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Sample records for peritoneal patch technique

  1. An Animal Model of Abdominal Aortic Aneurysm Created with Peritoneal Patch: Technique and Initial Results

    SciTech Connect

    Maynar, Manuel Hernandez, Javier; Sun Fei; Miguel, Carmen de; Crisostomo, Veronica; Uson, Jesus; Pineda, Luis-Fernando

    2003-04-15

    technique for the creation of an infrarenal AAA model was developed using a peritoneal patch in swine. The aneurysm model proved to have potential for further growth of the sac and a tendency to rupture. Because of the growth potential, this might be a better model than those with a noncompliant aneurysmal wall for the preclinical evaluation of stent-graft devices.

  2. Grid flexibility and patching techniques

    NASA Technical Reports Server (NTRS)

    Keith, T. G.; Smith, L. W.; Yung, C. N.; Barthelson, S. H.; Dewitt, K. J.

    1984-01-01

    The numerical determination of combustor flowfields is of great value to the combustor designer. An a priori knowledge of the flow behavior can speed the combustor design process and reduce the number of experimental test rigs required to arrive at an optimal design. Even 2-D steady incompressible isothermal flow predictions are of use; many codes of this kind are available, each employing different techniques to surmount the difficulties arising from the nonlinearity of the governing equations and from typically irregular combustor geometries. Mapping techniques (algebraic and elliptic PDE), and adaptive grid methods (both multi-grid and grid embedding) as applied to axisymmetric combustors are discussed.

  3. Peritonitis

    MedlinePlus

    Acute abdomen; Spontaneous bacterial peritonitis; SBP; Cirrhosis - spontaneous peritonitis ... blood, body fluids, or pus in the belly ( abdomen ). One type is called spontaneous bacterial peritonitis (SPP). ...

  4. New laparoscopic peritoneal pull-through vaginoplasty technique

    PubMed Central

    Mhatre, Pravin; Mhatre, Jyoti; Sahu, Rakhi

    2014-01-01

    BACKGROUND: Many reconstructive surgical procedures have been described for vaginal agenesis. Almost all of them are surgically challenging, multi-staged, time consuming or leave permanent scars on abdomen or skin retrieval sites. AIM: A new simple technique using laparoscopic peritoneal pull-through in creation of neo vagina has been described. MATERIAL AND METHODS: Total of thirty six patients with congenital absence of vagina (MRKH syndrome) were treated with laparoscopic peritoneal pull through technique of Dr. Mhatre between 2003 till 2012. The author has described 3 different techniques of peritoneal vaginoplasty. RESULTS: This technique has given excellent results over a period of one to seven years of follow-up. The peritoneal lining changes to stratified squamous epithelium resembling normal vagina and having acidic Ph. CONCLUSION: Apart from giving excellent normal vaginal function, as the ovary became accessible per vaginum three patients underwent ovum retrieval and pregnancy using surrogate mother, thus making this a fertility enhancing procedure. PMID:25395743

  5. Patch-augmented rotator cuff repair: influence of the patch fixation technique on primary biomechanical stability.

    PubMed

    Jung, Christian; Spreiter, Gregor; Audigé, Laurent; Ferguson, Stephen J; Flury, Matthias

    2016-05-01

    There is an ongoing debate about the potential of patch augmentation to improve biomechanical stability and healing associated with rotator cuff repair. The biomechanical properties of three different patch-augmented rotator cuff repair techniques were assessed in vitro and compared with a standard repair. Dermal collagen patch augmentation may increase the primary stability and strength of the repaired tendon in vitro, depending on the technique used for patch application. Forty cadaveric sheep shoulders with dissected infraspinatus tendons were randomized into four groups (n = 10/group) for tendon repair using a knotless double-row suture anchor technique. A xenologous dermal extracellular matrix patch was used for augmentation in the three test groups using an "integrated", "cover", or "hybrid" technique. Tendons were preconditioned, cyclically loaded from 10 to 30 N at 1 Hz, and then loaded monotonically to failure. Biomechanical properties and the mode of failure were evaluated. Patch augmentation significantly increased the maximum load at failure by 61 % in the "cover" technique test group (225.8 N) and 51 % in the "hybrid" technique test group (211.4 N) compared with the non-augmented control group (140.2 N) (P ≤ 0.015). For the test group with "integrated" patch augmentation, the load at failure was 28 % lower (101.6 N) compared with the control group (P = 0.043). There was no significant difference in initial and linear stiffness among the four experimental groups. The most common mode of failure was tendon pullout. No anchor dislocation, patch disruption or knot breakage was observed. Additional patch augmentation with a collagen patch influences the biomechanical properties of a rotator cuff repair in a cadaveric sheep model. Primary repair stability can be significantly improved depending on the augmentation technique.

  6. An Optimal Cell Detection Technique for Automated Patch Clamping

    NASA Technical Reports Server (NTRS)

    McDowell, Mark; Gray, Elizabeth

    2004-01-01

    While there are several hardware techniques for the automated patch clamping of cells that describe the equipment apparatus used for patch clamping, very few explain the science behind the actual technique of locating the ideal cell for a patch clamping procedure. We present a machine vision approach to patch clamping cell selection by developing an intelligent algorithm technique that gives the user the ability to determine the good cell to patch clamp in an image within one second. This technique will aid the user in determining the best candidates for patch clamping and will ultimately save time, increase efficiency and reduce cost. The ultimate goal is to combine intelligent processing with instrumentation and controls in order to produce a complete turnkey automated patch clamping system capable of accurately and reliably patch clamping cells with a minimum amount of human intervention. We present a unique technique that identifies good patch clamping cell candidates based on feature metrics of a cell's (x, y) position, major axis length, minor axis length, area, elongation, roundness, smoothness, angle of orientation, thinness and whether or not the cell is only particularly in the field of view. A patent is pending for this research.

  7. Cell-Detection Technique for Automated Patch Clamping

    NASA Technical Reports Server (NTRS)

    McDowell, Mark; Gray, Elizabeth

    2008-01-01

    A unique and customizable machinevision and image-data-processing technique has been developed for use in automated identification of cells that are optimal for patch clamping. [Patch clamping (in which patch electrodes are pressed against cell membranes) is an electrophysiological technique widely applied for the study of ion channels, and of membrane proteins that regulate the flow of ions across the membranes. Patch clamping is used in many biological research fields such as neurobiology, pharmacology, and molecular biology.] While there exist several hardware techniques for automated patch clamping of cells, very few of those techniques incorporate machine vision for locating cells that are ideal subjects for patch clamping. In contrast, the present technique is embodied in a machine-vision algorithm that, in practical application, enables the user to identify good and bad cells for patch clamping in an image captured by a charge-coupled-device (CCD) camera attached to a microscope, within a processing time of one second. Hence, the present technique can save time, thereby increasing efficiency and reducing cost. The present technique involves the utilization of cell-feature metrics to accurately make decisions on the degree to which individual cells are "good" or "bad" candidates for patch clamping. These metrics include position coordinates (x,y) in the image plane, major-axis length, minor-axis length, area, elongation, roundness, smoothness, angle of orientation, and degree of inclusion in the field of view. The present technique does not require any special hardware beyond commercially available, off-the-shelf patch-clamping hardware: A standard patchclamping microscope system with an attached CCD camera, a personal computer with an imagedata- processing board, and some experience in utilizing imagedata- processing software are all that are needed. A cell image is first captured by the microscope CCD camera and image-data-processing board, then the image

  8. Peritonitis

    MedlinePlus

    ... complication of colonoscopy or endoscopy. A ruptured appendix, stomach ulcer or perforated colon. Any of these conditions can ... risk of developing peritonitis: cirrhosis, appendicitis, Crohn's disease, stomach ulcers, diverticulitis and pancreatitis. History of peritonitis. Once you' ...

  9. Treatment of major vein injury with the hemostatic fleece TachoSil by interposing a peritoneal patch to avoid vein thrombosis: A feasibility study in pigs

    PubMed Central

    Dregelid, Einar B; Pedersen, Gustav

    2011-01-01

    Background: Vein lacerations in awkward locations are difficult to repair and carry high mortality. The hemostatic fleece, TachoSil, is effective in preventing intraoperative bleeding in different settings, but has not been recommended for use in large vein injury. TachoSil with a peritoneal patch interposed to avoid vein thrombosis has been reported as a method to obtain hemostasis in vein laceration, but further studies of this method are needed. Materials and Methods: A 1.5 × 1 cm defect was created in the vena cava in five pigs. A 26 × 32 mm peritoneal patch was applied on the coagulant side of a 48 × 48 mm TachoSil sheet, and used to cover the defect. Light compression with a wet sponge was applied for 3 min. No vascular suturing was performed. Results: Successful hemostasis was obtained in four out of the five pigs although the minimum TachoSil gluing zone surrounding the peritoneal patch was only 0–2 mm. The fifth pig died of hemorrhage 30 min after surgery due to a 4-mm stretch with no TachoSil gluing zone outside the peritoneal patch. At six days postoperatively the peritoneal patch was well integrated into the vein wall. After 28 days, the peritoneal patch was almost indiscernible from surrounding vein endothelium. Conclusions: Vein wall defects can be repaired using TachoSil with a peritoneal patch interposed to prevent contact between the thrombogenic TachoSil sheet and the vein lumen. An adequate TachoSil gluing zone all around the patch is essential. PMID:21633573

  10. A Carrel patch technique for renal transplantation in cats.

    PubMed

    Budgeon, Casey; Hardie, Robert J; McAnulty, Jonathan F

    2017-08-31

    To evaluate the feasibility of a Carrel patch method in feline renal transplantation. Descriptive case series. Nine healthy donor cats and 9 client recipient cats with chronic renal failure. Renal transplantation was performed in 9 cats with chronic renal failure after collection of a donor's left kidney with a Carrel patch technique. A patch of donor aortic wall was removed with either 2 or 1 renal artery (ies) (n = 1 and 8 cats, respectively) central to the patch, with a cuff of tissue (≤1 mm) protruding from the base of the vessels. The Carrel patch was implanted in recipient cats with an end-to-side artery-to-aorta anastomosis, in a simple-continuous pattern of 9-0 nylon. The renal vein and ureter were implanted as previously described. All donors and recipients survived surgery without vascular complication. The Carrel patch is a novel approach allowing the harvest of kidneys with multiple renal arteries. The technique also simplified the implant procedure, potentially decreasing the risks of bleeding and thrombosis. © 2017 The American College of Veterinary Surgeons.

