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Sample records for peritoneal transport status

  1. Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients.

    PubMed

    Waniewski, Jacek; Antosiewicz, Stefan; Baczynski, Daniel; Poleszczuk, Jan; Pietribiasi, Mauro; Lindholm, Bengt; Wankowicz, Zofia

    2016-01-01

    During peritoneal dialysis (PD), the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21-87) years; median time on PD 19 (3-100) months) underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed. The estimated fluid transport parameters, including hydraulic permeability (LpS), fraction of ultrasmall pores (α u), osmotic conductance for glucose (OCG), and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters). Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher. Thus, fluid transport parameters--rather than solute transport parameters--are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane. PMID:26989432

  2. Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients

    PubMed Central

    Waniewski, Jacek; Antosiewicz, Stefan; Baczynski, Daniel; Poleszczuk, Jan; Pietribiasi, Mauro; Lindholm, Bengt; Wankowicz, Zofia

    2016-01-01

    During peritoneal dialysis (PD), the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87) years; median time on PD 19 (3–100) months) underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed. The estimated fluid transport parameters, including hydraulic permeability (LpS), fraction of ultrasmall pores (αu), osmotic conductance for glucose (OCG), and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters). Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher. Thus, fluid transport parameters—rather than solute transport parameters—are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane. PMID:26989432

  3. Vitamin K Status of Canadian Peritoneal Dialysis Patients

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vitamin K –dependent proteins have been implicated in the regulation of vascular calcification, a condition that is prevalent among peritoneal dialysis patients. Vitamin K status in this patient population is unknown. In a cross-sectional study of 22 peritoneal dialysis patients selected from a Can...

  4. Interstitial Fibrosis Restricts Osmotic Water Transport in Encapsulating Peritoneal Sclerosis.

    PubMed

    Morelle, Johann; Sow, Amadou; Hautem, Nicolas; Bouzin, Caroline; Crott, Ralph; Devuyst, Olivier; Goffin, Eric

    2015-10-01

    Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication of peritoneal dialysis (PD) characterized by extensive fibrosis of the peritoneum. Changes in peritoneal water transport may precede EPS, but the mechanisms and potential predictive value of that transport defect are unknown. Among 234 patients with ESRD who initiated PD at our institution over a 20-year period, 7 subsequently developed EPS. We evaluated changes in peritoneal transport over time on PD in these 7 patients and in 28 matched controls using 3.86% glucose peritoneal equilibration tests. Compared with long-term PD controls, patients with EPS showed early loss of ultrafiltration capacity and sodium sieving before the onset of overt EPS. Multivariate analysis revealed that loss of sodium sieving was the most powerful predictor of EPS. Compared with long-term PD control and uremic peritoneum, EPS peritoneum showed thicker submesothelial fibrosis, with increased collagen density and a greater amount of thick collagen fibers. Reduced osmotic conductance strongly correlated with the degree of peritoneal fibrosis, but not with vasculopathy. Peritoneal fibrosis was paralleled by an excessive upregulation of vascular endothelial growth factor and endothelial nitric oxide synthase, but the expression of endothelial aquaporin-1 water channels was unaltered. Our findings suggest that an early and disproportionate reduction in osmotic conductance during the course of PD is an independent predictor of EPS. This functional change is linked to specific alterations of the collagen matrix in the peritoneal membrane of patients with EPS, thereby validating the serial three-pore membrane/fiber matrix and distributed models of peritoneal transport. PMID:25636412

  5. Nutritional status in peritoneal dialysis: studies in body composition, lipoprotein metabolism and peritoneal function.

    PubMed

    Johansson, Ann-Cathrine

    2002-01-01

    This thesis is based on clinical studies including virtually all patients treated with peritoneal dialysis in Gothenburg during the 1990s. The patients had a fundamentally altered body composition compared to healthy subjects, characterised by a reduction in body cell mass and body fat already at start of dialysis. During PD treatment. a further decrease in body cell mass was observed. Energy stores tended to normalise during the first years of treatment and remained constant thereafter, or declined subsequently. Extracellular water, calculated from the four-compartment model, was increased when patients started PD treatment and increased further, in parallel to the reduction in body cell mass. These alterations were seen in combination with a normal. or slightly reduced, body weight. Standard methods of assessing nutritional status may therefore not be valid in the dialysis population. Prediction equations to estimate total body water, used in measurements of dialysis adequacy, give erroneous results in PD patients, as shown in a study on our PD population. This may have important clinical consequences, especially in wasted patients. Reduced muscle mass is a marker of protein-energy malnutrition, and therefore simple and reliable methods to measure muscle mass are warranted. When lean body mass was calculated from creatinine generation rate and compared to lean body mass estimated from measurements of total body potassium. the agreement between the two methods was low. Furthermore, when repeated measurements of creatinine generation rate were performed, the variation coefficient was unacceptably high. Thus. creatinine generation rate cannot be recommended as a method to evaluate somatic protein status in PD patients. The lipoprotein metabolic derangements are pronounced in PD patients. in which a further increase in cholesterol and cholesterol-rich apoB-containing lipoproteins are added to the already pre-existing renal dyslipidemia. characterised by increased

  6. Neighborhood Socioeconomic Status and Barriers to Peritoneal Dialysis: A Mixed Methods Study

    PubMed Central

    Perzynski, Adam T.; Austin, Peter C.; Wu, C. Fangyun; Lawless, Mary Ellen; Paterson, J. Michael; Quinn, Rob R.; Sehgal, Ashwini R.; Oliver, Matthew James

    2013-01-01

    Summary Background and objectives The objective of this study was to evaluate the association between neighborhood socioeconomic status and barriers to peritoneal dialysis eligibility and choice. Design, setting, participants, & measurements This study was a mixed methods parallel design study using quantitative and qualitative data from a prospective clinical database of ESRD patients. The eligibility and choice cohorts were assembled from consecutive incident chronic dialysis patients entering one of five renal programs in the province of Ontario, Canada, between January 1, 2004 and December 31, 2010. Socioeconomic status was measured as median household income and percentage of residents with at least a high school education using Statistics Canada dissemination area-level data. Multivariable models described the relationship between socioeconomic status and likelihood of peritoneal dialysis eligibility and choice. Barriers to peritoneal dialysis eligibility and choice were classified into qualitative categories using the thematic constant comparative approach. Results The peritoneal dialysis eligibility and choice cohorts had 1314 and 857 patients, respectively; 65% of patients were deemed eligible for peritoneal dialysis, and 46% of eligible patients chose peritoneal dialysis. Socioeconomic status was not a significant predictor of peritoneal dialysis eligibility or choice in this study. Qualitative analyses identified 16 barriers to peritoneal dialysis choice. Patients in lower- versus higher-income Statistics Canada dissemination areas cited built environment or space barriers to peritoneal dialysis (4.6% versus 2.7%) and family or social support barriers (8.3% versus 3.5%) more frequently. Conclusions Peritoneal dialysis eligibility and choice were not associated with socioeconomic status. However, socioeconomic status may influence specific barriers to peritoneal dialysis choice. Additional studies to determine the effect of targeting interventions to

  7. Peritonitis

    MedlinePlus

    Acute abdomen ... of blood, body fluids, or pus in the abdomen ( intra-abdominal abscess ). Types of peritonitis are: Spontaneous ... The belly (abdomen) is very painful or tender. The pain may become worse when the belly is touched or when you ...

  8. Peritoneal transport characteristics with glucose polymer based dialysate.

    PubMed

    Ho-dac-Pannekeet, M M; Schouten, N; Langendijk, M J; Hiralall, J K; de Waart, D R; Struijk, D G; Krediet, R T

    1996-09-01

    it remained unchanged during the dwell. In contrast, D/PNa+ of 1.36% glucose increased during the dwell, whereas D/PNa+ decreased with 3.86% glucose until 60 minutes, followed by a subsequent increase. The ultrafiltration coefficient (UFC) of the total peritoneal membrane was assessed using 3.86% glucose (0.18 +/- 0.04 ml/min/mm Hg), and the UFC of the small pores was assessed using icodextrin (0.06 +/- 0.008 ml/min/mm Hg). The difference between these represented the UFC through the transcellular pores, which averaged 50.5% of the total UFC, but with a very wide range (0 to 85%). An inverse relation existed between the duration of CAPD treatment and the total ultrafiltration coefficient (r = -0.68, P < 0.04), which could be attributed to a lower UFC of the transcellular pores in long-term patients (r = -0.66, P < 0.05), but not to the UFC of the small pores (r = -0.48, NS). The TCUFRo-60 min through the transcellular pores correlated with the sodium gradient, corrected for diffusion, in the first hour of the dwell (r = 0.69, P < 0.04), indicating that both parameters indeed measure transcellular water transport. It can be concluded that the glucose polymer solution induced sustained ultrafiltration and had no effect on peritoneal membrane characteristics. In addition, the results of the present study support the hypothesis that the glucose polymer solutions exerts its osmotic pressure across intercellular pores with radii of about 40 A. This leads to increased clearances of low molecular weight proteins such as beta 2m that are transported through these pores without sieving of Na+. The latter, as found during 3.86% glucose dialysate, is probably caused by transcellular water transport. The transcellular water transport accounted for 50% of the total ultrafiltration with glucose based dialysis solutions. It was lower in long-term CAPD patients. PMID:8872974

  9. Peritoneal tumor spread in serous ovarian cancer-epithelial mesenchymal status and outcome

    PubMed Central

    Auer, Katharina; Bachmayr-Heyda, Anna; Aust, Stefanie; Sukhbaatar, Nyamdelger; Reiner, Agnes Teresa; Grimm, Christoph; Horvat, Reinhard; Zeillinger, Robert; Pils, Dietmar

    2015-01-01

    In this study we aimed to analyze the biological mechanisms underlying apparently different modes of peritoneal tumor spread in serous ovarian cancer: miliary (widespread, millet-like lesions) versus non-miliary (bigger, exophytically growing implants). Tumor tissues and ascites from 23 chemotherapy naive patients were analyzed by RNA-sequencing and flow cytometry. On the basis of differential gene expression between miliary and non-miliary, gene signatures were developed. A calculated tumor spread factor revealed a significant independent negative impact of miliary spread on overall survival (HR 3.77; CI95 1.14–12.39; p = 0.029) in an independent cohort of 165 serous ovarian cancer patients. Comparing previously published epithelial-mesenchymal transition (EMT) gene signatures, non-miliary spread correlated significantly with a reduced epithelial status. We conclude that serous ovarian cancer is a heterogeneous disease with distinct modes of peritoneal tumor spread, differing not only in clinical appearance, but also in molecular characteristics and outcome.. EMT, peritoneal inflammation status, and therapeutic options are discussed. Significance More than half of serous epithelial ovarian cancer patients present with a newly described type of intraperitoneal tumor spread, associated with differences in the inflammation status, activated oncogenic pathways, lack of EMT, and thus reduced overall survival. Both, the diminished immune reaction and the enhanced epithelial and malignant characteristics of the tumor cells open new avenues for therapeutic options and strategies, like Catumaxomab, already in clinical use. PMID:25991672

  10. Concomitant bidirectional transport during peritoneal dialysis can be explained by a structured interstitium.

    PubMed

    Stachowska-Pietka, Joanna; Waniewski, Jacek; Flessner, Michael F; Lindholm, Bengt

    2016-06-01

    Clinical and animal studies suggest that peritoneal absorption of fluid and protein from dialysate to peritoneal tissue, and to blood and lymph circulation, occurs concomitantly with opposite flows of fluid and protein, i.e., from blood to dialysate. However, until now a theoretical explanation of this phenomenon has been lacking. A two-phase distributed model is proposed to explain the bidirectional, concomitant transport of fluid, albumin and glucose through the peritoneal transport system (PTS) during peritoneal dialysis. The interstitium of this tissue is described as an expandable two-phase structure with phase F (water-rich, colloid-poor region) and phase C (water-poor, colloid-rich region) with fluid and solute exchange between them. A low fraction of phase F is assumed in the intact tissue, which can be significantly increased under the influence of hydrostatic pressure and tissue hydration. The capillary wall is described using the three-pore model, and the conditions in the peritoneal cavity are assumed commencing 3 min after the infusion of glucose 3.86% dialysis fluid. Computer simulations demonstrate that peritoneal absorption of fluid into the tissue, which occurs via phase F at the rate of 1.8 ml/min, increases substantially the interstitial pressure and tissue hydration in both phases close to the peritoneal cavity, whereas the glucose-induced ultrafiltration from blood occurs via phase C at the rate of 15 ml/min. The proposed model delineating the phenomenon of concomitant bidirectional transport through PTS is based on a two-phase structure of the interstitium and provides results in agreement with clinical and experimental data. PMID:26945084

  11. Zinc status in patients with chronic renal failure on conservative and peritoneal dialysis treatment

    PubMed Central

    Yonova, D; Vazelov, E; Tzatchev, K

    2012-01-01

    Background and aim: The physiological mechanisms regulating zinc homeostasis in humans have been elucidated and described, but the knowledge of zinc status and zinc distribution in the tissues and in the different biological compartments of patients with conservatively treated chronic renal failure (CRF) and on peritoneal dialysis is still insufficient. This investigation examines and compares zinc content in urine, erythrocytes, plasma, and outflow dialysis solution in a group of continuous ambulatory peritoneal dialysis (CAPD) patients, a group of patients with CRF on conservative treatment and in healthy controls. Material and Methods: Data from the last 6 months of 22 adult hemodialysis patients with a mean age of 61 ± 14 years were analyzed retrospectively. Dialysis vintage, normalized protein catabolic rate (nPCR), serum biochemical parameters, mid arm muscle circumference (MAMC) were determined as mean and standard deviation. Correlations between the variables were computed by coefficient p of Pearson. Results and conclusion: In patients on CAPD treatment (group 3) compared to healthy controls (group 1) plasma zinc level was diminished (р<0.05), while erythrocyte zinc elevated (р<0.01). The investigation found out difference between plasma, erythrocyte and urine levels of zinc between the patients with chronic renal failure (group 2) on conservative treatment and those treated by CAPD (group 3), which proves, that continuous ambulatory peritoneal dialysis influences redistribution of zinc in human organism "per se". PMID:23935317

  12. Transport reactor development status

    SciTech Connect

    Rush, R.E.; Fankhanel, M.O.; Campbell, W.M.

    1994-10-01

    This project is part of METC`s Power Systems Development Facility (PSDF) located at Wilsonville, Alabama. The primary objective of the Advanced Gasifier module is to produce vitiated gases for intermediate-term testing of Particulate Control Devices (PCDs). The Transport reactor potentially allows particle size distribution, solids loading, and particulate characteristics in the off-gas stream to be varied in a number of ways. Particulates in the hot gases from the Transport reactor will be removed in the PCDs. Two PCDs will be initially installed in the module; one a ceramic candle filter, the other a granular bed filter. After testing of the initial PCDs they will be removed and replaced with PCDs supplied by other vendors. A secondary objective is to verify the performance of a Transport reactor for use in advanced Integrated Gasification Combined Cycle (IGCC), Integrated Gasification Fuel Cell (IG-FC), and Pressurized Combustion Combined Cycle (PCCC) power generation units. This paper discusses the development of the Transport reactor design from bench-scale testing through pilot-scale testing to design of the Process Development Unit (PDU-scale) facility at Wilsonville.

  13. Neutrophils and monocytes transport tumor cell antigens from the peritoneal cavity to secondary lymphoid tissues

    SciTech Connect

    Terasawa, Masao; Nagata, Kisaburo; Kobayashi, Yoshiro

    2008-12-12

    Antigen-transporting cells take up pathogens, and then migrate from sites of inflammation to secondary lymphoid tissues to induce an immune response. Among antigen-transporting cells, dendritic cells (DCs) are believed to be the most potent and professional antigen-presenting cells that can stimulate naive T cells. However, the cells that transport antigens, tumor cell antigens in particular, have not been clearly identified. In this study we have analyzed what types of cells transport tumor cell antigens to secondary lymphoid tissues. We show that neutrophils, monocytes and macrophages but not DCs engulf X-irradiated P388 leukemic cells after their injection into the peritoneal cavity, and that neutrophils and monocytes but not macrophages migrate to the parathymic lymph nodes (pLN), the blood, and then the spleen. The monocytes in the pLN comprise Gr-1{sup -} and Gr-1{sup +} ones, and some of these cells express CD11c. Overall, this study demonstrates that neutrophils and monocytes transport tumor cell antigens from the peritoneal cavity to secondary lymphoid tissues.

  14. [Immunological status and somatotropic activity of the pituitary in combined abdominal injuries complicated by peritonitis].

    PubMed

    Deriabin, I I; Shvyrev, N I; Nemchenko, N S; Gubar', L N

    1985-11-01

    Associated injuries of the abdomen result in peritonitis twice more often than isolated ones, the peritonitis having more severe course and being the cause of lethal outcomes in 57% of the victims. The immune deficient state is thought to be one of the causes responsible for the reduced resistance to infection and the development of peritonitis in the postshock period. Patients with associated traumas show a considerable inhibition of the immune system within several hours and an impairment of its regulation which grows during the next day. So, even at the early terms the operative methods must be similar to those used in operations for the developed peritonitis. PMID:3879406

  15. Peritoneal solute transport rate as an independent risk factor for total and cardiovascular mortality in a population of peritoneal dialysis patients.

    PubMed

    Janda, Katarzyna; Krzanowski, Marcin; Dumnicka, Paulina; Kuśnierz-Cabala, Beata; Miarka, Przemysław; Sułowicz, Władysław

    2014-01-01

    The aim of the present study was to assess the influence of peritoneal permeability expressed as the dialysate-to-plasma ratio of creatinine (D/P Cr) on total and cardiovascular (CV) mortality in a population of peritoneal dialysis (PD) patients during a 6-year observation period. The study recruited 55 patients (mean age: 53 years) treated with PD for a median of 24 months. Hematology parameters and serum albumin were determined using routine methods. Tumor necrosis factor alpha (TNF-alpha) and transforming growth factor beta (TGF-beta1) were determined by high-sensitivity ELISA. Peritoneal transport characteristics were identified using D/P Cr reference values after a peritoneal equilibration test. During the 6-year observation period, 22 patients (40%) died, mostly from CV complications (77% of deaths). In multiple Cox regression, D/P Cr and dialysate volume at PD initiation predicted total [hazard ratio (HR): 1.57; p = 0.02; and HR: 1.20; p = 0.04 respectively] and CV mortality (HR: 1.65; p = 0.02; and HR: 1.23; p = 0.05 respectively) independent of age, dialysis therapy duration, serum albumin concentration, dialysis adequacy measures, TGF-beta1, and TNF-alpha. Additionally, TNF-alpha was independently associated with all-cause and CV mortality, and albumin, with all-cause mortality. Baseline D/P Cr was a strong independent marker of survival in PD patients. Baseline D/P Cr and dialysate volume were independent risk factors for total and CV mortality in the PD population and could be significant for assessing CV risk in this population. PMID:25338416

  16. Vitamin D Status Is an Independent Risk Factor for Global Cognitive Impairment in Peritoneal Dialysis Patients

    PubMed Central

    Liu, Gui-Ling; Pi, Hai-Chen; Hao, Li; Li, Dan-Dan; Wu, Yong-Gui; Dong, Jie

    2015-01-01

    Objective Vitamin D (VD) deficiency is an independent risk factor for cognitive impairment (CI) in the general population, but VD status in peritoneal dialysis (PD) patients has not been investigated. In this study, we aimed to investigate the relationship between serum VD levels and global and specific cognitive functions in PD patients. Design and Setting Cross-sectional study, simultaneously conducted at two PD centers. Patients Clinically stable patients (n = 273) undergoing PD for at least 3 months were enrolled over a period of one year. Main outcome Measures Demographic and comorbidity data were recorded, and routine biochemical parameters and serum 25-hydroxyvitamin D (25(OH) D) levels of overnight fasted patients were determined. Global cognitive function was assessed by the Modified Mini-Mental State Examination (3MS) score; executive function, by the trail making tests (Trails A and B); and immediate memory, delayed memory, and language ability by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) sub-tests. Results In the univariate analysis, serum 25(OH) D levels significantly correlated with 3MS scores (r = -0.139; P = 0.02), and Trail A (r = -0.188; P = 0.002) and B (r = -0.154; P = 0.01) completion times. In the multivariate analysis, 25(OH) D was found to be independently associated with global CI, but not with executive dysfunction. Serum 25(OH) D could not predict scores of immediate/delayed memory and language ability. Conclusions VD deficiency is highly prevalent in PD patients and is an independent risk factor for global CI in this patient cohort. PMID:26630385

  17. Differential regulation of tissue thiol-disulfide redox status in a murine model of peritonitis

    PubMed Central

    2012-01-01

    Background Glutathione (GSH)/glutathione disulfide (GSSG) and cysteine (Cys)/cystine (CySS) are major redox pools with important roles in cytoprotection. We determined the impact of septic peritonitis on thiol-disulfide redox status in mice. Methods FVB/N mice (6–12 week old; 8/group) underwent laparotomy with cecal ligation and puncture (CLP) or laparotomy alone (control). Sections of ileum, colon, lung and liver were obtained and GSH, GSSG, Cys and CySS concentrations determined by HPLC 24 h after laparotomy. Redox potential [Eh in millivolts (mV)] of the GSH/GSSG and Cys/CySS pools was calculated using the Nernst equation. Data were analyzed by ANOVA (mean ± SE). Results GSH/GSSG Eh in ileum, colon, and liver was significantly oxidized in septic mice versus control mice (ileum: septic −202±4 versus control −228±2 mV; colon: -195±8 versus −214±1 mV; and liver: -194±3 vs. -210±1 mV, all P<0.01). Lung GSH/GSSG redox was similar in each group (−191±3 versus −190±2 mV). In contrast, ileal and colonic Cys/CySS Eh was unchanged with CLP, while liver and lung Cys/CySS Eh became significantly more reducing (liver: septic = −103±3 versus control −90±2 mV; lung: -101±5 versus −81±1 mV, each P<0.05). Conclusions Septic peritonitis induced by CLP oxidizes ileal and colonic GSH/GSSG redox but Cys/CySS Eh remains unchanged in these intestinal tissues. In liver, CLP oxidizes the GSH/GSSG redox pool and CyS/CySS Eh becomes more reducing; in lung, CLP does not alter GSH/GSSG Eh, and Cys/CySS Eh is less oxidized. CLP-induced infection/inflammation differentially regulates major thiol-disulfide redox pools in this murine model. PMID:23033955

  18. Enhancement of carrier-mediated transport after immunologic activation of peritoneal macrophages.

    PubMed

    Bonventre, P F; Straus, D; Baughn, R E; Imhoff, J

    1977-05-01

    Immunologically activated peritoneal macrophages from inbred mice and Hartley strain guinea pigs demonstrate a markedly greater than normal transport of 2-deoxy-D-glucose and L-leucine. The degree of nutrilite transport enhancement was greatest when animals were injected with the appropriate eliciting antigens before harvesting and also, if antigen was included in the tissue culture medium during the initial hours of in vitro culture. Enhanced hexose and amino acid uptake could also be achieved by exposure of macrophages from nonimmunized animals for 48 hr to supernatants of sensitized splenic lymphocyte cultures incubated with specific antigens. The animal systems in which this phenomenon was observed included CBA/J and C57BL/6J mice immunized with Staphylococcus aureus or sub-lethal doses of Listeria monocytogens, and the Hartley strain, albino guinea pig immunized with S. aureus or BCG. In all cases, immunization resulted in a state of delayed hypersensitivity as measured by skin testing or footpad swelling. Splenic cell supernatants contained lymphokines as detected by the presence of macrophage inhibitory factor (MIF), and by the supernatants' capacity to stimulate incorporation of 14C-glucosamine by macrophages in vitro. No increase of glucose or leucine transport by macrophages was observed in the absence of appropriate antigen stimulation in vivo or in vitro. We previously showed that a phagocytic stimulus results in a significant increase in hexose transport by normal macrophages; leucine transport by these same cells was unaltered after phagocytosis. In contrast, immunologically activated macrophages do not transport measurably more 2-deoxy-C-glucose after particle ingestion; activation or the phagocytic stimulus enhance 2-deoxy-C-glucose uptake to approximately the same extent. Analysis of nutrilite transport kinetics revealed that immunologic activation of macrophages increases the initial velocity (V1) and Vmax but does not change the Km values of

  19. Comparison of Volume Status in Asymptomatic Haemodialysis and Peritoneal Dialysis Outpatients

    PubMed Central

    Papakrivopoulou, Eugenia; Booth, John; Pinney, Jennifer; Davenport, Andrew

    2012-01-01

    Background The majority of haemodialysis (HD) patients gain weight between dialysis sessions and thereby become volume overloaded, whereas peritoneal dialysis (PD) is a more continuous technique. Cardiovascular mortality and hypertension is increased with both treatment modalities. We therefore wished to compare volume status in PD and HD to determine whether PD patients are chronically volume overloaded, as a risk factor for cardiovascular mortality. Study Design, Setting and Participants:We retrospectively audited 72 healthy HD patients and 115 healthy PD patients attending a university hospital dialysis centre for routine outpatient treatment, who had multi-frequency bioimpedance measurements of extracellular water to total body water (ECW/TBW). Results The groups were well matched for age, sex, weight and ethnicity, PD patients had greater urine output [1,075 (485–1,613) vs. 42.5 (0–1,020) ml/day, p < 0.001], but there was no difference in antihypertensive prescription (63.5 vs. 76.4%), mean arterial blood pressure (post-dialysis 101.6 ± 1.5 mm Hg vs. pre-dialysis 102 ± 2.4 mm Hg), although post-dialysis arterial blood pressure was lower than in PD patients (96.4 ± 3.1 mm Hg, p < 0.05). The ratio of ECW/TBW fell after HD (pre-dialysis 0.394 ± 0.001 vs. post-dialysis 0.389 ± 0.004, p < 0.001) and was similar in the PD group to the group before HD (0.393 ± 0.001), and greater than that in the group after HD (p < 0.001). ECW/TBW was greater than the normal reference range in 30% PD patients, 28% patients before HD and 20% patients after HD. Conclusions Overhydration is common in healthy stable PD outpatients, and ECW volumes in PD patients are not dissimilar to those of pre-dialysis HD patients. The role of chronic volume overload as a risk factor for cardiovascular disease needs further investigation. PMID:22619667

  20. Space Transportation System - Status report

    NASA Technical Reports Server (NTRS)

    Scherer, L. R.

    1979-01-01

    A series of detailed illustrations present graphically the status of the STS. The Shuttle vehicle is compared to other expendable vehicles hitherto used by NASA, and data on the Shuttle's components and dimensions and weights are provided. Also presented is the mission profile for the Shuttle and the installation of Spacelab into the Orbiter. Illustrations cover the steps of the vehicle preparation for launch and a chart is given representing current plans for the launch of various payloads. Finally, the automated beam builder for aluminum beams, orbital test of a space machine for fabrication of structural elements or beams and a multibeam communications antenna, which can be used for very small receivers, are described.

  1. STATUS OF THE MCNPX TRANSPORT CODE

    SciTech Connect

    Hughes, H.G.; Chadwick, M.B.

    2000-10-01

    The Monte Carlo particle transport code MCNPX and its associated data have been the focus of a major development effort at Los Alamos for several years. The system has reached a mature state, and has become a significant tool for many intermediate and high-energy particle transport applications. A recent version has been released to the Radiation Safety Information Computational Center (RSICC). A recent report provides an overview of the code and an extensive set of references for the component physics modules used in the code. In this paper we review the status of the developmental version of MCNPX, and describe some important new enhancements, including the use of evaluated nuclear data files for proton transport; the use of photonuclear reaction data; improved elastic and inelastic react ion cross sections for nucleons, antinucleons, pions, and kaons; and two new modes of operation of the code. We also illustrate the use of the new proton and photonuclear data in two representative applications.

  2. The impact of oxidized serum albumin on the oncotic pressure and hydration status of peritoneal dialysis patients

    PubMed Central

    Hassan, Kamal; Kristal, Batya; Hassan, Fadi; Abo Saleh, Saad; Michelis, Regina

    2016-01-01

    Objective Hypoalbuminemia, fluid overload (FO), and oxidative stress (OS) may be related to cardiovascular morbidity and mortality in peritoneal dialysis (PD) patients. OS produces molecular modifications of serum albumin that interfere with its quantification by the commonly used bromocresol green assay. This study evaluated the impact of oxidized serum albumin (OSA) on oncotic pressure (OP) and hydration status. Patients and methods Twenty-four stable hypoalbuminemic PD patients were enrolled in the study. After performing physical examination, assessment of the hydration status using a whole-body bioimpedance spectroscopy technique was performed, and blood samples were drawn for determination of OP, serum albumin levels, and OSA. Results Extracellular to total body water (E/TBW) ratio was higher in patients with FO ≥1.5 L with or without edema than in patients with FO <1.5 L (P≤0.043). E/TBW ratio was higher in patients with FO ≥1.5 L and edema compared to those with FO ≥1.5 L but without edema (P=0.004). OP was significantly higher in patients with FO ≥1.5 L and without edema compared to those with FO ≥1.5 L and with edema (P<0.001). Albumin-detection index (ADI) in patients with FO ≥1.5 L and without edema was similar to ADI in patients with FO <1.5 L (P=0.520). ADI was significantly lower in patients with FO ≥1.5 L and without edema compared to those with FO ≥1.5 L and edema (P=0.034). E/TBW ratio correlated positively with the ADI (r=0.60, P=0.001) and inversely with the OP (r=−0.54, P=0.002). Conclusion Overhydration may be clinically undetectable in PD patients. Assessing the hydration status and measuring the total serum albumin levels, including the oxidized fraction, should be considered in evaluating hydration status in PD patients. PMID:27069365

  3. Space transportation system payload status and reimbursement policy

    NASA Technical Reports Server (NTRS)

    Yardley, J. F.

    1977-01-01

    The status of the Space Transportation System (STS) is reviewed. The management structure and project planning status are discussed, including considerations of STS utilization, payloads, cost assessments, and pricing policy.

  4. Peritonitis - spontaneous

    MedlinePlus

    ... a catheter used in peritoneal dialysis. Antibiotics may control infection in cases of spontaneous peritonitis with liver or kidney disease. Intravenous therapy can treat dehydration . You may need to stay in the hospital so health care providers can rule out conditions ...

  5. Peritoneal Disorders

    MedlinePlus

    Your peritoneum is the tissue that lines your abdominal wall and covers most of the organs in your abdomen. ... the surface of this tissue. Disorders of the peritoneum are not common. They include Peritonitis - an inflammation ...

  6. Peritonitis - secondary

    MedlinePlus

    ... blood pressure. Tests may include: Blood culture Blood chemistry, including pancreatic enzymes Complete blood count Liver and kidney function tests X-rays or CT scan Peritoneal fluid culture Urinalysis

  7. Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis.

    PubMed Central

    von Graevenitz, A; Amsterdam, D

    1992-01-01

    The process of continuous ambulatory peritoneal dialysis has provided a useful, relatively inexpensive, and safe alternative for patients with end-stage renal disease. Infectious peritonitis, however, has limited a more widespread acceptance of this technique. The definition of peritonitis in this patient population is not universally accepted and does not always include the laboratory support of a positive culture (or Gram stain). In part, the omission of clinical microbiological findings stems from the lack of sensitivity of earlier microbiological efforts. Peritonitis results from decreased host phagocytic efficiency with depressed phagocytosis and bactericidal capacity of peritoneal macrophages. During episodes of peritonitis, fluid movement is reversed, away from the lymphatics and peritoneal membrane and toward the cavity. As a result, bloodstream infections are rare. Most peritonitis episodes are caused by bacteria. Coagulase-negative staphylococci are the most frequently isolated organisms, usually originating from the skin flora, but a wide array of microbial species have been documented as agents of peritonitis. Clinical microbiology laboratories need to be cognizant of the diverse agents so that appropriate primary media can be used. The quantity of dialysate fluid that is prepared for culture is critical and should constitute at least 10 ml. The sensitivity of the cultural approach depends on the volume of dialysate, its pretreatment (lysis or centrifugation), the media used, and the mode of incubation. The low concentration of microorganisms in dialysate fluids accounts for negative Gram stain results. Prevention of infection in continuous ambulatory peritoneal dialysis patients is associated with the socioeconomic status of the patient, advances in equipment (catheter) technology, and, probably least important, the application of prophylactic antimicrobial agents. PMID:1735094

  8. The Stoke contribution to peritoneal dialysis research.

    PubMed

    Wilkie, Martin E; Jenkins, Sarah B

    2011-03-01

    The Stoke Renal Unit has been at the forefront of peritoneal dialysis (PD) research for much of the past two decades. Central to this work is the PD cohort study, which was started in 1990 and is based on regular outpatient measurements of peritoneal and clinical function, correlating these with long-term outcomes. It has provided a wealth of information on risk factors for morbidity and mortality in patients on PD, the most significant being demonstration of the effects of time and dialysate glucose exposure on changes to the peritoneal membrane, as evidenced by increases in small solute transport. Early on, the study confirmed the adverse relationship between high small-solute transport status and outcome but more recently suggested that this relationship no longer held with modern techniques for managing patients on PD. Central themes of the PD research in Stoke have included evaluation of euvolemia, the importance of ultrafiltration and how best to achieve it, and detailed assessments of transmembrane water movement. The work has included the study of sodium removal and the use of novel low sodium dialysates. More recently, attention has turned to the significance of impaired ultrafiltration capacity in patients on PD as a sign of structural membrane damage. It is hoped that further work in this area will identify preventive strategies. PMID:21364207

  9. Practical guidelines for automated peritoneal dialysis.

    PubMed

    Sritippayawan, Suchai; Nilwarangkur, Sukij; Aiyasanon, Nipa; Jattanawanich, Parnthip; Vasuvattakul, Somkiat

    2011-09-01

    The development of APD technologies enables physician to customize PD treatment for optimal dialysis. Dialysis dose can be increased with APD alone or in conjunction with daytime dwells. Although there is no strong evidence of the advantage over CAPD, APD is generally recommended for patients having a high peritoneal transport, outflow problems or high intraperitoneal pressure (IPP) and those who depend on caregivers for their dialysis. The benefits of APD over CAPD depends on the problems and treatment results among dialysis centers. Before starting the APD, medical, psychosocial and financial aspects, catheter function, residual renal function (RRF), body surface area and peritoneal transport characteristic must be evaluated. The recommended starting prescription for APD is the dwell volume of 1,500 ml/m2, 2 hours/cycle, and 5 cycles/session, which will provides 10-15 L of total volume and 10 hours per session. The IPP should be monitored and kept below 18 cmH2O. NIPD is accepted for patients with significant RRF. Anuric patients usually require 15-20 L of total fill volume and may need 1-2 day-dwells of 2L icodextrin or hypertonic glucose solutions. Small solute clearances and ultrafiltration depend on the peritoneal catheter function and dialysis schedule. The clinical outcomes and small solute clearances must be monitored and adjusted accordingly to meet the weekly total Kt/V urea > or = 1.7 and in low peritoneal transporters, the weekly total CCr should be > or = 45 L/1.73 m2. The volume status must be normal. To diagnose the peritonitis in NIPD patients, 1 L of PDF should be infused and permitted to dwell for 2 hours before sending for analysis. The differential of white cell count may be more useful than the total cell counts. In Siriraj Hospital, APD patients had 1.5-3 times less peritonitis than CAPD patients and most of our anuric patients can achieve the weekly total Kt/V urea target with 10 L of NIPD. PMID:22043586

  10. Peritoneal "melanosis".

    PubMed

    Chang, Ea-sle; Bachul, Piotr; Szura, Mirosław; Szpor, Joanna; Okoń, Krzysztof; Walocha, Jerzy A

    2015-09-01

    A case of a23 year old female with peritoneal melanosis associated with adenocarcinoma of the rectum is reported. During laparoscopic anterior resection of the rectum, diffuse black pigmentations on the parietal peritoneum, greater omentum, mesenteric lymph nodes and ovaries were discovered. The histopathological findings revealed the presence of macrophages packed with black pigment. These results together with clinical data excluded metastatic melanoma and confirmed the diagnosis of the race condition called peritoneal melanosis. Due to the begin character of the lesions the laparoscopic treatment was continued. There were no remissions or progression of the reported in English literature and this is the second case of peritoneal melanosis that has been associated with adenocarcinoma of the large intestine. PMID:26619112

  11. Peritoneal Dialysis.

    PubMed

    Al-Natour, Mohammed; Thompson, Dustin

    2016-03-01

    Peritoneal dialysis is becoming more important in the management of patients with end-stage renal disease. Because of the efforts of the "Fistula First Breakthrough Initiative," dialysis venous access in the United States has become focused on promoting arteriovenous fistula creation and reducing the number of patients who start dialysis with a tunneled catheter. This is important because tunneled catheters can lead to infection, endocarditis, and early loss of more long-term access. When planned for, peritoneal dialysis can offer patients the opportunity to start dialysis at home without jeopardizing central access or the possibilities of eventual arteriovenous fistula creation. The purpose of this review is to highlight the indications, contraindications, and procedural methods for implanting peritoneal dialysis catheters in the interventional radiology suite. PMID:27011420

  12. [Peritoneal echinococcosis].

    PubMed

    Vara-Thorbeck, C; Vara-Thorbeck, R

    1986-01-01

    Secondary peritoneal echinococcosis was recorded from 50 in 312 patients (16 per cent) who had been hospitalised for liver echinococcosis. Hydatido and peritoneal hydatidiosis were recorded from 34 of these patients and thus accounted for the two most common pathological forms of secondary peritoneal echinococcosis, according to Dévè. Peritoneal echinococcosis usually is not diagnosed until conspicuous symptoms grow manifest due to cyst growth or other complications. Positive responses were recorded from all the above cases to laboratory tests (eosinophilia in over five to nine per cent) and were also established on the basis of immune reactions, including the complement fixation reaction according to Weinberg, the intracutaneous test by Casoni, and latex echinococcus reaction. Surgery, at present, is the only promising therapeutic approach to the problem. Surgical intervention could not even be avoided by application of mebendazol. Postoperative lethality amounted to four per cent and morbidity to ten per cent. They were comparatively low, measured by the generally poor prognosis of the disease. PMID:3776378

  13. Dialysis - peritoneal

    MedlinePlus

    ... The number of exchanges and amount of dwell time depends on the method of PD you use and other factors. Your ... PD: Continuous ambulatory peritoneal dialysis (CAPD) . For this ... routine until it is time to drain the fluid. You are not hooked ...

  14. Expression of aquaporin-1 in a long-term peritoneal dialysis patient with impaired transcellular water transport.

    PubMed

    Goffin, E; Combet, S; Jamar, F; Cosyns, J P; Devuyst, O

    1999-02-01

    Aquaporin-1 (AQP1) has been claimed to be the molecular counterpart of the transcellular pathway for free-water movement across the peritoneum during peritoneal dialysis. We report the case of a 67-year-old man, on peritoneal dialysis for 11 years, in whom ultrafiltration failure due to an abolition of the transcellular water transfer (documented by a loss of sodium sieving) was associated with an apparently normal expression of AQP1. We suggest that an alteration of AQP1 structure, rather than of its expression, accounts for this observation. PMID:10023655

  15. Vadose Zone Transport Field Study: Status Report

    SciTech Connect

    Gee, Glendon W.; Ward, Anderson L.

    2001-11-30

    Studies were initiated at the Hanford Site to evaluate the process controlling the transport of fluids in the vadose zone and to develop a reliable database upon which vadose-zone transport models can be calibrated. These models are needed to evaluate contaminant migration through the vadose zone to underlying groundwaters at Hanford. A study site that had previously been extensively characterized using geophysical monitoring techniques was selected in the 200 E Area. Techniques used previously included neutron probe for water content, spectral gamma logging for radionuclide tracers, and gamma scattering for wet bulk density. Building on the characterization efforts of the past 20 years, the site was instrumented to facilitate the comparison of nine vadose-zone characterization methods: advanced tensiometers, neutron probe, electrical resistance tomography (ERT), high-resolution resistivity (HRR), electromagnetic induction imaging (EMI), cross-borehole radar (XBR), and cross-borehole seismic (XBS). Soil coring was used to obtain soil samples for analyzing ionic and isotopic tracers.

  16. Differential GPS for air transport: Status

    NASA Technical Reports Server (NTRS)

    Hueschen, Richard M.

    1993-01-01

    The presentation presents background on what the Global Navigation Satellite System (GNSS) is, desired target dates for initial GNSS capabilities for aircraft operations, and a description of differential GPS (Global Positioning System). The presentation also presents an overview of joint flight tests conducted by LaRC and Honeywell on an integrated differential GPS/inertial reference unit (IRU) navigation system. The overview describes the system tested and the results of the flight tests. The last item presented is an overview of a current grant with Ohio University from LaRC which has the goal of developing a precision DGPS navigation system based on interferometry techniques. The fundamentals of GPS interferometry are presented and its application to determine attitude and heading and precision positioning are shown. The presentation concludes with the current status of the grant.

  17. Baseline hydration status in incident peritoneal dialysis patients: the initiative of patient outcomes in dialysis (IPOD-PD study)†

    PubMed Central

    Ronco, Claudio; Verger, Christian; Crepaldi, Carlo; Pham, Jenny; De los Ríos, Tatiana; Gauly, Adelheid; Wabel, Peter; Van Biesen, Wim

    2015-01-01

    Background Non-euvolaemia in peritoneal dialysis (PD) patients is associated with elevated mortality risk. There is an urgent need to collect data to help us understand the association between clinical practices and hydration and nutritional status, and their effects on patient outcome. Methods The aim of this prospective international, longitudinal observational cohort study is to follow up the hydration and nutritional status, as measured by bioimpedance spectroscopy using the body composition monitor (BCM) of incident PD patients for up to 5 years. Measures of hydration and nutritional status and of clinical, biochemical and therapy-related data are collected directly before start of PD treatment, at 1 and 3 months, and then every 3 months. This paper presents the protocol and a pre-specified analysis of baseline data of the cohort. Results A total of 1092 patients (58.1% male, 58.0 ± 15.3 years) from 135 centres in 32 countries were included. Median fluid overload (FO) was 2.0 L (males) and 0.9 L (females). Less than half of the patients were normohydrated (38.7%), whereas FO > 1.1 L was seen in 56.5%. Systolic and diastolic blood pressure were 139.5 ± 21.8 and 80.0 ± 12.8 mmHg, respectively, and 25.1% of patients had congestive heart failure [New York Heart Association (NYHA) 1 or higher]. A substantial number of patients judged to be not overhydrated on clinical judgement appeared to be overhydrated by BCM measurement. Overhydration at baseline was independently associated with male gender and diabetic status. Conclusions The majority of patients starting on PD are overhydrated already at start of PD. This may have important consequences on clinical outcomes and preservation of residual renal function. Substantial reclassification of hydration status by BCM versus on a clinical basis was necessary, especially in patients who were not overtly overhydrated. Both clinical appreciation and bioimpedance should be combined in clinical decision-making on

  18. Matrix metalloproteinase-2 as a superior biomarker for peritoneal deterioration in peritoneal dialysis

    PubMed Central

    Hirahara, Ichiro; Kusano, Eiji; Morishita, Yoshiyuki; Inoue, Makoto; Akimoto, Tetsu; Saito, Osamu; Muto, Shigeaki; Nagata, Daisuke

    2016-01-01

    AIM: To investigate the efficacy of effluent biomarkers for peritoneal deterioration with functional decline in peritoneal dialysis (PD). METHODS: From January 2005 to March 2013, the subjects included 218 PD patients with end-stage renal disease at 18 centers. Matrix metalloproteinase-2 (MMP-2), interleukin-6 (IL-6), hyaluronan, and cancer antigen 125 (CA125) in peritoneal effluent were quantified with enzyme-linked immunosorbent assay. Peritoneal solute transport rate was assessed by peritoneal equilibration test (PET) to estimate peritoneal deterioration. RESULTS: The ratio of the effluent level of creatinine (Cr) obtained 4 h after injection (D) to that of plasma was correlated with the effluent levels of MMP-2 (ρ = 0.74, P < 0.001), IL-6 (ρ = 0.46, P < 0.001), and hyaluronan (ρ = 0.27, P < 0.001), but not CA125 (ρ = 0.13, P = 0.051). The area under receiver operating characteristic curve for the effluent levels of MMP-2, IL-6, and hyaluronan against high PET category were 0.90, 0.78, 0.62, and 0.51, respectively. No patient developed new-onset encapsulating peritoneal sclerosis for at least 1.5 years after peritoneal effluent sampling. CONCLUSION: The effluent MMP-2 level most closely reflected peritoneal solute transport rate. MMP-2 can be a reliable indicator of peritoneal deterioration with functional decline. PMID:26981446

  19. Inflammation status in adipose tissue and peritoneal macrophages of young and old mice in diet-induced obesity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Obesity causes a low grade inflammation. We have shown that aging is also associated with upregulated inflammation in adipose tissue. In this study, we investigated effect of diet-induced obesity on inflammation status in young and old mice. Young (2-mo) and old (19-mo) C57BL/6 mice were fed low fat...

  20. The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial

    PubMed Central

    Szeto, Cheuk-Chun; Kwan, Bonnie C. H.; Chow, Kai-Ming; Cheng, Phyllis M. S.; Kwong, Vickie W. K.; Choy, Agnes S. M.; Law, Man-Ching; Leung, Chi-Bon; Li, Philip K. T.

    2015-01-01

    Background Previous studies report conflicting results on the benefit of peritoneal dialysis (PD) patients treated with low glucose degradation product (GDP) solution. The effects of low GDP solution on body fluid status and arterial pulse wave velocity (PWV) have not been studied. Methods We randomly assigned 68 incident PD patients to low GDP (Intervention Group) or conventional solutions (Control Group); 4 dropped off before they received the assigned treatment. Patients were followed for 52 weeks for changes in ultrafiltration, residual renal function, body fluid status and arterial PWV. Result After 52 weeks, Intervention Group had higher overhydration (3.1 ± 2.6 vs 1.9 ± 2.2 L, p = 0.045) and extracellular water volume (17.7 ± 3.9 vs 15.8 ± 3.1 L, p = 0.034) than Control Group. There was no significant difference in PWV between groups. There was no significant difference in residual renal function between the Groups. Intervention Group had lower ultrafiltration volume than Control Group at 4 weeks (0.45 ± .0.61 vs 0.90 ± 0.79 L/day, p = 0.013), but the difference became insignificant at later time points. Intervention Group had lower serum CRP levels than Control Group (4.17 ± 0.77 vs 4.91 ± 0.95 mg/dL, p < 0.0001). Conclusion Incident PD patients treated with low GDP solution have less severe systemic inflammation but trends of less ultrafiltration, and more fluid accumulation. However, the effects on ultrafiltration and fluid accumulation disappear with time. The long term effect of low GDP solution requires further study. Trial Registration ClinicalTrials.gov NCT00966615 PMID:26510186

  1. Longitudinal Changes in Health-Related Quality of Life Scores in Brazilian Incident Peritoneal Dialysis Patients (BRAZPD): Socio-economic Status Not a Barrier

    PubMed Central

    dos Santos Grincenkov, Fabiane Rossi; Fernandes, Natália; Chaoubah, Alfredo; da Silva Fernandes, Neimar; Bastos, Kleyton; Lopes, Antonio Alberto; Qureshi, Abdul Rashid; Finkelstein, Fredric O.; Pecoits-Filho, Roberto; Divino-Filho, José Carolino; Bastos, Marcus Gomes

    2013-01-01

    ♦ Background and Objectives: A large proportion of the patients on peritoneal dialysis (PD) in Brazil have low levels of education and family income. The present study assessed whether education level and family income are associated with baseline and longitudinal changes in health-related quality of life (HRQOL) scores during the first year of PD therapy. ♦ Methods: We evaluated 1624 incident patients from the Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD) at baseline, and 486 of them after 12 months. The SF-36 was used to determine HRQOL and the Karnofsky index (KI), physical performance. ♦ Results: At baseline, patients received high KI scores compared with scores on the SF-36. The means of the mental and physical components at baseline and after 12 months were 39.9 ± 10.5 compared with 38.7 ± 11.7 and 41.8 ± 9.6 compared with 40.7 ± 9.8 respectively, which were not statistically different. A multivariate regression analysis showed that age, sex, diabetes, and cardiovascular disease were predictors of the mental component (respectively, β = 0.12, p < 0.001; β = 0.11, p < 0.001; β = -0.08, β = 0.007; and β = -0.07, p = 0.007) and that age, sex, diabetes, cardiovascular disease, hemoglobin, glucose, and creatinine were predictors of the physical component (respectively, β = -0.28, p < 0.001; β = 0.06, p = 0.009; β = -0.09, p = 0.002; β = -0.09, p = 0.001; β = 0.07, p = 0.004; β = -0.05, p = 0.040; and β = 0.05, p = 0.040). Education level and family income were not significantly associated with HRQOL (mental and physical components) in the multivariate regression. ♦ Conclusions: The results indicate that, as predictors, family income and education level have no impact on HRQOL, supporting the idea that socio-economic status should not be a barrier to the selection of PD as a treatment modality in Brazil. PMID:24335126

  2. Peritoneal fluid culture

    MedlinePlus

    Culture - peritoneal fluid ... sent to the laboratory for Gram stain and culture. The sample is checked to see if bacteria ... based on more than just the peritoneal fluid culture (which may be negative even if you have ...

  3. Peritoneal fluid analysis

    MedlinePlus

    ... at fluid that has built up in the space in the abdomen around the internal organs. This area is called the peritoneal space. ... sample of fluid is removed from the peritoneal space using a needle and syringe. Your health care ...

  4. Peritoneal Fluid Analysis

    MedlinePlus

    ... limited. Home Visit Global Sites Search Help? Peritoneal Fluid Analysis Share this page: Was this page helpful? Formal name: Peritoneal Fluid Analysis Related tests: Pleural Fluid Analysis , Pericardial Fluid ...

  5. Output of peritoneal cells during peritoneal dialysis.

    PubMed Central

    Fakhri, O; Al-Mondhiry, H; Rifaat, U N; Khalil, M A; Al-Rawi, A M

    1978-01-01

    Peritoneal dialysis provides a good source for the collection of macrophages. Six patients with chronic renal failure undergoing peritoneal dialysis for the first time were studied, and maximum cell egress, mostly macrophages, occurred at 24-48 hours and diminished after 48 hours. PMID:670419

  6. Current status of the PSG Monte Carlo neutron transport code

    SciTech Connect

    Leppaenen, J.

    2006-07-01

    PSG is a new Monte Carlo neutron transport code, developed at the Technical Research Centre of Finland (VTT). The code is mainly intended for fuel assembly-level reactor physics calculations, such as group constant generation for deterministic reactor simulator codes. This paper presents the current status of the project and the essential capabilities of the code. Although the main application of PSG is in lattice calculations, the geometry is not restricted in two dimensions. This paper presents the validation of PSG against the experimental results of the three-dimensional MOX fuelled VENUS-2 reactor dosimetry benchmark. (authors)

  7. Peritoneal dialysis solution and nutrition.

    PubMed

    Verger, Christian

    2012-01-01

    20-70% of peritoneal dialysis patients have some signs of malnutrition. Anorexia, protein and amino acid losses in dialysate, advanced age of elderly patients, inflammation and cardiac failure are among the main causes. Modern dialysis solutions aim to reduce these causes, but none of them is without side effects: glucose is relatively safe and brings additional energy but induces anorexia and lipid abnormalities, amino acids compensate dialysate losses but may increase uremia and acidosis, icodextrin helps control hyperhydration and chronic heart failure and minimizes glucose side effects, but may sometimes cause inflammation, and poly chamber bags allow the replacement of lactate by bicarbonate and are more biocompatible, decrease GDP, induce less inflammation and have a better effect on nutritional status. However, it appears that the management of nutrition with the different solutions available nowadays necessitates various combinations of solutions adapted to different patient profiles and there is not actually a single universal solution to minimize malnutrition in peritoneal dialysis patients. PMID:22652708

  8. Status of NASA's commercial cargo and crew transportation initiative

    NASA Astrophysics Data System (ADS)

    Lindenmoyer, Alan; Stone, Dennis

    2010-03-01

    To stimulate the commercial space transportation industry, the National Aeronautics and Space Administration (NASA) is facilitating the demonstration of Commercial Orbital Transportation Services (COTS) to Low Earth Orbit (LEO) by private-sector companies. In 2006, NASA entered into funded agreements with two such companies to share NASA's 500 million investment, Space Exploration Technologies (SpaceX) and Rocketplane Kistler (RpK), each of which proposed to obtain the additional private financing needed to complete its flight demonstrations. In 2007, NASA terminated the agreement with RpK because it failed to meet a series of technical and financial milestones which were necessary to receive the incremental NASA payments. In 2008, NASA conducted another competition for the remaining 170 million of NASA funding and entered into a funded agreement with Orbital Sciences Corporation (OSC). This paper provides an overview of the COTS approach of SpaceX and OSC and the status of their efforts to develop reliable and cost-effective commercial transportation to serve the LEO marketplace.

  9. Peritoneal clearance of leptin in continuous ambulatory peritoneal dialysis.

    PubMed

    Arkouche, W; Juillard, L; Delawari, E; Lasne, Y; Combarnous, F; Sibaï-Galland, R; Traeger, J; Laville, M; Fouque, D

    1999-11-01

    Leptin is a 16-kd protein that increases energy expenditure and limits food intake. Serum leptin (S-leptin) is elevated in dialysis patients, and little data have been reported on leptin clearance (Cl) during dialysis. We analyzed the peritoneal dialysis (PD) Cl of leptin in 15 continuous ambulatory peritoneal dialysis (CAPD) patients and compared the results to beta(2)-microglobulin (beta(2)-m), urea, and creatinine PD Cl. S-leptin was significantly elevated (Kruskal-Wallis, P < 0.005) in CAPD women (58.4 +/- 42.4 [SE] microg/L, n = 5) as compared with CAPD men (13.9 +/- 7.1, n = 10) and with healthy women (11.0 +/- 1.4, n = 13) and men (5.1 +/- 0. 9, n = 14). Correlations were found between percent of fat mass and S-leptin (P < 0.05); between S-leptin and the 24-hour PD leptin (P < 0.05); and between dialysate-to-plasma (D/P) beta(2)-m and D/P leptin (P < 0.01). PD leptin Cl (1.80 +/- 0.43 mL/min/1.73 m(2)) was higher than beta(2)-m Cl (1.22 +/- 0.31) (P < 0.01), but reduced as compared with urea Cl (8.84 +/- 1.20) (P < 0.005) and creatinine Cl (7.71 +/- 0.99) (P < 0.005). These results indicate that leptin is eliminated through the peritoneum membrane. However, peritoneal leptin clearance, as beta(2)-m, appears to be clearly restricted as compared with peritoneal transport of smaller molecules. Hence, leptin could use the same diffusion transport pathway as beta(2)-m. In addition, leptin, which has a higher molecular weight than beta(2)-m, was significantly more eliminated into the peritoneal dialysate. More studies are necessary to clarify whether this is an active leptin elimination process by peritoneal secretion or by a different restriction coefficient of diffusion through the peritoneum membrane. PMID:10561139

  10. Peritonitis caused by Rothia mucilaginosa in a peritoneal dialysis patient.

    PubMed

    Gosmanova, Elvira O; Garrett, Tiffani R; Wall, Barry M

    2013-12-01

    Peritonitis is an important cause of morbidity in patients undergoing peritoneal dialysis. Rothia mucilaginosa has been reported as an unusual cause of peritoneal dialysis associated peritonitis. Difficulty in the management of this microorganism lies in the absence of uniform recommendations for anti-microbial therapy directed against this pathogen. The current report describes the clinical course of an episode of peritoneal dialysis associated peritonitis caused by Rothia mucilaginosa. Treatment options for this organism are summarized. PMID:24263080

  11. Peritoneal dialysis in Asia.

    PubMed

    Cheng, I K

    1996-01-01

    The socioeconomic status of Asian countries is diverse, and government reimbursement policies for treatment of patients suffering from end-stage renal disease (ESRD) vary greatly from one country to another. Both of these factors have a major impact not only on the choice of treatment for ESRD but also on the utilization of peritoneal dialysis (PD) in this region. Based on the data collected from 11 representative Asian countries, several observations can be made. First, the treatment rates for ESRD in these countries correlated closely with their gross domestic product (GDP) per capita income. Second, the PD utilization rate appeared to have a biphasic relationship with the GDP per capita income and treatment rate, in that countries with the highest and the lowest treatment rates tended to have lower PD utilization rates, whereas countries with modest treatment rates tended to have higher PD utilization rates. The reason for low PD utilization in countries with the highest treatment rates differs from that in countries with low treatment rates. In the former, because of full government reimbursement, there is little physician incentive to introduce PD as an alternative form of ESRD treatment to in-center hemodialysis (HD), whereas in the latter, the complete lack of government reimbursement prevents the introduction of PD as a form of treatment. This pattern is likely to change in the future because, of the 11 countries surveyed, all except Thailand have recorded a growth rate which is higher for PD than HD over the last three years. The rate of utilization of different PD systems varies greatly among different Asian countries. Automated PD has yet to gain popularity in Asia. Conventional straight-line systems remain the dominant PD systems in use in Hong Kong, Korea, Thailand, and the Philippines, while in Malaysia and Singapore UV germicidal connection devices are most popular. However, in all these countries there has been a progressive shift over the last

  12. Status of spent-fuel transportation system development

    SciTech Connect

    Chapman, R.L.; Hall, I.K.

    1988-01-01

    The purpose of the Cask Systems Development Program (CSDP) is to develop a variety of cask systems that can safely and economically be used to move commercial spent fuel and high-level waste from the generator to the federal repository or monitored retrievable storage facility. There are four initiatives to the CSDP, but only the first, from reactor casks, has been activated. This paper is limited to a discussion of the status of that initiative. Schedule objectives for the CSDP include development of spent-fuel cask systems by 1995 to support the Office of Civilian Radioactive Waste Management shipments of spent fuel from utilities beginning in the late 1990s. The US Department of Energy (DOE)-Idaho, with the support of EG G Idaho, Inc., Sandia National Laboratories, and selected cask development contractors, has been assigned the responsibility for developing a family of cask systems that are suitable for the task. Initially, four categories of spent-fuel casks were to be developed. They are legal-weight truck (LWT) casks, overweight truck (OWT) casks, rail/barge (R/B) casks, and dual purpose (DP) (storage/transport) casks. For a variety of reasons, OWT and DP cask development activities have been deferred. Program goals include developing a family of casks that will permit minimizing total system life cycle costs, ensure safety to the general public and to occupational workers, and attain public confidence in the transportation system.

  13. Status of the PXIE Low Energy Beam Transport Line

    SciTech Connect

    Prost, Lionel; Andrews, Richard; Chen, Alex; Hanna, Bruce; Scarpine, Victor; Shemyakin, Alexander; Steimel, Jim; D'Arcy, Richard

    2014-07-01

    A CW-compatible, pulsed H- superconducting RF linac (a.k.a. PIP-II) is envisaged as a possible path for upgrading Fermilab’s injection complex [1]. To validate the concept of the front-end of such machine, a test accelerator (a.k.a. PXIE) [2] is under construction. The warm part of this accelerator comprises a 10 mA DC, 30 keV H- ion source, a 2m-long LEBT, a 2.1 MeV CW RFQ, and a MEBT that feeds the first cryomodule. In addition to operating in the nominal CW mode, the LEBT should be able to produce a pulsed beam for both PXIE commissioning and modelling of the front-end nominal operation in the pulsed mode. Concurrently, it needs to provide effective means of inhibiting beam as part of the overall machine protection system. A peculiar feature of the present LEBT design is the capability of using the ~1m-long section immediately preceding the RFQ in two regimes of beam transport dynamics: neutralized and space charge dominated. This paper introduces the PXIE LEBT, reports on the status of the ion source and LEBT installation, and presents the first beam measurements.

  14. Status of the MORSE multigroup Monte Carlo radiation transport code

    SciTech Connect

    Emmett, M.B.

    1993-06-01

    There are two versions of the MORSE multigroup Monte Carlo radiation transport computer code system at Oak Ridge National Laboratory. MORSE-CGA is the most well-known and has undergone extensive use for many years. MORSE-SGC was originally developed in about 1980 in order to restructure the cross-section handling and thereby save storage. However, with the advent of new computer systems having much larger storage capacity, that aspect of SGC has become unnecessary. Both versions use data from multigroup cross-section libraries, although in somewhat different formats. MORSE-SGC is the version of MORSE that is part of the SCALE system, but it can also be run stand-alone. Both CGA and SGC use the Multiple Array System (MARS) geometry package. In the last six months the main focus of the work on these two versions has been on making them operational on workstations, in particular, the IBM RISC 6000 family. A new version of SCALE for workstations is being released to the Radiation Shielding Information Center (RSIC). MORSE-CGA, Version 2.0, is also being released to RSIC. Both SGC and CGA have undergone other revisions recently. This paper reports on the current status of the MORSE code system.

  15. Multicystic peritoneal mesothelioma

    PubMed Central

    Tentes, Antonios-Apostolos; Zorbas, Georgios; Pallas, Nicolaos; Fiska, Aliki

    2012-01-01

    Summary Background: Multicystic peritoneal mesothelioma is a rare disease. It is not certain if it is a benign or a borderline tumor. Although many therapeutic approaches have been used, complete cytoreductive surgery in combination with hyperthermic intraoperative intraperitoneal chemotherapy has gained acceptance. Case Report: A case of multicystic peritoneal mesothelioma in a 16-year old patient is reported. The patient underwent complete cytoreduction and received intraoperative hyperthermic intraperitoneal chemotherapy. The patient is disease-free one year after surgery. Conclusions: Complete cytoreductive surgery in combination with hyperthermic intraoperative intraperitoneal chemotherapy appears to be a rational therapeutic approach in multicystic peritoneal mesothelioma. PMID:23569544

  16. Treatment Methods for Kidney Failure: Peritoneal Dialysis

    MedlinePlus

    ... 3.70 MB) MedlinePlus Alternate Language URL Peritoneal Dialysis Page Content On this page: What is peritoneal ... Points to Remember Clinical Trials What is peritoneal dialysis and how does it work? Peritoneal dialysis is ...

  17. Hamster bite peritonitis: Pasteurella pneumotropica peritonitis in a dialysis patient.

    PubMed

    Campos, A; Taylor, J H; Campbell, M

    2000-11-01

    We report the first case of Pasteurella pneumotropica peritonitis in a peritoneal dialysis patient. This rare infection was the result of contamination of the dialysis tubing by a pet hamster. We stress the importance of household pets as a source of infection in the peritoneal dialysis population. PMID:11095007

  18. [Adequacy of peritoneal dialysis and laboratory procedures].

    PubMed

    Klarić, Dragan; Predovan, Gorana

    2012-07-01

    Peritoneal dialysis is an equally valuable method for some patients. It is a method with some advantages and thus should be considered the method of choice. Are the trends of treatment with this method instead of terminal kidney disease replacement stagnating? In our ten-year retrospective study, we tried to do assess how to control the efficiency of dialysis and what was its influence on patient survival. We compared clinical state of patients, laboratory indicators of dialysis dosage (Kt/v) and peritoneal membrane transport function (PET). Patients were divided according to Kt/v values <1.7, 1.7-2.2 and >2.2. According to PET findings, they were divided into four standard groups. Kt/v and PET are unavoidable evaluation factors of peritoneal membrane and for prescribing dialysis. The transport, ultrafiltration and other membrane characteristics change with time and with inflammatory processes. On any calculation of adequacy, it is essential to distinguish diuretic and anuric patients. The adequacy of peritoneal dialysis should be incorporated in the conclusion on prescriptions and quality treatment of each individual patient. PMID:23441537

  19. Peritoneal manifestations of parasitic infection.

    PubMed

    Kim, So Yeon; Ha, Hyun Kwon

    2008-01-01

    The purpose of this study was to describe of peritoneal manifestations of parasitic infection at CT. A broad spectrum of CT findings can be seen in the peritoneal cavity, including a varying degree of omental or mesenteric infiltration, single or multiple peritoneal mass or nodule, and peritoneal thickening or stranding. Recognition of these findings are crucial for establish an early diagnosis and helps avoid unnecessary surgery. PMID:17924162

  20. Peritoneal Dialysis Dose and Adequacy

    MedlinePlus

    ... Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Peritoneal Dialysis Dose and Adequacy Page Content On this page: ... from the abdominal cavity. [ Top ] Types of Peritoneal Dialysis The two types of peritoneal dialysis differ mainly ...

  1. Peritoneal Dialysis Registry With 2012 Survey Report.

    PubMed

    Hasegawa, Takeshi; Nakai, Shigeru; Moriishi, Misaki; Ito, Yasuhiko; Itami, Noritomo; Masakane, Ikuto; Hanafusa, Norio; Taniguchi, Masatomo; Hamano, Takayuki; Shoji, Tetsuo; Yamagata, Kunihiro; Shinoda, Toshio; Kazama, Junichiro; Watanabe, Yuzo; Shigematsu, Takashi; Marubayashi, Seiji; Morita, Osamu; Wada, Atsushi; Hashimoto, Seiji; Suzuki, Kazuyuki; Kimata, Naoki; Wakai, Kenji; Fujii, Naohiko; Ogata, Satoshi; Tsuchida, Kenji; Nishi, Hiroshi; Iseki, Kunitoshi; Tsubakihara, Yoshiharu; Nakamoto, Hidetomo

    2015-12-01

    Since 2009, the peritoneal dialysis (PD) registry survey has been carried out as part of the annual nationwide survey conducted by the Statistical Survey Committee of the Japanese Society for Dialysis Therapy with the cooperation of the Japanese Society for Peritoneal Dialysis. In this report, the current status of PD patients is presented on the basis of the results of the survey conducted at the end of 2012. The subjects were PD patients who lived in Japan and participated in the 2012 survey. Descriptive analysis of various items was performed, which included the current status of the combined use of PD and another dialysis method such as hemodialysis (HD) or hemodiafiltration (HDF), the method of exchanging dialysate, the use of an automated peritoneal dialysis (APD) machine, and the rates of peritonitis and catheter exit-site infection. From the results of the facility survey in 2012, the number of PD patients was 9514, a decrease of 128 from 2011. Among the entire dialysis patient population, 3.1% were PD patients, a decrease of 0.1%. Among the studied patients, 347 had a peritoneal catheter and underwent peritoneal lavage, 175 were started on PD in 2012 but introduced to other blood purification methods in the same year, and 1932 underwent both PD and another dialysis method such as HD or HDF. The percentage of patients who underwent PD and another dialysis method increased with PD vintage: <1 year, 4.8%; 1 to <2 years, 9.2%; 2 to <4 years, 16.3%; 4 to <8 years, 32.0%; and ≥8 years, 47.5%. The percentage of PD patients who completely manually exchanged the dialysate was 29.8%. The percentages of PD patients who used a double-bag exchange system with ultraviolet-light irradiation and those who used the same system but with a sterile connecting device were 54.7 and 13.9%, respectively. The percentage of patients on PD for <1 year using an APD machine was 43.4%, and it decreased with a PD vintage of ≥2 years. The mean rate of peritonitis was 0.22 per patient

  2. Adequacy and nutrition in pediatric peritoneal dialysis.

    PubMed

    Cano, Francisco J; Marín, Verónica S; Azocar, Marta A; Delucchi, Maria A; Rodriguez, Eugenio E; Diaz, Erick D; Villegas, Rodrigo C

    2003-01-01

    negatively correlated with age and body surface area (p < 0.001). The mean daily nPNA was 0.94 +/- 0.33 g/kg, which was negatively correlated with age and body surface area (p < 0.05, r = -0.51), and positively correlated with daily DPI and total and residual Kt/V (p < 0.0001). Our patients could be classified as high-average transporters, with low-average ultrafiltration. The high transport state was associated with greater peritoneal albumin losses, a point of concern at younger ages. Total Kt/V and nPNA were higher for the youngest patients, suggesting a favorable nutrition status, but more studies are needed to determine the best value for both parameters in clinical practice. PMID:14763078

  3. Vadose Zone Transport Field Study: FY 2002 Status Report

    SciTech Connect

    Ward, Anderson L.; Gee, Glendon W.; Zhang, Z. F.; Keller, Jason M.

    2003-01-02

    This work reported here is part of the U. S. Department of Energy’s Science and Technology Initiative to develop improved conceptual models of flow and transport in the vadose zone, particularly for the Hanford Site, Washington. The National Academy of Sciences has identified significant knowledge gaps in conceptual model development as one reason for discovery of subsurface contamination in unexpected places. Inadequate conceptualizations limits, not only the understanding of long-term fate and transport, but also the selection and design of remediation technologies. Current conceptual models are limited partly because they do not account for the random heterogeneity that occurs under the extremes of very nonlinear flow behavior typical of the Hanford vadose zone. A major improvement in conceptual modeling of the Hanford vadose zone includes a better understanding and description of soil anisotropy, a property that appears to control much of the subsurface flow and transport in layered sediments at the Hanford Site.

  4. French National Registry of Rare Peritoneal Surface Malignancies

    ClinicalTrials.gov

    2016-07-12

    Rare Peritoneal Surface Malignancies; Pseudomyxoma Peritonei; Peritoneal Mesothelioma; Desmoplastic Small Round Cell Tumor; Psammocarcinoma; Primary Peritoneal Serous Carcinoma; Diffuse Peritoneal Leiomyomatosis; Appendiceal Mucinous Neoplasms

  5. Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

    PubMed Central

    Martin, Luis C.; Caramori, Jacqueline C.T.; Fernandes, Natalia; Divino-Filho, Jose C.; Pecoits-Filho, Roberto

    2011-01-01

    Summary Background and objectives Peritonitis remains as the most frequent cause of peritoneal dialysis (PD) failure, impairing patient's outcome. No large multicenter study has addressed socioeconomic, educational, and geographic issues as peritonitis risk factors in countries with a large geographic area and diverse socioeconomic conditions, such as Brazil. Design, setting, participants, & measurements Incident PD patients recruited from 114 dialysis centers and reporting to BRAZPD, a multicenter observational study, from December 2004 through October 2007 were included. Clinical, dialysis-related, demographic, and socioeconomic variables were analyzed. Patients were followed up until their first peritonitis. Cox proportional model was used to determine independent factors associated with peritonitis. Results In a cumulative follow-up of 2032 patients during 22.026 patient-months, 474 (23.3%) presented a first peritonitis episode. In contrast to earlier findings, PD modality, previous hemodialysis, diabetes, gender, age, and family income were not risk predictors. Factors independently associated with increased hazard risk were lower educational level, non-white race, region where patients live, shorter distance from dialysis center, and lower number of patients per center. Conclusions Educational level and geographic factors as well as race and center size are associated with risk for the first peritonitis, independent of socioeconomic status, PD modality, and comorbidities. PMID:21737854

  6. Increasing sodium removal on peritoneal dialysis: applying dialysis mechanics to the peritoneal dialysis prescription.

    PubMed

    Fischbach, Michel; Schmitt, Claus Peter; Shroff, Rukshana; Zaloszyc, Ariane; Warady, Bradley A

    2016-04-01

    Optimal fluid removal on peritoneal dialysis (PD) requires removal of water coupled with sodium, which is predominantly achieved via the small pores in the peritoneal membrane. On the other hand, free-water transport takes place through aquaporin-1 channels, but leads to sodium retention and over hydration. PD prescription can be adapted to promote small pore transport to achieve improved sodium and fluid management. Both adequate dwell volume and dwell time are required for small pore transport. The dwell volume determines the amount of "wetted" peritoneal membrane being increased in the supine position and optimized at dwell volumes of approximately 1400 ml/m(2). Diffusion across the recruited small pores is time-dependent, favored by a long dwell time, and driven by the transmembrane solute gradient. According to the 3-pore model of conventional PD, sodium removal primarily occurs via convection. The clinical application of these principles is essential for optimal performance of PD and has resulted in a new approach to the automated PD prescription: adapted automated PD. In adapted automated PD, sequential short- and longer-dwell exchanges, with small and large dwell volumes, respectively, are used. A crossover trial in adults and a pilot study in children suggests that sodium and fluid removal are increased by adapted automated PD, leading to improved blood pressure control when compared with conventional PD. These findings are not explained by the current 3-pore model of peritoneal permeability and require further prospective crossover studies in adults and children for validation. PMID:26924063

  7. A novel mechanism for neutrophil priming in trauma: potential role of peritoneal fluid

    PubMed Central

    Shah, Shinil K.; Jimenez, Fernando; Walker, Peter A.; Aroom, Kevin R.; Xue, Hasen; Feeley, Teri D.; Uray, Karen S.; Norbury, Kenneth C.; Stewart, Randolph H.; Laine, Glen A.; Cox, Charles S.

