Journal articles: 'Transudate'

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Majhi, Chakradhar, Butungeshwar Pradhan, Bikash C. Nanda, and Sagnika Tripathy. "Pleural fluid cholesterol level is an important parameter in differentiating exudative from transudative pleural effusions." International Journal of Advances in Medicine 5, no. 3 (May 22, 2018): 520. http://dx.doi.org/10.18203/2349-3933.ijam20181983.

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Background: The first important step is to decide whether the pleural effusion is transudate or exudates by Light’s criteria. Light’s criteria can misclassify 25% of pleural transudates as exudates. Pleural fluid cholesterol level can differentiate transudates from exudates as a single parameter instead of multiple parameters used in Light’s criteria. Measurement of pleural fluid cholesterol levels to differentiate transudative effusions from exudative effusions.Methods: Consecutive 60 cases of pleural effusion were taken in the study. Pleural fluid analysis was done for parameters of Light’s criteria along with pleural fluid cholesterol levels. First exudative and transudative effusion was classified by Light’s criteria. Other clinical and relevant biochemical tests were done to arrive in the final etiological diagnosis and data were collected and analysed .Pleural fluid cholesterol levels was correlated to Light’s criteria.Results: Total 60 cases of pleural effusion were there in the study. There were 43 exudative and 17 transudative effusions. Mean cholesterol level was 64.2± 7.5mg/dl in exudative effusions and 26.05±8.01 mg/dl in transudates. Pleural fluid cholesterol was ≥55mg /dl in 43 cases of exudates and <55mg/dl in 17 cases of transudates.Conclusions: Pleural fluid cholesterol level of ≥ 55mg/dl had similar sensitivity and specificity to Light’s criteria and as a single important parameter to differentiate exudative from transudative pleural effusion

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Navarro, Alejandro, Carmen Bárcena, Pilar Pozo, Alberto Díez-Guerrier, Irene Martínez, Coral Polo, Clara Duque, David Rodríguez-Lázaro, Joaquín Goyache, and Nerea García. "Liver Transudate, a Potential Alternative to Detect Anti-Hepatitis E Virus Antibodies in Pigs and Wild Boars (Sus scrofa)." Microorganisms 8, no. 3 (March 23, 2020): 450. http://dx.doi.org/10.3390/microorganisms8030450.

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In recent years, cases of hepatitis E virus (HEV) infection have increased in Europe in association with the consumption of contaminated food, mainly from pork products but also from wild boars. The animal’s serum is usually tested for the presence of anti-HEV antibodies and viral RNA but, in many cases such as during hunting, an adequate serum sample cannot be obtained. In the present study, liver transudate was evaluated as an alternative matrix to serum for HEV detection. A total of 125 sera and liver transudates were tested by enzyme-linked immunosorbent assay at different dilutions (1:2, 1:10, 1:20), while 58 samples of serum and liver transudate were checked for the presence of HEV RNA by RT-qPCR. Anti- HEV antibodies were detected by ELISA in 68.0% of the serum samples, and in 61.6% of the undiluted transudate, and in 70.4%, 56.8%, and 44.8% of 1:2, 1:10, or 1:20 diluted transudate, respectively. The best results were obtained for the liver transudate at 1:10 dilution, based on the Kappa statistic (0.630) and intraclass correlation coefficient (0.841). HEV RNA was detected by RT-qPCR in 22.4% of the serum samples and 6.9% of the transudate samples, all samples used for RT-qPCR were positive by ELISA. Our results indicate that liver transudate may be an alternative matrix to serum for the detection of anti-HEV antibodies.

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Babu Rajendran, Suwetha Babu, and Sheju Jonathan Jha J. "Pleural Fluid Cholesterol Level in Differentiating Exudate from Trasudate Pleural Effusion." International Journal of Research in Pharmaceutical Sciences 11, no. 4 (October 20, 2020): 6478–85. http://dx.doi.org/10.26452/ijrps.v11i4.3465.

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Correlation of pleural fluid cholesterol level with light’s criteria to differentiate exudate from transudate pleural effusion. Classification of transudate and exudate clinically was done independently based on the light's criteria. Pleural fluid cholesterol levels of 100 selected patients were obtained. The cholesterol levels were compared with the earlier obtained data to study its specificity and sensitivity in differentiating exudate from transudate effusion. It was found that pleural fluid cholesterol in comparison to protein values in differentiating exudate from transudate showed a sensitivity of 79.55%, specificity of 91.07%, the positive predictive value of 87.50%, the negative predictive value of 85.00%, with a P-value of <0.001. Comparison of pleural fluid cholesterol with LDH values showed a sensitivity of 86.36% specificity of 94.64%, the positive predictive value of 92.68%, the negative predictive value of 89.83%, with a P-value of <0.001. Also, a comparison of pleural fluid cholesterol to light's criteria showed a sensitivity of 100% and 86.4% in the transudative group and sensitivity of 100% and 91.1 % in the exudative group, respectively. Routine measurement of pleural fluid cholesterol may serve as a valuable diagnostic indicator for differentiating exudate from transudate effusion.

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Maranhão, Bernardo Henrique Ferraz, Cyro Teixeira da Silva Junior, Jorge Luiz Barillo, Carmem Lucia Teixeira de Castro, Joeber Bernardo Soares de Souza, Patricia Siqueira Silva, and Roberto Stirbulov. "Diagnostic Accuracy with Total Adenosine Deaminase as a Biomarker for Discriminating Pleural Transudates and Exudates in a Population-Based Cohort Study." Disease Markers 2021 (April 10, 2021): 1–7. http://dx.doi.org/10.1155/2021/6648535.

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Background. An initial step in the evaluation of patients with pleural effusion syndrome (PES) is to determine whether the pleural fluid is a transudate or an exudate. Objectives. To investigate total adenosine deaminase (ADA) as a biomarker to classify pleural transudates and exudates. Methods. An assay of total ADA in pleural fluids (P-ADA) was observed using a commercial kit in a population-based cohort study. Results. 157 pleural fluid samples were collected from untreated individuals with PES due to several causes. The cause most prevalent in transudate samples (21%, n = 33 / 157 ) was congestive heart failure (79%, 26/33) and that among exudate samples (71%, n = 124 / 157 ) was tuberculosis (28.0%, 44/124). There was no significant difference in the proportion of either sex between the transudate and exudate groups. The median values of P-ADA were significantly different ( P < 0.0001 ) between both total exudates (18.4 U/L; IQR, 9.85-41.4) and exudates without pleural tuberculosis (11.0 U/L; IQR, 7.25-19.75) and transudates (6.85; IQR, 2.67-11.26). For exudates, the AUC was 0.820 (95% CI, 0.751-0.877; P < 0.001 ), with excellent discrimination. The optimum cut-off point in the ROC curve was determined as the level that provided the maximum positive likelihood ratio (PLR; 14.64; 95% CI, 2.11-101.9) and was22.0 U/L. For transudates, the AUC was 0.8245 (95% CI, 0.7470-0.9020; P < 0.0001 ). Internal validation of the AUC after 1000 resamples was evaluated with a tolerance minor than 2%. The clinical utility was equal to 92% (95% CI, 0.84 to 0.96, P < 0.05 ).Conclusions. P-ADA is a useful biomarker for distinguishing pleural exudates from transudates.