  11. Surgery for supravalvular aortic stenosis - the three-patch technique.

    PubMed

    Arnáiz, Elena; Koolbergen, Dave; Adsuar, Alejandro; Hazekamp, Mark G

    2008-01-01

    The objective of this paper is to describe the three-patch technique for repair of supravalvular aortic stenosis (SVAS). Supravalvular aortic stenosis is a rare malformation as a result of an abnormal thickening of the aortic wall. SVAS may present in two forms: a localized form (affecting only the aortic sinotubular junction) and a diffuse form, where the aortic arch and its side branches are also affected. Since 1960, multiple surgical techniques have been described with the aim of relieving the aortic narrowing and restoring the aortic root. We present the three-patch technique as originally developed by Brom. After transection of the aorta at the sinotubular junction, three longitudinal incisions are made into the three sinuses. The aortic root geometry is then restored by placement of three separate patches of autologous pericardium in the opened sinuses. Brom's technique provides a complete and symmetric restoration of the aortic anatomy. The technique is illustrated by angiographies, surgical drawings, videos and a review of the literature. The results of the three-patch technique are good and our long-term experience will be described.

  12. Rediscovering sperm ion channels with the patch-clamp technique

    PubMed Central

    Kirichok, Yuriy; Lishko, Polina V.

    2011-01-01

    Upon ejaculation, mammalian spermatozoa have to undergo a sequence of physiological transformations within the female reproductive tract that will allow them to reach and fertilize the egg. These include initiation of motility, hyperactivation of motility and perhaps chemotaxis toward the egg, and culminate in the acrosome reaction that permits sperm to penetrate the protective vestments of the egg. These physiological responses are triggered through the activation of sperm ion channels that cause elevations of sperm intracellular pH and Ca2+ in response to certain cues within the female reproductive tract. Despite their key role in sperm physiology and their absolute requirement for the process of fertilization, sperm ion channels remain poorly understood due to the extreme difficulty in application of the patch-clamp technique to spermatozoa. This review covers the topic of sperm ion channels in the following order: first, we discuss how the intracellular Ca2+ and pH signaling mediated by sperm ion channels controls sperm behavior during the process of fertilization. Then, we briefly cover the history of the methodology to study sperm ion channels, which culminated in the recent development of a reproducible whole-cell patch-clamp technique for mouse and human cells. We further discuss the main approaches used to patch-clamp mature mouse and human spermatozoa. Finally, we focus on the newly discovered sperm ion channels CatSper, KSper (Slo3) and HSper (Hv1), identified by the sperm patch-clamp technique. We conclude that the patch-clamp technique has markedly improved and shifted our understanding of the sperm ion channels, in addition to revealing significant species-specific differences in these channels. This method is critical for identification of the molecular mechanisms that control sperm behavior within the female reproductive tract and make fertilization possible. PMID:21642646

  13. Left ventricle remodelling by double-patch sandwich technique

    PubMed Central

    Tappainer, Ernesto; Fiorani, Vinicio; Pederzolli, Nicola; Manfredi, Jacopo; Nocchi, Andrea; Zogno, Mario

    2007-01-01

    Background The sandwich double-patch technique was adopted as an alternative method for reconstruction of the left ventricle after excision of postinfarction dysfunctional myocardium to solve technical problems due to the thick edges of the ventricular wall. Methods Over a 5-year period, 12 of 21 patients with postinfarction antero-apical left ventricular aneurysm had thick wall edges after wall excision. It was due to akinetic muscular thick tissue in 6 cases, while in the other 6 with classic fibrous aneurysm, thick edges remained after the cut of the border zone. The ventricular opening was sandwiched between two patches and this is a technique which is currently used for the treatment of the interventricular septum rupture. In our patients the patches are much smaller than the removed aneurysm and they were sutured simply by a single row of single stitches. However, in contrast to interventricular septum rupture where the patches loosen the tension of the tissues, in our patients the patches pull strongly and restrain the walls by fastening their edges and supporting tight stitches. In this way they could narrow the cavity and close the ventricle. Results The resected area varied from 5 × 4 to 8 × 8 cm. Excision was extended into the interventricular septum in 5 patients, thus opening the right ventricle. CABG was performed on all patients but two. Left ventricular volumes and the ejection fraction changed significantly: end-systolic volume 93.5 ± 12.4 to 57.8 ± 8.9 ml, p < 0.001; end-diastolic volume 157.2 ± 16.7 to 115.3 ± 14.9 ml, p < 0.001; ejection fraction 40.3 ± 4.2 to 49.5 ± 5.7%, p < 0.001. All patients did well. One patient suffered from bleeding, which was not from the wall suture, and another had a left arm paresis. The post-operative hospital stay was 5 to 30 days with a mean 10.5 ± 7.5 days/patient. At follow-up, 9 to 60 months mean 34, all patients were symptom-free. NYHA class 2.5 ± 0.8 changed to 1.2 ± 0.4, p < 0.001. Conclusion The

  14. Deep patch technique for landslide repair. Final report

    SciTech Connect

    Helwany, B.M.

    1994-10-01

    The report describes the laboratory testing of the `USFS deep patch` technique and a CTI modification of this technique for repairing landslides with geosynthetic reinforcement. The technique involves replacing sections of roadway lost due to landslides on top of a geosynthetically-reinforced embankment. The CTI modification involves replacing the reinforced slope with a geosynthetically-reinforced retaining wall with a truncated base. Both techniques rely on the cantilevering ability of the reinforced mass to limit the load on the foundation with a high slide potential. The tests with road base showed that (1) both the USFS and CTI repair reduced effectively the adverse effects of local landsliding on the highway pavement by preventing crack propagation; (2) the USFS repair increased the stability of the repaired slope, which was in progressive failure, by reducing the stresses exerted on it; and (3) the CTI repair produced substantially greater stresses on its foundation due to the truncated base of the reinforced mass.

  15. Dental dam patch: an effective intraoral repair technique using cyanoacrylate.

    PubMed

    Liebenberg, W H

    1998-10-01

    Secondary dental dam retention is a critical component of successful dental dam isolation and relates to the provision of an effective seal at the dam/tooth junction. Restorative success can be compromised if this seal is inadvertently interrupted during the operative effort. One such periodic mishap is entanglement of the bur and the interdental dam strip during caries or restorative removal. This invariably results in a gaping interproximal defect in the dam. This article discusses the importance of optimum isolation as it relates to current "wet bonding" adhesive procedures, and introduces a repair technique using a patch of dental dam and cyanoacrylate.

  16. Image processing techniques in computer-assisted patch clamping

    NASA Astrophysics Data System (ADS)

    Azizian, Mahdi; Patel, Rajni; Gavrilovici, Cezar; Poulter, Michael O.

    2010-02-01

    Patch clamping is used in electrophysiology to study single or multiple ion channels in cells. Multiple micropipettes are used as electrodes to collect data from several cells. Placement of these electrodes is a time consuming and complicated task due to the lack of depth perception, limited view through the microscope lens and the possibility of collisions between micro-pipettes. To aid in this process, a computer-assisted approach is developed using image processing techniques applied to images obtained through the microscope. Image processing algorithms are applied to perform autofocusing, relative depth estimation, distance estimation and tracking of the micro-pipettes in the images without making any major changes in the existing patch clamp equipment. An autofocusing algorithm with a micrometer precision is developed and the relative depth estimation is performed based on autofocusing. A micro-pipette tip detection algorithm is developed which can be used to initialize or reset the tracking algorithm and to calibrate the system by registering the relative image and micro-manipulator coordinates. An image-based tracking algorithm is also developed to track a micro-pipette tip in real time. The real-time tracking data is then used for visual servoing the micro-pipette tips and updating the calibration information.

  17. Security Verification Techniques Applied to PatchLink COTS Software

    NASA Technical Reports Server (NTRS)

    Gilliam, David P.; Powell, John D.; Bishop, Matt; Andrew, Chris; Jog, Sameer

    2006-01-01

    Verification of the security of software artifacts is a challenging task. An integrated approach that combines verification techniques can increase the confidence in the security of software artifacts. Such an approach has been developed by the Jet Propulsion Laboratory (JPL) and the University of California at Davis (UC Davis). Two security verification instruments were developed and then piloted on PatchLink's UNIX Agent, a Commercial-Off-The-Shelf (COTS) software product, to assess the value of the instruments and the approach. The two instruments are the Flexible Modeling Framework (FMF) -- a model-based verification instrument (JPL), and a Property-Based Tester (UC Davis). Security properties were formally specified for the COTS artifact and then verified using these instruments. The results were then reviewed to determine the effectiveness of the approach and the security of the COTS product.

  18. Security Verification Techniques Applied to PatchLink COTS Software

    NASA Technical Reports Server (NTRS)

    Gilliam, David P.; Powell, John D.; Bishop, Matt; Andrew, Chris; Jog, Sameer

    2006-01-01

    Verification of the security of software artifacts is a challenging task. An integrated approach that combines verification techniques can increase the confidence in the security of software artifacts. Such an approach has been developed by the Jet Propulsion Laboratory (JPL) and the University of California at Davis (UC Davis). Two security verification instruments were developed and then piloted on PatchLink's UNIX Agent, a Commercial-Off-The-Shelf (COTS) software product, to assess the value of the instruments and the approach. The two instruments are the Flexible Modeling Framework (FMF) -- a model-based verification instrument (JPL), and a Property-Based Tester (UC Davis). Security properties were formally specified for the COTS artifact and then verified using these instruments. The results were then reviewed to determine the effectiveness of the approach and the security of the COTS product.

  19. A Novel Miniaturization Technique of a Microstrip Patch Antenna using Patch Resonators

    NASA Astrophysics Data System (ADS)

    Kakita, Katsutoshi; Morita, Norihiko; Horii, Yasushi

    Microstrip patch antennas have been widely used in mobile and satellite communication systems due to their great advantages of low cost, low profile, lightweight and easy fabrication. However, the dimensions of a classical patch antenna are on the order of half a wavelength. This paper proposes a new approach to reduce the size of the antenna by embedding several patch resonators in an antenna substrate. Periodically installed resonators are expected to exhibit slow-wave effects. First of all, a microstrip delay line having a train of patch resonators in its substrate is demonstrated theoretically by the conventional FDTD method, and the slow-wave effect is discussed. Next, a 2-dimentional patch resonator array is applied to a microstrip patch antenna, and the effectiveness of the proposed structure is evaluated in the respect of antenna dimensions. Also, several experiments have been carried out to confirm the theoretical predictions. Using a prototype model fabricated on an LTCC substrate, the size reduction of more the 50% is attained.