    2010-01-01

    Introduction We sought to determine the effect of peritoneal fluid from a novel animal model of abdominal compartment syndrome (ACS) on the pro-inflammatory status of PMNs (polymorphonuclear leukocytes) and monocytes. We hypothesize that peritoneal fluid is a potential priming and/or activating agent for PMNs/monocytes. Materials and Methods ACS was induced in female Yorkshire swine and peritoneal fluid was collected at the time of decompressive laparotomy. Naïve PMN’s/monocytes were primed and/or activated with peritoneal fluid, PAF (phosphatidylcholine) plus peritoneal fluid, peritoneal fluid plus fMLP (n-formyl-met-leu-phe), and peritoneal fluid plus PMA (phorbol 12-myristate 13-acetate). Activation was determined by surface marker expression of integrins (CD11b, CD18) and selectins (CD62L). Additionally, pro-inflammatory cytokines in peritoneal fluid were analyzed. Results Peritoneal fluid did not activate PMNs but increased CD11b expression on monocytes. When used as a primer for fMLP or PMA induced activation, peritoneal fluid significantly increased CD11b and CD18 expression on PMN’s and monocytes. Peritoneal fluid collected at 6 and 12 hours post decompressive laparotomy had similar effects. IL-6 and TNF-alpha levels were increased in peritoneal fluid. Discussion Peritoneal fluid represents a primer for PMN’s/monocytes and appears to act through receptor dependent and independent pathways. Strategies to reduce the amount of peritoneal fluid may decrease the locoregional and systemic inflammatory response by reducing priming and activation of neutrophils/monocytes. PMID:20466401

  8. Status of high transport current ROEBEL assembled coated conductor cables

    NASA Astrophysics Data System (ADS)

    Goldacker, Wilfried; Frank, Antje; Kudymow, Andrej; Heller, Reinhard; Kling, Andrea; Terzieva, Stanimira; Schmidt, Curt

    2009-03-01

    Assembling coated conductors (CC) into flat ROEBEL bars (RACC cable) was introduced in 2005 by the authors as a practicable method of reaching high transport currents in a low AC loss cable, which is a cable design suited for application in windings. The transport current of 1.02 kA in self-field at 77 K achieved so far, however, is still too low for several applications in electrical machinery such as larger transformers and generators/motors. A new cable concept for further increased currents was presented just recently. The goal of the new design was primarily to demonstrate the possibility of strongly increased transport currents without changing the important cable features for low AC losses. such as, for example, the transposition length of the strands. We present detailed investigations of the properties of this progressed cable design, which has threefold layered strands, an unchanged transposition pitch of 18.8 cm and finally the application of 45 coated conductors in the cable. A 1.1 m long sample (equivalent to six transposition lengths) was prepared from commercial Cu stabilized coated conductors purchased from Superpower. The measured new record DC transport current of the cable was 2628 A at 77 K in self-field (5 µV cm-1 criterion). The use of three slightly different current carrying batches of strand material (± 10%) was a special feature of the cable, which allowed for interesting investigations of current redistribution effects in the cable, by monitoring a representative strand of each batch during the critical current measurement. Although current redistribution effects showed a complex situation, the behaviour of the cable was found to be absolutely stable under all operational conditions, even above the critical current. The high self-field degradation of the critical current reached the order of 60% at 77 K, and could be modelled satisfactory with calculations based on a proven Biot-Savart-law approach, adapted to the specific boundary

  9. Angiotensin II receptors and peritoneal dialysis-induced peritoneal fibrosis.

    PubMed

    Morinelli, Thomas A; Luttrell, Louis M; Strungs, Erik G; Ullian, Michael E

    2016-08-01

    The vasoactive hormone angiotensin II initiates its major hemodynamic effects through interaction with AT1 receptors, a member of the class of G protein-coupled receptors. Acting through its AT1R, angiotensin II regulates blood pressure and renal salt and water balance. Recent evidence points to additional pathological influences of activation of AT1R, in particular inflammation, fibrosis and atherosclerosis. The transcription factor nuclear factor κB, a key mediator in inflammation and atherosclerosis, can be activated by angiotensin II through a mechanism that may involve arrestin-dependent AT1 receptor internalization. Peritoneal dialysis is a therapeutic modality for treating patients with end-stage kidney disease. The effectiveness of peritoneal dialysis at removing waste from the circulation is compromised over time as a consequence of peritoneal dialysis-induced peritoneal fibrosis. The non-physiological dialysis solution used in peritoneal dialysis, i.e. highly concentrated, hyperosmotic glucose, acidic pH as well as large volumes infused into the peritoneal cavity, contributes to the development of fibrosis. Numerous trials have been conducted altering certain components of the peritoneal dialysis fluid in hopes of preventing or delaying the fibrotic response with limited success. We hypothesize that structural activation of AT1R by hyperosmotic peritoneal dialysis fluid activates the internalization process and subsequent signaling through the transcription factor nuclear factor κB, resulting in the generation of pro-fibrotic/pro-inflammatory mediators producing peritoneal fibrosis. PMID:27167177

  10. Sclerosing Encapsulating Peritonitis

    PubMed Central

    Machado, Norman O.

    2016-01-01

    Sclerosing encapsulating peritonitis (SEP) is a rare chronic inflammatory condition of the peritoneum with an unknown aetiology. Also known as abdominal cocoon, the condition occurs when loops of the bowel are encased within the peritoneal cavity by a membrane, leading to intestinal obstruction. Due to its rarity and non-specific clinical features, it is often misdiagnosed. The condition presents with recurrent episodes of small bowel obstruction and can be idiopathic or secondary; the latter is associated with predisposing factors such as peritoneal dialysis or abdominal tuberculosis. In the early stages, patients can be managed conservatively; however, surgical intervention is necessary for those with advanced stage intestinal obstruction. A literature review revealed 118 cases of SEP; the mean age of these patients was 39 years and 68.0% were male. The predominant presentation was abdominal pain (72.0%), distension (44.9%) or a mass (30.5%). Almost all of the patients underwent surgical excision (99.2%) without postoperative complications (88.1%). PMID:27226904

  11. Status of EarthScope's Transportable Array in Alaska

    NASA Astrophysics Data System (ADS)

    Hafner, K.; Busby, R. W.; Enders, M.

    2014-12-01

    The EarthScope's Transportable Array has completed its first year of operations in Alaska. The proposed station grid uses 85 km spacing & consists of ~290 locations in Alaska and Western Canada. About 60 of the grid locations will be at existing seismic stations operated by the AEC, AVO & ATWC and are being upgraded with shallow borehole installations or higher quality sensors as appropriate. About 10 new stations will be collocated with PBO GPS stations. At the end of July 2014, 90% of the site reconnaissance has been completed, & 25 sites have been permitted with private landowners or the State of Alaska. 11 new TA stations have been installed, & 7 existing stations (AK network code) have been upgraded. Data from these stations is flowing to the Array Network Facility (ANF) and being archived at the IRIS DMC. As the Transportable Array has moved to Alaska, IRIS has experimented with different portable drills and drilling techniques to create shallow holes (1-5 m deep, 15-20 cm in diameter) in permafrost and rock outcrops for seismometer installation. The goal of these new methods is to maintain or enhance a station's noise performance while minimizing its footprint & the equipment, materials, and overall expense required for its construction. Motivating this approach are recent developments in posthole broadband seismometer design & the unique conditions for operating in Alaska, where most areas are only accessible by small plane or helicopter, & permafrost underlies much of the region. IRIS contracted with a drilling specialist to create a prototype Transportable Drill (less than 1300 lbs with tooling) that is capable of augering to 5 m in unconsolidated materials and permafrost, downhole hammering to 2.5 m in bedrock with a steel casing following the bit and diamond coring in solid rock to 2 m. This drill has been successfully deployed by helicopter to create a hole 2.7 m deep and 15 cm diameter in bedrock. The auger mode was used successfully to install a

  12. 78 FR 49254 - Approval of Subzone Status; GE Transportation; Lawrence Park Township and Grove City, Pennsylvania

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... FR 30270-30271, 5-22-2013). The FTZ staff examiner reviewed the applications and determined that they... Foreign-Trade Zones Board Approval of Subzone Status; GE Transportation; Lawrence Park Township and Grove..., in Lawrence Park Township and Grove City, Pennsylvania. The applications were processed in...

  13. 77 FR 8252 - Adequacy Status of the Anchorage, Alaska, Carbon Monoxide Maintenance Plan for Transportation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... AGENCY Adequacy Status of the Anchorage, Alaska, Carbon Monoxide Maintenance Plan for Transportation... budget (MVEB) in the Anchorage, Alaska, Carbon Monoxide (CO) Maintenance Plan, submitted by the State of... notice of EPA's adequacy finding regarding the motor vehicle emissions budget (MVEB) in the...

  14. Earthscope's Transportable Array: Current Status and Future Developments

    NASA Astrophysics Data System (ADS)

    Hafner, K.; Busby, R. W.; Woodward, R.

    2009-12-01

    The Transportable Array (TA) element of Earthscope/ US Array is a large deployment of 400 high quality broadband seismographs. The construction of this array began in September 2003 and the 400th station was installed in September of 2007. The full deployment is now continuously rolling from west to east across the continental US, requiring the installation (and removal) of approximately 18 stations each month for a ten year period. New stations have been installed in 2009 in a north-south swath extending from North Dakota to Texas. Stations were removed from Arizona northward to western Montana. We provide updates to equipment additions made to the TA, timing of data availability, and plans for future activities. Equipment improvements at the stations now include power regulation for sensors and the addition of data channels recording temperature and barometric pressure. Additional data channels are available that could be used for auxiliary sensors such as infrasound. Although all sites have real-time telemetry, on-site data recording hardware has also been improved to reduce the time required before the final and complete archival data are released. All data are telemetered via an Array Network Facility at UCSD to the IRIS DMC where they are available in real-time. The network up-time has averaged greater that 95%. The final data archiving for a TA station, which includes full quality control and fills in any remaining data gaps, takes place a few months after the station has been removed. The goal is to shorten this time, such that complete, updated archival data are available within a few months after real-time acquisition. In addition to hardware changes documented in the SEED metadata files, the TA now produces a narrative archival report for each station called a “Station Digest”. This report summarizes the details about the equipment, station performance and service history. This report is available as a Data Product from the IRIS Data Management

  15. Encapsulating peritoneal sclerosis: common or rare in peritoneal dialysis?

    PubMed

    Triga, Konstantina

    2013-03-01

    Encapsulating peritoneal sclerosis (EPS) is a serious and often fatal complication of long-term peritoneal dialysis (PD) with severe malnutrition and poor prognosis. It causes progressive obstruction and encapsulation of the bowel loops. As EPS becomes more prevalent with longer duration of PD, large multicenter prospective studies are needed to establish its incidence and identify risk factors, therapeutic approach, and prognosis. PMID:23538342

  16. Encapsulating peritoneal sclerosis—a rare but devastating peritoneal disease

    PubMed Central

    Moinuddin, Zia; Summers, Angela; Van Dellen, David; Augustine, Titus; Herrick, Sarah E.

    2015-01-01

    Encapsulating peritoneal sclerosis (EPS) is a devastating but, fortunately, rare complication of long-term peritoneal dialysis. The disease is associated with extensive thickening and fibrosis of the peritoneum resulting in the formation of a fibrous cocoon encapsulating the bowel leading to intestinal obstruction. The incidence of EPS ranges between 0.7 and 3.3% and increases with duration of peritoneal dialysis therapy. Dialysis fluid is hyperosmotic, hyperglycemic, and acidic causing chronic injury and inflammation in the peritoneum with loss of mesothelium and extensive tissue fibrosis. The pathogenesis of EPS, however, still remains uncertain, although a widely accepted hypothesis is the “two-hit theory,” where, the first hit is chronic peritoneal membrane injury from long standing peritoneal dialysis followed by a second hit such as an episode of peritonitis, genetic predisposition and/or acute cessation of peritoneal dialysis, leading to EPS. Recently, EPS has been reported in patients shortly after transplantation suggesting that this procedure may also act as a possible second insult. The process of epithelial–mesenchymal transition of mesothelial cells is proposed to play a central role in the development of peritoneal sclerosis, a common characteristic of patients on dialysis, however, its importance in EPS is less clear. There is no established treatment for EPS although evidence from small case studies suggests that corticosteroids and tamoxifen may be beneficial. Nutritional support is essential and surgical intervention (peritonectomy and enterolysis) is recommended in later stages to relieve bowel obstruction. PMID:25601836

  17. Continuous Ambulatory Peritoneal Dialysis Peritonitis due to Enterococcus cecorum

    PubMed Central

    De Baere, Thierry; Claeys, Geert; Verschraegen, Gerda; Devriese, Luc A.; Baele, Margo; Van Vlem, Bruno; Vanholder, Raymond; Dequidt, Clement; Vaneechoutte, Mario

    2000-01-01

    Enterococcus cecorum was isolated as the etiologic agent of a continuous ambulatory peritoneal dialysis peritonitis episode in an alcoholic patient. To date, this is only the third infection due to this bacterium, found in the intestinal tract of many domestic animals, that has been reported in humans. PMID:10970419

  18. Paecilomyces variotii in peritoneal dialysate.

    PubMed Central

    Marzec, A; Heron, L G; Pritchard, R C; Butcher, R H; Powell, H R; Disney, A P; Tosolini, F A

    1993-01-01

    Four cases of peritonitis caused by the filamentous fungus Paecilomyces variotii in patients on continuous ambulatory peritoneal dialysis are reported. Removal of the Tenckhoff catheter and antifungal chemotherapy led to resolution of symptoms in all cases. Possible contaminating events are discussed, and reported infections with P. variotii are reviewed. PMID:8408561

  19. [Malignant peritoneal mesothelioma].

    PubMed

    Scripcariu, V; Dajbog, Elena; Lefter, L; Ferariu, D; Pricop, Adriana; Grigoraş, M; Dragomir, Cr

    2006-01-01

    Mesothelioma is a neoplasm originating from the mesothelial surface lining cells of the serous human cavities. It may involve the pleura, less frequently the peritoneum rarely, the pericardium, the tunica vaginalis testis and ovarian epithelium. Asbestos has been widely used in industry. A causal relationship between asbestos exposure and pleural, peritoneal and pericardial malign mesothelioma was suggested, the risk of cancer being correlated to cumulate exposure. Studies from National Cancer Institute, USA, show that the malignant mesothelioma is a rare and aggressive asbestos related malignancy. The symptomatology is insidious and poses difficult problems in diagnosis and treatment. This paper presents the case of a 59 year old patient with malignant peritoneal mesothelioma who worked almost 40 years as an electrician, exposed to asbestos fibers. He was hospitalized for important weight loss, abdominal pain and tiredness being diagnosed after imaging tests with a giant tumor, localized at the abdominal upper level, which seems to originate from the spleen's superior pole. During surgery we discovered a tumor with cystic parts, intense vascularized, which turn to be adherent in the upper side to the lower face of the left midriff cupola, to the spleen superior pole and 1/3 middle level of the great gastric curve. It was performed surgical ablation of the tumor, splenectomy with favorable postoperative evolution, the patient being now under chemotherapy treatment. PMID:17283842

  20. Rat Models of Acute and/or Chronic Peritoneal Injuries Including Peritoneal Fibrosis and Peritoneal Dialysis Complications.

    PubMed

    Mizuno, Masashi; Ito, Yasuhiko

    2016-01-01

    Peritoneal injury is a major cause of discontinuation from long-term peritoneal dialysis. However, the precise mechanisms underlying such injury remain unclear. Suitable animal models of peritoneal injury may be useful to analyze pathogenic mechanisms and facilitate the development of therapeutic approaches. We describe herein two rat models of peritoneal injury that we have recently proposed. PMID:26676125

  1. Repeated Burkholderia cepacia Peritonitis in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

    PubMed Central

    Apostolovic, BL; Velickovic-Radovanovic, RM; Andjelkovic-Apostolovic, MR; Cvetkovic, TP; Dinic, MM; Radivojevic, JD

    2015-01-01

    ABSTRACT Burkholderia cepacia (B cepacia) is a rare opportunistic pathogen in continuous ambulatory peritoneal dialysis (CAPD) peritonitis. We describe the first case of repeated B cepacia CAPD peritonitis, occurring in an outpatient environment, treated with antimicrobial medication without peritoneal catheter removal. B cepacia may lead to repeat infection, therefore, we should insist on catheter removal during each peritonitis episode. PMID:26426187

  2. Effect of transport on blood selenium and glutathione status in feeder lambs.

    PubMed

    Hall, J A; Bobe, G; Nixon, B K; Vorachek, W R; Hugejiletu; Nichols, T; Mosher, W D; Pirelli, G J

    2014-09-01

    Stress from transport may be linked to increased generation of reactive oxygen species, the removal of which requires reduced glutathione and selenium. The aim of this experiment was to examine the effect of transport on glutathione and Se status of feeder lambs. Recently weaned lambs (n = 40) were blocked by gender and BW on d 0 of the experiment and randomly assigned to 2 treatment groups: group 1, no transport and full access to feed and water (control), and group 2, 8-h road transport followed by another 16 h of feed deprivation (transport). After 24 h, both treatment groups were treated the same. All lambs were weighed, and blood samples were collected at 0, 8, 24, and 72 h and analyzed for whole-blood (WB) and serum Se concentrations, serum NEFA concentrations, and erythrocyte concentrations of glutathione. Transport of feeder lambs for 8 h followed by another 16 h of feed deprivation transiently (significant at 24 h but no longer different at 72 h) decreased BW and erythrocyte glutathione concentrations and increased serum NEFA and blood Se concentrations compared with control lambs. Our results suggest that 8 h of transport followed by another 16 h of feed deprivation results in fatty acid and Se mobilization from tissue stores with a coincident decrease in erythrocyte glutathione concentrations. PMID:25035242

  3. Peritoneal dialysis in microencephaly.

    PubMed

    Peters, April

    2008-01-01

    J.T. was able to remain home in her familiar environment and receive safe and adequate treatment for her renal disease. J.T. had no infectious episodes or hospitalizations while under this unit's care for 35 months. She was also able to participate in her regular activities of daily living, interact with her family members, and travel on occasion, thus maintaining a good quality of life. Therefore, unit goals for her care were met. J.T.'s experience demonstrates that with proper teaching, preparation, and support from the dialysis care team working with a dedicated family, peritoneal dialysis can be an ideal modality for the treatment of ESRD in people with mental disabilities. PMID:19260611

  4. Evolution of management in peritoneal surface malignancies

    PubMed Central

    Canbay, Emel; Torun, Bahar Canbay; Torun, Ege Sinan; Yonemura, Yutaka

    2016-01-01

    Management of peritoneal surface malignancies has gradually evolved by the introduction of cytoreductive surgery in combination with intraperitoneal chemotherapy applications. Recently, peritoneal metastases of intraabdominal solid organ tumors and primary peritoneal malignancies such as peritoneal mesothelioma are being treated with this new approach. Selection criteria are important to reduce morbidity and mortality rates of patients who will experience minimal or no benefit from these combined treatment modalities. Management of peritoneal surface malignancies with this current trend is presented in this review. PMID:27528813

  5. Acinetobacter Peritoneal Dialysis Peritonitis: A Changing Landscape over Time

    PubMed Central

    Chao, Chia-Ter; Lee, Szu-Ying; Yang, Wei-Shun; Chen, Huei-Wen; Fang, Cheng-Chung; Yen, Chung-Jen; Chiang, Chih-Kang; Hung, Kuan-Yu; Huang, Jenq-Wen

    2014-01-01

    Background Acinetobacter species are assuming an increasingly important role in modern medicine, with their persistent presence in health-care settings and antibiotic resistance. However, clinical reports addressing this issue in patients with peritoneal dialysis (PD) peritonitis are rare. Methods All PD peritonitis episodes caused by Acinetobacter that occurred between 1985 and 2012 at a single centre were retrospectively reviewed. Clinical features, microbiological data, and outcomes were analysed, with stratifications based upon temporal periods (before and after 2000). Results Acinetobacter species were responsible for 26 PD peritonitis episodes (3.5% of all episodes) in 25 patients. A. baumannii was the most common pathogen (54%), followed by A. iwoffii (35%), with the former being predominant after 2000. Significantly more episodes resulted from breaks in exchange sterility after 2000, while those from exit site infections decreased (P = 0.01). The interval between the last and current peritonitis episodes lengthened significantly after 2000 (5 vs. 13.6 months; P = 0.05). All the isolates were susceptible to cefepime, fluoroquinolone, and aminoglycosides, with a low ceftazidime resistance rate (16%). Nearly half of the patients (46%) required hospitalisation for their Acinetobacter PD-associated peritonitis, and 27% required an antibiotic switch. The overall outcome was fair, with no mortality and a 12% technique failure rate, without obvious interval differences. Conclusions The temporal change in the microbiology and origin of Acinetobacter PD-associated peritonitis in our cohort suggested an important evolutional trend. Appropriate measures, including technique re-education and sterility maintenance, should be taken to decrease the Acinetobacter peritonitis incidence in PD patients. PMID:25314341

  6. Protective Effects of Paricalcitol on Peritoneal Remodeling during Peritoneal Dialysis

    PubMed Central

    Stavenuiter, Andrea W. D.; Farhat, Karima; Vila Cuenca, Marc; Schilte, Margot N.; Keuning, Eelco D.; Paauw, Nanne J.; ter Wee, Pieter M.; Beelen, Robert H. J.; Vervloet, Marc G.

    2015-01-01

    Peritoneal dialysis (PD) is associated with structural and functional alterations of the peritoneal membrane, consisting of fibrosis, angiogenesis, and loss of ultrafiltration capacity. Vitamin D receptor activation (VDRA) plays an important role in mineral metabolism and inflammation, but also antiangiogenic and antifibrotic properties have been reported. Therefore, the effects of active vitamin D treatment on peritoneal function and remodeling were investigated. Rats were either kept naïve to PDF exposure or daily exposed to 10 mL PDF and were treated for five or seven weeks with oral paricalcitol or vehicle control. Non-PDF-exposed rats showed no peritoneal changes upon paricalcitol treatment. Paricalcitol reduced endogenous calcitriol but did not affect mineral homeostasis. However, upon PDF exposure, loss of ultrafiltration capacity ensued which was fully rescued by paricalcitol treatment. Furthermore, PD-induced ECM thickening was significantly reduced and omental PD-induced angiogenesis was less pronounced upon paricalcitol treatment. No effect of paricalcitol treatment on total amount of peritoneal cells, peritoneal leukocyte composition, and epithelial to mesenchymal transition (EMT) was observed. Our data indicates that oral VDRA reduces tissue remodeling during chronic experimental PD and prevents loss of ultrafiltration capacity. Therefore, VDRA is potentially relevant in the prevention of treatment technique failure in PD patients. PMID:26605330

  7. Animal models in peritoneal dialysis

    PubMed Central

    Nikitidou, Olga; Peppa, Vasiliki I.; Leivaditis, Konstantinos; Eleftheriadis, Theodoros; Zarogiannis, Sotirios G.; Liakopoulos, Vassilios

    2015-01-01

    Peritoneal dialysis (PD) has been extensively used over the past years as a method of kidney replacement therapy for patients with end stage renal disease (ESRD). In an attempt to better understand the properties of the peritoneal membrane and the mechanisms involved in major complications associated with PD, such as inflammation, peritonitis and peritoneal injury, both in vivo and ex vivo animal models have been used. The aim of the present review is to briefly describe the animal models that have been used, and comment on the main problems encountered while working with these models. Moreover, the differences characterizing these animal models, as well as, the differences with humans are highlighted. Finally, it is suggested that the use of standardized protocols is a necessity in order to take full advantage of animal models, extrapolate their results in humans, overcome the problems related to PD and help promote its use. PMID:26388781

  8. Diagnostic peritoneal lavage - series (image)

    MedlinePlus

    ... abdominal injury has occurred in a blunt trauma victim. In many cases, the decision about when to ... One procedure used to determine whether blunt trauma victims require surgery is diagnostic peritoneal lavage (DPL). DPL ...

  9. Peritoneal dialysis: from bench to bedside

    PubMed Central

    Krediet, Raymond T.

    2013-01-01

    Peritoneal dialysis was first employed in patients with acute renal failure in the 1940s and since the 1960s for those with end-stage renal disease. Its popularity increased enormously after the introduction of continuous ambulatory peritoneal dialysis in the end of 1970s. This stimulated both clinical and basic research. In an ideal situation, this should lead to cross-fertilization between the two. The present review describes two examples of interactions: one where it worked out very well and another where basic science missed the link with clinical findings. Those on fluid transport are examples of how old physiological findings on absorption of saline and glucose solutions were adopted in peritoneal dialysis by the use of glucose as an osmotic agent. The mechanism behind this in patients was first solved mathematically by the assumption of ultrasmall intracellular pores allowing water transport only. At the same time, basic science discovered the water channel aquaporin-1 (AQP-1), and a few years later, studies in transgenic mice confirmed that AQP-1 was the ultrasmall pore. In clinical medicine, this led to its assessment in patients and the notion of its impairment. Drugs for treatment have been developed. Research on biocompatibility is not a success story. Basic science has focussed on dialysis solutions with a low pH and lactate, and effects of glucose degradation products, although the first is irrelevant in patients and effects of continuous exposure to high glucose concentrations were largely neglected. Industry believed the bench more than the bedside, resulting in ‘biocompatible’ dialysis solutions. These solutions have some beneficial effects, but are evidently not the final answer. PMID:26120456

  10. New Developments in Peritoneal Fibroblast Biology: Implications for Inflammation and Fibrosis in Peritoneal Dialysis

    PubMed Central

    Witowski, Janusz; Kawka, Edyta; Rudolf, Andras; Jörres, Achim

    2015-01-01

    Uraemia and long-term peritoneal dialysis (PD) can lead to fibrotic thickening of the peritoneal membrane, which may limit its dialytic function. Peritoneal fibrosis is associated with the appearance of myofibroblasts and expansion of extracellular matrix. The extent of contribution of resident peritoneal fibroblasts to these changes is a matter of debate. Recent studies point to a significant heterogeneity and complexity of the peritoneal fibroblast population. Here, we review recent developments in peritoneal fibroblast biology and summarize the current knowledge on the involvement of peritoneal fibroblasts in peritoneal inflammation and fibrosis. PMID:26495280

  11. Postoperative Peritoneal Adhesions

    PubMed Central

    Ryan, Graeme B.; Grobéty, Jocelyne; Majno, Guido

    1971-01-01

    This paper describes an experimental model of peritoneal adhesions, in the rat, based on two relatively minor accidents that may occur during abdominal surgery in man: drying of the serosa, and bleeding. Drying alone had little effect; drying plus bleeding consistently produced adhesions to the dried area. Fresh blood alone produced adhesions between the three membranous structures [omentum and pelvic fat bodies (PFBs)]. The formation of persistent adhesions required whole blood. Preformed clots above a critical size induced adhesions even without previous serosal injury; they were usually captured by the omentum and PFBs. If all three membranous structures were excised, the clots caused visceral adhesions. The protective role of the omentum, its structure, and the mechanism of omental adhesions, are discussed. These findings are relevant to the pathogenesis of post-operative adhesions in man. ImagesFig 3Fig 4Fig 5Fig 6Fig 7Fig 12Fig 13Fig 1Fig 2Fig 14Fig 15Fig 8Fig 9Fig 10Fig 11 PMID:5315369

  12. Plasma total antioxidant status in horses after 8-hours of road transportation

    PubMed Central

    2013-01-01

    Background The aim of this study was to investigate the effects of 8-hour road transport on plasma total antioxidant status (PTAS) and general clinical appearance in horses. Findings The study was conducted on a group of 60 horses of different breeds aged from 4 to 10 years. Venous blood was collected and a clinical examination was performed immediately before loading horses onto trailers for an 8 hour transport (I), immediately after unloading them from the trailer (II), and after a subsequent 24 hour stall rest (III). The ferric-reducing ability of plasma (FRAP) was used to determine PTAS. The transportation significantly increased respiratory and heart rates. The average PTAS increased during the three subsequent samplings: I: 170 ± 77 (μmol/l) II: 204 ± 70 (μmol/l) III: 221 ± 74 (μmol/l). Conclusion Long-distance transport increased the PTAS horses, as well as respiratory and heart rates. PMID:23945316

  13. [Biocompatibility of peritoneal dialysis fluids].

    PubMed

    Boulanger, Eric; Moranne, Olivier; Wautier, Marie-Paule; Rougier, Jean-Phillipe; Ronco, Pierre; Pagniez, Dominique; Wautier, Jean-Luc

    2005-03-01

    Repeated and long-term exposure to conventional glucose-based peritoneal dialysis fluids (PDFs) with poor biocompatibility plays a central role in the pathogenesis of the functional and structural changes of the peritoneal membrane. We have used immortalized human peritoneal mesothelial cells in culture to assess in vitro the biocompatibility of PDFs. Low pH, high glucose concentration and heat sterilization represent major factors of low biocompatibility. Two recent groups of glucose derivatives have been described. Glucose degradation products (GDPs) are formed during heat sterilization (glycoxidation) and storage. GDPs can bind protein and form AGEs (Advanced Glycation End-products), which can also result from the binding of glucose to free NH2 residues of proteins (glycation). The physiological pH, and the separation of glucose during heat sterilization (low GDP content) in the most recent PDFs dramatically increase the biocompatibility. The choice of PD programs with high biocompatibility PDFs allows preserving the function of the peritoneal membrane. Improvement of PDF biocompatibility may limit the occurrence of chronic chemical peritonitis and may allow long-term PD treatment. PMID:16895663

  14. Barium Peritonitis in Small Animals

    PubMed Central

    KO, Jae Jin; MANN, F. A. (Tony)

    2014-01-01

    ABSTRACT Barium peritonitis is extremely rare, but is difficult to treat and may be life-threatening. Barium suspension leakage from the gastrointestinal tract into the abdominal cavity has a time-dependent and synergistically deleterious effect in patients who have generalized bacterial peritonitis. The severity of barium peritonitis is dependent on the quantity of barium in the abdominal cavity. Barium sulfate leakage results in hypovolemia and hypoproteinemia by worsening the exudation of extracellular fluid and albumin. Abdominal fluid analysis is a useful and efficient method to diagnose barium peritonitis. Serial radiographs may not be a reliable or timely diagnostic technique. Initial aggressive fluid resuscitation and empirical broad-spectrum antibiotic treatment should be instituted promptly, followed quickly by celiotomy. During exploratory surgical intervention, copious irrigation and direct wiping with gauze are employed to remove as much barium as possible. Omentectomy should be considered when needed to expedite barium removal. Despite aggressive medical and surgical treatments, postoperative prognosis is guarded to poor due to complications, such as acute vascular shock, sepsis, diffuse peritonitis, hypoproteninemia, electrolyte imbalance, cardiac arrest, small bowel obstruction related to progression of granulomas and adhesions in the abdominal cavity. Therefore, intensive postoperative monitoring and prompt intervention are necessary to maximize chances for a positive outcome. For those that do survive, small bowel obstruction is a potential consequence due to progression of abdominal adhesions. PMID:24430662

  15. Tuberculosis peritonitis: gallium-67 scintigraphic appearance.

    PubMed

    Sumi, Y; Ozaki, Y; Hasegawa, H; Shindoh, N; Katayama, H; Tamamoto, F

    1999-06-01

    Tuberculosis peritonitis is a rare manifestation of extrapulmonary tuberculosis. The results of gallium-67 scintigraphy of three patients with tuberculosis peritonitis were reviewed to assess its usefulness in the diagnosis of this condition. Tuberculosis peritonitis was associated with diffuse or focal abdominal localization and decreased hepatic accumulation of gallium-67. These gallium-67 scan features of tuberculosis peritonitis may help to optimize the diagnosis and management of this disease. PMID:10435380

  16. Current Status of Radiation Transport Tools for Proliferation and Terrorism Prevention

    SciTech Connect

    Sale, K E

    2004-09-13

    We present the current status and future plans for the set of calculational tools and data bases developed and maintained at LLNL. The calculational tools include the Monte Carlo codes TART and COG as well as the deterministic code ARDRA. In addition to these codes presently in use there is a major development effort for a new massively parallel transport code. An important part of the capability we're developing is a sophisticated user interface, based on a commercial 3-D modeling product, to improve the model development process. A major part of this user interface tool is being developed by Strela under the Nuclear Cities Initiative. Strela has developed a hub-and-spoke technology for code input interconversions (between COG, TART and MCNP) and will produce the plug-ins that extend the capabilities of the 3-D modeler for use as a radiation transport input generator. The major advantages of this approach are the built-in user interface for 3-D modeling and the ability to read a large variety of CAD-file formats. In addition to supporting our current radiation transport codes and developing new capabilities we are working on some nuclear data needs for homeland security. These projects are carried out and the Lawrence Berkeley National Laboratory 88'' cyclotron and at the Institute for Nuclear Research of the National Academy of Science of Ukraine under an STCU contract.

  17. A Rare Reason of Ileus in Renal Transplant Patients With Peritoneal Dialysis History: Encapsulated Peritoneal Sclerosis.

    PubMed

    Gökçe, Ali Murat; Özel, Leyla; İbişoğlu, Sevinç; Ata, Pınar; Şahin, Gülizar; Gücün, Murat; Kara, V Melih; Özdemir, Ebru; Titiz, M İzzet

    2015-12-01

    Encapsulating peritoneal sclerosis is a rare complication of long-term peritoneal dialysis ranging from moderate inflammation of peritoneal structures to severe sclerosing peritonitis and encapsulating peritoneal sclerosis. Complicated it, ileus may occur during or after peritoneal dialysis treatment or after kidney transplant. We sought to evaluate 3 posttransplant encapsulating peritoneal sclerosis through clinical presentation, radiologic findings, and outcomes. We analyzed 3 renal transplant patients with symptoms of encapsulating peritoneal sclerosis admitted posttransplant to our hospital with ileus between 2012 and 2013. Conservative treatment was applied to the patients whenever necessary to avoid surgery. One patient improved with medical therapy. Surgical treatment was delayed and we decided it as a last resort, in 2 cases with no response to conservative treatment for a long time. Finally, patients with peritoneal dialysis history should be searched carefully before renal transplant for intermittent bowel obstruction story. PMID:25343532

  18. A comprehensive treatment for peritoneal metastases from gastric cancer with curative intent.

    PubMed

    Yonemura, Y; Canbay, E; Li, Y; Coccolini, F; Glehen, O; Sugarbaker, P H; Morris, D; Moran, B; Gonzaletz-Moreno, S; Deraco, M; Piso, P; Elias, D; Batlett, D; Ishibashi, H; Mizumoto, A; Verwaal, V; Mahtem, H

    2016-08-01

    Recently, Peritoneal Surface Oncology Group International (PSOGI) developed a novel comprehensive treatment consisting of cytoreductive surgery (CRS) and perioperative chemotherapy (POC) for the treatment of peritoneal metastases (PM) from gastric cancer with curative intent. This article reviews the results of this treatment and verifies its indication. In this strategy, peritoneal cancer index (PCI) is determined by laparoscopy, and a peritoneal port is placed. Neoadjuvant bidirectional intraperitoneal/systemic chemotherapy (NIPS) is performed for 3 cycles, and then laparotomy is performed. Cytoreductive surgery with peritonectomy procedures and hyperthermic intraperitoneal chemoperfusion (HIPEC) are performed. Multivariate analyses showed that completeness of cytoreduction, pathologic response to NIPS and PCI level and cytologic status after NIPS, as independent prognostic factors. PCI less than cut-off level after NIPS, negative cytology after NIPS, and positive response to NIPS were identified as the indications for comprehensive treatment. Patients who hold these criteria should be considered as the candidates for CRS and HIPEC. PMID:27160355

  19. Effect of gastric acid suppressants and prokinetics on peritoneal dialysis-related peritonitis

    PubMed Central

    Kwon, Ji Eun; Koh, Seong-Joon; Chun, Jaeyoung; Kim, Ji Won; Kim, Byeong Gwan; Lee, Kook Lae; Im, Jong Pil; Kim, Joo Sung; Jung, Hyun Chae

    2014-01-01

    AIM: To investigate the effect of gastric acid suppressants and prokinetics on peritonitis development in peritoneal dialysis (PD) patients. METHODS: This was a single-center, retrospective study. The medical records of 398 PD patients were collected from January 2000 to September 2012 and analyzed to compare patients with at least one episode of peritonitis (peritonitis group, group A) to patients who never had peritonitis (no peritonitis group, group B). All peritonitis episodes were analyzed to compare peritonitis caused by enteric organisms and peritonitis caused by non-enteric organisms. RESULTS: Among the 120 patients who met the inclusion criteria, 61 patients had at least one episode of peritonitis and 59 patients never experienced peritonitis. Twenty-four of 61 patients (39.3%) in group A and 15 of 59 patients (25.4%) in group B used gastric acid suppressants. Only the use of H2-blocker (H2B) was associated with an increased risk of PD-related peritonitis; the use of proton pump inhibitors, other antacids, and prokinetics was not found to be a significant risk factor for PD-related peritonitis. A total of 81 episodes of peritonitis were divided into enteric peritonitis (EP) or non-enteric peritonitis, depending on the causative organism, and gastric acid suppressants and prokinetics did not increase the risk of EP in PD patients. CONCLUSION: The use of H2B showed a trend for an increased risk of overall PD-related peritonitis, although further studies are required to clarify the effects of drugs on PD-related peritonitis. PMID:25057226

  20. Retinoic Acid Improves Morphology of Cultured Peritoneal Mesothelial Cells from Patients Undergoing Dialysis

    PubMed Central

    Retana, Carmen; Sanchez, Elsa I.; Gonzalez, Sirenia; Perez-Lopez, Alejandro; Cruz, Armando; Lagunas-Munoz, Jesus; Alfaro-Cruz, Carmen; Vital-Flores, Socorro; Reyes, José L.

    2013-01-01

    Patients undergoing continuous ambulatory peritoneal dialysis are classified according to their peritoneal permeability as low transporter (low solute permeability) or High transporter (high solute permeability). Factors that determine the differences in permeability between them have not been fully disclosed. We investigated morphological features of cultured human peritoneal mesothelial cells from low or high transporter patients and its response to All trans retinoic Acid (ATRA, vitamin A active metabolite), as compared to non-uremic human peritoneal mesothelial cells. Control cells were isolated from human omentum. High or low transporter cells were obtained from dialysis effluents. Cells were cultured in media containing ATRA (0, 50, 100 or 200 nM). We studied length and distribution of microvilli and cilia (scanning electron microscopy), epithelial (cytokeratin, claudin-1, ZO-1 and occludin) and mesenchymal (vimentin and α-smooth muscle actin) transition markers by immunofluorescence and Western blot, and transforming growth factor β1 expression by Western blot. Low and high transporter exhibited hypertrophic cells, reduction in claudin-1, occludin and ZO-1 expression, cytokeratin and vimentin disorganization and positive α-smooth muscle actin label. Vimentin, α-smooth muscle actin and transforming growth factor- β1 were overexpressed in low transporter. Ciliated cells were diminished in low and high transporters. Microvilli number and length were severely reduced in high transporter. ATRA reduced hypertrophic cells number in low transporter. It also improved cytokeratin and vimentin organization, decreased vimentin and α-smooth muscle actin expression, and increased claudin 1, occludin and ZO-1 expression, in low and high transporter. In low transporter, ATRA reduced transforming growth factor-β1 expression. ATRA augmented percentage of ciliated cells in low and high transporter. It also augmented cilia length in high transporter. Alterations in

  1. Peritonitis with multiple rare environmental bacteria in a patient receiving long-term peritoneal dialysis.

    PubMed

    Levitski-Heikkila, Teresa V; Ullian, Michael E

    2005-12-01

    We describe a patient receiving long-term peritoneal dialysis who experienced 2 episodes of peritonitis in successive months caused by unusual bacteria of environmental origin: Agrobacterium radiobacter, Pseudomonas oryzihabitans, and Corynebacterium aquaticum. A radiobacter and P oryzihabitans occurred simultaneously in the first episode of peritonitis, and C aquaticum, in the second episode. The patient's vocation necessitated exposure to moist soiled conditions. Both episodes responded promptly to antibiotics commonly used to treat peritonitis. Although these organisms rarely lead to loss of life and commonly are considered to be contaminants, they can cause symptomatic peritonitis and peritoneal dialysis catheter loss. A review of previous case reports is included. PMID:16310563

  2. Peritoneal dialysis prescription during the third trimester of pregnancy.

    PubMed

    Batarse, Rodolfo R; Steiger, Ralph M; Guest, Steven

    2015-01-01

    Management of the pregnant patient on peritoneal dialysis (PD) is potentially challenging because uterine enlargement may negatively affect catheter function and prescribed dwell volumes. Additional reports of the management of these patients are needed. Here, we describe a near-full-term delivery in a 27-year-old woman who had been on dialysis for 7 years. Peritoneal dialysis was continued during the entire pregnancy. In the third trimester, a higher delivered automated PD volume allowed for adequate clearance and control of volume status. A decision to hospitalize the patient to limit activity and facilitate the delivery of increased dialysate is believed to have contributed to the successful outcome for mother and infant. Our report discusses the management of this patient and reviews published dialysis prescriptions used during the third trimester of pregnancy in patients treated with PD. PMID:24711639

  3. Explaining socio-economic status differences in walking for transport: An ecological analysis of individual, social and environmental factors

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The identification of potential mechanisms of influence (mediators) of socio-economic status (SES) on walking for transport is important, because the likely opposing forces of influence may obscure pathways for intervention across different SES groups. This study examined individual, and perceived s...

  4. Peritoneal Metastases: Prevention and Treatment.

    PubMed

    Sugarbaker, Paul H

    2016-06-01

    Colorectal cancer is a surgicaly curable disease. It requires multimodality of treatment in Localy advanced and metastatic disease. Molecular markers like RAS mutation has brought in change in the mangement of metastatic disease. Nearly 15 to 20 % presents with peritonieal surface metastasis. The debate continues with systomic vs Cyutoreductive surgery with are without HIPEC. This article highlights management of peritoneal metastasis with special reference to prevention and treatment. PMID:27065703

  5. [Optimal use of peritoneal dialysis fluids in type 2 diabetes mellitus patients].

    PubMed

    Ryckelynck, Jean-Philippe; Allard, Catherine; Cousin, Maud; Hurault de Ligny, Bruno; El Haggan, Wael; Lobbedez, Thierry

    2006-01-01

    The glucose side-effects, the main osmotic agent in conventional peritoneal dialysis (PD) solutions, are structural and functional changes of the peritoneal membrane, especially diabetic alterations in the microvasculature. Therefore, hyperpermeability with high small solutes transport and less ultrafiltration necessitates more and more high glucose concentration solutions. Glucose degradation products (PDF) and advanced glycation end-products (AGE) are formed and may induce peritoneal membrane alterations. More biocompatible solutions have to be used with less PDF and physiological pH. Icodextrin containing PD solutions have beneficial effect on sustained ultrafiltration for long dwells in PD, limitating fluid overload common in PD patients above all during peritonitis episodes. Amino acid-based PD solutions contribute to the prevention of malnutrition often observed in the diabetic PD population. PMID:17378147

  6. The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial

    PubMed Central

    Johnson, David W.; Brown, Fiona G.; Clarke, Margaret; Boudville, Neil; Elias, Tony J.; Foo, Marjorie W.Y.; Jones, Bernard; Kulkarni, Hemant; Langham, Robyn; Ranganathan, Dwarakanathan; Schollum, John; Suranyi, Michael G.; Tan, Seng H.; Voss, David

    2012-01-01

    Background The balANZ trial recently reported that neutral pH, low glucose degradation product (biocompatible) peritoneal dialysis (PD) solutions significantly delayed anuria and reduced peritonitis rates compared with conventional solutions. This article reports a secondary outcome analysis of the balANZ trial with respect to peritoneal membrane function. Methods Adult, incident PD patients with residual renal function were randomized to receive either biocompatible or conventional (control) PD solutions for 2 years. Peritoneal equilibration tests were performed at 1, 6, 12, 18 and 24 months. Peritoneal small solute clearances and ultra-filtration (UF) were measured at 3, 6, 9, 12, 18 and 24 months. Results Of the 185 patients recruited into the trial, 85 patients in the Balance group and 82 patients in the control group had peritoneal membrane function evaluated. Mean 4-h dialysate:plasma creatinine ratios (D:P Cr 4h) at 1 month were significantly higher in the Balance group compared with controls (0.67 ± 0.10 versus 0.62 ± 0.10, P = 0.002). Over the 2-year study period, mean D:P Cr 4 h measurements remained stable in the Balance group but increased significantly in controls [difference −0.004 per month, 95% confidence interval (95% CI) −0.005 to −0.002, P < 0.001]. Similar results were obtained for dialysate glucose ratios (D/D0 glucose). Peritoneal UF was significantly lower in the Balance group than in controls at 3 and 6 months. Over the 2-year study period, peritoneal UF increased significantly in the Balance group but remained stable in controls (difference 24 mL/day/month, 95% CI 9–39, P = 0.002). No differences in peritoneal small solute clearances, prescribed dialysate fill volumes or peritoneal glucose exposure were observed between the two groups. Conclusions Biocompatible and conventional PD solutions exert differential effects on peritoneal small solute transport rate and UF over time. Adequately powered trials assessing the impact of these

  7. Mycobacterium fortuitum Peritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis (CAPD): A Case Report.

    PubMed

    Sangwan, Jyoti; Lathwal, Sumit; Kumar, Satish; Juyal, Deepak

    2013-12-01

    Mycobacterium fortuitum, an environmental organism, is capable of producing a variety of clinical infections such as cutaneous infections, abscesses and nosocomial infections. Rarely, it has been a documented as a cause of peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD). Continuous Ambulatory Peritoneal dialysis (CAPD) is one of the treatment options which are used for patients with end-stage renal disease (ESRD). Although peritonitis rates have declined in parallel with advances in peritoneal dialysis (PD) technology, peritonitis remains a leading complication of CAPD and it is the major cause for transfer to other methods of dialysis. We are reporting a case of M. fortuitum peritonitis in a patient who was undergoing CAPD, which was successfully treated. This case emphasizes the importance of mycobacterial cultures in patients with CAPD-associated peritonitis, whose routine cultures may yield no organisms. PMID:24551685

  8. Peritonitis and catheter exit-site infection in patients on peritoneal dialysis at home1

    PubMed Central

    Abud, Ana Cristina Freire; Kusumota, Luciana; dos Santos, Manoel Antônio; Rodrigues, Flávia Fernanda Luchetti; Damasceno, Marta Maria Coelho; Zanetti, Maria Lúcia

    2015-01-01

    Objective: to analyze the complications related to peritonitis and catheter exit-site infections, in patients on peritoneal dialysis at home. Method: quantitative and cross-sectional study, carried out with 90 patients on peritoneal dialysis at home, in a municipality in the Northeast region of Brazil. For data collection, it was used two structured scripts and consultation on medical records. Descriptive analysis and comparison tests among independent groups were used, considering p<0.05 as level of statistical significance. Results: by comparing the frequency of peritonitis and the length of treatment, it was found that patients over two years of peritoneal dialysis were more likely to develop peritonitis (X²=6.39; p=0.01). The number of episodes of peritoneal catheter exit-site infection showed association with the length of treatment (U=224,000; p=0.015). Conclusion: peritonitis and catheter exit-site infection are associated with the length of treatment. PMID:26487141

  9. Relapsing peritonitis with Bacillus cereus in a patient on continuous ambulatory peritoneal dialysis.

    PubMed

    Magnussen, Eyð Tausen; Vang, Amanda Gratton; Á Steig, Torkil; Gaini, Shahin

    2016-01-01

    We present a case where Bacillus cereus was determined to be the causative agent of relapsing peritonitis in a patient on continuous ambulatory peritoneal dialysis (CAPD). The patient, a 70-year-old man from the Faroe Islands, was admitted with relapsing peritonitis four times over a 3-month period. Peritoneal cultures were positive for growth of B. cereus, a rare bacterial cause of peritonitis. The cultures demonstrated susceptibility to vancomycin, and therefore the patient was treated with intraperitoneal vancomycin, intraperitoneal gentamycin and oral ciprofloxacin. As a result of the relapsing B. cereus peritonitis diagnosis and a CT scan showing contraction of the peritoneum after longstanding inflammation, the peritoneal catheter was removed and the patient converted to haemodialysis. To date, the patient has not been readmitted due to peritonitis. A lack of proper hygiene when changing the dialysis bag was the suspected source of infection with B. cereus. PMID:27118739

  10. Mesenteric ischemia masquerading as refractory peritonitis in continuous ambulatory peritoneal dialysis patients.

    PubMed

    Vishwakarma, K; Anandh, U

    2015-01-01

    We report two cases of mesenteric ischemia in patients on long term peritoneal dialysis both of which were associated with poor outcomes. Both were diabetic and on peritoneal dialysis for a long time. On evaluation of refractory peritonitis we found evidence of non occlusive mesenteric ischemia. Despite adequate treatment both succumbed to their illness. Abdominal pathology, especially mesenteric ischemia leading to gut infarction, should be considered in patients with refractory peritonitis. PMID:26664217

  11. Diffuse peritoneal deciduosis mimicking metastatic lesions

    PubMed Central

    Baroni Cruz, Dennis; Dhamer, Thricy; da Rocha, Vívian Wünderlich; Dupont, Roberta Finkler

    2014-01-01

    A 32-year-old woman with an uneventful antenatal period underwent a caesarean section for breech presentation. At laparotomy, there were multiple yellowish elastic nodules distributed along the parietal peritoneal surface, totalling over 30 lesions and worrying the surgical team. The conclusive diagnosis of peritoneal deciduosis was supported by pathological analysis (histology and immunohistochemistry). The present case reports an uncommon presentation of diffuse peritoneal deciduosis mimicking metastatic lesions. PMID:24526201

  12. Dialysate leaks in peritoneal dialysis.

    PubMed

    Leblanc, M; Ouimet, D; Pichette, V

    2001-01-01

    Dialysate leakage represents a major noninfectious complication of peritoneal dialysis (PD). An exit-site leak refers to the appearance of any moisture around the PD catheter identified as dialysate; however, the spectrum of dialysate leaks also includes any dialysate loss from the peritoneal cavity other than via the lumen of the catheter. The incidence of dialysate leakage is somewhat more than 5% in continuous ambulatory peritoneal dialysis (CAPD) patients, but this percentage probably underestimates the number of early leaks. The incidence of hydrothorax or pleural leak as a complication of PD remains unclear. Factors identified as potentially related to dialysate leakage are those related to the technique of PD catheter insertion, the way PD is initiated, and weakness of the abdominal wall. The pediatric literature tends to favor Tenckhoff catheters over other catheters as being superior with respect to dialysate leakage, but no consensus on catheter choice exists for adults in this regard. An association has been found between early leaks (< or =30 days) and immediate CAPD initiation and perhaps median catheter insertion. Risk factors contributing to abdominal weakness appear to predispose mostly to late leaks; one or more of them can generally be identified in the majority of patients. Early leakage most often manifests as a pericatheter leak. Late leaks may present more subtly with subcutaneous swelling and edema, weight gain, peripheral or genital edema, and apparent ultrafiltration failure. Dyspnea is the first clinical clue to the diagnosis of a pleural leak. Late leaks tend to develop during the first year of CAPD. The most widely used approach to determine the exact site of the leakage is with computed tomography after infusion of 2 L of dialysis fluid containing radiocontrast material. Treatments for dialysate leaks include surgical repair, temporary transfer to hemodialysis, lower dialysate volumes, and PD with a cycler. Recent recommendation propose

  13. Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans

    PubMed Central

    2011-01-01

    An 87 -year-old female who was undergoing peritoneal dialysis presented with peritonitis caused by Alcaligenes faecalis and Pantoea agglomerans in consecutive years. With the following report we discuss the importance of these unusual microorganisms in peritoneal dialysis patients. PMID:21477370

  14. Pathophysiology and prevention of postoperative peritoneal adhesions

    PubMed Central

    Arung, Willy; Meurisse, Michel; Detry, Olivier

    2011-01-01

    Peritoneal adhesions represent an important clinical challenge in gastrointestinal surgery. Peritoneal adhesions are a consequence of peritoneal irritation by infection or surgical trauma, and may be considered as the pathological part of healing following any peritoneal injury, particularly due to abdominal surgery. The balance between fibrin deposition and degradation is critical in determining normal peritoneal healing or adhesion formation. Postoperative peritoneal adhesions are a major cause of morbidity resulting in multiple complications, many of which may manifest several years after the initial surgical procedure. In addition to acute small bowel obstruction, peritoneal adhesions may cause pelvic or abdominal pain, and infertility. In this paper, the authors reviewed the epidemiology, pathogenesis and various prevention strategies of adhesion formation, using Medline and PubMed search. Several preventive agents against postoperative peritoneal adhesions have been investigated. Their role aims in activating fibrinolysis, hampering coagulation, diminishing the inflammatory response, inhibiting collagen synthesis or creating a barrier between adjacent wound surfaces. Their results are encouraging but most of them are contradictory and achieved mostly in animal model. Until additional findings from future clinical researches, only a meticulous surgery can be recommended to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery. In the current state of knowledge, pre-clinical or clinical studies are still necessary to evaluate the effectiveness of the several proposed prevention strategies of postoperative peritoneal adhesions. PMID:22147959

  15. Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

    MedlinePlus

    ... Professionals Questions to Ask about Your Treatment Research Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal ... primary peritoneal cancer that are not listed here. Drugs Approved for Ovarian, Fallopian Tube, or Primary Peritoneal ...

  16. Pleuro-Peritoneal Fistula – An Important Condition to Consider in Patients using Peritoneal Dialysis.

    PubMed

    Shah, Shreena; Robson, Natalie; Sajid, Salman

    2015-01-01

    Pleural effusions are a common finding in patients admitted on the medical take. This case decribes a patient using peritoneal dialysis who presented with progressive dyspnoea. Clinical examination and chest x-ray confirmed the presence of a pleural effusion. Thoracocentesis confirmed a 'sweet' effusion (higher pleural: serum glucose content), suggesting a pleuro-peritoneal leak. Optimal management involved switch from peritoneal to haemodialysis and referral to a specialised renal unit. This case highlights the need to consider the diagnosis of pleuro-peritoneal leak in patients using peritoneal dialysis who present to the acute medical unit with pleural effusion. PMID:26305084

  17. Oral Tori in Chronic Peritoneal Dialysis Patients

    PubMed Central

    Hsu, Chia-Lin; Hsu, Ching-Wei; Chang, Pei-Ching; Huang, Wen-Hung; Weng, Cheng-Hao; Yang, Huang-Yu; Liu, Shou-Hsuan; Chen, Kuan-Hsing; Weng, Shu-Man; Chang, Chih-Chun; Wang, I-Kuan

    2016-01-01

    .790). Furthermore, there were no differences between patients with and without oral tori in dialysis adequacy (weekly Kt/Vurea, 2.14±0.39 versus 2.11±0.33, P = 0.533; weekly creatinine clearance rate, 59.31±17.58 versus 58.57±13.20 L/1.73 m2, P = 0.781), or peritoneal membrane transporter characteristics (P = 0.098). Conclusion Secondary hyperparathyroidism does not contribute to the formation of tori in peritoneal dialysis patients. Further studies are warranted. PMID:27275607

  18. In vitro Staphylococcus aureus-induced oxidative stress in mice murine peritoneal macrophages: a duration-dependent approach

    PubMed Central

    Chakraborty, Subhankari Prasad; Roy, Somenath

    2014-01-01

    Objective To evaluate the free radical generation and status of the antioxidant enzymes in murine peritoneal macrophage during in vitro vancomycin sensitive Staphylococcus aureus (VSSA) treatment with different time interval. Methods Peritoneal macrophages were treated with 5×106 CFU/mL VSSA cell suspension in vitro for different time interval (1, 2, 3, 6, 12, and 24 h) and superoxide anion generation, NADPH oxidase activity, myeloperoxidase activity, nitric oxide generation, antioxidant enzyme status and components of glutathione cycle were analyzed. Results Superoxide anion generation, NADPH oxidase activity, myeloperoxidase activity and nitric oxide generation got peak at 3 h, indicating maximum free radical generation through activation of NADPH oxidase in murine peritoneal macrophages during VSSA infection. Reduced glutathione level, glutathione peroxidase, glutathione reductase, and glutathione-s-transferase activity were decreased significantly (P<0.05) with increasing time of VSSA infection. But the oxidized glutathione level was time dependently increased significantly (P<0.05) in murine peritoneal macrophages. All the changes in peritoneal macrophages after 3 h in vitro VSSA treatment had no significant difference. Conclusions From this study, it may be summarized that in vitro VSSA infection not only generates excess free radical but also affects the antioxidant status and glutathione cycle in murine peritoneal macrophages. PMID:25183101

  19. Fluid dwell impact induces peritoneal fibrosis in the peritoneal cavity reconstructed in vitro.

    PubMed

    Aoki, Shigehisa; Noguchi, Mitsuru; Takezawa, Toshiaki; Ikeda, Satoshi; Uchihashi, Kazuyoshi; Kuroyama, Hiroyuki; Chimuro, Tomoyuki; Toda, Shuji

    2016-03-01

    Peritoneal fluid dwell impacts the peritoneum by creating an abnormal physiological microenvironment. Little is known about the precise effects of fluid dwell on the peritoneum, and no adequate in vitro models to analyze the impact of fluid dwell have been established. In this study, we developed a peritoneal fluid dwell model combined with an artificial peritoneal cavity and fluid stirring generation system to clarify the effects of different dwelling solutions on the peritoneum over time. To replicate the peritoneal cavity, we devised a reconstructed peritoneal cavity utilizing a mesothelial layer, endothelial layer, and collagen membrane chamber. The reconstructed peritoneal cavity was infused with Dulbecco's modified Eagle's medium, saline, lactated Ringer's solution or peritoneal dialysis solution with repeated 4-h dwells for 10 or 20 consecutive days. The above-described solutions induced epithelial-mesenchymal transition (EMT) and hyperplasia of mesothelial cells. All solution types modulated nitric oxide synthase activities in mesothelial and endothelial cells and nitric oxide concentrations in dwelling solutions. Inhibition of nitric oxide synthase activity acted synergistically on mesothelial EMT and hyperplasia. The present findings suggest that solutions infused into the peritoneal cavity are likely to affect nitric oxide production in the peritoneum and promote peritoneal fibrosis. Our newly devised peritoneal cavity model should be a promising tool for understanding peritoneal cellular kinetics and homeostasis. PMID:26318752

  20. Chronic Infusion of Sterile Peritoneal Dialysis Solution Abrogates Enhanced Peritoneal Gene Expression Responses to Chronic Peritoneal Catheter Presence

    PubMed Central

    Zakaria, El Rasheid; Matheson, Paul J.; Hurt, Ryan T.; Garrison, Richard N.

    2008-01-01

    Chronic exposure to sterile peritoneal dialysis (PD) solutions is associated with microvascular and interstitial changes within the blood–peritoneal barrier (peritoneum). These changes are commonly linked to loss of peritoneal function over time, presumably because of angiogenesis-related increased vascular area. However, the effects on peritoneal microvascular function of chronic peritoneal exposure to PD solutions are unknown. The present study examined peritoneal microvascular function after chronic exposure to sterile PD solution. Six rats underwent permanent catheter insertion under anesthesia. Three rats were treated with approximately 16 mL conventional PD solution daily for 6 weeks; catheter insertion controls received 1 mL saline daily. At 6 weeks, visceral peritoneal microvascular function was assessed in vivo using intravital microscopy. Endothelial cell functions were assessed using messenger RNA (mRNA) gene microarray analysis. In both groups, significant angiogenesis was seen, predominantly in the base of the mesentery. Sensitivity and reactivity of the intestinal visceral peritoneal pre-capillary arterioles (A3 arterioles, 8 – 15μm in diameter) were decreased in the catheter controls, but not in the chronic PD infusion rats. Chronic catheter presence increased the expression of 18 genes in the controls as compared with 12 genes in the chronic infusion rats. In both groups, expression of fibronectin, integrin-β, integrin-α5, collagen type XVIII-α1, and matrix metalloproteinase was enhanced. Endothelial expression of proinflammatory genes (interleukin-1β tissue pathway inhibitor, chemokine ligand 2) was enhanced by chronic catheter insertion, but not after chronic PD fluid infusion. Increased expression of genes encoding proteins involved in inflammation and tissue remodeling results from peritoneal catheter–related endothelial cell activation. Chronic exposure of the nonuremic peritoneum to sterile PD solutions overrides the catheter

  1. Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma

    PubMed Central

    Iacoponi, S; Calleja, J; Hernandez, G; de la Cuesta, R Sainz

    2015-01-01

    Benign multicystic mesothelioma is a rare tumour that originates from the abdominal peritoneum with a predisposition to the pelvic peritoneum. It typically affects women of reproductive age. There have been less than 200 cases of this rare neoplasia reported to date. We present the case of a 35-year-old woman who was referred to our centre because of the detection of a peritoneal carcinomatosis during a gynaecological exam. A diagnostic laparoscopy was performed. The findings included multiple cysts appearing as ‘a bunch of grapes’ occupying the omentum. Biopsies were taken during the surgery and the results showed benign multicystic peritoneal mesothelioma. Benign multicystic mesothelioma can simulate other conditions, such as malignant ovarian tumours or cystic lymphangioma. It is often diagnosed accidentally during surgery performed for another reason. The diagnosis is interoperative, observing multicystic structures grouped as a ‘bunch of grapes’ containing clear fluid with thin walls made of connective tissue. Immunohistochemistry confirmed mesothelial origin. Surgery is considered the treatment of choice and is based on the removal of the cysts from the abdominal cavity. Hyperthermic intraperitoneal chemotherapy can be considered as a primary treatment in patients with recurrences or even as a part of primary treatment associated with surgery. Survival at 5 years is 100% and invasive or malignant progression is extraordinary. The treatment approach should be multidisciplinary, and the patient should be referred to a referral centre. PMID:26715942

  2. A Report of Peritonitis from Aeromonas sobria in a Peritoneal Dialysis (PD) Patient with Necrotizing Fasciitis.

    PubMed

    Janma, Jirayut; Linasmita, Patcharasarn; Changsirikulchai, Siribha

    2015-11-01

    A 70-years of age, male patient with underlying type 2 diabetes mellitus, hypertension, dyslipidemia and ischemic heart disease had undergone continuous ambulatory peritoneal dialysis (CAPD)for 3 years without any episodes of peritonitis. He was diagnosed with necrotizing fasciitis and later developed peritonitis after receiving a laceration from an aquatic injury suffered during the flood disaster of 2011. The blood culture, necrotic tissue and the clear dialysate collected upon admission had shown Aeromonas sobria. The route of peritonitis may be from the hematogenous spread of A. sobria resulting in necrotizing fasciitis. A. sobria should be considered as the pathogen of peritonitis in PD patients who have history of wounds from contaminated water. We suggest that the PD patients who present with septicemia and did not meet the criteria for peritonitis, the initial dialysate effluent should be sent for culture. The benefit of this is to allow early recognition and treatment of peritonitis. PMID:27276849

  3. Spilled Gallstones Mimicking Peritoneal Metastases

    PubMed Central

    Loan, William; Carey, Declan P.

    2009-01-01

    Background: Spillage of bile and gallstones due to accidental perforation of the gallbladder wall is often encountered during laparoscopic cholecystectomy. Although spilled stones were once considered harmless, there is increasing evidence that they can result in septic or other potential complications. Case Report: We report a case of spilled gallstones mimicking peritoneal metastases on radiological investigations; diagnosis was confirmed by diagnostic laparoscopy. Conclusion: Every effort should be made to retrieve spilled gallstones during laparoscopic cholecystectomy. When all the stones cannot be retrieved, it should be documented in the patient's medical records to avoid delay in the diagnosis of late complications. Diagnostic laparoscopy is useful when the radiological investigations are inconclusive. PMID:19366546

  4. Chronic peritoneal dialysis in children

    PubMed Central

    Fraser, Nia; Hussain, Farida K; Connell, Roy; Shenoy, Manoj U

    2015-01-01

    The incidence of end-stage renal disease in children is increasing. Peritoneal dialysis (PD) is the modality of choice in many European countries and is increasingly applied worldwide. PD enables children of all ages to be successfully treated while awaiting the ultimate goal of renal transplantation. The advantages of PD over other forms of renal replacement therapy are numerous, in particular the potential for the child to lead a relatively normal life. Indications for commencing PD, the rationale, preparation of family, technical aspects, and management of complications are discussed. PMID:26504404

  5. [The past and present of peritoneal dialysis].

    PubMed

    Polner, Kálmán

    2008-01-01

    The author reviews briefly the history of peritoneal dialysis, and highlights the significance of the work of two Hungarian nephrologists, Stephen I. Vas and István Taraba . By now, peritoneal dialysis has been considered as equal renal replacement modality compared to haemodialysis. It is even more advantageous in the protection of the patients' residual renal function, morbidity-mortality indices, and quality of life peritoneal dialysis in the first two years. From economical point of view peritoneal dialysis is less expensive than hemodialysis, therefore in the future its greater role can be expected in the treatment of more and more renal patients. The recently achieved technical development, and also the more widespread use of the automated peritoneal dialysis machines contribute to quality improvement. The peritoneal dialysis therapy, by the patients' self-treatment, establishes a new kind of relationship between the patients and the medical personnel; there is a growing requirement for patient education, the patients' self-esteem and cooperation increase, which altogether provides better results in rehabilitation and higher quality of life. Our national peritoneal dialysis utilization falls behind the European achievements, but has been growing dynamically, and we can expect an increase of the number of renal patients on peritoneal dialysis. PMID:18089476

  6. Molecular Mechanisms Underlying Peritoneal EMT and Fibrosis

    PubMed Central

    Strippoli, Raffaele; Moreno-Vicente, Roberto; Battistelli, Cecilia; Cicchini, Carla; Noce, Valeria; Amicone, Laura; Marchetti, Alessandra; del Pozo, Miguel Angel; Tripodi, Marco

    2016-01-01

    Peritoneal dialysis is a form of renal replacement alternative to the hemodialysis. During this treatment, the peritoneal membrane acts as a permeable barrier for exchange of solutes and water. Continual exposure to dialysis solutions, as well as episodes of peritonitis and hemoperitoneum, can cause acute/chronic inflammation and injury to the peritoneal membrane, which undergoes progressive fibrosis, angiogenesis, and vasculopathy, eventually leading to discontinuation of the peritoneal dialysis. Among the different events controlling this pathological process, epithelial to mesenchymal transition of mesothelial cells plays a main role in the induction of fibrosis and in subsequent functional deterioration of the peritoneal membrane. Here, the main extracellular inducers and cellular players are described. Moreover, signaling pathways acting during this process are elucidated, with emphasis on signals delivered by TGF-β family members and by Toll-like/IL-1β receptors. The understanding of molecular mechanisms underlying fibrosis of the peritoneal membrane has both a basic and a translational relevance, since it may be useful for setup of therapies aimed at counteracting the deterioration as well as restoring the homeostasis of the peritoneal membrane. PMID:26941801

  7. The surgical management of peritoneal dialysis catheters.

    PubMed Central

    Brook, Nicholas R.; White, Steven A.; Waller, Julian R.; Nicholson, Michael L.

    2004-01-01

    Peritoneal dialysis is a safe and effective form of renal-replacement therapy. Its use is increasing as the gap widens between the number of patients waiting for renal transplants and the number of available organs. This article reviews the surgical considerations and complications of peritoneal dialysis that may present to general surgeons. PMID:15140305

  8. P-glycoprotein Mediates Postoperative Peritoneal Adhesion Formation by Enhancing Phosphorylation of the Chloride Channel-3

    PubMed Central

    Deng, Lulu; Li, Qin; Lin, Guixian; Huang, Dan; Zeng, Xuxin; Wang, Xinwei; Li, Ping; Jin, Xiaobao; Zhang, Haifeng; Li, Chunmei; Chen, Lixin; Wang, Liwei; Huang, Shulin; Shao, Hongwei; Xu, Bin; Mao, Jianwen

    2016-01-01

    P-glycoprotein (P-gp) is encoded by the multidrug resistance (MDR1) gene and is well studied as a multi-drug resistance transporter. Peritoneal adhesion formation following abdominal surgery remains an important clinical problem. Here, we found that P-gp was highly expressed in human adhesion fibroblasts and promoted peritoneal adhesion formation in a rodent model. Knockdown of P-gp expression by intraperitoneal injection of MDR1-targeted siRNA significantly reduced both the peritoneal adhesion development rate and adhesion grades. Additionally, we found that operative injury up-regulated P-gp expression in peritoneal fibroblasts through the TGF-β1/Smad signaling pathway and histone H3 acetylation. The overexpression of P-gp accelerated migration and proliferation of fibroblasts via volume-activated Cl- current and cell volume regulation by enhancing phosphorylation of the chloride channel-3. Therefore, P-gp plays a critical role in postoperative peritoneal adhesion formation and may be a valuable therapeutic target for preventing the formation of peritoneal adhesions. PMID:26877779

  9. A Status of the Advanced Space Transportation Program from Planning to Action

    NASA Technical Reports Server (NTRS)

    Lyles, Garry; Griner, Carolyn

    1998-01-01

    A Technology Plan for Enabling Commercial Space Business was presented at the 48th International Astronautical Congress in Turin, Italy. This paper presents a status of the program's accomplishments. Technology demonstrations have progressed in each of the four elements of the program; (1) Low Cost Technology, (2) Advanced Reusable Technology, (3) Space Transfer Technology and (4) Space Transportation Research. The Low Cost Technology program element is primarily focused at reducing development and acquisition costs of aerospace hardware using a "design to cost" philosophy with robust margins, adapting commercial manufacturing processes and commercial off-the-shelf hardware. The attributes of this philosophy for small payload launch are being demonstrated at the component, sub-system, and system level. The X-34 "Fastrac" engine has progressed through major component and subsystem demonstrations. A propulsion system test bed has been implemented for system-level demonstration of component and subsystem technologies; including propellant tankage and feedlines, controls, pressurization, and engine systems. Low cost turbopump designs, commercial valves and a controller are demonstrating the potential for a ten-fold reduction in engine and propulsion system costs. The Advanced Reusable Technology program element is focused on increasing life through high strength-to-weight structures and propulsion components, highly integrated propellant tanks, automated checkout and health management and increased propulsion system performance. The validation of rocket based combined cycle (RBCC) propulsion is pro,-,ressing through component and subsystem testing. RBCC propulsion has the potential to provide performance margin over an all rocket system that could result in lower gross liftoff weight, a lower propellant mass fraction or a higher payload mass fraction. The Space Transfer Technology element of the program is pursuing technology that can improve performance and

  10. Postnatal Treatment in Antenatally Diagnosed Meconium Peritonitis.

    PubMed

    Ionescu, S; Andrei, B; Oancea, M; Licsandru, E; Ivanov, M; Marcu, V; Popa-Stanila, R; Mocanu, M

    2015-01-01

    Meconium peritonitis is a rare prenatal disease with an increased rate of morbidity and mortality in the neonatal period. Distinctive features revealed by prenatal and postnatal ultrasoundmay be present: abdominal calcifications, ascites, polyhydramnios, meconium pseudocyst, echogenic mass and dilated bowel or intestinal obstruction. Establishing clear postnatal treatment and prognosis is difficult because of the heterogeneity of the results obtained by ultrasound. The aim of the study is to determine how prenatal diagnosis of meconium peritonitis is associated with perinatal management and further evolution. Clinical results are different depending on the presence of antenatal diagnosis of meconium peritonitis and its form, which can be mild or severe. Surgical treatment and management of meconium peritonitis depend on the clinical presentation of the newborn. Meconium peritonitis diagnosed prenatally differs from that of the newborn, not only concerning the mortality rates but also through reduced morbidity and overall better prognosis. PMID:26713828

  11. Simultaneous measurement of peritoneal glucose and free water osmotic conductances.

    PubMed

    La Milia, V; Limardo, M; Virga, G; Crepaldi, M; Locatelli, F

    2007-09-01

    Ultrafiltration (UF) failure is one of the most important causes of long-term peritoneal dialysis (PD) failure in patients. Osmotic forces acting across small and ultra-small pores generate a UF with solutes through the small pore and free water transport (FWT) through the ultra-small pore. The ability of glucose to exert an osmotic pressure sufficient to cause UF is the so-called 'osmotic conductance to glucose' (OCG) of the peritoneal membrane. Our study proposes a simple method to determine both the OCG and FWT. In 50 patients on PD, a Double Mini-Peritoneal Equilibration Test (Double Mini-PET), consisting of two Mini-PET, was performed consecutively. A solution of 1.36% glucose was used for the first test, whereas a solution of 3.86% glucose was used for the second test. The sodium removal values and the differences in UF between the two tests were used to calculate FWT and the OCG. Patients with UF failure showed significant reductions not only in the OCG and the FWT but also of UF of small pores. The Double Mini-PET is simple, fast, and could become useful to evaluate patients on PD in everyday clinical practice. PMID:17609692

  12. Inflammation and the Peritoneal Membrane: Causes and Impact on Structure and Function during Peritoneal Dialysis

    PubMed Central

    Baroni, Gilberto; Schuinski, Adriana; de Moraes, Thyago P.; Meyer, Fernando; Pecoits-Filho, Roberto

    2012-01-01

    Peritoneal dialysis therapy has increased in popularity since the end of the 1970s. This method provides a patient survival rate equivalent to hemodialysis and better preservation of residual renal function. However, technique failure by peritonitis, and ultrafiltration failure, which is a multifactorial complication that can affect up to 40% of patients after 3 years of therapy. Encapsulant peritoneal sclerosis is an extreme and potentially fatal manifestation. Causes of inflammation in peritoneal dialysis range from traditional factors to those related to chronic kidney disease per se, as well as from the peritoneal dialysis treatment, including the peritoneal dialysis catheter, dialysis solution, and infectious peritonitis. Peritoneal inflammation generated causes significant structural alterations including: thickening and cubic transformation of mesothelial cells, fibrin deposition, fibrous capsule formation, perivascular bleeding, and interstitial fibrosis. Structural alterations of the peritoneal membrane described above result in clinical and functional changes. One of these clinical manifestations is ultrafiltration failure and can occur in up to 30% of patients on PD after five years of treatment. An understanding of the mechanisms involved in peritoneal inflammation is fundamental to improve patient survival and provide a better quality of life. PMID:22547910

  13. 21 CFR 876.5630 - Peritoneal dialysis system and accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Peritoneal dialysis system and accessories. 876... Peritoneal dialysis system and accessories. (a) Identification. (1) A peritoneal dialysis system and... peritoneal dialysis, a source of dialysate, and, in some cases, a water purification mechanism. After...

  14. 21 CFR 876.5630 - Peritoneal dialysis system and accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Peritoneal dialysis system and accessories. 876... Peritoneal dialysis system and accessories. (a) Identification. (1) A peritoneal dialysis system and... peritoneal dialysis, a source of dialysate, and, in some cases, a water purification mechanism. After...

  15. 21 CFR 876.5630 - Peritoneal dialysis system and accessories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Peritoneal dialysis system and accessories. 876... Peritoneal dialysis system and accessories. (a) Identification. (1) A peritoneal dialysis system and... peritoneal dialysis, a source of dialysate, and, in some cases, a water purification mechanism. After...

  16. 21 CFR 876.5630 - Peritoneal dialysis system and accessories.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Peritoneal dialysis system and accessories. 876... Peritoneal dialysis system and accessories. (a) Identification. (1) A peritoneal dialysis system and... peritoneal dialysis, a source of dialysate, and, in some cases, a water purification mechanism. After...

  17. 21 CFR 876.5630 - Peritoneal dialysis system and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Peritoneal dialysis system and accessories. 876... Peritoneal dialysis system and accessories. (a) Identification. (1) A peritoneal dialysis system and... peritoneal dialysis, a source of dialysate, and, in some cases, a water purification mechanism. After...

  18. Cameraless Peritoneal Entry in Abdominal Laparoscopy

    PubMed Central

    Carlson, William H.; Tully, Griffeth; Rajguru, Amit; Burnett, Dan R.

