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Cardiac Disease
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Megan Horsley, Jeffrey Anderson
Chyle is often described as a white, milky-appearing substance composed of chylomicrons and lymph. Lymph fluid from the intestines, as well as the lower extremities and liver, is transported by lymphatic channels that converge into the thoracic duct at the level of the cisterna chyli. The majority of terminal drainage of lymphatic fluid into the venous system is through the thoracic duct and main connection at the junction of the left subclavian and internal jugular veins. The primary purpose of chyle is the absorption and transportation of long-chain triglycerides (LCT) in the intestines. Chyle is formed in the lacteals of the intestines during digestion in response to the presence of intraluminal fat. The chyle binds with LCT to form chylomicrons, which are then absorbed and transported by the intestinal lymphatics to the bloodstream. Chyle is also rich in proteins and is responsible for absorbing fat-soluble vitamins; therefore, high losses are of great nutritional concern. When a person is fasting, the fluid can appear less white, and more yellowish or clear.
Miscellaneous procedures
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
A similar technique can be used to access the para-aortic or other deeply seated lymph nodes when the use of ultrasound-guided access is not possible. This technique requires careful planning with C-arm angiography using a CBCT facility with guidance software as discussed elsewhere in this chapter to ensure that vital structurers are avoided. Alternatively, conventional CT can be used for needle guidance. CT imaging is used for the assessment of leakage of chyle in the abdomen or thorax and follow-up after treatment (Fig. 13.25c).
How should aggressive chyloreflux (e.g., chyluria, chyloascites, chylothorax, chyle leakage) be handled?
Published in Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic, Vascular Malformations, 2019
Cristobal M. Papendieck, Miguel Amore
Chyle is a milky appearing fluid formed exclusively through the jejunoileal epithelium during food digestion as a part of normal fatty acid metabolism. Daily chyle volume depends exclusively on intake, and on epithelial jejunoileum competence.
Chylothorax in Behçet’s disease
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2021
Sophie B. Kermelly, Marie-Ève Boucher, François Côté, François Maltais
Chylothorax is managed with dietary fat restriction to medium-chain triglycerols to reduce the production of monoglycerides and free fatty acids circulating in the chyle.18 Attempting to reduce chyle accumulation in the pleural space is warranted to prevent denutrition and immunodepression related to the loss of lymphocytes present in the liquid. Failure of medical therapy of the underlying cause or recurrent effusions often necessitate surgical approaches such as thoracic drains, blood patch, tetracycline or talc pleurodesis, and ligature of the thoracic duct that have all been attempted with good short-term outcomes.14,19–21 Thoracic duct embolization is another interventional technique with good success rate, particularly in the context of traumatic chylothoraces.22 In our particular case, since the underlying pathophysiology of chylothorax formation was high venous pressure with a chyle backflow, the main therapeutic strategy was to prevent the formation of new thrombosis with anticoagulation and immunosuppression, hoping for repermeabilization of the superior vena cava to occur. It was also felt important to reduce the formation of chyle with the nutritional intervention. This combined therapy was successful in resolving our patient’s chylothorax without surgical management.
Development of a designated comparison method for alkaline phosphatase measurements and its application to evaluating routine methods
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Qingxiang Liu, Qi Guo, Jing Wang, Yuhang Deng, Jie Zeng, Weiyan Zhou, Haijian Zhao, Chuanbao Zhang
According to CLSI EP7-A2 [8], using the ‘paired difference’ experimental method, the fresh serum was divided into two parts; one part was mixed with the interfering substance in a ratio of 9:1 as the sample H; another was mixed with the interfering substance blank control substance at a ratio of 9:1 as the sample L. Sample H and sample L were mixed in proportion to prepare five interference samples, and the concentrations of interfering substances in interfering samples are shown in ESM Table 2. The interfering substances included free/conjugated bilirubin, chyle and hemoglobin. Chyle refers to fat particles that have a milky appearance in the lymph fluid, and its turbidity is expressed by FTU. Each interference sample was measured in triplicate, and the average value of each sample was subtracted from the average value of the control group to obtain the interference value. The criteria of interference bias was 5%.
The role of pleurodesis in respiratory diseases
Published in Expert Review of Respiratory Medicine, 2018
Rachel M. Mercer, Maged Hassan, Najib M. Rahman
Chylothoraces require a different management strategy to other benign effusions, as a chylothorax contains large amounts of protein, fat, electrolytes, vitamins, immunoglobulins, and T-lymphocytes. Thus, ongoing drainage can put the patient at risk of infections due to reduced immunity and malnutrition [87]. Pleurodesis will often only be attempted once conservative management, surgical, and radiological options have been exhausted [87] due to the difficulty of achieving a dry pleural space without developing complications from the persistent loss of chyle.