  20. Multicenter Registry Analysis of Center Characteristics Associated with Technique Failure in Patients on Incident Peritoneal Dialysis.

    PubMed

    Htay, Htay; Cho, Yeoungjee; Pascoe, Elaine M; Darssan, Darsy; Nadeau-Fredette, Annie-Claire; Hawley, Carmel; Clayton, Philip A; Borlace, Monique; Badve, Sunil V; Sud, Kamal; Boudville, Neil; McDonald, Stephen P; Johnson, David W

    2017-07-07

    Technique failure is a major limitation of peritoneal dialysis. Our study aimed to identify center- and patient-level predictors of peritoneal dialysis technique failure. All patients on incident peritoneal dialysis in Australia from 2004 to 2014 were included in the study using data from the Australia and New Zealand Dialysis and Transplant Registry. Center- and patient-level characteristics associated with technique failure were evaluated using Cox shared frailty models. Death-censored technique failure and cause-specific technique failure were analyzed as secondary outcomes. The study included 9362 patients from 51 centers in Australia. The technique failure rate was 0.35 (95% confidence interval, 0.34 to 0.36) episodes per patient-year, with a sevenfold variation across centers that was mainly associated with center-level characteristics. Technique failure was significantly less likely in centers with larger proportions of patients treated with peritoneal dialysis (>29%; adjusted hazard ratio, 0.83; 95% confidence interval, 0.73 to 0.94) and more likely in smaller centers (<16 new patients per year; adjusted hazard ratio, 1.10; 95% confidence interval, 1.00 to 1.21) and centers with lower proportions of patients achieving target baseline serum phosphate levels (<40%; adjusted hazard ratio, 1.15; 95% confidence interval, 1.03 to 1.29). Similar results were observed for death-censored technique failure, except that center target phosphate achievement was not significantly associated. Technique failure due to infection, social reasons, mechanical causes, or death was variably associated with center size, proportion of patients on peritoneal dialysis, and/or target phosphate achievement, automated peritoneal dialysis exposure, icodextrin use, and antifungal use. The variation of hazards of technique failure across centers was reduced by 28% after adjusting for patient-specific factors and an additional 53% after adding center-specific factors. Technique failure

  1. Silicone Rubber Superstrate Loaded Patch Antenna Design Using Slotting Technique

    NASA Astrophysics Data System (ADS)

    Kaur, Bhupinder; Saini, Garima; Saini, Ashish

    2016-09-01

    For the protection of antenna from external environmental conditions, there is a need that antenna should be covered with a stable, non-reactive, highly durable and weather resistive material which is insensitive to changing external environment. Hence, in this paper silicone rubber is proposed as a superstrate layer for patch antenna for its protection. The electrical properties of silicon rubber sealant are experimentally found out and its effect of using as superstrate on coaxial fed microstrip patch antenna using transmission line model is observed. The overall performance is degraded by slightly after the use of superstrate. Further to improve the performance of superstrate loaded antenna, patch slots and ground defects have been proposed. The proposed design achieves the wideband of 790 MHz (13.59 %), gain of 7.12 dB, VSWR of 1.12 and efficiency of 83.02 %.

  2. A Technique to Address Peritoneal Dialysis Catheter Malfunction

    PubMed Central

    Mason, Mark C.; Madura, James A.; Harold, Kristi L.

    2010-01-01

    Background: A 66-year-old male with a history of severe ischemic myopathy and renal failure underwent a combined heart and kidney transplant. Postoperative failure of the transplanted kidney eventually led to the need for peritoneal dialysis (PD). Methods: After one month, the PD catheter was laparoscopically repositioned after it was found to have migrated from its correct position in the pelvis and twisted and clogged in the omentum. After one more month, the same complication recurred. Laparoscopy was again used to clear the clogged catheter and reposition it. This time, a testicular prosthesis was sewn to the catheter and used as an anchoring weight for the proper position in the pelvis. Results: Six months after anchoring with the testicular prosthesis, the peritoneal dialysis catheter continues to function appropriately, and the patient has no complaints. Conclusions: Mal-positioned peritoneal dialysis catheters may be repositioned and anchored by using a testicular prosthesis in the event that weighted catheters are not available. PMID:21605534

  3. A Comparison of the Performance and Application Differences Between Manual and Automated Patch-Clamp Techniques

    PubMed Central

    Yajuan, Xiao; Xin, Liang; Zhiyuan, Li

    2012-01-01

    The patch clamp technique is commonly used in electrophysiological experiments and offers direct insight into ion channel properties through the characterization of ion channel activity. This technique can be used to elucidate the interaction between a drug and a specific ion channel at different conformational states to understand the ion channel modulators’ mechanisms. The patch clamp technique is regarded as a gold standard for ion channel research; however, it suffers from low throughput and high personnel costs. In the last decade, the development of several automated electrophysiology platforms has greatly increased the screen throughput of whole cell electrophysiological recordings. New advancements in the automated patch clamp systems have aimed to provide high data quality, high content, and high throughput. However, due to the limitations noted above, automated patch clamp systems are not capable of replacing manual patch clamp systems in ion channel research. While automated patch clamp systems are useful for screening large amounts of compounds in cell lines that stably express high levels of ion channels, the manual patch clamp technique is still necessary for studying ion channel properties in some research areas and for specific cell types, including primary cells that have mixed cell types and differentiated cells that derive from induced pluripotent stem cells (iPSCs) or embryonic stem cells (ESCs). Therefore, further improvements in flexibility with regard to cell types and data quality will broaden the applications of the automated patch clamp systems in both academia and industry. PMID:23346269

  4. Electromagnetic Wave Absorbing Technique Using Periodic Patterns for Low RCS Patch Array Antenna

    NASA Astrophysics Data System (ADS)

    Jang, Hong-Kyu; Lee, Yeon-Gwan; Shin, Jae-Hwan; Kim, Chun-Gon

    2013-07-01

    This paper presents an electromagnetic wave absorbing technique to reduce a radar cross-section (RCS) of a patch array antenna without compromising their antenna performance. The technique is based on periodic patterns, which is made of resistive materials. The 2×2 patch array antenna with a resonance frequency of 3.0 GHz was designed and fabricated. To reduce the RCS of the patch array antenna, the periodic patterns using a square patch element were proposed and applied to the surface between the four antenna patches. The printed lossy periodic patterns have radar absorbing performance at 12.0 GHz frequency. The measured results show that the lossy periodic patterns have no significant effect on the antenna radiation performance. On the other hand, the RCS is reduced by more than 98% compared to the conventional antenna at the target frequency.

  5. Correlation of open cell-attached and excised patch clamp techniques.

    PubMed

    Filipovic, D; Hayslett, J P

    1995-11-01

    The excised patch clamp configuration provides a unique technique for some types of single channel analyses, but maintenance of stable, long-lasting preparations may be confounded by rundown and/or rapid loss of seal. Studies were performed on the amiloride-sensitive Na+ channel, located on the apical surface of A6 cells, to determine whether the nystatin-induced open cell-attached patch could serve as an alternative configuration. Compared to excised inside-out patches, stable preparations were achieved more readily with the open cell-attached patch (9% vs. 56% of attempts). In both preparations, the current voltage (I-V) relation was linear, current amplitudes were equal at opposite equivalent clamped voltages, and Erev was zero in symmetrical Na+ solutions, indicating similar Na+ activities on the cytosolic and external surfaces of the patch. Moreover, there was no evidence that nystatin altered channel activity in the patch because slope conductance (3-4pS) and Erev (75 mV), when the bath was perfused with a high K:low Na solution (ENa = 80 mV), were nearly equal in both patch configurations. Our results therefore indicate that the nystatin-induced open cell-attached patch can serve as an alternative approach to the excised inside-out patch when experiments require modulation of univalent ions in the cytosol.

  6. The “peritoneal scaffold” technique of extended pelvic lymph node dissection during radical prostatectomy: A novel technique

    PubMed Central

    Mallikarjuna, Chiruvella; Nayak, Prasant; Ghouse, Syed Mohammed; Reddy, K. Purnachandra; Ragoori, Deepak Reddy; Bendigeri, M. T.; Reddy, Siva

    2016-01-01

    Introduction: Laparoscopic or robotic-assisted laparoscopic radical prostatectomy (RALP) is a frequently used approach for localized carcinoma prostate. For intermediate and high-risk cancers, extended pelvic lymph node dissection (e-PLND), is often performed. Conventional e-PLND involves piecemeal retrieval of lymphatic tissue. We describe a novel technique of laparoscopic e-PLND, which involves en-masse removal of pelvic lymph nodes from each side, based on an overlying peritoneal scaffold. Materials and Methods: Fifteen cases of intermediate and high-risk carcinoma prostate underwent laparoscopic radical prostatectomy (LRP) with peritoneal scaffold based e-PLND within a period of 1 year. We describe the surgical techqniue and outcomes in terms of operative time and lymph nodes retrieved. Results: The mean operating times for “peritoneal scaffold” lymphatic dissection was 48 min (38–64). The total number of lymph nodes retrieved was 18 (14–22). There were no cases with postoperative lymph collection or hematoma. Conclusion: The “peritoneal scaffold” technique of e-PLND is a novel technique, which involves having a peritoneal scaffold to bind and hold all the lymphatic tissues together in its anatomical orientation during dissection. This enables complete retrieval of specimen during LRP and RALP. PMID:27843216

  7. Patch Clamp: A Powerful Technique for Studying the Mechanism of Acupuncture

    PubMed Central

    Zhang, D.

    2012-01-01

    Cellular and molecular events can be investigated using electrophysiological techniques. In particular, the patch-clamp method provides detailed information. In addition, the patch-clamp technique has become a powerful method for investigating the mechanisms underlying the effects of acupuncture. In this paper, recent researches on how acupuncture might modulate electrophysiological responses in the central nervous system (CNS) and affect peripheral structures are reviewed. PMID:23133497

  8. Synthesizing MR contrast and resolution through a patch matching technique

    NASA Astrophysics Data System (ADS)

    Roy, Snehashis; Carass, Aaron; Prince, Jerry L.