    2012-01-01

    Background and Objectives: Despite significant advances in laparoscopic instrumentation and techniques, injury to intraabdominal structures remains a potentially serious complication of peritoneal access. Consensus on the best method to obtain peritoneal access is lacking. A safe technique that does not rely on direct visualization of the abdominal layers could shorten the learning curve for surgeons and potentially be adopted by other physicians for a variety of nonsurgical indications for peritoneal entry. Methods: A prospective series of 99 consecutive patients who underwent upper-abdominal laparoscopic surgery performed by a single surgeon between January 2009 and June 2010 was reviewed. The method used to obtain peritoneal access was the fluid-based peritoneal entry indication technique (C-PET) with the EndoTIP trocar. Results: Successful abdominal entry using C-PET was achieved in 90 (90.9%) of the patients; no trocar-related injuries or other injuries associated with peritoneal access occurred. The mean time from incision to confirmed peritoneal access was 21.4 s (range, 12 to 65). Of the 9 cases in which C-PET did not successfully gain entry, 6 occurred during the first 20 surgeries and only 3 in the final 79. Conclusions: C-PET is simple, safe, timely, and effective for gaining peritoneal access during laparoscopic abdominal surgeries. In this series, C-PET produced no complications and proved effective across a wide variety of patients, including the obese and those who had had previous surgery. Furthermore, C-PET does not require visual recognition of anatomic layers and potentially could easily be taught to nonsurgeon physicians who perform peritoneal access. PMID:23484564

  19. Satisfaction with care in peritoneal dialysis patients.

    PubMed

    Kirchgessner, J; Perera-Chang, M; Klinkner, G; Soley, I; Marcelli, D; Arkossy, O; Stopper, A; Kimmel, P L

    2006-10-01

    Patient satisfaction is an important aspect of dialysis care, only recently evaluated in clinical studies. We developed a tool to assess peritoneal dialysis (PD) customer satisfaction, and sought to evaluate and validate the Customer Satisfaction Questionnaire (CSQ), quantifying PD patient satisfaction. The CSQ included questions regarding administrative issues, Delivery Service, PD Training, Handling Requests, and transportation. The study was performed using interviews in all Hungarian Fresenius Medical Care dialysis centers offering PD. CSQ results were compared with psychosocial measures to identify if patient satisfaction was associated with perception of social support and illness burden, or depression. We assessed CSQ internal consistency and validity. Factor analysis explored potential underlying dimensions of the CSQ. One hundred and thirty-three patients treated with PD for end-stage renal disease for more than 3 months were interviewed. The CSQ had high internal consistency. There was high patient satisfaction with customer service. PD patient satisfaction scores correlated with quality of life (QOL) and social support measures, but not with medical or demographic factors, or depressive affect. The CSQ is a reliable tool to assess PD customer satisfaction. PD patient satisfaction is associated with perception of QOL. Efforts to improve customer satisfaction may improve PD patients' quantity as well as QOL. PMID:16900092

  20. A case of tuberculous peritonitis in childhood.

    PubMed

    Avcu, Gulhadiye; Sensoy, Gulnar; Karli, Arzu; Caltepe, Gonul; Sullu, Yurdanur; Belet, Nursen; Bilgici, Meltem C

    2015-01-01

    Currently, tuberculosis remains a major public health problem worldwide. Peritoneal tuberculosis occurs in approximately 1% of all of tuberculosis cases and is rarely observed in children. Diagnosis and treatment delays caused by mimicking many other intra-abdominal diseases can lead to increases in morbidity and mortality. Here, we present a case of a four-year-old child with tuberculosis peritonitis who was diagnosed by laparoscopic biopsy and histopathological examination and recovered with antituberculosis therapy. Peritoneal tuberculosis should be considered in younger patients and adults with fever, abdominal pain and weight loss in endemic areas. PMID:25868903

  1. Peritoneal tuberculosis in pregnancy: a case report

    PubMed Central

    Alaoui, Fatima Zohra Fdili; Rachad, Myriem; Chaara, Hikmat; Bouguern, Hakima; Melhouf, Moulay Abdilah

    2012-01-01

    Peritoneal tuberculosis in pregnancy is one of the least common forms of extrapulmonory tuberculosis in pregnancy. Early diagnosis is important to prevent obstetrical and neonatal morbidity. We report the case of a 37-year-old pregnant woman who presented with abdominal volume increase, night-sweat, anorexia, loss of weight and abdominal pain at 23 weeks. A peritoneal laparoscopic biopsy was performed and confirmed the diagnosis of tuberculous peritonitis. The patient received antituberculosis chemotherapy. The recovery was good as gave birth to a healthy infant of 3200Kg at 37th week's gestation by vaginal delivery. PMID:23024824

  2. Peritoneal tuberculosis in pregnancy: a case report.

    PubMed

    Alaoui, Fatima Zohra Fdili; Rachad, Myriem; Chaara, Hikmat; Bouguern, Hakima; Melhouf, Moulay Abdilah

    2012-01-01

    Peritoneal tuberculosis in pregnancy is one of the least common forms of extrapulmonory tuberculosis in pregnancy. Early diagnosis is important to prevent obstetrical and neonatal morbidity. We report the case of a 37-year-old pregnant woman who presented with abdominal volume increase, night-sweat, anorexia, loss of weight and abdominal pain at 23 weeks. A peritoneal laparoscopic biopsy was performed and confirmed the diagnosis of tuberculous peritonitis. The patient received antituberculosis chemotherapy. The recovery was good as gave birth to a healthy infant of 3200Kg at 37th week's gestation by vaginal delivery. PMID:23024824

  3. Ureaplasma urealyticum continuous ambulatory peritoneal dialysis-associated peritonitis diagnosed by 16S rRNA gene PCR.

    PubMed

    Yager, Jessica E; Ford, Emily S; Boas, Zachary P; Haseley, Leah A; Cookson, Brad T; Sengupta, Dhruba J; Fang, Ferric C; Gottlieb, Geoffrey S

    2010-11-01

    In some patients with peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD), a causative organism is never identified. We report a case of Ureaplasma urealyticum CAPD-associated peritonitis diagnosed by 16S rRNA gene PCR. Ureaplasma may be an underrecognized cause of peritonitis because it cannot be recovered using routine culture methods. PMID:20739488

  4. Peritonitis due to uncommon gram-positive pathogens in children undergoing peritoneal dialysis

    PubMed Central

    Dotis, J; Printza, N; Papachristou, F

    2012-01-01

    Peritonitis is still the main complication of peritoneal dialysis (PD) in children. Staphylococcus, especially Staphylococcus epidermidis and Staphylococcus aureus, are the predominant species isolated, followed by Streptococcus spp. and by far by gram-negative bacteria and fungi. We describe three cases of PD-related peritonitis in pediatric patients due to uncommon gram-positive pathogens, which were treated with intraperitoneal antibiotic agents. PMID:23935296

  5. Comparison of five body-composition methods in peritoneal dialysis patients.

    PubMed

    Stall, S H; Ginsberg, N S; DeVita, M V; Zabetakis, P M; Lynn, R I; Gleim, G W; Wang, J; Pierson, R N; Michelis, M F

    1996-08-01

    Body-composition assessment is an important method of evaluating nutritional status in peritoneal dialysis patients. Because body-composition measurement estimates have not been fully validated in this population, we assessed five body-composition methods in 30 well-dialyzed peritoneal dialysis patients. The techniques studied included bioelectrical impedance analysis, dual-energy X-ray absorptiometry, total-body potassium counting, and anthropometry by two techniques. The dialysis patients were matched for age, race, sex, height, weight, and body mass index with 29 healthy control subjects in our laboratory database. By 5 x 2 x 2 analysis of variance, significant differences were found between results by modality (P < 0.0001) as well as by sex, with women having an increased percentage of fat (P < 0.0001). However, there was no significant intermethod difference by condition (peritoneal dialysis or control). That is, although significantly different percentage fat values were found between the body-composition techniques, this variability was independent of whether the measurement was made on control or peritoneal dialysis patients. Despite the differences between modalities, all techniques were found to correlate significantly with each other (P < 0.01 or better for men and P < 0.001 or better for women). Our experience shows that these routine techniques for measuring body composition can be readily applied to stable peritoneal dialysis patients. PMID:8694010

  6. A mathematical model of peritoneal fluid absorption in tissue.

    PubMed

    Stachowska-Pietka, Joanna; Waniewski, Jacek; Flessner, Michael F; Lindholm, Bengt

    2005-01-01

    To investigate how water flow and interstitial pressure change in tissue during a peritoneal dwell with isotonic fluid, we developed a mathematical model of water transport in the tissue. Transport through muscle alone (M) and through muscle with intact skin (MS) were considered for the rat abdominal wall, using various parameters for muscle and skin. Based on the concept of distributed capillary and lymphatic systems, two main transport barriers were taken into account. capillary membrane and interstitium. We calculated the tissue hydrostatic pressure profiles and compared them with experimental data. The theoretic steady-state pressure distribution for model M is in good agreement with the experimental data. In model MS, the theoretic distribution diverges from the data in the subcutaneous layer. The transient times for fluid flow in the tissue for both model simulations are rather long (40 minutes in model M and 95 minutes in model MS) and depend on intraperitoneal pressure. The fraction of fluid absorbed from the tissue by the lymphatics increases with time from 10% to 97% of fluid flow from the peritoneal cavity. PMID:16686276

  7. microRNA Regulation of Peritoneal Cavity Homeostasis in Peritoneal Dialysis

    PubMed Central

    Lopez-Anton, Melisa; Bowen, Timothy; Jenkins, Robert H.

    2015-01-01

    Preservation of peritoneal cavity homeostasis and peritoneal membrane function is critical for long-term peritoneal dialysis (PD) treatment. Several microRNAs (miRNAs) have been implicated in the regulation of key molecular pathways driving peritoneal membrane alterations leading to PD failure. miRNAs regulate the expression of the majority of protein coding genes in the human genome, thereby affecting most biochemical pathways implicated in cellular homeostasis. In this review, we report published findings on miRNAs and PD therapy, with emphasis on evidence for changes in peritoneal miRNA expression during long-term PD treatment. Recent work indicates that PD effluent- (PDE-) derived cells change their miRNA expression throughout the course of PD therapy, contributing to the loss of peritoneal cavity homeostasis and peritoneal membrane function. Changes in miRNA expression profiles will alter regulation of key molecular pathways, with the potential to cause profound effects on peritoneal cavity homeostasis during PD treatment. However, research to date has mainly adopted a literature-based miRNA-candidate methodology drawing conclusions from modest numbers of patient-derived samples. Therefore, the study of miRNA expression during PD therapy remains a promising field of research to understand the mechanisms involved in basic peritoneal cell homeostasis and PD failure. PMID:26495316

  8. Continuous Hyperthermic Peritoneal Perfusion (CHPP) With Cisplatin for Children With Peritoneal Cancer

    ClinicalTrials.gov

    2012-03-29

    Peritoneal Neoplasms; Retroperitoneal Neoplasms; Gastrointestinal Neoplasms; Adenocarcinoma; Neuroblastoma; Ovarian Neoplasms; Sarcoma; Adrenocortical Carcinoma; Wilms Tumor; Rhabdomyosarcoma; Desmoplastic Small Round Cell Tumor

  9. [99mTc-MAA peritoneal scintigraphy in pleuroperitoneal comunication in peritoneal dialysis patients].

    PubMed

    Hernández Martínez, A C; Marín Ferrer, M D; Coronado Poggio, M; Escabias Del Pozo, C; Coya Viña, J; Martín Curto, L

    2010-01-01

    Peritoneal dialysis is a fully-contrasted alternative for the treatment of end-stage renal disease although it is not exempt of complications. Peritonitis and exit-site infections are among the most frequent complications found. Pleural effusion secondary to pleuroperitoneal communication (PPC) is a serious and uncommon complication in these patients. We present the case of a 50-year old man diagnosed of end-stage renal disease undergoing treatment with peritoneal dialysis who presented progressive dyspnea and right pleural effusion. The peritoneal scintigraphy with (99m)Tc-MAA makes it possible to confirm communication of intraperitoneal dialysis fluid to the pleural cavity. PMID:20117860

  10. Catumaxomab for Treatment of Peritoneal Carcinomatosis in Patients With Gastric Adenocarcinomas

    ClinicalTrials.gov

    2016-06-15

    Gastric Adenocarcinoma With Peritoneal Carcinomatosis; Siewert Type II Adenocarcinoma of Esophagogastric Junction With Peritoneal Carcinomatosis; Siewert Type III Adenocarcinoma of Esophagogastric Junction With Peritoneal Carcinomatosis

  11. Treatment of peritoneal metastases from colorectal cancer

    PubMed Central

    März, Loreen; Piso, Pompiliu

    2015-01-01

    Peritoneal seedings of a colorectal tumor represent the second most frequent site of metastasis (after the liver). In the era of 5-fluorouracil (5-FU)-only chemotherapy, the prognosis was poor for colorectal cancer with peritoneal metastases. Within the last few years, new chemotherapeutic and targeted agents have improved the prognosis; however, the response to these treatments seems to be lower than that for liver metastases. The combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy have further improved both disease-free survival and overall survival. Keeping this in mind, every patient presenting with peritoneal metastases from colorectal cancer should be evaluated and receive adequate treatment, if possible in the above-mentioned combination. This paper reviews recent advancements in the therapy of peritoneal carcinomatosis. PMID:26424828

  12. An Unusual Manifestation of Q Fever: Peritonitis.

    PubMed

    Yılmaz, Gülden; Öztürk, Bengi; Memikoğlu, Osman; Coşkun, Belgin; Yalçı, Aysun; Metin, Özge; Ünal, Hatice; Kurt, Halil

    2015-01-01

    Q fever has rarely been reported and can be difficult to diagnose, especially in immunocompromised patients. In the present report, we describe an unusual case of Q fever that presented as peritonitis and was treated with long-term combination therapy with doxycycline, ciprofloxacin and rifampicin for five weeks in a patient who had been on peritoneal dialysis for six years due to hypertensive nephropathy. PMID:25899561

  13. Transportation for School-Age Child Care: Current Status in Westchester County.

    ERIC Educational Resources Information Center

    Child Care Council of Westchester, Inc., White Plains, NY.

    Based on countywide interviews with transportation and child care personnel in Westchester County, New York, this report describes current practices, legislation, and issues related to the transportation of elementary school children to and from child care providers. Following a brief introduction, the report discusses various regulated and…

  14. Effect of Curcumin in Experimental Peritonitis.

    PubMed

    D, Savitha; Mani, Indu; Ravikumar, Gayatri; Avadhany, Sandhya T

    2015-12-01

    Despite medical advancements, the inflammatory cascade and oxidative stress worsen the prognosis in most cases of peritonitis. Curcumin has emerged as a potential antioxidant and anti-inflammatory agent in few of the acute inflammatory and infective conditions. We examined the effect of intraperitoneal injection of curcumin in endotoxin-induced peritonitis in rats. The blood and peritoneal fluid samples were collected at 3 and 24 h following the induction of peritonitis. Animals were sacrificed at 24 h and the organs preserved. The histopathological report of lung, liver, and intestines in the curcumin-treated rats showed maintenance of tissue architecture to a large extent compared to the control group which showed massive congestion, hemorrhage, and necrosis. The blood and peritoneal fluid total count and differential neutrophil counts were significantly higher at 24 h of induction of peritonitis. Serum amyloid assay and lipid peroxidation were significantly lower, and myeloperoxidase assay was higher in the curcumin-treated group at the end of 24 h; thus, curcumin probably demonstrated a neutrophil-mediated immunopotentiation and anti-inflammatory action thereby protecting the animal from endotoxemia-induced multi-organ damage. PMID:26884658

  15. Overcoming the Underutilisation of Peritoneal Dialysis

    PubMed Central

    Pajek, Jernej

    2015-01-01

    Peritoneal dialysis is troubled with declining utilisation as a form of renal replacement therapy in developed countries. We review key aspects of therapy evidenced to have a potential to increase its utilisation. The best evidence to repopulate PD programmes is provided for the positive impact of timely referral and systematic and motivational predialysis education: average odds ratio for instituting peritoneal dialysis versus haemodialysis was 2.6 across several retrospective studies on the impact of predialysis education. Utilisation of PD for unplanned acute dialysis starts facilitated by implantation of peritoneal catheters by interventional nephrologists may diminish the vast predominance of haemodialysis done by central venous catheters for unplanned dialysis start. Assisted peritoneal dialysis can improve accessibility of home based dialysis to elderly, frail, and dependant patients, whose quality of life on replacement therapy may benefit most from dialysis performed at home. Peritoneal dialysis providers should perform close monitoring, preventing measures, and timely prophylactic therapy in patients judged to be prone to EPS development. Each peritoneal dialysis programme should regularly monitor, report, and act on key quality indicators to manifest its ability of constant quality improvement and elevate the confidence of interested patients and financing bodies in the programme. PMID:26640787

  16. Perforation peritonitis and the developing world.

    PubMed

    Bali, Rajandeep Singh; Verma, Sushant; Agarwal, P N; Singh, Rajdeep; Talwar, Nikhil

    2014-01-01

    Background. Perforation peritonitis is the one of the commonest emergency encountered by surgeons. The aim of this paper is to provide an overview of the spectrum of perforation peritonitis managed in a single unit of a tertiary care hospital in Delhi. Methods. A retrospective study was carried out between May 2010 and June 2013 in a single unit of the department of Surgery, Lok Nayak Hospital, Delhi. It included 400 patients of perforation peritonitis (diffuse or localized) who were studied retrospectively in terms of cause, site of perforation, surgical treatment, complications, and mortality. Only those patients who underwent exploratory laparotomy for management of perforation peritonitis were included. Results. The commonest cause of perforation peritonitis included 179 cases of peptic ulcer disease (150 duodenal ulcers and 29 gastric ulcers) followed by appendicitis (74 cases), typhoid fever (48 cases), tuberculosis (40 cases), and trauma (31). The overall mortality was 7%. Conclusions. Perforation peritonitis in India has a different spectrum as compared to the western countries. Peptic ulcer perforation, perforating appendicitis, typhoid, and tubercular perforations are the major causes of gastrointestinal perforations. Early surgical intervention under the cover of broad spectrum antibiotics preceded by adequate aggressive resuscitation and correction of electrolyte imbalances is imperative for good outcomes minimizing morbidity and mortality. PMID:25006512

  17. The importance of ultrasonographic measurement of peritoneal wall thickness in pediatric chronic peritoneal dialysis patients.

    PubMed

    Yavaşcan, Önder; Aksu, Nejat; Alparslan, Caner; Sarıtaş, Serdar; Elmas, Cengiz Han; Eraslan, Ali Nihat; Duman, Soner; Mir, Sevgi

    2015-04-01

    Loss of peritoneal function due to peritoneal fibrosing syndrome (PFS) is a major factor leading to treatment failure in chronic peritoneal dialysis (PD) patients. Although the precise biologic mechanisms responsible for these changes have not been defined, the general assumption is that alterations in peritoneal function are related to structural changes in the peritoneal membrane. Studies of the peritoneal membrane by non-invasive ultrasonography (US) in chronic PD patients are limited. The aim of the present study is to assess the relationship between functional parameters of peritoneum and peritoneal thickness measured by US in children treated by chronic PD. We recruited two groups of patients: 23 subjects (13 females, 10 males) on chronic PD (patient group) and 26 (7 females, 19 males) on predialysis out-patient follow-up (creatinine clearance: 20-60 mL/min/1.73 m(2)) (control group). Age, sex, weight, height, body mass index (BMI), chronic PD duration, episodes of peritonitis and the results of peritoneal equilibration test (PET) were recorded. Hemoglobin (Hb), blood pressure (BP), left ventricular mass index (LVMI) and renal osteodystrophy (ROD) parameters were also obtained. The thickness of the parietal peritoneum was measured by trans-abdominal US in all children. Statistical analyses were performed by using Student's t and Pearson's correlation tests. Mean peritoneal thickness in chronic PD patients (1028.26 ± 157.26 μm) was significantly higher than control patients (786.52 ± 132.33). Mean peritoneal thickness was significantly correlated with mean body height (R(2) = 0.93, p < 0.05), BMI (R(2) = 0.25, p < 0.05), chronic PD duration (R(2) = 0.64, p < 0.05), episodes of peritonitis (R(2) = 0.93, p < 0.05), D/Pcreatinine (R(2) = 0.76, p < 0.05) and D4/D0glucose (R(2) = 0.81, p < 0.05). No correlation was found between peritoneal thickness and Hb, BP, LVMI and ROD parameters. In conclusion

  18. Effluent Tenascin-C Levels Reflect Peritoneal Deterioration in Peritoneal Dialysis: MAJOR IN PD Study

    PubMed Central

    Hirahara, Ichiro; Kusano, Eiji; Imai, Toshimi; Morishita, Yoshiyuki; Inoue, Makoto; Akimoto, Tetsu; Saito, Osamu; Muto, Shigeaki; Nagata, Daisuke

    2015-01-01

    Peritoneal deterioration causing structural changes and functional decline is a major complication of peritoneal dialysis (PD). The aim of this study was to explore effluent biomarkers reflecting peritoneal deterioration. In an animal study, rats were intraperitoneally administered with PD fluids adding 20 mM methylglyoxal (MGO) or 20 mM formaldehyde (FA) every day for 21 days. In the MGO-treated rats, tenascin-C (TN-C) levels in the peritoneal effluents were remarkably high and a cluster of TN-C-positive mesothelial cells with epithelial-to-mesenchymal transition- (EMT-) like change excessively proliferated at the peritoneal surface, but not in the FA-treated rats. Effluent matrix metalloproteinase-2 (MMP-2) levels increased in both the MGO- and FA-treated rats. In a clinical study at 18 centers between 2006 and 2013, effluent TN-C and MMP-2 levels were quantified in 182 PD patients with end-stage renal disease. Peritoneal function was estimated using the peritoneal equilibration test (PET). From the PET results, the D/P Cr ratio was correlated with effluent levels of TN-C (ρ = 0.57, p < 0.001) and MMP-2 (ρ = 0.73, p < 0.001). We suggest that TN-C in the effluents may be a diagnostic marker for peritoneal deterioration with EMT-like change in mesothelial cells in PD. PMID:26770971

  19. [Peritonitis due to Kocuria rosea in a continuous ambulatory peritoneal dialysis case].

    PubMed

    Kaya, Kiliç Esra; Kurtoğlu, Yasemin; Cesur, Salih; Bulut, Cemal; Kinikli, Sami; Irmak, Hasan; Demiröz, Ali Pekcan; Karakoç, Esra

    2009-04-01

    Micrococcus strains which are the normal flora members of skin, mucosa and oropharynx, may lead to infections associated with intravenous catheter, chronic ambulatory peritoneal dialysis, venticular shunt and prosthetic valve. In this paper, a case of peritonitis due to Kocuria rosea of Micrococcea family, in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD), was presented. Fiftysix years old female patient was admitted to the hospital by complaints of abdominal pain, nausea and fever. The patient was undergoing CAPD due to chronic renal failure for one and a half year and turbidity was detected in the peritoneal fluid during dialysis. Examination of the peritoneal fluid revealed 1800 cells/mm3, with no evidence of bacteria in Gram and Ziehl-Neelsen stained smears. No bacterial growth was detected in conventional culture media, however, bacteria was isolated from the peritoneal fluid culture on second day by Bactec (Becton Dickinson, USA) automated blood culture system. By means of API identification system (bioMerieux, USA), the causative agent was identified as Kocuria rosea. The patient was successfully treated with intraperitoneal teicoplanin (4 x 40 mg) for 14 days. In conclusion, in patients undergoing CAPD, rare pathogens should be considered in case of peritonitis and peritoneal fluid samples should be inoculated into automated culture systems. PMID:19621623

  20. Two Cases of Peritonitis Caused by Kocuria marina in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis▿

    PubMed Central

    Lee, Ja Young; Kim, Si Hyun; Jeong, Haeng Soon; Oh, Seung Hwan; Kim, Hye Ran; Kim, Yeong Hoon; Lee, Jeong Nyeo; Kook, Joong-Ki; Kho, Weon-Gyu; Bae, Il Kwon; Shin, Jeong Hwan

    2009-01-01

    Kocuria spp. are members of the Micrococcaceae family that are frequently found in the environment and on human skin. Few human infections have been reported. We describe what appear to be the first two cases of Kocuria marina peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. PMID:19692561

  1. Successful Treatment of Peritoneal Dialysis Catheter-Related Polymicrobial Peritonitis Involving Clostridium difficile

    PubMed Central

    Malhotra, Prashant; Juretschko, Stefan

    2015-01-01

    Clostridium difficile is one of the most common nosocomial pathogens and the cause of pseudomembranous colitis in cases of prior antimicrobial exposure. Extraintestinal manifestations of C. difficile are uncommon and rarely reported. We report the first successfully treated case of catheter-related C. difficile peritonitis in a patient undergoing peritoneal dialysis. PMID:26378285

  2. Implementation of standardized follow-up care significantly reduces peritonitis in children on chronic peritoneal dialysis.

    PubMed

    Neu, Alicia M; Richardson, Troy; Lawlor, John; Stuart, Jayne; Newland, Jason; McAfee, Nancy; Warady, Bradley A

    2016-06-01

    The Standardizing Care to improve Outcomes in Pediatric End stage renal disease (SCOPE) Collaborative aims to reduce peritonitis rates in pediatric chronic peritoneal dialysis patients by increasing implementation of standardized care practices. To assess this, monthly care bundle compliance and annualized monthly peritonitis rates were evaluated from 24 SCOPE centers that were participating at collaborative launch and that provided peritonitis rates for the 13 months prior to launch. Changes in bundle compliance were assessed using either a logistic regression model or a generalized linear mixed model. Changes in average annualized peritonitis rates over time were illustrated using the latter model. In the first 36 months of the collaborative, 644 patients with 7977 follow-up encounters were included. The likelihood of compliance with follow-up care practices increased significantly (odds ratio 1.15, 95% confidence interval 1.10, 1.19). Mean monthly peritonitis rates significantly decreased from 0.63 episodes per patient year (95% confidence interval 0.43, 0.92) prelaunch to 0.42 (95% confidence interval 0.31, 0.57) at 36 months postlaunch. A sensitivity analysis confirmed that as mean follow-up compliance increased, peritonitis rates decreased, reaching statistical significance at 80% at which point the prelaunch rate was 42% higher than the rate in the months following achievement of 80% compliance. In its first 3 years, the SCOPE Collaborative has increased the implementation of standardized follow-up care and demonstrated a significant reduction in average monthly peritonitis rates. PMID:27165827

  3. Tissue response to peritoneal implants

    NASA Technical Reports Server (NTRS)

    Picha, G. J.

    1980-01-01

    Peritoneal implants were fabricated from poly 2-OH, ethyl methacrylate (HEMA), polyetherurethane (polytetramethylene glycol 1000 MW, 1,4 methylene disocynate, and ethyl diamine), and untreated and sputter treated polytetrafluoroethylene (PTFE). The sputter treated PTFE implants were produced by an 8 cm diameter argon ion source. The treated samples consisted of ion beam sputter polished samples, sputter etched samples (to produce a microscopic surface cone texture) and surface pitted samples (produced by ion beam sputtering to result in 50 microns wide by 100 microns deep square pits). These materials were implanted in rats for periods ranging from 30 minutes to 14 days. The results were evaluated with regard to cell type and attachment kinetics onto the different materials. Scanning electron microscopy and histological sections were also evaluated. In general the smooth hydrophobic surfaces attracted less cells than the ion etched PTFE or the HEMA samples. The ion etching was observed to enhance cell attachment, multinucleated giant cell (MNGC) formation, cell to cell contact, and fibrous capsule formation. The cell responsed in the case of ion etched PTFE to an altered surface morphology. However, equally interesting was the similar attachment kinetics of HEMA verses the ion etched PTFE. However, HEMA resulted in a markedly different response with no MNGC's formation, minimal to no capsule formation, and sample coverage by a uniform cell layer.

  4. Compliance with automated peritoneal dialysis.

    PubMed

    Rivetti, M; Battú, S; Barrile, P; Benotto, S; Berruto, L; Bosio, A; d'Auria, L

    2002-01-01

    Compliance in peritoneal dialysis is reported as being a significant problem. In CAPD, the percentage of non-compliant patients varies between 10 and 40%. In APD the phenomenon seems to be more limited, at 15% - 20%. We considered 23 patients who had been on APD for more than 3 months.The dialytic treatment was performed using the Home Choice Pro device to record all the parameters of the dialysis session. The last 30 days of treatment were considered in the assessment of compliance, evaluating differences in daytime and night-time volumes between the prescription and the actual treatment,the length of the night-time session, and the days of treatment. As regards volume and duration, no differences were found compared to the dialytic prescriptions. For the days of treatment, a differencewas onlyfound in 3 patients: 2 self-administered patients missed day of therapy out of 30, and in both cases the missed tretment was ageed with the Centre; non-compliance was only found in 1 patient (4,3%), whose treatment was performed by the family, and who missed 4 days out of 30. PMID:12035903

  5. An unusual cause of peritonitis in peritoneal dialysis patients: Pantoea agglomerans.

    PubMed

    Kazancioglu, Rumeyza; Buyukaydin, Banu; Iraz, Meryem; Alay, Murat; Erkoc, Reha

    2014-07-01

    Peritonitis is a serious infection and early diagnosis and treatment is mandatory. A variety of microorganisms are identified in these cases and during recent years a new one was included, Pantoea agglomerans. In this case report, a female patient on continuous ambulatory peritoneal dialysis therapy with a peritonitis episode caused by this organism is described. The source of infection was thought to be due to contact of catheter with non-sterile surfaces. In microbiologic culture, this organism was identified and the patient successfully treated with a three week course of gentamicin therapy. The number of reported cases with this organism has increased in last years and various infection localizations and clinical progress patterns have been identified. In peritoneal dialysis patients presenting with peritonitis, this organism must be kept in mind. PMID:25022305

  6. Using a Multidisciplinary Training Program to Reduce Peritonitis in Peritoneal Dialysis Patients

    PubMed Central

    Gadola, Liliana; Poggi, Carla; Poggio, María; Sáez, Lucía; Ferrari, Alejandra; Romero, Jorge; Fumero, Soledad; Ghelfi, Gianella; Chifflet, Liliana; Borges, Patricia Larre

    2013-01-01

    ♦ Objectives: The present study evaluated the tool used to assess patients’ skills and the impact on peritonitis rates of a new multidisciplinary peritoneal dialysis (PD) education program (PDEP). ♦ Methods: After the University Hospital Ethics Committee approved the study, the educational and clinical records of PD patients were retrospectively analyzed in two phases. In phase I, an Objective Structured Assessment (OSA) was used during August 2008 to evaluate the practical skills of 25 patients with adequate Kt/V and no mental disabilities who had been on PD for more than 1 month. Test results were correlated with the prior year’s peritonitis rate. In phase II, the new PDEP, consisting of individual lessons, a retraining schedule, and group meetings, was introduced starting 1 September 2008. Age, sex, years of education, time on PD, number of training sessions, and peritonitis episodes were recorded. Statistical analyses used t-tests, chi-square tests, and Poisson distributions; a p value of less than 0.05 was considered significant. ♦ Results: In phase I, 25 patients [16 men, 9 women; mean age: 54 ± 15 years (range: 22 - 84 years); mean time on PD: 35 ± 30 months (range: 1 - 107 months)] were studied. The OSA results correlated with peritonitis rates: patients who passed the test had experienced significantly lower peritonitis rates during the prior year (p < 0.05). In phase II, after the new PDEP was introduced, overall peritonitis rates significantly declined (to 0.28 episodes/patient-year from 0.55 episodes/patient-year, p < 0.05); the Staphylococcus peritonitis rate also declined (to 0.09 episodes/patient-year from 0.24 episodes/patient-year, p < 0.05). ♦ Conclusions: The OSA is a reliable tool for assessing patients’ skills, and it correlates with peritonitis rates. The multidisciplinary PDEP significantly improved outcomes by further lowering peritonitis rates. PMID:22753455

  7. Tamoxifen Ameliorates Peritoneal Membrane Damage by Blocking Mesothelial to Mesenchymal Transition in Peritoneal Dialysis

    PubMed Central

    del Peso, Gloria; Gónzalez-Mateo, Guadalupe; Fernández-Millara, Vanessa; Santamaria, Beatríz; Bajo, Maria Auxiliadora; Sánchez-Tomero, José Antonio; Guerra-Azcona, Gonzalo; Selgas, Rafael; López-Cabrera, Manuel; Aguilera, Abelardo I.

    2013-01-01

    Mesothelial-to-mesenchymal transition (MMT) is an auto-regulated physiological process of tissue repair that in uncontrolled conditions such as peritoneal dialysis (PD) can lead to peritoneal fibrosis. The maximum expression of peritoneal fibrosis induced by PD fluids and other peritoneal processes is the encapsulating peritoneal sclerosis (EPS) for which no specific treatment exists. Tamoxifen, a synthetic estrogen, has successfully been used to treat retroperitoneal fibrosis and EPS associated with PD. Hence, we used in vitro and animal model approaches to evaluate the efficacy of Tamoxifen to inhibit the MMT as a trigger of peritoneal fibrosis. In vitro studies were carried out using omentum-derived mesothelial cells (MCs) and effluent-derived MCs. Tamoxifen blocked the MMT induced by transforming growth factor (TGF)-β1, as it preserved the expression of E-cadherin and reduced the expression of mesenchymal-associated molecules such as snail, fibronectin, collagen-I, α-smooth muscle actin, and matrix metalloproteinse-2. Tamoxifen-treatment preserved the fibrinolytic capacity of MCs treated with TGF-β1 and decreased their migration capacity. Tamoxifen did not reverse the MMT of non-epitheliod MCs from effluents, but it reduced the expression of some mesenchymal molecules. In mice PD model, we demonstrated that MMT progressed in parallel with peritoneal membrane thickness. In addition, we observed that Tamoxifen significantly reduced peritoneal thickness, angiogenesis, invasion of the compact zone by mesenchymal MCs and improved peritoneal function. Tamoxifen also reduced the effluent levels of vascular endothelial growth factor and leptin. These results demonstrate that Tamoxifen is a therapeutic option to treat peritoneal fibrosis, and that its protective effect is mediated via modulation of the MMT process. PMID:23637793

  8. Psychosocial effects on caregivers for children on chronic peritoneal dialysis.

    PubMed

    Tsai, T-C; Liu, S-I; Tsai, J-D; Chou, L-H

    2006-12-01

    The study was designed to explore the psychosocial effects on caretakers of children in Taiwan on chronic peritoneal dialysis (CPD). This is a case-control study, performed with subjects drawn from eight medical centers. The study group consisted of caretakers of 32 children with renal failure being treated with CPD. For comparison, a control group of caretakers of 64 healthy children as well as the regional Taiwanese studies were used. Two instruments were used to explore the presence of probable depression and quality of life (QOL) of the caretakers: the Taiwanese Depression Questionnaire, and the World Health Organization QOL BRIEF-Taiwan Version. In the study group, only 25% of caregivers had full-time jobs, and 66% of families had an annual income of less than US dollar 15,000. Of the 32 families in the study group, 16% had only a single parent. The prevalence of probable depression was significantly more common in the study group compared with control and referent group (28% vs 5% and 9.44%; P = 0.001). QOL scores in four domains were also significantly lower in the study group. In conclusion, even with the advances of peritoneal dialysis techniques, caring for children on CPD in Taiwan has significant adverse psychosocial effects on the primary caregivers. Attention should be paid to the psycho-social status of the caregivers. PMID:16985519

  9. The Liquid Hydrogen Option for the Subsonic Transport: A status report

    NASA Technical Reports Server (NTRS)

    Korycinski, P. F.

    1977-01-01

    Continued subsonic air transport design studies include the option for a liquid hydrogen fuel system as an aircraft fuel conservation measure. Elements of this option discussed include: (1) economical production of hydrogen; (2) efficient liquefaction of hydrogen; (3) materials for long service life LH2 fuel tanks; (4) insulation materials; (5) LH2 fuel service and installations at major air terminals; (6) assessment of LH2 hazards; and (7) the engineering definition of an LH2 fuel system for a large subsonic passenger air transport.

  10. Idiopathic encapsulating peritonitis: report of two cases.

    PubMed

    Da Luz, Magda Maria Profeta; Barral, Sumara Marques; Barral, Carlyle Marques; Bechara, Cristiane De Souza; Lacerda-Filho, Antônio

    2011-12-01

    This report presents two cases of young males who developed the rare idiopathic form of sclerosing encapsulating peritonitis (SEP) presented as partial bowel obstruction, both diagnosed during surgical treatment, with satisfactory outcomes. Sclerosing encapsulating peritonitis is a rare and enigmatic condition, characterized by intraperitoneal fibrosclerosis, which causes intestinal obstruction. It is a chronic entity with a poorly elucidated pathophysiology, leading to the constitution of a thick white nacreous fibrosis membrane that wraps the bowel in a concertina-like fashion with some adhesions configuring an intra-abdominal cocoon. Sclerosing encapsulating peritonitis is reported in a wide variety of patients, including those who have undergone peritoneal dialysis, young adolescent girls, cirrhotic patients after peritoneal-venous shunting, and patients treated with β-blockers. Nevertheless, the etiology of SEP remains obscure. This entity presents many difficulties in preoperative diagnosis because of its peculiar characteristics. Recognition of the SEP results in proper management and prevents unnecessary bowel resection. Regardless of cause, the treatment of the obstruction is surgical, with dissection of the encasing membrane from the intestine and separation of adherent loops of small bowel until they are laid free and returned to their normal configuration. The prognosis after appropriate surgical therapy is good, but depends on coexisting diseases. PMID:21969199

  11. Acute chylous peritonitis due to acute pancreatitis.

    PubMed

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide. PMID:22563182

  12. Peritoneal dialysis in developing countries.

    PubMed

    Nayak, K S; Prabhu, M V; Sinoj, K A; Subhramanyam, S V; Sridhar, G

    2009-01-01

    Peritoneal dialysis (PD) is acknowledged worldwide as a well-accepted form of renal replacement therapy (RRT) for end-stage renal disease (ESRD). Ideally, PD should be the preferred modality of RRT for ESRD in developing countries due to its many inherent advantages. Some of these are cost savings (especially if PD fluids are manufactured locally or in a neighboring country), superior rehabilitation and quality of life (QOL), home-based therapy even in rural settings, avoidance of hospital based treatment and the need for expensive machinery, and freedom from serious infections (hepatitis B and C). However, this is not the ground reality, due to certain preconceived notions of the health care givers and governmental agencies in these countries. With an inexplicable stagnation or decline of PD numbers in the developed world, the future of PD will depend on its popularization in Latin America and in Asia especially countries such as China and India, with a combined population of 2.5 billion and the two fastest growing economies worldwide. A holistic approach to tackle the issues in the developing countries, which may vary from region to region, is critical in popularizing PD and establishing PD as the first-choice RRT for ESRD. At our center, we have been pursuing a 'PD first' policy and promoting PD as the therapy of choice for various situations in the management of renal failure. We use certain novel strategies, which we hope can help PD centers in other developing countries working under similar constraints. The success of a PD program depends on a multitude of factors that are interlinked and inseparable. Each program needs to identify its strengths, special circumstances, and deficiencies, and then to strategize accordingly. Ultimately, teamwork is the 'mantra' for a successful outcome, the patient being central to all endeavors. A belief and a passion for PD are the fountainhead and cornerstone on which to build a quality PD program. PMID:19494625

  13. Oral Hygiene Practices and Dentition Status of Public Transport Workers of India- A Cross-sectional Study

    PubMed Central

    Sohi, Ramandeep Kaur; Singh, Gurminder; Brar, Rajdeep; Singh, Harpreet; Kakar, Heena

    2014-01-01

    Objectives: To evaluate the oral hygiene practices and dentition statuses of transport workers who were working in a public bus transport system (C.T.U.) of Chandigarh (U.T.), India. Materials and Methods: The data were recorded on a modified W.H.O. format (1997). A total of 1008 subjects constituted the final sample size. Information was obtained regarding the oral hygiene practices and clinical examinations were conducted. Statistical analysis was done by using ANOVA and Z-test. Results: The mean age of the subjects was 45.3 ± 7.8 years. Mean DMFT of the subjects who were not using tobacco in any form was 5.02. 80.2% (808). 88.7% of the subjects brushed their teeth as least once a day. Mean number of decayed and missing teeth were 1.67 ± 2.16 and 1.46 ± 2.8, respectively and their relation with age was found to be statistically significant. Conclusion: Dental caries was found to be major indication in all the age groups. More elderly subjects than young needed extractions. This study emphasized the need of an improved dental awareness and availability of dental facilities to transport workers. PMID:25386518

  14. IGF-I regulates redox status in breast cancer cells by activating the amino acid transport molecule xC−

    PubMed Central

    Yang, Yuzhe; Yee, Douglas

    2014-01-01

    Insulin-like growth factors (IGFs) stimulate cell growth in part by increasing amino acid uptake. xCT (SLC7A11) encodes the functional subunit of the cell surface transport system xC− which mediates cystine uptake, a pivotal step in glutathione synthesis and cellular redox control. In this study, we show that IGF-I regulates cystine uptake and cellular redox status by activating the expression and function of xCT in estrogen receptor-positive (ER+) breast cancer cells by a mechanism that relies on the IGF receptor substrate-1 (IRS-1). Breast cancer cell proliferation mediated by IGF-I was suppressed by attenuating xCT expression or blocking xCT activity with the pharmacological inhibitor sulfasalazine (SASP). Notably, SASP sensitized breast cancer cells to inhibitors of the IGF-I receptor in a manner reversed by the ROS scavenger N-acetyl-L-cysteine. Thus, IGF-I promoted the proliferation of ER+ breast cancer cells by regulating xC− transporter function to protect cancer cells from ROS in an IRS-1 dependent manner. Our findings suggest that inhibiting xC− transporter function may synergize with modalities that target the IGF-I receptor to heighten their therapeutic effects. PMID:24686172

  15. 76 FR 8736 - Status of Motor Vehicle Budgets in Submitted State Implementation Plan for Transportation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... Connecticut's 2008, 2009, and 2012 MVEBs adequate for transportation conformity purposes. See 73 FR 33428... has attained the 1997 8-hour ozone standard. See 75 FR 53219; August 31, 2010. EPA has not yet taken... CONTACT: Donald O. Cooke, Environmental Scientist, Air Quality Planning Unit, U.S....

  16. Perceived health status associated with transport choice for short distance trips

    PubMed Central

    Scheepers, C.E.; Wendel-Vos, G.C.W.; van Wesemael, P.J.V.; den Hertog, F.R.J.; Stipdonk, H.L.; Int Panis, L.L.R.; van Kempen, E.E.M.M.; Schuit, A.J.

    2015-01-01

    Background This study examines the association between active transport and perceived general health, perceived psychological wellbeing and a healthy body weight in the Netherlands. Methods Data were collected by an online questionnaire (N = 3663) in the Netherlands. Data collection was conducted over a period of one calendar year starting July 2012. Logistic regression analyses were used to investigate the association between choice of transport mode (bicycling vs car use and walking vs car use) and perceived general health, perceived psychological wellbeing and having a healthy weight respectively. The presented OR's may be interpreted as the likelihood of an average person in our dataset to have a better perceived health or body weight when choosing active transport (either bicycling or walking) over using the car for trips up to 7.5 km. Results Cycling was found to be significantly associated with a better perceived general health (OR = 1.35, 95%CI:1.07–1.70) and having a healthy body weight (OR = 1.52, 95%CI:1.28–1.79), but not with a better perceived psychological wellbeing (OR = 1.12, 95%CI:0.93–1.34). Walking was found to be significantly associated with having a healthy body weight (OR = 1.35, 95%CI:1.09–1.69), but not with a better perceived general (OR = 1.12, 95%CI:0.84–1.51) or psychological wellbeing (OR = 0.85, 95%CI:0.67–1.08). Conclusion Our results suggest that active transport use has been associated with a better perceived general health and a healthy body weight. However, more research is needed to be able to elucidate which factors cause this better health. No associations were observed between transport choice and perceived psychological wellbeing. PMID:26844158

  17. Newer antibiotics for the treatment of peritoneal dialysis-related peritonitis.

    PubMed

    Ma, Terry King-Wing; Leung, Chi Bon; Chow, Kai Ming; Kwan, Bonnie Ching-Ha; Li, Philip Kam-Tao; Szeto, Cheuk Chun

    2016-08-01

    Peritonitis is a debilitating infectious complication of peritoneal dialysis (PD). Drug-resistant bacterial peritonitis typically has a lower response rate to antibiotics. In the past 15 years, newer antibiotics with activities against drug-resistant Gram-positive bacteria have been developed. In most circumstances, peritonitis due to methicillin-resistant staphylococci responds to vancomycin. If vancomycin cannot be used due to allergy and/or non-susceptibility, there is increasing evidence that linezolid and daptomycin are the drugs of choice. It is reasonable to start linezolid orally or intravenously, but subsequent dose reduction may be necessary in case of myelosuppression. Daptomycin can be given intravenously or intraperitoneally and has excellent anti-biofilm activity. Other treatment options for drug-resistant Gram-positive bacterial peritonitis include teicoplanin, tigecycline and quinupristin/dalfopristin. Teicoplanin is not available in some countries (e.g. the USA). Tigecycline can only be given intravenously. Quinupristin/dalfopristin is ineffective against Enterococcus faecalis and there is only low-quality evidence to support its efficacy in the treatment of peritonitis. Effective newer antibiotics against drug-resistant Gram-negative bacteria are lacking. Polymyxins can be considered, but evidence on its efficacy is limited. In this review, we will discuss the potential use of newer antibiotics in the treatment of drug-resistant bacterial peritonitis in PD patients. PMID:27478608

  18. Newer antibiotics for the treatment of peritoneal dialysis-related peritonitis

    PubMed Central

    Ma, Terry King-Wing; Leung, Chi Bon; Chow, Kai Ming; Kwan, Bonnie Ching-Ha; Li, Philip Kam-Tao; Szeto, Cheuk Chun

    2016-01-01

    Peritonitis is a debilitating infectious complication of peritoneal dialysis (PD). Drug-resistant bacterial peritonitis typically has a lower response rate to antibiotics. In the past 15 years, newer antibiotics with activities against drug-resistant Gram-positive bacteria have been developed. In most circumstances, peritonitis due to methicillin-resistant staphylococci responds to vancomycin. If vancomycin cannot be used due to allergy and/or non-susceptibility, there is increasing evidence that linezolid and daptomycin are the drugs of choice. It is reasonable to start linezolid orally or intravenously, but subsequent dose reduction may be necessary in case of myelosuppression. Daptomycin can be given intravenously or intraperitoneally and has excellent anti-biofilm activity. Other treatment options for drug-resistant Gram-positive bacterial peritonitis include teicoplanin, tigecycline and quinupristin/dalfopristin. Teicoplanin is not available in some countries (e.g. the USA). Tigecycline can only be given intravenously. Quinupristin/dalfopristin is ineffective against Enterococcus faecalis and there is only low-quality evidence to support its efficacy in the treatment of peritonitis. Effective newer antibiotics against drug-resistant Gram-negative bacteria are lacking. Polymyxins can be considered, but evidence on its efficacy is limited. In this review, we will discuss the potential use of newer antibiotics in the treatment of drug-resistant bacterial peritonitis in PD patients. PMID:27478608

  19. Effect of Icodextrin Solution on the Preservation of Residual Renal Function in Peritoneal Dialysis Patients: A Randomized Controlled Study.

    PubMed

    Chang, Tae Ik; Ryu, Dong-Ryeol; Yoo, Tae-Hyun; Kim, Hyung Jong; Kang, Ea Wha; Kim, Hyunwook; Chang, Jae Hyun; Kim, Dong Ki; Moon, Sung Jin; Yoon, Soo Young; Han, Seung Hyeok

    2016-03-01

    Although icodextrin solution has been highlighted in the fluid management compared to glucose-based solutions, proof of a beneficial effect of icodextrin solution on residual renal function (RRF) is lacking. We conducted a multicenter prospective randomized controlled open-label trial to investigate whether icodextrin solution can preserve RRF.One hundred patients with urine volume ≥750 mL/day from 8 centers in Korea were randomly assigned to receive 1 exchange of icodextrin solution for a ≥8 hour-dwell time and 2 exchanges of 1.5% glucose-based biocompatible neutral pH solution or 1 exchange of ≥2.5% and 2 exchanges of 1.5% glucose-based biocompatible solutions. Using mixed-effects general linear models, we analyzed changes in residual glomerular filtration rate (GFR) and daily urine volume at 1 year.Forty-nine patients were assigned to the icodextrin group and 51 to the glucose solution group. During follow-up, the slope of the decline in residual GFR was -0.170 mL/min/month/1.73 m² in the icodextrin group, while it was -0.155 mL/min/month/1.73 m² in the glucose solution group (95% confidence interval [CI], -0.06 to 0.10; P = 0.701). Daily urine volume decreased faster in the glucose solution group than in the icodextrin group (-31.02 vs -11.88 mL per month; 95% CI, -35.85 to -2.44; P = 0.025). Results were consistent when we analyzed using intention-to-treat and per protocol principles. There were no differences in fluid status, peritoneal ultrafiltration, and peritoneal transport between groups during follow-up.This study clearly showed that icodextrin solution preserves residual urine volume better than glucose solution. PMID:27043667

  20. Brevibacterium casei isolated as a cause of relapsing peritonitis.

    PubMed

    Althaf, Mohammed Mahdi; Abdelsalam, Mohamed Said; Alsunaid, Mohammed Sunaid; Hussein, Maged Hassan

    2014-01-01

    We report a case of relapsing peritonitis in a 33-year-old woman on automated peritoneal dialysis. End-stage renal disease was secondary to systemic lupus erythematosus complicated with lupus nephritis. The organism isolated was Brevibacterium casei that was not readily identified, delaying appropriate management with an extended antibiotic course. Definite management of B casei peritonitis was peritoneal dialysis catheter removal. PMID:24648477

  1. Site and facility waste transport planning documents (SPDs) status and findings

    SciTech Connect

    Schmid, S P; Danese, F L; Wankerl, M W

    1993-05-01

    Site and Facility Waste Transportation Services Planning Documents (SPDS) are detailed desk-top reference documents that initiate planning for shipping commercial spent nuclear fuel (SNF) from the sites where it is currently generated and/or stored to another location. Because of the unique design features and individual variations in the spent fuel handling and cask loading operation requirements for each facility, one SPD will be written for each of the commercial facilities currently expected to deliver SNF into the Civilian Radioactive Waste Management System (CRWMS) disposal system. One primary purpose of an SPD is to initiate the discussions that will lead to a determination of the type of spent fuel cask and transport mode that will be used to transport spent fuel from each facility. The initial assessment of which cask type and mode would best serve each facility is based on the principle that the largest possible capacity casks should be used at the greatest number of facilities to reduce the total number of spent fuel shipments. The final selection of cask and transportation mode will be arrived at following discussion with the facility licensed operator. Once agreed upon by OCRWM and the facility owner, the SPD wig be used as a primary input to the development of a Site Specific Servicing Plan (SSSP) that will detail chosen servicing options for the individual site. This paper will discuss the purpose and development of SPDs and the preliminary results of an evaluation of the ability of delivering facilities to handle and ship spent fuel casks within the confines of the local nation infrastructure.

  2. 78 FR 8122 - Adequacy Status of Motor Vehicle Emission Budgets for Transportation Conformity Purposes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-05

    ...-hour PM2.5 Area Year 2025 MVEBs for the Connecticut Portion of the New York-Northern New 516 9,728.1 Jersey-Long Island, NY-NJ-CT 1997 annual PM2.5 and 2006 24-hour PM2.5 Area Transportation conformity is... letter to Connecticut Department of Energy and Environmental Protection on January 8, 2013, stating...

  3. Secondary Peritonitis Caused by Streptomyces viridis

    PubMed Central

    Arora, Shilpa; Jain, Ruby; Chander, Jagdish; van de Sande, Wendy

    2012-01-01

    Streptomyces organisms are soil inhabitants rarely causing nonmycetomic infections. We describe a case of secondary peritonitis caused by Streptomyces viridis in a chronic alcoholic patient who presented with fever, abdominal distension, and pain in the abdomen. The most likely source of infection was by inoculation through multiple paracenteses, done for treatment of ascites, before the patient came to our health care center. This is the second case report of Streptomyces peritonitis and the first case caused by Streptomyces viridis, which is usually found in the soil in our geographic region. PMID:22337982

  4. Primary peritonitis due to group A streptococcus.

    PubMed

    Moskovitz, M; Ehrenberg, E; Grieco, R; Chamovitz, B; Burke, M; Snyder, D; Book, M

    2000-04-01

    Primary peritonitis is a rare condition occurring, by definition, in patients without underlying causes, such as perforated viscus, pre-existing ascites, or nephrosis. We report a case of primary peritonitis and shock due to group A beta-hemolytic streptococcus, a rare etiology. A review of the world's literature shows a predilection for women to have this condition. The entry site is obscure in most cases. Asymptomatic genital tract colonization may be a portal of entry in some women. Shock or toxic shock syndrome often accompany the abdominal findings. Laparotomy to exclude a perforated viscus may be unavoidable. Despite the significant morbidity, expeditious and appropriate antibiotic therapy is curative. PMID:10777203

  5. Benign Cystic Mesothelioma Misdiagnosed as Peritoneal Carcinomatosis

    PubMed Central

    Shin, Hyun Deok; Kim, Suk Bae

    2016-01-01

    Benign cystic mesothelioma (BCM) is a rare benign disease that forms multicystic masses in the abdomen, pelvis, and retroperitoneum. It occurs predominantly in young to middle-aged women. The majority of cases were associated with a history of abdominal or pelvic operation, a history of endometriosis, and pelvic inflammatory disease. We present a unique case of BCM which is different to the previous cases. The patient was a 52-year-old man showing features of peritoneal carcinomatosis accompanied by ascites on abdominal computed tomography scans. We herein report a case of BCM misdiagnosed with peritoneal carcinomatosis.

  6. [Some immunologic aspects in postoperative peritonitis].

    PubMed

    Perfil'ev, D F

    1998-01-01

    Examination of blood serum and cellular elements of 45 patients with postoperative diffuse purulent peritonitis shows that in the majority of examined persons before and in the first days after the operation immunodepression exists. The dynamics of immunologic disturbances (antibody titers, phagocytosis, immunoglobulines, T- and B-lymphocytes) are sufficiently informative and as a rule, correlate with clinical course of peritonitis. Adequate reaction of the organism to infection resulted in a favourable outcome. Low values of immunologic indices in postoperative period necessitate the use of stimulant therapy in combined treatment of this complication. PMID:9916429

  7. Notes concerning the peritonitis of urinary aetiology

    PubMed Central

    Bratu, 0; Ilie, C; Madan, V

    2008-01-01

    Urinary peritonitis (the uroperitoneum) is categorized as a difficult to diagnose clinical entity due to its poor manifestations. Vesical trauma following pelvis bone fracture is the most frequently involved in the uroperitoneum aetiology, followed by spontaneous vesical rupture and intraoperative iatrogenic lesions. One of the most important and constant signs that can occur is diffuse abdominal tension, without tenderness. The imagistic procedure that sets the diagnosis is retrograde cystography showing intraperitoneal urine effusion. Vesical rupture is a surgical emergency. The uroperitoneum is a particular type of peritonitis that has hidden and misleading symptoms which can delay the diagnosis long enough to endanger the patient's life. PMID:20108482

  8. Ventriculoperitoneal Shunt Peritoneal Catheter Knot Formation

    PubMed Central

    Ul-Haq, Anwar; Al-Otaibi, Faisal; Alshanafey, Saud; Sabbagh, Mohamed Diya; Al Shail, Essam

    2013-01-01

    The ventriculoperitoneal (VP) shunt is a common procedure in pediatric neurosurgery that carries a risk of complications at cranial and abdominal sites. We report on the case of a child with shunt infection and malfunction. The peritoneal catheter was tethered within the abdominal cavity, precluding its removal. Subsequently, laparoscopic exploration identified a knot at the distal end of the peritoneal catheter around the omentum. A new VP shunt was inserted after the infection was healed. This type of complication occurs rarely, so there are a limited number of case reports in the literature. This report is complemented by a literature review. PMID:24109528

  9. Case Report of the Reliability 1,3-β-d-Glucan Monitoring during Treatment of Peritoneal Candidiasis in a Child Receiving Continuous Peritoneal Dialysis

    PubMed Central

    Ginocchio, Francesca; Verrina, Enrico; Furfaro, Elisa; Cannavò, Rossella; Bandettini, Roberto

    2012-01-01

    Fungal peritonitis is an unusual but severe complication of continuous peritoneal dialysis. The role of 1,3-β-d-glucan is unknown in early diagnosis and in treatment monitoring of peritoneal candidiasis. This case report shows the utility of 1,3-β-d-glucan monitoring in management of Candida peritonitis in a child undergoing continuous peritoneal dialysis. PMID:22357650

  10. Adequate peritoneal dialysis: theoretical model and patient treatment.

    PubMed

    Tast, C

    1998-01-01

    The objective of this study was to evaluate the relationship between adequate PD with sufficient weekly Kt/V (2.0) and Creatinine clearance (CCR) (60l) and necessary daily dialysate volume. This recommended parameter was the result of a recent multi-centre study (CANUSA). For this there were 40 patients in our hospital examined and compared in 1996, who carried out PD for at least 8 weeks and up to 6 years. These goals (CANUSA) are easily attainable in the early treatment of many individuals with a low body surface area (BSA). With higher BSA or missing RRF (Residual Renal Function) the daily dose of dialysis must be adjusted. We found it difficult to obtain the recommended parameters and tried to find a solution to this problem. The simplest method is to increase the volume or exchange rate. The most expensive method is to change from CAPD to APD with the possibility of higher volume or exchange rates. Selection of therapy must take into consideration: 1. patient preference, 2. body mass, 3. peritoneal transport rates, 4. ability to perform therapy, 5. cost of therapy and 6. risk of peritonitis. With this information in mind, an individual prescription can be formulated and matched to the appropriate modality of PD. PMID:10392062

  11. Pupil Transportation.

    ERIC Educational Resources Information Center

    Stollar, Dewey H.

    The purpose of this NEFP satellite study is to provide an overview of pupil transportation. The first phase of the study discusses the early legal and financial bases for student transportation, the second the current status of student transportation, and the third the future status of student transportation needs and financing for 1980.…

  12. Flavimonas oryzihabitans (Pseudomonas oryzihabitans; CDC group Ve-2): an emerging pathogen in peritonitis related to continuous ambulatory peritoneal dialysis?

    PubMed

    Bendig, J W; Mayes, P J; Eyers, D E; Holmes, B; Chin, T T

    1989-01-01

    A case of peritonitis caused by Flavimonas oryzihabitans (Pseudomonas oryzihabitans; CDC group VE-2) in a patient on continuous ambulatory peritoneal dialysis is reported. This is the seventh case of infection caused by this organism reported in the English literature and the third reported case of continuous ambulatory peritoneal dialysis-related peritonitis caused by this organism; it is the first case of infection of any kind caused by this organism in England. PMID:2913032

  13. Angiogenic Factors and Risks of Technique Failure and Cardiovascular Events in Patients Receiving Peritoneal Dialysis

    PubMed Central

    Matsui, Masaru; Samejima, Ken-ichi; Takeda, Yukiji; Morimoto, Katsuhiko; Tagawa, Miho; Onoue, Kenji; Okayama, Satoshi; Kawata, Hiroyuki; Kawakami, Rika; Akai, Yasuhiro; Okura, Hiroyuki; Saito, Yoshihiko

    2016-01-01

    Background Placental growth factor (PlGF) is a member of the vascular endothelial growth factor family that acts as a pleiotropic cytokine capable of stimulating angiogenesis and accelerating atherogenesis. Soluble fms-like tyrosine kinase-1 (sFlt-1) antagonizes PlGF action. Higher levels of PlGF and sFlt-1 have been associated with cardiovascular events in patients with chronic kidney disease, yet little is known about their relationship with adverse outcomes in patients on peritoneal dialysis (PD). The aim of this study was to investigate the association of PlGF and sFlt-1 with technique survival and cardiovascular events. Methods We measured serum levels of PlGF and plasma levels of sFlt-1 in 40 PD patients at Nara Medical University. Results PlGF and sFlt-1 levels were significantly correlated with the dialysate-to-plasma ratio of creatinine (r = 0.342, p = 0.04 and r = 0.554, p < 0.001) although PlGF and sFlt-1 levels were not correlated with total creatinine clearance and total Kt/V. Additionally, both PlGF and sFlt-1 levels were significantly higher in patients with high transport membranes compared to those without (p = 0.039 and p < 0.001, respectively). Patients with PlGF levels above the median had lower technique survival and higher incidence of cardiovascular events than patients with levels below the median, with hazard ratios of 11.9 and 7.7, respectively, in univariate Cox regression analysis. However, sFlt-1 levels were not associated with technique survival or cardiovascular events (p = 0.11 and p = 0.10, respectively). Conclusion Elevated PlGF and sFlt-1 are significantly associated with high transport membrane status. PlGF may be a useful predictor of technique survival and cardiovascular events in PD patients.

  14. Effect of Icodextrin Solution on the Preservation of Residual Renal Function in Peritoneal Dialysis Patients

    PubMed Central

    Chang, Tae Ik; Ryu, Dong-Ryeol; Yoo, Tae-Hyun; Kim, Hyung Jong; Kang, Ea Wha; Kim, Hyunwook; Chang, Jae Hyun; Kim, Dong Ki; Moon, Sung Jin; Yoon, Soo Young; Han, Seung Hyeok

    2016-01-01

    Abstract Although icodextrin solution has been highlighted in the fluid management compared to glucose-based solutions, proof of a beneficial effect of icodextrin solution on residual renal function (RRF) is lacking. We conducted a multicenter prospective randomized controlled open-label trial to investigate whether icodextrin solution can preserve RRF. One hundred patients with urine volume ≥750 mL/day from 8 centers in Korea were randomly assigned to receive 1 exchange of icodextrin solution for a ≥8 hour-dwell time and 2 exchanges of 1.5% glucose-based biocompatible neutral pH solution or 1 exchange of ≥2.5% and 2 exchanges of 1.5% glucose-based biocompatible solutions. Using mixed-effects general linear models, we analyzed changes in residual glomerular filtration rate (GFR) and daily urine volume at 1 year. Forty-nine patients were assigned to the icodextrin group and 51 to the glucose solution group. During follow-up, the slope of the decline in residual GFR was −0.170 mL/min/month/1.73 m2 in the icodextrin group, while it was −0.155 mL/min/month/1.73 m2 in the glucose solution group (95% confidence interval [CI], −0.06 to 0.10; P = 0.701). Daily urine volume decreased faster in the glucose solution group than in the icodextrin group (−31.02 vs −11.88 mL per month; 95% CI, −35.85 to −2.44; P = 0.025). Results were consistent when we analyzed using intention-to-treat and per protocol principles. There were no differences in fluid status, peritoneal ultrafiltration, and peritoneal transport between groups during follow-up. This study clearly showed that icodextrin solution preserves residual urine volume better than glucose solution. PMID:27043667

  15. Successful treatment of Cryptococcus laurentii peritonitis in a patient on peritoneal dialysis.

    PubMed

    Asano, Marina; Mizutani, Makoto; Nagahara, Yasuko; Inagaki, Koji; Kariya, Tetsuyoshi; Masamoto, Daijiro; Urai, Makoto; Kaneko, Yukihiro; Ohno, Hideaki; Miyazaki, Yoshitsugu; Mizuno, Masashi; Ito, Yasuhiko

    2015-01-01

    A 32-year-old man on peritoneal dialysis (PD) was hospitalized for seven days due to fever. A diagnosis of yeast-like fungal peritonitis was made by Gram staining. The patient was started on intravenous micafungin and oral fluconazole therapy following removal of the PD catheter. A fungal pathogen was isolated from the peritoneal fluid and identified as Cryptococcus species. Based on antifungal susceptibility testing, the treatment was changed to voriconazole and continued for 3 months. A genetic analysis identified the isolate as Cryptococcus laurentii (C. laurentii). This patient was diagnosed with C. laurentii PD-related peritonitis and was successfully treated with voriconazole and removal of the PD catheter. PMID:25876577

  16. A case report of peritoneal tuberculosis with multiple miliary peritoneal deposits mimicking advanced ovarian carcinoma

    PubMed Central

    Yazdani, Shahla; Sadeghi, Mahmod; Alijanpour, Abolhasan; Naeimi-rad, Mojgan

    2016-01-01

    Background: Peritoneal tuberculosis accounts 1-2% of all forms of tuberculosis. Peritoneal tuberculosis is an important differential diagnosis for ovarian cancer in women with ascites, adnexal mass and elevated cancer antigen 125 (CA125) levels. We report a case of a 32- year -old woman with multiple miliary peritoneal deposits mimicking advanced ovarian carcinoma. Case Presentation: A 32-year-old drug addicted woman presented with menometrorrhagia, fever and shivering, ascites and pelvis mass. Ultrasonography revealed a 53×65 mm cyst in left ovary and ascites. Multiple miliary peritoneal deposits were observed during laparatomy without any mass, histologic examination confirmed tuberculosis of uterus, tubes, omentum, liver and external surfaces of small intestine. Finally, the patient recovered with anti-tuberculosis treatment. Conclusion: These findings highlight considering tuberculosis in the differential diagnosis of any patients with adnexal mass, ascitis and elevated serum CA125 even with negative cytology and bacteriology test results. PMID:26958336

  17. Pathophysiology of the Peritoneal Membrane during Peritoneal Dialysis: The Role of Hyaluronan

    PubMed Central

    Yung, Susan; Chan, Tak Mao

    2011-01-01

    During peritoneal dialysis (PD), constant exposure of mesothelial cells to bioincompatible PD solutions results in the denudation of the mesothelial monolayer and impairment of mesothelial cell function. Hyaluronan, a major component of extracellular matrices, is synthesized by mesothelial cells and contributes to remesothelialization, maintenance of cell phenotype, and tissue remodeling and provides structural support to the peritoneal membrane. Chronic peritoneal inflammation is observed in long-term PD patients and is associated with increased hyaluronan synthesis. During inflammation, depolymerization of hyaluronan may occur with the generation of hyaluronan fragments. In contrast to native hyaluronan which offers a protective role to the peritoneum, hyaluronan fragments exacerbate inflammatory and fibrotic processes and therefore assist in the destruction of the tissue. This paper will discuss the contribution of mesothelial cells to peritoneal membrane alterations that are induced by PD and the putative role of hyaluronan in these processes. PMID:22203782

  18. Nocardia asteroides peritoneal dialysis-related peritonitis: First case in pediatrics, treated with protracted linezolid.

    PubMed

    El-Naggari, Mohamed; El Nour, Ibtisam; Al-Nabhani, Dana; Al Muharrmi, Zakaria; Gaafar, Heba; Abdelmogheth, Anas A W

    2016-01-01

    Nocardia asteroides is a rare pathogen in peritoneal dialysis-related peritonitis. We report on a 13-year-old female with Nocardia asteroides peritonitis complicated by an intra-abdominal abscess. Linezolid was administered intravenously for 3 months and followed by oral therapy for an additional 5 months with close monitoring for adverse effects. The patient was discharged after 3 months of hospitalization on hemodialysis. The diagnosis and management of such cases can be problematic due to the slow growth and difficulty of identifying Nocardia species. The optimal duration of treatment for Nocardia peritonitis is not known. Linezolid can be used for prolonged periods in cases of trimethoprim/sulfamethoxazole-resistant cases with close monitoring for adverse effects. PMID:26768669

  19. Calcium transport, thiol status, and hepatotoxicity following N-nitrosodimethylamine exposure in mice

    SciTech Connect

    Reitman, F.A.; Berger, M.L.; Minnema, D.J.; Shertzer, H.G.

    1988-01-01

    The hepatotoxicant N-nitrosodimethylamine (NDMA) is presumed to exert toxicity through reactive metabolites. NDMA is similar in this respect to numerous other hepatotoxicants, for which hepatotoxicity is also associated with a rapid depletion of soluble and/or protein thiols, and an inhibition of calcium transport systems. The authors examined the hypothesis that hepatotoxicity for NDMA is preceded by thiol depletion and/or inhibition of calcium transport in isolated liver subcellular fractions. Centrizonal liver necrosis in mice was evident at 24 but not at 12 h subsequent to intraperitoneal administration of 40 mg NDMA/kg. Hepatotoxicity was not preceded by depletion of liver protein-free sulfhydryls, nor by protein sulfhydryl depletion in liver whole homogenate, microsomal, or plasma membrane fractions. NDMA-mediated toxicity was also not preceded by inhibition of calcium uptake capability by microsomal, mitochondrial, or plasma membrane fractions. In contrast, carbon tetrachloride produced the expected rapid decrease in microsomal calcium uptake capability, followed by a centrizonal necrosis that was maximal at about 24 h. These studies suggest that the mechanism of NDMA hepatotoxicity may differ from that of a number of other hepatotoxicants (e.g., carbon tetrachloride, acetaminophen, bromobenzene) for which toxicity is also mediated through reactive metabolites.

  20. Comamonas testosteroni-associated peritonitis in a pediatric peritoneal dialysis patient

    PubMed Central

    Parolin, Mattia; Baraldi, Maura; Valentini, Elena; Murer, Luisa; Vidal, Enrico

    2016-01-01

    Comamonas testosteroni (C. testosteroni) has been rarely observed as an infectious agent in clinical practice. Few reports described its potential pathogenicity in bloodstream and abdominal infections. Here, we report our experience in the treatment of a C. testosteroni-associated peritonitis in a four-year-old girl receiving chronic peritoneal dialysis (PD). The organism was shown to be highly susceptible to appropriate antibiotic therapy. Infection responded promptly and the patient was managed conservatively without withdrawal from PD. PMID:26981448

  1. Comamonas testosteroni-associated peritonitis in a pediatric peritoneal dialysis patient.

    PubMed

    Parolin, Mattia; Baraldi, Maura; Valentini, Elena; Murer, Luisa; Vidal, Enrico

    2016-03-01

    Comamonas testosteroni (C. testosteroni) has been rarely observed as an infectious agent in clinical practice. Few reports described its potential pathogenicity in bloodstream and abdominal infections. Here, we report our experience in the treatment of a C. testosteroni-associated peritonitis in a four-year-old girl receiving chronic peritoneal dialysis (PD). The organism was shown to be highly susceptible to appropriate antibiotic therapy. Infection responded promptly and the patient was managed conservatively without withdrawal from PD. PMID:26981448

  2. MRI in the diagnosis of a peritoneal leak in continuous ambulatory peritoneal dialysis.

    PubMed

    Arbeiter, K M; Aufricht, C; Mueller, T; Balzar, E; Prokesch, R W

    2001-10-01

    Mechanical problems in continuous ambulatory peritoneal dialysis (CAPD) can result in ultrafiltration failure and disruption of CAPD therapy. The recently described tool of CT peritoneography with water-soluble contrast medium has the disadvantage of radiation and instillation of nephrotoxic substances. We report a child with a peritoneal leak diagnosed by MRI after instillation of a gadodiamide-dialysate mixture. This method provided good anatomical detail without radiation or nephrotoxic agents. PMID:11685447

  3. Peritoneal tuberculosis due to Mycobacterium caprae

    PubMed Central

    Nebreda, T.; Álvarez-Prida, E.; Blanco, B.; Remacha, M.A.; Samper, S.; Jiménez, M.S.

    2016-01-01

    The incidence of tuberculosis in humans due to Mycobacterium caprae is very low and is almost confined to Europe. We report a case of a previously healthy 41-year-old Moroccan with a 6 month history of abdominal pain, weight loss, fatigue and diarrhea. A diagnosis of peritoneal tuberculosis due to M. caprae was made. PMID:27134824

  4. [Malignant peritoneal mesothelioma: its relation to asbestos].

    PubMed

    Pentimone, F; Moruzzo, D; Siuti, E; del Corso, L

    1995-10-01

    Chronic exposure to asbestos can induce malignant peritoneal mesothelioma (PMM) without pulmonary or pleural involvement (PIMM). The localization to the peritoneum depends on the different susceptibility of the two mesotheliums and, perhaps, on the length of asbestos fibers which can facilitate their direct translocation. PMID:8622811

  5. [Chemoprophylaxis of secondary peritoneal hydatidosis. Experimental study].