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Agrawal, Pawan, Tirtha Man Shrestha, Pratap Narayan Prasad, Ramesh Prasad Aacharya, and Priyanka Gupta. "Pleural fluid serum bilirubin ratio for differentiating exudative and transudative effusions." Journal of Nepal Medical Association 56, no. 211 (June 30, 2018): 662–65. http://dx.doi.org/10.31729/jnma.3569.

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Background: In pleural effusion, differentiating exudative and transudative fluid is an important clinical evaluation. The objective of the study was to determine the efficacy of pleural fluid serum bilirubin ratio in differentiating exudative and transudative effusions. In resource-limited settings with no facilities to measure lactate dehydrogenase (LDH) levels, using pleural fluid bilirubin ratio may help in better clinical decision. Methods: It was a prospective observational study, conducted in the emergency department of Tribhuvan University Teaching Hospital. All the patients attending for emergency care with pleural effusion from 6th Jan 2015 to 5th Jan 2016 were included. The cases were divided as exudates and transudates on basis of final diagnosis. Serum and pleural fluid specimen were collected and sent for investigations. The data for various laboratory parameters especially those of lights criteria and bilirubin ratio were then analyzed and fluid nature was compared with results from parameters and final diagnoses. Results: Among 103 cases, 71.84% had exudate and 28.16% had transudate. The commonest cause of effusion was pneumonia 35.92%, second being tubercular 23.30% followed by malignant effusion 12.60%, congestive heart failure 11.65%, chronic kidney disease 10.67% and liver cirrhosis 5.82%. The mean bilirubin ratio for exudates exceeded that for transudates. Considering the cutoff point of 0.6, the sensitivity, specificity, positive predictive value and negative predictive value were respectively 88.00%, 93.00%, 97.00% & 75.00%. Conclusions: Pleural fluid serum bilirubin ratio can be utilized as a diagnostic tool for differentiating exudative and transudative effusions. Keywords: bilirubin ratio; exudates; light’s criteria; pleural effusion; transudates.

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Probo, Monica, Valentina Valenti, Luigi Venco, Saverio Paltrinieri, Emme Lavergne, Catherine Trumel, and Walter Bertazzolo. "Pleural lymphocyte-rich transudates in cats." Journal of Feline Medicine and Surgery 20, no. 8 (September 18, 2017): 767–71. http://dx.doi.org/10.1177/1098612x17731045.

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Objectives Non-chylous lymphorrhagic pleural effusions are transudative effusions with a predominance of lymphocytes; however, they do not contain chylomicrons and therefore do not have the classical milky aspect of true chylous effusion. This type of effusion has been anecdotally associated with cardiac diseases in cats, but studies are lacking. The aim of this study was to investigate the association between this type of effusion and the primary disease. Methods In this study, feline non-chylous lymphorrhagic pleural effusions were retrospectively selected from the database of the authors’ institutions over a 3 year period. All cases underwent thoracic imaging, including echocardiography. Effusions classified as transudates with a predominance of lymphocytes on cytology were included. Results Thirty-three cases fulfilled the inclusion criteria: 23 (69.7%) had a concurrent cardiac disease, eight (24.2%) cases were associated with the presence of a mediastinal lymphoma or carcinoma or a thoracic mass, one case (3.0%) was a thymoma and one case (3.0%) was a sequela of a pyothorax. Conclusions and relevance Since a clear lymphatic origin of the fluid could not be demonstrated, lymphocyte-rich transudate might be considered a better designation for these kinds of effusions rather than non-chylous lymphorrhagic effusions. Although the number of cases in this preliminary study is low, the presence of a pleural lymphocyte-rich transudate in a cat should prompt the search for cardiac disease or intrathoracic neoplasia.

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Sutanto, Efelina, Liong Boy Kurniawan, and Fitriani Mangarengi. "TOTAL CHOLESTEROL ANALYSIS FOR DIFFERENTIATING EXUDATES AND TRANSUDATES IN PLEURAL FLUIDS." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 24, no. 2 (September 30, 2018): 136. http://dx.doi.org/10.24293/ijcpml.v24i2.1312.

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The aimed of this study is to compare the diagnostic value of pleural fluid total cholesterol and Light’s criteria to determine exudate or transudate. The samples used in this cross-sectional study were pleural fluid specimens sent to the Clinical Pathology Laboratory of the Dr.Wahidin Sudirohusodo Hospital Makassar during the period of August-September 2016. Data were grouped according to the type of effusion then statistically analyzed using nonparametric Mann Whitney U-test. The result of this study showed from 55 samples, there were 22 transudates and 33 exudates. The mean total cholesterol levels of exudate is higher than transudate (p=0.006). By using cut-off value of total cholesterol pleural fluid 56 mg/dL, it had sensitivity 72.7%; specificity 78.8%; Positive Predictive Value (PPV) 81.3% and Negative Predictive Value (NPV) 69.6% while Light’s criteria had sensitivity 97%; specificity 63.6%; PPV 80% and NPV 93.3%. Pleural fluid total cholesterol level with cut-off 56 mg/dL is proposed to be used for differentiating exudate and transudate because it is easier and more simple to perform than Light’s criteria.

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Sunanda, V., K. Shravanthi, B. Prabhakar Rao, CN Prasad, N. Satyanarayana, and P. Sunitha. "The diagnostic separation of transudates and exudates in pleural effusion." Journal of College of Medical Sciences-Nepal 7, no. 3 (August 28, 2012): 24–28. http://dx.doi.org/10.3126/jcmsn.v7i3.6705.

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The present study was undertaken to compare plasma-pleural effusion albumin gradient with Light’s traditional criteria for differentiating exudates from transudate in pleural effusion who were undergoing diagnostic and therapeutic thoracocentesis in whom the etiology of effusion could be determined were studied. Blood and pleural fluid chemistries were measured to determine plasma-pleural effusion albumin gradient and Light’s criteria parameters like pleural fluid proteins, fluid to plasma protein ratio, fluid LDH and fluid to serum LDH ratio and we observed some misclassifications in exudates and transudates. Using an albumin gradient of 1.2 gm/dl or less to indicate exudate and >1.2 gm/dl to indicate transudate, none of the transudates were found to be is misclassifical, but 1 case of exudate (malignant pleural effusion) was misclassifical. We conclude that although Light’s criteria for exudates are very sensitive, albumin gradient of 1.2 gm/dl or less tends to be more specific to exudates.DOI: http://dx.doi.org/10.3126/jcmsn.v7i3.6705 Journal of College of Medical Sciences-Nepal, 2011, Vol-7, No-3, 24-28

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Garcia Sevila, Raquel, Encarnacion Barroso, Concepcion Martin, Ignacio Aranda, and Santiago Romero. "Lymphangitic Carcinomatosis as a Cause of Malignant Transient Pleural Transudate." Case Reports in Medicine 2009 (2009): 1–3. http://dx.doi.org/10.1155/2009/598741.

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Although it is generally accepted that a malignant transient pleural transudate may appear during the early stages of lymphatic obstruction, cases demonstrating such probability are rare in literature. A 67-year-old woman was admitted to hospital because a lymphangitic carcinomatosis and a transudative infrapulmonary pleural effusion with a cytology positive for adenocarcinoma. One month later the effusion keeps being positive for adenocarcinoma but exudative in character. Lymphatic obstruction appears as the cause of the initial transudative characteristics of the pleural effusion.

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Mogila, A. A. "GONARTHRITIS:EXUDATE OR TRANSUDATE?" World of Medicine and Biology 13, no. 61 (2017): 041. http://dx.doi.org/10.26724/2079-8334-2017-3-61-41-44.