    2010-03-01

    Tissue contrast and resolution of magnetic resonance neuroimaging data have strong impacts on the utility of the data in clinical and neuroscience tasks such as registration and segmentation. Lengthy acquisition times typically prevent routine acquisition of multiple MR tissue contrast images at high resolution, and the opportunity for detailed analysis using these data would seem to be irrevocably lost. This paper describes an example based approach using patch matching from a multiple resolution multiple contrast atlas in order to change an image's resolution as well as its MR tissue contrast from one pulse-sequence to that of another. The use of this approach to generate different tissue contrasts (T2/PD/FLAIR) from a single T1-weighted image is demonstrated on both phantom and real images.

  9. [Easy and reproducible technique to address tricuspid valve regurgitation with patch augmentation.

    PubMed

    Solinas, Marco; Bianchi, Giacomo; Glauber, Mattia

    2013-11-01

    We describe a patch augmentation of the anterior leaflet of the tricuspid valve to address tricuspid valve regurgitation due to leaflet retraction. The area of the anterior leaflet is measured using a tricuspid valve annuloplasty sizer; a glutaraldehyde-fixed autologous pericardial patch is trimmed with slight 5 mm oversize. The anterior leaflet is detached and the patch is sutured with three 5/0 running interlocked sutures, then an annuloplasty is performed with an undersized ring. This technique offers an easy and reproducible tool to address tricuspid regurgitation due to lack of leaflet coaptation.

  10. Changes in Patient and Technique Survival over Time among Incident Peritoneal Dialysis Patients in Canada

    PubMed Central

    Wald, Ron; Bargman, Joanne M.; Na, Yingbo; Jassal, S. Vanita; Jain, Arsh K.; Moist, Louise; Nessim, Sharon J.

    2012-01-01

    Summary Background and objectives In the last 15 years in Canada, there have been less stringent guidelines for peritoneal dialysis (PD) adequacy, availability of novel PD solutions, and lower PD-related peritonitis rates. Effects of these changes on outcomes of incident patients treated with PD during this period are unknown. Design, setting, participants, & measurements Risk of PD technique failure and mortality were compared among three incident cohorts of PD patients who initiated dialysis during the following periods: 1995–2000, 2001–2005, and 2006–2009. A multivariable model was used to evaluate time to PD technique failure using inverse probability of treatment and censoring weights accounting for changing survival and transplantation rates. Results Between 1995 and 2009,13,120 incident adult PD patients were identified from the Canadian Organ Replacement Register. Compared with the 1995–2000 cohort (n=5183), the risk of PD technique failure was lower among patients between 2001 and 2005 (n=4316) but similar among incident patients between 2006 and 2009 (n=3621). Cause-specific PD technique failure revealed no difference in PD peritonitis-related technique failure over time. PD technique failure due to inadequate PD was initially higher in the 2001–2005 cohort but lower in the 2006–2009 cohort compared with the 1995–2000 cohort. Relative to incident patients between 1995 and 2000, adjusted mortality was lower among incident patients between 2001 and 2005 and 2006 and 2009. Conclusions Survival on PD continues to improve with only modest changes in PD technique failure. Peritonitis remains an ongoing and modifiable source of PD technique failure. PMID:22554718

  11. Lower Education Level Is a Risk Factor for Peritonitis and Technique Failure but Not a Risk for Overall Mortality in Peritoneal Dialysis under Comprehensive Training System

    PubMed Central

    Kim, Hyo Jin; Lee, Joongyub; Park, Miseon; Kim, Yuri; Lee, Hajeong; Kim, Dong Ki; Joo, Kwon Wook; Kim, Yon Su; Cho, Eun Jin; Ahn, Curie

    2017-01-01

    Background Lower education level could be a risk factor for higher peritoneal dialysis (PD)-associated peritonitis, potentially resulting in technique failure. This study evaluated the influence of lower education level on the development of peritonitis, technique failure, and overall mortality. Methods Patients over 18 years of age who started PD at Seoul National University Hospital between 2000 and 2012 with information on the academic background were enrolled. Patients were divided into three groups: middle school or lower (academic year≤9, n = 102), high school (912, n = 324). Outcomes were analyzed using Cox proportional hazards models and competing risk regression. Results A total of 655 incident PD patients (60.9% male, age 48.4±14.1 years) were analyzed. During follow-up for 41 (interquartile range, 20–65) months, 255 patients (38.9%) experienced more than one episode of peritonitis, 138 patients (21.1%) underwent technique failure, and 78 patients (11.9%) died. After adjustment, middle school or lower education group was an independent risk factor for peritonitis (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.10–2.36; P = 0.015) and technique failure (adjusted HR, 1.87; 95% CI, 1.10–3.18; P = 0.038), compared with higher than high school education group. However, lower education was not associated with increased mortality either by as-treated (adjusted HR, 1.11; 95% CI, 0.53–2.33; P = 0.788) or intent-to-treat analysis (P = 0.726). Conclusions Although lower education was a significant risk factor for peritonitis and technique failure, it was not associated with increased mortality in PD patients. Comprehensive training and multidisciplinary education may overcome the lower education level in PD. PMID:28056058

  12. Lower Education Level Is a Risk Factor for Peritonitis and Technique Failure but Not a Risk for Overall Mortality in Peritoneal Dialysis under Comprehensive Training System.

    PubMed

    Kim, Hyo Jin; Lee, Joongyub; Park, Miseon; Kim, Yuri; Lee, Hajeong; Kim, Dong Ki; Joo, Kwon Wook; Kim, Yon Su; Cho, Eun Jin; Ahn, Curie; Oh, Kook-Hwan

    2017-01-01

    Lower education level could be a risk factor for higher peritoneal dialysis (PD)-associated peritonitis, potentially resulting in technique failure. This study evaluated the influence of lower education level on the development of peritonitis, technique failure, and overall mortality. Patients over 18 years of age who started PD at Seoul National University Hospital between 2000 and 2012 with information on the academic background were enrolled. Patients were divided into three groups: middle school or lower (academic year≤9, n = 102), high school (912, n = 324). Outcomes were analyzed using Cox proportional hazards models and competing risk regression. A total of 655 incident PD patients (60.9% male, age 48.4±14.1 years) were analyzed. During follow-up for 41 (interquartile range, 20-65) months, 255 patients (38.9%) experienced more than one episode of peritonitis, 138 patients (21.1%) underwent technique failure, and 78 patients (11.9%) died. After adjustment, middle school or lower education group was an independent risk factor for peritonitis (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.10-2.36; P = 0.015) and technique failure (adjusted HR, 1.87; 95% CI, 1.10-3.18; P = 0.038), compared with higher than high school education group. However, lower education was not associated with increased mortality either by as-treated (adjusted HR, 1.11; 95% CI, 0.53-2.33; P = 0.788) or intent-to-treat analysis (P = 0.726). Although lower education was a significant risk factor for peritonitis and technique failure, it was not associated with increased mortality in PD patients. Comprehensive training and multidisciplinary education may overcome the lower education level in PD.

  13. Modified Single-Patch Technique Versus Two-Patch Technique for the Repair of Complete Atrioventricular Septal Defect: A Meta-Analysis.

    PubMed

    Li, Dongxu; Fan, Qiang; Iwase, Tomoyuki; Hirata, Yasutaka; An, Qi

    2017-07-15

    Technical selection for surgical repair of complete atrioventricular septal defect (CAVSD) still remains controversial. This meta-analysis aimed to compare the modified single-patch (MP) technique with the two-patch (TP) technique for patients with CAVSD. Relevant studies comparing the MP technique with the TP technique were identified through a literature search using MEDLINE, EMBASE, Google Scholar, Cochrane Library, and the China National Knowledge Infrastructure databases. The variables were ventricular septal defect (VSD) size, cardiopulmonary bypass (CBP) time, aortic cross-clamp (ACC) time, intensive care unit stay, hospital stay, and other outcomes involving mortality, left ventricular outflow tract obstruction, atrioventricular valve regurgitation, residual septal shunt, atrioventricular block, and reoperation. A random-effect/fixed-effect model was used to summarize the estimates of mean difference/odds ratio with 95% confidence interval. Subgroup analysis stratified by region was performed. Fifteen publications involving 1034 patients were included. This meta-analysis demonstrated that (1) VSD size in the MP group was significantly smaller; (2) CBP time, ACC time, and hospital stay in the MP group experienced improvement; (3) Other postoperative outcomes showed no significant differences between two groups; and (4) The trends in China and other countries were close. The MP and TP techniques had comparable outcomes; however, the MP technique was performed with significantly shorter CBP and ACC times in patients with smaller VSDs. Given this limitation of data, the results of comparison of the two techniques in patients with larger VSDs remain unknown. Further studies are needed.

  14. Comparison between the fixation of peritoneal dialysis catheters to the peritoneal wall and the conventional placement technique: clinical experience and follow-up of a new implant technique for peritoneal dialysis catheters.

    PubMed

    Io, Hiroaki; Maeda, Kunimi; Sekiguchi, Yoshimi; Shimaoka, Tetsutaro; Aruga, Seiki; Nakata, Junichiro; Nakamoto, Hirotaka; Hotta, Yoko; Koyanagi, Ichiro; Inaba, Masanori; Kanda, Reo; Nakano, Takanori; Wakabayashi, Keiichi; Sasaki, Yuu; Inuma, Jiro; Kaneko, Kayo; Hamada, Chieko; Fukui, Mitsumine; Tomino, Yasuhiko

    2014-01-01

    Peritoneal dialysis (PD) catheters often become severely dislocated, which may lead to malfunction. With the aim of preventing this complication, we have developed a simple method of fixing the catheter downwards in the peritoneal cavity (fixation technique), a technique that does not require a laparoscope. Sixteen patients were implanted using the conventional placement technique and 25 patients were implanted using the fixation technique. The location of the catheter tip was classified from grade 1 (downward, normal) to 5 (dislocated). The frequency of dislocation (defined as the extended time and/or decrease in volume when draining the PD solution) was measured for both the fixation technique and conventional placement technique. There was a significant difference in grade between the fixation technique (2.72 ± 1.01) and conventional technique (3.92 ± 1.31). The time until first dislocation was significantly different between the fixation technique (59.3 ± 48.1 days) and conventional technique (8.8 ± 14.6 days). The time until any dislocation was significantly different between the fixation technique (69.2 ± 41.9 days) and conventional technique (12.9 ± 13.7 days). Complications were not significantly different between the fixation technique and conventional technique. The fixation technique appears to be simple, safe, and useful for preventing severe dislocation and for lengthening the time until dislocation in PD patients.