    PubMed

    Errasti Alustiza, J; Arévalo Alonso, J M; Ortiz Tudanca, J; Rebollar Saenz, J; Martínez Blázquez, C; Vítores López, J M

    1993-09-01

    We have studied the effectiveness of pharmacologic prophylaxis of experimental peritoneal hydatidosis. Mice (n = 140, divided in ten groups) suffered intraperitoneal contamination with protoscoleces of E. granulosus from sheep. Each group received different treatment (mebendazole, praziquantel, or both), in three different schedules (during 3 days before contamination, during 7 days after contamination, or both before and after Mebendazole 150 mg/kg-day), praziquantel (25 mg/kg-day) were given in three daily doses. Mice were sacrificed six months later and the number and type of existing peritoneal cysts was recorded. Prophylaxis prior to contamination was shown ineffective. Early treatment greatly decreased the severity of the peritoneal hydatidosis. The administration of the drug before and after contamination, did not improve the results obtained when the drug was given after contamination. Both mebendazole and praziquantel were effective, though the former obtained better results. The association of both drugs does not improve the results obtained with mebendazole alone. These experimental results recommend the early use of mebendazol or praziquantel after open surgery for hydatidosis, in order to prevent the occurrence of secondary peritoneal hydatidosis. PMID:8217380

  6. Exit-site care in peritoneal dialysis.

    PubMed

    Wadhwa, Nand K; Reddy, Gampala H

    2007-01-01

    Exit-site infection (ESI), tunnel infection and associated peritonitis are major causes of morbidity and catheter loss in chronic peritoneal dialysis patients. Meticulous exit-site care is vital in preventing ESI. Avoiding trauma to the exit-site and daily cleaning of the exit-site with a dedicated antimicrobial soap is essential for the longevity of the peritoneal dialysis catheter. Antibiotics cream and disinfectant agents including povidone-iodine, chlorhexidine, electrolytic chloroxidizing solutions (Amuchina 10% - ExSept Plus, Amuchina 5% - ExSept) are useful to keep the resident micro-organisms inhibited. ESI rates in peritoneal dialysis patients treated with Amuchina 10% (ExSept Plus) and Amuchina 5% (ExSept) for the exit-site care are similar or lower compared to povidone-iodine or chlorhexidine. Electrolytic chloroxidizing (Amuchina 10% - ExSept Plus and Amuchina 5% - ExSept) solutions for exit-site care are effective for prevention and treatment of ESI. PMID:17099306

  7. Treatment principles for peritoneal surface malignancies.

    PubMed

    Deraco, Marcello; Kusamura, Shigeki; Corbellini, Carlo; Guaglio, Marcello; Paviglianiti, Cosimo; Baratti, Dario

    2016-04-01

    A paradigm shift has recently occurred in the clinical management of peritoneal surface malignancies (PSM). Once regarded as end-stage disseminated conditions only to be palliated, PSM are now increasingly recognized as local-regional disease entities amenable to potentially curative therapies. Better knowledge of the natural history and patterns of disease-progression has evolved into a novel treatment approach combining aggressive cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy, to treat the microscopic residual disease. Such a complex comprehensive treatment has reportedly resulted in a survival improvement over historical controls, and it is gaining an increasing acceptance as standard of care for selected patients with peritoneal metastases from gastrointestinal and gynecological tumor and rare primary peritoneal malignancies. This article addresses the rational bases supporting the comprehensive treatment of PSM. The biology and patho-physiology of peritoneal tumor dissemination, with their implication on surgical and local-regional management are reviewed. The cytoreductive surgical procedures and intraperitoneal chemotherapy administration techniques are described, together with the theoretical principles from which have originated. The main controversial issues in the operative management of PSM are discussed, focusing on the technical variants adopted in our institution. The most recent literature data on both patient selection and appropriate indications for combined treatment are presented. Additionally, a brief overview of treatment results and long-term outcomes following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in the different PSM is provided. PMID:26847729

  8. Francisella tularensis Peritonitis in Stomach Cancer Patient

    PubMed Central

    Ho, Linus X.; Safdar, Amar

    2004-01-01

    Tularemia with peritonitis developed in a 50-year-old man soon after diagnosis of stomach cancer with metastasis. The ascites grew Francisella tularensis subsp. holarctica, which was identified by sequencing analysis of the 16S rDNA. The infection resolved with antimicrobial treatment. Antibodies detected 4 weeks after onset disappeared after chemotherapy-associated lymphopenia. PMID:15663872

  9. Peritoneal flap ureteropexy for idiopathic retroperitoneal fibrosis.

    PubMed

    Fowler, J W

    1987-07-01

    Eight patients had 13 ureters treated by peritoneal flap ureteropexy. There were no significant post-operative complications. Eleven ureters were functioning normally after an average follow-up of 28 months. The operation is suggested as a method of choice where omental wrapping is not possible. PMID:3620842

  10. Imaging of the peritoneal cavity in CAPD.

    PubMed

    Wankowicz, Z; Pietrzak, B; Skrobowska, E

    1996-01-01

    The aim of our study was the use of the optimal imaging of the peritoneal cavity (PC) for continuous ambulatory peritoneal dialysis (CAPD)-related problems. Ultrasonography (USG), direct abdominal radiography (DAR), peritoneoscintigraphy (PSG), and standard peritoneo-computed tomography (PCT) with reconstruction (R-PCT) were performed in 25 patients on CAPD from three to 44 months. Studies were done at the beginning of CAPD (1-3 months) as well as in the noncomplicated and complicated course of CAPD. Group 1 comprised 17 patients in whom 77 PC images were taken in the non-complicated course of CAPD. Group II comprised 15 patients in whom 65 images were taken during or after complications. For USG and DAR we used standard equipment, PSG was done with sulfur colloid labeled with technetium 99m (Tc 99m), PCT, and R-PCT were done with Omnipaque and Somatom HiQ Siemens unit. In PCT, two- and three dimensional reconstruction were done by our own computer program. USG was recommended for imaging of tunnel infections, exit-site infection (ESI), and adhesion. PSG was useful in almost all observed complications of CAPD except thickening of the peritoneal membrane (PM). Standard PCT with R-PCT was more useful than PCT because of a more legible image of the peritoneal cavity, which gives the possibility of monitoring fluid distribution and measuring of intraperitoneal fluid volume. PMID:8728239

  11. Removal of phosphorus by peritoneal dialysis.

    PubMed

    Delmez, J A

    1993-01-01

    Substantial evidence exists that peritoneal dialysis, as currently practiced, cannot alone remove adequate amounts of phosphorus in well-nourished patients. Current efforts should address the possibility of developing improved nontoxic oral phosphorus binders and/or different compositions of dialysate fluid. PMID:8399639

  12. Pasteurella species peritoneal dialysis-associated peritonitis: Household pets as a risk factor

    PubMed Central

    Poliquin, Philippe Guillaume; Lagacé-Wiens, Philippe; Verrelli, Mauro; Allen, David W; Embil, John M

    2015-01-01

    BACKGROUND: Pasteurella species are Gram-negative coccobacilli that are a part of the normal oropharyngeal flora of numerous domestic animals. They have been recognized as a rare but significant cause of peritonitis in patients undergoing peritoneal dialysis (PD). A consensus about management strategies for PD-associated peritonitis caused by Pasteurella species currently does not exist. METHODS: The microbiological database serving the Manitoba Renal Program was searched from 1997 to 2013 for cases of Pasteurella species PD-associated peritonitis, and charts were reviewed. PubMed was searched for case reports and data were abstracted. RESULTS: Seven new local cases and 30 previously reported cases were analyzed. This infection is clinically similar to other forms of PD peritonitis, with household pet exposure appearing to be the strongest risk factor. Cats are the most commonly implicated pet. Direct contact between the pet and the equipment was commonly reported (25 of 37 patients) but was not necessary for infection to develop. The mean duration of treatment was 15 days. Complication rates were low, with only 11% of patients requiring PD catheter removal. There was no mortality reported. CONCLUSION: Pasteurella species are a rare cause of PD-associated peritonitis that can be successfully treated with a two-week course of intraperitoneal antibiotics with a high likelihood of catheter salvage. PMID:25798157

  13. Peritoneal adhesions after laparoscopic gastrointestinal surgery

    PubMed Central

    Mais, Valerio

    2014-01-01

    Although laparoscopy has the potential to reduce peritoneal trauma and post-operative peritoneal adhesion formation, only one randomized controlled trial and a few comparative retrospective clinical studies have addressed this issue. Laparoscopy reduces de novo adhesion formation but has no efficacy in reducing adhesion reformation after adhesiolysis. Moreover, several studies have suggested that the reduction of de novo post-operative adhesions does not seem to have a significant clinical impact. Experimental data in animal models have suggested that CO2 pneumoperitoneum can cause acute peritoneal inflammation during laparoscopy depending on the insufflation pressure and the surgery duration. Broad peritoneal cavity protection by the insufflation of a low-temperature humidified gas mixture of CO2, N2O and O2 seems to represent the best approach for reducing peritoneal inflammation due to pneumoperitoneum. However, these experimental data have not had a significant impact on the modification of laparoscopic instrumentation. In contrast, surgeons should train themselves to perform laparoscopy quickly, and they should complete their learning curves before testing chemical anti-adhesive agents and anti-adhesion barriers. Chemical anti-adhesive agents have the potential to exert broad peritoneal cavity protection against adhesion formation, but when these agents are used alone, the concentrations needed to prevent adhesions are too high and could cause major post-operative side effects. Anti-adhesion barriers have been used mainly in open surgery, but some clinical data from laparoscopic surgeries are already available. Sprays, gels, and fluid barriers are easier to apply in laparoscopic surgery than solid barriers. Results have been encouraging with solid barriers, spray barriers, and gel barriers, but they have been ambiguous with fluid barriers. Moreover, when barriers have been used alone, the maximum protection against adhesion formation has been no greater than

  14. Status of the SNS H- ion source and low-energy beam transport system

    SciTech Connect

    Keller, R.; Thomae, R.; Stockli, M.; Welton, R.

    2002-04-01

    The ion source and Low-Energy Transport (LEBT) system that will provide H{sup -} ion beams to the Spallation Neutron Source (SNS) Front End and the accelerator chain have been developed into a mature unit that will satisfy the operational needs through the commissioning and early operating phases of SNS. The ion source was derived from the SSC ion source, and many of its original features have been improved to achieve reliable operation at 6% duty factor, producing beam currents in the 35-mA range and above. The LEBT utilizes purely electrostatic focusing and includes static beam-steering elements and a pre-chopper. This paper will discuss the latest design features of the ion source and LEBT, give performance data for the integrated system, and report on relevant commissioning results obtained with the SNS RFQ accelerator. Perspectives for further improvements will be outlined in concluding remarks.

  15. Effect of altered thyroid status on the transport of hepatobiliary radiopharmaceuticals

    SciTech Connect

    Pahuja, D.N.; Noronha, O.P.

    1985-10-01

    The effect of induced hypothyroidism (by feeding an antithyroid drug-propylthiouracil) on the transport and clearance of the routinely used hepatobiliary radiopharmaceuticals--radioiodinated iodine- T (131I) rose bengal and technetium-99m-N-(4-n-butylphenylcarbamoylmethyl) iminodiacetate, was studied in the rats. Hypothyroidism was associated with depressed growth and retarded clearance of these radiotracers from the in vivo system. Treatment of the hypothyroid rats with thyroxine (2-5 micrograms/100 g b.w. day) for 6 wk, restored these parameters towards normal values. These data suggest that delayed clearance of these hepatobiliary tracers could be related to reduced metabolic rate accompanied with the hypotonia and hypomotility of intestine normally observed in the hypothyroid state.

  16. Current Status of the Development of a Transportable and Compact VLBI System by NICT and GSI

    NASA Technical Reports Server (NTRS)

    Ishii, Atsutoshi; Ichikawa, Ryuichi; Takiguchi, Hiroshi; Takefuji, Kazuhiro; Ujihara, Hideki; Koyama, Yasuhiro; Kondo, Tetsuro; Kurihara, Shinobu; Miura, Yuji; Matsuzaka, Shigeru; Tanimoto, Daisuke

    2010-01-01

    MARBLE (Multiple Antenna Radio-interferometer for Baseline Length Evaluation) is under development by NICT and GSI. The main part of MARBLE is a transportable VLBI system with a compact antenna. The aim of this system is to provide precise baseline length over about 10 km for calibrating baselines. The calibration baselines are used to check and validate surveying instruments such as GPS receiver and EDM (Electro-optical Distance Meter). It is necessary to examine the calibration baselines regularly to keep the quality of the validation. The VLBI technique can examine and evaluate the calibration baselines. On the other hand, the following roles are expected of a compact VLBI antenna in the VLBI2010 project. In order to achieve the challenging measurement precision of VLBI2010, it is well known that it is necessary to deal with the problem of thermal and gravitational deformation of the antenna. One promising approach may be connected-element interferometry between a compact antenna and a VLBI2010 antenna. By measuring repeatedly the baseline between the small stable antenna and the VLBI2010 antenna, the deformation of the primary antenna can be measured and the thermal and gravitational models of the primary antenna will be able to be constructed. We made two prototypes of a transportable and compact VLBI system from 2007 to 2009. We performed VLBI experiments using theses prototypes and got a baseline length between the two prototypes. The formal error of the measured baseline length was 2.7 mm. We expect that the baseline length error will be reduced by using a high-speed A/D sampler.

  17. Detection of disseminated peritoneal tumors by fluorescein diacrylate in mice

    NASA Astrophysics Data System (ADS)

    Harada, Yoshinori; Furuta, Hirokazu; Murayama, Yasutoshi; Dai, Ping; Fujikawa, Yuta; Urano, Yasuteru; Nagano, Tetsuo; Morishita, Koki; Hasegawa, Akira; Takamatsu, Tetsuro

    2009-02-01

    Tumor invasion to the peritoneum is a poor prognostic factor in cancer patients. Accurate diagnosis of disseminated peritoneal tumors is essential to accurate cancer staging. To date, peritoneal washing cytology during laparotomy has been used for diagnosis of peritoneal dissemination of gastrointestinal cancer, but its sensitivity has not been satisfactory. Thus, a more direct approach is indispensable to detect peritoneal dissemination in vivo. Fluorescein diacrylate (FDAcr) is an esterase-sensitive fluorescent probe derived from fluorescein. In cancer cells, fluorescent fluorescein generated by exogenous application of FDAcr selectively deposits owing to its stronger hydrolytic enzyme activity and its lower leakage rate. We examined whether FDAcr can specifically detect disseminated peritoneal tumors in athymic nude mouse models. Intraperitoneally administered FDAcr revealed disseminated peritoneal microscopic tumors not readily recognized on white-light imaging. These results suggest that FDAcr is a useful probe for detecting disseminated peritoneal tumors.

  18. Optimizing peritoneal dialysis prescription for volume control: the importance of varying dwell time and dwell volume.

    PubMed

    Fischbach, Michel; Zaloszyc, Ariane; Schaefer, Betti; Schmitt, Claus Peter

    2014-08-01

    Not only adequate uremic toxin removal but also volume control is essential in peritoneal dialysis (PD) to improve patient outcome. Modification of dwell time impacts on both ultrafiltration (UF) and purification. A short dwell favors UF but preferentially removes small solutes such as urea. A long dwell favors uremic toxin removal but also peritoneal fluid reabsorption due to the time-dependent loss of the crystalloid osmotic gradient. In particular, the long daytime dwell in automated PD may result in significant water and sodium reabsorption, and in such cases icodextrin should be considered. Increasing dwell volume favors the removal of solutes such as sodium due to the increased volume of diffusion and the recruitment of peritoneal surface area. A very large fill volume with too high an intraperitoneal pressure (IPP) may, however, result in back-filtration and thus reduced UF and sodium clearance. Based on these principles and the individual transport and pressure kinetics obtained from peritoneal equilibration tests and IPP measurements, we suggest combining short dwells with a low fill volume to favor UF with long dwells and a large fill volume to favor solute removal. Results from a recent randomized cross-over trial and earlier observational data in children support this concept: the absolute UF and UF relative to the administered glucose increased and solute removal and blood pressure improved. PMID:23903692

  19. Increasing peritoneal contact area during dialysis improves mass transfer.

    PubMed

    Flessner, M F; Lofthouse, J; Williams, A

    2001-10-01

    Previous studies in mice demonstrated that relatively large volumes in the peritoneal cavity made contact with only 40% of the anatomic peritoneum and that this contact area (A(contact)) could be increased with use of a surfactant, dioctyl sodium sulfosuccinate (DSS). To investigate the hypothesis that mass transfer rates during peritoneal dialysis are dependent on the area of peritoneum in contact with the dialysis solution, rats were dialyzed for 2 h with a solution that contained (14)C-mannitol, with or without 0.02% DSS. The mass transfer-area coefficients (MTAC) were determined to be (mean +/- SEM, ml/min): no DSS, 0.163 +/- 0.008; with DSS, 0.247 +/- 0.006 (P < 0.002). DSS also caused an increase in total protein loss over 2 h (mean +/- SEM, mg): no DSS, 83.8 +/- 15.8; DSS, 159.5 +/- 6.3 (P < 0.001). In a separate set of animals, the ratio (R) of A(contact) to anatomic area in each plane was measured as in the previous study R(mean) (mean +/- SEM) and equaled 0.466 +/- 0.075, no DSS; 0.837 +/- 0.074, with DSS. The ratio of MTAC (1.52) and protein loss (1.90) approximate the ratio of R(mean(S)) (1.78). Because MTAC = mass transfer coefficient (MTC) x A(contact), small peritoneal transport chambers were used to determine MTC for (14)C-mannitol and fluorescein isothiocyanate-albumin. MTC(mannitol) did not change significantly with the addition of DSS. MTC(albumin) (cm/min x 10(4), mean +/- SEM) equaled 1.47 +/- 0.45 without DSS and 1.78 +/- 0.52 with DSS (P < 0.04). It was concluded that DSS increases the mass transfer rates of mannitol and protein by increasing A(contact), whereas protein transport is further augmented by an apparent increase in the barrier permeability to protein. PMID:11562413

  20. Preventing amikacin related ototoxicity with N-acetylcysteine in patients undergoing peritoneal dialysis.

    PubMed

    Kocyigit, Ismail; Vural, Alperen; Unal, Aydin; Sipahioglu, Murat Hayri; Yucel, Hasan Esat; Aydemir, Samet; Yazici, Cevat; İlhan Sahin, M; Oymak, Oktay; Tokgoz, Bulent

    2015-10-01

    Amikacin is a frequently used antibiotic in the treatment of peritoneal dialysis (PD)-related peritonitis. Ototoxicity is a well-known complication of amikacin for which increased oxidative stress and free oxygen radicals are thought to be responsible. In this study, the effect of N-acetyl-cysteine (NAC) on cochlear function and oxidant situation in the amikacin related ototoxicity in PD-related peritonitis patients are investigated. Forty-six patients who had their first PD-related peritonitis attacks receiving empirical amikacin treatment were enrolled in the study. The patients were randomized into two groups; the first group (n = 23) as NAC receiving and the second group (n = 23) as a placebo receiving, control group. Otoacoustic emissions were measured before, 1 week after and 4 weeks after the treatment. Oxidative stress measurements were performed concurrently in order to evaluate the effectiveness of NAC. The results of screening with otoacoustic emission testing after amikacin treatment showed that cochlear function is protected especially in higher frequencies in NAC group when compared with the control group. Evaluation of the antioxidant status of the two groups showed no differences in the basal values, but at the first week there was an increase in the NAC group compared with the control group, and this increase became significant at the fourth week. NAC is found to be safe and effective in amikacin-related ototoxicity in patients with PD-related peritonitis. We suggest a close monitoring of the patients receiving amikacin containing treatment protocols and if amikacin is administrated supplementing the treatment with NAC. PMID:25073872

  1. Promotion of angiogenesis and proliferation cytokines patterns in peritoneal fluid from women with endometriosis.

    PubMed

    Rakhila, Halima; Al-Akoum, Mahera; Bergeron, Marie-Eve; Leboeuf, Mathieu; Lemyre, Madeleine; Akoum, Ali; Pouliot, Marc

    2016-08-01

    Studies have long sought specific cytokines that could characterize endometriosis. Either due to variations between study designs regarding the assessment criteria for the cytokine or to low power resulting from small sample size, no factor proved to be sufficiently specific to endometriosis. In other clinical fields, a combination of several markers proved to be more powerful than a single-molecule approach. As well, in the context of endometriosis, simultaneous assessment of several cytokines present in the peritoneal fluid might help in unveiling patho-physiological processes, thus contributing to a better understanding of the condition. Therefore, the objective of this study was to investigate peritoneal fluid cytokines-derived of endometriotic women. For this retrospective case-control study, peritoneal fluid samples were obtained at laparoscopy and assessed by multiplex. Our data showed distinct patterns of peritoneal fluid cytokine concentrations in endometriotic women most notably a marked increase in EGF, FGF-2, IL-1α, MIP-1β, TGFα, PDGF-AA, PDGF-BB, MCP-3, sCD40L, Gro Pan, IL-17α, MDC and Rantes. The overall effect of fertility status revealed a significant difference for only one cytokine, namely MDC. Furthermore, FLT-3L and IP-10 levels were decreased in endometriosis patients, the former in both menstrual cycle phases and the latter in the secretory phase. A significant inverse Pearson correlation (p<0.05) was noted between pro-angiogenic cytokines EGF and FGF and the anti-angiogenic cytokine IP-10 in endometriosis patients at stages III-IV and in the secretory phase. These changes may exacerbate the local peritoneal angiogenic and proliferative reaction observed in women with endometriosis, and contributes to its pathophysiology. PMID:27128987

  2. The role of HIPEC in the treatment of peritoneal carcinomatosis from gastric cancer: between lights and shadows.

    PubMed

    Di Vita, Maria; Cappellani, Alessandro; Piccolo, Gaetano; Zanghì, Antonio; Cavallaro, Andrea; Bertola, Giulio; Bolognese, Antonio; Facchini, Gaetano; D'Aniello, Carmine; Di Francia, Raffaele; Cardì, Francesco; Berretta, Massimiliano

    2015-02-01

    Gastric cancer is one of the most dreadful neoplastic diseases and remains the second cause of cancer death worldwide. Patients who develop peritoneal metastasis have a poor prognosis, with a median survival of less than 6 months. Despite being the cause of 60% of deaths from gastric cancer, peritoneal metastasis can still be considered a local disease and a local multidisciplinary approach can improve the prognosis even in this end-stage disease. At present, hyperthermic intraperitoneal chemotherapy (HIPEC) is the most widely accepted treatment for peritoneal surface diseases and can be performed in patients with different stages of cancer and with various antitumoral drugs. We performed a systematic review of the current status of HIPEC in the treatment of gastric peritoneal metastasis in an attempt to obtain answers to the questions that still remain: do results differ with these different methods? Does HIPEC exert a significant effect on the intracavitary delivery of drugs? Which patients should be treated and which should not? What can we expect from this approach in terms of survival, morbidity, and mortality? On reviewing the literature, despite the lack of trials comparing the different methods, we found that HIPEC has been shown to be an effective tool whenever a complete or an almost complete resection of the peritoneal implants can be performed. Therefore, it is advisable to refer all at-risk patients to specialized centers to be enrolled in randomized trials to achieve truly reliable results. PMID:25406023

  3. Update on the Status of the FLUKA Monte Carlo Transport Code

    NASA Technical Reports Server (NTRS)

    Pinsky, L.; Anderson, V.; Empl, A.; Lee, K.; Smirnov, G.; Zapp, N; Ferrari, A.; Tsoulou, K.; Roesler, S.; Vlachoudis, V.; Battisoni, G.; Ceruti, F.; Gadioli, M. V.; Garzelli, M.; Muraro, S.; Rancati, T.; Sala, P.; Ballarini, R.; Ottolenghi, A.; Parini, V.; Scannicchio, D.; Pelliccioni, M.; Wilson, T. L.

    2004-01-01

    The FLUKA Monte Carlo transport code is a well-known simulation tool in High Energy Physics. FLUKA is a dynamic tool in the sense that it is being continually updated and improved by the authors. Here we review the progresses achieved in the last year on the physics models. From the point of view of hadronic physics, most of the effort is still in the field of nucleus--nucleus interactions. The currently available version of FLUKA already includes the internal capability to simulate inelastic nuclear interactions beginning with lab kinetic energies of 100 MeV/A up the the highest accessible energies by means of the DPMJET-II.5 event generator to handle the interactions for greater than 5 GeV/A and rQMD for energies below that. The new developments concern, at high energy, the embedding of the DPMJET-III generator, which represent a major change with respect to the DPMJET-II structure. This will also allow to achieve a better consistency between the nucleus-nucleus section with the original FLUKA model for hadron-nucleus collisions. Work is also in progress to implement a third event generator model based on the Master Boltzmann Equation approach, in order to extend the energy capability from 100 MeV/A down to the threshold for these reactions. In addition to these extended physics capabilities, structural changes to the programs input and scoring capabilities are continually being upgraded. In particular we want to mention the upgrades in the geometry packages, now capable of reaching higher levels of abstraction. Work is also proceeding to provide direct import into ROOT of the FLUKA output files for analysis and to deploy a user-friendly GUI input interface.

  4. Update On the Status of the FLUKA Monte Carlo Transport Code*

    NASA Technical Reports Server (NTRS)

    Ferrari, A.; Lorenzo-Sentis, M.; Roesler, S.; Smirnov, G.; Sommerer, F.; Theis, C.; Vlachoudis, V.; Carboni, M.; Mostacci, A.; Pelliccioni, M.

    2006-01-01

    The FLUKA Monte Carlo transport code is a well-known simulation tool in High Energy Physics. FLUKA is a dynamic tool in the sense that it is being continually updated and improved by the authors. We review the progress achieved since the last CHEP Conference on the physics models, some technical improvements to the code and some recent applications. From the point of view of the physics, improvements have been made with the extension of PEANUT to higher energies for p, n, pi, pbar/nbar and for nbars down to the lowest energies, the addition of the online capability to evolve radioactive products and get subsequent dose rates, upgrading of the treatment of EM interactions with the elimination of the need to separately prepare preprocessed files. A new coherent photon scattering model, an updated treatment of the photo-electric effect, an improved pair production model, new photon cross sections from the LLNL Cullen database have been implemented. In the field of nucleus-- nucleus interactions the electromagnetic dissociation of heavy ions has been added along with the extension of the interaction models for some nuclide pairs to energies below 100 MeV/A using the BME approach, as well as the development of an improved QMD model for intermediate energies. Both DPMJET 2.53 and 3 remain available along with rQMD 2.4 for heavy ion interactions above 100 MeV/A. Technical improvements include the ability to use parentheses in setting up the combinatorial geometry, the introduction of pre-processor directives in the input stream. a new random number generator with full 64 bit randomness, new routines for mathematical special functions (adapted from SLATEC). Finally, work is progressing on the deployment of a user-friendly GUI input interface as well as a CAD-like geometry creation and visualization tool. On the application front, FLUKA has been used to extensively evaluate the potential space radiation effects on astronauts for future deep space missions, the activation

  5. Prognostic Relevance of the Peritoneal Surface Disease Severity Score Compared to the Peritoneal Cancer Index for Colorectal Peritoneal Carcinomatosis

    PubMed Central

    Ng, Jia Lin; Ong, Whee Sze; Chia, Claramae Shulyn; Tan, Grace Hwei Ching; Soo, Khee-Chee; Teo, Melissa Ching Ching

    2016-01-01

    Background. Peritoneal Carcinomatosis Index (PCI) is a widely established scoring system that describes disease burden in isolated colorectal peritoneal carcinomatosis (CPC). Its significance may be diminished with complete cytoreduction. We explore the utility of the recently described Peritoneal Surface Disease Severity Score (PSDSS) and compare its prognostic value against PCI. Methods. The endpoints were overall survival (OS), progression-free survival (PFS), and survival less than 18 months (18 MS). Results. Fifty patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) for CPC from 2003 to 2014, with 98% achieving complete cytoreduction. Median OS was 28.8 months (95% CI, 18.0–39.1); median PFS was 9.4 months (95% CI, 7.7–13.9). Univariate analysis showed that higher PCI was significantly associated with poorer OS (HR 1.11; 95% CI, 1.03–1.20) and PFS (HR 1.09; 95% CI, 1.03–1.14). Conversely, PSDSS was not associated with either endpoint. Multivariate analysis showed that PCI, but not PSDSS, was predictive of OS and PFS. PCI was also able to discriminate survival outcomes better than PSDSS for both OS and PFS. There was no association between 18 MS and either score. Conclusion. PCI is superior to PSDSS in predicting OS and PFS and remains the prognostic score of choice in CPC patients undergoing CRS/HIPEC. PMID:27006828

  6. Fungal Peritonitis: Underestimated Disease in Critically Ill Patients with Liver Cirrhosis and Spontaneous Peritonitis

    PubMed Central

    Lahmer, Tobias; Brandl, Andreas; Rasch, Sebastian; Schmid, Roland M.; Huber, Wolfgang

    2016-01-01

    Introduction Spontaneous peritonitis, especially spontaneous fungal peritonitis (SFP), is an important and potentially fatal complication in patients with endstage liver disaese. We evaluated potential risk factors, microbiological findings, and outcome of patients with SFP compared to spontaneous bacterial peritonitis (SBP) in critically ill patients. Methods Retrospective analyses of critically ill patients with suspected spontaneous peritonitis. Results Out of 205 patients, 20 (10%) had SFP, 28 (14%) had SBP, 48 (24%) had peritonitis without microbiological findings (SP) and 109 (52%) had no-peritonitis (NP). APACHE II and SOFA score were significantly higher in patients with SFP (26; 22–28; p<0.004 and 16; 14–18; p<0.002), SBP (26; 22–28; p<0.004 and 16; 14–18; p<0.002) and SP (24; 18–30; p<0.045 and 14; 10–18; p<0.044) as compared to NP (22; 16–24 and 12; 10–14). CHILD Pugh classification was mainly CHILD C and MELD Score was in patients with SFP (34; 18–40; p<0.001), SBP (32;12–40 p<0.002) and SP (29; 14–40 p<0.003) significantly higher as compared to NP (25;8–40). Nosocomial peritonitis could be significantly more often found in patients with SFP (65%; p<0.023) and SBP (62%, p<0.030) as compared to SP (51 p = 0.243) and NP (45%). Antibiotic pretreatment last 3 month prior peritonitis was significantly more often in patients with SFP (85%; p<0.002), SBP (71%, p<0.033), and SP (56; p<0.040) as compared to NP (33%). Candida albicans (60%; 12/20) was the most common isolated fungus, followed by Candida glabrata (13%) and Candida krusei (13%). Mortality rate was significantly higher in patients with SFP (90%, p<0.001), followed by SBP (75%; p<0.001) and SP (69%; p<0.001) as compared to NP (45%). Conclusion SFP is not a rare complication in end stage liver disease which is associated with increased mortality. Physicians should be aware of SFP in patients with CHILD C liver cirrhosis, elevated MELD score, antibiotic pretreatment and

  7. A prospective study evaluating utility of Mannheim peritonitis index in predicting prognosis of perforation peritonitis

    PubMed Central

    Sharma, Rajesh; Ranjan, Vikrant; Jain, Suraj; Joshi, Tulika; Tyagi, Anurag; Chaphekar, Rohan

    2015-01-01

    Aims: We aimed to validate Mannheim peritonitis index (MPI) for prediction of outcome in patients with perforation peritonitis. Materials and Methods: A prospective study involving 100 subjects operated for perforation peritonitis over the period of 2 years was designed. Postevaluation of predesigned performa, MPI score was calculated and analyzed for each patient with death being the main outcome measure. The MPI scores were divided into three categories; scores <15 (category 1), 16-25 (category 2), and >25 (category 3). Results: Our study consisted of 82 males and 18 females (male:female ratio 4.56:1), with the mean patients age of 37.96 ± 17.49 years. 47, 26, and 27 cases belonged to MPI score categories 1, 2, and 3, respectively. The most common origin of sepsis was ileal with small intestine dominating the source of perforation. When the individual parameters of MPI score were assessed against the mortality only, age >50 years (P = 0.015), organ failure (P = 0.0001), noncolonic origin of sepsis (P = 0.002), and generalized peritonitis (P = 0.0001) significantly associated with mortality. The sensitivity of MPI was 92% with a specificity of 78% in receiver operating characteristic curves. Conclusion: MPI is an effective tool for prediction of mortality in cases of perforation peritonitis. PMID:26604619

  8. Bowel Perforation During Peritoneal Dialysis Catheter Placement.

    PubMed

    Abreo, Kenneth; Sequeira, Adrian

    2016-08-01

    Interventional nephrologists and radiologists place peritoneal dialysis catheters using the percutaneous fluoroscopic technique in both the inpatient and outpatient setting. Nephrologists caring for such patients may have to diagnose and manage the complications resulting from these procedures. Abdominal pain can occur following peritoneal dialysis catheter placement when the local and systemic analgesia wears off. However, abdominal pain with hypotension is suggestive of a serious complication. Bleeding into the abdomen and perforation of the colon or bladder should be considered in the differential diagnosis. In the case reported here, the peritoneogram showed contrast in the bowel, and correct interpretation by the interventionist would have prevented this complication. The characteristic pattern of peritoneogram images in this case will guide interventionists to avoid this complication, and the discussion of the differential diagnosis and management will assist nephrologists in taking care of such patients. PMID:26857647

  9. Particle size and traffic of phagocytes between the turbot peritoneal cavity and lymphoid organs.

    PubMed

    Folgueira, I; Noia, M; Blanco-Abad, V; Mallo, N; Leiro, J; Lamas, J

    2015-06-01

    New adjuvants based on microparticles are being developed for use in fish vaccines. The size of the microparticles may affect the immune response generated, as the adjuvant can either be retained at the site of injection or transported to lymphoid organs. The objectives of this study were to evaluate the maximum size of particles that can be exported out of the cavity, to determine the phagocytosis kinetics and to establish the routes whereby particle-containing cells move from the peritoneal cavity after injection. Fish were injected intraperitoneally with fluorescent cyclodextrins or with fluorescent particles of different size (0.1-10 μm). Phagocytes containing beads of size 4 μm or larger did not reach lymphoid organs, although some were able to cross the peritoneal mesothelium. The number of free peritoneal neutrophils and macrophage-like cells containing beads peaked at 6 and 24 h respectively, and the numbers then decreased quickly, indicating migration of cells to the peritoneum or other body areas. Migration of cells containing beads mainly occurs through the visceral peritoneum. These cells were found on the latero-ventral surfaces of the peritoneal folds that connect the visceral organs. Except for some vascularised areas, the surfaces of liver, stomach and intestine were devoid of particle-containing cells. Some cells containing beads were also found attached to the parietal peritoneum, although in lower numbers than in the visceral peritoneum. Such cells were also found in high numbers in the spleen and kidney 6 h post injection. Because cells containing phagocytosed material quickly become attached to the peritoneum or migrate to lymphoid organs, the immune response generated by a vaccine or by an inflammatory stimulus should probably be evaluated in attached cells as well as in free peritoneal cells. PMID:25839970

  10. [A case of peritoneal serous papillary carcinoma].

    PubMed

    Takeuchi, Nobuhiro; Sakata, Yoshio; Nishida, Yu; Nomura, Yusuke; Makino, Tetsuya; Maeda, Tetsuo; Tada, Hidetoshi; Kimoto, Takeo; Ueno, Sayaka; Fujiwara, Kiyoshi

    2011-08-01

    A 65-year-old female was admitted to our hospital with abdominal distension. Abdominal CT and MRI revealed massive ascites and an omental cake, but the ovaries were of normal size. After an omentum biopsy was performed during open abdominal surgery, she was diagnosed as peritoneal serous papillary adenocarcinoma. After 6 courses of chemotherapy with paclitaxel and carboplatin, the massive ascites totally disappeared, and a second look operation could be performed. She is still alive with no sign of recurrence. PMID:21829076

  11. Urgent-start peritoneal dialysis: nursing aspects.

    PubMed

    Groenhoff, Cheryl; Delgado, Edna; McClernon, Marilyn; Davis, Alicia; Malone, Latasha; Majirsky, Janet; Guest, Steven

    2014-01-01

    Urgent-start peritoneal dialysis (PD) refers to the initiation of dialysis soon after a PD catheter placement and is a treatment option available to the late-referred patient with advanced kidney disease. This article reviews nursing aspects of urgent-start PD and can serve as a guide for this evolving clinical pathway that can provide renal replacement therapy for a critical segment of the population with Stage 5 chronic kidney disease who require renal replacement therapy. PMID:25244889

  12. Peritoneal dialysis infections: an opportunity for improvement.

    PubMed

    Rodrigues, Anabela; Maciel, Marília; Santos, Cledir; Machado, Diana; Sampaio, Joana; Lima, Nelson; Carvalho, Maria J; Cabrita, António; Martins, Margarida

    2014-09-01

    Peritoneal dialysis (PD) catheter-associated infections remain a challenging cause of technique failure. Patient training and preventive measures are key elements in the management of infection rates. Twenty-seven of the 167 PD catheter transfer sets analyzed (19%) yielded a positive microbial culture (58% gram-negative bacteria). These results show that subclinical contamination, particularly from environmental gram-negative bacteria, is a potential hazard, indicating the need for a protocol for regular transfer set changes. PMID:25179339

  13. Multimodality treatment strategies have changed prognosis of peritoneal metastases.

    PubMed

    Lungoci, Corneliu; Mironiuc, Aurel Ion; Muntean, Valentin; Oniu, Traian; Leebmann, Hubert; Mayr, Max; Piso, Pompiliu

    2016-01-15

    For a long time, treatment of peritoneal metastases (PM) was mostly palliative and thus, this status was link with "terminal status/despair". The current multimodal treatment strategy, consisting of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources (multi-center and -institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results (similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists' perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams. PMID:26798438

  14. Multimodality treatment strategies have changed prognosis of peritoneal metastases

    PubMed Central

    Lungoci, Corneliu; Mironiuc, Aurel Ion; Muntean, Valentin; Oniu, Traian; Leebmann, Hubert; Mayr, Max; Piso, Pompiliu

    2016-01-01

    For a long time, treatment of peritoneal metastases (PM) was mostly palliative and thus, this status was link with “terminal status/despair”. The current multimodal treatment strategy, consisting of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources (multi-center and -institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results (similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists’ perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams. PMID:26798438

  15. Treatment strategies for gastric cancer patients with peritoneal metastasis.

    PubMed

    Imano, Motohiro; Okuno, Kiyotaka

    2014-03-01

    Although the treatment of gastric cancer improves the clinical outcomes, the survival of gastric cancer patients with peritoneal metastasis is still very poor. Effective drugs against peritoneal metastasis, coupled with new therapeutic modalities, are needed to improve the prognoses of these patients. Paclitaxel and TS-1 are candidate drugs for peritoneal metastasis, and intraperitoneal chemotherapy and targeted therapy are potential new therapeutic modalities. Two phase II studies using TS-1 and intraperitoneal and systemic paclitaxel for gastric cancer patients with peritoneal metastasis showed respectable survival results. In addition, peritoneal metastatic lesions showed high levels of epithelial cellular adhesion molecule (ECAM) and very low levels of human epidermal growth factor receptor 2 (HER2), thus indicating that an anti-ECAM monoclonal antibody, catumaxomab, would be effective against gastric cancer-derived peritoneal metastasis. Although catumaxomab and intraperitoneally administered paclitaxel are not generally used in Japan at present, these treatment strategies might therefore be effectively used in Japan in the near future. PMID:23677598

  16. Chronic peritoneal dialysis catheters: challenges and design solutions.

    PubMed

    Ash, S R

    2006-01-01

    Although highly successful as transcutaneous access devices, today's peritoneal dialysis catheters still have imperfect hydraulic function, biocompatibility and resistance to infection. Success of Tenckhoff catheters is greatly improved by the proper positioning of deep and subcutaneous cuffs and intraperitoneal segment. Newer peritoneal catheter designs are intended to improve hydraulic function, avoid outflow failure, and diminish exit site infection. These catheter designs serve as excellent alternatives for patients with various types of failure of Tenckhoff catheters. Catheters have been designed for Continuous Flow Peritoneal Dialysis, and have generally been successful in providing high peritoneal dialysis flow rate, but not always successful in optimally distributing flow of peritoneal fluid. Improvements in catheter design may expand the use of peritoneal dialysis as a successful home dialysis therapy. PMID:16485243

  17. Evaluating the effect of intraoperative peritoneal lavage on bacterial culture in dogs with suspected septic peritonitis

    PubMed Central

    Swayne, Seanna L.; Brisson, Brigitte; Weese, J. Scott; Sears, William

    2012-01-01

    This pilot study describes the effect of intraoperative peritoneal lavage (IOPL) on bacterial counts and outcome in clinical cases of septic peritonitis. Intraoperative samples were cultured before and after IOPL. Thirty-three dogs with presumed septic peritonitis on the basis of cytology were managed surgically during the study period. Positive pre-lavage bacterial cultures were found in 14 cases, 13 of which were a result of intestinal leakage. The post-lavage cultures showed fewer isolates in 9 cases and in 1 case became negative. The number of dogs with a decrease in the concentration of bacteria cultured from pre-lavage to post-lavage samples was not statistically significant. There was no significant effect of the change in pre- to post-lavage culture, single versus multiple types of bacteria, selection of an appropriate empiric antimicrobial on survival or the need for subsequent surgery. PMID:23450861

  18. [DISSEMINATED PERITONEAL LEYOMYOMATOSIS--PRACTICAL APPROACH TO DIAGNOSIS].

    PubMed

    Gincheva, D; Nikolova, M

    2016-01-01

    Disseminated peritoneal leiomyomatosis (DPL) is a rare condition characterized by the presence of multiple histologically benign smooth muscle nodules on the surface subperitoneal tissue simulating macroscopic peritoneal carcinomatosis. This disease is rare, but in recent years, in connection with the widespread introduction of laparoscopic surgery, the reports of disseminated peritoneal leiomyomatosis occurring after laparoscopic morcellation, were frequent. The knowledge of DPL is necessary to develop methods of prevention, and individualized treatment depending on the pathogenesis and clinical manifestations in each patient. PMID:27509658

  19. Transportation.

    ERIC Educational Resources Information Center

    Crank, Ron

    This instructional unit is one of 10 developed by students on various energy-related areas that deals specifically with transportation and energy use. Its objective is for the student to be able to discuss the implication of energy usage as it applies to the area of transportation. Some topics covered are efficiencies of various transportation…

  20. Gastric Cancer with Peritoneal Tuberculosis: Challenges in Diagnosis and Treatment

    PubMed Central

    Alshahrani, Amer Saeed

    2016-01-01

    Herein, we report a 39-year-old female patient presenting with gastric cancer and tuberculous peritonitis. The differential diagnosis between advanced gastric cancer with peritoneal carcinomatosis and early gastric cancer with peritoneal tuberculosis (TB), and the treatment of these two diseases, were challenging in this case. Physicians should have a high index of suspicion for peritoneal TB if the patient has a history of this disease, especially in areas with a high incidence of TB, such as South Korea. An early diagnosis is critical for patient management and prognosis. A surgical approach including tissue biopsy or laparoscopic exploration is recommended to confirm the diagnosis. PMID:27433397

  1. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer—Patient Version

    Cancer.gov

    Information about ovarian, fallopian tube, and primary peritoneal cancer treatment, prevention, genetics, causes, screening, clinical trials, research and statistics from the National Cancer Institute.

  2. Iron Inhibits Respiratory Burst of Peritoneal Phagocytes In Vitro

    PubMed Central

    Gotfryd, Kamil; Jurek, Aleksandra; Kubit, Piotr; Klein, Andrzej; Turyna, Bohdan

    2011-01-01

    Objective. This study examines the effects of iron ions Fe3+ on the respiratory burst of phagocytes isolated from peritoneal effluents of continuous ambulatory peritoneal dialysis (CAPD) patients, as an in vitro model of iron overload in end-stage renal disease (ESRD). Material and Methods. Respiratory burst of peritoneal phagocytes was measured by chemiluminescence method. Results. At the highest used concentration of iron ions Fe3+ (100 μM), free radicals production by peritoneal phagocytes was reduced by 90% compared to control. Conclusions. Iron overload may increase the risk of infectious complications in ESRD patients. PMID:22203913

  3. Clinical outcomes and mortality in elderly peritoneal dialysis patients

    PubMed Central

    Sakacı, Tamer; Ahbap, Elbis; Koc, Yener; Basturk, Taner; Ucar, Zuhal Atan; Sınangıl, Ayse; Sevınc, Mustafa; Kara, Ekrem; Akgol, Cuneyt; Kayalar, Arzu Ozdemır; Caglayan, Feyza Bayraktar; Sahutoglu, Tuncay; Ünsal, Abdulkadir

    2015-01-01

    OBJECTIVES: To evaluate the clinical outcomes and identify the predictors of mortality in elderly patients undergoing peritoneal dialysis. METHODS: We conducted a retrospective study including all incident peritoneal dialysis cases in patients ≥65 years of age treated from 2001 to 2014. Demographic and clinical data on the initiation of peritoneal dialysis and the clinical events during the study period were collected. Infectious complications were recorded. Overall and technique survival rates were analyzed. RESULTS: Fifty-eight patients who began peritoneal dialysis during the study period were considered for analysis, and 50 of these patients were included in the final analysis. Peritoneal dialysis exchanges were performed by another person for 65% of the patients, whereas 79.9% of patients preferred to perform the peritoneal dialysis themselves. Peritonitis and catheter exit site/tunnel infection incidences were 20.4±16.3 and 24.6±17.4 patient-months, respectively. During the follow-up period, 40 patients were withdrawn from peritoneal dialysis. Causes of death included peritonitis and/or sepsis (50%) and cardiovascular events (30%). The mean patient survival time was 38.9±4.3 months, and the survival rates were 78.8%, 66.8%, 50.9% and 19.5% at 1, 2, 3 and 4 years after peritoneal dialysis initiation, respectively. Advanced age, the presence of additional diseases, increased episodes of peritonitis, the use of continuous ambulatory peritoneal dialysis, and low albumin levels and daily urine volumes (<100 ml) at the initiation of peritoneal dialysis were predictors of mortality. The mean technique survival duration was 61.7±5.2 months. The technique survival rates were 97.9%, 90.6%, 81.5% and 71% at 1, 2, 3 and 4 years, respectively. None of the factors analyzed were predictors of technique survival. CONCLUSIONS: Mortality was higher in elderly patients. Factors affecting mortality in elderly patients included advanced age, the presence of comorbid

  4. A new internet tool to report peritoneal malignancy extent. PeRitOneal MalIgnancy Stage Evaluation (PROMISE) application.

    PubMed

    Villeneuve, L; Thivolet, A; Bakrin, N; Mohamed, F; Isaac, S; Valette, P-J; Glehen, O; Rousset, P

    2016-06-01

    Based on the importance of assessing the true extent of peritoneal disease, PeRitOneal MalIgnancy Stage Evaluation (PROMISE) internet application (www.e-promise.org) has been developed to facilitate tabulation and automatically calculate surgically validated peritoneal cancer index (PCI), and other surgically validated scores as Gilly score, simplified peritoneal cancer index (SPCI), Fagotti and Fagotti-modified scores. This application offers computer-assistance to produce simple, quick but precise and standardized pre, intra and postoperative reports of the extent of peritoneal metastases and may help specialized and non-specialized institutions in their current practice but also facilitate research and multicentre studies on peritoneal surface malignancies. PMID:27067193

  5. Protein kinase C α inhibition prevents peritoneal damage in a mouse model of chronic peritoneal exposure to high-glucose dialysate.

    PubMed

    Wang, Le; Balzer, Michael S; Rong, Song; Menne, Jan; von Vietinghoff, Sibylle; Dong, Lei; Gueler, Faikah; Jang, Mi-Sun; Xu, Gang; Timrott, Kai; Tkachuk, Sergey; Hiss, Marcus; Haller, Hermann; Shushakova, Nelli

    2016-06-01

    Chronic exposure to commercial glucose-based peritoneal dialysis fluids during peritoneal dialysis induces peritoneal membrane damage leading to ultrafiltration failure. In this study the role of protein kinase C (PKC) α in peritoneal membrane damage was investigated in a mouse model of peritoneal dialysis. We used 2 different approaches: blockade of biological activity of PKCα by intraperitoneal application of the conventional PKC inhibitor Go6976 in C57BL/6 wild-type mice and PKCα-deficient mice on a 129/Sv genetic background. Daily administration of peritoneal dialysis fluid for 5 weeks induced peritoneal upregulation and activation of PKCα accompanied by epithelial-to-mesenchymal transition of peritoneal mesothelial cells, peritoneal membrane fibrosis, neoangiogenesis, and macrophage and T cell infiltration, paralleled by reduced ultrafiltration capacity. All pathological changes were prevented by PKCα blockade or deficiency. Moreover, treatment with Go6976 and PKCα deficiency resulted in strong reduction of proinflammatory, profibrotic, and proangiogenic mediators. In cell culture experiments, both treatment with Go6976 and PKCα deficiency prevented peritoneal dialysis fluid-induced release of MCP-1 from mouse peritoneal mesothelial cells and ameliorated transforming growth factor-β1-induced epithelial-to-mesenchymal transition and peritoneal dialysis fluid-induced MCP-1 release in human peritoneal mesothelial cells. Thus, PKCα plays a crucial role in the pathophysiology of peritoneal membrane dysfunction induced by peritoneal dialysis fluids, and we suggest that its therapeutic inhibition might be a valuable treatment option for peritoneal dialysis patients. PMID:27142955

  6. Busted Butte Unsaturated Zone Transport Test: Fiscal Year 1998 Status Report Yucca Mountain Site Characterization Program Deliverable SPU85M4

    SciTech Connect

    Bussod, G.Y.; Turin, H.J.; Lowry, W.E.

    1999-11-01

    This report describes the status of the Busted Butte Unsaturated Zone Transport Test (UZTT) and documents the progress of construction activities and site and laboratory characterization activities undertaken in fiscal year 1998. Also presented are predictive flow-and-transport simulations for Test Phases 1 and 2 of testing and the preliminary results and status of these test phases. Future anticipated results obtained from unsaturated-zone (UZ) transport testing in the Calico Hills Formation at Busted Butte are also discussed in view of their importance to performance assessment (PA) needs to build confidence in and reduce the uncertainty of site-scale flow-and-transport models and their abstractions for performance for license application. The principal objectives of the test are to address uncertainties associated with flow and transport in the UZ site-process models for Yucca Mountain, as identified by the PA working group in February 1997. These include but are not restricted to: (1) The effect of heterogeneities on flow and transport in unsaturated and partially saturated conditions in the Calico Hills Formation. In particular, the test aims to address issues relevant to fracture-matrix interactions and permeability contrast boundaries; (2) The migration behavior of colloids in fractured and unfractured Calico Hills rocks; (3) The validation through field testing of laboratory sorption experiments in unsaturated Calico Hills rocks; (4) The evaluation of the 3-D site-scale flow-and-transport process model (i.e., equivalent-continuum/dual-permeability/discrete-fracture-fault representations of flow and transport) used in the PA abstractions for license application; and (5) The effect of scaling from lab scale to field scale and site scale.

  7. Placental Expression of the Heme Transporter, Feline Leukemia Virus Subgroup C Receptor, Is related to Maternal Iron Status in Pregnant Adolescents123

    PubMed Central

    Jaacks, Lindsay M.; Young, Melissa F.; Essley, Bridget V.; McNanley, Thomas J.; Cooper, Elizabeth M.; Pressman, Eva K.; McIntyre, Allison W.; Orlando, Mark S.; Abkowitz, Janis L.; Guillet, Ronnie; O'Brien, Kimberly O.

    2011-01-01

    Little is known about the expression of heme transporters in human placenta and possible associations between these transporters and maternal or neonatal iron status. To address this area of research, relative protein expression of 2 heme transporters, Feline Leukemia Virus, Subgroup C, Receptor 1 (FLVCR1) and Breast Cancer Resistance Protein (BCRP), was assessed using Western-blot analysis in human placental tissue in relation to maternal/neonatal iron status and placental iron concentration. Placental FLVCR1 (n = 71) and BCRP (n = 83) expression were assessed at term (36.6–41.7 wk gestation) in a cohort of pregnant adolescents (13–18 y of age) at high-risk of iron deficiency. Both FLVCR1 and BCRP were detected in all placental samples assayed. Placental FLVCR1 expression was positively related to placental BCRP expression (n = 69; R2 = 0.104; P < 0.05). Adolescents that were anemic at delivery had lower placental FLVCR1 expression (n = 49; P < 0.05). Placental FLVCR1 expression was positively associated with placental iron concentration at delivery (n = 61; R2 = 0.064; P < 0.05). In contrast, placental BCRP expression was not significantly associated with maternal iron status or placental iron content. Both FLVCR1 and BCRP are highly expressed in human placental tissue, but only FLVCR1 was significantly inversely associated with maternal iron status and placental iron concentration. Further analysis is needed to explore potential functional roles of FLVCR1 in human placental iron transport. PMID:21593354

  8. Peritoneal dialysis. An adjunct to pediatric postcardiotomy fluid management.

    PubMed Central

    Stromberg, D; Fraser, C D; Sorof, J M; Drescher, K; Feltes, T F

    1997-01-01

    Patients requiring cardiopulmonary bypass for congenital heart surgery commonly exhibit impaired renal function and extravascular fluid retention. These conditions contribute to early postoperative fluid overload, which may result in significant morbidity and mortality. We examined the safety and efficacy of peritoneal dialysis in removing extravascular fluid from critically ill postcardiotomy patients. A retrospective case review from July of 1995 through April of 1996 was conducted. All patients undergoing peritoneal dialysis achieved a net negative fluid balance. Average urine output increased from 2.1 cc/kg/hr to 3.9 cc/kg/hr (P < 0.01) during the pre-peritoneal dialysis to post-peritoneal dialysis period, and the mean number of inotropic agents decreased from 2.2 to 1.7 (P < 0.05). Controlled comparison revealed that the peritoneal dialysis cohort more rapidly achieved a negative weight-adjusted fluid balance throughout the early postoperative course. The peritoneal dialysis group's illness severity decreased more rapidly within the 24-hour period after initiation of peritoneal dialysis than did that of the control cohort over the same period of time. No difference in postoperative morbidity or mortality existed between the study groups. Complications from the catheter placement were minimal, and no patient experienced peritonitis or metabolic or hemodynamic instability during peritoneal dialysis catheter placement, usage, or removal. Peritoneal dialysis is a safe and effective form of renal replacement therapy, even among critically ill pediatric postcardiotomy patients. Early postsurgical institution of peritoneal dialysis may hasten early postoperative recovery. We speculate that intraoperative catheter placement reduces the complication rate associated with this treatment modality. PMID:9456479

  9. Laboratory diagnosis of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis

    PubMed Central

    Fenton, Patricia

    1982-01-01

    A simple laboratory method for culture of continuous ambulatory peritoneal dialysis (CAPD) fluids is described. Guidelines for antimicrobial therapy are discussed based on results from 18 patients studied over an 11-week period. Cephalosporins appeared to be a rational choice for therapy while awaiting laboratory results. PMID:6754760

  10. Late presentation of encapsulating peritoneal sclerosis following renal transplantation and the potential under-reporting of the incidence and prevalence of encapsulating peritoneal sclerosis.

    PubMed

    Davenport, Andrew

    2015-07-01

    Encapsulating peritoneal sclerosis is an infrequent but potentially devastating complication of peritoneal dialysis. The reported incidence and prevalence of encapsulating peritoneal sclerosis vary markedly between countries. Currently, peritoneal dialysis vintage remains the major risk factor for encapsulating peritoneal sclerosis, and dialysis vintage differs between countries due to the relative competing risks of transplantation, availability of haemodialysis and peritonitis. However, the diagnosis of encapsulating peritoneal sclerosis is often only established when patients have transferred modality to transplantation or haemodialysis. Switching treatment modality may potentially lead to an under-reporting of encapsulating peritoneal sclerosis, as many countries which collect data on dialysis patients in national registries often have separate registries for dialysis and transplant patients, and this may potentially lead to under-reporting of encapsulating peritoneal sclerosis in patients presenting after renal transplantation. Secondly, the question arises as to how long former peritoneal dialysis patients should be followed before a diagnosis of encapsulating peritoneal sclerosis can be confidently excluded. To highlight this point, we present four cases that developed symptomatic encapsulating peritoneal sclerosis more than 5 years, and in once case more than 10 years after the discontinuation of peritoneal dialysis. Delayed or late presentation may not only delay the diagnosis, but also risk surgical interventions by non-specialists. A more robust system is required to record cases of encapsulating peritoneal sclerosis to determine the incidence and prevalence, and so provide accurate information to both patients and clinicians as to the risks of long-term peritoneal dialysis therapy. PMID:26063486

  11. Effect of aflatoxins on rat peritoneal macrophages.

    PubMed Central

    Cusumano, V; Costa, G B; Seminara, S

    1990-01-01

    Phagocytosis, intracellular killing of Candida albicans, and superoxide production by rat peritoneal macrophages exposed to aflatoxins B1, B2, G1, G2, B2a, and M1 at several times and concentrations were analyzed to evaluate the intensity of a depressive effect for each mycotoxin. All aflatoxins used at very low concentrations had a depressive effect on the functions of macrophages. The biggest impairment of phagocytosis, intracellular killing, and spontaneous superoxide production was observed in macrophages exposed to aflatoxins B1 and M1. PMID:2176448

  12. Pleural effusion in a peritoneal dialysis patient.

    PubMed

    Bae, Eun Hui; Kim, Chang Seong; Choi, Joon Seok; Kim, Soo Wan

    2011-04-01

    A 34-year-old female presented with end-stage renal disease (ESRD) treated by peritoneal dialysis (CAPD) complained of a dry cough. Chest X-ray and chest computed tomography (CT) scan revealed massive right hydrothorax. Because the glucose concentration of pleural fluid was markedly high compared with that of serum, we performed isotope and contrast peritoneography. We used CT for localizing it. MRI was also trying to show transdiaphragmatic leakage in peritoneoflural fistula. Temporary discontinuation of CAPD, tetracycline instillation into the pleural space and surgical patch grafting of the diaphragmatic leak have all been described. A novel method may be video-assisted talc pleurodesis. PMID:22111056

  13. [A new view on pathochemical mechanisms of prolonged peritoneal dialysis].

    PubMed

    Petrovich, Iu A; Iarema, I V; Terekhina, N A; Kichenko, S M

    2010-01-01

    New data on etiology, pathogenesis, clinics, quantity estimation, treatment and complications of peritoneal dialysis are observed. The role of aquaporine, nitric oxide, NO-synthase, inflammation and sepsis markers (procalcitonine, C-reactive protein) in pathochemical mechanism of peritoneal dialysis is discussed. PMID:20734476

  14. [The nature of postoperative complications in patients with peritonitis].

    PubMed

    Churpiĭ, I K

    2014-01-01

    We studied the postoperative period in patients with peritonitis. The structure of the most important factors that slow down the healing process and lead to mortality. Among the factors that affect the healing process is the most important character of fluid, and the prevalence of peritonitis (causative factor), which causes complications on the part of the internal organs and wounds. PMID:25906657

  15. Outcome Comparisons Between Patients on Peritoneal Dialysis With and Without Polycystic Kidney Disease

    PubMed Central

    Yang, Ju-Yeh; Chen, Likwang; Chao, Chia-Ter; Peng, Yu-Sen; Chiang, Chih-Kang; Kao, Tze-Wah; Chien, Kuo-Liong; Wu, Hon-Yen; Huang, Jenq-Wen; Hung, Kuan-Yu

    2015-01-01

    Abstract Polycystic kidney disease (PCKD) is the most common hereditary cause of end-stage renal disease. The complications associated with this disease may affect the performance of peritoneal dialysis (PD). The aim of this study was to compare the outcomes between patients on PD with PCKD and without PCKD. We extracted an incident cohort of adult (≥20 years old) patients on long-term PD from the Taiwan National Health Insurance Research Database. Patients with PCKD were identified by specific diagnosis codes. We recorded baseline comorbidities, socioeconomic status, timing of referral to a nephrologist, prior hemodialysis history before PD, and the type of PD modalities. We compared the risk of death, technique failure, peritonitis, hospitalization, and outpatient visiting as well as overall medical expenditure between the patients with PCKD and a groups of patients without PCKD who were propensity-score matched (1:3). The analysis was carried out by various Cox regression models that considered competing risk and time-varying coefficients. We enrolled 139 patients with PCKD and 7739 patients without PCKD who started long-term PD between 1999 and 2010. Patients with PCKD were less comorbid and more often treated with automated PD. In the propensity-score matched analysis, both overall survival and technique survival did not differ between the patients and the result was similar for hospitalization and peritonitis after adjusting for the application of automated PD. Furthermore, the overall annual medical expenditures were similar between the patients with and without PCKD. PD patients with PCKD are comparable to PD patients without PCKD in terms of risk of death, peritonitis, technique failure, and hospitalization in the present study. Furthermore, the medical expenses of the 2 groups after initiation of PD are also indistinguishable. PMID:26632899

  16. A biocompatibility study on peritoneal dialysis solution bags for CAPD.

    PubMed

    Carozzi, S; Nasini, M G; Schelotto, C; Caviglia, P M; Santoni, O; Pietrucci, A

    1993-01-01

    Numerous factors related to the composition of peritoneal dialysis solutions (PDS) contribute to the pathogenesis of peritoneal fibrosis during continuous ambulatory peritoneal dialysis (CAPD). They include high osmolarity, low pH, and the presence of lactate, which may be responsible for stimulating the proliferation of peritoneal fibroblasts (PF) and for the toxicity on the peritoneal mesothelial cells (PMC). Similar effects could be hypothesized for the plasticizers released from the PDS bags, usually made of polyvinyl chloride (PVC), such as the acid esters of phthalic acid, particularly bis-(2-ethylhexyl) phthalate (BEHP). Recently, however, new BEHP-free bags (Clear-Flex, Bieffe, Italy) made of three layers (polyethylene, nylon, and polypropylene) have been introduced. The aim of this work is to evaluate in vitro the effects of samples of PDS contained in PVC bags (Bieffe) and in Clear-Flex bags on the proliferative capacity of peritoneal fibroblasts and peritoneal mesothelial cells, and the release of interferon gamma (IFN gamma), interleukin-1 (IL-1) and prostaglandin E2 (PGE2) from peritoneal T lymphocytes (PTLs) and macrophages (PM phi s). Results have shown that in the presence of PDS samples contained in PVC bags, the proliferative capacity of peritoneal fibroblasts was higher than in Clear-Flexbags. There was also an increased release of IFN-gamma and IL-1 from PTLs and PM phi s (cytokines that stimulate the collagen synthesis) and a decreased release of PGE2 (cytokines which inhibit the collagen synthesis). An inhibiting action on peritoneal mesothelial cells was also seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8105908

  17. Aeromonas hydrophila as a causative organism in peritoneal dialysis-related peritonitis: case report and review of the literature.

    PubMed

    Liakopoulos, V; Arampatzis, S; Kourti, P; Tsolkas, T; Zarogiannis, S; Eleftheriadis, T; Giannopoulou, M; Stefanidis, I

    2011-02-01

    Most episodes of peritoneal dialysis (PD)-related peritonitis could be attributed to a single organism, but in almost 10% of peritonitis episodes multiple organisms are identified. Polymicrobial peritonitis is often related to intra-abdominal pathology, and the prognosis may be poor. Aeromonas spp. have rarely been identified as the causative pathogen in PD-related peritonitis, and a very small number of cases has been reported in the literature. These rod-shaped, gram-negative microorganisms have been isolated from wastewater drainage systems, food, vegetables, and soil. Herein we report a case of polymicrobial peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) patient with systemic lupus erythematosus (SLE), due to a combination of Streptococcus viridans and Aeromonas hydrophila infection. The patient was involved in gardening and was not compliant with her technique protocol. She did not wear a mask and omitted thorough hand washing. The patient was treated with i.p. vancomycin and ceftazidime and peritonitis was resolved. The patient's technique was reassessed, and she was retrained by our PD nurses. PMID:21269597

  18. Are the Mesothelial-to-Mesenchymal Transition, Sclerotic Peritonitis Syndromes, and Encapsulating Peritoneal Sclerosis Part of the Same Process?

    PubMed Central

    Loureiro, Jesús; Gónzalez-Mateo, Guadalupe; Jimenez-Heffernan, José; Selgas, Rafael; López-Cabrera, Manuel; Aguilera Peralta, Abelardo

    2013-01-01

    Mesothelial-to-mesenchymal transition (MMT) is an autoregulated physiological process of tissue repair that in uncontrolled conditions, such as peritoneal dialysis (PD), can lead to peritoneal fibrosis. The maximum expression of sclerotic peritoneal syndromes (SPS) is the encapsulating peritoneal sclerosis (EPS) for which no specific treatment exists. The SPS includes a wide range of peritoneal fibrosis that appears progressively and is considered as a reversible process, while EPS does not. EPS is a serious complication of PD characterized by a progressive intra-abdominal inflammatory process that results in bridles and severe fibrous tissue formation which cover and constrict the viscera. Recent studies show that transdifferentiated mesothelial cells isolated from the PD effluent correlate very well with the clinical events such as the number of hemoperitoneum and peritonitis, as well as with PD function (lower ultrafiltration and high Cr-MTC). In addition, in peritoneal biopsies from PD patients, the MMT correlates very well with anatomical changes (fibrosis and angiogenesis). However, the pathway to reach EPS from SPS has not been fully and completely established. Herein, we present important evidence pointing to the MMT that is present in the initial peritoneal fibrosis stages and it is perpetual over time, with at least theoretical possibility that MMT initiated the fibrosing process to reach EPS. PMID:23476771

  19. Possible development of idiopathic sclerosing encapsulating peritonitis.

    PubMed

    Yanagi, H; Kusunoki, M; Yamamura, T

    1999-01-01

    We report a rare case of idiopathic sclerosing encapsulating peritonitis (SEP). During a laparotomy before undergoing a distal gastrectomy with Billroth II reconstruction for early gastric cancer, the patient was found to have a membranous encapsulation wrapping each small bowel loop, unlike peritoneal encapsulation or typical SEP. He had complained of persistent heartburn, distension and diarrhea for 2 months in the post-operative course. The second laparotomy, which was performed to improve prolonged transit, revealed typical SEP with a thick and fibrotic membrane that encased the small bowel entirely. Stripping of the sclerosing encasing membrane, separation of the adherent loops of the proximal small bowel, and Braun's anastomosis were performed. The patient complained of epigastric fullness and diarrhea after he was relieved from the complete bowel obstruction for 45 days post-operatively. Trimebutine maleate was administrated 5 months after the second operation and this markedly improved his symptoms. This case might reflect the developmental process of idiopathic SEP. In addition, the use of a motility regulator may improve symptoms related to the abnormal intestinal motility by this disease. PMID:10228820

  20. Dynasore, a Dynamin Inhibitor, Inhibits Trypanosoma cruzi Entry into Peritoneal Macrophages

    PubMed Central

    Barrias, Emile S.; Reignault, Lissa C.; De Souza, Wanderley; Carvalho, Tecia M. U.

    2010-01-01

    Background Trypanosoma cruzi is an intracellular parasite that, like some other intracellular pathogens, targets specific proteins of the host cell vesicular transport machinery, leading to a modulation of host cell processes that results in the generation of unique phagosomes. In mammalian cells, several molecules have been identified that selectively regulate the formation of endocytic transport vesicles and the fusion of such vesicles with appropriate acceptor membranes. Among these, the GTPase dynamin plays an important role in clathrin-mediated endocytosis, and it was recently found that dynamin can participate in a phagocytic process. Methodology/Principal Findings We used a compound called dynasore that has the ability to block the GTPase activity of dynamin. Dynasore acts as a potent inhibitor of endocytic pathways by blocking coated vesicle formation within seconds of its addition. Here, we investigated whether dynamin is involved in the entry process of T. cruzi in phagocytic and non-phagocytic cells by using dynasore. In this aim, peritoneal macrophages and LLC-MK2 cells were treated with increasing concentrations of dynasore before interaction with trypomastigotes, amastigotes or epimastigotes. We observed that, in both cell lines, the parasite internalization was drastically diminished (by greater than 90% in LLC-MK2 cells and 70% in peritoneal macrophages) when we used 100 µM dynasore. The T. cruzi adhesion index, however, was unaffected in either cell line. Analyzing these interactions by scanning electron microscopy and comparing peritoneal macrophages to LLC-MK2 cells revealed differences in the stage at which cell entry was blocked. In LLC-MK2 cells, this blockade is observed earlier than it is in peritoneal macrophages. In LLC-MK2 cells, the parasites were only associated with cellular microvilli, whereas in peritoneal macrophages, trypomastigotes were not completely engulfed by a host cell plasma membrane. Conclusions/Significance Taken

  1. Theoretical analysis of osmotic agents in peritoneal dialysis. What size is an ideal osmotic agent?

    PubMed

    Rippe, B; Zakaria el-R; Carlsson, O

    1996-01-01

    In this article the difference between osmotic fluid flow (ultrafiltration) as driven by osmotic pressure and diffusion through thin leaky membranes is discussed. It is pointed out that water transport induced by osmosis is fundamentally different from the process of water diffusion. Applying modern hydrodynamic pore theory, the molar solute concentration and the solute concentration in grams per 100 mL, exerting the same initial transmembrane osmotic pressure as a 1% glucose solution, was investigated as a function of solute molecular weight (MW). It was then assumed, base on experimental data, that the major pathway responsible for the peritoneal osmotic barrier characteristics is represented by pores of radius approximately 47 A. With increasing solute radius, the osmotic reflection coefficient (sigma) and, hence, the osmotic efficiency per mole of solute will increase. However, simultaneously, the molar concentration per unit solute weight will decrease. The balance point between these two events apparently occurs at a solute MW of approximately 1 kDa. An additional advantage of using solutes of high MW as osmotic agents during peritoneal dialysis (PD), rather than increased osmotic efficiency per se, lies in the fact that large solutes, due to their low peritoneal diffusion capacity, will maintain a sustained rate of ultrafiltration (osmosis) over a prolonged period. To illustrate this, we have performed computer simulations of peritoneal fluid transport according to the three-pore model of peritoneal permselectivity. According to these simulations, 4% of an 800 Da polymer solution (+50 mmol/L above isotonicity) will produce the same cumulative amount of intraperitoneal fluid volume ultrafiltered (UF) during 360-400 minutes as 4% of a 2 kDa polymer solution (+20 mmol/L) or 6.5% of a 10 kDa polymer solution (+6.5 mmol/L) having the same electrolyte concentration as dialysis solutions conventionally used for PD. Similar cumulative UF volumes (during 400 minutes

  2. Molecular mechanisms of peritoneal dissemination in gastric cancer

    PubMed Central

    Kanda, Mitsuro; Kodera, Yasuhiro

    2016-01-01

    Peritoneal dissemination represents a devastating form of gastric cancer (GC) progression with a dismal prognosis. There is no effective therapy for this condition. The 5-year survival rate of patients with peritoneal dissemination is 2%, even including patients with only microscopic free cancer cells without macroscopic peritoneal nodules. The mechanism of peritoneal dissemination of GC involves several steps: detachment of cancer cells from the primary tumor, survival in the free abdominal cavity, attachment to the distant peritoneum, invasion into the subperitoneal space and proliferation with angiogenesis. These steps are not mutually exclusive, and combinations of different molecular mechanisms can occur in each process of peritoneal dissemination. A comprehensive understanding of the molecular events involved in peritoneal dissemination is important and should be systematically pursued. It is crucial to identify novel strategies for the prevention of this condition and for identification of markers of prognosis and the development of molecular-targeted therapies. In this review, we provide an overview of recently published articles addressing the molecular mechanisms of peritoneal dissemination of GC to provide an update on what is currently known in this field and to propose novel promising candidates for use in diagnosis and as therapeutic targets. PMID:27570420

  3. Molecular mechanisms of peritoneal dissemination in gastric cancer.

    PubMed

    Kanda, Mitsuro; Kodera, Yasuhiro

    2016-08-14

    Peritoneal dissemination represents a devastating form of gastric cancer (GC) progression with a dismal prognosis. There is no effective therapy for this condition. The 5-year survival rate of patients with peritoneal dissemination is 2%, even including patients with only microscopic free cancer cells without macroscopic peritoneal nodules. The mechanism of peritoneal dissemination of GC involves several steps: detachment of cancer cells from the primary tumor, survival in the free abdominal cavity, attachment to the distant peritoneum, invasion into the subperitoneal space and proliferation with angiogenesis. These steps are not mutually exclusive, and combinations of different molecular mechanisms can occur in each process of peritoneal dissemination. A comprehensive understanding of the molecular events involved in peritoneal dissemination is important and should be systematically pursued. It is crucial to identify novel strategies for the prevention of this condition and for identification of markers of prognosis and the development of molecular-targeted therapies. In this review, we provide an overview of recently published articles addressing the molecular mechanisms of peritoneal dissemination of GC to provide an update on what is currently known in this field and to propose novel promising candidates for use in diagnosis and as therapeutic targets. PMID:27570420

  4. A Rare Case of Ascites due to Peritoneal Amyloidosis

    PubMed Central

    Stofer, Fernanda; Barretto, Maria Fernanda; Gouvea, Ana Luisa; Ribeiro, Mario; Neves, Marcio; Gismondi, Ronaldo Altenburg; Mocarzel, Luís Otavio

    2016-01-01

    Patient: Male, 65 Final Diagnosis: Peritoneal amyloidosis Symptoms: Anasarca • Dyspnea • Orthopnea Medication: — Clinical Procedure: Paracentesis and peritoneal biopsy Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: The clinical manifestations of amyloidosis depend on the type of insoluble protein as well as the location of amyloid deposits in tissues or organs. In the gastrointestinal tract, the small intestine is the most common site of amyloid deposits, whereas peritoneal involvement and ascites are rare. Case Report: We report on a case of ascites due to peritoneal amyloidosis. A 65-year-old patient was admitted to our institution due to anasarca and pulmonary congestion, mimicking heart failure. We started the patient on diuretics and vasodilators. Despite improvement in pulmonary congestion and peripheral edema, his ascites was not reduced. Echocardiogram revealed restrictive cardiomyopathy and a speckle-tracking pattern suggestive of cardiac amyloidosis. Subcutaneous and peritoneal biopsies revealed amyloidosis. Conclusions: Amyloidosis is rare in the peritoneum and is usually asymptomatic. Ascites occurs in only 20% of patients with peritoneal amyloidosis. We searched PubMed using “ascites” and “amyloidosis” and identified only eight case reports of amyloidosis with ascites. Physicians should be particularly careful in heart failure and anasarca cases when ascites is disproportional or not responsive to diuretic treatment. To date, there is no specific treatment for peritoneal amyloidosis. PMID:27353538

  5. Current status, research needs, and opportunities in applications of surface processing to transportation and utilities technologies. Proceedings of a December 1991 workshop

    SciTech Connect

    Czanderna, A.W.; Landgrebe, A.R.

    1992-09-01

    Goal of surface processing is to develop innovative methods of surface modification and characterization for optimum performance and environmental protection for cost-effective operational lifetimes of systems, materials, and components used in transportation and utilities. These proceedings document the principal discussions and conclusions reached at the workshop; they document chapters about the current status of surface characterization with focus on composition, structure, bonding, and atomic-scale topography of surfaces. Also documented are chapters on the current status of surface modification techniques: electrochemical, plasma-aided, reactive and nonreactive physical vapor deposition, sol-gel coatings, high-energy ion implantation, ion-assisted deposition, organized molecular assemblies, solar energy. Brief chapters in the appendices document basic research in surface science by NSF, Air Force, and DOE. Participants at the workshop were invited to serve on 10 working groups. Separate abstracts were prepared for the data base where appropriate.

  6. Linagliptin Ameliorates Methylglyoxal-Induced Peritoneal Fibrosis in Mice

    PubMed Central

    Nagai, Takuo; Doi, Shigehiro; Nakashima, Ayumu; Irifuku, Taisuke; Sasaki, Kensuke; Ueno, Toshinori; Masaki, Takao

    2016-01-01

    Recent studies have reported increases of methylglyoxal (MGO) in peritoneal dialysis patients, and that MGO-mediated inflammation plays an important role in the development of peritoneal fibrosis through production of transforming growth factor-β1 (TGF-β1). Linagliptin, a dipeptidyl peptidase-4 inhibitor, exerts anti-inflammatory effects independent of blood glucose levels. In this study, we examined whether linagliptin suppresses MGO-induced peritoneal fibrosis in mice. Male C57/BL6 mice were divided into three groups: control, MGO injection plus saline, and MGO injection plus linagliptin (n = 6 per group). Peritoneal fibrosis was induced by daily intraperitoneal injection of saline containing 40 mmol/L MGO for 21 days. Saline was administered intraperitoneally to the control group. Linagliptin (10 mg/kg) or saline were administrated by once-daily oral gavage from 3 weeks before starting MGO injections. Immunohistochemical staining revealed that linagliptin suppressed expression of α-smooth muscle actin and fibroblast-specific protein-1, deposition of type I and III collagen, and macrophage (F4/80) infiltration. Peritoneal equilibration testing showed improved peritoneal functions in mice treated with linagliptin. Peritoneal injection of MGO increased plasma levels of glucagon-like peptide-1 (GLP-1) in mice, and a further increase was observed in linagliptin-treated mice. Although MGO increased plasma glucose levels, linagliptin did not decrease plasma glucose levels. Moreover, linagliptin reduced the TGF-β1 concentration in the peritoneal fluid of MGO-treated mice. GLP-1 receptor (GLP-1R) was expressed in monocytes/macrophages and linagliptin suppressed GLP-1R expression in MGO-injected mice. These results suggest that oral administration of linagliptin ameliorates MGO-induced peritoneal fibrosis. PMID:27513960

  7. Incidence and predictive factors of first episode of spontaneous bacterial peritonitis in cirrhosis with ascites: relevance of ascitic fluid protein concentration.