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Agarwal, N., HM Kansal, and SK Bhargava. "Role of Ultrasound in Determining the Nature of Pleural Effusion." Nepalese Journal of Radiology 4, no. 1 (October 30, 2014): 34–37. http://dx.doi.org/10.3126/njr.v4i1.11367.

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Purpose of the study: The differentiation of pleural effusion into transudate and exudate may affect the diagnostic approach and patients’ management. The conventional Light criteria require both pleural fluid and blood samples along with three biochemical tests. This study was undertaken to assess the usefulness of ultrasound as an alternative in differentiating the type of pleural effusion. Method: A prospective cross sectional study was conducted over a period of one year. Eighty patients clinically diagnosed to have pleural effusion underwent high frequency ultrasound and also lab tests for Light criteria. The efficacy of ultrasound was then assessed in differentiating transudate from exudate. Results: It was concluded in our study that all pleural effusions which were echogenic on ultrasound, with or without septations or with pleural thickening more than 3 mm (n=46) were exudates (p< 0.01). The anechoic effusions on ultrasound could be transudates or exudates. Conclusion: Ultrasound acts as a useful non invasive alternative for determining the type of pleural effusion. DOI: http://dx.doi.org/10.3126/njr.v4i1.11367 Nepalese Journal of Radiology, Vol.4(1) 2014: 34-37

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Molina, Ramon M., Wayne Chittick, Eric A. Nelson, Jane Christopher-Hennings, Raymond R. R. Rowland, and Jeffrey J. Zimmerman. "Diagnostic Performance of Assays for the Detection of Anti-Porcine Reproductive and Respiratory Syndrome Virus Antibodies in Serum and Muscle Transudate (“Meat Juice”) Based on Samples Collected under Experimental Conditions." Journal of Veterinary Diagnostic Investigation 20, no. 6 (November 2008): 735–43. http://dx.doi.org/10.1177/104063870802000604.

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Three assays were evaluated for their ability to detect antibodies against Porcine reproductive and respiratory syndrome virus (PRRSV) in porcine muscle transudate (“meat juice”) samples. Samples were derived from 91 pigs inoculated with PRRSV isolate VR-2332 and 46 age-matched controls. Serum and muscle ( Musculus longissimus dorsi) samples were collected from randomly selected animals euthanized at ∼14-day intervals from 28 to 202 days postinoculation. Serum samples were assayed at a dilution of 1:40, and muscle transudate samples were assayed at 5 dilutions (1:2, 1:5, 1:10, 1:20, 1:40) using a commercial PRRSV antibody enzyme-linked immunosorbent assay (ELISA). In addition, muscle transudate samples were tested using an indirect fluorescent antibody test (IFAT) at 5 dilutions (1:2, 1:5, 1:10, 1:20, 1:40). Attempts to assay muscle transudate samples for neutralizing antibodies using a modified fluorescent focus neutralization assay were unsuccessful. Receiver operator characteristic (ROC) curve analyses were used to estimate cutoff thresholds and the associated diagnostic sensitivities and specificities for ELISA and IFAT at each dilution. For ELISA, muscle transudate samples at the ROC-optimized cutoffs were >95% sensitive and 100% specific at each dilution. At a cutoff dilution of ≥1:5, the IFAT diagnostic sensitivity and specificity of muscle transudate was estimated at 63.3% and 100%, respectively. These findings validated the use of muscle transudate samples in PRRSV surveillance programs based on ELISA antibody testing.

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Bartter, Thaddeus, Rocco J. Santarelli, and Melvin R. Pratter. "Transudate vs Exudate: Genug!" Chest 109, no. 6 (June 1996): 1419–21. http://dx.doi.org/10.1378/chest.109.6.1419.

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Zoia, Andrea, Linda A. Slater, Jane Heller, David J. Connolly, and David B. Church. "A new approach to pleural effusion in cats: Markers for distinguishing transudates from exudates." Journal of Feline Medicine and Surgery 11, no. 10 (October 2009): 847–55. http://dx.doi.org/10.1016/j.jfms.2009.04.005.

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Classification of pleural effusion (PE) is central to diagnosis. Traditional veterinary classification has distinguished between transudates, modified transudates and exudates. In human medicine PEs are divided into only two categories: transudates and exudates. The aim of this study was to evaluate, in 20 cats presented with PE, paired samples of serum and pleural fluid for the following parameters: Light's criteria (pleural fluid lactate dehydrogenase concentration (LDHp), pleural fluid/serum LDH ratio, pleural fluid/serum total protein ratio (TPr)), pleural fluid total protein, pleural fluid cholesterol concentration, pleural fluid/serum cholesterol ratio (CHOLr), serum-effusion cholesterol gradient (serum cholesterol minus PE cholesterol concentration (CHOLg)), PE total nucleated cells count (TNCCp) and pleural fluid glucose (GLUp). LDHp and TPr were found most reliable when distinguishing between transudates and exudates, with sensitivity of 100% and 91% and specificity of 100%, respectively. When conflict between the clinical picture and laboratory results exists, calculation of CHOLr, CHOLg and TNCCp measurement may help in the classification of the effusion. Measurement of serum albumin (in the case of a transudate) may provide additional information regarding the pathogenesis of the effusion.

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Sridhar, MS, MRajendra Prasad, P. Gopalakrishna, and MS Madhuri. "Pancreatic ascites with 'inflammatory transudate'." Journal of Clinical and Scientific Research 8, no. 1 (2019): 29. http://dx.doi.org/10.4103/jcsr.jcsr_26_19.

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Martínez, Prudencio, José Maria Eiros, Raul Ortiz de Lejarazu, and Antonio Rodriguez Torres. "Gingivocrevicular transudate for HIV screening." Clinical Microbiology and Infection 3, no. 5 (October 1997): 588–90. http://dx.doi.org/10.1111/j.1469-0691.1997.tb00319.x.

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Aliabadi, F. Shojaee, M. F. Landoni, and P. Lees. "Pharmacokinetics (PK), Pharmacodynamics (PD), and PK-PD Integration of Danofloxacin in Sheep Biological Fluids." Antimicrobial Agents and Chemotherapy 47, no. 2 (February 2003): 626–35. http://dx.doi.org/10.1128/aac.47.2.626-635.2003.

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ABSTRACT The fluoroquinolone antimicrobial drug danofloxacin was administered to sheep intravenously (i.v.) and intramuscularly (i.m.) at a dose of 1.25 mg/kg of body weight in a two-period crossover study. The pharmacokinetic properties of danofloxacin in serum, inflamed tissue cage fluid (exudate), and noninflamed tissue cage fluid (transudate) were established by using a tissue cage model. The in vitro and ex vivo activities of danofloxacin in serum, exudate, and transudate against a pathogenic strain of Mannheimia haemolytica were established. Integration of in vivo pharmacokinetic data with the in vitro MIC provided mean values for the area under the curve (AUC)/MIC for serum, exudate, and transudate of 60.5, 85.6, and 45.7 h, respectively, after i.v. dosing and 55.9, 77.9, and 49.1 h, respectively, after i.m. dosing. After i.m. dosing, the maximum concentration/MIC ratios for serum, exudate, and transudate were 10.8, 3.0, and 1.6, respectively. The ex vivo growth inhibition data after i.m. dosing were fitted to the inhibitory sigmoid E max equation to provide the values of AUC/MIC required to produce bacteriostasis, bactericidal activity, and elimination of bacteria. The respective values for serum were 17.8, 20.2, and 28.7 h, and slightly higher values were obtained for transudate and exudate. It is proposed that use of these data might provide a novel approach to the rational design of dosage schedules.