  15. Novel On-wafer Radiation Pattern Measurement Technique for MEMS Actuator Based Reconfigurable Patch Antennas

    NASA Technical Reports Server (NTRS)

    Simons, Rainee N.

    2002-01-01

    The paper presents a novel on-wafer, antenna far field pattern measurement technique for microelectromechanical systems (MEMS) based reconfigurable patch antennas. The measurement technique significantly reduces the time and the cost associated with the characterization of printed antennas, fabricated on a semiconductor wafer or dielectric substrate. To measure the radiation patterns, the RF probe station is modified to accommodate an open-ended rectangular waveguide as the rotating linearly polarized sampling antenna. The open-ended waveguide is attached through a coaxial rotary joint to a Plexiglas(Trademark) arm and is driven along an arc by a stepper motor. Thus, the spinning open-ended waveguide can sample the relative field intensity of the patch as a function of the angle from bore sight. The experimental results include the measured linearly polarized and circularly polarized radiation patterns for MEMS-based frequency reconfigurable rectangular and polarization reconfigurable nearly square patch antennas, respectively.

  16. Research on Handwashing Techniques of Peritoneal Dialysis Patients From Yiwu, Southeast China.

    PubMed

    Ye, Yuanjun; Zhang, Xiaohui; Liu, Yansu; Lou, Hongqing; Shou, Zhangfei

    2017-03-10

    The aim of the present study was to evaluate handwashing technique, bacteriology, and factors influencing handwashing technique of 86 stable chronic peritoneal dialysis (PD) patients from Yiwu City in Southeast China. Based on the "Hygienic standard for disinfection in the hospital", we also performed sampling for bacteriology from PD operators after they washed their hands. We compared their clinical features including the pathogenic bacteria of their previous peritonitis episodes and their handwashing evaluation results according to their bacteriologic sampling results. 65% of patients turned off the tap by bare hand, and 74% did not follow the six-step handwashing method. Dialysis duration longer than 6 months (P = 0.04) and lower income (P = 0.05) were independent risk factors for higher handwashing error scores. The overall rate of appropriate handwashing, according to the "hygienic standard for disinfection in the hospital" was 26%. The bacteriologic sampling results showed that the most common pathogenic bacterium was Staphylococcus aureus (92%). PD operators whose hand bacteria culture was qualified contained a lower proportion of participants with advanced age (P = 0.07). Patients with repeated peritonitis occurrence had a significantly higher score on handwashing error (P < 0.01) and were more likely to develop Staphylococcus infection. We found that in Yiwu city patients on dialysis for more than 6 months, were of low income and had multiple prior episodes of PD peritonitis had poor handwashing compliance. Elderly patients had higher rates of positive bacterial culture (Staphylococcus) from their hands.

  17. Infrared video patch-clamp technique for spiral ganglion neurons in rat cochlear slices.

    PubMed

    Zha, Ding-Jun; Lin, Ying; Wang, Zhi-Ming; Lu, Lian-Jun; Xue, Tao; Gao, Xue; Li, Yun-Qing; Qiao, Li; Qiu, Jian-Hua

    2009-05-01

    Cochlear slice and infrared video patch-clamp techniques can be used in real-time observation. They provide a good method and platform for further study of the electrophysiological properties and auditory transduction mechanism of spiral ganglion neuron (SGN). To establish the isolated rat cochlear slice technique combined with the infrared video patch-clamp technique to explore the electrophysiological properties of the SGN. SD rats were divided into three groups according to postnatal days (0-2 days, 3-6 days and 7-14 days). After quickly making SD rat cochlear slices, the electrophysiological properties of the SGN were observed using the infrared differential interference contrast technique and patch-clamp recording, and the factors that affect the cochlear slice quality and patch-clamp recording were analysed. The successful slice rate was highest in 3-6-day-old SD rats and two to four slices could be prepared using each cochlea. It is crucial to maintain the connection of partial skull with the cochlea and the volute integrity when producing slices. The position of the cochlear axis and blade, and the slice preparation time were also important factors affecting slice quality and cell activity. SGN cells in good condition could easily be found using the infrared video patch-clamp technique to help the assessment of the seal test process. SGN resting membrane potential of whole-cell recording was -45.6+/-5.3 mV (n=52) and the currents of Na+ and K+ could be recorded.

  18. Recording single-channel currents using "smart patch-clamp" technique.

    PubMed

    Bhargava, Anamika; Gorelik, Julia

    2013-01-01

    Microdomains that form on the plasma membrane of cells are essential for signalling compartmentation within cells. The localization of ion channels in these surface microdomains is important in defining what signalling cascades will be generated. For example, in cardiomyocytes, similar to other excitable cells, action potential propagation depends essentially on the properties of ion channels that are functionally and spatially coupled. In this chapter we describe a novel advanced patch-clamp technique, "Smart patch-clamp," which enables the study of functional ion channels in the cell surface microdomains in a wide variety of biological cells and tissues. Smart patch-clamp combines conventional patch-clamp and Scanning Ion Conductance Microscopy (SICM). SICM uses a glass micropipette as scanning probe and generates a high-resolution topography image of the cell surface. Next, same micropipette is used as a patch-clamp pipette to record ion channel signals from specific spots on the cell surface as determined by SICM. In this chapter we focus on recording single channel L-type calcium channel currents from T-tubules of adult rat cardiomyocytes.

  19. Blood patch treatment of chylothorax following transthoracic oesophagogastrectomy: a novel technique to aid surgical management.

    PubMed

    Windhaber, R A J; Holbrook, A G; Krysztopik, R J

    2010-05-01

    Chylothorax is a well-recognised complication of oesophagectomy, occurring in around 3% of cases. If managed conservatively, the mortality rate can be over 50%. We describe our experience of managing a patient with a chylothorax following oesophagectomy, and the use of a blood patch (a novel technique) to overcome persistent leakage following re-operation. The authors feel that this technique has the potential for a wider application in the treatment of chyle leak, especially if combined with minimally invasive or radiological techniques.

  20. Robotic Single-Site Sacrocolpopexy Using Barbed Suture Anchoring and Peritoneal Tunneling Technique: Tips and Tricks.

    PubMed

    Guan, Xiaoming; Ma, Yingchun; Gisseman, Jordan; Kleithermes, Christopher; Liu, Juan

    2017-01-01

    To demonstrate the tips and tricks of a simpler technique for single-site sacrocolpopexy using barbed suture anchoring and retroperitoneal tunneling to make the procedure more efficient and reproducible. Step-by-step description of surgical tutorial using a narrated video (Canadian Task Force classification III). Academic tertiary care hospital. Patient with Stage III uterine prolapse. Sacrocolpopexy is increasing utilized since the FDA warning about complications of vaginal mesh surgery. It is the gold standard for repair of apical prolapse. However, there is great variation in the sacrocolpopexy procedure techniques and they have not been standardized. Traditional single-site laparoscopic sacrocolpopexy is very challenging as the procedure time is long and suturing is difficult. The advantages of suturing with wristed needle drivers in robotic single-site surgery simplify this complex procedure. Furthermore, using barbed suture anchoring and peritoneal tunneling technique potentially decreases the surgeon's learning curve and makes the procedure reproducible. In this video, we demonstrate a supracervial hysterectomy with a stepwise explanation of the correct technique for performing a robotic single incision sacrocolpopexy. Sacrocolpopexy is increasing used since the US Food and Drug Administration warning about complications of vaginal mesh surgery. It is the gold standard for repair of apical prolapse. However, a great variation exists in the sacrocolpopexy procedure techniques that need to be standardized. Traditional single-site laparoscopic sacrocolpopexy is very challenging because the procedure time is long and suturing is difficult. The advantages of suturing with wristed needle drivers in robotic single-site surgery simplify this complex procedure. Furthermore, using the barbed suture anchoring and peritoneal tunneling technique potentially decreases the surgeon's learning curve and makes the procedure reproducible. In this video, we demonstrate a

  1. A new technique using free ileocaecal patch transplantation for secondary voice restoration after total laryngectomy.

    PubMed

    Kobayashi, M; Meguro, E; Hayakawa, Y; Irinoda, T; Noda, Y

    2008-09-01

    We introduce our newly designed voice restoration technique, which uses free ileocaecal patch transplantation for patients who have undergone prior total laryngectomy. Two women received ileocaecal patch transplantation for secondary voice restoration after total laryngectomy. In order to make the tracheoesophageal shunt for speech, a new orifice on the anterior wall of the hypopharynx had to be opened, which was closed at the time of laryngectomy. The hypopharyngeal orifice was covered by a free caecal patch harvested from an ileocaecal segment. Then, a tracheoesophageal shunt was created by anastomosing the terminal ileum of the patch and the remnant of the cervical trachea. Expiratory air was diverted into the pharynx through the ileum of the transplanted graft when the tracheostoma was closed by digital occlusion. Aspiration through an oesophagotracheal shunt in swallowing was prevented by the ileocaecal valve on the patch. Both patients began to speak up to 4 weeks after surgery without requiring training or difficult practice to achieve initial phonation and to be able to swallow without aspiration. The advantages of our procedure are (1) it can be carried out at the time of laryngectomy and also at secondary voice restoration after earlier laryngectomy; (2) the graft contains an ileocaecal valve that prevents aspiration through the shunt and also functions as a vibrating device to produce voice; (3) our procedure can be adapted to individuals whose tracheostoma is detached from the oesophagus and becomes contraindicated for a voice prosthesis. We believe that our newly designed procedure is a unique and useful alternative, especially for secondary voice restoration after prior total laryngectomy.