    PubMed

    Llach, J; Rimola, A; Navasa, M; Ginès, P; Salmerón, J M; Ginès, A; Arroyo, V; Rodés, J

    1992-09-01

    To investigate the long-term probability of the appearance of the first episode of spontaneous bacterial peritonitis in cirrhosis with ascites and to identify predictors of this complication, we closely followed throughout their illness 127 patients consecutively admitted to our unit for the treatment of an episode of ascites without prior spontaneous bacterial peritonitis (follow-up period: 21 +/- 22 mo). Thirteen patients (10%) had the first spontaneous bacterial peritonitis episode during follow-up. The appearance probability of this complication is 11% at 1 yr and 15% at 3 yr. Thirty-three variables obtained at admission (including clinical data, standard liver and kidney function test results, ascitic fluid protein concentrations and hemodynamic parameters) were analyzed in relation to their value in predicting spontaneous bacterial peritonitis development. In univariate analysis (Kaplan-Meier curves) five variables reached statistical significance (p less than 0.05) as predictive factors for the development of the first spontaneous bacterial peritonitis episode. These five variables were poor nutritional status, increased serum bilirubin levels, increased serum AST levels, decreased prothrombin activity and reduced total protein concentration in ascitic fluid. When these five variables were introduced in a multivariate analysis, only the ascitic fluid protein concentration was found to correlate independently with spontaneous bacterial peritonitis development (p = 0.002). The probability of first spontaneous bacterial peritonitis after 3 yr of follow-up was 24% and 4% in patients with ascitic fluid protein content lower than 1 gm/dl and greater than or equal to 1 gm/dl, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1505916

  8. Source of peritoneal proteoglycans. Human peritoneal mesothelial cells synthesize and secrete mainly small dermatan sulfate proteoglycans.

    PubMed Central

    Yung, S.; Thomas, G. J.; Stylianou, E.; Williams, J. D.; Coles, G. A.; Davies, M.

    1995-01-01

    This study describes experiments that compare the proteoglycans (PGs) extracted from the dialysate from patients receiving continuous peritoneal ambulatory dialysis (CAPD) with those secreted by metabolically labeled human peritoneal mesothelial cells in vitro. The PGs isolated from both sources were predominantly small chondroitin sulfate/dermatan sulfate PGs. Western blot of the core proteins obtained after chondroitin ABC lyase treatment with specific antibodies identified decorin and biglycan. With [35S]sulfate and [35S]methionine as labeling precursors it was shown that dermatan sulfate rather than chondroitin sulfate were the major glycosaminoglycan chains and that decorin was the predominant species. These data provide the first evidence that human peritoneal mesothelial cells may be the principal source of PGs in the peritoneum. Given the proposed functions of decorin and biglycan, the results suggest that these PGs may be involved in the control of transforming growth factor-beta activity and collagen fibril formation in the peritoneum. Images Figure 2 Figure 7 Figure 8 PMID:7856761

  9. Pharmacokinetics of piperacillin in patients on peritoneal dialysis with and without peritonitis.

    PubMed

    Debruyne, D; Ryckelynck, J P; Hurault De Ligny, B; Moulin, M

    1990-02-01

    The pharmacokinetics of piperacillin given intravenously (1 or 2 g) to nine patients with chronic renal failure and undergoing continuous ambulatory peritoneal dialysis was intermediate between values obtained in healthy volunteers and in patients with renal insufficiency studied between dialyses: half-life, 2.4 h; total clearance, 100 mL/min; urinary or peritoneal clearance, 3 mL/min. The intraperitoneal administration of piperacillin in dialysis fluid (400 mg or 1 g to five patients) increased the half-life (6 to 7 h) and decreased the volume of distribution of about two thirds. In both instances, the area under the curve was well correlated with dosage. The absorption of piperacillin by an inflamed peritoneum in eight patients suffering from peritonitis and treated with 400 mg, 1 g, or 2 g, was increased and returned to normal concurrently with care. Consequently, the recommended dosage is intravenous administration of 2 g of piperacillin every 8 h or intraperitoneal administration of 1 g every 6 h in the dialysate. With such conditions, serum concentrations greater than minimal inhibitory concentrations and sufficient to avoid dissemination of piperacillin-susceptible organisms without risk of accumulation are obtained. PMID:2324971

  10. Ceftriaxone-Induced Acute Encephalopathy in a Peritoneal Dialysis Patient

    PubMed Central

    Safadi, Sami; Mao, Michael; Dillon, John J.

    2014-01-01

    Encephalopathy is a rare side effect of third and fourth generation cephalosporins. Renal failure and preexisting neurological disease are notable risk factors. Recognition is important as discontinuing the offending agent usually resolves symptoms. We present a case of acute encephalopathy in a patient with end stage renal disease (ESRD) treated with peritoneal dialysis (PD) who received intravenous ceftriaxone for peritonitis. This case illustrates the potential severe neurologic effects of cephalosporins, which are recommended by international guidelines as first-line antimicrobial therapy for spontaneous bacterial peritonitis. PMID:25544915

  11. IMAGING DIAGNOSIS-SCLEROSING ENCAPSULATING PERITONITIS IN A DOG.

    PubMed

    Veiga-Parga, Tamara; Hecht, Silke; Craig, Linden

    2015-01-01

    An approximately 5-month-old American Staffordshire terrier was presented with a history of recurrent peritoneal effusion. Abdominal radiographs and ultrasound showed a loculated effusion in the ventral abdomen with dorsal displacement of abdominal organs, hepatomegaly and rounding of liver and splenic margins. Computed tomography demonstrated centrally located gastrointestinal segments surrounded by a thin soft tissue band and a thickened peritoneal lining. At necropsy a fibrous membrane continuous with liver and splenic capsules encapsulated all abdominal organs. Microscopically the abdominal wall and fibrous capsule consisted of an irregular thick layer of hypocellular connective tissue. The final diagnosis was sclerosing encapsulating peritonitis. PMID:26095283

  12. CT findings in acute peritonitis: a pattern-based approach

    PubMed Central

    Filippone, Antonella; Cianci, Roberta; Pizzi, Andrea Delli; Esposito, Gianluigi; Pulsone, Pierluigi; Tavoletta, Alessandra; Timpani, Mauro; Cotroneo, Antonio Raffaele

    2015-01-01

    Many inflammatory and infectious entities may acutely affect the peritoneum causing a thickening of its layers. Unfortunately, several acute peritoneal diseases can have overlapping features, both clinically and at imaging. Therefore, the awareness of the clinical context, although useful, may be sometimes insufficient to identify the underlying cause. This article provides a specific computed tomography-based approach including morphologic characteristics of peritoneal thickening (e.g., smooth, irregular, or nodular) and ancillary findings to narrow the differential diagnosis of acute peritonitis. PMID:26359872

  13. Rapamycin Protects from Type-I Peritoneal Membrane Failure Inhibiting the Angiogenesis, Lymphangiogenesis, and Endo-MT

    PubMed Central

    Aguirre, Anna Rita; Loureiro, Jesús; Abensur, Hugo; Sandoval, Pilar; Sánchez-Tomero, José Antonio; del Peso, Gloria; Jiménez-Heffernan, José Antonio; Ruiz-Carpio, Vicente; Selgas, Rafael; López-Cabrera, Manuel; Aguilera, Abelardo; Liappas, Georgios

    2015-01-01

    Preservation of peritoneal membrane (PM) is essential for long-term survival in peritoneal dialysis (PD). Continuous presence of PD fluids (PDF) in the peritoneal cavity generates chronic inflammation and promotes changes of the PM, such as fibrosis, angiogenesis, and lymphangiogenesis. Mesothelial-to-mesenchymal transition (MMT) and endothelial-to-mesenchymal transition (Endo-MT) seem to play a central role in this pathogenesis. We speculated that Rapamycin, a potent immunosuppressor, could be beneficial by regulating blood and lymphatic vessels proliferation. We demonstrate that mice undergoing a combined PD and Rapamycin treatment (PDF + Rapa group) presented a reduced PM thickness and lower number of submesothelial blood and lymphatic vessels, as well as decreased MMT and Endo-MT, comparing with their counterparts exposed to PD alone (PDF group). Peritoneal water transport in the PDF + Rapa group remained at control level, whereas PD effluent levels of VEGF, TGF-β, and TNF-α were lower than in the PDF group. Moreover, the treatment of mesothelial cells with Rapamycin in vitro significantly decreased VEGF synthesis and selectively inhibited the VEGF-C and VEGF-D release when compared with control cells. Thus, Rapamycin has a protective effect on PM in PD through an antifibrotic and antiproliferative effect on blood and lymphatic vessels. Moreover, it inhibits Endo-MT and, at least partially, MMT. PMID:26688823

  14. Hydrothorax: pleural effusion associated with peritoneal dialysis.

    PubMed

    Lew, Susie Q

    2010-01-01

    Hydrothorax in a patient treated with peritoneal dialysis (PD) poses a diagnostic dilemma. Hydrothorax due to migration of dialysis fluid across the diaphragm and into the pleural space creates a serious complication of PD but generally does not threaten life. Shortness of breath causes the patient to seek medical attention. A sudden diminution in dialysis adequacy or poor ultrafiltration rate constitutes a unique marker for patients treated with PD compared to the general population. This article reviews the etiology for hydrothorax specifically in the PD population. Thoracentesis with chemical analysis of the fluid, imaging studies with and without contrast or markers, and video-assisted thoracoscopic surgery play important roles in the evaluation of hydrothorax. A conservative PD regimen, surgical intervention, and pleurodesis provide treatment options to those receiving PD. PMID:20056973

  15. Unusual appearance of malignant peritoneal mesothelioma.

    PubMed

    Haberman, Amy

    2015-01-01

    Malignant peritoneal mesothelioma (MPM) is a rare and fatal cancer arising from the mesothelial cells lining the peritoneum. This typically occurs in men in their fifth and sixth decades, but can be seen in women and any age group. Pleural and extrapleural mesothelioma can arise in the setting of asbestos exposure, but other reported causes of MPM include exposure to silicate fibers and radiation therapy. Because it presents with vague symptoms such as abdominal pain, anorexia, and weight loss, it is generally advanced at diagnosis. This is a case of MPM that presented initially at contrast-enhanced computed tomography as a small focal lesion in the lesser sac, ultimately resulting in death from complications of the disease. PMID:25793652

  16. Primary peritoneal angiosarcoma: a case report.

    PubMed

    Litvan, Juan; Aghazarian, Marta; Wiley, Elizabeth; Guleria, Sonia; Dudek, Arkadiusz Z

    2014-09-01

    Peritoneal angiosarcoma is an extremely rare sarcoma (0.01287% incidence per 100,000) with an aggressive clinical course and a poor prognosis. We herein report a case of a young man with diagnosis of angiosarcoma whose tumor adhering to the inferior wall of his bladder and omentum was initially thought to be rhabdomyosarcoma. His disease state progressively worsened, despite initiation of different types of chemotherapies. Blood was tested for cytokine and soluble receptor levels. Unexpectedly and never previously reported, very high levels of interleukin-6 (IL-6), osteopontin, and prolactin were found. Surprisingly, angiogenic cytokines levels were low. The patient died 5 months after initial presentation. In the present report, we discuss the difficulties in diagnosing this rare sarcoma and possible therapeutic targets, including the IL-6 pathway that may provide more effective ways in controlling this cancer in its metastatic stage. PMID:25202083

  17. Peritoneal mesothelioma presenting as a skin nodule.

    PubMed

    Abban, Cynthia; Viglione, Michael

    2009-06-01

    Mesothelioma is a malignancy of the pleura, pericardium and peritoneum that is rarely seen in cutaneous biopsies. We present a case of a 75-year-old man with significant occupational exposure to asbestos who developed peritoneal mesothelioma that presented as a skin nodule in an old appendectomy scar. The patient presented with a complaint of increased hardness along his appendectomy scar. Physical examination revealed an anterior abdominal wall mass overlying the appendectomy scar, which was subsequently biopsied. Histologic examination of the abdominal wall mass revealed an infiltrating epithelioid and papillary neoplasm within the dermis and subcutaneous tissue. Immunohistochemical stains showed immunoreactivity for cytokeratin (CK) 7, CK 5/6, calretinin and vimentin. CK 20, monoclonal carcinoembryonic antigen, prostate-specific antigen and prostate-specific acid phosphatase were negative. The profile supported the diagnosis of mesothelioma. Cutaneous presentation of mesothelioma is rare but should be considered in the differential diagnosis of patients with significant asbestos exposure. PMID:19515047

  18. Morphological Retrospective Study of Peritoneal Biopsies from Patients with Encapsulating Peritoneal Sclerosis: Underestimated Role of Adipocytes as New Fibroblasts Lineage?

    PubMed Central

    Tooulou, Monika; Demetter, Pieter; Hamade, Anwar; Keyzer, Caroline; Nortier, Joëlle L.; Pozdzik, Agnieszka A.

    2015-01-01

    Background. Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis (PD). Besides the endothelial-to-mesenchymal transition (EMT), recently peritoneal adipocytes emerged as a potential source of fibrosis. We performed immunohistochemistry to approach EMT and to localize peritoneal adipocytes in peritoneal biopsies from PD-related EPS patients. Material and Methods. We investigated tissue expression of podoplanin, cytokeratin AE1/AE3 (mesothelium), calretinin (adipocytes), alpha-smooth muscle actin [α-SMA] (mesenchymal cells), interstitial mononuclear cell inflammation, and neoangiogenesis (CD3, CD4, CD8, CD20, CD68, and CD31 immunostainings, resp.). Results. Three patients (1 man/2 women; 17, 64, and 39 years old, resp.) developed EPS after 21, 90, and 164 months of PD therapy. In patients with EPS, we observed (1) loss of AE1/AE3 cytokeratin+ mesothelial cells without any evidence of migration into the interstitium, (2) disappearance of adipose tissue, (3) diffuse infiltration of calretinin+ cells in the areas of submesothelial fibrosis with a huge number of α-SMA and calretinin+ fusiform cells, and (4) increased vascular density. Conclusion. We report that the involvement of EMT in peritoneal fibrosis is difficult to demonstrate and that the calretinin+ adipocytes might be an underestimated component and a new source of myofibroblasts in peritoneal remodeling during PD-related EPS. PMID:26366298

  19. Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis

    PubMed Central

    Wu, Cho-Kai; Lee, Jen-Kuang; Wu, Yi-Fan; Tsai, Chia-Ti; Chiang, Fu-Tien; Hwang, Juey-Jen; Lin, Jiunn-Lee; Hung, Kuan-Yu; Huang, Jenq-Wen; Lin, Jou-Wei

    2015-01-01

    Abstract Left ventricular diastolic dysfunction (LVDD) is common among patients undergoing peritoneal dialysis (PD). We examined the relationship between LVDD, major adverse cardiovascular events (MACE), and mortality in PD patients. A total of 149 patients undergoing PD with preserved left ventricular systolic function were included and followed for 3.5 years. LVDD was diagnosed (according to the European Society of Cardiology guidelines) by conventional and tissue Doppler echocardiography. Serum high-sensitivity C-reactive protein (hsCRP) was measured. The location and volume of adipose tissue were assessed by computed tomography (CT) at the level of the fourth lumbar vertebra. Subjects with LVDD had higher levels of hsCRP, and more visceral and peritoneal fat than controls. The relationship between adjusted visceral adipose tissue and LVDD became nonsignificant when hsCRP and baseline demographic data were introduced into the logistic regression model (odds ratio = 1.52, P = 0.07). Subsequent hierarchical multivariate Cox regression analysis showed that LVDD was one of the most powerful determinants of MACE and mortality after adjusting for all confounding factors (hazard ratio [HR]: 1.71, 95% confidence interval [CI]: 1.43–3.51, P = 0.02 and HR: 2.25, 95% CI: 1.45–2.91, P = 0.04, respectively). Systemic inflammation (hsCRP) was also significantly associated with MACE and mortality (HR: 2.03, P = 0.03 and HR: 2.16, P = 0.04, respectively). LVDD is associated with systemic inflammation and increased visceral fat in patients undergoing PD. LVDD is also a sensitive, independent indicator of future MACE and mortality in PD patients. PMID:25997054

  20. Sunitinib Malate in Treating Patients With Recurrent Ovarian Epithelial, Fallopian Tube, or Primary Peritoneal Cancer

    ClinicalTrials.gov

    2015-01-15

    Recurrent Fallopian Tube Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Primary Peritoneal Cavity Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Primary Peritoneal Cavity Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Primary Peritoneal Cavity Cancer

  1. Microbiological Surveillance of Peritoneal Dialysis Associated Peritonitis: Antimicrobial Susceptibility Profiles of a Referral Center in GERMANY over 32 Years

    PubMed Central

    Kitterer, Daniel; Latus, Joerg; Pöhlmann, Christoph; Alscher, M. Dominik; Kimmel, Martin

    2015-01-01

    Objectives Peritonitis is one of the most important causes of treatment failure in peritoneal dialysis (PD) patients. This study describes changes in characteristics of causative organisms in PD-related peritonitis and antimicrobial susceptibility. Methods In this single center study we analyzed retrospective 487 susceptibility profiles of the peritoneal fluid cultures of 351 adult patients with peritonitis from 1979 to 2014 (divided into three time periods, P1-P3). Results Staphylococcus aureus decreased from P1 compared to P2 and P3 (P<0.05 and P<0.01, respectively). Methicillin-resistant S. aureus (MRSA) occurred only in P3. Methicillin-resistant Staphylococcus epidermidis (MRSE) increased in P3 over P1 and P2 (P <0.0001, respectively). In P2 and P3, vancomycin resistant enterococci were detected. The percentage of gram-negative organisms remained unchanged. Third generation cephalosporin resistant gram-negative rods (3GCR-GN) were found exclusively in P3. Cefazolin-susceptible gram-positive organisms decreased over the three decades (93% in P1, 75% in P2 and 58% in P3, P<0.01, P<0.05 and P<0.0001, respectively). Vancomycin susceptibility decreased and gentamicin susceptibility in gram-negatives was 94% in P1, 82% in P2 and 90% in P3. Ceftazidim susceptibility was 84% in P2 and 93% in P3. Conclusions Peritonitis caused by MSSA decreased, but peritonitis caused by MRSE increased. MRSA peritonitis is still rare. Peritonitis caused by 3GCR-GN is increasing. An initial antibiotic treatment protocol should be adopted for PD patients to provide continuous surveillance. PMID:26405797

  2. Methanol extract of Ocimum gratissimum protects murine peritoneal macrophages from nicotine toxicity by decreasing free radical generation, lipid and protein damage and enhances antioxidant protection

    PubMed Central

    Mahapatra, Santanu Kar; Chakraborty, Subhankari Prasad; Das, Subhasis

    2009-01-01

    In the present study, methanol extract of Ocimum gratissimum Linn (ME-Og) was tested against nicotine-induced murine peritoneal macrophage in vitro. Phytochemical analysis of ME-Og shown high amount of flavonoid and phenolic compound present in it. The cytotoxic effect of ME-Og was studied in murine peritoneal macrophages at different concentrations (0.1 to 100 µg/ml) using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5 diphenyltetrazolium bromide (MTT) method. To establish the protective role of ME-Og against nicotine toxicity, peritoneal macrophages from mice were treated with nicotine (10 mM), nicotine + ME-Og (1 to 25 µg/ml) for 12 h in culture media. The significantly (p < 0.05) increased super oxide anion generation, reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity, myeloperoxidase (MPO) activity, lipid peroxidation, protein carbonyls, oxidized glutathione levels were observed in nicotine-treated group as compared to control group; those were significantly (p < 0.05) reduced in ME-Og supplemented groups in concentration dependent manner. More over, significantly (p < 0.05) reduced antioxidant status due to nicotine exposure was effectively ameliorated by ME-Og supplementation in murine peritoneal macrophages. Among the different concentration of ME-Og, maximum protective effect was observed by 25 µg/ml, which does not produce significant cell cytotoxicity in murine peritoneal macrophages. These findings suggest the potential use and beneficial role of O. gratissimum as a modulator of nicotine-induced free radical generation, lipid-protein damage and antioxidant status in important immune cell, peritoneal macrophages. PMID:20716908

  3. A case of perforative peritonitis caused by a piece of bamboo in a patient on peritoneal dialysis.

    PubMed

    Suzuki, Yasuhiro; Mizuno, Masashi; Nakashima, Ryoko; Hiramatsu, Hideki; Toda, Susumu; Sato, Waichi; Tsuboi, Naotake; Ito, Isao; Maruyama, Shoichi; Imai, Enyu; Matsuo, Seiichi; Ito, Yasuhiko

    2011-12-01

    We report a case of peritonitis resulting from colon perforation caused by ingestion of a rare foreign body in a patient on peritoneal dialysis (PD). A 72-year-old woman on PD was hospitalized with abdominal pain and cloudy PD fluid (PDF). Although conventional antibiotic therapy was started because of a diagnosis of infectious peritonitis, low-grade fever, abdominal pain and a high number of white blood cells in PDF persisted. On day 3, anaerobic bacteria were recognized on bacterial culture of PDF, suggesting a gastrointestinal etiology. During exploratory laparotomy, sigmoidal perforation by a piece of bamboo, probably resulting from ingestion of contaminated food, was found. PMID:21879431

  4. Regulation of Synthesis and Roles of Hyaluronan in Peritoneal Dialysis

    PubMed Central

    Bowen, Timothy; Meran, Soma; Williams, Aled P.; Newbury, Lucy J.; Sauter, Matthias; Sitter, Thomas

    2015-01-01

    Hyaluronan (HA) is a ubiquitous extracellular matrix glycosaminoglycan composed of repeated disaccharide units of alternating D-glucuronic acid and D-N-acetylglucosamine residues linked via alternating β-1,4 and β-1,3 glycosidic bonds. HA is synthesized in humans by HA synthase (HAS) enzymes 1, 2, and 3, which are encoded by the corresponding HAS genes. Previous in vitro studies have shown characteristic changes in HAS expression and increased HA synthesis in response to wounding and proinflammatory cytokines in human peritoneal mesothelial cells. In addition, in vivo models and human peritoneal biopsy samples have provided evidence of changes in HA metabolism in the fibrosis that at present accompanies peritoneal dialysis treatment. This review discusses these published observations and how they might contribute to improvement in peritoneal dialysis. PMID:26550568

  5. Benign Multicystic Peritoneal Mesothelioma: A Rare Tumour of the Abdomen

    PubMed Central

    Somasundaram, Soundappan; Khajanchi, Monty; Vaja, Tejas; Jajoo, Bhushan; Dey, Amit Kumar

    2015-01-01

    Benign multicystic peritoneal mesothelioma: a rare tumor of the abdomen, is a diagnostic dilemma. This report emphasizes the importance of diagnostic laparoscopy in the diagnosis of the tumour. PMID:25866695

  6. General Information About Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

    MedlinePlus

    ... condition or to keep cancer from starting. General Information About Ovarian, Fallopian Tube, and Primary Peritoneal Cancer ... PDQ Screening and Prevention Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  7. Peritoneal Dialysis in Diabetics: There Is Room for More

    PubMed Central

    Cotovio, P.; Rocha, A.; Rodrigues, A.

    2011-01-01

    End stage renal disease diabetic patients suffer from worse clinical outcomes under dialysis-independently of modality. Peritoneal dialysis offers them the advantages of home therapy while sparing their frail vascular capital and preserving residual renal function. Other benefits and potential risks deserve discussion. Predialysis intervention with early nephrology referral, patient education, and multidisciplinary support are recommended. Skilled and updated peritoneal dialysis protocols must be prescribed to assure better survival. Optimized volume control, glucose-sparing peritoneal dialysis regimens, and elective use of icodextrin are key therapy strategies. Nutritional evaluation and support, preferential use of low-glucose degradation products solutions, and prescription of renin-angiotensin-aldosterone system acting drugs should also be part of the panel to improve diabetic care under peritoneal dialysis. PMID:22013524

  8. Status of the solar and infrared radiation submodels in the LLNL 1-D and 2-D chemical-transport models

    SciTech Connect

    Grant, K.E.; Taylor, K.E.; Ellis, J.S.; Wuebbles, D.J.

    1987-07-01

    The authors have implemented a series of state of the art radiation transport submodels in previously developed one dimensional and two dimensional chemical transport models of the troposphere and stratosphere. These submodels provide the capability of calculating accurate solar and infrared heating rates. They are a firm basis for further radiation submodel development as well as for studying interactions between radiation and model dynamics under varying conditions of clear sky, clouds, and aerosols. 37 refs., 3 figs.

  9. [Combined exchange transfusion and peritoneal dialysis treatment in a neonatal case of methylmalonic acidemia with severe hyperammonemia].

    PubMed

    Sanjurjo, P; Jaquotot, C; Vallo, A; Uriarte, R; Prats, J M; Ugarte, M; Rodríguez Soriano, J

    1982-10-01

    A case of methyl-malonic acidemia with severe neonatal hyperammoniemia is presented. Treatment during the first days of live with exchange-transfusion, with protein-free blood and peritoneal dialysis induced a decrease of blood ammonia values from 1360 to 270 micrograms/dl and the correction of systemic metabolic acidosis. Continuation of treatment by dietary means was followed by normalization of clinical status and almost total correction of the urinary excretion of methyl-malonic and propionic acids, but the patient died at 33 days of life due to an intercurrent infection. This case, together with a case previously reported of propionic acidemia with neonatal hyperammoniemia and prolonged survival, demonstrates that complementary treatment by means of exchange transfusion and peritoneal dialysis is mandatory in all cases of neonatal hyperammoniemia of metabolic origin, since survival without irreversible neurological damage is possible. PMID:6818879

  10. The kampo medicine Daikenchuto inhibits peritoneal fibrosis in mice.

    PubMed

    Kitamura, Mineaki; Nishino, Tomoya; Obata, Yoko; Oka, Satoru; Abe, Shinichi; Muta, Kumiko; Ozono, Yoshiyuki; Koji, Takehiko; Kohno, Shigeru

    2015-01-01

    Long-term peritoneal dialysis therapy causes inflammation and histological changes in the peritoneal membrane. Inflammation generally activates fibroblasts and results in fibroblast-myofibroblast differentiation. Heat-shock protein 47 (HSP 47), a collagen-specific molecular chaperone, is localized in myofibroblasts and is involved in the progression of peritoneal fibrosis. Daikenchuto (DKT), a Kampo medicine, is used to prevent postoperative colon adhesion. It inhibits inflammation and HSP 47 expression in the gastrointestinal tract. We examined the effect of DKT on chlorhexidine gluconate (CG)-induced peritoneal fibrosis in mice injected with 0.1% CG dissolved in 15% ethanol. DKT was dissolved in the drinking water. Histological changes were assessed using Masson trichrome staining. Cells expressing α-smooth muscle actin (α-SMA), HSP 47, phospho-Smad 2/3, F4/80, and monocyte chemotactic protein-1 were examined immunohistochemically. Compared with the control group, the peritoneal tissues of the CG group were markedly thickened, and the number of cells expressing α-SMA, HSP 47, phospho-Smad 2/3, F4/80, and monocyte chemotactic protein-1 was significantly increased. However, these changes were inhibited in the DKT-treated group. These results indicate that DKT can prevent peritoneal fibrosis by inhibiting inflammation and HSP 47 expression. PMID:25747978

  11. The Effect of Peritoneal Air Exposure on Intestinal Mucosal Barrier

    PubMed Central

    Bao, Jun; Tan, Shanjun; Yu, Wenkui; Lin, Zhiliang; Dong, Yi; Chen, Qiyi; Shi, Jialiang; Duan, Kaipeng; Bai, Xiaowu; Xu, Lin; Li, Jieshou

    2014-01-01

    Background. Damage of the intestinal mucosa barrier may result in intestinal bacterial and endotoxin translocation, leading to local and systemic inflammation. The present study was designed to investigate whether peritoneal air exposure induces damage of intestinal mucosal barrier. Methods. Sprague-Dawley rats (weighing 210 to 230 g) were randomized into five groups (6/group): a control group, a sham group, and three exposure groups with peritoneal air exposure for 1, 2, and 3 h, respectively. At 24 h after surgery, blood and terminal ileum were sampled. The serum D-lactate levels were determined using an ELISA kit. The intestinal permeability was determined by measuring the intestinal clearance of FITC-dextran (FD4). The histopathological changes in terminal ileum were also assessed. Results. Compared with the controls, peritoneal air exposure caused an increase in both serum D-lactate level and intestinal FD4 clearance, which were proportional to the length of peritoneal air exposure and correlated to Chiu's scores, indices for intestinal mucosal injury. Edema and inflammatory cells were also observed in mucosa and submucosa of ileum in three exposure groups. Conclusions. Peritoneal air exposure could induce damage to the intestinal mucosal barrier, which is proportional to the time length of peritoneal air exposure. PMID:25210511

  12. The Role of Tyrosine Kinase Receptors in Peritoneal Fibrosis.

    PubMed

    Wang, Li; Zhuang, Shougang

    2015-01-01

    Peritoneal dialysis (PD) is a modality for treatment of patients with end-stage renal disease (ESRD) that depends on the structural and functional integrity of the peritoneal membrane. However, long-term PD can lead to morphological and functional changes in the peritoneum; in particular, peritoneal fibrosis has become one of the most common complications that ultimately results in ultrafiltration failure (UFF) and discontinuation of PD. Several factors and mechanisms such as inflammation and overproduction of transforming growth factor-β1 have been implicated in the development of peritoneal fibrosis, but there is no effective therapy to prevent or delay this process. Recent studies have shown that activation of multiple receptor tyrosine kinases (RTKs) is associated with the development and progression of tissue fibrosis in various organs, and there are also reports indicating the involvement of some RTKs in peritoneal fibrosis. This review will describe the role and mechanisms of RTKs in peritoneal fibrosis and discuss the possibility of using them as therapeutic targets for prevention and treatment of this complication. PMID:26450477

  13. (1→3)-β-D-glucan and galactomannan testing for the diagnosis of fungal peritonitis in peritoneal dialysis patients, a pilot study.

    PubMed

    Worasilchai, Navaporn; Leelahavanichkul, Asada; Kanjanabuch, Talerngsak; Thongbor, Nisa; Lorvinitnun, Pichet; Sukhontasing, Kanya; Finkelman, Malcolm; Chindamporn, Ariya

    2015-05-01

    Fungal peritonitis is an uncommon but serious complication of peritoneal dialysis (PD) due to the fact that routine culture to recovered the etiologic agents are time consuming and KOH staining has very low sensitivity. Peritoneal (1→3)-β-D-glucan (BG) or galactomannan (GM), both fungal cell wall components, are candidate biomarkers of fungal peritonitis. Hence, a comparative cross-sectional analysis of peritoneal dialysis fluid (PDF) BG (Fungitell, Cape Cod, MA, USA) and GM (Platelia Aspergillus Ag kits, Bio-rad, France) from all PD patients with and without fungal peritonitis (13 cases, identified by culture), over a 1 year period, was performed. PDF of the fungal peritonitis group showed very high BG (494 ± 19 pg/ml) and high GM (3.41 ± 1.24) similar results were noted in specimens from cases of peritonitis with other causes, especially gram negative bacterial peritonitis. A BG cut-off value at 240 pg/ml and GM at 0.5 showed sensitivity/ specificity at 100%/ 83% and 77%/ 58%, respectively. A concomitantly positive GM reduced the false positive rate of BG from nonfungal peritonitis. In conclusion, BG and GM in peritoneal fluid with provisional cut-off values were applicable as surrogate biomarkers for the diagnosis of fungal peritonitis in PD patients. PMID:25851260

  14. Fat tissue and inflammation in patients undergoing peritoneal dialysis

    PubMed Central

    Rincón Bello, Abraham; Bucalo, Laura; Abad Estébanez, Soraya; Vega Martínez, Almudena; Barraca Núñez, Daniel; Yuste Lozano, Claudia; Pérez de José, Ana; López-Gómez, Juan M.

    2016-01-01

    Background Body weight has been increasing in the general population and is an established risk factor for hypertension, diabetes, and all-cause and cardiovascular mortality. Patients undergoing peritoneal dialysis (PD) gain weight, mainly during the first months of treatment. The aim of this study was to assess the relationship between body composition and metabolic and inflammatory status in patients undergoing PD. Methods This was a prospective, non-interventional study of prevalent patients receiving PD. Body composition was studied every 3 months using bioelectrical impedance (BCM®). We performed linear regression for each patient, including all BCM® measurements, to calculate annual changes in body composition. Thirty-one patients in our PD unit met the inclusion criteria. Results Median follow-up was 26 (range 17–27) months. Mean increase in weight was 1.8 ± 2.8 kg/year. However, BCM® analysis revealed a mean increase in fat mass of 3.0 ± 3.2 kg/year with a loss of lean mass of 2.3 ± 4.1 kg/year during follow-up. The increase in fat mass was associated with the conicity index, suggesting that increases in fat mass are based mainly on abdominal adipose tissue. Changes in fat mass were directly associated with inflammation parameters such as C-reactive protein (r = 0.382, P = 0.045) and inversely associated with high-density lipoprotein cholesterol (r=−0.50, P = 0.008). Conclusions Follow-up of weight and body mass index can underestimate the fat mass increase and miss lean mass loss. The increase in fat mass is associated with proinflammatory state and alteration in lipid profile. PMID:27274820

  15. Pleuro-peritoneal shunting. Alternative therapy for pleural effusions.

    PubMed Central

    Little, A G; Kadowaki, M H; Ferguson, M K; Staszek, V M; Skinner, D B

    1988-01-01

    Pleural effusions are resistant to standard therapy, which causes discomfort and can require prolonged hospitalization. As an alternative, pleuroperitoneal shunting for pleural effusions of various etiologies was evaluated. We implanted 36 shunts in 29 patients. Two patients had bilateral shunts and five had shunt revisions. The effusion was related to a malignancy in 22 patients, postoperative chylothorax in two patients, and other causes in five patients. Therapeutic thoracentesis had been attempted in 28 patients, and eight had had chest tube placement previously with attempted sclerosis. Seven patients had a trapped lung syndrome. There was no operative mortality. All patients were deemed ready for discharge from the hospital if they had recovered from the operation within 48 hours. Five patients had poor results, either because of a moribund status or their refusal or inability to pump the shunt. Of the remaining 24 patients, four had good results with temporary improvement, and excellent results were achieved in 20 patients (83.3%), who experienced symptomatic relief and stabilization or regression of pleural effusion until the time of their death. Patients with chylothorax experienced complete resolution. The 14 patients with malignant effusions had a median survival of 4 months, and there were no instances of peritoneal tumor seeding. In conclusion, pleuroperitoneal shunting is an alternative therapy for pleural effusions that requires a limited hospitalization only, is associated with minimal and short-term discomfort, achieves excellent results in properly selected patients, and is the only viable therapy when lung expansion cannot be achieved. Images Fig. 1. Figs. 3A-C. Figs. 3A-C. Figs. 4A and B. Figs. 5A-C. Figs. 5A-C. Figs. 6A-C. Figs. 6A-C. PMID:3178332

  16. Peritonitis in children with automated peritoneal dialysis: a single-center study of a 10-year experience.

    PubMed

    Dotis, John; Myserlis, Pavlos; Printza, Nikoleta; Stabouli, Stella; Gkogka, Chrysa; Pavlaki, Antigoni; Papachristou, Fotios

    2016-08-01

    Peritoneal dialysis (PD) constitutes the preferred dialysis modality for children requiring renal replacement therapy with peritonitis being one of the most common complications of PD. This study was performed to evaluate the epidemiology, microbiology, and outcomes of PD-associated peritonitis in Greek children for a 10-year period. A total of 27 patients (16 males) with a mean age 121.8 ± 57.2 months were retrospective analyzed. Patients were on PD therapy for a mean duration of 45.2 ± 26.1 months. We found 23 episodes of PD-associated peritonitis occurred in 9 out of 27 patients (0.23 episodes/patient-year), with four patients experienced two or more peritonitis episodes. Gram-positive bacteria were responsible for 15 (65.2%) peritonitis episodes, with Staphylococcus aureus being the predominant specie isolated in 30.4% of cases. A total of seven episodes of exit-site infections (ESIs) were identified in five patients (0.069 episodes/patient-year) with the most common bacteria isolated being S. aureus (57.4%). Initial antibiotic treatment included intraperitoneal vancomycin plus ceftazidime in the majority of cases (82.6%). At the end of study, 12 (44.4%) patients remained on PD, 11 (41.8%) underwent renal transplantation, 2 (7.4%) shifted to hemodialysis and unfortunately, two patients (7.4%) died. Conclusively, our study revealed a noticeable low peritonitis and ESIs rate as compared to international data and represents the first evaluation of the characteristics and outcomes of peritonitis in the Greek pediatric PD population. PMID:27185324

  17. Evidence-based medicine: An update on treatments for peritoneal dialysis-related peritonitis

    PubMed Central

    Barretti, Pasqual; Doles, João Vitor Pereira; Pinotti, Douglas Gonçalves; El Dib, Regina Paolucci

    2015-01-01

    Peritonitis continues to be a major complication of peritoneal dialysis (PD), and adequate treatment is crucial for a favorable outcome. There is no consensus regarding the optimal therapeutic regimen, and few prospective controlled studies have been published. The objective of this manuscript is to review the results of PD peritonitis treatment reported in narrative reviews, systematic reviews, and proportional meta-analyses. Two narrative reviews, the only existing systematic review and its update published between 1991 and 2014 were included. In addition, we reported the results of a proportional meta-analysis published by our group. Results from systematic reviews of randomized control trials (RCT) and quasi-RCT were not able to identify any optimal antimicrobial treatment, but glycopeptide regimens were more likely to achieve a complete cure than a first generation cephalosporin. Compared to urokinase, simultaneous catheter removal and replacement resulted in better outcomes. Continuous and intermittent IP antibiotic use had similar outcomes. Intraperitoneal antibiotics were superior to intravenous antibiotics in reducing treatment failure. In the proportional meta-analysis of RCTs and the case series, the resolution rate (86%) of ceftazidime plus glycopeptide as initial treatment was significantly higher than first generation cephalosporin plus aminoglycosides (66%) and glycopeptides plus aminoglycosides (75%). Other comparisons of regimens used for either initial treatment or treatment of gram-positive rods or gram-negative rods did not show statistically significant differences. The superiority of a combination of a glycopeptide and a third generation cephalosporin was also reported by a narrative review study published in 1991, which reported an 88% resolution rate. PMID:25949943

  18. Transperitoneal administration of dissolved hydrogen for peritoneal dialysis patients: a novel approach to suppress oxidative stress in the peritoneal cavity

    PubMed Central

    2013-01-01

    Background Oxidative stress (OS) related to glucose degradation products such as methylglyoxal is reportedly associated with peritoneal deterioration in patients treated with peritoneal dialysis (PD). However, the use of general antioxidant agents is limited due to their harmful effects. This study aimed to clarify the influence of the novel antioxidant molecular hydrogen (H2) on peritoneal OS using albumin redox state as a marker. Methods Effluent and blood samples of 6 regular PD patients were obtained during the peritoneal equilibrium test using standard dialysate and hydrogen-enriched dialysate. The redox state of albumin in effluent and blood was determined using high-performance liquid chromatography. Results Mean proportion of reduced albumin (ƒ(HMA)) in effluent was significantly higher in H2-enriched dialysate (62.31 ± 11.10%) than in standard dialysate (54.70 ± 13.08%). Likewise, serum ƒ(HMA) after administration of hydrogen-enriched dialysate (65.75 ± 7.52%) was significantly higher than that after standard dialysate (62.44 ± 7.66%). Conclusions Trans-peritoneal administration of H2 reduces peritoneal and systemic OS. PMID:23816239

  19. [Candida peritonitis and sepsis due to Acinetobacter baumannii in peritoneal dialysis: an association with prognosis not always unfavourable].

    PubMed

    Rapisarda, Francesco; Aliotta, Roberta; Pocorobba, Barbara; Portale, Grazia; Ferrario, Silvia; Zanoli, Luca; Fatuzzo, Pasquale

    2015-01-01

    Fungal infections have a high incidence in patients receiving peritoneal dialysis. (1)
Peritoneal dialysis is often complicated by peritonitis which has only minimally mycotic etiology, but nonetheless it is associated with 15-45% mortality (8).
 The opportunistic pathogens such as Candida can cause infection in immunocompromised conditions. Even the Acinetobacter tends to infect immunocompromised individuals and it has the same risk factors for infection as Candida: immunosuppression, malignancy, HIV positivity and all the other conditions of immunosuppression, central venous catheterization, mechanical ventilation and prolonged antibiotic therapy. The sepsis by Acinetobacter predicts a negative prognosis with the mortality rate between 20 to 60% (12), especially in cases of isolation of multi-resistant germs.
 We present a case report of a CKD patient undergoing peritoneal dialysis therapy who was hospitalized for acute pancreatitis, later complicated by the development of pancreatic pseudocysts, C. albicans peritonitis with hematologic spread of the fungus, superimposed Acinetobacter baumannii sepsis and pneumonia. She has been subjected to percutaneous drainage of pseudocysts, to switch from peritoneal dialysis to hemodialysis, to various evacuative thoracentesis, and to polymicrobial therapy (meropenem, teicoplanina, tigeciclina, linezolid, colimicina, fluconazolo, etc.) that allowed the resolution of sepsis. The peculiarity of this case is represented by the numerous morbidity that the patient developed simultaneously, with the genesis of a complex clinical picture, by the combination of infections due to Candida albicans and Acinetobacter baumannii. Successful treatment strategies allowed to fight and cure a medical condition associated with a high mortality rate. PMID:26845211

  20. Imaging in assessing hepatic and peritoneal metastases of gastric cancer: a systematic review

    PubMed Central

    2011-01-01

    Background Hepatic and peritoneal metastases of gastric cancer are operation contraindications. Systematic review to provide an overview of imaging in predicting the status of liver and peritoneum pre-therapeuticly is essential. Methods A systematic review of relevant literatures was performed in Pubmed/Medline, Embase, The Cochrane Library and the China Biological Medicine Databases. QUADAS was used for assessing the methodological quality of included studies and the bivariate model was used for this meta-analysis. Results Totally 33 studies were included (8 US studies, 5 EUS studies, 22 CT studies, 2 MRI studies and 5 18F-FDG PET studies) and the methodological quality of included studies was moderate. The result of meta-analysis showed that CT is the most sensitive imaging method [0.74 (95% CI: 0.59-0.85)] with a high rate of specificity [0.99 (95% CI: 0.97-1.00)] in detecting hepatic metastasis, and EUS is the most sensitive imaging modality [0.34 (95% CI: 0.10-0.69) ] with a specificity of 0.96 (95% CI: 0.87-0.99) in detecting peritoneal metastasis. Only two eligible MRI studies were identified and the data were not combined. The two studies found that MRI had both high sensitivity and specificity in detecting liver metastasis. Conclusion US, EUS, CT and 18F-FDG PET did not obtain consistently high sensitivity and specificity in assessing liver and peritoneal metastases of gastric cancer. The value of laparoscopy, PET/CT, DW-MRI, and new PET tracers such as 18F-FLT needs to be studied in future. PMID:21385469

  1. Feline infectious peritonitis: still an enigma?

    PubMed

    Kipar, A; Meli, M L

    2014-03-01

    Feline infectious peritonitis (FIP) is one of the most important fatal infectious diseases of cats, the pathogenesis of which has not yet been fully revealed. The present review focuses on the biology of feline coronavirus (FCoV) infection and the pathogenesis and pathological features of FIP. Recent studies have revealed functions of many viral proteins, differing receptor specificity for type I and type II FCoV, and genomic differences between feline enteric coronaviruses (FECVs) and FIP viruses (FIPVs). FECV and FIP also exhibit functional differences, since FECVs replicate mainly in intestinal epithelium and are shed in feces, and FIPVs replicate efficiently in monocytes and induce systemic disease. Thus, key events in the pathogenesis of FIP are systemic infection with FIPV, effective and sustainable viral replication in monocytes, and activation of infected monocytes. The host's genetics and immune system also play important roles. It is the activation of monocytes and macrophages that directly leads to the pathologic features of FIP, including vasculitis, body cavity effusions, and fibrinous and granulomatous inflammatory lesions. Advances have been made in the clinical diagnosis of FIP, based on the clinical pathologic findings, serologic testing, and detection of virus using molecular (polymerase chain reaction) or antibody-based methods. Nevertheless, the clinical diagnosis remains challenging in particular in the dry form of FIP, which is partly due to the incomplete understanding of infection biology and pathogenesis in FIP. So, while much progress has been made, many aspects of FIP pathogenesis still remain an enigma. PMID:24569616

  2. Genotyping coronaviruses associated with feline infectious peritonitis.

    PubMed

    Lewis, Catherine S; Porter, Emily; Matthews, David; Kipar, Anja; Tasker, Séverine; Helps, Christopher R; Siddell, Stuart G

    2015-06-01

    Feline coronavirus (FCoV) infections are endemic among cats worldwide. The majority of infections are asymptomatic or result in only mild enteric disease. However, approximately 5 % of cases develop feline infectious peritonitis (FIP), a systemic disease that is a frequent cause of death in young cats. In this study, we report the complete coding genome sequences of six FCoVs: three from faecal samples from healthy cats and three from tissue lesion samples from cats with confirmed FIP. The six samples were obtained over a period of 8 weeks at a single-site cat rescue and rehoming centre in the UK. We found amino acid differences located at 44 positions across an alignment of the six virus translatomes and, at 21 of these positions, the differences fully or partially discriminated between the genomes derived from the faecal samples and the genomes derived from the tissue lesion samples. In this study, two amino acid differences fully discriminated the two classes of genomes: these were both located in the S2 domain of the virus surface glycoprotein gene. We also identified deletions in the 3c protein ORF of genomes from two of the FIP samples. Our results support previous studies that implicate S protein mutations in the pathogenesis of FIP. PMID:25667330

  3. Tackling feline infectious peritonitis via reverse genetics

    PubMed Central

    Thiel, Volker; Thiel, Heinz-Jürgen; Tekes, Gergely

    2014-01-01

    Feline infectious peritonitis (FIP) is caused by feline coronaviruses (FCoVs) and represents one of the most important lethal infectious diseases of cats. To date, there is no efficacious prevention and treatment, and our limited knowledge on FIP pathogenesis is mainly based on analysis of experiments with field isolates. In a recent study, we reported a promising approach to study FIP pathogenesis using reverse genetics. We generated a set of recombinant FCoVs and investigated their pathogenicity in vivo. The set included the type I FCoV strain Black, a type I FCoV strain Black with restored accessory gene 7b, two chimeric type I/type II FCoVs and the highly pathogenic type II FCoV strain 79–1146. All recombinant FCoVs and the reference strain isolates were found to establish productive infections in cats. While none of the type I FCoVs and chimeric FCoVs induced FIP, the recombinant type II FCoV strain 79–1146 was as pathogenic as the parental isolate. Interestingly, an intact ORF 3c was confirmed to be restored in all viruses (re)isolated from FIP-diseased animals. PMID:25482087

  4. Tackling feline infectious peritonitis via reverse genetics.

    PubMed

    Thiel, Volker; Thiel, Heinz-Jürgen; Tekes, Gergely

    2014-01-01

    Feline infectious peritonitis (FIP) is caused by feline coronaviruses (FCoVs) and represents one of the most important lethal infectious diseases of cats. To date, there is no efficacious prevention and treatment, and our limited knowledge on FIP pathogenesis is mainly based on analysis of experiments with field isolates. In a recent study, we reported a promising approach to study FIP pathogenesis using reverse genetics. We generated a set of recombinant FCoVs and investigated their pathogenicity in vivo. The set included the type I FCoV strain Black, a type I FCoV strain Black with restored accessory gene 7b, two chimeric type I/type II FCoVs and the highly pathogenic type II FCoV strain 79-1146. All recombinant FCoVs and the reference strain isolates were found to establish productive infections in cats. While none of the type I FCoVs and chimeric FCoVs induced FIP, the recombinant type II FCoV strain 79-1146 was as pathogenic as the parental isolate. Interestingly, an intact ORF 3c was confirmed to be restored in all viruses (re)isolated from FIP-diseased animals. PMID:25482087

  5. Genotyping coronaviruses associated with feline infectious peritonitis

    PubMed Central

    Lewis, Catherine S.; Porter, Emily; Matthews, David; Kipar, Anja; Tasker, Séverine; Helps, Christopher R.

    2015-01-01

    Feline coronavirus (FCoV) infections are endemic among cats worldwide. The majority of infections are asymptomatic or result in only mild enteric disease. However, approximately 5 % of cases develop feline infectious peritonitis (FIP), a systemic disease that is a frequent cause of death in young cats. In this study, we report the complete coding genome sequences of six FCoVs: three from faecal samples from healthy cats and three from tissue lesion samples from cats with confirmed FIP. The six samples were obtained over a period of 8 weeks at a single-site cat rescue and rehoming centre in the UK. We found amino acid differences located at 44 positions across an alignment of the six virus translatomes and, at 21 of these positions, the differences fully or partially discriminated between the genomes derived from the faecal samples and the genomes derived from the tissue lesion samples. In this study, two amino acid differences fully discriminated the two classes of genomes: these were both located in the S2 domain of the virus surface glycoprotein gene. We also identified deletions in the 3c protein ORF of genomes from two of the FIP samples. Our results support previous studies that implicate S protein mutations in the pathogenesis of FIP. PMID:25667330

  6. Recommendations for bowel obstruction with peritoneal carcinomatosis.

    PubMed

    Laval, Guillemette; Marcelin-Benazech, Blandine; Guirimand, Frédéric; Chauvenet, Laure; Copel, Laure; Durand, Aurélie; Francois, Eric; Gabolde, Martine; Mariani, Pascale; Rebischung, Christine; Servois, Vincent; Terrebonne, Eric; Arvieux, Catherine

    2014-07-01

    This article reports on the clinical practice guidelines developed by a multidisciplinary group working on the indications and uses of the various available treatment options for relieving intestinal obstruction or its symptoms in patients with peritoneal carcinomatosis. These guidelines are based on a literature review and expert opinion. The recommended strategy involves a clinical and radiological evaluation, of which CT of the abdomen is a crucial component. The results, together with an analysis of the prognostic criteria, are used to determine whether surgery or stenting is the best option. In most patients, however, neither option is feasible, and the main emphasis, therefore, is on the role and administration of various symptomatic medications such as glucocorticoids, antiemetic agents, analgesics, and antisecretory agents (anticholinergic drugs, somatostatin analogues, and proton-pump inhibitors). Nasogastric tube feeding is no longer used routinely and should instead be discussed on a case-by-case basis. Recent studies have confirmed the efficacy of somatostatin analogues in relieving obstruction-related symptoms such as nausea, vomiting, and pain. However, the absence of a marketing license and the high cost of these drugs limit their use as the first-line treatment, except in highly selected patients (early recurrence). When these medications fail to alleviate the symptoms of obstruction, venting gastrostomy should be considered promptly. Rehydration is needed for virtually every patient. Parenteral nutrition and pain management should be adjusted according to the patient needs and guidelines. PMID:24798105

  7. Peritoneal dialysis solutions--at a crossroad.

    PubMed

    Diaz-Buxo, J A; Gotloib, L

    2006-06-01

    After many decades of evolution and with many choices available for the formulation of peritoneal dialysis fluids (PDF), we find ourselves at a crossroads. A review of related developments, laboratory trials and clinical evaluations is offered to stimulate future research in this area. The information presented here raises more questions than it provides answers, but opens the door to innumerable possibilities for improvement. The search for a biocompatible osmotic agent designed to replace those currently used has been frustrating and is far from being considered a success. Research on cytokines and other mediators of inflammation produced a huge amount of interesting scientific knowledge that may help our understanding. However, it is unlikely that it will identify a specifically targeted anticytokine, or combination of them, designed to neutralize and/or reverse inflammatory changes resulting from the use of poorly biocompatible PDF. The development of low glucose degradation product (GDP) solutions by means of multi-chambered bags appear to be a step in the right direction and perhaps is the most significant improvement in this field in many decades. GDPs are important, but not the only offenders or the exclusive source of oxidative stress. Thus, the addition of antioxidants to PDF formulations, in our opinion, deserves further consideration. Additionally, repopulation of the mesothelial monolayer by means of periodic autotransplantation of mesothelial cells may well become a useful tool to prevent and/or correct membrane failure. We are fortunate to have choices at this crossroad, which we must evaluate rigorously. PMID:16767068

  8. Evidence of neurotrophic events due to peritoneal endometriotic lesions.

    PubMed

    Barcena de Arellano, Maria Luisa; Arnold, Julia; Lang, Helene; Vercellino, Giuseppe Filiberto; Chiantera, Vito; Schneider, Achim; Mechsner, Sylvia

    2013-05-01

    To investigate the neurotrophic properties of endometriosis, as well as the involvement of neurotrophic factors in the development of chronic pelvic pain in patients with endometriosis, we performed a prospective clinical study. The presence of neurotrophins was investigated in the peritoneal fluid (PF) of patients with peritoneal endometriotic lesions or adenomyosis, as well as from women with non-endometriotic adhesions and from women without endometriosis/adenomyosis/adhesions. The PF from patients with peritoneal endometriotic lesions was divided in three groups: asymptomatic endometriosis, minimal pain and severe pain. PF from patients with adenomyosis or with non-endometriotic adhesions and the control group were divided in patients without pain and with pain. Neurotrophin expression in PF was analyzed using Elisa and the neuronal growth assay with cultured chicken sensory ganglia (dorsal-root-ganglia, DRG) and sympathetic ganglia. PF from women with peritoneal endometriotic lesions overexpress nerve growth factor (NGF) and neurotrophin-3 (NT-3), but not brain derived neurotrophic factor (BDNF), whereas the PF of women with adenomyosis or adhesions seems to express normal amounts of these factors. Neurotrophin expression did not differ among the pain groups. Furthermore, the PF from patients with peritoneal endometriotic lesions induced a strong sensory and a marginal sympathetic neurite outgrowth, while the PF from women with adenomyosis and non-endometriotic adhesions induced an outgrowth similar to the control group. The induced neurite outgrowth could only be inhibited in DRG incubated with peritoneal endometriotic lesions. Interestingly, the outgrowth of sympathetic ganglia was inhibited in all studied groups. The present study suggests that only peritoneal endometriotic lesions lead to an increased release of NGF and NT-3 into the PF and that NGF modulates the nerve fiber growth in endometriosis. PMID:23545214

  9. Pharmacokinetics of cefepime in patients undergoing continuous ambulatory peritoneal dialysis.

    PubMed Central

    Barbhaiya, R H; Knupp, C A; Pfeffer, M; Zaccardelli, D; Dukes, G M; Mattern, W; Pittman, K A; Hak, L J

    1992-01-01

    The pharmacokinetics of cefepime were studied in 10 male patients receiving continuous ambulatory peritoneal dialysis therapy. Five patients received a single 1,000-mg dose and the other five received a single 2,000-mg dose; all doses were given as 30-min intravenous infusions. Serial plasma, urine, and peritoneal dialysate samples were collected; and the concentrations of cefepime in these fluids were measured over 72 h by using a high-performance liquid chromatographic assay with UV detection. Pharmacokinetic parameters were calculated by noncompartmental methods. The peak concentrations in plasma and the areas under the plasma concentration-versus-time curve for the 2,000-mg dose group were twice as high as those observed for the 1,000-mg dose group. The elimination half-life of cefepime was about 18 h and was independent of the dose. The steady-state volume of distribution was about 22 liters, and values for the 1,000- and 2,000-mg doses were not significantly different. The values for total body clearance and peritoneal dialysis clearance were about 15 and 4 ml/min, respectively. No dose dependency was observed for the clearance estimates. Over the 72-h sampling period, about 26% of the dose was excreted intact into the peritoneal dialysis fluid. For 48 h postdose, mean concentrations of cefepime in dialysate at the end of each dialysis interval exceeded the reported MICs for 90% of the isolates (MIC90s) for bacteria which commonly cause peritonitis resulting from continuous peritoneal dialysis. A parenteral dose of 1,000 or 2,000 mg of cefepime every 48 h would maintain the antibiotic levels in plasma and peritoneal fluid above the MIC90s for the most susceptible bacteria for the treatment of systemic and intraperitoneal infections [corrected]. PMID:1510432

  10. Association between blood cadmium levels and malnutrition in peritoneal dialysis

    PubMed Central

    2014-01-01

    Background Malnutrition is associated with an increased risk of cardiovascular death and may cause protein-energy wasting in individuals with chronic kidney disease. A previous study demonstrated that blood cadmium levels (BCLs) were associated with malnutrition in maintenance hemodialysis (MHD) patients. However, the correlation between cadmium exposure and malnutrition remains unclear in chronic peritoneal dialysis (CPD) patients. This study examined the possible adverse effects of environmental cadmium exposure in CPD patients. Methods A total of 301 CPD patients were enrolled and divided into 3 study groups based on the following BCL tertiles: low (<0.19 μg/L), middle (0.19–0.39 μg/L), and high (>0.39 μg/L). Demographic, hematological, biochemical, and dialysis-related data were obtained for analysis. The analysis also included values of nutritional and inflammatory markers. Results The BCLs of CPD patients were lower than those of MHD patients. At baseline, patients in the high BCL group were older and had a higher prevalence of diabetes mellitus but lower serum albumin, creatinine, and phosphate levels than the patients in the other 2 groups. After adjusting for potential variables, stepwise backward multiple linear regression analysis revealed that age and alanine aminotransferase levels were positively associated with logarithmic transformation of BCLs (log BCLs), while serum albumin levels were negatively associated with log BCLs in CPD patients. The log BCLs were a significant determinant (beta coefficient ± standard error = -0.185 ± 0.074; P = 0.013) of nutritional status and significantly associated with the presence of malnutrition (odds ratio = 2.64; 95% confidence interval: 1.07–6.48; P = 0.035) in CPD patients after adjustment for related variables. Conclusions BCL is significantly associated with nutritional status and malnutrition in CPD patients. Therefore, it is important for CPD patients to avoid

  11. Icodextrin does not impact infectious and culture-negative peritonitis rates in peritoneal dialysis patients: a 2-year multicentre, comparative, prospective cohort study

    PubMed Central

    Vychytil, Andreas; Remón, César; Michel, Catherine; Williams, Paul; Rodríguez-Carmona, Ana; Marrón, Belén; Vonesh, Ed; van der Heyden, Synke; Filho, Jose C. Divino

    2008-01-01

    Background. Icodextrin is a glucose polymer derived by hydrolysis of cornstarch. The different biocompatibility profile of icodextrin-containing peritoneal dialysis (PD) solutions may have a positive influence on peritoneal host defence. Furthermore, cases of sterile peritonitis potentially associated with icodextrin have been reported. Methods. The primary objective of this multicentre, longitudinal, observational, non-interventional, prospective cohort study, which included 722 PD patients, was to evaluate the incidence of overall peritonitis in patients treated with icodextrin-containing PD solutions (Extraneal™) used during one long-dwell exchange/day compared with those treated with non-icodextrin-containing PD solutions. The secondary objective was to determine if culture-negative peritonitis rates differed between patients treated with icodextrin from two independent manufacturers. All peritonitis episodes were assessed by a Steering Committee in a blind manner. Results. There was no significant difference between icodextrin-treated and control patients in the adjusted overall, culture-positive or culture-negative peritonitis rates. When stratified by the icodextrin supplier, there was no significant difference in the adjusted rate of culture-negative peritonitis episodes between groups. Conclusion. Subjects receiving icodextrin as part of their PD regimen experienced neither a higher rate of culture-negative peritonitis nor a lower rate of infectious peritonitis compared with non-icodextrin users. There was no significant influence of the icodextrin raw material supplier on peritonitis rates. PMID:18556747

  12. Space Shuttle: Status of advanced solid rocket motor program. Report to the Chair, Subcommittee on Government Activities and Transportation, Committee on Government Operations, House of Representatives

    NASA Astrophysics Data System (ADS)

    1992-11-01

    The Advanced Solid Rocket Motor is one of the National Aeronautics and Space Administration's (NASA) most expensive and controversial programs. Two reusable solid rocket motors are attached to the Space Shuttle to provide most of the thrust needed to lift it into orbit. The advanced motor is being designed to replace the current motor, which is a redesigned version of the motor that caused the January 1986 Challenger accident. The Chair of the Subcommittee on Government Activities and Transportation, House Committee on Government Operations, requested that GAO review the program's status. The specific objectives were to: (1) assess the extent to which the need for the program has changed; and (2) determine the reasons for cost growth and schedule slippage.

  13. Systemic oxygen delivery by peritoneal perfusion of oxygen microbubbles.

    PubMed

    Feshitan, Jameel A; Legband, Nathan D; Borden, Mark A; Terry, Benjamin S

    2014-03-01

    Severe hypoxemia refractory to pulmonary mechanical ventilation remains life-threatening in critically ill patients. Peritoneal ventilation has long been desired for extrapulmonary oxygenation owing to easy access of the peritoneal cavity for catheterization and the relative safety compared to an extracorporeal circuit. Unfortunately, prior attempts involving direct oxygen ventilation or aqueous perfusates of fluorocarbons or hemoglobin carriers have failed, leading many researchers to abandon the method. We attribute these prior failures to limited mass transfer of oxygen to the peritoneum and have designed an oxygen formulation that overcomes this limitation. Using phospholipid-coated oxygen microbubbles (OMBs), we demonstrate 100% survival for rats experiencing acute lung trauma to at least 2 h. In contrast, all untreated rats and rats treated with peritoneal oxygenated saline died within 30 min. For rats treated with OMBs, hemoglobin saturation and heart rate were at normal levels over the 2-h timeframe. Peritoneal oxygenation with OMBs was therefore shown to be safe and effective, and the method requires less equipment and technical expertise than initiating and maintaining an extracorporeal circuit. Further translation of peritoneal oxygenation with OMBs may provide therapy for acute respiratory distress syndrome arising from trauma, sepsis, pneumonia, aspiration, burns and other pulmonary diseases. PMID:24439406

  14. A large pleural effusion in a patient receiving peritoneal dialysis.

    PubMed

    Tapawan, Karen; Chen, Elaine; Selk, Natalie; Hong, Edward; Virmani, Sumeet; Balk, Robert

    2011-01-01

    Hydrothorax as a complication of peritoneal dialysis (PD) is a rare but recognized event. Proposed mechanisms for the development of a pleuro-peritoneal communication include congenital diaphragmatic defects, acquired weakening of diaphragmatic fibers caused by high intra-abdominal pressures during peritoneal dialysis, and impairments in lymphatic drainage. Pleural fluid analysis and diagnostic imaging assist in differentiation from other causes of pleural effusion. Nearly 50% of patients with this diagnosis have resolution of hydrothorax after temporary cessation of PD with interim hemodialysis for 2-6 weeks. Historically, other treatment options have included conventional pleurodesis and open thoracotomy with direct repair, producing variable results. With the advent of video-assisted thoracoscopy (VATS), surgical repairs and pleurodesis are now frequently performed under direct visualization with minimal invasiveness. We report a case of hydrothorax in a patient after recent introduction to peritoneal dialysis. Pleuro-peritoneal communication was documented with thoracentesis and radionuclide scanning. VATS pleurodesis with talc was performed. Repeat scintigraphy performed 1 week after the procedure revealed no residual communication, and patient was able to resume PD without further complications. PMID:21480997

  15. Cytotoxic Glucose Degradation Products in Fluids for Peritoneal Dialysis

    PubMed Central

    Adib, Noushin; Shekarchi, Maryam; Hajimehdipoor, Homa; Shalviri, Gloria; Shekarchi, Maral; Imaninejad, Maryam

    2011-01-01

    During the standard heat sterilization process of the lactate–buffered peritoneal dialysis solutions, glucose (an osmotic active substance) degrades to form compounds called glucose degradation products which are cytotoxic and affect the survival of the peritoneal membrane. This case presentation is based on an observation of 224 aseptic peritonitis cases of unknown etiology. For the purpose of clarification, we analyzed the peritoneal dialysis solutions for the presence of acetaldehyde by using a developed and validated high-performance liquid chromatography (HPLC) pre-column derivitazation. The method was validated with respect to validation factors such as linearity, precision, recovery and (LOD). The acetaldehyde level of solutions before heat sterilization was 1.78 ± 2.7 ppm whereas in samples after heat sterilization was about 20 ± 2.07 ppm. Based on the forementioned findings, we hypothesized that the higher levels of acetaldehyde and possibly the other glucose degradation products may have been an etiological factor in these 224 cases of chemical peritonitis. So it is important for the manufacturers to carefully review the heat of sterilization process in the production line. PMID:24363689

  16. A Rare Case of Ascites due to Peritoneal Amyloidosis.

    PubMed

    Stofer, Fernanda; Barretto, Maria Fernanda; Gouvea, Ana Luisa; Ribeiro, Mario; Neves, Marcio; Gismondi, Ronaldo Altenburg; Mocarzel, Luís Otavio

    2016-01-01

    BACKGROUND The clinical manifestations of amyloidosis depend on the type of insoluble protein as well as the location of amyloid deposits in tissues or organs. In the gastrointestinal tract, the small intestine is the most common site of amyloid deposits, whereas peritoneal involvement and ascites are rare. CASE REPORT We report on a case of ascites due to peritoneal amyloidosis. A 65-year-old patient was admitted to our institution due to anasarca and pulmonary congestion, mimicking heart failure. We started the patient on diuretics and vasodilators. Despite improvement in pulmonary congestion and peripheral edema, his ascites was not reduced. Echocardiogram revealed restrictive cardiomyopathy and a speckle-tracking pattern suggestive of cardiac amyloidosis. Subcutaneous and peritoneal biopsies revealed amyloidosis. CONCLUSIONS Amyloidosis is rare in the peritoneum and is usually asymptomatic. Ascites occurs in only 20% of patients with peritoneal amyloidosis. We searched PubMed using "ascites" and "amyloidosis" and identified only eight case reports of amyloidosis with ascites. Physicians should be particularly careful in heart failure and anasarca cases when ascites is disproportional or not responsive to diuretic treatment. To date, there is no specific treatment for peritoneal amyloidosis. PMID:27353538

  17. Laparoscopic peritoneal lavage: our experience and review of the literature

    PubMed Central

    Parisi, Amilcare; Desiderio, Jacopo; Petrina, Adolfo; Trastulli, Stefano; Grassi, Veronica; Sani, Marco; Pironi, Daniele; Santoro, Alberto

    2016-01-01

    Introduction Over the years various therapeutic techniques for diverticulitis have been developed. Laparoscopic peritoneal lavage (LPL) appears to be a safe and useful treatment, and it could be an effective alternative to colonic resection in emergency surgery. Aim This prospective observational study aims to assess the safety and benefits of laparoscopic peritoneal lavage in perforated sigmoid diverticulitis. Material and methods We surgically treated 70 patients urgently for complicated sigmoid diverticulitis. Thirty-two (45.7%) patients underwent resection of the sigmoid colon and creation of a colostomy (Hartmann technique); 21 (30%) patients underwent peritoneal laparoscopic lavage; 4 (5.7%) patients underwent colostomy by the Mikulicz technique; and the remaining 13 (18.6%) patients underwent resection of the sigmoid colon and creation of a colorectal anastomosis with a protective ileostomy. Results The 66 patients examined were divided into 3 groups: 32 patients were treated with urgent surgery according to the Hartmann procedure; 13 patients were treated with resection and colorectal anastomosis; 21 patients were treated urgently with laparoscopic peritoneal lavage. We had no intraoperative complications. The overall mortality was 4.3% (3 patients). In the LPL group the morbidity rate was 33.3%. Conclusions Currently it cannot be said that LPL is better in terms of mortality and morbidity than colonic resection. These data may, however, be proven wrong by greater attention in the selection of patients to undergo laparoscopic peritoneal lavage. PMID:27458487

  18. Quantitation of Intra-peritoneal Ovarian Cancer Metastasis.

    PubMed

    Lewellen, Kyle A; Metzinger, Matthew N; Liu, Yueying; Stack, M Sharon

    2016-01-01

    Epithelial ovarian cancer (EOC) is the leading cause of death from gynecologic malignancy in the United States. Mortality is due to diagnosis of 75% of women with late stage disease, when metastasis is already present. EOC is characterized by diffuse and widely disseminated intra-peritoneal metastasis. Cells shed from the primary tumor anchor in the mesothelium that lines the peritoneal cavity as well as in the omentum, resulting in multi-focal metastasis, often in the presence of peritoneal ascites. Efforts in our laboratory are directed at a more detailed understanding of factors that regulate EOC metastatic success. However, quantifying metastatic tumor burden represents a significant technical challenge due to the large number, small size and broad distribution of lesions throughout the peritoneum. Herein we describe a method for analysis of EOC metastasis using cells labeled with red fluorescent protein (RFP) coupled with in vivo multispectral imaging. Following intra-peritoneal injection of RFP-labelled tumor cells, mice are imaged weekly until time of sacrifice. At this time, the peritoneal cavity is surgically exposed and organs are imaged in situ. Dissected organs are then placed on a labeled transparent template and imaged ex vivo. Removal of tissue auto-fluorescence during image processing using multispectral unmixing enables accurate quantitation of relative tumor burden. This method has utility in a variety of applications including therapeutic studies to evaluate compounds that may inhibit metastasis and thereby improve overall survival. PMID:27500635

  19. Comparison of intra-peritoneal bupivacaine and intravenous paracetamol for postoperative pain relief after laparoscopic cholecystectomy

    PubMed Central

    Upadya, M.; Pushpavathi, S. H.; Seetharam, Kaushik Rao

    2015-01-01

    Background: Nonsteroidal anti-inflammatory drugs used for postoperative analgesia have considerable adverse effects, with paracetamol having a different mechanism of action, superior side effect profile and availability in intravenous (IV) form, this study was conducted to compare intra-peritoneal bupivacaine with IV paracetamol for postoperative analgesia following laparoscopic cholecystectomy. Aim: The aim was to compare the efficacy of intra-peritoneal administration of bupivacaine 0.5% and IV acetaminophen for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Settings and Design: Randomized, prospective trial. Materials and Methods: A total of 60 patients of American Society of Anesthesiologists physical Status I and II scheduled for laparoscopic cholecystectomy were enrolled for this study. Group I received 2 mg/kg of 0.5% bupivacaine as local intra-peritoneal application and Group II patients received IV 1 g paracetamol 6th hourly. Postoperatively, the patients were assessed for pain utilizing Visual Analog Scale (VAS), Visual Rating Prince Henry Scale (VRS), shoulder pain. The total number of patients requiring rescue analgesia and any side-effects were noted. Statistical Analysis: Data analysis was performed using Students unpaired t-test. SPSS version 11.5 was used. Results: The VAS was significantly higher in Group I compared with Group II at 8th, 12th and 24th postoperative hour. At 1st and 4th postoperative hours, VAS was comparable between the two groups. Although the VRS was higher in Group I compared with Group II at 12th and 24th postoperative hour; the difference was statistically significant only at 24th postoperative hour. None of the patients in either of the groups had shoulder pain up to 8 h postoperative. The total number of patients requiring analgesics was higher in Group II than Group I at 1st postoperative hour. Conclusion: Although local anesthetic infiltration and intra-peritoneal administration of 0

  20. Metformin in Peritoneal Dialysis: A Pilot Experience

    PubMed Central

    Al-Hwiesh, Abdulla Khalaf; Abdul-Rahman, Ibrahiem Saeed; El-Deen, Mohammad Ahmad Nasr; Larbi, Emmanuel; Divino-Filho, Jose C.; Al-Mohanna, Fahd Abdul-Aziz; Gupta, Krishan L.

    2014-01-01

    ♦ Objective: In a number of patients, the antidiabetic drug metformin has been associated with lactic acidosis. Despite the fact that diabetes mellitus is the most common cause of end-stage renal disease (ESRD) and that peritoneal dialysis (PD) is an expanding modality of treatment, little is known about optimal treatment strategies in the large group of PD patients with diabetes. In patients with ESRD, the use of metformin has been limited because of the perceived risk of lactic acidosis or severe hypoglycemia. However, metformin use is likely to be beneficial, and PD might itself be a safeguard against the alleged complications. ♦ Methods: Our study involved 35 patients with insulin-dependent type 2 diabetes [median age: 54 years; interquartile range (IQR): 47-59 years] on automated PD (APD) therapy. Patients with additional risk factors for lactic acidosis were excluded. Metformin was introduced at a daily dose in the range 0.5 - 1.0 g. All patients were monitored for glycemic control by blood sugar levels and HbA1c. Plasma lactic acid levels were measured weekly for 4 weeks and then monthly to the end of the study. Plasma and effluent metformin and plasma lactate levels were measured simultaneously. ♦ Results: In this cohort, the median duration of diabetes was 18 years (IQR: 14 - 21 years), median time on PD was 31 months (IQR: 27 - 36 months), and median HbA1c was 6.8% (IQR: 5.9% - 6.9%). At metformin introduction and at the end of the study, the median anion gap was 11 mmol/L (IQR: 9 - 16 mmol/L) and 12 mmol/L (IQR: 9 - 16 mmol/L; p > 0.05) respectively, median pH was 7.33 (IQR: 7.32 - 7.36) and 7.34 (IQR: 7.32 - 7.36, p > 0.05) respectively, and mean metformin concentration in plasma and peritoneal fluid was 2.57 ± 1.49 mg/L and 2.83 ± 1.7 mg/L respectively. In the group overall, mean lactate was 1.39 ± 0.61 mmol/L, and hyperlactemia (>2 mmol/L to 5 mmol/L) was found in 4 of 525 plasma samples (0.76%), but the patients presented no symptoms. None

  1. Post-Flowering Nitrate Uptake in Wheat Is Controlled by N Status at Flowering, with a Putative Major Role of Root Nitrate Transporter NRT2.1

    PubMed Central

    Taulemesse, François; Le Gouis, Jacques; Gouache, David; Gibon, Yves; Allard, Vincent

    2015-01-01

    In bread wheat (Triticum aestivum L.), the simultaneous improvement of both yield and grain protein is difficult because of the strong negative relationship between these two traits. However, some genotypes deviate positively from this relationship and this has been linked to their ability to take up nitrogen (N) during the post-flowering period, regardless of their N status at flowering. The physiological and genetic determinants of post-flowering N uptake relating to N satiety are poorly understood. This study uses semi-hydroponic culture of cv. Récital under controlled conditions to explore these controls. The first objective was to record the effects of contrasting N status at flowering on post-flowering nitrate (NO3-) uptake under non-limiting NO3- conditions, while following the expression of key genes involved in NO3- uptake and assimilation. We found that post-flowering NO3- uptake was strongly influenced by plant N status at flowering during the first 300–400 degree-days after flowering, overlapping with a probable regulation of nitrate uptake exerted by N demand for growth. The uptake of NO3- correlated well with the expression of the gene TaNRT2.1, coding for a root NO3- transporter, which seems to play a major role in post-flowering NO3- uptake. These results provide a useful knowledge base for future investigation of genetic variability in post-flowering N uptake and may lead to concomitant gains in both grain yield and grain protein in wheat. PMID:25798624

  2. Role of surfactant in peritoneal dialysis.

    PubMed

    Hills, B A

    2000-01-01

    Evidence is reviewed that demonstrates how the mesothelial cell in the normal peritoneum and comparable serosal cavities secretes surface-active phospholipid (SAPL) as a means of protecting itself and the membrane it forms with its neighbors. It is shown how SAPL, if adsorbed (reversibly bound) to mesothelium, can impart excellent lubricity, antiwear and release (antistick) properties, while impeding surgical adhesion formation. More-speculative benefits include acting as a deterrent to fibrosis and as a barrier to both protein leakage and pathogen invasion by spanning cell junctions. Such spanning would also "pin down" cell corners, impeding peeling as the first step in exfoliation encountered in prolonged continuous ambulatory peritoneal dialysis (CAPD). The molecular mechanism underlying each of these possible functions is adsorption. Morphological and hydrophobicity studies are discussed as validation for such an adsorbed lining and how it can be fortified by administering exogenous SAPL. Any role for SAPL in ultrafiltration is much more controversial. However, a surfactant lining can explain the very high permeability of the membrane to lipid-soluble drugs, implying that it is a barrier to water-soluble solutes. The clinical and animal evidence is conflicting but would seem to be best explained by a role for the barrier in promoting semipermeability, and hence the osmotic driving force for water transmission. Thus, adsorption of exogenous SAPL in CAPD patients with low ultrafiltration seems to restore this barrier function. The future direction for surfactant in CAPD would seem to rest with the physical chemists in producing formulations that optimize adsorption, probably involving a compromise between water solubility and surface activity of the phospholipids selected. It might even warrant using the interdialytic interval for readsorbing SAPL without the problem of dilution by a large volume of dialysate. PMID:11117241

  3. [Anemia treatment in peritoneal dialysis patients].