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Hartono, Saraswati Wulandari, Nurhayana Sennang, and Fitriani Mangarengi. "DIAGNOSTIC VALUE OF URIC ACID IN PLEURAL EFFUSION." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 24, no. 2 (September 30, 2018): 146. http://dx.doi.org/10.24293/ijcpml.v24i2.1314.

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Pleural effusion is excessive pleural fluid accumulation in the aimed pleural cavity, are categorized into exudate and transudate. Light’s criteria (1972) has become a classic criteria to distinguish pleural effusion types. Other criteria were evaluated such as pleural fluid uric acid. The aimed of this study was to analyze the difference of uric acid level between transudate and exudate and to compare it with Light’s criteria. A cross-sectional study was conducted in Clinical Pathology Laboratory of the Dr. Wahidin Sudirohusodo Hospital Makassar in September 2016. Uric acid level of pleural effusion samples was measured by ABX Pentra 400. Statistical analysis used Mann-Whitney U test, significance was indicated if p<0.05. Cut-off, sensitivity and specificity of uric acid used ROC curve. Total subjects were 56 patients, mean age 49.54+13.63 years-old, 31 males (55.4%) and 25 females (44.6%). Most cases were exudative effusion (58.9%) with 19 malignancy cases (33.9%). Uric acid level median was 6.6 mg/dL (3.24-17.50 mg/dL) higher in transudate than exudate 5.01 mg/dL (0.6-9.40 mg/dL) (p=0.001). The cut-off point for pleural fluid uric acid was 5.845 mg/dL, with a sensitivity of 78.3% and specificity of 66.7%. Sensitivity and specificity of Light’s criteria was 97% and 60.9%. There was a significant difference between pleural fluid uric acid level in transudate and exudate, higher in transudate than exudate. Light’s criteria were higher in sensitivity than uric acid, but lower in specificity. Further research is needed with better sampling method to reduce bias.

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Kyriacou, E. "The Exudate-Transudate Definition Is Dated." Scandinavian Journal of Gastroenterology 32, no. 7 (January 1997): 736. http://dx.doi.org/10.3109/00365529708996527.

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Headrick, J. P., S. W. Ely, G. P. Matherne, and R. M. Berne. "Myocardial adenosine, flow, and metabolism during adenosine antagonism and adrenergic stimulation." American Journal of Physiology-Heart and Circulatory Physiology 264, no. 1 (January 1, 1993): H61—H70. http://dx.doi.org/10.1152/ajpheart.1993.264.1.h61.

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Relationships between interstitial transudate adenosine and coronary flow and between global adenosine formation and cytosolic metabolism were examined in constant-pressure perfused guinea pig hearts during norepinephrine (NE) stimulation and adenosine antagonism with 10 microM 8-phenyltheophylline. Basal coronary flow was 5.7 ml.min-1 x g-1, and transudate and venous adenosine levels were approximately 0.26 and 0.06 microM, respectively. During 10 min of NE stimulation (15 nM), coronary flow and adenosine levels increased, the phosphocreatine-to-inorganic phosphate ratio ([PCr]/[Pi]) declined, and ATP and pH remained stable. Despite phasic release of adenosine, coronary flow correlated dose dependently with transudate adenosine, and adenosine release was inversely related to [PCr]/[Pi] under all conditions. 8-Phenyltheophylline infusion attenuated functional hyperemia by approximately 40%, enhanced the fall in [PCr]/[Pi], and potentiated elevations in transudate and venous adenosine. Similar results and correlations were obtained in hearts perfused at a constant-flow of 5.7 ml.min-1 x g-1, although stimulated adenosine levels and metabolic changes were greater and contractile responses smaller. These data indicate that: 1) endogenous adenosine plays a primary role in functional hyperemia in perfused guinea pig heart; 2) global adenosine formation appears related to phosphorylation status; and 3) adenosine receptor antagonism enhances metabolic disturbances during adrenergic stimulation and markedly potentiates adenosine release, indicating that the functional effects of antagonists may significantly underestimate the dilatory role of endogenous adenosine.

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Chodri, Tanvir A., and Maritza L. Groth. "Transudate or Exudate: That is the Question." Clinical Pulmonary Medicine 9, no. 2 (March 2002): 127–28. http://dx.doi.org/10.1097/00045413-200203000-00010.

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Ali, Nor Jannah, Ani Kartini Dr, and Darmawaty Effendi Dr. "EVALUATION OF PLEURA EFUSION DETERMINATION BY LIGHT’S DAN HEFFNER’S CRITERIA." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 26, no. 1 (November 22, 2019): 76. http://dx.doi.org/10.24293/ijcpml.v26i1.1365.

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EVALUATION OF PLEURA EFUSION DETERMINATION BY LIGHT’S DAN HEFFNER’S CRITERIANordjannah1, Ani Kartini2, Darmawaty ER 31 Medical Doctor Specialist Education Programe of Clinical Pathology, Faculty of Medicine Hasanuddin University/dr.Wahidin Sudirohusodo Hospital, Makassar2 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Labuang Baji Hospital Makassar3 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Hospital Islam Faisal Hospital Makassar ABSTRACT Background : Pleural effusion is a condition of abnormal pleural fluid accumulation in the pleural cavity due to excessive transudation or exudation. Light’s criteria is used as the standard method to distinguish between exudates and transudates. Some recent studies reported misclassifications so several alternative criteria are developed, one of which is Heffner’s criteria. The purpose of this study was to determine the sensitivity and specificity of Heffner’s criteria in determining the type of pleural effusion.Methods : An observational study with cross sectional method using a pleural effusion fluid sample of patients examined at the Clinical Pathology Laboratory Instalation at Wahidin Sudirohusodo Hospital on July 2018. Total protein, LDH and cholesterol levels were examined in all samples that met the inclusion and exclusion criteria.Results : There were 45 samples of pleural effusion, 30 of which classified as transudate and 15 samples as exudates. Based on clinical diagnosis, the Light’s criteria obtained 3 misclassifications and Heffner’s criteria obtained 2 misclassifications. Based on the data above, the statistical data showed that Light’s criteria has sensitivity of 96,7 % and specificity of 86,7 %. Heffner’s criteria has sensitivity of 100 % and specificity of 86,7 %. Conclusion : Heffner’s criteria offers better sensitivity and specificity than Light’s criteria. Heffner’s criteria can be used as an alternative in determining the type of pleural effusion Keywords: Heffner’s criteria, Light’s criteria, transudate, exudate, pleural effusion

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Akash Jain, Mahendra Patil, and Kanetkar S R. "Serous effusions: A clinicopathological study." International Journal of Research in Pharmaceutical Sciences 11, no. 3 (July 8, 2020): 3284–88. http://dx.doi.org/10.26452/ijrps.v11i3.2453.

