scholarly journals ANALISIS CAIRAN DARAH (TRANSUDAT) DAN SERUM CAMPURAN (EKSUDAT) DI PENDERITA DENGAN REMBESAN SELAPUT PARU (EFUSI PLEURA)

Author(s):  
Didi Irwadi ◽  
Sulina Y. Wibawa ◽  
Hardjoeno Hardjoeno

Pleural effusion is a fluid excess into pleural cavity due to transudation or exudation processes. The fluid deposited in the cavity canthreat the patient’s life. The pleural effusion could be produced in a patient with tuberculosis, cancer, cardiac failure, renal failure orviral/bacterial infection. The study is aimed to analyze the patterns of substance in the pleural effusion fluids produced by differentdiseases. A cross sectional study was performed from June 2006 to June 2007 at Clinical Pathology Laboratory of Dr. WahidinSudirohusodo Hospital, Makassar. The fluids were tested for glucose, total protein, LDH, and leukocyte count. Of 87 pleural effusion fluidsamples from 14–80 years old patients, 34.5% were transudates and 65.5% were exudates. Glucose value was higher (one tail T test,p < 0.01) in transudates group, whereas protein, LDH and leukocyte count were higher (one tail T test, p < 0.01) in exudates group.There were no significant differences of glucose, protein, LDH and leukocyte count among diseases within transudates group, as well aswithin exudates group. Staphylococcus spp., Klebsiella spp., and Acinetobacter spp., were the predominant bacteria revealed from thefluid cultures. Values of glucose, protein, LDH and leukocyte count have a different pattern between transudates and exudates groups.However, no special patterns were found among diseases within groups.

Author(s):  
Vina Zakiah Latuconsina ◽  
Irda Handayani ◽  
Asvin Nurulita ◽  
Uleng Bahrun Uleng Bahrun

Hepatitis is an inflammation of liver cells caused by infection (virus, bacteria, paracytes), medication, alcohol consumption, excessive lipid and autoimmune disease. Increasing method (sensitivity) of HBsAg test is often followed by a lot of false positive test results, which need a confirmation test which takes a longer time and higher cost so that it is needed to determine an optimal gray zone range for a confirmation test. This analytical cross-sectional study was held at the Clinical Pathology Laboratory of the Dr.Wahidin Sudirohusodo Hospital Makassar. The subjects were specimens which HBsAg value was within 0.06-1 COI. Specimens were examined using HBsAg confirmation test. Over 49 samples collected there were 32 reactive and 17 non-reactive. 14 out of 32 reactive samples (43.8%) were confirmed as negative (false positive) by HBsAg confirmation test and 3 out of 17 non-reactive samples (17.6%) were confirmed as positive (false negative). Chi-square test showed a significant correlation between HBsAg value and HBsAg confirmation test value (p=0.009). Chi-square test with some intervals with α=1% showed that the interval of HBsAg value 0.13-0.17 COI was the interval with the lowest significant value (p=0.004). This subsequent interval was recommended as the gray zone range. The range 0.13-0.17 was most optimal as HBsAg gray zone to determine the need for a confirmation test. A further study with larger samples is suggested. 


Author(s):  
Efelina Sutanto ◽  
Liong Boy Kurniawan ◽  
Fitriani Mangarengi

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.  


Author(s):  
Angga J Suryadi ◽  
Kanadi Sumapradja

Objective: To compare the classic examination results of antiphospholipid (aPS) and antiphospatidylserine (aPL) antibody profile to establish the diagnosis from suspected antiphospholipid antibody syndrome (APS) patient in order to state the subsequent treatment strategies. Method: This descriptive cross-sectional study design was conducted at outpatient clinics of Dr. Cipto Mangunkusumo Hospital (RSCM) from January to December 2015. The laboratory test was held in Clinical Pathology Laboratory RSCM/Faculty of Medicine Universitas Indonesia (FKUI) and in corporation with Prodia laboratory. Result: All of normal patients did not have positive result in any laboratory examination (Lupus Anti-coagulant (LA), anticardiolipin (aCL), anti-?2 glycoprotein I (anti-?2GPI), and aPS). In patient suspected APS, 11 (37.1%) patients had positive aCL, 7 (25.9%) patients had positive anti-?2GPI, and 11 (37.1%) patients had positive aPS. The most positive cross laboratory examination was between aCL and aPS (25.9%). In this study, we found the most positive test result was aCL and aPS (62.9%). From this study, suspected APS patient who had negative result in classic laboratory examination, but showing the positive result in aPS was in 5 (18.5%) patients. Conclusion: All normal pregnant patients do not have any positive classic examination and aPS. Meanwhile, in patients with suspected APS, less than 20% patients show positive result of aPS with negative result in classic laboratory examination. Keywords: antiphospatidylserine, antiphospolipid syndrome


Author(s):  
Nor Jannah Ali ◽  
Ani Kartini Dr ◽  
Darmawaty Effendi Dr

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 


Author(s):  
Misnah Misnah ◽  
Agus Alim Abdullah ◽  
Mansyur Arif ◽  
Burhanuddin Bahar