  2. Effects of icodextrin on patient survival and technique success in patients undergoing peritoneal dialysis.

    PubMed

    Han, Seung Hyeok; Ahn, Song Vogue; Yun, Jee Young; Tranaeus, Anders; Han, Dae-Suk

    2012-05-01

    Many studies have suggested clinical benefits of icodextrin in peritoneal dialysis (PD) patients regarding fluid management, glycaemic control and metabolic improvement. However, reports on whether icodextrin can improve patient and technique survival is sparse. A total of 2163 patients from 54 centres in Korea who initiated PD from July 2003 to December 2006 were enrolled. Outcomes data were retrieved retrospectively from the Baxter Korea database. Among these patients, 641 patients who had been prescribed icodextrin for >50% of their PD duration were defined as the 'icodextrin' group and the remaining 1522 patients as the 'non-icodextrin' group. Propensity score matching yielded 640 matched pairs of patients. We compared all-cause mortality and technique failure rates between the two groups. There were no significant differences in age, gender, diabetes, cardiovascular comorbidity, socioeconomic status, biocompatible solution use in short dwells or centre experience between the two groups. Death occurred in 92 (14.4%) patients in the icodextrin group compared with 128 (20.0%) in the non-icodextrin group [hazard ratio (HR), 0.69; 95% confidence interval (CI), 0.53-0.90; P = 0.006]. In addition, icodextrin use was associated with a significantly lower risk of technique failure (HR, 0.60; 95% CI, 0.40-0.92; P = 0.018). The icodextrin group had fewer technique failures due to non-compliance compared with the non-icodextrin group whereas peritonitis- or ultrafiltration failure-related technique failure was not different between the two groups. This study further supports previous findings of long-term utilization of icodextrin solution improving patient and technique survival in PD patients. To confirm these results, a large randomized prospective study is warranted.

  3. Technique failure in Korean incident peritoneal dialysis patients: a national population-based study.

    PubMed

    Lee, Shina; Kim, Hyunwook; Kim, Kyoung Hoon; Hann, Hoo Jae; Ahn, Hyeong Sik; Kim, Seung-Jung; Kang, Duk-Hee; Choi, Kyu Bok; Ryu, Dong-Ryeol

    2016-12-01

    Technique failure is an important issue for peritoneal dialysis (PD) patients. In this study, we aimed to analyze technique failure rate in detail and to determine the predictors for technique failure in Korea. We identified all patients who had started dialysis between January 1, 2005, and December 31, 2008, in Korea, using the Korean Health Insurance Review and Assessment Service database. A total of 7,614 PD patients were included, and the median follow-up was 24.9 months. The crude incidence rates of technique failure in PD patients were 54.1 per 1,000 patient-years. The cumulative 1-, 2-, and 3-year technique failure rates of PD patients were 4.9%, 10.3%, and 15.6%, respectively. However, those technique failure rates by Kaplan-Meier analysis were overestimated compared with the values by competing risks analysis, and the differences increased with the follow-up period. In multivariate analyses, diabetes mellitus and Medical Aid as a crude reflection of low socioeconomic status were independent risk factors in both the Cox proportional hazard model and Fine and Gray subdistribution model. In addition, cancer was independently associated with a lower risk of technique failure in the Fine and Gray model. Technique failure was a major concern in patients initiating PD in Korea, especially in diabetic patients and Medical Aid beneficiaries. The results of our study offer a basis for risk stratification for technique failure.

  4. Percutaneous Peritoneal Dialysis Catheter Insertion by a Nephrologist: A New, Simple, and Safe Technique

    PubMed Central

    Al-Hwiesh, Abdullah Khalaf

    2014-01-01

    ♦ Background: Insertion of the peritoneal dialysis (PD) catheter by a nephrologist has been encouraged by several studies. The ultimate goal is to provide safe, timely, and effective catheter insertion without an unduly long wait time or delay. The success of PD depends partly on the ease of catheter insertion. We developed a new technique for percutaneous PD catheter insertion by nephrologists. Our new technique, in addition to being easy, proved to be safe and to eliminate the need for the peel-away sheath. ♦ Methods: Data were collected prospectively on all patients having a PD catheter inserted by a nephrologist using our new technique (40 catheters in 38 patients). All catheters were evaluated for infectious and mechanical complications. ♦ Results: The mean duration of the procedure from skin sterilization to the end of insertion was 24 ± 3 minutes. No bowel perforation or serious hemorrhage was recorded. Poor initial drainage was recorded in 12.5% of the catheters (n = 5) during the 4 weeks after insertion. The incidence of early exit-site leakage was 2.5% (1 catheter). Episodes of exit-site infection occurred in 5.0% and 12.5% of catheters (within 1 month and by the end of study period respectively). Two episodes of peritonitis were reported by the end of the 12-month period. Catheter survival was 95.0% and 87.5% at 6 months and 12 months respectively. ♦ Conclusions: Percutaneous bedside placement of PD catheters using our new technique is safe and carries less morbidity in terms of bowel perforation, catheter-related infection, and exit-site leak. In addition, our new technique appears to have a high success rate and to offer considerable savings in terms of operating time. PMID:24084842

  5. Icodextrin decreases technique failure and improves patient survival in peritoneal dialysis patients.

    PubMed

    Wang, I-Kuan; Li, Yu-Fen; Chen, Jin-Hua; Liang, Chih-Chia; Liu, Yao-Lung; Lin, Hsin-Hung; Chang, Chiz-Tzung; Tsai, Wen-Chen; Yen, Tzung-Hai; Huang, Chiu-Ching

    2015-03-01

    It remains unclear whether long-term daily icodextrin use can decrease technique failure and improve survival in peritoneal dialysis (PD) patients. The aim of the present study was to investigate whether icodextrin use, once daily, can decrease technique failure and prolong patient survival in incident PD patients. Incident PD patients who survived more than 90 days were recruited from the China Medical University Hospital, Taiwan, between 1 January 2007 and 31 December 2011. All patients were followed until transfer to haemodialysis (HD), renal transplantation, transfer to another centre, death, or 31 December 2011. A total of 306 incident PD patients (89 icodextrin users, 217 icodextrin non-users) were recruited during the study period. Icodextrin users were more likely to have hypertension, diabetes and high or high-average peritoneal transport compared with non-users. During the follow-up period, 43 patients were transferred to HD: seven (7.87%) of the icodextrin group, and 36 (16.59%) of the non-icodextrin group. Thirty-two patients died during the follow-up period: five (5.62%) of the icodextrin group, and 27 (12.44%) of the non-icodextrin group. Icodextrin use was significantly associated with a better prognosis, in terms of technique failure (adjusted HR = 0.32; 95% CI = 0.14-0.72). With regard to patient survival, icodextrin use (adjusted HR = 0.33; 95% CI = 0.12-0.87) was associated with a significantly lower risk of death. The use of icodextrin once daily may decrease technique failure and improve survival in incident PD patients. © 2014 Asian Pacific Society of Nephrology.

  6. Minilaparoscopic Technique for Inguinal Hernia Repair Combining Transabdominal Pre-Peritoneal and Totally Extraperitoneal Approaches

    PubMed Central

    Loureiro, Marcelo P.; Bonin, Eduardo A; Claus, Christiano P.; Silva, Frederico W.; Cury, Antonio M.; Fernandes, Flavio A.M.

    2012-01-01

    Introduction: Endoscopic surgical repair of inguinal hernia is currently conducted using 2 techniques: the totally extraperitoneal (TEP) and the transabdominal (TAPP) hernia repair. The TEP procedure is technically advantageous, because of the use of no mesh fixation and the elimination of the peritoneal flap, leading to less postoperative pain and faster recovery. The drawback is that TEP is not performed as frequently, because of its complexity and longer learning curve. In this study, we propose a hybrid technique that could potentially become the gold standard of minimally invasive inguinal hernia surgery. This will be achieved by combining established advantages of TEP and TAPP associated with the precision and cosmetics of minilaparoscopy (MINI). Materials and Surgical Technique: Between January and July 2011, 22 patients were admitted for endoscopic inguinal hernia repair. The combined technique was initiated with TAPP inspection and direct visualization of a minilaparoscopic trocar dissection of the preperitoneum space. A10-mm trocar was then placed inside the previously dissected preperitoneal space, using the same umbilical TAPP skin incision. Minilaparoscopic retroperitoneal dissection was completed by TEP, and the surgical procedure was finalized with intraperitoneal review and correction of the preperitoneal work. Discussion: The minilaparoscopic TEP-TAPP combined approach for inguinal hernia is feasible, safe, and allows a simple endoscopic repair. This is achieved by combining features and advantages of both TAPP and TEP techniques using precise and sophisticated MINI instruments. Minilaparoscopic preperitoneal dissection allows a faster and easier creation of the preperitoneal space for the TEP component of the procedure. PMID:23484566

  7. Treatment of necrotizing acute pancreatitis with peritoneal lavage and dialysis by a new simplified technique insert catheters: One retrospective study.

    PubMed

    Li, Qi; Zhu, Bai; Zhu, Xueyan; Piao, Chenglin; Cui, Wenpeng; Wang, Yangwei; Sun, Jing; Chen, Wenguo; Miao, Lining

    2016-06-01

    Peritoneal lavage and dialysis is an approach to treat necrotizing acute pancreatitis as it removes dialyzable toxins and reduces severe metabolic disturbances. Successful catheter implantation is important for delivering adequate peritoneal lavage and dialysis. The aim of the present study was to describe a new modified percutaneous technique for the placement of peritoneal dialysis catheters and assess the effectiveness and safety of peritoneal lavage and dialysis used for treatment of necrotizing acute pancreatitis. We conducted a retrospective data review of 35 patients of necrotizing acute pancreatitis from January 2010 to December 2014 in Jilin City Central Hospital and The First Affiliated Hospital of ZheJiang University. In total, 18 patients underwent peritoneal lavage and dialysis after inserting catheters by our new technique (group A), whereas 17 patients underwent ultrasound-guided percutaneous catheter drainage (group B). By analyzing the patients' data, the drainage days and mean number of hours between the debut of the symptoms and the hospital admission were lower in group A (P < 0.05, P < 0.05, respectively). The complication rate of 5.6 and 17.6%, respectively (P = 0.261), and a mortality rate of 16.7 and 5.9% for each group, respectively (P = 0.316). Likewise, hospitalization time was similar for the group A: 31 ± 25.3 days compared with 42.8 ± 29.4 days in the group B (P = 0.211). Peritoneal lavage and dialysis can be used in necrotizing acute pancreatitis, and our new modified percutaneous technique offers the same complication and mortality rate as ultrasound-guided drainage but with a shorter drainage days.