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This study is a prospective, observational study done for two years, comprising of 267 cases. Their episodes were while tapping pleural cavity, peritoneal cavity and pericardial sac, pleural, ascitic and pericardial fluids were collected. Majority of the samples received were from our hospital (98%) while 2% (5 samples) were obtained from outside. The male cases (55%) outnumbered the females (45%). And, a maximum number of instances in quinquagenarian among males and sexagenarian among females. In peritoneal fluids, females (29/30) outnumbered males. Fifty-nine (22%) samples showed the presence of clot with the majority being in pleural fluid (35/59). Few of the cases of TB showed neutrophilic (10%) or eosinophilic (2.5%) exudate instead of lymphocytic effusion. In contrast, a few cases of liver cirrhosis showed exudative effusion instead of transudative because of bacterial peritonitis. Majority cases were exudates (58.2%) excluding the peritoneal fluids, out of 71 cases of known malignancy. Out of these, 50% of the malignant effusions were nonhemorrhagic. Common microorganisms were gram-negative bacilli and grampositive cocci. There were three unusual cases in this study, viz: Eosinophilic effusion, Parasite (Ascaris) in pleural fluid and an example of a second malignancy. If the effusion is suspected for malignancy, the fluid typing of exudate or transudate may be done. Also, wet mount preparation for abnormal cells may be done before Examination of fixed smears for cancerous cells, as we did not find any transudate fluid positive for malignancy. Diagnostic effusion tapping, followed by immediate processing of fluid in a laboratory may improve cytological outcome. Malignant effusions may not be hemorrhagic in appearance. Rarely effusion may be the first manifestation of malignancy.

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Qureshi, Abdul Rasheed, Muhammad Irfan, Huma Bilal, Muhammad Sajid, and Zeeshan Ashraf. "Frequency of Tuberculosis and Malignancy in Transudative-pleural effusions: A rare but real finding." Journal of Rawalpindi Medical College 24, no. 4 (December 30, 2020): 296–301. http://dx.doi.org/10.37939/jrmc.v24i4.1159.

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Objectives: To determine the frequency of tuberculosis and malignancy in transudative pleural effusions.Material and Method: The study was conducted in Pulmonology-OPD, Gulab Devi Teaching Hospital Lahore from Oct. 2017 to Feb. 2019. One hundred and twenty-eight consecutive patients with transudative pleural effusions and 14-69 years age, willing for invasive investigations & ADA estimation were included, while those not willing for further investigations, participation in the study, and exudative effusions were excluded. The clinical features, pleural fluid analysis findings, ADA(Adenosine deaminase) estimation results, hematology, echocardiography, bronchoscopy, Lymph node biopsy, CT-thorax, ultrasound chest & abdomen results were recorded on a preformed proforma. Findings were summarized, tabulated, and analyzed statistically using SPSS-16 software.Results: Out of 1370 cases of pleural effusion, 128 cases (9.34%) with pleural transudate were isolated. In all patients, pleural fluid protein/serum protein level was < 0.5. The age ranged 14-69 years with a mean of 39 years + 11.3. Fifty-two cases (40.62%) had right-sided, 38 cases (29.68%) left-sided while 38 cases (29.68%) had bilateral pleural effusions. Seventy-six aspirates (59.37%) were yellow, 20 (15.62%) reddish, 18 (14.06%) straw-colored and 14 fluids (10.93%) were watery in color. Out of 128 transudative effusions, malignant etiology was found in 23 cases (17.96%), tubercular in 17 cases (13.28%) and 19 cases (14.84%) of Para-pneumonic origin were detected.Conclusion: Tuberculosis and malignancy can be the possible etiology of transudative effusion.

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Qureshi, Abdul Rasheed, Muhammad Irfan, Huma Bilal, Muhammad Sajid, and Zeeshan Ashraf. "Frequency of Tuberculosis and Malignancy in Transudative-pleural effusions: A rare but real finding." Journal of Rawalpindi Medical College 24, no. 4 (December 30, 2020): 296–301. http://dx.doi.org/10.37939/jrmc.v24i4.1159.

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Objectives: To determine the frequency of tuberculosis and malignancy in transudative pleural effusions.Material and Method: The study was conducted in Pulmonology-OPD, Gulab Devi Teaching Hospital Lahore from Oct. 2017 to Feb. 2019. One hundred and twenty-eight consecutive patients with transudative pleural effusions and 14-69 years age, willing for invasive investigations & ADA estimation were included, while those not willing for further investigations, participation in the study, and exudative effusions were excluded. The clinical features, pleural fluid analysis findings, ADA(Adenosine deaminase) estimation results, hematology, echocardiography, bronchoscopy, Lymph node biopsy, CT-thorax, ultrasound chest & abdomen results were recorded on a preformed proforma. Findings were summarized, tabulated, and analyzed statistically using SPSS-16 software.Results: Out of 1370 cases of pleural effusion, 128 cases (9.34%) with pleural transudate were isolated. In all patients, pleural fluid protein/serum protein level was < 0.5. The age ranged 14-69 years with a mean of 39 years + 11.3. Fifty-two cases (40.62%) had right-sided, 38 cases (29.68%) left-sided while 38 cases (29.68%) had bilateral pleural effusions. Seventy-six aspirates (59.37%) were yellow, 20 (15.62%) reddish, 18 (14.06%) straw-colored and 14 fluids (10.93%) were watery in color. Out of 128 transudative effusions, malignant etiology was found in 23 cases (17.96%), tubercular in 17 cases (13.28%) and 19 cases (14.84%) of Para-pneumonic origin were detected.Conclusion: Tuberculosis and malignancy can be the possible etiology of transudative effusion.

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Raji, Hanie, Seyed Hamid Borsi, Mehrdad Dargahi MalAmir, and Ahmad Reza Asadollah Salmanpour. "Assessment of the diagnostic value of CEA, CA125, and CRP and their cut-off point for discrimination of exudative pleural effusions." Bionatura 3, no. 3 (August 15, 2021): 1944–47. http://dx.doi.org/10.21931/rb/2021.06.03.10.

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Pleural effusion is divided into exudative and transudative effusion, and the distinction between exudate and transudate requires multiple investigations of biochemical parameters and their comparison in pleural fluid and serum. This study aimed to assess the diagnostic value of CEA, CA125, and CRP and their cut-off point for discrimination of exudative pleural effusions. This epidemiological and cross-sectional study was performed on 50 patients aged between 18 to 90 years with the diagnosis of exudative pleural effusion referred to Imam Khomeini Hospital in Ahvaz in 2018 and 2019. Demographic and clinical information of patients were collected. The pleural effusion was diagnosed based on physical examination and chest radiography. Pleural effusion was confirmed by thoracentesis. A pleural fluid sample was taken from all patients, and the levels of CEA, CA125, and CRP markers were measured in the pleural fluid. Differentiation of transudate and exudate pleural effusions was performed using Light criteria. The mean CEA and CA125 level of pleural fluid were significantly higher, and the mean CRP level of pleural fluid was significantly lower in patients with malignant diagnoses (P <0.05). Cut-off value with highest sensitivity and specificity in differentiating types of exudative pleural effusions was obtained for CEA tumor marker (greater than 49.8), CA125 tumor marker (greater than 814.02), and CRP marker (less than 7.56). Also, in differentiating types of exudative pleural effusions, CEA tumor marker had sensitivity (89.03%) and specificity (78.42%); CA125 tumor marker had sensitivity (53.18%) and specificity (62.44%), and CRP marker had sensitivity (82.16%), and specificity (89.05%) were. Although the tumor markers had high specificity in the present study, the low sensitivity of some of these tumor markers reduced their diagnostic value. On the other hand, given the numerous advantages of tumor markers, such as low cost and non-invasive, combining them with another can increase the diagnostic value and accuracy.