    PubMed

    Janković, Nikola; Janković, Mateja

    2009-09-01

    Anemia is highly prevalent among chronic kidney disease (CKD) patients and patients receiving renal replacement therapy. In this paper we will outline the prevention and treatment of anemia in patients treated with peritoneal dialysis (PD). PD patients are less anemic and more sensitive to erythropoesis-stimulating agent (ESA) than their hemodialysis (HD) counterparts and, in general, dosages required for achieving similar hemoglobin levels to those achieved in HD patients are remarkably less. Before starting with ESA treatment we have to evaluate the degree of anemia and excluded other causes which are not connected with CKD and method of treatment. Patient's compliance is crucial for a successful therapy and it can be improved by decreasing frequency of administration of ESA. Since ESAare expensive, "cost-effectivnes" studies represent an important factor in choosing a distinct drug. Subcutaneous administration provides better long-term utilization of ESA in comparison to intravenous administration and is therefore preferred in PD patients. Intraperitoneal administration is not recommended due to poor bioavailability. In some patients we can observe the reduced response to ESA therapy. The definition of reduced response is generally regarded as a failure to achieve target hemoglobin concentration of >11 g/dL. Identification of underlying cause is not always easy but every attempt should be made to investigate every patient with resistance to therapy because some causes are easily corrected. Since 2005 particular ESA drugs have been approved by Croatian Institute for Health Insurance and registered for use in Croatia. For PD patients the ESAcan be prescribed by general practitioner. The list of available drugs is available in the official government newspaper Nardone novine No.27, March 2nd, 2009. PMID:20232548

  4. Establishment of a novel method to evaluate peritoneal microdissemination and therapeutic effect using luciferase assay.

    PubMed

    Takahashi, Ryo; Yokobori, Takehiko; Osone, Katsuya; Tatsuki, Hironori; Takada, Takahiro; Suto, Toshinaga; Yajima, Reina; Kato, Toshihide; Fujii, Takaaki; Tsutsumi, Souichi; Kuwano, Hiroyuki; Asao, Takayuki

    2016-03-01

    Peritoneal dissemination is a major cause of recurrence in patients with malignant tumors in the peritoneal cavity. Effective anticancer agents and treatment protocols are necessary to improve outcomes in these patients. However, previous studies using mouse models of peritoneal dissemination have not detected any drug effect against peritoneal micrometastasis. Here we used the luciferase assay to evaluate peritoneal micrometastasis in living animals and established an accurate mouse model of early peritoneal microdissemination to evaluate tumorigenesis and drug efficacy. There was a positive correlation between luminescence intensity in in vivo luciferase assay and the extent of tumor dissemination evaluated by ex vivo luciferase assay and mesenteric weight. This model has advantages over previous models because optimal luciferin concentration without cell damage was validated and peritoneal microdissemination could be quantitatively evaluated. Therefore, it is a useful model to validate peritoneal micrometastasis formation and to evaluate drug efficacy without killing mice. PMID:26716425

  5. Olaparib and Cediranib Maleate in Treating Patients With Recurrent Ovarian, Primary Peritoneal, or Fallopian Tube Cancer

    ClinicalTrials.gov

    2016-08-24

    BRCA1 Gene Mutation; BRCA2 Gene Mutation; Fallopian Tube Endometrioid Adenocarcinoma; Fallopian Tube Serous Adenocarcinoma; High Grade Ovarian Serous Adenocarcinoma; Ovarian Endometrioid Tumor; Primary Peritoneal Serous Adenocarcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma

  6. The relationships between activation of non-specific inflammatory process and malnutrition in patients on peritoneal dialysis.

    PubMed

    Wójcik, Katarina; Stompór, Tomasz; Krzanowski, Marcin; Miarka, Przemysław; Zdzienicka, Anna; Sułowicz, Wladyslaw

    2007-01-01

    Malnutrition is a frequent complication among patients on chronic peritoneal dialysis and early recognition of malnutrition can be a key factor in successful treatment. The aim of the study was to assess the nutritional status of patients on peritoneal dialysis and to search for the relationships between activation of non-specific inflammatory process and progression of malnutrition. The study group included 60 patients (age 50.4+/-14 years) on peritoneal dialysis for 17.6+/-20 months. Fourty-six patients completed the entire 24-month observation period. Nutritional status was assessed using SGA scale, anthropometric measures, bioimpendance, and several biochemical parameters. Inflammatory markers included: IL-6, TNFalpha, fibrinogen and CRP. Severe malnutrition was observed in the range between 8.4% (5 subjects, group C in SGA scale) to 11.7% (7 subjects, BMI <20 kg/m2) of patients. The nutritional status of the entire cohort was constant over 2 years of observation (based on SGA scale), although the mean albumin level decreased significantly after 24 months of observation (from 39.55+/-3.5 to 37.63+/-3.7 g/l; p<0.01). The mean concentrations of CRP (4.8 and 5.25 mg/l), IL-6 (3.45 and 6.8 pg/ml) and leptin (22.95 and 22.2 ng/ml) were above reference ranges both at the initial and final assessment. Moreover, the concentration of IL-6 significantly increased (p<0.001) after 24 months of observation. Patients treated with PD are frequently affected by malnutrition. Our results indicate a strong association between nutritional indices and markers of inflammation. PMID:18928174

  7. Suppression of neutrophil superoxide production by conventional peritoneal dialysis solution.

    PubMed

    Ing, B L; Gupta, D K; Nawab, Z M; Zhou, F Q; Rahman, M A; Daugirdas, J T

    1988-09-01

    The pH of conventional peritoneal dialysis solution is normally in the range of 5.0 to 5.5, because acid has been added during the manufacturing process to prevent caramelization of dextrose during sterilization. We studied the effects of normalizing the pH of conventional peritoneal dialysis solution on superoxide production by normal human neutrophils. At a pH of 6.0, superoxide generation was 4.07 +/- 2.56 (SD) nanomoles per million cells. With normalization of pH to 7.4, superoxide production was 19.3 +/- 7.3 (p less than 0.001). The results suggest that the unphysiologic acidity of conventional peritoneal dialysis solution has deleterious consequences on neutrophil superoxide formation. PMID:2847987

  8. Diagnostic peritoneal lavage in evaluating acute abdominal pain.

    PubMed

    Barbee, C L; Gilsdorf, R B

    1975-06-01

    A study was performed to determine the value of peritoneal lavage in the acute abdomen not related to trauma. Lavage was performed in 33 patients in the evaluation of abdominal pain of sufficient degree to warrant consideration for surgical intervention. Peritoneal lavage was truly positive or truly negative in 64% of the cases. It showed false negative results in 28% and false positive results in 8%. The lavage was most accurate in the evaluation of appendicitis, colonic disease, and intra abdominal bleeding. It was highly inaccurate in the evaluation of cholecystitis and peptic ulcer disease. It was concluded that the peritoneal lavage can be a useful adjunct in the evaluation of patients with abdominal pain and should be considered in difficult diagnostic problems but not routinely employed. PMID:1138636

  9. Outcome Comparisons Between Patients on Peritoneal Dialysis With and Without Polycystic Kidney Disease: A Nationwide Matched Cohort Study.

    PubMed

    Yang, Ju-Yeh; Chen, Likwang; Chao, Chia-Ter; Peng, Yu-Sen; Chiang, Chih-Kang; Kao, Tze-Wah; Chien, Kuo-Liong; Wu, Hon-Yen; Huang, Jenq-Wen; Hung, Kuan-Yu

    2015-12-01

    Polycystic kidney disease (PCKD) is the most common hereditary cause of end-stage renal disease. The complications associated with this disease may affect the performance of peritoneal dialysis (PD). The aim of this study was to compare the outcomes between patients on PD with PCKD and without PCKD.We extracted an incident cohort of adult (≥ 20 years old) patients on long-term PD from the Taiwan National Health Insurance Research Database. Patients with PCKD were identified by specific diagnosis codes. We recorded baseline comorbidities, socioeconomic status, timing of referral to a nephrologist, prior hemodialysis history before PD, and the type of PD modalities. We compared the risk of death, technique failure, peritonitis, hospitalization, and outpatient visiting as well as overall medical expenditure between the patients with PCKD and a groups of patients without PCKD who were propensity-score matched (1:3). The analysis was carried out by various Cox regression models that considered competing risk and time-varying coefficients. We enrolled 139 patients with PCKD and 7739 patients without PCKD who started long-term PD between 1999 and 2010. Patients with PCKD were less comorbid and more often treated with automated PD. In the propensity-score matched analysis, both overall survival and technique survival did not differ between the patients and the result was similar for hospitalization and peritonitis after adjusting for the application of automated PD. Furthermore, the overall annual medical expenditures were similar between the patients with and without PCKD. PD patients with PCKD are comparable to PD patients without PCKD in terms of risk of death, peritonitis, technique failure, and hospitalization in the present study. Furthermore, the medical expenses of the 2 groups after initiation of PD are also indistinguishable. PMID:26632899

  10. Peritoneal dialysis associated infections: An update on diagnosis and management

    PubMed Central

    Akoh, Jacob A

    2012-01-01

    Peritoneal dialysis (PD) is associated with a high risk of infection of the peritoneum, subcutaneous tunnel and catheter exit site. Although quality standards demand an infection rate < 0.67 episodes/patient/year on dialysis, the reported overall rate of PD associated infection is 0.24-1.66 episodes/patient/year. It is estimated that for every 0.5-per-year increase in peritonitis rate, the risk of death increases by 4% and 18% of the episodes resulted in removal of the PD catheter and 3.5% resulted in death. Improved diagnosis, increased awareness of causative agents in addition to other measures will facilitate prompt management of PD associated infection and salvage of PD modality. The aims of this review are to determine the magnitude of the infection problem, identify possible risk factors and provide an update on the diagnosis and management of PD associated infection. Gram-positive cocci such as Staphylococcus epidermidis, other coagulase negative staphylococcoci, and Staphylococcus aureus (S. aureus) are the most frequent aetiological agents of PD-associated peritonitis worldwide. Empiric antibiotic therapy must cover both gram-positive and gram-negative organisms. However, use of systemic vancomycin and ciprofloxacin administration for example, is a simple and efficient first-line protocol antibiotic therapy for PD peritonitis - success rate of 77%. However, for fungal PD peritonitis, it is now standard practice to remove PD catheters in addition to antifungal treatment for a minimum of 3 wk and subsequent transfer to hemodialysis. To prevent PD associated infections, prophylactic antibiotic administration before catheter placement, adequate patient training, exit-site care, and treatment for S. aureus nasal carriage should be employed. Mupirocin treatment can reduce the risk of exit site infection by 46% but it cannot decrease the risk of peritonitis due to all organisms. PMID:24175248

  11. Percutaneous aspiration of fluid for management of peritonitis in space

    NASA Technical Reports Server (NTRS)

    Kirkpatrick, A. W.; Nicolaou, S.; Campbell, M. R.; Sargsyan, A. E.; Dulchavsky, S. A.; Melton, S.; Beck, G.; Dawson, D. L.; Billica, R. D.; Johnston, S. L.; Hamilton, D. R.

    2002-01-01

    BACKGROUND: As a medical emergency that can affect even well-screened, healthy individuals, peritonitis developing during a long-duration space exploration mission may dictate deviation from traditional clinical practice due to the absence of otherwise indicated surgical capabilities. Medical management can treat many intra-abdominal processes, but treatment failures are inevitable. In these circumstances, percutaneous aspiration under sonographic guidance could provide a "rescue" strategy. Hypothesis: Sonographically guided percutaneous aspiration of intra-peritoneal fluid can be performed in microgravity. METHODS: Investigations were conducted in the microgravity environment of NASA's KC-135 research aircraft (0 G). The subjects were anesthetized female Yorkshire pigs weighing 50 kg. The procedures were rehearsed in a terrestrial animal lab (1 G). Colored saline (500 mL) was introduced through an intra-peritoneal catheter during flight. A high-definition ultrasound system (HDI-5000, ATL, Bothell, WA) was used to guide a 16-gauge needle into the peritoneal cavity to aspirate fluid. RESULTS: Intra-peritoneal fluid collections were easily identified, distinct from surrounding viscera, and on occasion became more obvious during weightless conditions. Subjectively, with adequate restraint of the subject and operators, the procedure was no more demanding than during the 1-G rehearsals. CONCLUSIONS: Sonographically guided percutaneous aspiration of intra-peritoneal fluid collections is feasible in weightlessness. Treatment of intra-abdominal inflammatory conditions in spaceflight might rely on pharmacological options, backed by sonographically guided percutaneous aspiration for the "rescue" of treatment failures. While this risk mitigation strategy cannot guarantee success, it may be the most practical option given severe resource limitations.

  12. Early Diagnosis of Colonic Anastomotic Leak With Peritoneal Endoscopy

    PubMed Central

    Gaarden, Morten; Mortensen, Frank Viborg

    2015-01-01

    Background and Objectives: At present, we do not have a reliable method for the early diagnosis of colorectal anastomotic leakage (AL). We tested peritoneal flexible endoscopy through a port placed in the abdominal wall in the early postoperative course, as a new diagnostic method for detection of this complication and evaluated the suggested method for safety, feasibility, and accuracy. Methods: Ten swine were randomized into 2 groups: group A, colorectal anastomosis without leakage; and group B, colorectal anastomosis with leakage. A button gastrostomy feeding tube was inserted percutaneously into the peritoneal cavity. Colorectal anastomosis (with or without defect) was created 48 hours after the first operation. The swine were examined by peritoneal flexible endoscopy 8 and 24 hours after the colonic operation, by a consultant surgeon who was blinded to both the presence and the allocated location of the of the anastomotic defect. Results: None of the animals showed signs of illness 48 hours after the intraperitoneal gastrostomy tube placement. More than half of the anastomosis circumference was identified in 60 and 10% of the animals at endoscopy 8 and 24 hours, respectively, after the anastomosis was created. Excessive adhesion formation was observed in all animals, irrespective of AL. The sensitivity and specificity of endoscopy in detecting peritonitis 24 hours after AL were both 60%. Conclusions: Peritoneal endoscopy is a safe and simple procedure. Visualization of the peritoneal cavity in the early postoperative course was limited due to adhesion formation. Further studies are needed to clarify the accuracy of the procedure and to address additional methodological concerns. PMID:26273185

  13. Unusual presentation of peritonitis with persistent clear aspirate: a case report

    PubMed Central

    2010-01-01

    Introduction Peritonitis is the most frequent complication of peritoneal dialysis. Diagnosis of peritonitis includes symptoms and signs of peritonitis with a cloudy aspirate of more than 100 WBC/ml, as well as positive cultures. Although sterile peritonitis has been reported in the literature, to the best of our knowledge this is the first report of an unusual presentation of peritonitis without any white blood cells in the peritoneal aspirate despite multiple positive peritoneal cultures. Case presentation An 82-year-old Caucasian man who had been on continuous cycling peritoneal dialysis for 12 years was admitted to our hospital with general malaise, loss of appetite, weight loss and somnolence. He did not describe abdominal pain or fever. Even though his peritoneal fluid was consistently negative for leukocytes and clear, he had peritonitis with different organisms consecutively. Conclusions Our case report shows that any patient on peritoneal dialysis presenting with evidence of infection (fever, peripheral leukocytosis) without an obvious cause should have aspirate cultures done even if the aspirate is clear and abdominal pain is absent. Our case report may change the initial work-up and management of these patients. We believe this report is of interest to general medicine and emergency room physicians as well as nephrologists. PMID:21110897

  14. Sclerosing peritonitis: an unusual cause of ascites in a patient with systemic lupus erythematosus.

    PubMed

    Pepels, M J A E; Peters, F P J; Mebis, J J I R; Ceelen, Th L; Hoofwijk, A G M; Erdkamp, F L G

    2006-10-01

    Sclerosing peritonitis is a rare condition characterised by fibrosis and adhesion of the peritoneum to loops of the small intestine. It is generally associated with continuous peritoneal dialysis, peritoneo-venous shunts or &beta-adrenergic blocking agents. In this case we report a female patient with idiopathic sclerosing peritonitis and systemic lupus erythematosus. PMID:17057274

  15. Diagnosis and management of peritoneal metastases from ovarian cancer.

    PubMed

    Halkia, Evgenia; Spiliotis, John; Sugarbaker, Paul

    2012-01-01

    The management and the outcome of peritoneal metastases or recurrence from epithelial ovarian cancer are presented. The biology and the diagnostic tools of EOC peritoneal metastasis with a comprehensive approach and the most recent literatures data are discussed. The definition and the role of surgery and chemotherapy are presented in order to focuse on the controversial points. Finally, the paper discusses the new data about the introduction of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of advanced epithelial ovarian cancer. PMID:22888339

  16. Spontaneous bacterial peritonitis due to streptococcus pneumoniae--case report.

    PubMed

    Litarski, Andrzej; Janczak, Dariusz; Cianciara, Jan; Merenda, Marcin

    2011-05-01

    Spontaneous bacterial peritonitis is caused by infection of ascitic fluid without any apparent intraabdominal source of infection. The disease most commonly occurs in patients with cirrhosis and 70% of cases of infections are caused by pathogenes from gastrointestinal tract. The article presents the case of 38-year-old patient with spontaneous peritonitis who was treated surgically. The primary nature of the disease was confirmed by laparotomy and bacteriological examination results (Streptoccocus pneumonia) of ascitic fluid. After 54 days of hospitalisation and undergoing re-laparotomy, he was discharged in good condition. PMID:22166482

  17. Hepatic teratoma and peritoneal gliomatosis: a case report

    PubMed Central

    2009-01-01

    The hepatic teratoma is a very rare entity of which only 25 cases have been published so far. In our case the hepatic teratoma is associated with peritoneal gliomatosis, which is an indicator for an ongoing peritoneal spread of a teratoma. Wall calcifications and the homogeneity as well as the well defined border misled the radiologist to the diagnosis of an echinococcal cyst, which is the most common differential diagnosis, however the hepatic teratoma has to be taking into consideration when dealing with unclear hepatic cysts, although it is very rare. PMID:20062626

  18. Adult abdominal Burkitt lymphoma with isolated peritoneal involvement

    PubMed Central

    Oliveira, Catarina; Matos, Hugo; Serra, Paula; Catarino, Rui; Estevão, Amélia

    2014-01-01

    Burkitt lymphoma is a fast-growing high grade B-cell neoplasm that rarely affects adults. Three clinical variants are described in the World Health Organization classification: endemic, sporadic, and immunodeficiency-associated. The non-endemic form typically presents as an abdominal mass in children. Symptoms usually occur due to mass effect or direct intestinal involvement. We describe a very unusual presentation of a sporadic Burkitt lymphoma case in a 61-year-old male with diffuse peritoneal and omental involvement, without lymphadenopathies, mimicking peritoneal carcinomatosis. PMID:24967011

  19. Peritoneal culture alters Streptococcus pneumoniae protein profiles and virulence properties

    NASA Technical Reports Server (NTRS)

    Orihuela, C. J.; Janssen, R.; Robb, C. W.; Watson, D. A.; Niesel, D. W.

    2000-01-01

    We have examined the properties of Streptococcus pneumoniae cultured in the murine peritoneal cavity and compared its virulence-associated characteristics to those of cultures grown in vitro. Analysis of mRNA levels for specific virulence factors demonstrated a 2.8-fold increase in ply expression and a 2.2-fold increase in capA3 expression during murine peritoneal culture (MPC). Two-dimensional gels and immunoblots using convalescent-phase patient sera and murine sera revealed distinct differences in protein production in vivo (MPC). MPC-grown pneumococci adhered to A549 epithelial cell lines at levels 10-fold greater than those cultured in vitro.

  20. [DISSEMINATED PERITONEAL LEYOMYOMATOSIS AFTER LAPAROSCOPIC MORCELLATION--A CASE REPORT].

    PubMed

    Gincheva, D; Nikolova, M

    2016-01-01

    We presented a case of 41-year-old patient underwent two laparoscopic Myomectomies and current laparotomy regarding suspection of necrotic leiomyoma. Intraoperative finding was suggestive of disseminated malignancy, but gefrir study showed benign smooth muscle tumors. The patient underwent total hysterectomy with right adnesectomy and total omentectomy. After histological and immunohistochemical study of the entire macroscopic material the final diagnosis was disseminated peritoneal leiomyomatosis. This disease is rare, but in recent years, in connection with the widespread introduction of laparoscopic surgery the reports of disseminated peritoneal leiomyomatosis occurring after laparoscopic morcellation, were frequent. PMID:27514144

  1. Peritoneal fluid modifies the response of human spermatozoa to follicular fluid.

    PubMed

    Caille, Adriana M; Berta, Cesar L; Cuasnicú, Patricia S; Munuce, Maria Jose

    2012-04-01

    The aim of this study was to elucidate the mechanism involved in the acrosome reaction (AR) induced by follicular fluid (FF) in spermatozoa previously exposed to peritoneal fluid (PF). The influence of progesterone was also investigated. Semen samples were from 18 normozoospermic donors. PF samples were from 13 women with unexplained infertility and from a woman treated with synthetic progestagen. FF samples were collected from six women undergoing IVF/embryo transfer and pooled. Motile spermatozoa were capacitated overnight and a kinetic and inhibition study on the FF-induced AR was performed. Spermatozoa pretreated with PF were challenged with either FF or progesterone. The ability of progesterone- and progestagen-supplemented PF to induce AR was analysed. Enzyme-digested PF was also tested. Pre-incubation with PF for 60 min completely prevented the FF-induced AR; spermatozoa treated with PF were unable to respond to FF or progesterone and this effect was not reversible. Progesterone- and progestagen-supplemented PF stimulated the AR relative to controls. Enzyme-digested PF did not have an inhibitory capacity. These data strongly suggest that there are one or more inhibitory proteins in PF that interact with spermatozoa so as to prevent access of progesterone to its receptor and thus inhibit the occurrence of the AR. The oviduct, or Fallopian tube, provides a place for spermatozoa and egg transport and storage, fertilization and early embryo development. If ovulation has not occurred, spermatozoa may reside in the oviduct for several hours or even a few days, awaiting oocyte arrival. It is assumed that fluids present in the female genital tract may have a role in synchronizing the timing required to guarantee the success of fertilization. We previously observed that the peritoneal fluid that bathes the peritoneal cavity is a suitable medium for sperm survival and we also reported that this fluid could stabilize spermatozoa. In this study we show further evidence

  2. Piperine metabolically regulates peritoneal resident macrophages to potentiate their functions against bacterial infection.

    PubMed

    Pan, Hao; Xu, Li-Hui; Huang, Mei-Yun; Zha, Qing-Bing; Zhao, Gao-Xiang; Hou, Xiao-Feng; Shi, Zi-Jian; Lin, Qiu-Ru; Ouyang, Dong-Yun; He, Xian-Hui

    2015-10-20

    Pepper, a daily-used seasoning for promoting appetite, is widely used in folk medicine for treating gastrointestinal diseases. Piperine is the major alkaloid in pepper and possesses a wide range of pharmacological activities. However, the mechanism for linking metabolic and medicinal activities of piperine remains unknown. Here we report that piperine robustly boosts mTORC1 activity by recruiting more system L1 amino acid transporter (SLC7A5/SLC3A2) to the cell membrane, thus promoting amino acid metabolism. Piperine-induced increase of mTORC1 activity in resident peritoneal macrophages (pMΦs) is correlated with enhanced production of IL-6 and TNF-α upon LPS stimulation. Such an enhancement of cytokine production could be abrogated by inhibitors of the mTOR signaling pathway, indicating mTOR's action in this process. Moreover, piperine treatment protected resident pMΦs from bacterium-induced apoptosis and disappearance, and increased their bacterial phagocytic ability. Consequently, piperine administration conferred mice resistance against bacterial infection and even sepsis. Our data highlight that piperine has the capacity to metabolically reprogram peritoneal resident macrophages to fortify their innate functions against bacterial infection. PMID:26439699

  3. Disaster planning for peritoneal dialysis programs.

    PubMed

    Kleinpeter, Myra A; Norman, Lisa D; Krane, N Kevin

    2006-01-01

    Because of increased intensity of hurricanes in the Gulf Coast region of the United States, peritoneal dialysis (PD) programs have been disrupted and patients relocated temporarily following these catastrophic events. We describe the disaster planning, implementation, and follow-up that occurred in one such PD program in New Orleans following Hurricane Katrina. Each year at the beginning of the North American hurricane season, the PD program's disaster plan is reviewed by clinic staff and copies are distributed to patients. Patients are instructed to assemble a disaster kit and are provided with contact numbers for dialysis suppliers and for a PD program in their planned evacuation city. In July 2005, this disaster plan was tested when an early tropical storm and hurricane entered the Gulf and several patients briefly relocated or evacuated because of power loss and then returned without incident. However, when Hurricane Katrina, a category 5 storm, was predicted to strike the metropolitan area, patients were notified by telephone to evacuate, and contact information, including their evacuation city and telephone and cellular phone numbers, was obtained. Patients were also reminded to take all medications, bottled water, antibacterial soap, hand sanitizer, and 4-5 days of PD supplies. Following the storm, telephone and cellular phone services were severely disrupted. However, text messaging was available to contact patients to confirm safety and to provide further instructions. Arrangements with the major dialysis suppliers to ship emergency supplies to new locations were made by the PD nurse and the patients. Only 2 of 22 patients required hospitalization because of complications resulting from evacuation failure, contamination, and inability to perform dialysis for a prolonged period of time. Both of these patients were quickly released and have continued PD. Following the event, all patients remained on PD, and most have planned to return to their home PD

  4. Weekly Paclitaxel Versus Three-Weekly Paclitaxel in Recurrent Platinum-Resistant Epithelial Ovarian and Peritoneal Cancers: A Phase III Study

    PubMed Central

    Osman, Mohammed A.; Elkady, Mohammad S.; Nasr, Khalid E.

    2016-01-01

    INTRODUCTION Treatment of recurrent platinum-resistant ovarian and peritoneal cancers represents a therapeutic challenge. The aim of this Phase III prospective study was to compare the survival benefits, objective response rate, and toxicities among patients treated by weekly paclitaxel with those who underwent three-weekly paclitaxel in recurrent platinum-resistant ovarian and peritoneal cancers. METHOD Patients with recurrent platinum-resistant ovarian and peritoneal cancer were allocated to receive either weekly paclitaxel (arm 1) at 80 m/m2 or three-weekly paclitaxel (arm 2) at 175 mg/m2. RESULTS Fifty-five patients were enrolled (30 arm 1, 25 arm 2). The mean age was 56.7 years, and the median performance status was 0 (Eastern Cooperative Oncology Group [ECOG]). For arms 1 and 2, the objective response rates were 27% and 16%, the median progression-free survival were 7 and 4.5 months, and the median overall survival were 15.5 and 12.5 months, respectively. Treatments also significantly improved the quality of life. Treatment was associated with mild toxicities, and while neuropathy was slightly higher for weekly paclitaxel over three-weekly paclitaxel, hematological toxicities were significantly lower for the former than the latter. CONCLUSION Paclitaxel rechallenge showed antitumor activity in recurrent platinum-resistant ovarian and peritoneal cancers. Weekly paclitaxel achieved better results than three-weekly paclitaxel in terms of survival benefits, quality of life, and toxicities. PMID:27147900

  5. Primary peritonitis by Streptococcus pyogenes. A condition as rare as it is aggressive.

    PubMed

    Abellán Morcillo, Israel; González, Antonio; Selva Cabañero, Pilar; Bernabé, Antonio

    2016-04-01

    We report the case of a 60-year-old female patient who presented to the emergency room for abdominal pain standing with impaired general status, fever of up to 38.7ºC, and somnolence. Upon arrival the patient had a heart rate of 115 bpm, hypotension (80/40 mmHg),acute respiratory distress, and both hepatic and renal failure. During her examination the patient was drowsy and had a diffusely tender abdomen with peritoneal irritation signs. Blood tests revealed 22,000 WBCs (82%N), CRP 32.4 mg/dL, total bilirubin 3.2 mg/dL, GOT 300 U/L, GPT 160 U/L, LDH 200 U/L, AP 310 U/L, 91,000 platelets, creatinine2.3 mg/dL, and PA 64%. An abdominal CT scan was performed, which revealed a minimal amount of free intraperitoneal fluid with no other findings. Given the patient's poor status an exploratory laparoscopy was carried out, which found a moderate amount of diffuse purulent exudate, particularly in interloop and lesser pelvis areas, with no additional findings. Following surgery she was transferred to the intensive care unit on wide spectrum antibiotics .Peritoneal exudate cultures from the surgical procedure revealed Streptococcus pyogenes. The patient had a favorable outcome being subsequently discharged from hospital at day 10 after the procedure. S. pyogenesis a beta hemolytic streptococcus well known as a cause of pharyngotonsillar, skin and soft tissues infection. Primary peritonitis by S.pyogenesis a rare condition with only a few isolated cases reported. PP cases by S.pyogenes predominantly involve previously healthy young women. PP diagnosis is usually retrospective, when other causes have been ruled out by surgery and culture is positive post hoc. An appropriate differential diagnosis from conditions such as gram-negative shock, staphylococcal toxic shock, meningococcal disease, viral infection, etc., is crucial. Abdominal CT may be helpful but a variable amount of free intraperitoneal fluid is usually the only finding. The surgical approach is usually laparoscopy

  6. Automated Peritoneal Dialysis Is Associated with Better Survival Rates Compared to Continuous Ambulatory Peritoneal Dialysis: A Propensity Score Matching Analysis

    PubMed Central

    Beduschi, Gabriela de Carvalho; Figueiredo, Ana Elizabeth; Olandoski, Marcia; Pecoits-Filho, Roberto; Barretti, Pasqual; de Moraes, Thyago Proenca

    2015-01-01

    Introduction The impact of peritoneal dialysis modality on patient survival and peritonitis rates is not fully understood, and no large-scale randomized clinical trial (RCT) is available. In the absence of a RCT, the use of an advanced matching procedure to reduce selection bias in large cohort studies may be the best approach. The aim of this study is to compare automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) according to peritonitis risk, technique failure and patient survival in a large nation-wide PD cohort Methods This is a prospective cohort study that included all incident PD patients with at least 90 days of PD recruited in the BRAZPD study. All patients who were treated exclusively with either APD or CAPD were matched for 15 different covariates using a propensity score calculated with the nearest neighbor method. Clinical outcomes analyzed were overall mortality, technique failure and time to first peritonitis. For all analysis we also adjusted the curves for the presence of competing risks with the Fine and Gray analysis. Results After the matching procedure, 2,890 patients were included in the analysis (1,445 in each group). Baseline characteristics were similar for all covariates including: age, diabetes, BMI, Center-experience, coronary artery disease, cancer, literacy, hypertension, race, previous HD, gender, pre-dialysis care, family income, peripheral artery disease and year of starting PD. Mortality rate was higher in CAPD patients (SHR1.44 CI95%1.21-1.71) compared to APD, but no difference was observed for technique failure (SHR0.83 CI95%0.69-1.02) nor for time till the first peritonitis episode (SHR0.96 CI95%0.93-1.11). Conclusion In the first large PD cohort study with groups balanced for several covariates using propensity score matching, PD modality was not associated with differences in neither time to first peritonitis nor in technique failure. Nevertheless, patient survival was significantly better

  7. Intermittent Peritoneal Dialysis: Urea Kinetic Modeling and Implications of Residual Kidney Function

    PubMed Central

    Guest, Steven; Akonur, Alp; Ghaffari, Arshia; Sloand, James; Leypoldt, John K.

    2012-01-01

    ♦ Background: Intermittent peritoneal dialysis (IPD) is an old strategy that has generally been eclipsed, in the home setting, by daily peritoneal therapies. However, for a select group of patients with exhausted vascular access or inability to receive PD at home, in-center IPD may remain an option or may serve as an incremental strategy before initiation of full-dose PD. We investigated the residual kidney clearance requirements necessary to allow thrice-weekly IPD regimens to meet current adequacy targets. ♦ Methods: The 3-pore model of peritoneal transport was used to examine 2 thrice-weekly IPD dialysis modalities: 5 – 6 dwells with 10 – 12 L total volume (low-dose IPD), and 50% tidal with 20 – 24 L total volume (high-dose IPD). We assumed an 8-hour dialysis duration and 1.5% dextrose solution, with a 2-L fill volume, except in tidal mode. The PD Adequest application (version 2.0: Baxter Healthcare Corporation, Deerfield, IL, USA) and typical patient kinetic parameters derived from a large dataset [data on file from Treatment Adequacy Review for Gaining Enhanced Therapy (Baxter Healthcare Corporation)] were used to model urea clearances. The minimum glomerular filtration rate (GFR) required to achieve a total weekly urea Kt/V of 1.7 was calculated. ♦ Results: In the absence of any dialysis, the minimum residual GFR necessary to achieve a weekly urea Kt/V of 1.7 was 9.7 mL/min/1.73 m2. Depending on membrane transport type, the low-dose IPD modality met urea clearance targets for patients with a GFR between 6.0 mL/min/1.73 m2 and 7.6 mL/min/1.73 m2. Similarly, the high-dose IPD modality met the urea clearance target for patients with a GFR between 4.7 mL/min/1.73 m2 and 6.5 mL/min/1.73 m2. ♦ Conclusions: In patients with residual GFR of at least 7.6 mL/min/1.73 m2, thrice-weekly low-dose IPD (10 L) achieved a Kt/V urea of 1.7 across all transport types. Increasing the IPD volume resulted in a decreased residual GFR requirement of 4.7 mL/min/1.73 m2

  8. Mycobacterium avium complex-associated peritonitis with CAPD after unrelated bone marrow transplantation.

    PubMed

    Miyashita, Emiko; Yoshida, Hisao; Mori, Daisuke; Nakagawa, Natsuki; Miyamura, Takako; Ohta, Hideaki; Seki, Masafumi; Tomono, Kazunori; Hashii, Yoshiko; Ozono, Keiichi

    2014-12-01

    Peritonitis remains an important complication of peritoneal dialysis and is mostly caused by aerobic enteric bacteria. Non-tuberculous mycobacteria (NTM)-associated peritonitis is an unusual but serious infection, requiring special culture techniques to avoid delay in diagnosis. We report the case of an 11-year-old girl with aplastic anemia on ambulatory peritoneal dialysis who had Mycobacterium avium complex-associated peritonitis after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This case emphasizes that we should be constantly cautious about NTM infection in allo-HSCT recipients, especially when standard cultures are negative and the infection is refractory to empirical antibiotic therapy. PMID:25521993

  9. Increasing the use of biocompatible, glucose-free peritoneal dialysis solutions

    PubMed Central

    Qayyum, Ahad; Oei, Elizabeth Ley; Paudel, Klara; Fan, Stanley L

    2015-01-01

    A major concern inhibiting some clinicians from embracing peritoneal dialysis (PD) as the preferred first modality of dialysis is the effects of PD solutions on the peritoneal membrane. These anatomical and functional changes predispose to complications like peritonitis, encapsulating peritoneal sclerosis and ultrafiltration failure. In recent years, “biocompatible” and glucose-sparing PD regimens have been developed to minimize damage to the peritoneal membrane. Can the use of these more expensive solutions be justified on current evidence? In this review of the literature, we explore how we may individualize the prescription of biocompatible PD fluid. PMID:25664250

  10. Glutamate presynaptic vesicular transporter and postsynaptic receptor levels correlate with spatial memory status in aging rat models.

    PubMed

    Ménard, Caroline; Quirion, Rémi; Vigneault, Erika; Bouchard, Sylvain; Ferland, Guylaine; El Mestikawy, Salah; Gaudreau, Pierrette

    2015-03-01

    In humans, memory capacities are generally affected with aging, even without any reported neurologic disorders. The mechanisms behind cognitive decline are not well understood. We studied here whether postsynaptic glutamate receptor and presynaptic vesicular glutamate transporters (VGLUTs) levels may change in the course of aging and be related to cognitive abilities using various age-impaired (AI) or age-unimpaired rat strains. Twenty-four-month-old Long-Evans (LE) rats with intact spatial memory maintained postsynaptic ionotropic glutamate receptor levels in the hippocampal-adjacent cortex similar to those of young animals. In contrast, AI rats showed significantly reduced expression of ionotropic glutamate receptor GluR2, NR2A and NR2B subunits. In AI LE rats, VGLUT1 and VGLUT2 levels were increased and negatively correlated with receptor levels as shown by principal component analysis and correlation matrices. We also investigated whether glutamatergic receptors and VGLUT levels were altered in the obesity-resistant LOU/C/Jall (LOU) rat strain which is characterized by intact memory despite aging. No difference was observed between 24-month-old LOU rats and their young counterparts. Taken together, the unaltered spatial memory performance of 24-month-old age-unimpaired LE and LOU rats suggests that intact coordination of the presynaptic and postsynaptic hippocampal-adjacent cortex glutamatergic networks may be important for successful cognitive aging. Accordingly, altered expression of presynaptic and postsynaptic glutamatergic components, such as in AI LE rats, could be considered a marker of age-related cognitive deficits. PMID:25556161

  11. Collection and evaluation of equine peritoneal and pleural effusions.

    PubMed

    Cowell, R L; Tyler, R D; Clinkenbeard, K D; MacAllister, C G

    1987-12-01

    This article discusses collection, slide preparation, culture technique, fluid analysis and evaluation, and cytologic evaluation of peritoneal and pleural effusions. The morphologic characteristics of various effusions are described, and the physical characteristics (volume, color, turbidity) of effusions are discussed. An algorithm for classifying effusions as transudates, modified transudates, or exudates is included, and each category is discussed. PMID:3322526

  12. Kocuria Species Peritonitis: Although Rare, We Have To Care

    PubMed Central

    Dotis, John; Printza, Nikoleta; Stabouli, Stella; Papachristou, Fotios

    2015-01-01

    Kocuria species are found in the environment and on human skin. These micro-organisms are generally considered to be nonpathogenic saprophytes, rarely causing infection. However, the peritoneum has been reported to be a site of Kocuria infection. We reviewed all cases of peritonitis in peritoneal dialysis (PD) patients caused by Kocuria species that were reported in the worldwide literature. In total, 12 episodes of Kocuria species peritonitis have been reported in 9 PD patients. The median age of the patients was 62 years (range: 8 – 78 years). In the reported episodes, 4 different Kocuria species were isolated, with K. varians being the predominant species (41.7%). The most common initial symptom was abdominal pain (83.3%), followed by turbid effluent (75%) and fever (33.3%). Intraperitoneal first-generation cephalosporins and glycopeptides were the most-used antibiotics, with first-generation cephalosporins being more often preferred as first-line therapy. The median duration of treatment was 14 days, and in 2 episodes, the Tenckhoff catheter was removed. Although Kocuria peritonitis in PD patients is rare, it should be promptly treated because relapses can occur, especially with K. varians episodes. PMID:24584591

  13. Standardised Models for Inducing Experimental Peritoneal Adhesions in Female Rats

    PubMed Central

    Kraemer, Bernhard; Wallwiener, Christian; Rajab, Taufiek K.; Brochhausen, Christoph; Wallwiener, Markus; Rothmund, Ralf

    2014-01-01

    Animal models for adhesion induction are heterogeneous and often poorly described. We compare and discuss different models to induce peritoneal adhesions in a randomized, experimental in vivo animal study with 72 female Wistar rats. Six different standardized techniques for peritoneal trauma were used: brushing of peritoneal sidewall and uterine horns (group 1), brushing of parietal peritoneum only (group 2), sharp excision of parietal peritoneum closed with interrupted sutures (group 3), ischemic buttons by grasping the parietal peritoneum and ligating the base with Vicryl suture (group 4), bipolar electrocoagulation of the peritoneum (group 5), and traumatisation by electrocoagulation followed by closure of the resulting peritoneal defect using Vicryl sutures (group 6). Upon second look, there were significant differences in the adhesion incidence between the groups (P < 0.01). Analysis of the fraction of adhesions showed that groups 2 (0%) and 5 (4%) were significantly less than the other groups (P < 0.01). Furthermore, group 6 (69%) was significantly higher than group 1 (48%) (P < 0.05) and group 4 (47%) (P < 0.05). There was no difference between group 3 (60%) and group 6 (P = 0.2). From a clinical viewpoint, comparison of different electrocoagulation modes and pharmaceutical adhesion barriers is possible with standardised models. PMID:24809049

  14. Cefazolin and cephalexin kinetics in continuous ambulatory peritoneal dialysis.

    PubMed

    Bunke, C M; Aronoff, G R; Brier, M E; Sloan, R S; Luft, F C

    1983-01-01

    We studied single-dose cefazolin (CFZ) and cephalexin (CPX) kinetics in continuous ambulatory peritoneal dialysis (CAPD) patients to establish therapeutic guidelines for two cephalosporins commonly used to treat peritonitis in these patients. CFZ, 10 mg/kg, was given intravenously and intraperitoneally, while CPX, 500 mg, was given orally. CFZ led to serum concentrations of 25 microgram/ml at 24 hr, with a half-life (t 1/2) of 33 hr. CAPD accounted for only 20% of total body clearance. When CFZ was given intraperitoneally, 74% of the dose was absorbed and similar serum concentrations had much the same t 1/2. CPX, on the other hand, had a serum t 1/2 of 8.6 hr and resulted in much lower peritoneal concentrations than CFZ. The kinetic principal of superposition provided a model for the prediction of plasma concentrations after repeated intraperitoneal doses of CFZ. The model predicts that a 10-mg/kg intraperitoneal loading dose, followed by 5-mg/kg doses in each exchange the first day and 2.5-mg/kg doses thereafter, will lead to steady-state plasma concentrations of 50 to 65 microgram/ml. The data suggest that CFZ needs be given only intraperitoneally at doses lower than those in current use. CPX probably adds little to the treatment of peritonitis. PMID:6848301

  15. e-Health: remote health care models in peritoneal dialysis.

    PubMed

    Struijk, Dirk G

    2012-01-01

    A general review is given on advantages and disadvantages of the various forms of e-Health. The sparse available literature on e-Health and peritoneal dialysis is discussed. It is concluded that in general e-Health interventions lead to small but to moderate positive effects on primary health outcomes, although the evidence still is not fully convincing. PMID:22652719

  16. Kocuria species peritonitis: although rare, we have to care.

    PubMed

    Dotis, John; Printza, Nikoleta; Stabouli, Stella; Papachristou, Fotios

    2015-01-01

    Kocuria species are found in the environment and on human skin. These micro-organisms are generally considered to be nonpathogenic saprophytes, rarely causing infection. However, the peritoneum has been reported to be a site of Kocuria infection. We reviewed all cases of peritonitis in peritoneal dialysis (PD) patients caused by Kocuria species that were reported in the worldwide literature. In total, 12 episodes of Kocuria species peritonitis have been reported in 9 PD patients. The median age of the patients was 62 years (range: 8 - 78 years). In the reported episodes, 4 different Kocuria species were isolated, with K. varians being the predominant species (41.7%). The most common initial symptom was abdominal pain (83.3%), followed by turbid effluent (75%) and fever (33.3%). Intraperitoneal first-generation cephalosporins and glycopeptides were the most-used antibiotics, with first-generation cephalosporins being more often preferred as first-line therapy. The median duration of treatment was 14 days, and in 2 episodes, the Tenckhoff catheter was removed. Although Kocuria peritonitis in PD patients is rare, it should be promptly treated because relapses can occur, especially with K. varians episodes. PMID:24584591

  17. [Collateral effects of intraoperative hyperthermic chemotherapy in peritoneal carcinomatosis].

    PubMed

    Izzo, L; Galati, G; D'Aprile, M R; Stasolla, A; Kharrub, Z; Maccioni, F; Sassayannis, P G; D'Arielli, D; Marini, M; Gazzanelli, S; Caputo, M

    2004-01-01

    The association between chemotherapy and hypertermia produces a synergic effect. In this study the Authors present their experience, by the analysis of the results. From 1993 to 2000, 17 patients have been treated with surgery associated with hypertermic chemotherapy for peritoneal carcinomatosis. For the management of these patients a constant cooperation among surgeon, cardiologist and anaesthetist is very important. PMID:15112761

  18. [Peritoneal carcinomatosis: new strategies for more efficacious treatment].

    PubMed

    Zanon, Claudio

    2002-09-01

    The peritoneal carcinomatosis is considered an unlikely treatable disease using standard procedures as surgery or systemic chemotherapy. New improvements in the knowledge of the peritoneum are inducing to consider the mesothelium of the abdominal cavity as an organ similar to the other body organs. This new consideration, unified with the understanding of conditions permitting the implant of the tumor cell into the peritoneal space previous or during the surgical manipulation of the abdominal cancers, leads to the application of news strategies as the advanced cytoreduction with every nodes reduced less than 2.5 mm followed by the chemohyperthermic peritoneal perfusion (CHPP). Last papers indicate improvements in overall survival and quality of the life in ovarian, colonic and gastric cancer treated with an extensive surgical debulking plus CHPP. These results induce surgeons and oncologists to avoid incorrect strategies in the treatment of peritoneal carcinomatosis originating from ovarian and gastrointestinal tumors. In case of malignant untreatable ascites a peritoneo-venous shunt allows a control of the ascites avoiding several hospital admissions for continuous fastidious and sometime dangerous paracentesis. A palliative surgical operation in selected patients effected by trained surgical group permits an improvement of the patient's conditions in more than 80% with a positive feed back on his or her psychological behavior. PMID:12355981

  19. [Diverticular disease complicated by peritonitis: role of conservative surgical therapy].

    PubMed

    Lippi, Carlo Ettore; Braini, Andrea; Cervia, Silvio; Fabbricotti, Alaido; Ferrari, Teresa; Maruelli, Piero; Spessa, Elisabetta; Sturlese, Marco

    2007-01-01

    Peritonitis complicating diverticular disease may be treated by sigmoid resection (with or without primary anastomosis) or by a conservative surgical approach, either laparoscopically or by open surgery. The choice depends on the severity of the peritonitis (Hinchey), the patient's conditions (ASA) and the surgeon's experience. Sigmoid resection with primary anastomosis has a lower morbidity and mortality vs Hartmann's procedure. After the introduction of laparoscopy in colorectal surgery, exploratory laparoscopy combined with drainage has been proposed to treat acute episodes, followed by laparoscopic resection. Since 1982, over 1000 patients have been operated on for colorectal disease: 119 for complicated diverticulitis, 55 of which complicated by peritonitis. In the latter, we performed conservative surgery (25 patients) and resection (30 patients) laparoscopically or by open surgery. Our results show a higher morbidity and mortality for the Hartmann procedure vs sigmoid resection with primary anastomosis and a lower specific morbidity in patients undergoing laparoscopic exploration and drainage. Moreover, there was a low percentage (52%) of re-canalisations with the Hartmann procedure, with a morbidity of 32% associated with this procedure. In conclusion, we believe that a conservative laparoscopic surgical approach may be advocated in selected cases (Hinchey II and III without clear perforation), followed by laparoscopic sigmoidectomy, resection with primary anastomosis in Hinchey I or in cases of evident perforation with purulent or faecal peritonitis (possibly combined with a stoma), reserving the Hartmann procedure for compromised patients. PMID:18019645

  20. Associations of health, physical activity and weight status with motorised travel and transport carbon dioxide emissions: a cross-sectional, observational study

    PubMed Central

    2012-01-01

    Background Motorised travel and associated carbon dioxide (CO2) emissions generate substantial health costs; in the case of motorised travel, this may include contributing to rising obesity levels. Obesity has in turn been hypothesised to increase motorised travel and/or CO2 emissions, both because heavier people may use motorised travel more and because heavier people may choose larger and less fuel-efficient cars. These hypothesised associations have not been examined empirically, however, nor has previous research examined associations with other health characteristics. Our aim was therefore to examine how and why weight status, health, and physical activity are associated with transport CO2 emissions. Methods 3463 adults completed questionnaires in the baseline iConnect survey at three study sites in the UK, reporting their health, weight, height and past-week physical activity. Seven-day recall instruments were used to assess travel behaviour and, together with data on car characteristics, were used to estimate CO2 emissions. We used path analysis to examine the extent to which active travel, motorised travel and car engine size explained associations between health characteristics and CO2 emissions. Results CO2 emissions were higher in overweight or obese participants (multivariable standardized probit coefficients 0.16, 95% CI 0.08 to 0.25 for overweight vs. normal weight; 0.16, 95% CI 0.04 to 0.28 for obese vs. normal weight). Lower active travel and, particularly for obesity, larger car engine size explained 19-31% of this effect, but most of the effect was directly explained by greater distance travelled by motor vehicles. Walking for recreation and leisure-time physical activity were associated with higher motorised travel distance and therefore higher CO2 emissions, while active travel was associated with lower CO2 emissions. Poor health and illness were not independently associated with CO2 emissions. Conclusions Establishing the direction of causality

  1. Role for pro-inflammatory cytokines in regulating expression of GABA transporter type 1 and 3 in specific brain regions of kainic acid-induced status epilepticus.

    PubMed

    Su, Jing; Yin, Jian; Qin, Wei; Sha, Suxu; Xu, Jun; Jiang, Changbin

    2015-03-01

    In general, pro-inflammatory cytokines (PICs) contribute to regulation of epilepsy-associated pathophysiological processes in the central nerve system. In this report, we examined the specific activation of PICs, namely IL-1β, IL-6 and TNF-α in rat brain after kainic acid (KA)-induced status epilepticus (SE). Also, we examined the role played by PICs in regulating expression of GABA transporter type 1 and 3 (GAT-1 and GAT-3, respectively), which are the two important subtypes of GATs responsible for the regulation of extracellular GABA levels in the brain. Our results show that IL-1β, IL-6 and TNF-α were significantly increased in the parietal cortex, hippocampus and amygdala of KA-rats as compared with sham control animals (P < 0.05, KA rats vs. control rats). KA-induced SE also significantly increased (P < 0.05 vs. controls) the protein expression of GAT-1 and GAT-3 in those brain regions. In addition, central administration of antagonists to IL-1β and TNF-α receptors significantly attenuated amplified GAT-1 and GAT-3 (P < 0.05 vs. vehicle control for each antagonist group). However, antagonist to IL-6 receptor failed to attenuate enhancement in expression of GAT-1 and GAT-3 induced by KA-induced SE. Overall, our data demonstrate that PIC pathways are activated in the specific brain regions during SE which thereby selectively leads to upregulation of GABA transporters. As a result, it is likely that de-inhibition of GABA system is increased in the brain. This support a role for PICs in engagement of the adaptive mechanisms associated with epileptic activity, and has pharmacological implications to target specific PICs for neuronal dysfunction and vulnerability related to epilepsy. PMID:25708016

  2. Group A Streptococci: A rare and often misdiagnosed cause of spontaneous bacterial peritonitis in adults

    PubMed Central

    Malota, Mark; Felbinger, Thomas W.; Ruppert, Reinhard; Nüssler, Natascha C.

    2014-01-01

    Introduction Acute primary peritonitis due to group A Streptococci (GAS) is a rare but life-threatening infection. Unlike other forms of primary peritonitis it affects predominantly young previously healthy individuals and thus is often confused with the more frequent secondary peritonitis. A case series of three patients is presented as well as a review of the literature focusing on pitfalls in the diagnose and therapy of GAS peritonitis. Methods A retrospective analysis of three patients with primary GAS peritonitis was performed. Furthermore a systematic review of all cases of primary GAS peritonitis published from 1990 to 2013 was performed comparing demographics and clinical presentation, as well as radiological imaging, treatment and outcome. Results All three female patients presented initially with high fever, nausea and severe abdominal pain. Radiological imaging revealed intraperitoneal fluid collections of various degrees, but no underlying cause of peritonitis. Broad antibiotic treatment was started and surgical exploration was performed for acute abdomen in all three cases. Intraoperatively fibrinous peritonitis was observed, but the correct diagnosis was not made until microbiological analysis confirmed GAS peritonitis. One patient died within 24 h after admission. The other two patients recovered after multiple surgeries and several weeks on the intensive care unit due to multiple organ dysfunction syndrome. The fulminant clinical course of the three patients resembled those of many of the published cases: flu-like symptoms, high fever, severe acute abdominal pain and fibrinous peritonitis without obvious infectious focus were the most common symptoms reported in the literature. Conclusion GAS primary peritonitis should be considered in particular in young, previously healthy women who present with peritonitis but lack radiological findings of an infectious focus. The treatment of choice is immediate antibiotic therapy. Surgical intervention is

  3. Activation of salt-inducible kinase 2 promotes the viability of peritoneal mesothelial cells exposed to stress of peritoneal dialysis

    PubMed Central

    Wang, H-H; Lin, C-Y; Su, S-H; Chuang, C-T; Chang, Y-L; Lee, T-Y; Lee, S-C; Chang, C-J

    2016-01-01

    Maintaining mesothelial cell viability is critical to long-term successful peritoneal dialysis (PD) treatment. To clarify the viability mechanism of peritoneal mesothelial cells under PD solutions exposure, we examined the mechanisms of cellular response to this stress conditions. Here we report that the proteasome activity is inhibited when treated with PD solutions. Proteasome inhibition-mediated activation of salt-inducible kinase 2 (SIK2), an endoplasmic reticulum-resident protein, is important for mesothelial cell viability. SIK2 is mobilized to promote autophagy and protect the cells from apoptosis under PD solution or MG132 treatment. Immunofluorescence staining showed that SIK2 is colocalized with LC3B in the autophagosomes of mesothelial cells treated with PD solution or derived from patients undergoing PD treatment. SIK2 activation is likely via a two-step mechanism, upstream kinases relieving the autoinhibitory conformation of SIK2 molecule followed by autophosphorylation of Thr175 and activation of kinase activity. These results suggest that activation of SIK2 is required for the cell viability when proteasome activity is inhibited by PD solutions. Maintaining or boosting the activity of SIK2 may promote peritoneal mesothelial cell viability and evolve as a potential therapeutic target for maintaining or restoring peritoneal membrane integrity in PD therapy. PMID:27441650

  4. Laparoscopic Peritoneal Lavage: A Definitive Treatment for Diverticular Peritonitis or a “Bridge” to Elective Laparoscopic Sigmoidectomy?

    PubMed Central

    Cirocchi, Roberto; Trastulli, Stefano; Vettoretto, Nereo; Milani, Diego; Cavaliere, Davide; Renzi, Claudio; Adamenko, Olga; Desiderio, Jacopo; Burattini, Maria Federica; Parisi, Amilcare; Arezzo, Alberto; Fingerhut, Abe

    2015-01-01

    Abstract To this day, the treatment of generalized peritonitis secondary to diverticular perforation is still controversial. Recently, in patients with acute sigmoid diverticulitis, laparoscopic lavage and drainage has gained a wide interest as an alternative to resection. Based on this backdrop, we decided to perform a systematic review of the literature to evaluate the safety, feasibility, and efficacy of peritoneal lavage in perforated diverticular disease. A bibliographic search was performed in PubMed for case series and comparative studies published between January 1992 and February 2014 describing laparoscopic peritoneal lavage in patients with perforated diverticulitis. A total of 19 articles consisting of 10 cohort studies, 8 case series, and 1 controlled clinical trial met the inclusion criteria and were reviewed. In total these studies analyzed data from 871 patients. The mean follow-up time ranged from 1.5 to 96 months when reported. In 11 studies, the success rate of laparoscopic peritoneal lavage, defined as patients alive without surgical treatment for a recurrent episode of diverticulitis, was 24.3%. In patients with Hinchey stage III diverticulitis, the incidence of laparotomy conversion was 1%, whereas in patients with stage IV it was 45%. The 30-day postoperative mortality rate was 2.9%. The 30-day postoperative reintervention rate was 4.9%, whereas 2% of patients required a percutaneous drainage. Readmission rate after the first hospitalization for recurrent diverticulitis was 6%. Most patients who were readmitted (69%) required redo surgery. A 2-stage laparoscopic intervention was performed in 18.3% of patients. Laparoscopic peritoneal lavage should be considered an effective and safe option for the treatment of patients with sigmoid diverticulitis with Hinchey stage III peritonitis; it can also be consider as a “bridge” surgical step combined with a delayed and elective laparoscopic sigmoidectomy in order to avoid a Hartmann procedure

  5. Laparoscopic peritoneal lavage: a definitive treatment for diverticular peritonitis or a "bridge" to elective laparoscopic sigmoidectomy?: a systematic review.

    PubMed

    Cirocchi, Roberto; Trastulli, Stefano; Vettoretto, Nereo; Milani, Diego; Cavaliere, Davide; Renzi, Claudio; Adamenko, Olga; Desiderio, Jacopo; Burattini, Maria Federica; Parisi, Amilcare; Arezzo, Alberto; Fingerhut, Abe

    2015-01-01

    To this day, the treatment of generalized peritonitis secondary to diverticular perforation is still controversial. Recently, in patients with acute sigmoid diverticulitis, laparoscopic lavage and drainage has gained a wide interest as an alternative to resection. Based on this backdrop, we decided to perform a systematic review of the literature to evaluate the safety, feasibility, and efficacy of peritoneal lavage in perforated diverticular disease.A bibliographic search was performed in PubMed for case series and comparative studies published between January 1992 and February 2014 describing laparoscopic peritoneal lavage in patients with perforated diverticulitis.A total of 19 articles consisting of 10 cohort studies, 8 case series, and 1 controlled clinical trial met the inclusion criteria and were reviewed. In total these studies analyzed data from 871 patients. The mean follow-up time ranged from 1.5 to 96 months when reported. In 11 studies, the success rate of laparoscopic peritoneal lavage, defined as patients alive without surgical treatment for a recurrent episode of diverticulitis, was 24.3%. In patients with Hinchey stage III diverticulitis, the incidence of laparotomy conversion was 1%, whereas in patients with stage IV it was 45%. The 30-day postoperative mortality rate was 2.9%. The 30-day postoperative reintervention rate was 4.9%, whereas 2% of patients required a percutaneous drainage. Readmission rate after the first hospitalization for recurrent diverticulitis was 6%. Most patients who were readmitted (69%) required redo surgery. A 2-stage laparoscopic intervention was performed in 18.3% of patients.Laparoscopic peritoneal lavage should be considered an effective and safe option for the treatment of patients with sigmoid diverticulitis with Hinchey stage III peritonitis; it can also be consider as a "bridge" surgical step combined with a delayed and elective laparoscopic sigmoidectomy in order to avoid a Hartmann procedure. This minimally

  6. Overexpressing of OsAMT1-3, a High Affinity Ammonium Transporter Gene, Modifies Rice Growth and Carbon-Nitrogen Metabolic Status

    PubMed Central

    Bao, Aili; Liang, Zhijun; Zhao, Zhuqing; Cai, Hongmei

    2015-01-01

    AMT1-3 encodes the high affinity NH4+ transporter in rice roots and is predominantly expressed under nitrogen starvation. In order to evaluate the effect of AMT1-3 gene on rice growth, nitrogen absorption and metabolism, we generated AMT1-3-overexpressing plants and analyzed the growth phenotype, yield, carbon and nitrogen metabolic status, and gene expression profiles. Although AMT1-3 mRNA accumulated in transgenic plants, these plants displayed significant decreases in growth when compared to the wild-type plants. The nitrogen uptake assay using a 15N tracer revealed poor nitrogen uptake ability in AMT1-3-overexpressing plants. We found significant decreases in AMT1-3-overexpressing plant leaf carbon and nitrogen content accompanied with a higher leaf C/N ratio. Significant changes in soluble proteins and carbohydrates were also observed in AMT1-3-overexpressing plants. In addition, metabolite profile analysis demonstrated significant changes in individual sugars, organic acids and free amino acids. Gene expression analysis revealed distinct expression patterns of genes that participate in carbon and nitrogen metabolism. Additionally, the correlation between the metabolites and gene expression patterns was consistent in AMT1-3-overexpressing plants under both low and high nitrogen growth conditions. Therefore, we hypothesized that the carbon and nitrogen metabolic imbalance caused by AMT1-3 overexpressing attributed to the poor growth and yield of transgenic plants. PMID:25915023

  7. Old and New Perspectives on Peritoneal Dialysis in Italy Emerging from the Peritoneal Dialysis Study Group Census

    PubMed Central

    Marinangeli, Giancarlo; Cabiddu, Gianfranca; Neri, Loris; Viglino, Giusto; Russo, Roberto; Teatini, Ugo

    2012-01-01

    ♦ Background: To understand how peritoneal dialysis (PD) was being used in Italy in 2005 and 2008, a census of all centers was carried out. ♦ Methods: In 2005 and 2008, data were collected from, respectively, 222 and 223 centers, with respect to 4432 and 4094 prevalent patients. ♦ Results: In the two periods, the PD incidence remained stable (24.3% vs 22.9%), varying from center to center. Continuous ambulatory PD (CAPD) was the main initial method (55%), but APD was more widespread among prevalent patients (53%). Among patients returning to dialysis from transplantation (Tx), PD was used in 10%. The use of incremental CAPD increased significantly from 2005 to 2008, in terms both of the number of centers (27.0% vs 40.9%) and of patients (13.6% vs 25.7%). Late referrals remained stable at 28%, with less use of PD. The overall drop-out rate (episodes/100 patient-years) remained unchanged (31.0 vs 32.8), with 13.1 and 12.9 being the result of death, and 11.8 and 12.4 being the result of a switch to hemodialysis, mainly after peritonitis. A dialysis partner was required by 21.8% of the PD patients. The incidence of peritonitis was 1 episode in 36.5 and 41.1 patient-months, with negative cultures occurring in 17.1% of cases in both periods. The incidence of encapsulating peritoneal sclerosis (episodes/100 patient-years) was 0.70, representing 1.26% of patients treated. The catheter types used and the sites and methods of insertion varied widely from center to center. ♦ Conclusions: These censuses confirm the good results of PD in Italy, and provide insight into little-known aspects such as the use of incremental PD, the presence of a dialysis partner, and the incidence of encapsulating peritoneal sclerosis. PMID:22383633

  8. Strategies for preserving residual renal function in peritoneal dialysis patients

    PubMed Central

    Nongnuch, Arkom; Assanatham, Montira; Panorchan, Kwanpeemai; Davenport, Andrew

    2015-01-01

    Although there have been many advancements in the treatment of patients with chronic kidney disease (CKD) over the last 50 years, in terms of reducing cardiovascular risk, mortality remains unacceptably high, particularly for those patients who progress to stage 5 CKD and initiate dialysis (CKD5d). As mortality risk increases exponentially with progressive CKD stage, the question arises as to whether preservation of residual renal function once dialysis has been initiated can reduce mortality risk. Observational studies to date have reported an association between even small amounts of residual renal function and improved patient survival and quality of life. Dialysis therapies predominantly provide clearance for small water-soluble solutes, volume and acid-base control, but cannot reproduce the metabolic functions of the kidney. As such, protein-bound solutes, advanced glycosylation end-products, middle molecules and other azotaemic toxins accumulate over time in the anuric CKD5d patient. Apart from avoiding potential nephrotoxic insults, observational and interventional trials have suggested that a number of interventions and treatments may potentially reduce the progression of earlier stages of CKD, including targeted blood pressure control, reducing proteinuria and dietary intervention using combinations of protein restriction with keto acid supplementation. However, many interventions which have been proven to be effective in the general population have not been equally effective in the CKD5d patient, and so the question arises as to whether these treatment options are equally applicable to CKD5d patients. As strategies to help preserve residual renal function in CKD5d patients are not well established, we have reviewed the evidence for preserving or losing residual renal function in peritoneal dialysis patients, as urine collections are routinely collected, whereas few centres regularly collect urine from haemodialysis patients, and haemodialysis dialysis

  9. Fibroblast Growth Factor 21 (FGF-21) in Peritoneal Dialysis Patients: Natural History and Metabolic Implications

    PubMed Central

    González, Elena; Díez, Juan J.; Bajo, M. Auxiliadora; del Peso, Gloria; Grande, Cristina; Rodríguez, Olaia; Díaz-Almirón, Mariana

    2016-01-01

    Background Human fibroblast growth factor 21 (FGF-21) is an endocrine liver hormone that stimulates adipocyte glucose uptake independently of insulin, suppresses hepatic glucose production and is involved in the regulation of body fat. Peritoneal dialysis (PD) patients suffer potential interference with FGF-21 status with as yet unknown repercussions. Objectives The aim of this study was to define the natural history of FGF-21 in PD patients, to analyze its relationship with glucose homeostasis parameters and to study the influence of residual renal function and peritoneal functional parameters on FGF-21 levels and their variation over time. Methods We studied 48 patients with uremia undergoing PD. Plasma samples were routinely obtained from each patient at baseline and at 1, 2 and 3 years after starting PD therapy. Results Plasma FGF-21 levels substantially increased over the first year and were maintained at high levels during the remainder of the study period (253 pg/ml (59; 685) at baseline; 582 pg/ml (60.5–949) at first year and 647 pg/ml (120.5–1116.6) at third year) (p<0.01). We found a positive correlation between time on dialysis and FGF-21 levels (p<0.001), and also, those patients with residual renal function (RRF) had significantly lower levels of FGF-21 than those without RRF (ρ -0.484, p<0.05). Lastly, there was also a significant association between FGF-21 levels and peritoneal protein losses (PPL), independent of the time on dialysis (ρ 0.410, p<0.05). Conclusion Our study shows that FGF-21 plasma levels in incident PD patients significantly increase during the first 3 years. This increment is dependent on or is associated with RRF and PPL (higher levels in patients with lower RRF and higher PPL). FGF-21 might be an important endocrine agent in PD patients and could act as hormonal signaling to maintain glucose homeostasis and prevent potential insulin resistance. These preliminary results suggest that FGF-21 might play a protective role as

  10. Pretransplant peritoneal dialysis and graft thrombosis following pediatric kidney transplantation: a NAPRTCS report.

    PubMed

    McDonald, Ruth A; Smith, Jodi M; Stablein, Donald; Harmon, William E

    2003-06-01

    Graft thrombosis is a common cause of graft failure in pediatric renal transplantation. Several previous studies, including a North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) review of pretransplant dialysis status and graft outcomes, have described a potential correlation of peritoneal dialysis (PD) and graft thrombosis. This issue is of particular concern for pediatric transplant programs as more than 65% of children with end stage renal disease are treated with PD. We reviewed 7247 pediatric renal transplants performed between 1987 and 2001. Thrombosis was the cause of graft loss in 2.7% (199) of all the transplants performed. Among failed transplants, thrombosis was the third most common cause of graft loss in both index (11.6%) and subsequent transplants (14.5%). Thrombosis becomes the most common cause of graft failure (21%, 61/294) if one looks at transplants in the later cohort, from 1996 to 2001. This change is primarily because of a decrease in the incidence of acute rejection. In the PD group, 3.4% of all grafts were lost as a result of thrombosis. This compares with 1.9% in the hemodialysis group, 2.4% in the pre-emptive transplant group, and 4.1% among patients who received both dialysis modalities. There was a statistically significant difference in thrombosis failure risk in the different dialysis groups (p = 0.005) with those who received only peritoneal dialysis having the highest risk. Additional significant risk factors for graft thrombosis included; cadaver donor source (p < 0.001), cold ischemia time >24 h (p < 0.001), history of prior transplant (p < 0.001), donor age <6 yr (p < 0.001), and >5 pretransplant blood transfusions (p = 0.02). Using stepwise proportional hazards modeling, only pretransplant peritoneal dialysis, >24 h cold ischemia time, prior transplant, and donor age <6 yr were simultaneously associated with an increased risk of thrombosis. We conclude that pretransplant PD is associated with an increased risk

  11. Myofibroblastic Conversion and Regeneration of Mesothelial Cells in Peritoneal and Liver Fibrosis.

    PubMed

    Lua, Ingrid; Li, Yuchang; Pappoe, Lamioko S; Asahina, Kinji

    2015-12-01

    Mesothelial cells (MCs) form a single epithelial layer and line the surface of body cavities and internal organs. Patients who undergo peritoneal dialysis often develop peritoneal fibrosis that is characterized by the accumulation of myofibroblasts in connective tissue. Although MCs are believed to be the source of myofibroblasts, their contribution has remained obscure. We determined the contribution of peritoneal MCs to myofibroblasts in chlorhexidine gluconate (CG)-induced fibrosis compared with that of phenotypic changes of liver MCs. CG injections resulted in disappearance of MCs from the body wall and the accumulation of myofibroblasts in the connective tissue. Conditional linage tracing with Wilms tumor 1 (Wt1)-CreERT2 and Rosa26 reporter mice found that 17% of myofibroblasts were derived from MCs in peritoneal fibrosis. Conditional deletion of transforming growth factor-β type II receptor in Wt1(+) MCs substantially reduced peritoneal fibrosis. The CG treatment also induced myofibroblastic conversion of MCs in the liver. Lineage tracing with Mesp1-Cre mice revealed that Mesp1(+) mesoderm gave rise to liver MCs but not peritoneal MCs. During recovery from peritoneal fibrosis, peritoneal MCs, but not liver MCs, contribute to the regeneration of the peritoneal mesothelium, indicating an inherent difference between parietal and visceral MCs. In conclusion, MCs partially contribute to myofibroblasts in peritoneal and liver fibrosis, and protection of the MC layer leads to reduced development of fibrous tissue. PMID:26598235

  12. Experimental peritonitis induced by oral administration of indomethacin in Mongolian gerbils

    PubMed Central

    Lee, Jin-Uk

    2006-01-01

    The possibility of inducing peritoneal inflammation in three murine species (gerbils, rats and mice) via the oral administration of indomethacin was investigated with the overall aim of developing an experimental animal model for human peritonitis. Gerbils given high doses of indomethacin at a rate of 30 mg and 40 mg/kg body weight showed swelling of the abdomen, depression and dyspnea within 4 days after the treatment. The severity of the clinical symptoms increased with time. The animals were confirmed as having developed peritonitis based on the pathological features including inflammation of the peritoneum, and fibrinous adhesion of the abdominal organs in the abdominal cavity. The severity of peritonitis increased with increasing dose of indomethacin, and was not related to the gender of the animal. On the other hand, peritoneal inflammation did not develop in the rats and mice even at high doses. Therefore, the administration of 30 mg/kg body weight of indomethacin is an effective and simple method of inducing peritonitis in 5-week-old Mongolian gerbils. The animal peritonitis model used in this study can be used as an effective tool for examining potential therapeutic compounds for preventing peritoneal damage during peritonitis, and provide insight into the pathophysiology of peritonitis. PMID:16645338

  13. Effect of the Dialysis Fluid Buffer on Peritoneal Membrane Function in Children

    PubMed Central

    Nau, Barbara; Gemulla, Gita; Bonzel, Klaus E.; Hölttä, Tuula; Testa, Sara; Fischbach, Michel; John, Ulrike; Kemper, Markus J.; Sander, Anja; Arbeiter, Klaus; Schaefer, Franz

    2013-01-01

    Summary Background and objectives Double-chamber peritoneal dialysis fluids exert less toxicity by their neutral pH and reduced glucose degradation product content. The role of the buffer compound (lactate and bicarbonate) has not been defined in humans. Design, setting, participants, & measurements A multicenter randomized controlled trial in 37 children on automated peritoneal dialysis was performed. After a 2-month run-in period with conventional peritoneal dialysis fluids, patients were randomized to neutral-pH, low-glucose degradation product peritoneal dialysis fluids with 35 mM lactate or 34 mM bicarbonate content. Clinical and biochemical monitoring was performed monthly, and peritoneal equilibration tests and 24-hour clearance studies were performed at 0, 3, 6, and 10 months. Results No statistically significant difference in capillary blood pH, serum bicarbonate, or oral buffer supplementation emerged during the study. At baseline, peritoneal solute equilibration and clearance rates were similar. During the study, 4-hour dialysis to plasma ratio of creatinine tended to increase, and 24-hour dialytic creatinine and phosphate clearance increased with lactate peritoneal dialysis fluid but not with bicarbonate peritoneal dialysis fluid. Daily net ultrafiltration, which was similar at baseline (lactate fluid=5.4±2.6 ml/g glucose exposure, bicarbonate fluid=4.9±1.9 ml/g glucose exposure), decreased to 4.6±1.0 ml/g glucose exposure in the lactate peritoneal dialysis fluid group, whereas it increased to 5.1±1.7 ml/g glucose exposure in the bicarbonate content peritoneal dialysis fluid group (P=0.006 for interaction). Conclusions When using biocompatible peritoneal dialysis fluids, equally good acidosis control is achieved with lactate and bicarbonate buffers. Improved long-term preservation of peritoneal membrane function may, however, be achieved with bicarbonate-based peritoneal dialysis fluids. PMID:23124784

  14. Identification and Characterization of a Rare Fungus, Quambalaria cyanescens, Isolated from the Peritoneal Fluid of a Patient after Nocturnal Intermittent Peritoneal Dialysis

    PubMed Central

    Kuan, Chee Sian; Yew, Su Mei; Toh, Yue Fen; Chan, Chai Ling; Lim, Soo Kun; Lee, Kok Wei; Na, Shiang Ling; Hoh, Chee-Choong; Yee, Wai-Yan; Ng, Kee Peng

    2015-01-01

    Peritonitis is the leading complication of peritoneal dialysis, which is primarily caused by bacteria rather than fungi. Peritonitis is responsible for approximately 18% of the infection-related mortality in peritoneal dialysis patients. In this paper, we report the isolation of a rare fungus, Quambalaria cyanescens, from the peritoneal fluid of a man after he switched from continuous ambulatory peritoneal dialysis to nocturnal intermittent peritoneal dialysis. Based on the morphological examination and multigene phylogeny, the clinical isolate was confirmed as Q. cyanescens. This pathogen exhibited low sensitivity to all tested echinocandins and 5-flucytosine. Interestingly, morphological characterization revealed that Q. cyanescens UM 1095 produced different pigments at low temperatures (25°C and 30°C) on various culture media. It is important to monitor the emergence of this rare fungus as a potential human pathogen in the tropics. This study provides insight into Q. cyanescens UM 1095 phenotype profiles using a Biolog phenotypic microarray (PM). Of the 760 nutrient sources tested, Q. cyanescens UM 1095 utilized 42 compounds, and the fungus can adapt to a broad range of osmotic and acidic environments. To our knowledge, this is the first report of the isolation of Q. cyanescens from peritoneal fluid, revealing this rare fungus as a potential human pathogen that may be misidentified using conventional methods. The detailed morphological, molecular and phenotypic characterization of Q. cyanescens UM 1095 provides the basis for future studies on its biology, lifestyle, and potential pathogenicity. PMID:26716988

  15. Glycated Albumin versus Glycated Hemoglobin as a Glycemic Indicator in Diabetic Patients on Peritoneal Dialysis.

    PubMed

    Kobayashi, Hiroki; Abe, Masanori; Yoshida, Yoshinori; Suzuki, Hiroko; Maruyama, Noriaki; Okada, Kazuyoshi

    2016-01-01

    Compared with glycated hemoglobin (HbA1c), glycated albumin (GA) is superior in estimating glycemic control in diabetic patients on hemodialysis (HD). However, the better index for assessment of glycemic control in diabetic patients on peritoneal dialysis (PD) and the impact of protein loss on GA are unknown. Twenty diabetic patients on HD were matched by age, sex, and baseline postprandial plasma glucose (PG) levels to 20 PD patients. PG, HbA1c, GA, and serum albumin levels were measured for six months. Protein loss in PD patients was estimated by measuring the protein concentration in the peritoneal dialysate and by 24 h urine collection. Although PG and HbA1c did not differ significantly between the groups, the PD group had significantly lower GA (17.8% versus 20.8%, p < 0.001) and GA/HbA1c ratio (2.95% versus 3.45%, p < 0.0001) than the HD group. Although the PG level correlated significantly with the GA levels in both groups, it was not correlated with the HbA1c levels in both groups. HbA1c level was negatively associated with erythropoiesis-stimulating agent (ESA) dose in both groups, whereas GA was not significantly associated with serum albumin, hemoglobin concentration, ESA dose, and protein loss. Multiple regression analysis identified GA as the only independent factor associated with PG in PD patients. Our results suggested that GA was not significantly associated with protein loss, hemoglobin, serum albumin, and ESA dose. Although GA might underestimate glycemic status, it provided a significantly better measure for estimating glycemic control than HbA1c, even in PD patients. PMID:27120597

  16. Glycated Albumin versus Glycated Hemoglobin as a Glycemic Indicator in Diabetic Patients on Peritoneal Dialysis

    PubMed Central

    Kobayashi, Hiroki; Abe, Masanori; Yoshida, Yoshinori; Suzuki, Hiroko; Maruyama, Noriaki; Okada, Kazuyoshi

    2016-01-01

    Compared with glycated hemoglobin (HbA1c), glycated albumin (GA) is superior in estimating glycemic control in diabetic patients on hemodialysis (HD). However, the better index for assessment of glycemic control in diabetic patients on peritoneal dialysis (PD) and the impact of protein loss on GA are unknown. Twenty diabetic patients on HD were matched by age, sex, and baseline postprandial plasma glucose (PG) levels to 20 PD patients. PG, HbA1c, GA, and serum albumin levels were measured for six months. Protein loss in PD patients was estimated by measuring the protein concentration in the peritoneal dialysate and by 24 h urine collection. Although PG and HbA1c did not differ significantly between the groups, the PD group had significantly lower GA (17.8% versus 20.8%, p < 0.001) and GA/HbA1c ratio (2.95% versus 3.45%, p < 0.0001) than the HD group. Although the PG level correlated significantly with the GA levels in both groups, it was not correlated with the HbA1c levels in both groups. HbA1c level was negatively associated with erythropoiesis-stimulating agent (ESA) dose in both groups, whereas GA was not significantly associated with serum albumin, hemoglobin concentration, ESA dose, and protein loss. Multiple regression analysis identified GA as the only independent factor associated with PG in PD patients. Our results suggested that GA was not significantly associated with protein loss, hemoglobin, serum albumin, and ESA dose. Although GA might underestimate glycemic status, it provided a significantly better measure for estimating glycemic control than HbA1c, even in PD patients. PMID:27120597

  17. Risk Factors for New-Onset Cardiac Valve Calcification in Patients on Maintenance Peritoneal Dialysis

    PubMed Central

    Tian, Yunhuan; Feng, Sheng; Zhan, Zhoubing; Lu, Ying; Wang, Yancai; Jiang, Shan; Song, Kai; Shen, Huaying

    2016-01-01

    Objective Patients with end-stage renal disease are susceptible to cardiac valve calcification (CVC) due to mineral metabolism disorders and other factors. The purpose of this study was to investigate the risk factors for new-onset CVC in patients on maintenance peritoneal dialysis (PD). Methods This study included patients who underwent PD catheter insertion from January 2006 to June 2013 in our Peritoneal Dialysis Center. Clinical data were collected on CVC status during echocardiography evaluations (twice) at an interval of >6 months. The data collected included intact parathyroid hormone, C-reactive protein (CRP), serum phosphorus (P), serum calcium (Ca), albumin (Alb), prealbumin and the use of five types of antihypertensive drugs, statins, active vitamin D3 and Ca tablets. Results In total, 194 patients — 105 (54.1%) men, average age 60.5 ± 13.0 years — were included. CVC was present in 50 (25.8%) patients during PD catheter placement. After an average PD duration of 20.9 ± 10.4 months, CVC was detected in 97 patients (50.0%). New-onset CVC was found in 62 patients (32.0%). Multivariate logistic regression analysis revealed that only serum P levels (p = 0.01, OR = 2.569), Alb levels (p = 0.04, OR = 0.935), dialysis duration (p = 0.03, OR = 1.039) and CRP levels (p = 0.02, OR = 1.031) were associated with CVC. Conclusion Serum P, Alb and CRP levels as well as dialysis duration are independent risk factors for CVC. PMID:26989400

  18. Patients with Encapsulating Peritoneal Sclerosis Have Increased Peritoneal Expression of Connective Tissue Growth Factor (CCN2), Transforming Growth Factor-β1, and Vascular Endothelial Growth Factor

    PubMed Central

    Abrahams, Alferso C.; Habib, Sayed M.; Dendooven, Amélie; Riser, Bruce L.; van der Veer, Jan Willem; Toorop, Raechel J.; Betjes, Michiel G. H.; Verhaar, Marianne C.; Watson, Christopher J. E.; Nguyen, Tri Q.; Boer, Walther H.

