concentrations of interleukin-6 in pericardial fluidJOURNAL OF INTERNAL MEDICINE, Issue 2 2001N. Shikama Abstract. Shikama N, Isono A, Otsuka Y, Terano T, Hirai A (Department of Internal Medicine, Chiba Municipal Hospital; and Second Department of Internal Medicine, Chiba University School of Medicine, Chiba, Japan). A case of POEMS syndrome with high concentrations of interleukin-6 in pericardial fluid. J Intern Med 2001; 250: 170,173. The POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy of various forms, monoclonal gammopathy, skin changes) is a rare multisystem disorder of unknown pathogenesis. Overexpression of proinflammatory cytokines has been implicated in the pathogenesis of POEMS syndrome, however, it is not known whether there is an association between abnormalities in cytokines and pericardial fluid. We present a case of POEMS syndrome with high concentrations of interleukin-6 (IL-6) in pericardial fluid. In our patient, pericarditis developed into cardiac tamponade, and the concentration of IL-6 in pericardial fluid was remarkably elevated compared with that in serum (1760 vs. 6.57 pg mL,1). We suggest that IL-6 is associated with the progression or maintenance of pericarditis as a result of POEMS syndrome. [source] Septic pericarditis in a Yorkshire TerrierJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 2 2006Amanda Wagner DVM Abstract Objective: To describe a novel case management strategy for a small breed dog diagnosed with septic pericarditis. Case summary: An 8-year-old spayed female Yorkshire Terrier presented for evaluation of pericardial effusion and persistent hypoglycemia. The dog had been hospitalized at a primary care facility for acute onset of vomiting, lethargy, inappetance, and painful abdominal distension. Pericardial effusion was detected and upon referral, cytologic examination revealed a suppurative exudate with Gram-positive and Gram-negative bacteria. The dog was treated with pericardiocentesis and placement of an indwelling pericardial catheter. Subtotal pericardiectomy was performed and a thoracotomy tube was utilized postoperatively. A penicillin-susceptible Bacteroides species was cultured from the pericardial fluid and was treated with a 6-week course of antibiotics. The dog was discharged from the hospital and clinical signs have not recurred in over 2 years. New or unique information provided: Septic pericarditis, an uncommon cause of canine pericardial effusion, has been described primarily in large breed dogs and in association with bacterial infection secondary to Hordeum grass (foxtail) awn migration. This case was unique in that the dog was a small breed with no evidence of foreign body penetration or other precipitating cause for the pericarditis. In a novel management plan, an indwelling pericardial catheter was employed to stabilize the dog before subtotal pericardiectomy. [source] Biochemical Analysis of Pericardial Fluid and Whole Blood in Dogs with Pericardial EffusionJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2005Armelle M. de Laforcade Studies evaluating pericardial fluid analysis in dogs to determine the etiology of pericardial effusions have yielded conflicting results. The purpose of this prospective study was to compare acid-base status, electrolyte concentrations, glucose, and lactate of pericardial fluid to peripheral blood from dogs with pericardial effusion and to compare these variables between dogs with neoplastic and nonneoplastic pericardial effusion. Acid-base status, electrolyte concentrations, glucose, hematocrit, urea nitrogen, and lactate concentrations were evaluated in peripheral blood samples and in pericardial effusion samples of 41 client-owned dogs with pericardial effusion. Common abnormal findings in the peripheral blood of dogs with pericardial effusion included hyperlactatemia (n = 38 [of 41]; 93%), hyponatremia (n = 25/41; 61%), hyperglycemia (n = 13/41; 32%), and hypermagnesemia (n = 13/41; 32%). Bicarbonate, sodium, ionized calcium, glucose, and hematocrit were all significantly lower in the pericardial fluid compared with peripheral blood, whereas lactate, chloride, and PCO2 were significantly higher in the pericardial fluid. When comparing the concentrations of variables in the pericardial fluid of dogs with neoplasia (n = 28) to those without neoplasia (n = 13), pH, bicarbonate, and chloride were significantly lower in dogs with neoplasia, whereas lactate, hematocrit, and urea nitrogen were significantly higher in the pericardial fluid of dogs with neoplasia. The difference between peripheral and pericardial glucose concentrations was significantly larger in dogs with neoplasia than in dogs without neoplasia. Although differences between variables in dogs with neoplastic and nonneoplastic pericardial effusion were documented, clinical relevance is likely limited by the degree of overlap between the 2 groups. [source] Human pericardial fluid at microwave frequenciesMICROWAVE AND OPTICAL TECHNOLOGY LETTERS, Issue 1 2009Anil Lonappan Abstract This article reports a new method of analyzing pericardial fluid based on the measurement of the dielectric properties at microwave frequencies. The microwave measurements were performed by rectangular cavity perturbation method in the S-band of microwave frequency with the pericardial fluid from healthy persons as well as from patients suffering from pericardial effusion. It is observed that a remarkable change in the dielectric properties of patient samples with the normal healthy samples and these measurements were in good agreement with clinical analysis. This measurement technique and the method of extraction of pericardial fluid are simple. These results give light to an alternative in-vitro method of diagnosing onset pericardial effusion abnormalities using microwaves without surgical procedure. © 2008 Wiley Periodicals, Inc. Microwave Opt Technol Lett 51: 155,158, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.24010 [source] | ||||||||||