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Sridevi, M., and Karen Jaison. "Analysis of pleural fluid: Differentiating transudate from exudate." IP Archives of Cytology and Histopathology Research 4, no. 3 (October 15, 2019): 228–33. http://dx.doi.org/10.18231/j.achr.2019.043.

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MAEKAWA, Yoshihiro, Shinichi ICHIMURA, and Wakatoshi MATSUNAGA. "Striae atrophicae associated with transudate in the stroma." Nishi Nihon Hifuka 48, no. 6 (1986): 1079–81. http://dx.doi.org/10.2336/nishinihonhifu.48.1079.

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Monla-Hassan, Jaber, Michael Eichenhorn, Eric Spickler, Sanjay Talati, Russ Nockels, and Robert Hyzy. "Duropleural Fistula Manifested as a Large Pleural Transudate." Chest 114, no. 6 (December 1998): 1786–89. http://dx.doi.org/10.1378/chest.114.6.1786.

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Basille, Damien, Kevin Chevalier, Claire Andrejak, and Vincent Jounieaux. "Pleural transudate: pathophysiology during superior vena cava syndrome." ERJ Open Research 5, no. 1 (February 2019): 00251–2018. http://dx.doi.org/10.1183/23120541.00251-2018.

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Krenke, Rafal, Marta Maskey-Warzechowska, Piotr Korczynski, Monika Zielinska-Krawczyk, Joanna Klimiuk, Ryszarda Chazan, and Richard W. Light. "Pleural Effusion in Meigs’ Syndrome—Transudate or Exudate?" Medicine 94, no. 49 (December 2015): e2114. http://dx.doi.org/10.1097/md.0000000000002114.

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Ulrik, C. S., and K. Viskum. "Fibrous pleural tumour producing 171 litres of transudate." European Respiratory Journal 12, no. 5 (November 1, 1998): 1230–32. http://dx.doi.org/10.1183/09031936.98.12051230.

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Nunes, Nilson Júnior da Silva, Naila Cristina Blatt Duda, Juliana Pereira Matheus, Ana Paula Soares Borenstein, Bruno Albuquerque de Almeida, and Stella De Faria Valle. "Approach to Classification of Cavitary Effusion and Comparison between Manual and Automatic Methods for Total Nucleated Cell Count." Acta Scientiae Veterinariae 46, no. 1 (September 17, 2018): 8. http://dx.doi.org/10.22456/1679-9216.84760.

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Background: Two classifications are used to categorize cavitary effusions using total nucleated cell count (TNCC): protein concentration and pathophysiology of its formation. The aims of the present study were to evaluate the correlation between the TNCC values of cavitary effusions obtained in the automatic and the manual method, and also evaluating the classification methodology. Materials, Methods & Results: Cavitary effusions were analyzed for physical, chemical and cytological aspects, as well as manual and automatic cell counts for the correlation between the traditional methods and those suggested by Stockham & Scott. Bland-Altman regression and Spearman correlation analysis were performed. Of the total, 44 were abdominal effusions (73.3%), 15 thoracic (25%) and 1 pericardial (1.7%). According to the traditional classification, most of the effusions were classified as modified transudates (40%) and according to the classification of Stockham and Scott, as transudates poor in protein (31.7%). The correlation between cell counting techniques between pure, modified and exudate transudates was 0.94, 0.97 and 0.94, respectively, indicating an excellent correlation between the parameters (p = 0.95%).Discussion: Considering the concentration of proteins and CCNT, the effusions classified as modified transudate were mainly caused by neoplastic processes (carcinomas/adenocarcinomas), since there are several mechanisms of their formation, such as large variation of protein concentration. According to the Stockham & Scott classification a unique classification is considered for exfoliative neoplastic effusions, the variation of the protein concentration of the effusion does not alter its classification. In neoplastic effusions, classified as exudates, lymphomas were the most prevalent, and hypercellularity (approximately 150,000 cells / μL) allowed this classification. When considering low-protein transudates, the findings related to low concentrations did not differ much from the traditional classification. In the ruptures of viscera and vessels, the hemorrhagic ones were the most frequent, thus, the cytological diagnosis is essential, since it can give information about the contamination with blood during the collection. Most of these were due to neoplasia as the underlying cause. A case of chylotorax was diagnosed by comparing cholesterol and triglyceride values of effusion and serum. In cases of uroperitoneum, the presence of urine in the abdominal cavity promotes the dilution of the fluid from the cavity, being initially classified as pure transudate and, with its permanence in the cavity, increasing the CCNT, becomes an exudate. As in cases of exfoliative neoplastic effusions, the classification of the uroperitoneum, according to Stockham & Scott, is classified directly into effusion due to rupture of the viscera, giving a quick and clear diagnosis. According to Stockham & Scott, cases classified as nonseptic exudates (n = 3), two of which resulted from feline infectious peritonitis (PIF). The effusive form of PIF presents with accumulations of fluid in the abdomen, having an inflammatory character, but according to the traditional classification, they enter the category of modified transudates, because, despite containing protein concentrations close to or above the serum level, they present a CCNT lower than an exudate. Cavitary effusions were classified as septic exudates when intracellular bacteria were present and in the present study, two effusions were classified as such in two patients, one with septic peritonitis and in the other the final diagnosis was not found. The high values of Spearman correlation coefficients found when comparing the automatic counts with the manual demonstrate that there is an excellent correlation between the methods and, the Bland-Altman test showed significant agreement between them.

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Celikhisar, Hakan. "Determining The Etiological Factors in Pleural Fluid by Crp, Albumin And Procalcitonin Levels." Journal of Medical Research and Health Sciences 3, no. 2 (February 14, 2020): 880–85. http://dx.doi.org/10.15520/jmrhs.v3i2.157.

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Abstract Aim: The Light criteria with a specificity of 72% and a sensitivity of 100% have led to further research into the detection of more specific diagnostic methods for transudate exudate separation. In this study, we aimed to evaluate whether pleural fluid and serum CRP, procalcitonin, on the other hand CRP / Albumin and Procalcitonin / Albumin ratios may be suggested as an alternative to Light criteria in the differential diagnosis of pleural effusions. Material and Method: In this study, the pleural effusions of 121 patients who were aged ≥18 years were evaluated. The study was planned as a prospective cohort type study. Results: Effusions were divided into two sub-groups as transudate (n:37) and exudate (n:84); and malignant (n:30) and non-malignant (n:91). Serum procalcitonin level of 0.035 was having a sensitivity of 0.726 and specificity of 0.964; on the other hand, pleural fluid procalcitonin level of 0.035 was having a sensitivity of 0.690 and specificity of 0.919. For serum procalcitonin /albumin ratio, 0.0104 value was having a sensitivity of 0.774 and specificity of 0.757 while for pleural fluid procalcitonin /albumin ratio of 0.019 value was having a sensitivity of 0.667 and specificity of 0.649. Conclusion: Serum and pleural fluid procalcitonin levels and procalcitonin/ albumin ratio were having a significant role in differentiating transudate and exudate. However, procalcitonin, CRP or any other ratios obtained from these parameters were not useful in diagnosis of malignant effusions.

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Hardak, Emilia, Eli Peled, Yonatan Crispel, Shourouk Ghanem, Judith Attias, Keren Asayag, Inna Kogan, and Yona Nadir. "Heparan sulfate chains contribute to the anticoagulant milieu in malignant pleural effusion." Thorax 75, no. 2 (December 31, 2019): 143–52. http://dx.doi.org/10.1136/thoraxjnl-2018-212964.