  8. Impact of hernias on peritoneal dialysis technique survival and residual renal function.

    PubMed

    Balda, Sagrario; Power, Albert; Papalois, Vassilios; Brown, Edwina

    2013-01-01

    We evaluated the effect of hernias and their surgical or conservative management on peritoneal dialysis (PD) technique survival and residual renal function. This 10-year single-center retrospective case-control study (January 2001 - January 2011) compared patient survival, PD technique survival, and residual renal function in patients with a history of abdominal hernias and in a control cohort matched for age and PD vintage. Of 73 hernias identified in 63 patients (mean age: 55 years; 63% men), umbilical hernias were the most frequent (40%), followed by inguinal (33%), incisional, and epigastric hernias. Some hernias were surgically repaired before (n = 10) or at the time of PD catheter insertion (n = 11), but most (71%) were diagnosed and managed after initiation of PD. Overall, 49 of 73 (67%) hernias were treated surgically. In 53% of subjects, early postoperative dialysis was not needed; only 7 patients required temporary hemodialysis. The occurrence of a hernia and its treatment did not significantly affect residual renal function. After a hernia diagnosis or repair, 86% of patients were able to continue with PD. ♢ The incidence of abdominal hernia and hernia management in patients on PD do not significantly influence residual renal function or PD technique survival. Timely management of hernias is advisable and does not preclude continuation with PD as a dialysis modality.

  9. Comparison of peritoneal dialysis catheter insertion techniques: Peritoneoscopic, radiological and laparoscopic : A single-centre study.

    PubMed

    Sun, Tina Y-T; Voss, David; Beechey, Denise; Lam-Po-Tang, Michael

    2016-05-01

    Our centre introduced peritoneoscopic insertion of peritoneal dialysis (PD) catheter by nephrologists as a new method in August 2009 for its potential benefits. The aim of this study was to compare perioperative complications and catheter survival of three techniques: peritoneoscopic, surgical and radiological techniques within a single dialysis centre. This study used retrospective analysis of all PD catheter inserted from 1 August 2009 to 31 July 2013 within Counties Manukau DHB, Auckland, New Zealand. During the study period, 293 PD catheters were inserted, 84 (29%) peritoneoscopic (P), 140 (48%) surgical (S) and 69 (23%) radiological (R). Total duration of follow-up was 5848 catheter-months, with median follow-up of 17 months. There was no difference in perioperative exit-site infections and overall early infections. There was however increased overall perioperative complications in P compared with R (HR 2.08; P < 0.05), predominantly from catheter removal within 60 days. Although there was no difference observed in first catheter 1-year and overall survival between insertion techniques, there was poorer complication-free survival comparing P to S (HR 1.82, P = 0.001) but not to R. Analyses of the latter cohort of P confirmed improvement in catheter survival compared with an earlier cohort and to other insertion techniques. Peritoneoscopic PD catheter insertion is demonstrated to be a suitable alternative technique. As with any new procedure, 'learning curve' effects and development of operator expertise need to be taken into consideration. © 2015 Asian Pacific Society of Nephrology.

  10. Patch-based denoising method using low-rank technique and targeted database for optical coherence tomography image.

    PubMed

    Liu, Xiaoming; Yang, Zhou; Wang, Jia; Liu, Jun; Zhang, Kai; Hu, Wei

    2017-01-01

    Image denoising is a crucial step before performing segmentation or feature extraction on an image, which affects the final result in image processing. In recent years, utilizing the self-similarity characteristics of the images, many patch-based image denoising methods have been proposed, but most of them, named the internal denoising methods, utilized the noisy image only where the performances are constrained by the limited information they used. We proposed a patch-based method, which uses a low-rank technique and targeted database, to denoise the optical coherence tomography (OCT) image. When selecting the similar patches for the noisy patch, our method combined internal and external denoising, utilizing the other images relevant to the noisy image, in which our targeted database is made up of these two kinds of images and is an improvement compared with the previous methods. Next, we leverage the low-rank technique to denoise the group matrix consisting of the noisy patch and the corresponding similar patches, for the fact that a clean image can be seen as a low-rank matrix and rank of the noisy image is much larger than the clean image. After the first-step denoising is accomplished, we take advantage of Gabor transform, which considered the layer characteristic of the OCT retinal images, to construct a noisy image before the second step. Experimental results demonstrate that our method compares favorably with the existing state-of-the-art methods.

  11. Patch tests.

    PubMed

    Lazzarini, Rosana; Duarte, Ida; Ferreira, Alessandra Lindmayer

    2013-01-01

    Patch tests were introduced as a diagnostic tool in the late nineteenth century. Since then, they have improved considerably becoming what they are today. Patch tests are used in the diagnostic investigation of contact dermatitis worldwide. Batteries or series previously studied and standardized should be used in patch testing. The methodology is simple, but it requires adequate training for the results to be correctly interpreted and used. Despite having been used for over a century, it needs improvement like all other diagnostic techniques in the medical field.

  12. Patch tests*

    PubMed Central

    Lazzarini, Rosana; Duarte, Ida; Ferreira, Alessandra Lindmayer

    2013-01-01

    Patch tests were introduced as a diagnostic tool in the late nineteenth century. Since then, they have improved considerably becoming what they are today. Patch tests are used in the diagnostic investigation of contact dermatitis worldwide. Batteries or series previously studied and standardized should be used in patch testing. The methodology is simple, but it requires adequate training for the results to be correctly interpreted and used. Despite having been used for over a century, it needs improvement like all other diagnostic techniques in the medical field. PMID:24474094

  13. Mini Totally Extra-Peritoneal Repair of Inguinal Hernia with All 5 mm Ports: An Innovative "555 Technique".

    PubMed

    Gupta, Manish K; Muley, Kiran Kumar; Bethanbhatla, Murali Krishna; Nanavati, Juhil D; Manish, Kumar; Sarangi, Rathindra

    2017-03-01

    Totally extra-peritoneal (TEP) repair of inguinal hernia is now a standard surgical technique. A 12 mm incision in infra-umbilical region for Hasson trocar is must for TEP repair of inguinal hernia. This is the only technique known to laparoscopic surgeons. We have innovated a "555 Technique" for completing Mini TEP repair of inguinal hernia by using all three 5 mm ports. Sixty-one consecutive patients were subjected for TEP repair of inguinal hernia by our innovative "555 Technique" since October 2014. A simple "Manish Retractor" is devised to make extra-peritoneal space with 5 mm trocar. Fifty-nine cases were men and 2 cases were women. The mean age of patients was 44.6 years (range 23-82 years). Out of 61 cases, 27 were indirect inguinal hernia (23 unilateral, 4 bilateral), 32 direct inguinal hernia (21 unilateral, 11 bilateral), 1 femoral hernia, and 1 obturator hernia. One patient of indirect inguinal hernia had sliding hernia with sigmoid colon. Sixty cases were successfully operated by "555 Technique." There was conversion to trans-abdominal pre-peritoneal repair (TAPP) in 1 case. The average time for insertion of 5 mm trocar in preperitoneal space by our technique was 150 seconds. No complications were noted on 6 months follow-up. Small infra-umbilical scar was cosmetically more acceptable to patients. "555 Technique" is a feasible option without compromising the principles of TEP repair for inguinal hernia. Innovation of simple "Manish Retractor" is the key in completing Mini TEP repair. This technique is simple, less invasive, less morbid, and cost effective as it avoids dependence over costly Hasson trocar with better cosmetic results.

  14. The time for surgery of peritonitis associated with peritoneal dialysis.

    PubMed

    Mihalache, O; Bugă, C; Doran, H; Catrina, E; Bobircă, F; Andreescu, A; Mustățea, P; Pătrașcu, T

    2016-01-01

    Peritonitis is the main complication of peritoneal dialysis (PD) and also an important factor for raising the cost of the method to the level of hemodialysis. Associated with PD, peritonitis is responsible for the increase of morbidity and mortality of the procedure and, at the same time, the main cause of the technique failure. Severe and prolonged peritonitis or repeated episodes of peritonitis lead to ultrafiltration failure. Peritonitis treatment should aim for a rapid remission of inflammation in order to preserve the peritoneal membrane functional integrity. The treatment of PD peritonitis consists mainly of antibiotic therapy, surgical intervention not being usually required. However, it is of outmost importance to differentiate the so-called "catheter related" peritonitis from secondary peritonitis due to visceral lesions, in which the surgical treatment comes first. The confusion between secondary and "catheter related" peritonitis may lead to serious errors in choosing the correct treatment, endangering the patient's life. The differential diagnosis between a refractory or secondary peritonitis in a peritoneal dialyzed patient may be very difficult. In front of a refractory PD peritonitis, surgical exploration must not be delayed. Also we have to keep in mind that the aim of peritonitis treatment is the saving of the peritoneal membrane and not the catheter.

  15. The time for surgery of peritonitis associated with peritoneal dialysis

    PubMed Central

    Mihalache, O; Bugă, C; Doran, H; Catrina, E; Bobircă, F; Andreescu, A; Mustățea, P; Pătrașcu, T

    2016-01-01

    Peritonitis is the main complication of peritoneal dialysis (PD) and also an important factor for raising the cost of the method to the level of hemodialysis. Associated with PD, peritonitis is responsible for the increase of morbidity and mortality of the procedure and, at the same time, the main cause of the technique failure. Severe and prolonged peritonitis or repeated episodes of peritonitis lead to ultrafiltration failure. Peritonitis treatment should aim for a rapid remission of inflammation in order to preserve the peritoneal membrane functional integrity. The treatment of PD peritonitis consists mainly of antibiotic therapy, surgical intervention not being usually required. However, it is of outmost importance to differentiate the so-called “catheter related” peritonitis from secondary peritonitis due to visceral lesions, in which the surgical treatment comes first. The confusion between secondary and “catheter related” peritonitis may lead to serious errors in choosing the correct treatment, endangering the patient’s life. The differential diagnosis between a refractory or secondary peritonitis in a peritoneal dialyzed patient may be very difficult. In front of a refractory PD peritonitis, surgical exploration must not be delayed. Also we have to keep in mind that the aim of peritonitis treatment is the saving of the peritoneal membrane and not the catheter. PMID:27974935

  16. Hand Hygiene in Peritoneal Dialysis Patients: A Comparison of Two Techniques

    PubMed Central

    Figueiredo, Ana Elizabeth; de Siqueira, Soraia Lemos; Poli-de-Figueiredo, Carlos Eduardo; d’Avila, Domingos O.