    2014-01-01

    Introduction Encapsulating peritoneal sclerosis (EPS) is a devastating complication of peritoneal dialysis (PD). The pathogenesis is not exactly known and no preventive strategy or targeted medical therapy is available. CCN2 has both pro-fibrotic and pro-angiogenic actions and appears an attractive target. Therefore, we studied peritoneal expression of CCN2, as well as TGFβ1 and VEGF, in different stages of peritoneal fibrosis. Materials and methods Sixteen PD patients were investigated and compared to 12 hemodialysis patients and four pre-emptively transplanted patients. Furthermore, expression was investigated in 12 EPS patients in comparison with 13 PD and 12 non-PD patients without EPS. Peritoneal tissue was taken during kidney transplantation procedure or during EPS surgery. In a subset of patients, CCN2 protein levels in peritoneal effluent and plasma were determined. Samples were examined by qPCR, histology, immunohistochemistry, and ELISA. Results Peritoneal CCN2 expression was 5-fold higher in PD patients compared to pre-emptively transplanted patients (P<0.05), but did not differ from hemodialysis patients. Peritoneal expression of TGFβ1 and VEGF were not different between the three groups; neither was peritoneal thickness. Peritoneum of EPS patients exhibited increased expression of CCN2 (35-fold, P<0.001), TGFβ1 (24-fold, P<0.05), and VEGF (77-fold, P<0.001) compared to PD patients without EPS. In EPS patients, CCN2 protein was mainly localized in peritoneal endothelial cells and fibroblasts. CCN2 protein levels were significantly higher in peritoneal effluent of EPS patients compared to levels in dialysate of PD patients (12.0±4.5 vs. 0.91±0.92 ng/ml, P<0.01), while plasma CCN2 levels were not increased. Conclusions Peritoneal expression of CCN2, TGFβ1, and VEGF are significantly increased in EPS patients. In early stages of peritoneal fibrosis, only CCN2 expression is slightly increased. Peritoneal CCN2 overexpression in EPS patients is a

  19. [Echographic aspects of peritoneal tuberculosis. Apropos of 14 cases].

    PubMed

    Gastli, H; Hassine, W; Abdesselem, K; Gharbi, H A

    1983-05-01

    Ultrasonic images are analyzed in 14 patients aged 5 to 60 years with peritoneal tuberculosis. Images frequently demonstrated an anterior subparietal zone of transonance of variable thickness, associated with masses exhibiting transonance and multiple frequency outlines englobing digestive echos with intra-abdominal enlarged glands and free or partitioned ascites. Less frequently observed images were those of digestive tube loops adherent to the wall, hepatic or splenic lesions. Correlations were sought between these ultrasonic signs and results of endoscopy. Diagnosis of peritoneal tuberculosis is emphasized as being based mainly on histology and bacteriology, but ultrasonography conducted initially can reduce the time for diagnosis, suggest the diagnosis, assess any extension of the disease, and evaluate effects of treatment. PMID:6876014

  20. Case report: peritoneal mesothelioma from asbestos in hairdryers

    PubMed Central

    Dahlgren, James; Talbott, Patrick

    2015-01-01

    Background: The relationship between mesothelioma and exposure to asbestos is well established. As a result, the use of asbestos in buildings, construction sites, and mines, as well as the implications of disease for the workers has received considerable attention. However, asbestos was also used in household equipment and consumer products, including hairdryers. Purpose: To examine one case of peritoneal mesothelioma in a hairdresser and review the relevant literature on asbestos exposure from hairdryers. Methods: The subject’s medical and occupational records were obtained and reviewed and a physical examination was performed. Results: The results indicate that the subject developed peritoneal mesothelioma from her occupational exposure to asbestos containing hairdryers in accordance with the literature. Conclusion: Hairdryers are possible sources of asbestos exposure in patients with mesothelioma, and the asbestos exposure risk is higher for those who use hairdryers occupationally. PMID:25633928

  1. [Peritoneal tuberculosis in adults. Study of 207 cases].

    PubMed

    Hamdani, A; Sekkat, N; Alyoune, A; Merzouk, M; Moufid, S; el Meknassi, A; Mourid, A

    1987-05-01

    The authors report their experience about 207 cases of peritoneal tuberculosis in the adult, diagnosed and treated at the University Hospital Ibn Rochd in Casablanca, between january 1976 and october 1986. It concerned 139 women and 68 men--mean age 29.5 years. The most frequent clinical form was painful and febrile ascites (70% of the cases). The diagnosis was established most of the time by laparoscopy (180 examinations) which disclosed peritoneal granulations in 87% of the cases. Laparoscopy was impossible in 27 cases. Evolution was favorable in all patients except 5: 3 deaths, one relapse and one evolution to a fibro-adhesive form. During the long-term evolution in 50 patients (follow-up exceeding two years): one patient developed an occlusion and 7 had gynecological complications. PMID:2956924

  2. Continuous ambulatory peritoneal dialysis: nurses' experiences of teaching patients.

    PubMed

    Shubayra, Amnah

    2015-03-01

    Nine nurses were interviewed to determine nurses' experiences of teaching patients to use continuous ambulatory peritoneal dialysis (CAPD). The material was analyzed using content analysis. Data were sorted into four themes and ten subthemes. The themes were presented as follows: Importance of language, individualized teaching, teaching needs and structure of care in teaching. The findings highlighted important insights into how nurses experience teaching patients to perform CAPD. The study revealed some barriers for the nurses during teaching. The major barrier was shortage of Arabic speaking nursing staff. Incidental findings involved two factors that played an important role in teaching, retraining and a special team to perform pre-assessments, including home visits. In conclusion, the findings of this study showed several factors that are considered as barriers for the nurses during teaching the CAPD patients and the need to improve the communication and teaching in the peritoneal dialysis units, including the importance of individualized teaching. PMID:25758880

  3. Microsporidium infection and perforation peritonitis: A rare association

    PubMed Central

    Tanveer, Nadeem; Barman, Sandip

    2015-01-01

    Enteric protozoan infections are a well-documented cause of diarrhea in immunocompromised patients. Special stains on stool specimens are routinely performed in such patients to diagnose these protozoa namely cryptosporidium, microsporidium, and isospora. Duodenal and jejunal biopsies can also be performed to obtain a tissue diagnosis. We report a case of microsporidium enteritis diagnosed on histopathological examination of small bowel resection specimen in a case of perforation peritonitis. The patient was a known HIV-positive on antiretroviral treatment for 2 years and on antitubercular treatment for 3 months. This case report highlights the importance of carefully screening the resection specimens for protozoal infections in immunocompromised individuals. The association of perforation peritonitis and microsporidium is rare. Hence, the possibility that untreated microsporidium infection can lead to perforation cannot be ruled out. PMID:26692615

  4. [Malignant peritoneal mesothelioma. Case report and review of the literature].

    PubMed

    Ruiz-Tirado, María Luisa; Olvera-Rodríguez, Arturo; Díaz-Barranco, Irma; Ruiz-Romano, Agueda; Castillo-Ruiz, Natalia; Olvera-Quiroz, Silvia Eurydice

    2011-01-01

    A woman 88 years old with a clinical picture initiated eight days before characterized by asthenia, adynamia, hyporexia, increase of the abdominal perimeter, pain and constipation. Her husband worked at the automotive industry for more than 30 years (brakes specialist). She had a history of hypertension; abdominal ultrasound showed a metastatic liver of unknown origin and ascites. An ascites sample was gotten. Malignant cells matching with malignant peritoneal mesothelioma were observed. The patient died 30 days after the diagnosis. The peritoneal mesothelioma is a rare form of cancer that can be benign or malignant. Incidence rate increases with age. It is more frequent in men and over 60 years with a survival from five to twelve months after diagnosis. The most important risk factor is the chronic labor exposition to asbestos that includes the family. The diagnosis is difficult even for experts. Additionally, we present a brief review of the literature. PMID:21513666

  5. Phosphate balance in peritoneal dialysis patients: role of ultrafiltration.

    PubMed

    Granja, Carlos Andres; Juergensen, Peter; Finkelstein, Fredric O

    2009-01-01

    Current National Kidney Foundation's Disease Outcome Quality Initiative (K/DOQI) clinical practice guidelines for bone metabolism and disease in chronic kidney disease (CKD) recommend maintenance of serum phosphorus levels below 5.5 mg/dl. About 40% of patients maintained on chronic peritoneal dialysis (CPD) have phosphate levels above 5.5 mg%. The present study was designed to examine the relative contribution of ultrafiltration to phosphate removal in CPD patients. 24-hour dialysate collections were obtained in 28 CPD patients and the diffuse and ultrafiltration (UF) contributions to phosphate removal determined. 11% of phosphate removal was accounted for by UF. There was a highly significant correlation between UF rate and the % of phosphate removed by UF. The results of this study underscore the importance of individualizing the peritoneal dialysis prescription. PMID:19494614

  6. [Patient receiving peritoneal dialysis after treatment of ovarian cancer].

    PubMed

    Jaśkowski, Piotr; Krzanowska, Katarzyna; Miarka, Przemysław; Krzanowski, Marcin; Sułowicz, Wiadysław

    2014-01-01

    Peritoneal dialysis is one of the three available options for renal replacement therapy. This method of treatment of end-stage renal disease gives patients relatively high sense of independence and control over their disease, especially in comparison with hemodialysis, and therefore is often preferable method for young individuals wishing to lead an active lifestyle. We present a case of 22 year old female patient with stage 5 of chronic kidney disease, which is a consequence of multi-agent chemotherapy for endo-dermal sinus tumor of the right ovary (diagnosed at the age of 13). Particularly important in the context of treating our patient with peritoneal dialysis is the fact of confirmed metastases into the peritoneum, which was the reason for the use of chemotherapy reserved for high-risk patients (ifosfamide + etoposide + cisplatin). The selected program of chemotherapy provided effective eradication of cancer, but a side effect of treatment was renal tubular damage. In the period from 03.2006 to 05.2007 our patient required hemodialysis (with gradually reduce dose of dialysis), at a later time to 12.2011 patient did not require renal replacement therapy (stable renal function were observed at the stage 4 of chronic kidney disease), but in 12.2011 resumption of dialysis was necessary and the patient, in accordance with her selection, is receiving peritoneal dialysis. Qualification of our patient for treatment with peritoneal dialysis was associated with reasonable concern about the ability to provide acceptable adequacy of dialysis. Apprehensions proved to be unfounded, the clinical observation of the patient presents proper ratios of dialysis adequacy. Our patient was also qualified for renal transplantation. PMID:25546920

  7. [Acute pancreas necrosis with biliary peritonitis in cesarean section].

    PubMed

    Zoldos, L; Hincová, M

    1986-01-01

    The authors describe the case of a hemorrhagic pancreatitis with non-perforating biliary peritonitis. The abdomen symptomatology was hidden by the beginning contractions and due to the dystocia the delivery was finished by caesarean section. The presence of choleperitoneum required a surgical revision of the abdominal cavity which enabled to make the right diagnosis. This thesis deals with aetiology and mechanism of choleperitoneum inception during hemorrhagic pancreatitis. PMID:3788337

  8. Active Negative Pressure Peritoneal Therapy After Abbreviated Laparotomy

    PubMed Central

    Roberts, Derek J.; Faris, Peter D.; Ball, Chad G.; Kubes, Paul; Tiruta, Corina; Xiao, Zhengwen; Holodinsky, Jessalyn K.; McBeth, Paul B.; Doig, Christopher J.; Jenne, Craig N.

    2015-01-01

    Objective: To determine whether active negative pressure peritoneal therapy with the ABThera temporary abdominal closure device reduces systemic inflammation after abbreviated laparotomy. Background: Excessive systemic inflammation after abdominal injury or intra-abdominal sepsis is associated with poor outcomes. Methods: We conducted a single-center, randomized controlled trial. Forty-five adults with abdominal injury (46.7%) or intra-abdominal sepsis (52.3%) were randomly allocated to the ABThera (n = 23) or Barker's vacuum pack (n = 22). On study days 1, 2, 3, 7, and 28, blood and peritoneal fluid were collected. The primary endpoint was the difference in the plasma concentration of interleukin-6 (IL-6) 24 and 48 hours after temporary abdominal closure application. Results: There was a significantly lower peritoneal fluid drainage from the ABThera at 48 hours after randomization. Despite this, there was no difference in plasma concentration of IL-6 at baseline versus 24 (P = 0.52) or 48 hours (P = 0.82) between the groups. There was also no significant intergroup difference in the plasma concentrations of IL-1β, −8, −10, or −12 p70 or tumor necrosis factor α between these time points. The cumulative incidence of primary fascial closure at 90 days was similar between groups (hazard ratio, 1.6; 95% confidence interval, 0.82–3.0; P = 0.17). However, 90-day mortality was improved in the ABThera group (hazard ratio, 0.32; 95% confidence interval, 0.11–0.93; P = 0.04). Conclusions: This trial observed a survival difference between patients randomized to the ABThera versus Barker's vacuum pack that did not seem to be mediated by an improvement in peritoneal fluid drainage, fascial closure rates, or markers of systemic inflammation. Trial Registration: ClinicalTrials.gov identifier NCT01355094. PMID:25536308

  9. FDG PET/CT in Peritoneal Metastasis From Prostate Cancer.

    PubMed

    Gungor, Serkan; Asa, Sertac; Kupik, Osman

    2016-09-01

    Prostate cancer is one of the leading causes of cancer death in men. The prognosis in prostate cancer is greatly worsened by the presence of metastases, which are most commonly found in bone, lung, liver, and brain. The peritoneum is an extremely uncommon metastatic site for prostate cancer, even in autopsy series. We present a case of FDG PET/CT demonstration of peritoneal metastasis from prostate cancer. PMID:27187732

  10. Scoring Systems for Outcome Prediction of Patients with Perforation Peritonitis

    PubMed Central

    Litake, Manjusha Madhusudhan

    2016-01-01

    Introduction Peritonitis continues to be one of the major infectious problems confronting a surgeon. Mannheim Peritonitis Index (MPI), Physiological and Operative Severity Score for en Umeration of Mortality (POSSUM) and Morbidity and sepsis score of Stoner and Elebute have been devised for risk assessment and for prediction of postoperative outcome. Aim The aim of this study was to find the accuracy of these scores in predicting outcome in terms of mortality in patients undergoing exploratory laprotomy for perforation peritonitis. Materials and Methods The prospective study was carried out in 100 diagnosed cases of perforation at our centre in a single unit over a period of 21 months from December 2012 to August 2014. Study was conducted on all cases of peritonitis albeit primary, tertiary, iatrogenic and those with age less than 12 years were excluded from the study. All the relevant data were collected and three scores were computed from one set of data from the patient. The main outcome measure was survival of the patient. The Receiver Operator Characteristics (ROC) curves were obtained for the three scores. Area Under the Curves (AUC) was calculated. Sensitivity and specificity were calculated at a cut off point obtained from the ROC curves. Results POSSUM had an AUC of 0.99, sepsis score had an AUC of 0.98 and MPI had an AUC of 0.95. The cut off point score of 51 for POSSUM had an accuracy of 93.8 and positive predictive value of 70.5, the score of 29 for MPI had an accuracy of 82.8 and positive predictive value of 46 and the score of 22 for sepsis score had an accuracy of 95.9 and positive predictive value of 86.67. Conclusion POSSUM score was found to be superior in prediction of mortality as compared to sepsis score of Stoner and Elebute and MPI. POSSUM and MPI over predicted mortality in some cases. None of these scores are strictly preoperative. PMID:27134924

  11. Peritoneal Mesothelioma: An Unusual Cause of High-Protein Ascites

    PubMed Central

    2015-01-01

    We present a case illustrating the workup and diagnosis of peritoneal sarcomatous mesothelioma as an unusual etiology of intestinal obstruction and high-protein ascites in an otherwise healthy man. This rare disorder is diagnosed based on immunohistochemistry, which is necessary to differentiate it from other rare sarcomatous carcinomas. In many cases, localized disease can be treated to cure with surgery and intraperitoneal chemotherapy. Advanced disease is often treated for palliation of symptoms. PMID:26504886

  12. An unusual cause of peritonitis in a deployed environment.

    PubMed

    Proffitt, Adrian; Faulconer, R; Kreishman, P; Graybill, S; Craig, D

    2015-03-01

    Acute abdominal pain is a common presenting complaint to both primary and secondary care, and is a frequent cause of hospital admission among deployed personnel. Identification of generalised peritonism on abdominal examination is a classical indicator of intra-abdominal pathology that may warrant exploratory laparotomy. Negative findings at laparotomy should serve as a diagnostic prompt to consider other non-surgical mimics of an acute abdomen. PMID:24254746

  13. Peritonitis Due to Thermoascus taitungiacus (Anamorph Paecilomyces taitungiacus)

    PubMed Central

    Korzets, Asher; Weinberger, Miriam; Chagnac, Avry; Goldschmied-Reouven, Anna; Rinaldi, Michael G.; Sutton, Deanna A.

    2001-01-01

    The first case of human disease due to the thermophilic ascomycete Thermoascus taitungiacus (the teleomorph of Paecilomyces taitungiacus) is presented. T. taitungiacus was recovered from four dialysate fluid specimens of a 57-year-old patient undergoing chronic peritoneal dialysis. Identification was based upon cylindrical conidia, reddish orange nonostiolate ascomata, lack of growth at 20°C, thermotolerance, and ascospores that appeared pale yellow, elliptical, thick walled, and predominately echinulate by light microscopy but irregularly verrucose by scanning electron microscopy. PMID:11158134

  14. Outcomes with cytoreductive surgery and HIPEC for peritoneal metastasis.

    PubMed

    Ahmed, Shuja; Stewart, John H; Shen, Perry; Votanopoulos, Konstantinos I; Levine, Edward A

    2014-10-01

    Peritoneal metastasis (PM) has traditionally been approached with therapeutic nihilism. The evolution of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) over the last two decades, however, has caused a paradigm shift in treatment for PM. This modality is rapidly gaining acceptance as standard of care for PM from various cancers. This article reviews the current literature regarding the use of CRS/HIPEC for PM from the most common intra-abdominal malignancies. PMID:25164477

  15. Results in Assisted Peritoneal Dialysis: A Ten-Year Experience

    PubMed Central

    Querido, Sara; Branco, Patrícia Quadros; Costa, Elisabete; Pereira, Sara; Gaspar, Maria Augusta; Barata, José Diogo

    2015-01-01

    Background/Aims. Peritoneal dialysis is a successful renal replacement therapy (RRT) for old and dependent patients. We evaluated the clinical outcomes of an assisted peritoneal dialysis (aPD) program developed in a Portuguese center. Methods. Retrospective study based on 200 adult incident patients admitted during ten years to a PD program. We included all 17 patients who were under aPD and analysed various parameters, including complications with the technique, hospitalizations, and patient and technique survival. Results. The global peritonitis rate was lower in helped than in nonhelped patients: 0.4 versus 0.59 episodes/patient/year. The global hospitalization rate was higher in helped than in nonhelped patients: 0.67 versus 0.45 episodes/patient/year (p = NS). Technique survival in helped patients versus nonhelped patients was 92.3%, 92.3%, 83.1%, and 72.7% versus 91.9%, 81.7%, and 72.1%, and 68.3%, at 1, 2, 3, and 4 years, respectively (p = NS), and patient survival in helped patients versus nonhelped patients was 93.3%, 93.3%, 93.3%, and 74.7% versus 95.9% 93.7%, 89%, and 82% at 1, 2, 3, and 4 years, respectively (p = NS). Conclusions. aPD offers an opportune, reliable, and effective home care alternative for patients with no other RRT options. PMID:26600950

  16. Extra-hepatic fascioliasis with peritoneal malignancy tumor feature.

    PubMed

    Mohammadi-Ghalehbin, Behnam; Chinifroush-Asl, Mir Mehdi; Ramzi, Fatemeh

    2012-04-01

    Fascioliasis is a zoonose parasitic disease caused by Fasciola hepatica and Fasciola gigantica and is widespread in most regions of the world. Ectopic fascioliasis usually caused by juvenile Fasciola spp., but in recent years a few cases of tissue-embedded ova have been reported from different endemic areas. A 79-year-old Iranian man resident in Eird-e-Mousa village from Ardabil Province, north-west of Iran, complained with abdominal pain, nausea, and intestinal obstruction symptoms referred to Ardabil Fatemi hospital. In laparotomy multiple intestinal masses with peritoneal seeding resembling of a malignant lesion were seen. After appendectomy and peritoneal mass biopsy with numerous intraperitoneal adenopathy, paraffin embedded blocks were prepared from each tissues. A blood sample was taken from the patient 5 months later for serological diagnosis. Histopathological examination of sections showed fibrofatty stroma with dense mixed inflammatory cells infiltration and fibrosis in peritoneal masses. Large numbers of ova of Fasciola spp. were noted with typical circumscribed granulomas. Despite of anti-fasciola treatment, IHA test for detecting anti F. hepatica antibodies was positive 5 months after surgery with a titer of 1/128. Due to multiple clinical manifestation of extra-hepatic fascioliasis, its differential diagnosis from intraperitoneal tumors or other similar diseases should be considered. PMID:23542770

  17. Peritoneal dialysis in the developing world: the Mexican scenario.

    PubMed

    Treviño-Becerra, Alejandro; Maimone, Maria Antonieta Schettino

    2002-09-01

    In the developing countries it is not possible to determine the total amount of money spent in the treatment of chronic diseases, and the practice of renal replacement therapies faces many obstacles. In Mexico, the introduction of continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis (CCPD) achieved very good results. Unfortunately, renal disease still affected as much as 95% of chronic renal failure patients and it became a disaster with an annual mortality rate higher than 60%. This was known as the Mexican Model which failed in establishing peritoneal dialysis as the only procedure for treating patients. In order to avoid a similar scenario with the 2 replacement therapies, we created the Official Norm for hemodialysis, and now we are experimenting with an increase from 5% to 20% of hemodialysis patients who are receiving therapy, principally in private units that attend Social Security patients. In addition, the government has established a Council for Transplantation that acts as a regulatory board. In other words, we are in the process of making chronic renal diseases a priority within the National Program. PMID:12197926

  18. Results in Assisted Peritoneal Dialysis: A Ten-Year Experience.

    PubMed

    Querido, Sara; Branco, Patrícia Quadros; Costa, Elisabete; Pereira, Sara; Gaspar, Maria Augusta; Barata, José Diogo

    2015-01-01

    Background/Aims. Peritoneal dialysis is a successful renal replacement therapy (RRT) for old and dependent patients. We evaluated the clinical outcomes of an assisted peritoneal dialysis (aPD) program developed in a Portuguese center. Methods. Retrospective study based on 200 adult incident patients admitted during ten years to a PD program. We included all 17 patients who were under aPD and analysed various parameters, including complications with the technique, hospitalizations, and patient and technique survival. Results. The global peritonitis rate was lower in helped than in nonhelped patients: 0.4 versus 0.59 episodes/patient/year. The global hospitalization rate was higher in helped than in nonhelped patients: 0.67 versus 0.45 episodes/patient/year (p = NS). Technique survival in helped patients versus nonhelped patients was 92.3%, 92.3%, 83.1%, and 72.7% versus 91.9%, 81.7%, and 72.1%, and 68.3%, at 1, 2, 3, and 4 years, respectively (p = NS), and patient survival in helped patients versus nonhelped patients was 93.3%, 93.3%, 93.3%, and 74.7% versus 95.9% 93.7%, 89%, and 82% at 1, 2, 3, and 4 years, respectively (p = NS). Conclusions. aPD offers an opportune, reliable, and effective home care alternative for patients with no other RRT options. PMID:26600950

  19. Pleuroperitoneal leak complicating peritoneal dialysis: a case series.

    PubMed

    Kennedy, C; McCarthy, C; Alken, S; McWilliams, J; Morgan, R K; Denton, M; Conlon, P J; Magee, C

    2011-01-01

    Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis. PMID:21876802

  20. [Extraovarian peritoneal serous papillary carcinoma: an unusual surgical case].

    PubMed

    Meier, C; Seifert, M; Wehrli, H

    1999-01-01

    The extraovarian peritoneal serous papillary carcinoma (EPSPC) is a multicentric peritoneal tumor with minimal or absent involvement of the ovaries. The actual treatment regimen consists of a cytoreductive surgery followed by a combination chemotherapy. Few studies have compared outcome of EPSPC to papillary serous ovarian cancer (PSOC). Several authors have documented similar clinical behavior between EPSPC and PSOC, but this finding has not been universal. A 64-year-old female patient with symptomatic gall stone disease underwent elective laparoscopic cholecystectomy. Unexpectedly we found some uncommon small nodular structures on the serosa of the right colon. The histological findings suggested a poorly differentiated peritoneal serous papillary carcinoma. Biopsies of both ovaries showed no signs of tumor infiltration and the diagnosis of EPSPC was established. After surgery, a combination chemotherapeutic regimen with carboplatin and cyclophosphamid was given. Laparoscopic reassessment 7 months after the first procedure showed no tumor. 3 identical cycles completed chemotherapy. Normal ovaries and no other tumor sites were found in a final laparoscopic look after 11 months. PMID:10073126

  1. Pasteurella Multocida Peritonitis After Cat Scratch in a Patient with Cirrhotic Ascites

    PubMed Central

    Gunathilake, Roshan; Verma, Ajay; Caffery, Michael; Sowden, Sowden

    2015-01-01

    Pasteurella multocida, a zoonotic agent transmitted by canines and felines, has been very rarely reported to cause bacterial peritonitis in humans. Pasteurella multocida peritonitis is associated with high mortality even with appropriate treatment, therefore its early recognition is essential. We report a case of Pasteurella multocida peritonitis following cat scratch in a patient with Child Pugh Class C alcoholic cirrhosis, culminating in multiple organ failure and death PMID:26294953

  2. Pasteurella Multocida Peritonitis After Cat Scratch in a Patient with Cirrhotic Ascites.

    PubMed

    Gunathilake, Roshan; Verma, Ajay; Caffery, Michael; Sowden, Sowden

    2015-04-15

    Pasteurella multocida, a zoonotic agent transmitted by canines and felines, has been very rarely reported to cause bacterial peritonitis in humans. Pasteurella multocida peritonitis is associated with high mortality even with appropriate treatment, therefore its early recognition is essential. We report a case of Pasteurella multocida peritonitis following cat scratch in a patient with Child Pugh Class C alcoholic cirrhosis, culminating in multiple organ failure and death. PMID:26294953

  3. Arthritis associated with calcium oxalate crystals in an anephric patient treated with peritoneal dialysis

    SciTech Connect

    Rosenthal, A.; Ryan, L.M.; McCarty, D.J.

    1988-09-02

    The authors report a case of calcium oxalate arthropathy in a woman undergoing intermittent peritoneal dialysis who was not receiving pharmacologic doses of ascorbic acid. She developed acute arthritis, with calcium oxalate crystals in Heberden's and Bouchard's nodes, a phenomenon previously described in gout. Intermittent peritoneal dialysis may be less efficient than hemodialysis in clearing oxalate, and physicians should now consider calcium oxalate-associated arthritis in patients undergoing peritoneal dialysis who are not receiving large doses of ascorbic acid.

  4. Depressive Symptoms, Patient Satisfaction, and Quality of Life Over Time in Automated and Continuous Ambulatory Peritoneal Dialysis Patients

    PubMed Central

    Jung, Hee-Yeon; Jang, Hye Min; Kim, Yang Wook; Cho, Seong; Kim, Hye-Young; Kim, Sung-Ho; Bang, Kitae; Kim, Hyun Woo; Lee, So Young; Jo, Sang Kyung; Lee, Jonghyo; Choi, Ji-Young; Cho, Jang-Hee; Park, Sun-Hee; Kim, Chan-Duck; Kim, Yong-Lim

    2016-01-01

    Abstract Health-related quality of life (HRQOL) is an important clinical outcome for dialysis patients. However, relative superiority in HRQOL between automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) are not clearly known. We compared HRQOL over time between APD and CAPD patients and evaluated factors associated with HRQOL. All 260 incident patients initiating APD or CAPD at multiple centers throughout Korea were prospectively enrolled in this study between October 2010 and February 2013. HRQOL, depressive symptoms, and renal treatment satisfaction were assessed 1 and 12 months after the start of dialysis by the Kidney Disease Quality of Life Short Form 36 (KDQOL-36), the Beck Depression Inventory (BDI), and the Renal Treatment Satisfaction Questionnaire (RTSQ), respectively. Of 196 patients who completed all questionnaires and did not change the peritoneal dialysis (PD) modality during the 1-year follow-up period, 160 were matched. APD patients showed better baseline HRQOL than CAPD patients for the symptoms, patient satisfaction, pain, and social function domains. There were no differences in HRQOL between the 2 groups at 12 months, and CAPD patients had significantly greater improvements in symptoms (P = 0.02), the mental composite summary (P = 0.03), and health status domains (P = 0.03) than APD patients. There were similar improvements in depressive symptoms (P = 0.01) and patient satisfaction with treatment (P = 0.01) in CAPD and APD patients. Interestingly, depressive symptoms, not PD modality, was the most influential and consistent factor for HRQOL. Despite the spontaneous improvement of depressive symptoms, considerable PD patients still had depressive symptoms at the 1-year appointment. APD has no advantage over CAPD for HRQOL. Considering the substantial negative effect of depressive symptoms on HRQOL, it is important to evaluate PD patients for depression and to treat those with depression to

  5. Mean term follow-up of a series of post-traumatic syringomyelia patients after syringo-peritoneal shunting.

    PubMed

    Wiart, L; Dautheribes, M; Pointillart, V; Gaujard, E; Petit, H; Barat, M

    1995-05-01

    We report the follow-up of a series of post-traumatic syringomyelia patients treated by syringo-peritoneal shunting (SPS). The neurological status was determined following the international ASIA/IMSOP standards for neurological classification of spinal cord injury; this was completed by a modified Silberstein classification that identifies the ascending neurological symptoms as well as the increasing myelopathic symptoms in patients with post-traumatic syringomyelia. Magnetic resonance imaging (MRI) was systematically performed to assess the presence of a postoperative residual syrinx or of meningeal fibrosis. Eight patients were studied (five men, three women) with an age ranging from 17 to 54 years (mean of 30.7 years) at the time of the spinal cord injury. Three had a complete or nearly complete paraplegia, five were incomplete. The post-traumatic syringomyelia was diagnosed from 2 to 8 years after the spinal cord injury and was treated by syringo-peritoneal shunting. Early complications occurred in three patients: (1) displacement of the catheter, (2) obstruction of the catheter, and (3) haematomyelia, which disappeared after a new surgical procedure was performed. The postoperative follow-up ranged from 3 to 9 years (mean of 4.5 years). The neurological level decreased in every case and the ascending neurological symptoms decreased or were stabilised in seven patients. The postoperative ASIA/IMSOP scores and the increasing myelopathic symptoms improved in four patients but worsened in the four others, incomplete. The MRI showed an important decrease of the syrinxes in every patient associated with a serious meningeal fibrosis in five cases. Syringo-peritoneal shunting seems to be efficient in the treatment of the syrinx but may have a poor effect regarding the prevention of meningeal fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7630647

  6. Seventeen Years’ Experience of Peritoneal Dialysis in Iran: First Official Report of the Iranian Peritoneal Dialysis Registry

    PubMed Central

    Najafi, Iraj; Alatab, Sudabeh; Atabak, Shahnaz; Majelan, Nader Nouri; Sanadgol, Houshang; Makhdoomi, Khadijeh; Ardalan, Mohammad Reza; Azmandian, Jalal; Shojaee, Abbas; Keshvari, Amir; Hosseini, Mostafa

    2014-01-01

    ♦ Background: To facilitate planning, national renal registries provide reliable and up-to-date information on numbers of patients with end-stage renal disease (ESRD), developing trends, treatment modalities, and outcomes. To that end, the present publication represents the first official report from Iranian Peritoneal Dialysis Registry. ♦ Methods: The prevalence, demographics, and clinical characteristics of patients on peritoneal dialysis (PD) were collected from all PD centers throughout the country. ♦ Results: By the end of 2009, the prevalence of ESRD was 507 per million population in Iran. The most common renal replacement modality was hemodialysis (51.2%), followed by kidney transplantation (44.7%), and then PD (4.1%). The mean age of PD patients was 46 years, and the most common causes of ESRD were diabetes (33.5%), hypertension (24.4%), and glomerulonephritis (8.2%). Overall patient mortality was 25%, with cardiac events (46%), cerebral stroke (10%), and infection (8%) being the main causes of death. The 1-, 3-, and 5-year survivals were 89%, 64%, and 49% respectively. The most common cause of dropout was peritonitis (17.6%). Staphylococcus (coagulase-negative and S. aureus) was the most prevalent causative organism in peritonitis episodes; however, in more than 50% of episodes, a sterile culture was reported. Mean baseline serum hemoglobin and albumin were 10.7 g/dL and 3.6 g/dL respectively. ♦ Conclusions: Our registry results, representing the second largest report of PD in the Middle East, is almost comparable to available regional data. We hope that, in future, we can improve our shortcomings and lessen the gap with developed countries. PMID:23733658

  7. Hypomagnesemia Is Associated with Increased Mortality among Peritoneal Dialysis Patients

    PubMed Central

    Dai, Zhiwei; Zhu, Beixia; Fei, Jinping; Xue, Congping; Wu, Dan

    2016-01-01

    Objective Hypomagnesemia has been associated with an increase in mortality among the general population as well as patients with chronic kidney disease or those on hemodialysis. However, this association has not been thoroughly studied in patients undergoing peritoneal dialysis. The aim of this study was to evaluate the association between serum magnesium concentrations and all-cause and cardiovascular mortalities in peritoneal dialysis patients. Methods This single-center retrospective study included 253 incident peritoneal dialysis patients enrolled between July 1, 2005 and December 31, 2014 and followed to June 30, 2015. Patient’s demographic characteristics as well as clinical and laboratory measurements were collected. Results Of 253 patients evaluated, 36 patients (14.2%) suffered from hypomagnesemia. During a median follow-up of 29 months (range: 4–120 months), 60 patients (23.7%) died, and 35 (58.3%) of these deaths were attributed to cardiovascular causes. Low serum magnesium was positively associated with peritoneal dialysis duration (r = 0.303, p < 0.001) as well as serum concentrations of albumin (r = 0.220, p < 0.001), triglycerides (r = 0.160, p = 0.011), potassium (r = 0.156, p = 0.013), calcium(r = 0.299, p < 0.001)and phosphate (r = 0.191, p = 0.002). Patients in the hypomagnesemia group had a lower survival rate than those in the normal magnesium groups (p < 0.001). In a multivariate Cox proportional hazards regression analysis, serum magnesium was an independent negative predictor of all-cause mortality (hazard ratio [HR] = 0.075, p = 0.011) and cardiovascular mortality (HR = 0.003, p < 0.001), especially in female patients. However, in univariate and multivariate Cox analysis, △Mg(difference between 1-year magnesium and baseline magnesium) was not an independent predictor of all-cause mortality and cardiovascular mortality. Conclusion Hypomagnesemia was common among peritoneal dialysis patients and was independently associated with all

  8. Pharmacokinetics of cefradine, sulfamethoxazole and trimethoprim and their metabolites in a patient with peritonitis undergoing continuous ambulatory peritoneal dialysis.

    PubMed

    Martea, M; Hekster, Y A; Vree, T B; Voets, A J; Berden, J H

    1987-04-24

    Cefradine and co-trimoxazole pharmacokinetics were studied in a patient with peritonitis that complicated continuous ambulatory peritoneal dialysis (CAPD). Concentrations in the plasma reached after oral administration of 500 mg cefradine four times daily and 400/80 mg co-trimoxazole four times daily were for cefradine 100 micrograms/ml, for trimethoprim 15 micrograms/ml, and for sulfamethoxazole 100 micrograms/ml, respectively. In the dialysate concentrations were reached of 35-70 micrograms/ml cefradine, 2-5 micrograms/ml trimethoprim and 8-17 micrograms/ml sulfamethoxazole. The values for sulfamethoxazole are regarded too low to be clinically effective. Half-lives, protein binding values and CAPD clearances are presented. Low CAPD clearances were obtained during the night and high values during the day. The dosage yielded too high plasma trimethoprim concentrations, while sulfamethoxazole dialysate concentrations were too low. It seems questionable therefore whether co-trimoxazole can be used orally for the treatment of CAPD peritonitis. PMID:3495778

  9. Dasatinib in Treating Patients With Recurrent or Persistent Ovarian, Fallopian Tube, Endometrial or Peritoneal Cancer

    ClinicalTrials.gov

    2016-09-08

    Endometrial Clear Cell Adenocarcinoma; Estrogen Receptor Negative; Ovarian Clear Cell Cystadenocarcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma

  10. Primary Peritoneal Hydatid Cyst Presenting as Ovarian Cyst Torsion: A Rare Case Report.

    PubMed

    Gandhiraman, Kavitha; Balakrishnan, Renukadevi; Ramamoorthy, Rathna; Rajeshwari, Raja

    2015-08-01

    Hydatid cyst disease is a zoonotic disease caused by Echinococcus granulosus, E.multilocularis or E.Vogli. The most common primary site is liver (75%) followed by lungs (5-15%) and other organs constitute 10-20%. Peritoneal hydatid cysts are very rare especially primary peritoneal hydatid. Secondary peritoneal hydatid cysts are relatively common, which usually occurs due to rupture of primary hepatic hydatid cyst. We present a rare case of large primary peritoneal hydatid cyst misdiagnosed as torsion of ovarian cyst that underwent Laparotomy with cyst excision and postoperative Albendazole therapy. PMID:26436004

  11. Peritoneal Inclusion Cysts in Female Children: Pathogenesis, Treatment, and Multimodality Imaging Review

    PubMed Central

    Amodio, John

    2014-01-01

    We report the multimodality imaging findings of peritoneal inclusion cysts in two adolescent females each with a prior history of abdominal surgery. The few reports of peritoneal inclusion cysts in the pediatric population have largely focused on the clinical and pathological features of this entity. We wish to emphasize the imaging findings of peritoneal inclusion cysts on multiple modalities, the advantage of MRI in confirming the diagnosis, and the need to keep considering this diagnosis in patients who present with a pelvic cystic mass, with a history of surgery, even if remote. Additionally, we review the pathology, pathophysiology, differential diagnosis, and treatment options of peritoneal inclusion cysts. PMID:25143853

  12. Disseminated peritoneal leiomyomatosis. Clonality analysis by X chromosome inactivation and cytogenetics of a clinically benign smooth muscle proliferation.

    PubMed Central

    Quade, B. J.; McLachlin, C. M.; Soto-Wright, V.; Zuckerman, J.; Mutter, G. L.; Morton, C. C.

    1997-01-01

    Disseminated peritoneal leiomyomatosis (DPL, leiomyomatosis peritonealis disseminata) is a rare condition in which multiple histologically benign smooth muscle tumorlets diffusely stud peritoneal and omental surfaces in females, predominantly of reproductive age. Although the distribution of these lesions suggests a metastatic process, DPL generally has a benign clinical course and has been regarded as a metaplastic process. We assessed clonality of 42 tumorlets and 15 normal tissues from four females with DPL by analyzing X chromosome inactivation as indicated by the methylation status of the androgen receptor gene (HUMARA). In each of the four patients, the same parental X chromosome was nonrandomly inactivated in all tumorlets, consistent with a metastatic unicentric neoplasm, or alternatively, selection for an X-linked allele in clonal multicentric lesions. Anomalous demethylation of the marker for X inactivation (HUMARA) was associated with loss of heterozygosity for markers spanning the X chromosome, or monosomy X, in part of one leiomyomatous lesion. Biallelic demethylation of the HUMARA microsatellite polymorphism was also found in one intramural leiomyoma. Two of six DPL lesions karyotyped had cytogenetic abnormalities involving chromosomes 7, 12, and 18, suggesting a pathogenesis in common with uterine leiomyomas. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:9176406

  13. Diagnostic Laparoscopy in the Pre-operative Assessment of Patients Undergoing Cytoreductive Surgery and HIPEC for Peritoneal Surface Malignancies.

    PubMed

    Seshadri, Ramakrishnan Ayloor; Hemanth Raj E

    2016-06-01

    The introduction of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has led to an improvement in the survival of select patients with peritoneal surface malignancies (PSM). However, it is important to carefully identify patients who will benefit from this procedure and to avoid an unnecessary laparotomy in those who will not. The currently available imaging modalities are unable to accurately predict the peritoneal cancer index (PCI) score or the completeness of cytoreduction. In this article, we review the current status of staging laparoscopy in the assessment of patients with PSM who are planned for CRS & HIPEC. We discuss the patient selection, techniques, complications and efficacy of staging laparoscopy. To summarise, staging laparoscopy is a safe and feasible method of pre-operative assessment of patients with PSM. It has a high sensitivity and positive predictive value in identifying patients who can undergo a complete cytoreduction, thereby preventing many patients from undergoing an unnecessary laparotomy. With the exception of pseudomyxoma peritonei, it should be considered as a part of the routine assessment of patients with PSM who are being considered for CRS & HIPEC. PMID:27065714

  14. Activation of p38 Mitogen-Activated Protein Kinase Promotes Peritoneal Fibrosis by Regulating Fibrocytes

    PubMed Central

    Kokubo, Satoshi; Sakai, Norihiko; Furuichi, Kengo; Toyama, Tadashi; Kitajima, Shinji; Okumura, Toshiya; Matsushima, Kouji; Kaneko, Shuichi; Wada, Takashi

    2012-01-01

    ♦ Background: Peritoneal fibrosis is a serious complication of long-term peritoneal dialysis, and yet the precise pathogenic mechanisms of peritoneal fibrosis remain unknown. Fibrocytes participate in tissue fibrosis and express chemokine receptors that are necessary for migration. The p38 mitogen-activated protein kinase (MAPK) pathway regulates the production of chemokines and has been demonstrated to contribute to the pathogenesis of various fibrotic conditions. Accordingly, we used an experimental mouse model of peritoneal fibrosis to examine the dependency of fibrocytes on p38MAPK signaling. ♦ Methods: Peritoneal fibrosis was induced in mice by the injection of 0.1% chlorhexidine gluconate (CG) into the abdominal cavity. Mice were treated with FR167653, a specific inhibitor of p38MAPK, and immunohistochemical studies were performed to detect fibrocytes and cells positive for phosphorylated p38MAPK. The involvement of p38MAPK in the activation of fibrocytes also was also investigated in vitro. ♦ Results: Fibrocytes infiltrated peritoneum in response to CG, and that response was accompanied by progressive peritoneal fibrosis. The phosphorylation of p38MAPK, as defined by CD45+ spindle-shaped cells, was detected both in peritoneal mesothelial cells and in fibrocytes. The level of peritoneal expression of CCL2, a chemoattractant for fibrocytes, was upregulated by CG injection, and treatment with FR167653 reduced the number of cells positive for phosphorylated p38MAPK, the peritoneal expression of CCL2, and the extent of peritoneal fibrosis. Pretreatment with FR167653 inhibited the expression of procollagen type I α1 induced by transforming growth factor-β1. ♦ Conclusions: Our results suggest that p38MAPK signaling contributes to peritoneal fibrosis by regulating fibrocyte function. PMID:21719683

  15. Novel Endothelial Cell-Specific AQP1 Knockout Mice Confirm the Crucial Role of Endothelial AQP1 in Ultrafiltration during Peritoneal Dialysis

    PubMed Central

    Zhang, Wei; Freichel, Marc; van der Hoeven, Frank; Nawroth, Peter Paul; Katus, Hugo; Kälble, Florian

    2016-01-01

    The water channel aquaporin-1 (AQP1) mediates about 50% ultrafiltration during a 2-hour hypertonic dwell in global AQP1 knockout (AQP1-/-) mice. Although AQP1 is widely expressed in various cell types including mesothelial cells, the ultrafiltration has been assumed to be mediated via endothelial AQP1 of the peritoneum. The partial embryonic lethality and reduced body weight in AQP1-/- mice may reflect potential confounding phenotypic effects evoked by ubiquitous AQP1 deletion, which may interfere with functional analysis of endothelial AQP1. Using a Cre/loxP approach, we generated and characterised endothelial cell- and time-specific AQP1 knockout (AQP1fl/fl; Cdh5-Cre+) mice. Compared to controls, AQP1fl/fl; Cdh5-Cre+ mice showed no difference in an initial clinical and biological analysis at baseline, including body weight and survival. During a 1-hour 3.86% mini-peritoneal equilibration test (mini-PET), AQP1fl/fl; Cdh5-Cre+ mice exhibited strongly decreased indices for AQP1-related transcellular water transport (43.0% in net ultrafiltration, 93.0% in sodium sieving and 57.9% in free water transport) compared to controls. The transport rates for small solutes of urea and glucose were not significantly altered. Our data provide the first direct experimental evidence for the functional relevance of endothelial AQP1 to the fluid transport in peritoneal dialysis and thereby further validate essential predictions of the three-pore model of peritoneal transport. PMID:26760974

  16. The Use of Acute Peritoneal Dialysis in Critically Ill Newborns

    PubMed Central

    Ustyol, Lokman; Peker, Erdal; Demir, Nihat; Agengin, Kemal; Tuncer, Oguz

    2016-01-01

    Background To evaluate the efficacy, complications, and mortality rate of acute peritoneal dialysis (APD) in critically ill newborns. Material/Methods The study included 31 newborns treated in our center between May 2012 and December 2014. Results The mean birth weight, duration of peritoneal dialysis, and gestational age of the patients were determined as 2155.2±032.2 g (580–3900 g), 4 days (1–20 days), and 34 weeks (24–40 weeks), respectively. The main reasons for APD were sepsis (35.5%), postoperative cardiac surgery (16%), hypoxic ischemic encephalopathy (13%), salting of the newborn (9.7%), congenital metabolic disorders (6.1%), congenital renal diseases (6.5%), nonimmune hydrops fetalis (6.5%), and acute kidney injury (AKI) due to severe dehydration (3.2%). APD-related complications were observed in 48.4% of the patients. The complications encountered were catheter leakages in nine patients, catheter obstruction in three patients, peritonitis in two patients, and intestinal perforation in one patient. The general mortality rate was 54.8%, however, the mortality rate in premature newborns was 81.3%. Conclusions APD can be an effective, simple, safe, and important therapy for renal replacement in many neonatal diseases and it can be an appropriate treatment, where necessary, for newborns. Although it may cause some complications, they are not common. However, it should be used carefully, especially in premature newborns who are vulnerable and have a high mortality risk. The recommendation of APD therapy in such cases needs to be verified by further studies in larger patient populations. PMID:27121012

  17. Bacteria on Catheters in Patients Undergoing Peritoneal Dialysis

    PubMed Central

    Pihl, Maria; Davies, Julia R.; Johansson, Ann-Cathrine; Svensäter, Gunnel

    2013-01-01

    ♦ Background: Peritonitis is the leading cause of morbidity for peritoneal dialysis (PD) patients, and microbial biofilms have previously been identified on catheters from infected patients. However, few studies of catheters from patients without clinical signs of infection have been undertaken. The aim of the present study was to investigate the extent to which bacteria are present on catheters from PD patients with no symptoms of infection. ♦ Methods: Microbiologic culturing under aerobic and anaerobic conditions and confocal laser scanning microscopy were used to determine the distribution of bacteria on PD catheters from 15 patients without clinical signs of infection and on catheters from 2 infected patients. The 16S rRNA gene sequencing technique was used to identify cultured bacteria. ♦ Results: Bacteria were detected on 12 of the 15 catheters from patients without signs of infection and on the 2 catheters from infected patients. Single-species and mixed-microbial communities containing up to 5 species were present on both the inside and the outside along the whole length of the colonized catheters. The bacterial species most commonly found were the skin commensals Staphylococcus epidermidis and Propionibacterium acnes, followed by S. warneri and S. lugdunensis. The strains of these micro-organisms, particularly those of S. epidermidis, varied in phenotype with respect to their tolerance of the major classes of antibiotics. ♦ Conclusions: Bacteria were common on catheters from patients without symptoms of infection. Up to 4 different bacterial species were found in close association and may represent a risk factor for the future development of peritonitis in patients hosting such micro-organisms. PMID:22855889

  18. Comparison of different volume markers in peritoneal dialysis

    SciTech Connect

    De Paepe, M.; Belpaire, F.; Schelstraete, K.; Lameire, N.

    1988-04-01

    Four peritoneal volume markers (carbon /sup 14/-labeled dextran, dextran blue, radioactive albumin, and hemoglobin) were compared. In six rabbits /sup 14/C-dextran was compared with dextran blue during a 4-hour dwell with a 4.25% dextrose solution. The recovery of /sup 14/C-dextran at the end of the dwell was 71% +/- 3% vs. 92% +/- 1% for dextran blue (P less than 0.001). In six other rabbits, radioactive albumin (RISA) was compared with dextran blue. The recovery of RISA was 78% +/- 4%, compared with 85% +/- 2% for dextran blue (P less than 0.05). The calculated peritoneal volumes, uncorrected for disappearance of the markers, were consistently higher than when correction was made. After correction, the calculated end volumes were similar to actually measured end volumes. In six patients with chronic ambulatory peritoneal dialysis, the intraperitoneal volume during a single dwell of 6 hours was estimated in paired observations with lactated Ringer's solution and 1.5% dextrose dialysate, using simultaneously autologous hemoglobin and RISA. In eight additional patients, a single dwell with 4.25% dextrose dialysate was studied. The recoveries of both markers were related to the osmotic strength of the dialysate. Recoveries were 66.7% +/- 2.3% and 69.6% +/- 0.9% in lactated Ringer's solution, and increased to 81% +/- 3% and 82% +/- 2% in 4.25% dextrose for hemoglobin and RISA, respectively. With each dialysate, after correction for disappearance of the marker, no differences in volume profiles or between calculated or measured end volumes could be found with either hemoglobin or RISA.

  19. Videolaparoscopic Catheter Placement Reduces Contraindications to Peritoneal Dialysis

    PubMed Central

    Santarelli, Stefano; Zeiler, Matthias; Monteburini, Tania; Agostinelli, Rosa Maria; Marinelli, Rita; Degano, Giorgio; Ceraudo, Emilio

    2013-01-01

    ♦ Background: Videolaparoscopy is considered the reference method for peritoneal catheter placement in patients with previous abdominal surgery. The placement procedure is usually performed with at least two access sites: one for the catheter and the second for the laparoscope. Here, we describe a new one-port laparoscopic procedure that uses only one abdominal access site in patients not eligible for laparotomic catheter placement. ♦ Method: We carried out one-port laparoscopic placement in 21 patients presenting contraindications to blind surgical procedures because of prior abdominal surgery. This technique consists in the creation of a single mini-laparotomy access through which laparoscopic procedures and placement are performed. The catheter, rectified by an introducer, is inserted inside the port. Subsequently, the port is removed, leaving the catheter in pelvic position. The port is reintroduced laterally to the catheter, confirming or correcting its position. Laparotomic placement was performed in a contemporary group of 32 patients without contraindications to blind placement. Complications and long-term catheter outcome in the two groups were evaluated. ♦ Results: Additional interventions during placement were necessary in 12 patients of the laparoscopy group compared with 5 patients of the laparotomy group (p = 0.002). Laparoscopy documented adhesions in 13 patients, with need for adhesiolysis in 6 patients. Each group had 1 intraoperative complication: leakage in the laparoscopy group, and intestinal perforation in the laparotomy group. During the 2-year follow-up period, laparoscopic revisions had to be performed in 6 patients of the laparoscopy group and in 5 patients of the laparotomy group (p = 0.26). The 1-year catheter survival was similar in both groups. Laparoscopy increased by 40% the number of patients eligible to receive peritoneal dialysis. ♦ Conclusions: Videolaparoscopy placement in patients not eligible for blind surgical

  20. Sarcomatoid Peritoneal Mesothelioma: Clinicopathologic Correlation of 13 Cases.

    PubMed

    Pavlisko, Elizabeth N; Roggli, Victor L

    2015-11-01

    Peritoneal mesothelioma is rare, and the sarcomatoid variant is more infrequent, with <30 cases reported to date in the literature. Several case series have described the morphologic features of sarcomatoid peritoneal mesothelioma (SPe); however, the clinicopathologic features are not well characterized. To our knowledge, this is the first large series reporting the clinicopathologic features of SPe. We reviewed our database of 3106 malignant mesothelioma cases. Of 248 peritoneal mesotheliomas, 15 (4%) were sarcomatoid variant (0.5% of all mesotheliomas). Only cases with 100% sarcomatoid morphology diagnosed by open surgical biopsy and/or autopsy were included. Thus, 4 cases were excluded leaving 11 cases of SPe. Two additional cases of SPe previously published by 1 of the authors (V.L.R.), not included in the database, are added yielding 13 cases total. The median age at diagnosis was 66 years (range=48 to 85 y), and there was a male predominance (M:F=3.25:1). Survival from date of diagnosis to date of death was 5 months (range=0 to 12 mo). The most common presenting symptom was abdominal pain, and 3 of 4 women were suspected to have cholecystitis/cholelithiasis. All cases stained positive for cytokeratins, and 2 contained heterologous elements. Seven cases had objective markers of asbestos exposure, and 2 additional cases had occupations strongly associated with mesothelioma. Two cases with alleged household contact exposures could not be confirmed to be asbestos related by lung fiber analysis. SPe is a rare variant of mesothelioma attributed to asbestos exposure in 69% of our cases. PMID:26371785

  1. Fibroblast Growth Factor 23 in Patients Undergoing Peritoneal Dialysis

    PubMed Central

    Isakova, Tamara; Xie, Huiliang; Barchi-Chung, Allison; Vargas, Gabriela; Sowden, Nicole; Houston, Jessica; Wahl, Patricia; Lundquist, Andrew; Epstein, Michael; Smith, Kelsey; Contreras, Gabriel; Ortega, Luis; Lenz, Oliver; Briones, Patricia; Egbert, Phyllis; Ikizler, T. Alp; Jueppner, Harald

    2011-01-01

    Summary Background and objectives Fibroblast growth factor 23 (FGF23) is an independent risk factor for mortality in patients with ESRD. Before FGF23 testing can be integrated into clinical practice of ESRD, further understanding of its determinants is needed. Design, setting, participants, & measurements In a study of 67 adults undergoing peritoneal dialysis, we tested the hypothesis that longer dialysis vintage and lower residual renal function and renal phosphate clearance are associated with higher FGF23. We also compared the monthly variability of FGF23 versus parathyroid hormone (PTH) and serum phosphate. Results In unadjusted analyses, FGF23 correlated with serum phosphate (r = 0.66, P < 0.001), residual renal function (r = −0.37, P = 0.002), dialysis vintage (r = 0.31, P = 0.01), and renal phosphate clearance (r = −0.38, P = 0.008). In adjusted analyses, absence of residual renal function and greater dialysis vintage associated with higher FGF23, independent of demographics, laboratory values, peritoneal dialysis modality and adequacy, and treatment with vitamin D analogs and phosphate binders. Urinary and dialysate FGF23 clearances were minimal. In three serial monthly measurements, within-subject variability accounted for only 10% of total FGF23 variability compared with 50% for PTH and 60% for serum phosphate. Conclusions Increased serum phosphate, loss of residual renal function, longer dialysis vintage, and lower renal phosphate clearance are associated with elevated FGF23 levels in ESRD patients undergoing peritoneal dialysis. FGF23 may be a more stable marker of phosphate metabolism in ESRD than PTH or serum phosphate. PMID:21903990

  2. Peritoneal dissemination from high-grade appendiceal cancer treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)

    PubMed Central

    Cummins, Kathleen A.; Russell, Gregory B.; Votanopoulos, Konstantinos I.; Shen, Perry; Stewart, John H.

    2016-01-01

    Background Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have shown variability in survival outcomes when used to treat peritoneal surface disease (PSD) from appendiceal and colorectal cancers. The primary goal of this study was to examine outcomes for high-grade appendiceal (HGA) and high-grade colonic primaries after CRS-HIPEC to determine if a significant difference exists between the two groups. Methods A retrospective analysis of patients with peritoneal dissemination from appendiceal and colonic primaries were identified in a prospectively maintained database of 1,223 CRS-HIPEC procedures performed between 1991 and 2015. Patient demographics, performance status resection status, tumor grade, nodal status, morbidity, mortality, and survival were reviewed with biopsy-proven PSD being classified according to primary site. Univariate and multivariate analyses were performed, and outcomes compared. Results The study identified 171 CRS-HIPEC procedures for 165 patients: 110 (66.7%) for HGA and 55 (33.3%) for high-grade colonic lesions. Observed median disease-free survival (DFS) and overall survival (OS) for both groups were the same at14.4 and 18 months, respectively. Median survival according to resection status for R0/R1, R2a, and R2b/c were 36, 15.6, and 8.4 months (P<0.0001). Median OS for those who received preoperative chemotherapy versus those who did not were 14.4 and 20.4 months, respectively (P=0.01). For those who received preoperative chemotherapy, no difference was apparent in the DFS interval (P=0.34). Multivariate predictors of OS included resection status (P<0.0001) and lymph node involvement (P=0.0005). Conclusions Preoperative chemotherapy offered no clear DFS or OS benefit, for HGA or high-grade colon cancer patients. Complete cytoreduction offered the greatest survival benefit to both groups with a correlating drop in survival to resection status. Outcomes for high grade appendiceal cancer are remarkably

  3. Prevention of Peritoneal Adhesions Using Polymeric Rheological Blends

    PubMed Central

    Hoare, Todd; Yeo, Yoon; Bellas, Evangelia; Bruggeman, Joost P.

    2014-01-01

    The effectiveness of rheological blends of high molecular weight hyaluronic acid (HA) and low molecular weight hydroxypropyl methylcellulose (HPMC) in the prevention of peritoneal adhesions post-surgery is demonstrated. The physical mixture of the two carbohydrates increased the dwell time in the peritoneum while significantly improving the injectability of the polymer compared to hyaluronic acid alone. HA-HPMC treatment decreased the total adhesion area by ~70% relative to a saline control or no treatment in a repeated cecal injury model in the rabbit. No significant cytotoxicity and minimal inflammation was associated with the blend, and no chemical or physical processing was required prior to their use beyond simple mixing. PMID:24365709

  4. Biliary peritonitis due to gall bladder perforation after percutaneous nephrolithotomy.

    PubMed

    Ranjan, Nikhil; Singh, Rana Pratap; Tiwary, Rajesh

    2015-01-01

    A 19-year-old male patient underwent right percutaneous nephrolithotomy (PNL) for right renal 1.5 × 1.5 cm lower pole stone. The procedure was completed uneventfully with complete stone clearance. The patient developed peritonitis and shock 48 h after the procedure. Exploratory laparotomy revealed a large amount of bile in the abdomen along with three small perforations in the gall bladder (GB) and one perforation in the caudate lobe of the liver. Retrograde cholecystectomy was performed but the patient did not recover and expired post-operatively. This case exemplifies the high mortality of GB perforation after PNL and the lack of early clinical signs. PMID:26166971

  5. Rifaximin for the prevention of spontaneous bacterial peritonitis

    PubMed Central

    Kalambokis, Georgios N; Mouzaki, Athanasia; Rodi, Maria; Tsianos, Epameinondas V

    2012-01-01

    According to a review article by Biecker et al published in a previous issue of World Journal of Gastroenterology in March 2011, intestinal decontamination with norfloxacin remains the mainstay of primary prophylaxis of spontaneous bacterial peritonitis (SBP) at the expense of development of quinolone-resistant bacteria after long-term use. In our research, the administration of a 4-wk regimen with rifaximin 1200 mg/d reduced significantly the ascitic neutrophil count in cirrhotic patients with sterile ascites in line with a significant decrease in plasma endotoxin levels. Our observations concur with recent findings, showing a significantly reduced 5-year probability of SBP in cirrhotic patients taking rifaximin. PMID:22529702

  6. Rifaximin for the prevention of spontaneous bacterial peritonitis.

    PubMed

    Kalambokis, Georgios N; Mouzaki, Athanasia; Rodi, Maria; Tsianos, Epameinondas V

    2012-04-14

    According to a review article by Biecker et al published in a previous issue of World Journal of Gastroenterology in March 2011, intestinal decontamination with norfloxacin remains the mainstay of primary prophylaxis of spontaneous bacterial peritonitis (SBP) at the expense of development of quinolone-resistant bacteria after long-term use. In our research, the administration of a 4-wk regimen with rifaximin 1200 mg/d reduced significantly the ascitic neutrophil count in cirrhotic patients with sterile ascites in line with a significant decrease in plasma endotoxin levels. Our observations concur with recent findings, showing a significantly reduced 5-year probability of SBP in cirrhotic patients taking rifaximin. PMID:22529702

  7. Enterococcus gallinarum Spontaneous Bacterial Peritonitis in an HCV Cirrhotic.

    PubMed

    Abidali, Hussein; Sheikh, Maheen; Abidali, Moustapha; Abidali, Ali; Farraji, Hamoudi S; Berry, Andrew C

    2015-01-01

    We present the case of a 60-year-old Caucasian male with history of hepatitis C viral cirrhosis with portosystemic encephalopathy and ascites with evidence of spontaneous bacterial peritonitis (SBP) with absolute neutrophil count (ANC) of 944 cells/µL blood. Despite adequate treatment, the abdominal pain and elevated creatinine continued to persist. Initial ascites fluid cultures returned back positive for growth of Enterococcus gallinarum. Empiric antibiotics were then substituted with ampicillin/sulbactam. Our case of Enterococcus gallinarum causing SBP is only the seventh case reported in the literature to date. PMID:26064715

  8. A "sweet" hydrothorax in a child on peritoneal dialysis.

    PubMed

    Gidaris, D; Printza, N; Batzios, S; Belechri, A M; Papachristou, F

    2011-10-01

    Peritoneal dialysis (PD) is an established, effective long term renal replacement treatment modality for children with end stage renal disease (ESRD). A rarely reported complication of PD in children is the development of hydrothorax1. We report the case of an 8-year-old boy that developed a right-sided pleural effusion during automated PD (APD), in order to raise awareness amongst paediatricians; we also review the diversity of clinical presentation and the available diagnostic tools, discuss theories regarding aetiology and highlight the available treatment options. PMID:24391421

  9. Peritoneal inclusion cysts in pregnancy, a diagnostic challenge

    PubMed Central

    Hitzerd, Emilie; Jeurgens-Borst, Anneke J C M; Pijnenborg, Johanna M A

    2014-01-01

    A cystic pelvic mass detected during pregnancy is not uncommon, but can be a diagnostic challenge. Most of these pelvic masses are benign ovarian cysts and resolve spontaneously. However, rare non-ovarian causes can complicate the diagnostic and therapeutic management. In this report an unusual case is presented of a 27-year-old pregnant woman with an atypical multicystic lesion in the pelvis, seen on routine first trimester ultrasound. A laparoscopic exploration was performed to rule out ovarian malignancy, and after histological analysis she was diagnosed with peritoneal inclusion cysts. The diagnostic and therapeutic challenges inherent to this rare non-ovarian disease are addressed in this case report. PMID:24928933

  10. Pathogenicity of enterococci in a rat model of fecal peritonitis.

    PubMed

    Matlow, A G; Bohnen, J M; Nohr, C; Christou, N; Meakins, J

    1989-07-01

    The pathogenicity of enterococci in intraabdominal sepsis has not been clarified. Therefore, fecal-type peritonitis was induced in rats by intraperitoneal injection of barium sulfate along with a bacterial inoculum consisting of Escherichia coli, Bacteroides fragilis, and Clostridium perfringens with or without Streptococcus faecalis. Mortality at 19 d and characteristics of intraabdominal abscesses in survivors at 19 d were analyzed. The presence of S. faecalis in the original inoculum was significantly associated with death or large (greater than 20 mm) abscess formation when these two end points were examined together. S. faecalis may synergize with other bacteria in intraabdominal sepsis to augment morbidity and possibly mortality. PMID:2543707

  11. Skin Autofluorescence and Mortality in Patients on Peritoneal Dialysis

    PubMed Central

    Mácsai, Emília; Benke, Attila; Kiss, István

    2015-01-01

    Abstract Skin autofluorescence (SAF) is a proven prognostic factor of mortality in hemodialysis patients. Traditional and nontraditional risk factors are almost equivalent in peritoneal dialysis (PD), and cardiovascular disease (CVD) is the leading cause of death. Moreover, peritoneal glucose absorption accelerates the degenerative processes of connective tissues as in diabetes. In our study, we examined the predictive value of SAF for total mortality in the PD population. Data were collected from 198 prevalently adult Caucasian PD patients. One hundred twenty-six patients (mean age 66.2 y, men [n = 73], diabetes ratio 75/126) had anamnestic CVD (coronary heart disease, cerebrovascular disease, peripheral arterial disease). Initially, we evaluated factors affecting SAF and CVD by multivariate linear regression. Survival rates were estimated by recording clinical and demographic data associated with mortality during a 36-month follow-up using the Kaplan–Meier method. Analyses were further stratified based on the presence or absence of CVD and SAF levels above or below the upper tercile 3.61 arbitrary units. Skin autofluorescence was influenced by CVD (P < 0.01, 95% confidence interval [CI] 0.1–0.5) and white blood cell counts (P < 0.001, 95% CI 0.031–0.117). According to the Spearman correlation, SAF correlated with peritoneal cumulative glucose exposure (P = 0.02) and elapsed time in PD (P = 0.008). CVD correlated with age (P < 0.001, 95% CI 1.24–1.65) and diabetes (P < 0.001, 95% CI 2.58–10.66). More deaths were observed in the high SAF group than in the low SAF group (34/68 vs 44/130; P = 0.04). Comparing the CVD(−) low SAF group survival (mean 33.9 mos, standard error [SE] 1.39) to CVD(+) low SAF (mean 30.5 mos, SE 1.37, P = 0.03) and to CVD(+) high SAF group (mean 27.1 mos, SE 1.83, P = 0.001), the difference was significant. In conclusion, among PD patients, SAF values over 3.61 arbitrary units seem to be a

  12. [Drainage of the abdominal cavity in appendicular peritonitis in children].