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BackgroundWhile malignant pleural effusion (MPE) is a common and significant cause of morbidity in patients with cancer, current treatment options are limited. Human heparanase, involved in angiogenesis and metastasis, cleaves heparan sulfate (HS) side chains on the cell surface.AimsTo explore the coagulation milieu in MPE and infectious pleural effusion (IPE) focusing on the involvement of heparanase.MethodsSamples of 30 patients with MPE and 44 patients with IPE were evaluated in comparison to those of 33 patients with transudate pleural effusions, using heparanase ELISA, heparanase procoagulant activity assay, thrombin and factor Xa chromogenic assays and thromboelastography. A cell proliferation assay was performed. EMT-6 breast cancer cells were injected to the pleural cavity of mice. A peptide inhibiting heparanase activity was administered subcutaneously.ResultsLevels of heparanase, factor Xa and thrombin were significantly higher in exudate than transudate. Thromboelastography detected almost no thrombus formation in the whole blood, mainly on MPE addition. This effect was completely reversed by bacterial heparinase. Direct measurement revealed high levels of HS chains in pleural effusions. Higher proliferation was observed in tumour cell lines incubated with exudate than with transudate and it was reduced when bacterial heparinase was added. The tumour size in the pleural cavity of mice treated with the heparanase inhibitor were significantly smaller compared with control (p=0.005).ConclusionsHS chains released by heparanase form an anticoagulant milieu in MPE, preventing local thrombosis and enabling tumour cell proliferation. Inhibition of heparanase might provide a therapeutic option for patients with recurrent MPE.

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Hassan, T., M. Al-Alawi, S. H. Chotirmall, and N. G. McElvaney. "Pleural Fluid Analysis: Standstill or a Work in Progress?" Pulmonary Medicine 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/716235.

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Pleural fluid analysis yields important diagnostic information in pleural effusions in combination with clinical history, examination, and radiology. For more than 30 years, the initial and most pragmatic step in this process is to determine whether the fluid is a transudate or an exudate. Light's criteria remain the most robust in separating the transudate-exudate classification which dictates further investigations or management. Recent studies have led to the evaluation and implementation of a number of additional fluid analyses that may improve the diagnostic utility of this method. This paper discusses the current practice and future direction of pleural fluid analysis in determining the aetiology of a pleural effusion. While this has been performed for a few decades, a number of other pleural characteristics are becoming available suggesting that this diagnostic tool is indeed a work in progress.

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Ryder, Kathryn. "Usefulness of Oral Mucosal Transudate for HIV Antibody Testing." JAMA: The Journal of the American Medical Association 277, no. 20 (May 28, 1997): 1591. http://dx.doi.org/10.1001/jama.1997.03540440025014.

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Tessler, Leah F. "Usefulness of Oral Mucosal Transudate for HIV Antibody Testing." JAMA: The Journal of the American Medical Association 277, no. 20 (May 28, 1997): 1591. http://dx.doi.org/10.1001/jama.1997.03540440025015.

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Frank, Allan P. "Usefulness of Oral Mucosal Transudate for HIV Antibody Testing." JAMA: The Journal of the American Medical Association 277, no. 20 (May 28, 1997): 1591. http://dx.doi.org/10.1001/jama.1997.03540440025016.

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Martinez, Prudencio. "Usefulness of Oral Mucosal Transudate for HIV Antibody Testing." JAMA: The Journal of the American Medical Association 277, no. 20 (May 28, 1997): 1592. http://dx.doi.org/10.1001/jama.1997.03540440026017.

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41

Tessler, L. F. "Usefulness of oral mucosal transudate for HIV antibody testing." JAMA: The Journal of the American Medical Association 277, no. 20 (May 28, 1997): 1591b—1591. http://dx.doi.org/10.1001/jama.277.20.1591b.

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Ryder, K. "Usefulness of oral mucosal transudate for HIV antibody testing." JAMA: The Journal of the American Medical Association 277, no. 20 (May 28, 1997): 1591c—1591. http://dx.doi.org/10.1001/jama.277.20.1591c.

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Martinez, P. "Usefulness of oral mucosal transudate for HIV antibody testing." JAMA: The Journal of the American Medical Association 277, no. 20 (May 28, 1997): 1592. http://dx.doi.org/10.1001/jama.277.20.1592.

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Komatsuda, T., H. Ishida, K. Konno, Y. Hamashima, H. Naganuma, M. Sato, T. Suzuki, K. Shindoh, and S. Watanabe. "Differentiation of exudate from transudate ascites by Doppler sonography." Abdominal Imaging 28, no. 5 (October 2003): 609–13. http://dx.doi.org/10.1007/s00261-002-0087-2.

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Cornes, Michael P., Andrew J. Chadburn, Claire Thomas, Catherine Darby, Rachel Webster, Clare Ford, and Rousseau Gama. "The impact of between analytical platform variability on the classification of pleural effusions into exudate or transudate using Light's criteria." Journal of Clinical Pathology 70, no. 7 (February 16, 2017): 607–9. http://dx.doi.org/10.1136/jclinpath-2016-204142.

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BackgroundLight's criteria are ratios of pleural fluid to serum total protein (TP), pleural fluid to serum lactate dehydrogenase (LDH) and pleural fluid LDH to the upper reference limit for serum LDH. They are used to classify pleural effusions into an exudate or transudate when pleural fluid protein is 25–35 g/L. We evaluated the impact of between analytical platforms on the classification of pleural effusions using Light's criteria.MethodsLight's criteria were used to classify pleural effusions with fluid TP between 25 and 35 g/L into exudate and transudate. LDH and TP were analysed using an Abbott ARCHITECT c16000 analyser using a lactate to pyruvate method for LDH and two Roche Cobas 800 c702 analysers, one using a lactate to pyruvate method (laboratory B) and one a lactate to pyruvate method (laboratory C).ResultsEighty-three paired serum and pleural fluid samples were analysed. Of these, 44 samples had a pleural fluid TP between 25 and 35 g/L and were classified according to Light's criteria. Classification of pleural fluid into transudate or exudate using different analytical platforms was 82% concordant. The LDH ratio and TP ratio were similar in laboratory B and laboratory C, but these were respectively lower (p<0.001) and higher (p<0.001) than those at laboratory A.ConclusionsAlthough Light's criteria are ratios, which should minimise interassay variability, we report 18% discordance between different analytical platforms. The discordance was largely due to the performance of LDH and to a lesser extent protein assays in pleural fluid. Laboratories should be aware that assays may perform differently in serum and pleural fluid.

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Rhodus, Nelson L., Bin Cheng, and Frank Ondrey. "Th1/Th2 Cytokine Ratio in Tissue Transudates from Patients with Oral Lichen Planus." Mediators of Inflammation 2007 (2007): 1–5. http://dx.doi.org/10.1155/2007/19854.