Prothrombin Time (PT) and an activated Partial Thromboplastin Time (aPTT) are routine coagulation tests used for pre-operative screening. The analytical step as one of the laboratory test’s stage that plays the role in the determination of the test is influenced by several factors, one of them is choosing its proper devices. The aim of this study was to know the correlation of the PT and aPTT test’s result using Humaclot VA and Sysmex CA 500 devices. A cross sectional study has been done at the Clinical Pathology Laboratory of Wahidin Sudirohusodo Hospital Makassar started from May 2009 until June 2009. The data were analyzed with T and Pearson’s Correlation test. From the 50 samples were obtained the percentage of the corresponding frequency of the PT results between Humaclot VA and Sysmex CA 500 about 84%, whereas the frequency of the corresponding results aPPT between Humaclot VA and Sysmex CA 500 is 76%, the Pearson correlation test for PT=0.58, and aPTT=0.38. There were found the suitability of PT, aPTT of Humaclot VA with CA 500 and both tools have a positive correlation.


Author(s):  
Saraswati Wulandari Hartono ◽  
Nurhayana Sennang ◽  
Fitriani Mangarengi

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. 


2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.


2016 ◽  
pp. 66-71
Author(s):  
Van Mao Nguyen ◽  
Huyen Quynh Trang Pham

Background: The cytology and the support of clinical symptoms, biochemistry for diagnosis of the cases of effusions are very important. Objectives: - To describe some of clinical symptoms and biochemistry of effusions. - To compare the results between cytology and biochemistry by the causes of pleural, peritoneal fluids. Material & Method: A cross-sectional study to describe all of 47 patients with pleural, peritoneal effusions examinated by cytology in the Hospital of Hue University of Medicine and Pharmacy from April 2013 to January 2014. Results: In 47 cases with effusions, pleural effusion accounting for 55.32%, following peritoneal effusions 29.79% and 14.89% with both of them. The most common symptoms in patients with pleural effusions were diminished or absent tactile fremitus, dull percussion, diminished or absent breath sounds (100%), in patients with peritoneal effusions was ascites (95.24%). 100% cases with pleural effusions, 50% cases with peritoneal effusions and 80% cases with pleural and peritoneal effusions were exudates. The percentage of malignant cells in patients with pleural effusions was 26.92%, in peritoneal effusions was 28.57%, in pleural and peritoneal effusions was 42.86%. The percentage of detecting the malignant cells in patients with suspected cancer in the first test was 57.14%, in the second was 9.53% and 33.33% undetectable. Most of cases which had malignant cells and inflammatory were exudates, all of the cases which had a few cells were transudates. Besides, 7.5% cases which had high neutrophil leukocytes were transudates. Conclusion: Cytology should be carry out adding to the clinical examinations and biochemistry tests to have an exact diagnosis, especially for the malignant ones. For the case with suspected cancer, we should repeat cytology test one more time to increase the ability to detect malignant cells. Key words: Effusion, pleural effusion, peritoneal effusion, cytology, biochemistry


2020 ◽  
Vol 18 (6) ◽  
pp. 658-661
Author(s):  
Mafalda Lemos Caldas ◽  
Miguel Julião ◽  
Ana João Santos ◽  
Harvey Max Chochinov

AbstractIntroductionThe Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness.ObjectiveTo study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC).MethodA cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed.ResultsTwenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary.Significance of resultsThe PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiao Lu ◽  
Yuan Wang ◽  
Lihong Hou ◽  
Zhenxing Zuo ◽  
Na Zhang ◽  
...  

Abstract Background Influenced by various factors such as socio-demographic characteristics, behavioral lifestyles and socio-cultural environment, the multimorbidity patterns in old adults remain complex. This study aims to identify their characteristics and associated multi-layered factors based on health ecological model. Methods In 2019, we surveyed a total of 7480 participants aged 60+ by using a multi-stage random cluster sampling method in Shanxi province, China. Latent class analysis was used to discriminate the multimorbidity patterns in old adults, and hierarchical regression was performed to determine the multi-layered factors associated with their various multimorbidity patterns. Results The prevalence of multimorbidity was 34.70% among the old patients with chronic disease. Over half (60.59%) of the patients with multimorbidity had two co-existing chronic diseases. “Degenerative/digestive diseases”, “metabolic diseases” and “cardiovascular diseases” were three specific multimorbidity patterns. Behavioral lifestyles-layered factors had the most explanatory power for the three patterns, whose proportions of explanatory power were 54.00, 43.90 and 48.15% individually. But the contributions of other multi-layered factors were different in different patterns; balanced diet, medication adherence, the size of family and friendship network, and different types of basic medical insurance might have the opposite effect on the three multimorbidity patterns (p < 0.05). Conclusions In management of old patients with multimorbidity, we should prioritize both the “lifestyle change”-centered systematic management strategy and group-customized intervention programs.


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