    PubMed

    Tiktinskiĭ, V S; Berezhnoĭ, V I; Bodnar', B N; Tloka, V A; Goriachev, V V

    1989-01-01

    A comparative analysis of the effectiveness of different methods for drainage of the abdominal cavity in appendicular peritonitis in 138 children has shown, that the use of polyethylene drains permitted to achieve the minimal number of postoperative complications. In duration of the disease, which didn't exceed 24 hours, and in presence of less than 60 ml of exudate in the abdominal cavity, the microirrigators were used, in duration of the disease exceeding 48 hours and presence of more than 100 ml of exudate--the crimped films. PMID:2770144

  13. Severe peritonitis due to Balantidium coli acquired in France.

    PubMed

    Ferry, T; Bouhour, D; De Monbrison, F; Laurent, F; Dumouchel-Champagne, H; Picot, S; Piens, M A; Granier, P

    2004-05-01

    The case reported here concerns an alcoholic pork-butcher who presented with severe colitis with peritonitis, caused by the only ciliate protozoan capable of infecting humans, Balantidium coli. This parasite is common in a variety of domestic and wild mammals, mainly pigs; however, its prevalence rate in humans is very low--particularly in industrialised, northern countries, including France. The infection is most frequently acquired by ingesting food or water contaminated by pig faeces, and it may be asymptomatic or may cause acute diarrhoea. Specific antibiotic treatment is efficacious, and it is important to consider the risk of this parasitic disease in susceptible patients presenting with bloody diarrhoea. PMID:15112068

  14. Effect of lectins on mouse peritoneal macrophage phagocytic activity.

    PubMed

    Maldonado, G; Porras, F; Fernández, L; Vázquez, L; Zenteno, E

    1994-11-01

    We studied the in vitro ability of lectin-treated murine peritoneal macrophages to attach and phagocytize particulate antigens. Glucose and mannose specific lectins such as Con-A and lentil lectin, as well as complex lactosamine residues specific lectins, such as Phaseolus vulgaris var. cacahuate and Phaseolus coccineus var. alubia, increased the macrophage phagocytic activity towards heterologous erythrocytes, whereas peanut agglutinin, a galactose-specific lectin, diminished the macrophage phagocytic activity. These results suggest that a galactose-N-acetyl-D galactosamine-containing structure could participate as negative modulator of the phagocytic activity. PMID:7851961

  15. Peritoneal inclusion cysts in patients affected by Crohn's disease: magnetic resonance enterography findings in a case series.

    PubMed

    Mazziotti, Silvio; D'Angelo, Tommaso; Racchiusa, Sergio; Salamone, Ignazio; Blandino, Alfredo; Ascenti, Giorgio

    2016-01-01

    Peritoneal inclusion cystarises when fluid produced by ovary is trapped within peritoneal adhesions. In this article, we describe a case series of patients affected by Crohn's disease, undergoing to magnetic resonance enterography, in whom it was possible not only to monitor the pathological findings of small bowel but also to primarily diagnose the presence of peritoneal inclusion cysts. The current knowledge of peritoneal inclusion cyst concomitant to Crohn's disease is still limited, often leading radiologists to misdiagnose it. PMID:26456117

  16. First reported case of dialysis-related peritonitis due to Escherichia vulneris.

    PubMed

    Senanayake, Sanjaya N; Jadeer, Assad; Talaulikar, Girish S; Roy, Jhumur

    2006-11-01

    Escherichia vulneris is a recently identified environmental organism that can colonize humans and animals. To date, very few infections with E. vulneris have been reported. This is the first reported case of peritonitis due to E. vulneris in the setting of peritoneal dialysis. PMID:16971644

  17. Peritoneal seeding and subsequent progression of mantle cell lymphoma after splenectomy for debulking

    PubMed Central

    Bahat, G.; Saka, B.; Yenerel, M.N.; Yilmaz, E.; Tascioglu, C.; Dogan, O.

    2010-01-01

    Background Peritoneal seeding after abdominal surgery is a well known route of metastasis in intra-abdominal solid tumours. Direct mechanical contamination, local peritoneal trauma and subsequent inflammation, postoperative immunosuppression, and laparoscopic surgery are the proposed predisposing factors for this type of metastasis. These factors probably result in enhanced adhesion or growth of tumour cells. However, this route of metastasis has not yet been reported for lymphomas. Here, we report the first case of peritoneal seeding of lymphoma cells after an abdominal surgery. Case Description A 47-year-old man with mantle cell lymphoma had ascites because of infiltration of the liver. He underwent debulking splenectomy. The postoperative ascites cytology and control abdominal computed tomography imaging both confirmed peritoneal involvement and lymphoma progression. Demonstration of negative peritoneal involvement before surgery and close timing of peritoneal involvement after splenectomy suggested to us that the debulking surgery was the main cause of peritoneal seeding of lymphoma cells in our case. Conclusions Factors similar to those in solid tumour seeding may also be valid for lymphomas. Peritoneal seeding and consequent disease progression may be a potential complication of abdominal surgery in lymphoma with extensive intra-abdominal involvement. PMID:20567628

  18. Potential therapeutic failure of generic vancomycin in a liver transplant patient with MRSA peritonitis and bacteremia.

    PubMed

    Rodriguez, Carlos A; Agudelo, Maria; Cataño, Juan C; Zuluaga, Andres F; Vesga, Omar

    2009-10-01

    We report a case of generic vancomycin treatment failure in a liver transplant patient with MRSA peritonitis and bacteremia, followed by a rapid sterilization of blood and peritoneal fluid after switching to the branded product. It raises concern about therapeutic equivalence of generic vancomycin. PMID:19698745

  19. MV-NIS or Investigator's Choice Chemotherapy in Treating Patients With Ovarian, Fallopian, or Peritoneal Cancer

    ClinicalTrials.gov

    2016-06-24

    Fallopian Tube Transitional Cell Carcinoma; Malignant Ovarian Clear Cell Tumor; Malignant Ovarian Endometrioid Tumor; Malignant Ovarian Serous Tumor; Ovarian Seromucinous Carcinoma; Ovarian Transitional Cell Carcinoma; Primary Peritoneal Serous Adenocarcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Undifferentiated Fallopian Tube Carcinoma; Undifferentiated Ovarian Carcinoma

  20. Lineage Tracing Reveals Distinctive Fates for Mesothelial Cells and Submesothelial Fibroblasts during Peritoneal Injury

    PubMed Central

    Chen, Yi-Ting; Chang, Yu-Ting; Pan, Szu-Yu; Chou, Yu-Hsiang; Chang, Fan-Chi; Yeh, Pei-Ying; Liu, Yuan-Hung; Chiang, Wen-Chih; Chen, Yung-Ming; Wu, Kwan-Dun; Tsai, Tun-Jun; Duffield, Jeremy S.

    2014-01-01

    Fibrosis of the peritoneal cavity remains a serious, life-threatening problem in the treatment of kidney failure with peritoneal dialysis. The mechanism of fibrosis remains unclear partly because the fibrogenic cells have not been identified with certainty. Recent studies have proposed mesothelial cells to be an important source of myofibroblasts through the epithelial–mesenchymal transition; however, confirmatory studies in vivo are lacking. Here, we show by inducible genetic fate mapping that type I collagen–producing submesothelial fibroblasts are specific progenitors of α-smooth muscle actin–positive myofibroblasts that accumulate progressively in models of peritoneal fibrosis induced by sodium hypochlorite, hyperglycemic dialysis solutions, or TGF-β1. Similar genetic mapping of Wilms’ tumor-1–positive mesothelial cells indicated that peritoneal membrane disruption is repaired and replaced by surviving mesothelial cells in peritoneal injury, and not by submesothelial fibroblasts. Although primary cultures of mesothelial cells or submesothelial fibroblasts each expressed α-smooth muscle actin under the influence of TGF-β1, only submesothelial fibroblasts expressed α-smooth muscle actin after induction of peritoneal fibrosis in mice. Furthermore, pharmacologic inhibition of the PDGF receptor, which is expressed by submesothelial fibroblasts but not mesothelial cells, attenuated the peritoneal fibrosis but not the remesothelialization induced by hypochlorite. Thus, our data identify distinctive fates for injured mesothelial cells and submesothelial fibroblasts during peritoneal injury and fibrosis. PMID:24854266

  1. Effect of Intraperitoneal Etanercept on Oxidative Stress in Rats with Peritonitis

    PubMed Central

    Cellad, Esma Gulsum; Kara, Ali Veysel; Yilmaz, Zülfükar; Kadiroglu, Ali Kemal; Bahadir, Mehmet Veysi; Gul, Mesut; Ketani, Muzaffer Aydin; Yilmaz, Mehmet Emin

    2016-01-01

    Our aim was to evaluate effect of etanercept on oxidative stress parameters in rats with experimental peritonitis and investigate the availability of etanercept usage in the treatment of peritonitis in the future. Twenty-eight rats were divided into four groups as control (group 1), peritonitis (group 2), peritonitis + cefazolin sodium (group 3), and peritonitis + cefazolin sodium + etanercept (group 4). Peritoneal tissue and blood samples were taken from all of the rats for histopathological and biochemical examination. The oxidative stress parameters were examined in blood and tissue samples. It was observed that rats with peritonitis benefit from cefazolin sodium treatment. Evaluating the effectiveness of etanercept was our main objective for this study. In this perspective, we compared group 3 and group 4 and found statistically significant decreases in oxidative parameters and statistically significant increases in antioxidants in serum and tissue samples in group 4. It is observed that there was a significant contribution of etanercept on biochemical and also histopathological results. As a result, the TNF-α inhibitor, etanercept, in addition to antibiotics given in the early treatment of peritonitis results in more significant improvement of histopathological and oxidative parameters as compared to antibiotics alone. PMID:27066189

  2. Care of the Patient with Renal Disease: Peritoneal Dialysis and Transplants, Nursing 321A.

    ERIC Educational Resources Information Center

    Hulburd, Kimberly

    A description is provided of a course, "Care of the Patient with Renal Disease," offered at the community college level to prepare licensed registered nurses to care for patients with renal disease, including instruction in performing the treatments of peritoneal dialysis and continuous ambulatory peritoneal dialysis (CAPD). The first sections of…

  3. Pembrolizumab, Bevacizumab, and Cyclophosphamide in Treating Patients With Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

    ClinicalTrials.gov

    2016-09-02

    Fallopian Tube Clear Cell Adenocarcinoma; Fallopian Tube Endometrioid Adenocarcinoma; Fallopian Tube Mucinous Adenocarcinoma; Fallopian Tube Serous Adenocarcinoma; Ovarian Clear Cell Adenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Adenocarcinoma; Ovarian Serous Adenocarcinoma; Primary Peritoneal Serous Adenocarcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Undifferentiated Fallopian Tube Carcinoma; Undifferentiated Ovarian Carcinoma

  4. The peritoneal macrophage inflammatory profile in cirrhosis depends on the alcoholic or hepatitis C viral etiology and is related to ERK phosphorylation

    PubMed Central

    2012-01-01

    Background The development of ascites in cirrhotic patients generally heralds a deterioration in their clinical status. A differential gene expression profile between alcohol- and hepatitis C virus (HCV)-related cirrhosis has been described from liver biopsies, especially those associated with innate immune responses. The aim of this work was to identify functional differences in the inflammatory profile of monocyte-derived macrophages from ascites in cirrhotic patients of different etiologies in an attempt to extrapolate studies from liver biopsies to immune cells in ascites. To this end 45 patients with cirrhosis and non-infected ascites, distributed according to disease etiology, HCV (n = 15) or alcohol (n = 30) were studied. Cytokines and the cell content in ascites were assessed by ELISA and flow cytometry, respectively. Cytokines and ERK phosphorylation in peritoneal monocyte-derived macrophages isolated and stimulated in vitro were also determined. Results A different pattern of leukocyte migration to the peritoneal cavity and differences in the primed status of macrophages in cirrhosis were observed depending on the viral or alcoholic etiology. Whereas no differences in peripheral blood cell subpopulations could be observed, T lymphocyte, monocyte and polymorphonuclear cell populations in ascites were more abundant in the HCV than the alcohol etiology. HCV-related cirrhosis etiology was associated with a decreased inflammatory profile in ascites compared with the alcoholic etiology. Higher levels of IL-10 and lower levels of IL-6 and IL-12 were observed in ascitic fluid from the HCV group. Isolated peritoneal monocyte-derived macrophages maintained their primed status in vitro throughout the 24 h culture period. The level of ERK1/2 phosphorylation was higher in ALC peritoneal macrophages at baseline than in HCV patients, although the addition of LPS induced a greater increase in ERK1/2 phosphorylation in HCV than in ALC patients. Conclusions The

  5. Streptococcal Toxic Shock Syndrome: Life Saving Role of Peritoneal Lavage and Drainage

    PubMed Central

    Yokoyama, Minako; Oyama, Fumie; Ito, Asami; Yokota, Megumi; Matsukura, Daisuke; Tsutsumi, Shinji; Kasai, Tomonori; Nitobe, Yohshiro; Morikawa, Akiko; Ozaki, Takashi; Yokoyama, Yoshihito

    2016-01-01

    PURPOSE We encountered a case where an infection with group A streptococcus (GAS; ie, Streptococcus pyogenes) initially caused primary peritonitis and then subsequently caused streptococcal toxic shock syndrome. The patient’s life was likely saved by an emergency laparotomy followed by extensive peritoneal lavage and drainage. CASE PRESENTATION A 40-year-old woman was admitted to the Emergency Department for lower abdominal pain and numbness in the extremities. She presented with systemic inflammatory response syndrome. An emergency laparotomy was performed, and ascites that resembled pus and general peritonitis were noted. Peritoneal lavage and drainage were performed, and GAS was isolated from peritoneal fluid. Gram staining of cervical polyp specimens revealed Gram-positive bacteria. CONCLUSIONS The patient was diagnosed with streptococcal toxic shock syndrome due to an ascending GAS infection originating from vagina. PMID:27579001

  6. Ultrasound and Perforated Viscus; Dirty Fluid, Dirty Shadows, and Peritoneal Enhancement

    PubMed Central

    Shokoohi, Hamid; S. Boniface, Keith; M. Abell, Bruce; Pourmand, Ali; Salimian, Mohammad

    2016-01-01

    Early detection of free air in the peritoneal cavity is vital in diagnosis of life-threatening emergencies, and can play a significant role in expediting treatment. We present a series of cases in which bedside ultrasound (US) in the emergency department accurately identified evidence of free intra-peritoneal air and echogenic (dirty) free fluid consistent with a surgical final diagnosis of a perforated hollow viscus. In all patients with suspected perforated viscus, clinicians were able to accurately identify the signs of pneumoperitoneum including enhanced peritoneal stripe sign (EPSS), peritoneal stripe reverberations, and focal air collections associated with dirty shadowing or distal multiple reflections as ring down artifacts. In all cases, hollow viscus perforation was confirmed surgically. It seems that, performing US in patients with suspected perforated viscus can accurately identify presence of intra-peritoneal echogenic or “dirty” free fluid as well as evidence of free air, and may expedite patient management.

  7. Ultrasound and Perforated Viscus; Dirty Fluid, Dirty Shadows, and Peritoneal Enhancement.

    PubMed

    Shokoohi, Hamid; S Boniface, Keith; M Abell, Bruce; Pourmand, Ali; Salimian, Mohammad

    2016-01-01

    Early detection of free air in the peritoneal cavity is vital in diagnosis of life-threatening emergencies, and can play a significant role in expediting treatment. We present a series of cases in which bedside ultrasound (US) in the emergency department accurately identified evidence of free intra-peritoneal air and echogenic (dirty) free fluid consistent with a surgical final diagnosis of a perforated hollow viscus. In all patients with suspected perforated viscus, clinicians were able to accurately identify the signs of pneumoperitoneum including enhanced peritoneal stripe sign (EPSS), peritoneal stripe reverberations, and focal air collections associated with dirty shadowing or distal multiple reflections as ring down artifacts. In all cases, hollow viscus perforation was confirmed surgically. It seems that, performing US in patients with suspected perforated viscus can accurately identify presence of intra-peritoneal echogenic or "dirty" free fluid as well as evidence of free air, and may expedite patient management. PMID:27274522

  8. [PIPAC--Pressurized intraperitoneal aerosol chemotherapy. A novel treatment for peritoneal carcinomatosis].

    PubMed

    Hübner, Martin; Teixeira, Hugo; Boussaha, Tarek; Cachemaille, Matthieu; Lehmann, Kuno; Demartines, Nicolas

    2015-06-17

    Peritoneal carcinomatosis remains a diagnostic challenge with sparse treatment options. The effect of systemic chemotherapy remains limited inside the peritoneum due to low penetration and a relative resistance of peritoneal nodules. Heated IntraPeritoneal Chemotherapy (HIPEC) improves survival in selected patients but entails a high incidence of complications. Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) allows to disperse the active agents inside the peritoneal cavity by laparoscopy. Distribution and tissue penetration of chemotherapy by PIPAC are superior to HIPEC and systemic chemotherapy despite of lower doses. Systemic side effects are uncommon and surgical trauma is limited. Histological and clinical response rates in platinum-resistant patients approach 70% and survival data appear to be favorable compared with standard therapy. PMID:26255492

  9. Peritoneal fluid immunocytochemistry used for the diagnosis of a possible case of equine gastrointestinal B-cell lymphoma.

    PubMed

    Duran, Maria Carolina; Starrak, Gregory; Dickinson, Ryan; Montgomery, Julia

    2016-06-01

    After physical examination, ultrasonographic evaluation of thorax and abdomen, and peritoneal fluid analysis, gastrointestinal neoplasia with suspected diffuse peritoneal metastasis was diagnosed in a 17-year-old Arabian gelding. The owner elected euthanasia and declined postmortem examination. Immunocytochemistry analysis of the peritoneal fluid resulted in a diagnosis of B-cell lymphoma. PMID:27247458

  10. Fungal peritonitis in patients undergoing peritoneal dialysis (PD) in Brazil: molecular identification, biofilm production and antifungal susceptibility of the agents.

    PubMed

    Giacobino, Juliana; Montelli, Augusto Cezar; Barretti, Pasqual; Bruder-Nascimento, Ariane; Caramori, Jacqueline Teixeira; Barbosa, Luciano; Bagagli, Eduardo

    2016-10-01

    This paper presents data on fungal peritonitis (FP) in patients undergoing peritoneal dialysis (PD) at the University Hospital of Botucatu Medical School, São Paulo, Brazil. In a total of 422 patients, 30 developed FP, from which the medical records and the fungal isolates of 23 patient cases were studied. All patients presented abdominal pain, cloudy peritoneal effluent, needed hospitalization, had the catheter removed and were treated with fluconazole or fluconazole plus 5-flucitosine; six of them died due to FP. Concerning the agents, it was observed that Candida parapsilosis was the leading species (9/23), followed by Candida albicans (5/23), Candida orthopsilosis (4/23), Candida tropicalis (3/23), Candida guilliermondii (1/23), and Kodamaea ohmeri (1/23). All the isolates were susceptible to amphotericin B, voriconazole and caspofungin whereas C. albicans isolates were susceptible to all antifungals tested. Resistance to fluconazole was observed in three isolates of C. orthopsilosis, and dose-dependent susceptibility to this antifungal was observed in two isolates of C. parapsilosis and in the K. ohmeri isolate. Biofilm production estimates were high or moderate in most isolates, especially in C. albicans species, and low in C. parapsilosis species, with a marked variation among the isolates. This Brazilian study reinforces that FP in PD is caused by a diverse group of yeasts, most prevalently C. parapsilosis sensu stricto species. In addition, they present significant variation in susceptibility to antifungals and biofilm production, thus contributing to the complexity and severity of the clinical features. PMID:27143636

  11. Urgent-Start Peritoneal Dialysis: A Chance for a New Beginning

    PubMed Central

    Arramreddy, Rohini; Zheng, Sijie; Saxena, Anjali B.; Liebman, Scott E.; Wong, Leslie

    2014-01-01

    Peritoneal dialysis (PD) remains greatly underutilized in the United States despite the widespread preference of home modalities among nephrologists and patients. A hemodialysis-centric model of end-stage renal disease care has perpetuated for decades due to a complex set of factors, including late end-stage renal disease referrals and patients who present to the hospital requiring urgent renal replacement therapy. In such situations, PD rarely is a consideration and patients are dialyzed through a central venous catheter, a practice associated with high infection and mortality rates. Recently, the term urgent-start PD has gained momentum across the nephrology community and has begun to change this status quo. It allows for expedited placement of a PD catheter and initiation of PD therapy within days. Several published case reports, abstracts, and poster presentations at national meetings have documented the initial success of urgent-start PD programs. From a wide experiential base, we discuss the multifaceted issues related to urgent-start PD implementation, methods to overcome barriers to therapy, and the potential impact of this technique to change the existing dialysis paradigm. PMID:24246221

  12. Spontaneous bacterial peritonitis by Pasteurella multocida under treatment with rifaximin.

    PubMed

    Lutz, P; Parcina, M; Bekeredjian-Ding, I; Hoerauf, A; Strassburg, C P; Spengler, U

    2014-02-01

    Spontaneous bacterial peritonitis (SBP) is a life-threatening complication of liver cirrhosis. Recently, rifaximin, a non-absorbable antibiotic which is used to prevent recurrent hepatic encephalopathy, has been proposed as effective prophylaxis for SBP. Here, we present an unusual case of SBP under treatment with rifaximin. A 50-year-old woman with liver cirrhosis was admitted because of tense ascites and abdominal pain. She was under long-term oral prophylaxis with rifaximin due to hepatic encephalopathy. Paracentesis revealed SBP caused by Pasteurella multocida, which was sensitive to multiple antibiotics, including rifaximin. Treatment with ceftriaxone resulted in rapid resolution of the peritonitis and restoration of the patient. Since P. multocida is usually transmitted from pets, the patient's cat was tested and could be identified as the most likely source of infection. This case should elicit our awareness that uncommon pathogens and unusual routes of transmission may lead to SBP, despite antibacterial prophylaxis with non-absorbable antibiotics. Nevertheless, such infections may still remain sensitive to systemic therapy with conventional antibiotics. PMID:23526308

  13. Colorectal cancer-promoting activity of the senescent peritoneal mesothelium

    PubMed Central

    Mikuła-Pietrasik, Justyna; Sosińska, Patrycja; Maksin, Konstantin; Kucińska, Małgorzata; Piotrowska, Hanna; Murias, Marek; Woźniak, Aldona; Szpurek, Dariusz; Książek, Krzysztof

    2015-01-01

    Gastrointestinal cancers metastasize into the peritoneal cavity in a process controlled by peritoneal mesothelial cells (HPMCs). In this paper we examined if senescent HPMCs can intensify the progression of colorectal (SW480) and pancreatic (PSN-1) cancers in vitro and in vivo. Experiments showed that senescent HPMCs stimulate proliferation, migration and invasion of SW480 cells, and migration of PSN-1 cells. When SW480 cells were injected i.p. with senescent HPMCs, the dynamics of tumor formation and vascularization were increased. When xenografts were generated using PSN-1 cells, senescent HPMCs failed to favor their growth. SW480 cells subjected to senescent HPMCs displayed up-regulated expression of transcripts for various pro-cancerogenic agents as well as increased secretion of their products. Moreover, they underwent an epithelial-mesenchymal transition in the Smad 2/3-Snail1-related pathway. The search for mediators of senescent HPMC activity showed that increased SW480 cell proliferation was stimulated by IL-6, migration by CXCL8 and CCL2, invasion by IL-6, MMP-3 and uPA, and epithelial-mesenchymal transition by TGF-β1. Secretion of these agents by senescent HPMCs was increased in an NF-κB- and p38 MAPK-dependent mechanism. Collectively, our findings indicate that in the peritoneum senescent HPMCs may create a metastatic niche in which critical aspects of cancer progression become intensified. PMID:26284488

  14. Therapeutic options for peritoneal metastasis arising from colorectal cancer

    PubMed Central

    Glockzin, Gabriel; Schlitt, Hans J; Piso, Pompiliu

    2016-01-01

    Peritoneal metastasis is a common sign of advanced tumor stage, tumor progression or tumor recurrence in patients with colorectal cancer. Due to the improvement of systemic chemotherapy, the development of targeted therapy and the introduction of additive treatment options such as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), the therapeutic approach to peritoneal metastatic colorectal cancer (pmCRC) has changed over recent decades, and patient survival has improved. Moreover, in contrast to palliative systemic chemotherapy or best supportive care, the inclusion of CRS and HIPEC as inherent components of a multidisciplinary treatment regimen provides a therapeutic approach with curative intent. Although CRS and HIPEC are increasingly accepted as the standard of care for selected patients and have become part of numerous national and international guidelines, the individual role, optimal timing and ideal sequence of the different systemic, local and surgical treatment options remains a matter of debate. Ongoing and future randomized controlled clinical trials may help clarify the impact of the different components, allow for further improvement of patient selection and support the standardization of oncologic treatment regimens for pmCRC. The addition of further therapeutic options such as neoadjuvant intraperitoneal chemotherapy or pressurized intraperitoneal aerosol chemotherapy, should be investigated to optimize therapeutic regimens and further improve the oncological outcome. PMID:27602235

  15. Peritoneal dialysis-first policy made successful: perspectives and actions.

    PubMed

    Li, Philip Kam-tao; Chow, Kai Ming

    2013-11-01

    Peritoneal dialysis (PD) represents an important but underused strategy for patients who are beginning dialysis treatment worldwide. The development of a health care model that encourages increased use of PD is hampered by a lack of expertise and absence of pragmatic strategies. This article provides a brief review of a PD-first initiative that was implemented in Hong Kong more than 25 years ago and issues related to this policy. Clinical studies and research by the authors' and other teams around the world have shown evidence that, as a home-based dialysis therapy, PD can improve patient survival, retain residual kidney function, lower infection risk, and increase patient satisfaction while reducing financial stress to governments by addressing the burden of managing the growing number of patients with end-stage renal disease. Achieving a successful PD-first policy requires understanding inherent patient factors, selecting patients carefully, and improving technique-related factors by training physicians, nurses, patients, and caregivers better. Dialysis centers have the important role of fostering expertise and experience in PD patient management. Dialysis reimbursement policy also can be helpful in providing sufficient incentives for choosing PD. However, despite successes in improving patient survival, PD treatment has limitations, notably the shortcoming of technique failure. Potential strategies to and challenges of implementing a PD-first policy globally are discussed in this review. We highlight 3 important elements of a successful PD-first program: nephrologist experience and expertise, peritoneal dialysis catheter access, and psychosocial support for PD patients. PMID:23751775

  16. MELD Score Is Not Related to Spontaneous Bacterial Peritonitis

    PubMed Central

    Haddad, Luciana; Conte, Tatiana Morgado; Ducatti, Liliana; Nacif, Lucas; D'Albuquerque, Luiz Augusto Carneiro; Andraus, Wellington

    2015-01-01

    This study investigates the correlation between SBP and repeated paracentesis, and its relation to MELD score, in cirrhotic patients with refractory ascites in an outpatient setting. Through the data base, 148 cirrhotic patients were prospectively included in the study with refractory ascites undergoing relief paracentesis from March 2012 to March 2013. Demographics data, etiology of liver disease, MELD score, and inscription on the waiting list for liver transplantation were analyzed. The ascites removed was analyzed through cellular count and culture for the diagnosis of spontaneous bacterial peritonitis. The cirrhotic patients underwent a total of 854 paracentesis procedures in the ambulatory setting during the study period. Eighty-one patients (54%) were on the waiting list for liver transplantation. Patients on the liver transplant list had higher associated costs due to a higher total number of outpatient paracentesis procedures (394.7 ± 512.3 versus 291.7 ± 384.7) and a higher volume drained per procedure (6.5 ± 8.5 versus 4.8 ± 6.4). There were 28 episodes of SBP (3.3%) diagnosed in 24 patients. In conclusion, the prevalence of asymptomatic SBP in cirrhotic patients with refractory ascites undergoing repeated paracentesis is low. MELD score is not related to spontaneous bacterial peritonitis. PMID:26229528

  17. Therapeutic options for peritoneal metastasis arising from colorectal cancer.

    PubMed

    Glockzin, Gabriel; Schlitt, Hans J; Piso, Pompiliu

    2016-08-01

    Peritoneal metastasis is a common sign of advanced tumor stage, tumor progression or tumor recurrence in patients with colorectal cancer. Due to the improvement of systemic chemotherapy, the development of targeted therapy and the introduction of additive treatment options such as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), the therapeutic approach to peritoneal metastatic colorectal cancer (pmCRC) has changed over recent decades, and patient survival has improved. Moreover, in contrast to palliative systemic chemotherapy or best supportive care, the inclusion of CRS and HIPEC as inherent components of a multidisciplinary treatment regimen provides a therapeutic approach with curative intent. Although CRS and HIPEC are increasingly accepted as the standard of care for selected patients and have become part of numerous national and international guidelines, the individual role, optimal timing and ideal sequence of the different systemic, local and surgical treatment options remains a matter of debate. Ongoing and future randomized controlled clinical trials may help clarify the impact of the different components, allow for further improvement of patient selection and support the standardization of oncologic treatment regimens for pmCRC. The addition of further therapeutic options such as neoadjuvant intraperitoneal chemotherapy or pressurized intraperitoneal aerosol chemotherapy, should be investigated to optimize therapeutic regimens and further improve the oncological outcome. PMID:27602235

  18. Peritoneal mast cell stabilization potential of Pothos scandens L

    PubMed Central

    Gupta, Saurabh; Duraiswamy, B.; Satishkumar, M. N.

    2013-01-01

    Objective: To investigate the peritoneal mast cell stabilization activity of Pothos scandens extracts Materials and Methods: Pothos scandens L. (family- Araceae) aerial part was successively extracted with ethanol and aqueous to prepare extract of the plant. The extracts of P. scandens were evaluated for stabilization of mast cell in rat allergic models. The extract of P. scandens ethanolic, 50% aqueous ethanolic and aqueous (1, 10 and 100 μg/ml) was studied for peritoneal mast cell stabilization activity in rat mesenteric preparation induced by C 48/80. Result: Preliminary phytochemical analysis revealed the presence of carbohydrates, fixed oil, proteins, alkaloids, glycosides, flavonoids and phenolic compounds. The ethanolic, 50% aqueous ethanolic and aqueous extracts of P. scandens L. showed dose dependent increase in the number of intact cells when compare with C48/80 at the concentration of 10 and 100 μg/ml. It virtues further work towards the isolation of phytoconstituents from this plant. Conclusion: This finding provides evidence that the P. scandens L. inhibits mast cell-derived immediate-type allergic reactions and mast cell degranulation. P. scandens has a potential as allergic anti- asthmatic agent. PMID:23542883

  19. Transportation Security Administration Authorization Act

    THOMAS, 111th Congress

    Rep. Jackson-Lee, Sheila [D-TX-18

    2009-04-30

    06/08/2009 Received in the Senate and Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  20. Current status of dialytic therapy in Korea.

    PubMed

    Kim, Suk Young; Jin, Dong Chan; Bang, Byung Kee

    2003-10-01

    The status of dialytic therapy in Korea at the end of 2001 was reported by the end-stage renal disease (ESRD) registry committee of Korean Society of Nephrology, where data were collected through an internet on-line registry program. The number of dialysis centres was 335 and the number of haemodialysis machines was 5529. The total number of patients with dialysis was 23,057 (haemodialysis 17,568, peritoneal dialysis 5489). Prevalence and incidence of dialysis patients were 477.5 and 96.4 patients per million population. The most common primary cause of end-stage renal diseases was diabetic nephropathy (41.5%), hypertensive nephrosclerosis (15.4%), and chronic glomerulonephritis (13.6%). Eighty-six percent of haemodialysis patients were on dialysis therapy three times a week, the mean urea reduction ratio was 66.7 +/- 8.68% and mean Kt/V was 1.250 +/- 0.292 in male patients; 1.526 +/- 0.361 in female patients. The technical survival of haemodialysis in 5 years was 30.2% and peritoneal dialysis was 13.8%. The common complication of haemodialysis patients was hypertension (43.3%), gastrointestinal disease other than peptic ulcer (8.0%), congestive heart failure (7.6%), and of peritoneal dialysis patients were also hypertension (28.8%), congestive heart failure (5.0%), and peritonitis (4.8%). The most common causes of death were cardiac diseases (26.9%), vascular diseases, including cerebrovascular accidents (22.7%), and infection (17.8%). PMID:15012684

  1. Predicting One-Year Mortality in Peritoneal Dialysis Patients: An Analysis of the China Peritoneal Dialysis Registry

    PubMed Central

    Cao, Xue-Ying; Zhou, Jian-Hui; Cai, Guang-Yan; Tan, Ni-Na; Huang, Jing; Xie, Xiang-Cheng; Tang, Li; Chen, Xiang-Mei

    2015-01-01

    This study aims to investigate basic clinical features of peritoneal dialysis (PD) patients, their prognostic risk factors, and to establish a prognostic model for predicting their one-year mortality. A national multi-center cohort study was performed. A total of 5,405 new PD cases from China Peritoneal Dialysis Registry in 2012 were enrolled in model group. All these patients had complete baseline data and were followed for one year. Demographic and clinical features of these patients were collected. Cox proportional hazards regression model was used to analyze prognostic risk factors and establish prognostic model. A validation group was established using 1,764 new PD cases between January 1, 2013 and July 1, 2013, and to verify accuracy of prognostic model. Results indicated that model group included 4,453 live PD cases and 371 dead cases. Multivariate survival analysis showed that diabetes mellitus (DM), residual glomerular filtration rate (rGFR), , SBP, Kt/V, high PET type and Alb were independently associated with one-year mortality. Model was statistically significant in both within-group verification and outside-group verification. In conclusion, DM, rGFR, SBP, Kt/V, high PET type and Alb were independent risk factors for short-term mortality in PD patients. Prognostic model established in this study accurately predicted risk of short-term death in PD patients. PMID:26019685

  2. Surgery and Chemotherapy With or Without Chemotherapy After Surgery in Treating Patients With Ovarian, Fallopian Tube, Uterine, or Peritoneal Cancer

    ClinicalTrials.gov

    2016-08-18

    Recurrent Uterine Corpus Cancer; Recurrent Fallopian Tube Cancer; Recurrent Ovarian Cancer; Recurrent Primary Peritoneal Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Uterine Corpus Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cavity Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cavity Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  3. Sirolimus and Vaccine Therapy in Treating Patients With Stage II-IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

    ClinicalTrials.gov

    2016-08-15

    Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  4. Epacadostat Before Surgery in Treating Patients With Newly Diagnosed Stage III-IV Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

    ClinicalTrials.gov

    2016-03-09

    Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  5. Glutathione in Preventing Peripheral Neuropathy Caused by Paclitaxel and Carboplatin in Patients With Ovarian Cancer, Fallopian Tube Cancer, and/or Primary Peritoneal Cancer

    ClinicalTrials.gov

    2015-05-22

    Chemotherapeutic Agent Toxicity; Neuropathy; Neurotoxicity Syndrome; Pain; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  6. Methylglyoxal Induced Basophilic Spindle Cells with Podoplanin at the Surface of Peritoneum in Rat Peritoneal Dialysis Model

    PubMed Central

    Hirahara, Ichiro; Sato, Hideki; Imai, Toshimi; Onishi, Akira; Morishita, Yoshiyuki; Muto, Shigeaki; Kusano, Eiji; Nagata, Daisuke

    2015-01-01

    Peritoneal dialysis (PD) is a common treatment for patients with reduced or absent renal function. Long-term PD leads to peritoneal injury with structural changes and functional decline. At worst, peritoneal injury leads to encapsulating peritoneal sclerosis (EPS), which is a serious complication of PD. In order to carry out PD safely, it is important to define the mechanism of progression of peritoneal injury and EPS. We prepared rat models of peritoneal injury by intraperitoneal administration of glucose degradation products, such as methylglyoxal (MGO) or formaldehyde (FA), chlorhexidine gluconate (CG), and talc. In rats treated with MGO, peritoneal fibrous thickening with the appearance of basophilic spindle cells with podoplanin, cytokeratin, and α-smooth muscle actin at the surface of the peritoneum was observed. These cells may have been derived from mesothelial cells by epithelial-to-mesenchymal transition. In FA- or CG-treated rats, the peritoneum was thickened, and mesothelial cells were absent at the surface of the peritoneum. The CG- or MGO-treated rats presented with a so-called abdominal cocoon. In the talc-treated rats, extensive peritoneal adhesion and peritoneal thickening were observed. MGO-induced peritoneal injury model may reflect human histopathology and be suitable to analyze the mechanism of progression of peritoneal injury and EPS. PMID:26064894

  7. Methylglyoxal Induced Basophilic Spindle Cells with Podoplanin at the Surface of Peritoneum in Rat Peritoneal Dialysis Model.

    PubMed

    Hirahara, Ichiro; Sato, Hideki; Imai, Toshimi; Onishi, Akira; Morishita, Yoshiyuki; Muto, Shigeaki; Kusano, Eiji; Nagata, Daisuke

    2015-01-01

    Peritoneal dialysis (PD) is a common treatment for patients with reduced or absent renal function. Long-term PD leads to peritoneal injury with structural changes and functional decline. At worst, peritoneal injury leads to encapsulating peritoneal sclerosis (EPS), which is a serious complication of PD. In order to carry out PD safely, it is important to define the mechanism of progression of peritoneal injury and EPS. We prepared rat models of peritoneal injury by intraperitoneal administration of glucose degradation products, such as methylglyoxal (MGO) or formaldehyde (FA), chlorhexidine gluconate (CG), and talc. In rats treated with MGO, peritoneal fibrous thickening with the appearance of basophilic spindle cells with podoplanin, cytokeratin, and α-smooth muscle actin at the surface of the peritoneum was observed. These cells may have been derived from mesothelial cells by epithelial-to-mesenchymal transition. In FA- or CG-treated rats, the peritoneum was thickened, and mesothelial cells were absent at the surface of the peritoneum. The CG- or MGO-treated rats presented with a so-called abdominal cocoon. In the talc-treated rats, extensive peritoneal adhesion and peritoneal thickening were observed. MGO-induced peritoneal injury model may reflect human histopathology and be suitable to analyze the mechanism of progression of peritoneal injury and EPS. PMID:26064894

  8. Inhibition of adhesion and proliferation of peritoneally disseminated tumor cells by pegylated catalase.

    PubMed

    Hyoudou, Kenji; Nishikawa, Makiya; Kobayashi, Yuki; Kuramoto, Yukari; Yamashita, Fumiyoshi; Hashida, Mitsuru

    2006-01-01

    Hydrogen peroxide may aggravate the peritoneal dissemination of tumor cells by activating the expression of a variety of genes. In this study, we used pegylated catalase (PEG-catalase) to examine whether prolonged retention of catalase activity within the peritoneal cavity is effective in inhibiting peritoneal dissemination in mouse models. Murine B16-BL6 cells or colon 26 cells labeled with firefly luciferase gene were inoculated intraperitoneally into syngeneic mice. Compared with unmodified catalase, PEG-catalase was retained in the peritoneal cavity for a long period after intraperitoneal injection. A single injection of PEG-catalase just before tumor inoculation significantly reduced the number of the tumor cells at 1 and 7 days. The changes in the expression of molecules involved in the metastasis were evaluated by real time quantitative PCR analysis. Inoculation of the tumor cells increased the expression of intercellular adhesion molecule (ICAM)-1 in the greater omentum, which was inhibited by PEG-catalase. An injection of PEG-catalase at 3 days after tumor inoculation also reduced the number of the tumor cells, suggesting that processes other than the adhesion of tumor cells to peritoneal organs are also inhibited. Daily doses of PEG-catalase significantly prolonged the survival time of tumor-bearing mice. These results indicate that intraperitoneal injection of PEG-catalase inhibits the multiple processes of peritoneal dissemination of tumor cells by scavenging hydrogen peroxide in the peritoneal cavity. PMID:17086358

  9. Continuous ambulatory peritoneal dialysis and renal transplantation: a five year experience.

    PubMed Central

    Donnelly, P K; Lennard, T W; Proud, G; Taylor, R M; Henderson, R; Fletcher, K; Elliott, W; Ward, M K; Wilkinson, R

    1985-01-01

    Continuous ambulatory peritoneal dialysis is a new and increasingly popular method of routine dialysis, but its effect on renal transplantation is uncertain. A non-randomised comparison was made of the outcome of grafting in patients who had been treated before transplantation with continuous ambulatory peritoneal dialysis with that in patients treated with haemodialysis. During the five years, 1979-84, after continuous ambulatory peritoneal dialysis was introduced to Newcastle upon Tyne 220 patients have received transplants after either continuous ambulatory peritoneal dialysis (61 patients) or haemodialysis (159 patients). During follow up no significant differences occurred in survival of patients or grafts between the two treatment groups. One year after transplantation the percentages of survivors who had received continuous ambulatory peritoneal dialysis and haemodialysis were 88% and 91% respectively, and overall graft survival was 66% and 72%, respectively. A multiple regression model was used to allow for differences among patients--for example, duration of dialysis and number of preoperative transfusions--on the survival of grafts. When only first cadaver grafts were considered (in 152 patients) graft survival (non-immunological failures excluded) was not significantly different between the patients treated with continuous ambulatory peritoneal dialysis and haemodialysis. Continuous ambulatory peritoneal dialysis is not a risk factor in renal transplantation, and its continued use in treatment of potential renal graft recipients is recommended. PMID:3931765

  10. Proactive Management for Gastric, Colorectal and Appendiceal Malignancies: Preventing Peritoneal Metastases with Hyperthermic Intraperitoneal Chemotherapy (HIPEC).

    PubMed

    Sammartino, Paolo; Biacchi, Daniele; Cornali, Tommaso; Cardi, Maurizio; Accarpio, Fabio; Impagnatiello, Alessio; Sollazzo, Bianca Maria; Di Giorgio, Angelo

    2016-06-01

    An integrated treatment strategy using peritonectomy procedures plus hyperthermic intraperitoneal chemotherapy (HIPEC) is now a clinical standard of care in selected patients with peritoneal metastases and primary peritoneal tumors. This comprehensive approach can offer many patients, who hitherto had no hope of cure, a good quality of life and survival despite limited morbidity. The increasingly successful results and chance of interfering in the natural history of disease has prompted research to develop for some clinical conditions a therapeutic strategy designed to prevent malignant peritoneal dissemination before it becomes clinically evident and treat it microscopically (tertiary prevention). The main factor governing successful cytoreductive surgery and predicting outcome is the extent of peritoneal spread assessed with the peritoneal cancer index (PCI). In peritoneal metastases from colorectal and gastric cancer the PCI score acquires a specific role acting as the cut-off between patients who can undergo curative surgery or palliation. Long-term results show that the only group enjoying favorable results are patients with limited disease (a statistical minority). By applying to appropriately selected patients with primary malignancies a proactive management strategy including HIPEC we can treat patients with microscopic peritoneal dissemination and therefore at PCI 0. Among treated conditions pseudomyxoma peritonei enjoys the best results. But a major future advance comes from identifying among lesions at major risk of pseudomyxoma. PMID:27065712

  11. Low Molecular Weight Heparin (LMWH) Improves Peritoneal Function and Inhibits Peritoneal Fibrosis Possibly through Suppression of HIF-1α, VEGF and TGF-β1

    PubMed Central

    Li, Juan; Guo, Zhi Yong; Gao, Xian Hua; Bian, Qi; Jia, Meng; Li Lai, Xue; Wang, Tie Yun; Bian, Xiao Lu; Wang, Hai Yan

    2015-01-01

    Background Peritoneal fibrosis is the major cause of ultrafiltration failure, and intraperitoneal administration of Low Molecular Weight Heparin (LMWH) was reported to protect peritoneal function. But the exact mechanism of its influence on peritoneal structure and function is still unknown. Methods A fibrosis model of rat was established by intraperitoneal (IP) administration of PD fluid and Erythromycin Lactobionate. Fifty-two rats were randomly divided into 6 groups: (1) normal control group (CON, n = 6); (2) normal saline group (NS, n = 10); (3) high-glucose group (GLU, n = 10); (4) heparin group (HEP, n = 6); (5) low dose LMWH group (LLMWH, n = 10); (6) high dose LMWH group (HLMWH, n = 10). Two hour peritoneal equilibration test was performed after 28 days of intervention. The peritoneum, mesentery and omentum were harvested, and evaluated by Hematoxylin-Eosin and Masson Trichrome staining. The expressions of HIF-1α, VEGF and TGF-β1 in parietal peritoneum were detected by IHC and RT-PCR (Reverse Transcriptase Polymerase Chain Reaction). Results Compared with group CON and NS, ultrafiltration volume and D2/D0 glucose in group GLU decreased significantly, D/Purea (Dialysate-Plasma ratio of urea), D/Palb (Dialysate-Plasma ratio of albumin), peritoneal thickness, neoangiogenesis and inflammatory reaction increased significantly (all P<0.05). Administration of heparin and LMWH markedly alleviated these above pathological changes. The protein and mRNA levels of HIF-1α, VEGF and TGF-β1 increased significantly in group GLU, and decreased significantly after administration of LMWH in a dose-dependent manner. Conclusions LMWH ameliorates peritoneal function and inhibits peritoneal fibrosis, possibly through suppression of HIF-1α, VEGF and TGF-β1. PMID:25723475

  12. Vascular Endothelial Cell Injury Is an Important Factor in the Development of Encapsulating Peritoneal Sclerosis in Long-Term Peritoneal Dialysis Patients

    PubMed Central

    Tawada, Mitsuhiro; Ito, Yasuhiko; Hamada, Chieko; Honda, Kazuho; Mizuno, Masashi; Suzuki, Yasuhiro; Sakata, Fumiko; Terabayashi, Takeshi; Matsukawa, Yoshihisa; Maruyama, Shoichi; Imai, Enyu; Matsuo, Seiichi; Takei, Yoshifumi

    2016-01-01

    Background and Objectives Encapsulating peritoneal sclerosis (EPS) is a rare but serious and life-threatening complication of peritoneal dialysis (PD). However, the precise pathogenesis remains unclear; in addition, predictors and early diagnostic biomarkers for EPS have not yet to be established. Methods Eighty-three peritoneal membrane samples taken at catheter removal were examined to identify pathological characteristics of chronic peritoneal deterioration, which promotes EPS in patients undergoing long-term PD treatment with low occurrence of peritonitis. Results According to univariable logistic regression analysis of the pathological findings, thickness of the peritoneal membrane (P = 0.045), new membrane formation score (P = 0.006), ratio of luminal diameter to vessel diameter (L/V ratio, P<0.001), presence of CD31-negative vessels (P = 0.021), fibrin deposition (P<0.001), and collagen volume fraction (P = 0.018) were associated with EPS development. In analyses of samples with and without EPS matched for PD treatment period, non-diabetes, and PD solution, univariable analysis identified L/V ratio (per 0.1 increase: odds ratio (OR) 0.44, P = 0.003) and fibrin deposition (OR 6.35, P = 0.027) as the factors associated with EPS. L/V ratio was lower in patients with fibrin exudation than in patients without fibrin exudation. Conclusions These findings suggest that damage to vascular endothelial cells, as represented by low L/V ratio, could be a predictive finding for the development of EPS, particularly in long-term PD patients unaffected by peritonitis. PMID:27119341

  13. Accurate definition and management of idiopathic sclerosing encapsulating peritonitis

    PubMed Central

    Akbulut, Sami

    2015-01-01

    AIM: To review the literature on idiopathic sclerosing encapsulating peritonitis (SEP), also known as abdominal cocoon syndrome. METHODS: The PubMed, MEDLINE, Google Scholar, and Google databases were searched using specific key words to identify articles related to idiopathic SEP. These key words were “sclerosing encapsulating peritonitis,” “idiopathic sclerosing encapsulating peritonitis,” “abdominal cocoon,” and “abdominal cocoon syndrome.” The search included letters to the editor, case reports, review articles, original articles, and meeting presentations published in the English-language literature from January 2000 to May 2014. Articles or abstracts containing adequate information about age, sex, symptom duration, initial diagnosis, radiological tools, and surgical approaches were included in the study. Papers with missing or inadequate data were excluded. RESULTS: The literature search yielded 73 articles on idiopathic (primary) SEP published in 23 countries. The four countries that published the greatest number of articles were India (n = 21), Turkey (n = 14), China (n = 8) and Nigeria (n = 3). The four countries that reported the greatest number of cases were China (n = 104; 53.88%), India (n = 35; 18.13%), Turkey (n = 17; 8.80%) and Nigeria (n = 5; 2.59%). The present study included 193 patients. Data on age could be obtained for 184 patients (range: 7-87 years; mean ± SD, 34.7 ± 19.2 years), but were unavailable for nine patients. Of the 184 patients, 122 were male and 62 were female; sex data could not be accessed in the remaining nine patients. Of the 149 patients whose preoperative diagnosis information could be obtained, 65 (43.6%) underwent operations for abdominal cocoon, while the majority of the remaining patients underwent operations for a presumed diagnosis of intestinal obstruction and/or abdominal mass. Management information could be retrieved for 115 patients. Of these, 68 underwent excision + adhesiolysis (one

  14. Peritoneal Reactivity Evaluation in Horses Subjected to Experimental Small Colon Enterotomy and Treated with Subcutaneous Heparin

    PubMed Central

    Alonso, Juliana de Moura; Rodrigues, Karoline Alves; Yamada, Ana Lúcia Miluzzi; Watanabe, Marcos Jun; Alves, Ana Liz Garcia; Rodrigues, Celso Antonio; Hussni, Carlos Alberto

    2014-01-01

    Heparin is routinely administered in postoperative abdominal surgery aiming to prevent adhesions formation; however, there is no consensus indicating its effectiveness. This study evaluated the effect of heparin on peritoneal reactivity after abdominal surgery, through the association between peritoneal fluid features and ultrasonographic and laparoscopic examination. Ten adult horses were used: control group (CG) and treated group (TG). Both groups underwent laparotomy and small colon enterotomy. TG received subcutaneous heparin at 150 IU/kg every 12 hours for 5 days. The animals underwent ultrasonography and peritoneal fluid examination prior to enterotomy (M0) 12 hours (M1), 1 day (M2), 2 days (M3), 4 days (M4), 6 days (M5), 10 days (M6), and 14 days after enterotomy (M7) with laparoscopic examination being performed on the fifth postoperative day. Peritoneal inflammatory response was observed in both groups. The peritoneal fluid of TG animals showed higher echogenicity during heparin therapy. No inflammatory difference was observed between groups through peritoneal fluid features, except for the higher D-dimer concentration in CG. On laparoscopy, slightly diffuse peritoneal reactivity for both groups was observed, being higher for TG. Laparoscopy and ultrasonography association allowed detailed access to the abdominal cavity. Ultrasonography assessed the diffuse peritoneal inflammation, and laparoscopy allowed the detailed analysis of the segments. No gross beneficial reactions resulting from the use of heparin on peritoneal reactivity were observed; however, it was observed by D-dimer evaluation that the TG had less fibrin deposition, which is directly related to a lower rate of abdominal adhesions formation. PMID:25436172

  15. [Free peritoneal patch grafts in surgery on renal pelvis and ureter (author's transl)].

    PubMed

    Stadie, G; Schneider, H J; Brundig, P

    1981-09-01

    36 operations of the renal pelvis or ureter were carried out in 35 patients. In all these cases a split stenosis or a tissue defect were covered by free peritoneal patches. Urographic controls of 30 patients showed 29 good or very good results. The following statements can be made: 1. In cases of a secondary scarred stenosis, of renal pelvic or ureteral wall defects, plastic operations of intrarenal pelvis of transsinus operations of staghorn calculi the splitting with splinting and covering by autologous tissue seems to represent a suitable operation. -- 2. As material the renal capsule, the venous wall and the peritoneum are suitable. -- 3. In cases of severe ureteral stenoses, which have to be resected, especially in cases of considerable differences of the ureteral lumen, the semicircular suture with covering should be preferred to the circular suture. -- 4. The covering of the defects by patches of autologous material reduces the time of the postoperative urinary diversion with all its dangers and the period of hospitalization. -- 5. In cases of a short covered stenoses (up to 4 cm) postoperative disturbance of the transport or urine was observed only once. The results of stenoses, longer than 4 cm, cannot yet be evaluated. PMID:7197416

  16. Endotoxin-induced enhancement of glucose influx into murine peritoneal macrophages via GLUT1.

    PubMed Central

    Fukuzumi, M; Shinomiya, H; Shimizu, Y; Ohishi, K; Utsumi, S

    1996-01-01

    Hypoglycemia is among the most injurious metabolic disorders caused by endotoxemia. In experimental endotoxemia with lipopolysaccharide (LPS) in animals, a marked glucose consumption is observed in macrophage-rich organs. However, the direct effect of LPS on the uptake of glucose by macrophages has not been fully understood, and the present study was undertaken to shed light on this point. The consumption and uptake of glucose, as measured with 2-deoxy-D-[3H]glucose, by murine peritoneal exudate macrophages in culture were accelerated two- to threefold by stimulation with 3 ng of LPS per ml. The rate of glucose uptake reached a plateau after 20 min of stimulation and remained at the maximum as long as LPS was present. Northern (RNA) blot analysis with cDNA probes for five known isoforms of glucose transporter (GLUT) revealed that the expression of GLUT by macrophages was restricted to the GLUT1 isoform during LPS stimulation and the amount of GLUT1 mRNA was increased by the stimulation. These results suggest that macrophage responses to LPS are supported by a rapid and sustained glucose influx via GLUT1 and that this is a participating factor in the development of systemic hypoglycemia when endotoxemia is prolonged. PMID:8557327

  17. Sphingomonas paucimobilis peritonitis: A case report and review of the literature.

    PubMed

    Mohan, Dhanya; Railey, Mohammed

    2015-01-01

    Sphingomonas paucimobilis, a yellow-pigmented, aerobic, glucose non-fermenting, Gram-negative bacillus, is a rare cause of human infection normally associated with immunocompromised hosts. It has been associated with a few cases of continuous ambulatory peritoneal dialysis (PD) and is notorious for its resistance to the commonly used antibiotics. In half of the cases reported so far, the peritonitis was refractory to treatment, necessitating PD catheter removal. We report a case of Sphingomonas paucimobilis peritonitis in a 50-year-old patient who had been on PD for two years. The patient was successfully treated with intraperitoneal and intravenous antibiotics and the PD catheter was salvaged. PMID:26022030

  18. Primary ventriculo-peritoneal shunts in treatment of hydrocephalus associated with myelomeningocele

    PubMed Central

    Stark, G. D.; Drummond, M. B.; Poneprasert, S.; Robarts, F. H.

    1974-01-01

    In 50 children suffering from open myelomeningocele, a ventriculo-peritoneal shunt was employed as the primary procedure for control of hydrocephalus. In 11 cases the system was ultimately replaced by a ventriculo-atrial shunt, though this may not always have been necessary. In the remaining 39 patients satisfactory control of hydrocephalus was achieved. Obstruction, particularly of the peritoneal catheter, occurred frequently in the first 6 months but no revisions were required after 2 years. It is concluded that while ventriculo-peritoneal and ventriculo-atrial shunts achieve comparable success in controlling hydrocephalus, the former, due to the relatively innocuous complications, offers significant long-term advantages. PMID:4593818

  19. Peritoneal Malignant Mesothelioma with Epithelioid Type, Demonstrating High Serum and Ascitic KL-6 Levels: Immunohistochemical Analyses

    PubMed Central

    Nahar, Saifun; Nakamoto, Manabu; Hokama, Akira; Kobashigawa, Chiharu; Kaida, Masatoshi; Kinjo, Tetsu; Hirata, Tetsuo; Kinjo, Nagisa; Saio, Masanao; Yoshimi, Naoki; Ohtsuki, Yuji; Fujita, Jiro

    2015-01-01

    We report a case of KL-6 producing peritoneal malignant mesothelioma. A 56-year-old woman was referred to our hospital on November 2005 with severe abdominal distention. Peritoneal malignant mesothelioma with epithelioid type was diagnosed by clinical symptoms, laboratory investigations, imaging studies, and immunohistochemical examination of known tumor markers. In addition, high serum and ascitic KL-6 levels were observed and the immunostaining of the tumor for KL-6 was evident. We thus consider KL-6 to be a potential novel marker for peritoneal malignant mesothelioma with epithelioid type. PMID:26500734

  20. Peritoneal Malignant Mesothelioma with Epithelioid Type, Demonstrating High Serum and Ascitic KL-6 Levels: Immunohistochemical Analyses.

    PubMed

    Nahar, Saifun; Nakamoto, Manabu; Hokama, Akira; Kobashigawa, Chiharu; Kaida, Masatoshi; Kinjo, Tetsu; Hirata, Tetsuo; Kinjo, Nagisa; Saio, Masanao; Yoshimi, Naoki; Ohtsuki, Yuji; Fujita, Jiro

    2015-09-01

    We report a case of KL-6 producing peritoneal malignant mesothelioma. A 56-year-old woman was referred to our hospital on November 2005 with severe abdominal distention. Peritoneal malignant mesothelioma with epithelioid type was diagnosed by clinical symptoms, laboratory investigations, imaging studies, and immunohistochemical examination of known tumor markers. In addition, high serum and ascitic KL-6 levels were observed and the immunostaining of the tumor for KL-6 was evident. We thus consider KL-6 to be a potential novel marker for peritoneal malignant mesothelioma with epithelioid type. PMID:26500734

  1. [Pleuroperitoneal communication in patients on peritoneal dialysis. One hospital's experience and a review of the literature].

    PubMed

    Díaz Mancebo, R; Del Peso Gilsanz, G; Rodríguez, M; Fernández, B; Ossorio González, M; Bajo Rubio, M A; Selgas Gutiérrez, R

    2011-01-01

    Peritoneal dialysis is a treatment alternative in patients with advanced chronic kidney disease. The infusion of liquid into the peritoneal cavity leads to an increase in intra-abdominal pressure, which can sometimes produce leaks to the chest, giving rise to pleuroperitoneal communication. This is not a common complication, but it brings about high drop-out rates among patients using the technique. Diagnosis is easy and must be suspected in patients with sudden dyspnoea with low ultrafiltration and pleural effusion in the chest x-ray. Peritoneal rest and a temporary transfer to haemodialysis, and pleurodesis can be effective treatment strategies. PMID:21461016

  2. Occurrence of malignant peritoneal mesothelioma after surgery and irradiation for cervical cancer

    SciTech Connect

    Beier, K.M.; Gallup, D.G.; Burgess, R.; Stock, R.J.

    1984-03-01

    Mesothelioma of the peritoneal cavity after irradiation is rare, and the diagnosis is sometimes difficult to establish. The following case is a report of a mesothelioma occurring 9 years after radiation therapy for carcinoma of the cervix. In this patient, who had a hysterectomy and bilateral oophorectomy 7 years prior to the mesothelioma diagnosis, the histologic, histochemical, and ultrastructural findings were all consistent with a diagnosis of malignant peritoneal mesothelioma. It is believed that this case is one of the first well-documented cases of peritoneal mesothelioma in a female who was treated by pelvic irradiation for another neoplasm.

  3. [Assisted peritoneal dialysis: home-based renal replacement therapy for the elderly patient].

    PubMed

    Wiesholzer, Martin

    2013-06-01

    The number of elderly patients with end stage renal disease is constantly increasing. Conventional hämodiaylsis as the mainstay of renal replacement therapy is often poorly tolerated by frail eldery patients with multiple comorbidities. Although many of these patients would prefer a home based dialysis treatment, the number of elderly patients using peritoneal dialysis (PD) is still low. Impaired physical and cognitive function often generates insurmountable barriers for self care peritoneal dialysis. Assisted peritoneal dialysis can overcome many of these barriers and give elderly patients the ability of a renal replacement therapy in their own homes respecting their needs. PMID:23797681

  4. [Peritonitis caused by spontaneous rupture of pyonephrosis in pregnancy. Report of a case].

    PubMed

    Rabii, R; Rais, H; Sarf, I; Joual, A; Aboutaieb, R; Bennani, S; el Mrini, M; Benjelloun, S; Hamoudi, D; Idali, B; Harti, A; Barrou, L

    1999-01-01

    Peritonitis after spontaneous rupture of pyonephrosis into the peritoneal cavity is a rare complication, usually diagnosed intraoperatively. We report a case of a woman presenting with left lumbar pain and fever during pregnancy. On admission, ultrasonography showed a pregnancy with fetal activity for 16 weeks, and pyonephrosis in the left kidney, but on a normal right kidney. After antibiotic therapy and upper urinary, tract stenting renal drainage revealed purulent urine, fever persisted with acute abdomen. Clinical and radiological assessment showed features of acute peritonitis with pyonephrosis. Treatment consisted of laparotomy with nephrectomy and abdominal lavage and drainage. The postoperative complication was septic shock requiring resuscitation and artificial ventilation and prolonged convalescence. PMID:10095911

  5. Treatment of Syringomyelia due to Chiari Type I Malformation with Syringo-Subarachnoid-Peritoneal Shunt

    PubMed Central

    Akakın, Akın; Yılmaz, Baran; Kılıç, Türker

    2015-01-01

    Chiari type I malformation is a tonsillar herniation more than 3 mm from the level of foramen magnum, with or without concurrent syringomyelia. Different surgical treatments have been developed for syringomyelia secondary to Chiari's malformations: craniovertebral decompression with or without plugging of the obex, syringo-subarachnoid, syringo-peritoneal, and theco-peritoneal shunt placement. Shunt placement procedures are useful for neurologically symptomatic large-sized syrinx. In this paper, authors define the first successful treatment of a patient with syringomyelia due to Chiari type I malformation using a pre-defined new technique of syringo-subarachnoid-peritoneal shunt with T-tube system. PMID:25932303

  6. Plasma cholesterol metabolism in end-stage renal disease. Difference between treatment by hemodialysis or peritoneal dialysis.

    PubMed Central

    Dieplinger, H; Schoenfeld, P Y; Fielding, C J

    1986-01-01

    Plasma cholesterol metabolism was investigated in normotriglyceridemic patients with end-stage renal disease treated by hemo- or continuous ambulatory peritoneal dialysis (CAPD), and compared with that in a control group with normal renal function. A reversed net transport of free cholesterol from plasma to cultured fibroblasts, as well as greatly reduced levels of plasma cholesterol esterification and cholesterol ester transfer rates to low and very low density lipoproteins (LDL and VLDL), was found in the hemodialysis group compared to the controls. The LDL and VLDL contained increased amounts of free cholesterol and inhibited cholesterol ester transfer when recombined with control plasma. The LDL triglyceride content was doubled in the hemodialysis group, whereas cholesterol esters were decreased. Patients treated by CAPD, in marked contrast, had cholesterol metabolic rates that were within the normal range, as well as normal lipoprotein composition. PMID:3082933

  7. Wernicke-Korsakoff Syndrome in Primary Peritoneal Cancer

    PubMed Central

    Kim, Ki Hyang

    2013-01-01

    Wernicke encephalopathy is a disease that constitutes a medical emergency, but one that can be reversed with thiamine repletion if it is recognized early. Patients with cancer have a high risk of Wernicke encephalopathy because of malnutrition, the use of chemotherapeutic agents, and disease progression. Korsakoff syndrome can follow or accompany Wernicke encephalopathy. Although patients can recover from Wernicke encephalopathy via rapid repletion of thiamine, few patients recover from Korsakoff syndrome. Here, the case of a 76-year-old female patient who had primary peritoneal cancer and developed Wernicke-Korsakoff syndrome as a result of prolonged nutritional imbalance and fast-growing tumor cells is reported. The patient's neurologic symptoms improved, but she did not recover from the psychiatric effects of the disease. PMID:24474922

  8. An update on feline infectious peritonitis: diagnostics and therapeutics.

    PubMed

    Pedersen, Niels C

    2014-08-01

    This review is concerned with what has been learned about feline infectious peritonitis (FIP) diagnostics and therapeutics since the publication of an extensive overview of literature covering the period 1963-2009. Although progress has been made in both areas, obtaining a definitive diagnosis of FIP remains a problem for those veterinarians and/or cat owners who require absolute certainty. This review will cover both indirect and direct diagnostic tests for the disease and will emphasize their limitations, as well as their specificity and sensitivity. There is still no effective treatment for FIP, although there are both claims that such therapies exist and glimmers of hope coming from new therapies that are under research. FIP has also been identified in wild felids and FIP-like disease is now a growing problem among pet ferrets. PMID:24857253

  9. Transcriptome analysis of feline infectious peritonitis virus infection.

    PubMed

    Mehrbod, Parvaneh; Harun, Mohammad Syamsul Reza; Shuid, Ahmad Naqib; Omar, Abdul Rahman

    2015-01-01

    Feline infectious peritonitis (FIP) is a lethal systemic disease caused by FIP virus (FIPV). There are no effective vaccines or treatment available, and the virus virulence determinants and pathogenesis are not fully understood. Here, we describe the sequencing of RNA extracted from Crandell Rees Feline Kidney (CRFK) cells infected with FIPV using the Illumina next-generation sequencing approach. Bioinformatics analysis, based on Felis catus 2X annotated shotgun reference genome, using CLC bio Genome Workbench is used to map both control and infected cells. Kal's Z test statistical analysis is used to analyze the differentially expressed genes from the infected CRFK cells. In addition, RT-qPCR analysis is used for further transcriptional profiling of selected genes in infected CRFK cells and Peripheral Blood Mononuclear Cells (PBMCs) from healthy and FIP-diagnosed cats. PMID:25720485

  10. Chronic peritoneal dialysis in South Asia - challenges and future.

    PubMed

    Abraham, Georgi; Pratap, Balaji; Sankarasubbaiyan, Suresh; Govindan, Priyanka; Nayak, K Shivanand; Sheriff, Rezvi; Naqvi, S A Jaffar

    2008-01-01

    Chronic peritoneal dialysis (PD), especially continuous ambulatory PD (CAPD), is being increasingly utilized in South Asian countries (population of 1.4 billion). There are divergent geopolitical and socioeconomic factors that influence the growth and expansion of CAPD in this region. The majority of the countries in South Asia are lacking in government healthcare system for reimbursing renal replacement therapy. The largest utilization of chronic PD is in India, with nearly 6500 patients on this treatment by the end of 2006. A large majority of patients are doing 2 L exchanges 3 times per day, using glucose-based dialysis solution manufactured in India. Chronic PD is not being utilized in Myanmar, Bhutan, or Seychelles. Affirmative action by the manufacturing industry, medical professionals, government policy makers, and nongovernmental organizations for reducing the cost of chronic PD will enable the growth and utilization of this life-saving therapy. PMID:18178941

  11. Cytoreductive Surgery plus HIPEC for Peritoneal Metastases from Colorectal Cancer.

    PubMed

    Bhatt, Aditi; Goéré, Diane

    2016-06-01

    Occurring either synchronously or metachronously to the primary tumor, peritoneal metastases (PM) are diagnosed in 8 to 20 % of the patients with colorectal cancer (CRC). Prognosis of these patients appears to be worse than those with other sites of metastases. While systemic therapy has shown significant prolongation of survival in patients with stage IV colorectal cancer, the outcomes in the subset of patients with PM has been much inferior. Over the last 2 decades, cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) have been effective in substantially prolonging survival in patients with colorectal PM and have the potential to cure certain patients as well. This article reviews the current evidence for CRS and HIPEC to treat colorectal PM as well as future research going on in this form of locoregional treatment. PMID:27065708

  12. Imaging of peritoneal deposits in ovarian cancer: A pictorial review.

    PubMed

    Chandrashekhara, Sheragaru Hanumanthappa; Triveni, Gowramma Sannanaik; Kumar, Rahul

    2016-05-28

    As per incidence, ovarian carcinoma is the second most common gynaecological malignancy in women. In spite of advanced technology, patient awareness and effective screening methods, epithelial ovarian cancer is usually diagnosed at an advanced stage (stage III). Surgical debulking of disease is mainstay of improving the patient survival even in advanced stages. Thus exact delineation of cancer spread in the abdominal cavity guides the surgeon prior to the surgery, help them to decide resectability of lesion and plan for further need of other surgical speciality or need of neoadjuvant chemotherapy. Imaging particularly well-planned contrast-enhanced computed tomography answers most of the queries raised by the treating surgeon. The aim of this article is to review the way ovarian carcinoma spread in the peritoneal cavity and to stress the accurate interpretation of cancer deposits on imaging which can help the treating team to reach optimal management of patients. PMID:27247717

  13. Imaging of peritoneal deposits in ovarian cancer: A pictorial review

    PubMed Central

    Chandrashekhara, Sheragaru Hanumanthappa; Triveni, Gowramma Sannanaik; Kumar, Rahul

    2016-01-01

    As per incidence, ovarian carcinoma is the second most common gynaecological malignancy in women. In spite of advanced technology, patient awareness and effective screening methods, epithelial ovarian cancer is usually diagnosed at an advanced stage (stage III). Surgical debulking of disease is mainstay of improving the patient survival even in advanced stages. Thus exact delineation of cancer spread in the abdominal cavity guides the surgeon prior to the surgery, help them to decide resectability of lesion and plan for further need of other surgical speciality or need of neoadjuvant chemotherapy. Imaging particularly well-planned contrast-enhanced computed tomography answers most of the queries raised by the treating surgeon. The aim of this article is to review the way ovarian carcinoma spread in the peritoneal cavity and to stress the accurate interpretation of cancer deposits on imaging which can help the treating team to reach optimal management of patients. PMID:27247717

  14. Primary Gastro Intestinal Lymphoma Presenting as Perforation Peritonitis

    PubMed Central

    Ramachandra, Chandrashekar Shastry; Jackaya, Reuben Prakash

    2016-01-01

    Primary gastrointestinal lymphoma is very rare compared to gastrointestinal tract lymphoma arising Secondary to Primary nodal disease. Extra nodal lymphoma can involve any part of the gastrointestinal tract, most commonly being the stomach followed by small intestine and ileocecal region. They are indistinguishable from other benign and malignant conditions and clinically non-specific. Here, we have an interesting case where a patient presented with peritonitis and was found to have a perforated swelling in jejunum. Subsequently resection and anastomosis was done. Biopsy showed lymphoma. Patient was evaluated further by doing CECT of abdomen and thorax, which didn’t show any other site of lymphadenopathy. Patient improved with chemotherapy and is on regular follow up. Perforation in patient undergoing treatment for lymphoma are common but presentation of primary gastrointestinal lymphoma as perforation is rare and needs proper evaluation and management. PMID:27134938

  15. Infrastructure Requirements for an Urgent-Start Peritoneal Dialysis Program

    PubMed Central

    Ghaffari, Arshia; Kumar, Vijay; Guest, Steven

    2013-01-01

    Patients with advanced chronic kidney disease nearing dialysis but without pre-established access almost uniformly initiate dialysis with a temporary central venous catheter. These catheters are associated with high rates of infection and flow disturbances, requiring removal and subsequent replacement. Many of these patients might be candidates for peritoneal dialysis (PD), but because of the absence of prior catheter placement, the default initial modality is hemodialysis. Recent reports, however, have demonstrated the feasibility of initiating PD urgently despite the late referral for access placement. Urgent-start PD clinical pathways require a unique infrastructure and treatment approach. This article reviews the salient features required to establish an urgent-start PD program. PMID:24335123

  16. Acute peritoneal dialysis in a Jehovah's Witness post laparotomy.

    PubMed

    Appalsawmy, Usha Devi; Akbani, Habib

    2016-01-01

    A 56-year-old man who was a Jehovah's Witness with an advanced directive against autologous procedures developed acute kidney injury needing renal replacement therapy while he was intubated and ventilated on the intensive care unit. He was being treated for hyperosmolar hyperglycaemic state. He also had a healing laparotomy wound, having undergone a splenectomy less than a month ago following a road traffic accident. His hyperkalaemia and metabolic acidosis were refractory to medical treatment. As he became oligoanuric, decision was taken to carry out acute peritoneal dialysis (PD) by inserting a Tenckhoff catheter in his abdomen using peritoneoscopic technique. The patient was started on automated PD without any complications. His urine output gradually improved, and his renal function eventually recovered. On discharge from hospital, his renal function was within normal range, and he had no abdominal complications from the acute PD. PMID:27581233

  17. Benign Cystic Peritoneal Mesothelioma Revealed by Small Bowel Obstruction.

    PubMed

    Bray Madoué, Kaimba; Boniface, Moifo; Annick Laure, Edzimbi; Pierre, Herve

    2016-01-01

    Benign cystic peritoneal mesothelioma is a rare tumor which frequently occurs in women of reproductive age. Abdominal pain associated with pelvic or abdominal mass is the common clinical presentation. We report the case of a 22-year-old woman with a pathological proved benign cystic mesothelioma of the peritoneum revealed by a small bowel obstruction and a painful left-sided pelvic mass with signs of psoitis. Contrast enhanced abdominal CT-scan demonstrated a large pelvic cystic mass with mass effect on rectosigmoid and pelvic organs. The patient underwent surgical removal of the tumor. Pathological examination revealed the diagnosis of benign cystic mesothelioma of the peritoneum. The outcome was excellent with a 12-month recoil. PMID:27066288

  18. [Sapheno-peritoneal shunt for the treatment of ascites].

    PubMed

    Nagy, Z; Gyurkovics, E; Kaliszky, P; Kupcsulik, P

    2001-08-01

    For the surgical treatment of drug resistant ascites caused by hepatic cirrhosis usually different types of valvular plastic tubes are used, implanted as peritoneo-venous shunts. These shunts drain the ascites into the jugular vein. In the 1st Surgical Department of the Semmelweis University Budapest we have performed 267 peritoneo-venous shunt operations. We introduced a new method using an autolog venous graft with a peritoneo-venous anastomosis, that drains the ascites into the saphenous, then femoral vein. So far we performed 5 such interventions. The early results suggest that sapheno-peritoneal shunt can be successfully used for treatment of ascites. With this operation complications of plastic grafts are avoidable. PMID:11550492

  19. Fate of Mycobacterium tuberculosis inside rat peritoneal macrophages in vitro.

    PubMed

    Vishwanath, V; Meera, R; Puvanakrishnan, R; Narayanan, P R

    1997-10-01

    Rat peritoneal macrophages in vitro were infected with Mycobacterium tuberculosis and the fate of M. tuberculosis inside macrophages was monitored. Alteration in the levels of nitric oxide (NO) measured in terms of nitrite formed, hydrogen peroxide (H2O2) and lysosomal enzymes such as acid phosphatase, cathepsin-D and beta-glucuronidase in macrophages following M. tuberculosis infection was also studied. Elevation in the levels of nitrite were observed from 72 h of M. tuberculosis infection. Irrespective of the time point, M. tuberculosis infected macrophages produced elevated levels of H2O2. Maximum increase in the level of acid phosphatase was observed from 72 h of M. tuberculosis infection, whereas maximum elevation in the level of beta-glucuronidase was observed 48 h after M. tuberculosis infection. However these microbicidal agents did not alter the intracellular viability of M. tuberculosis. PMID:9350049

  20. Wernicke-korsakoff syndrome in primary peritoneal cancer.

    PubMed

    Kim, Ki Hyang

    2013-09-01

    Wernicke encephalopathy is a disease that constitutes a medical emergency, but one that can be reversed with thiamine repletion if it is recognized early. Patients with cancer have a high risk of Wernicke encephalopathy because of malnutrition, the use of chemotherapeutic agents, and disease progression. Korsakoff syndrome can follow or accompany Wernicke encephalopathy. Although patients can recover from Wernicke encephalopathy via rapid repletion of thiamine, few patients recover from Korsakoff syndrome. Here, the case of a 76-year-old female patient who had primary peritoneal cancer and developed Wernicke-Korsakoff syndrome as a result of prolonged nutritional imbalance and fast-growing tumor cells is reported. The patient's neurologic symptoms improved, but she did not recover from the psychiatric effects of the disease. PMID:24474922