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Objective. The characteristics of oral lichen planus (OLP) provoke investigators to explore possible biomarkers by which to monitor disease activity and therapeutic efficacy. Oral fluids may provide an accessible medium for analysis of such biomarkers. Previous studies have shown that activation of nuclear factor-kappa B (NF-κB) plays an important role in the pathogenesis of oral lichen planus (OLP), which is a chronic inflammatory disorder mediated by T cells. Prior to the present investigation, reports of the levels of NF-κB and its dependent cytokines in oral fluids have not been forthcoming. The purpose of this study was to detect the level of NF-κB dependent cytokines, TNF-alpha, IL-1-alpha, IL-6, and IL-8 in tissue transudates directly from lesions of OLP, and explore the feasibility of the data for clinical application.Study design. Thirteen definitively diagnosed OLP subjects were enrolled in the study as were 13 age-sex matched controls. In each subject, lesion tissue transudates (TTs) were collected by a novel collection technique with a filter paper. The level of cytokines, TNF-alpha, IL-1-alpha, IL-6, and IL-8 in three types of oral fluids were determined by ELISA.Results. In the tissue transudate(TT), there were significantly higher level of cytokines TNF-alpha, IL-1-alpha, IL-6, and IL-8 detected in OLP patients than in controls: (TT:40.0±9.8versus4.5±0.7,710±114versus305±78,150±25versus1.7±0.5,2800±260versus1450±130,P<.0001; unit: pg/mL).Conclusions. These results indicate that NF-κB dependent inflammatory cytokines may be detected at increased levels in oral lesion tissue transudates which may have diagnostic and prognostic potentials for monitoring disease activity and making therapeutic decisions in patients with OLP.

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Suman, Shanker, Divya Jyoti, Pramod Kumar Agrawal, and Bijoy Kumar Bhattacharya. "Clinicopathological correlation of serum ascites albumin gradient with ascitic fluid total protein in patients of ascites with portal hypertension attending a tertiary care hospital in Eastern Bihar, India." International Journal of Advances in Medicine 4, no. 3 (May 23, 2017): 842. http://dx.doi.org/10.18203/2349-3933.ijam20172282.

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Background: The level of ascitic fluid total protein (AFTP) is used to differentiate between transudative and exudative ascites. Ascites patients having portal hypertension are considered to be transudative in nature. The traditional transudate/exudate system of ascitic fluid classification based on ascitic fluid total protein concentration is sometimes misleading in patients of ascites with portal hypertension. Now a days SAAG (serum ascites albumin gradient) has become more acceptable in differentiating patients presenting with ascites due to portal hypertension. The objective of this prospective study was to correlate serum ascites albumin gradient with ascitic fluid total protein in patients of ascites having portal hypertension.Methods: 100 cases of ascites are selected randomly. All the provisional diagnosis are confirmed with the help of different biochemical, pathological and radiological investigations.Results: SAAG (≥1.1gm/dl) was more sensitive and specific (94% and 90% respectively) than ascitic fluid total protein concentration of <2.5 gm/dl (78% and 50% respectively) in detecting portal hypertension and had higher positive and negative predicative values (97% and 82% respectively) compared to AFTP concentration (85% and 38% respectively).Conclusions: Considering the advantages of measuring the serum-ascites albumin gradient in illuminating the pathogenesis of ascites and the ease with which this test can be done, it is suggested that this parameter should replace the traditional parameter of ascitic fluid total protein level in the routine analysis of ascites fluid and classification of ascites.

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Stanzel, Franz. "Pleuraerguss: Vereinfachte Kriterien zur Unterscheidung zwischen Exsudat und Transsudat." Kompass Pneumologie 7, no. 6 (2019): 331–32. http://dx.doi.org/10.1159/000504151.

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Background: An important part of the investigation of pleural effusion is the identification of markers that help separate exudate from transudate. Objectives: The purposes of this study were to compare the accuracy of published and new sets of criteria to distinguish between exudative and transudative pleural effusions, and to determine whether serum biochemical analysis is necessary. Methods: An externally validated cohort study was performed. Pleural effusions were determined to be transudative or exudative on the basis of an assessment of the medical record by two clinicians blinded to biochemical results. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the receiver operating characteristic curve were determined for each proposed combination of criteria. Results: Pleural fluid analysis was available for 311 thoracenteses in the main cohort and for 112 thoracenteses in the validation cohort. The best sensitivity (97% [95% CI 94-99]) and negative likelihood ratio (0.04 [95% CI 0.02-0.08]) for identifying exudative effusions were observed with criteria combining pleural fluid lactate dehydrogenase greater than 0.6 the upper limit of normal serum lactate dehydrogenase and pleural fluid cholesterol greater than 1.04 mmol/L (40 mg/dL). The overall diagnostic accuracy was similar to Light's criteria. Findings were similar in the validation cohort. Conclusions: Our proposed criteria using simultaneously pleural fluid lactate dehydrogenase and pleural fluid cholesterol can identify an exudate with a sensitivity and an overall diagnostic accuracy similar to Light's criteria. It avoids simultaneous blood sampling, thus reducing patient discomfort and potential costs.

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ATHANASIOU, L. V., M. SPYROPOULOU, and K. MEICHNER. "The laboratory diagnostic approach to thoracic and abdominal effusions in the dog, cat, and horse." Journal of the Hellenic Veterinary Medical Society 70, no. 3 (October 30, 2019): 1589. http://dx.doi.org/10.12681/jhvms.21781.

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Cases involving pleural and peritoneal effusions occur relatively frequently in clinical practice. Determining the underlying etiology in these cases relies mainly on fluid analysis. The technique used for obtaining the pleural or peritoneal fluid can impact greatly the results of the analysis. Most often used diagnostic tools include evaluation of gross appearance, Total Nucleated Cell Count / Total Protein (TNCC/TP) measurement, chemical/biochemical analysis (Lactate dehydrogenase and lactate, cholesterol, triglycerides, glucose, creatinine, pH, pO2, pCO2, and K measurements), cytology (identification of septic and non-septic inflammation and neoplasia), microbiology (Gram stain, culture, molecular techniques), and specific tests for certain clinical conditions and diseases. Classifying an effusion as transudate, modified transudate and exudate is traditionally based on the TNCC and TP values. New diagnostic methods encourage the clinician to approach the effusion etiologically instead of strictly following this traditional classification. Many of the diagnostic tests described in this review are simple and can be performed in-house, providing the clinician quickly with information about the cause of the effusion, essential for an effective treatment plan without wasting valuable time.

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Akarsu, Saadet, A. Nese Citak Kurt, Yasar Dogan, Erdal Yilmaz, Ahmet Godekmerdan, and A. Denizmen Aygun. "The Differential Diagnostic Values of Cytokine Levels in Pleural Effusions." Mediators of Inflammation 2005, no. 1 (2005): 2–8. http://dx.doi.org/10.1155/mi.2005.2.

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The aim is to examine whether the changes in pleural fluid interleukin (IL)-1β, IL-2, IL-6, and IL-8 levels were significant in differential diagnosis of childhood pleural effusions. IL-1β, IL-2, IL-6, and IL-8 levels in pleural fluids of all 36 patients were measured. The levels of IL-1β, IL-2, IL-6, and IL-8 in pleural fluids were statistically significantly higher in the transudate group compared with those of the exudate group. The levels of IL-1β, IL-6, and IL-8 were also found to be statistically significantly higher in the empyema group compared with both the parapneumonic and the tuberculous pleural effusion groups. The levels of IL-2 and IL-6 were detected to be statistically significantly higher in the tuberculous pleural effusion group in comparison with those of the parapneumonic effusion group. The results showed that pleural fluids IL-1β, IL-2, IL-6, and IL-8 could be used in pleural fluids exudate and transudate distinction.

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Journal articles on the topic 'Transudate'

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