    2013-01-01

    ♦ Introduction and Objectives: Hand hygiene is essential for preventing peritoneal dialysis (PD)-related infections. The present study compared the effectiveness of two hygiene techniques in reducing the number of colony-forming units (CFUs) on the hands of patients undergoing PD. ♦ Methods: In this controlled clinical trial, 22 participants enrolled in the same PD program underwent a two-hand evaluation for microbiologic flora. Participants participated in two treatments: a) simple hand hygiene plus antiseptic hand hygiene, in which the patients washed their hands with water and glycerin soap for 1 minute and then rubbed and dried their hands with 70% ethyl alcohol gel; and b) antiseptic hand hygiene, in which the patients rubbed their hands with 70% ethyl alcohol gel until fully dry. To sample distal finger surfaces, we asked the participants to touch sheep blood agar plates directly. ♦ Results: The CFU count for both hands was significantly higher in the regular hygiene group than in the gel-only group [69.0 (16.0 - 101.0) CFU vs 9.0 (2.2 - 55.5) CFU, p < 0.010]. Growth of coagulase-negative Staphylococcus colonies was significantly higher in right-hand cultures from the regular hygiene group than in those from the gel-only group [69.5 (26.25 - 101.0) CFU vs 9.5 (1.0 - 41.7) CFU; p < 0.050]. ♦ Conclusions: Among patients undergoing PD, using 70% ethyl alcohol gel to cleanse the hands may be more effective than following the regular hygiene recommendations in reducing bacterial populations. PMID:24179108

  17. Hand hygiene in peritoneal dialysis patients: a comparison of two techniques.

    PubMed

    Figueiredo, Ana Elizabeth; de Siqueira, Soraia Lemos; Poli-de-Figueiredo, Carlos Eduardo; d'Avila, Domingos O

    2013-01-01

    Hand hygiene is essential for preventing peritoneal dialysis (PD)-related infections. The present study compared the effectiveness of two hygiene techniques in reducing the number of colony-forming units (CFUs) on the hands of patients undergoing PD. In this controlled clinical trial, 22 participants enrolled in the same PD program underwent a two-hand evaluation for microbiologic flora. Participants participated in two treatments: a) simple hand hygiene plus antiseptic hand hygiene, in which the patients washed their hands with water and glycerin soap for 1 minute and then rubbed and dried their hands with 70% ethyl alcohol gel; and b) antiseptic hand hygiene, in which the patients rubbed their hands with 70% ethyl alcohol gel until fully dry. To sample distal finger surfaces, we asked the participants to touch sheep blood agar plates directly. The CFU count for both hands was significantly higher in the regular hygiene group than in the gel-only group [69.0 (16.0 - 101.0) CFU vs 9.0 (2.2 - 55.5) CFU, p < 0.010]. Growth of coagulase-negative Staphylococcus colonies was significantly higher in right-hand cultures from the regular hygiene group than in those from the gel-only group [69.5 (26.25 - 101.0) CFU vs 9.5 (1.0 - 41.7) CFU; p < 0.050]. Among patients undergoing PD, using 70% ethyl alcohol gel to cleanse the hands may be more effective than following the regular hygiene recommendations in reducing bacterial populations.

  18. The Impact of Transfer from Hemodialysis on Peritoneal Dialysis Technique Survival

    PubMed Central

    Nessim, Sharon J.; Bargman, Joanne M.; Jassal, S. Vanita; Oliver, Matthew J.; Na, Yingbo; Perl, Jeffrey

    2015-01-01

    ♦ Background: A significant proportion of peritoneal dialysis (PD) patients receive an initial period of hemodialysis (HD) before transitioning to PD (“PD-switch”). We sought to better understand the risks of PD technique failure (TF) and mortality for those patients compared with patients starting with PD as their first dialysis modality (“PD-first”). ♦ Methods: Using Canadian Organ Replacement Register data, we compared the risk of PD TF between PD-first and PD-switch patients within the first year after HD initiation. In a secondary analysis, the PD-switch patients were stratified into three groups based on timing of the switch from initial HD to PD as follows: 0 – 90 days, 91 – 180 days, and 181 – 365 days. Each group was compared with PD-first patients for risk of PD TF and death. ♦ Results: Between 2001 and 2010, 9404 patients initiated PD as their first renal replacement therapy, and 3757 switched from HD to PD. After multivariable adjustment, the risk of PD TF was higher among PD-switch patients than among PD-first patients [adjusted hazard ratio (AHR): 1.37; 95% confidence interval (CI): 1.26 to 1.49], particularly within the first year after the switch from HD to PD (AHR: 1.51; 95% CI: 1.36 to 1.68). There was no association between time on HD within the first year and subsequent risk of PD TF. For all the stratified PD-switch groups, death rates were higher than those for PD-first patients. ♦ Conclusions: Compared with patients who start renal replacement therapy with PD, those who transfer from HD to PD within the first year on dialysis experience higher rates of PD TF and death, with the highest risk being observed in the initial year after the switch to PD. PMID:24293665

  19. [Technique of rat cochlea slicing and study of rat spiral ganglion neurons by infrared visual slice patch clamp method].

    PubMed

    Zha, Ding-jun; Lin, Ying; Qiao, Li; Wang, Zhi-ming; Liu, Tao; Li, Yun-qing; Qiu, Jian-hua

    2007-06-01

    To establishing the cochlea slice technique and infrared visual slice patch clamp method in order to observe the electrophysiological characteristics of rat spiral ganglion neurons (SGN) METHODS: SD rats were divided into three groups according to postnatal days old (0-2 d, 3-6 d and 7-14 d). Making slice of SD rat cochlear quickly, using infrared differential interference contrast (IR-DIC) technique, together with slice patch clamp, the electrophysiological characteristics of rat spiral ganglion neurons were observed, and factors which affected the quality of cochlear slice and recording of patch clamp were analyzed. The success rate of 3-6 days SD was the highest, and 2-4 pieces of slice could be made from each cochlea. Cochlea connecting with partial skull and integrity of cochlear hull were the key for making slice, and the angle of modiolus axis should be adjusted to be parallel to the knife and the preparing time should be shorter. The SGN cell of good condition could be easily found and the seal test became easier with the help of infrared visual slice patch clamp method. The rest membrane potential was (-45.6 +/- 5.3) mV (x +/- s, n=52) and the current of Na+ and K+ could be activated. Cochlear slice technique can retain structural integrity, cell viability and their association in cochlea, which suggest that this technique provides carrier for electrophysiological study of rat spiral ganglion neurons, and patch clamp with infrared videomicroscopy method can be used to make direct real-time observation in electrophysiological experiments of SGN, which can provide important technique support and reference for deep study of electrophysiological characteristics of SGN and auditory neurotransmission in cochlea.

  20. A MEMS-based tunable coplanar patch antenna fabricated using PCB processing techniques

    NASA Astrophysics Data System (ADS)

    Maddela, M.; Ramadoss, R.; Lempkowski, R.

    2007-04-01

    In this paper, a tunable coplanar rectangular patch antenna (CPA) designed using a MEMS varactor is reported. The MEMS varactor is monolithically integrated with the antenna on Duroid substrate using printed circuit processing techniques. Specifically, the MEMS varactor located at one of the radiating edges capacitively loads the CPA. The resonant frequency of the antenna is tuned electrostatically by applying a DC bias voltage between the MEMS varactor and the actuation pad on the antenna. The movable MEMS varactor membrane deflects downward toward the actuation pad due to an electrostatic force of attraction caused by the applied DC bias voltage. The deflection of the varactor membrane decreases the air gap, thereby increasing the loading capacitance. The increase in the loading capacitance results in a downward shift in the resonant frequency of the CPA. The CPA is center fed at the second radiating edge using a 50 Ω CPW feed line. The CPA operates in the frequency range from 5.185 to 5.545 GHz corresponding to the down and up states of the varactor. The tunable frequency range is about 360 MHz and the return loss is better than 40 dB in the entire tuning range. In this tuning range, the required DC voltage is in the range of 0-116 V.

  1. Efficacy of a standardized technique of trans-vaginal entry into the peritoneal cavity for post-hysterectomy vaginal vault suspension.

    PubMed

    Park, Amy J; Ridgeway, Beri; Gustilo-Ashby, A Marcus; Paraiso, Marie Fidela R; Walters, Mark D; Barber, Matthew D

    2008-10-01

    The aim of this paper is to describe the efficacy and safety of a standardized technique of trans-vaginal entry into the peritoneal cavity for post-hysterectomy vault prolapse and determine how well the pre-operative pelvic examination predicted successful peritoneal entry. A retrospective review of patients undergoing post-hysterectomy trans-vaginal apical suspensions using a standardized technique of peritoneal entry was employed in this study. A subset of patients underwent a standardized pre-operative evaluation to predict what organ was behind the vaginal cuff and posterior cul-de-sac. Peritoneal entry was attempted in 280 patients, and successfully achieved in 223(80%). One cystotomy and one proctotomy (0.3%) occurred during attempted entry. Of those who underwent the standardized pre-operative evaluation, peritoneal entry was successful 86% of the time when small bowel was predicted to lie behind the vaginal cuff or posterior cul-de-sac. Peritoneal entry can be safely achieved in the majority of post-hysterectomy prolapse patients. Pre-operative examination assists in predicting successful peritoneal entry.

  2. Long-term results of the single-patch repair technique for sinus venosus atrial septal defects.

    PubMed

    Temizkan, Veysel; Ugur, Murat; Alp, Ibrahim; Ucak, Alper; Yilmaz, Ahmet Turan

    2013-04-01

    Anomalous pulmonary venous drainage commonly accompanies sinus venosus atrial septal defects (SVASDs). Many techniques have been reported for avoiding postoperative complications, such as narrowing of the superior vena cava (SVC) or the pulmonary system, and arrhythmia. We perform a single V-Y pericardial patch plasty repair technique for SVASDs. The purpose of this study is to report on the long-term results of this surgical technique. We retrospectively analyzed patients who had a diagnosis of ASD and who underwent their operations between 2000 and 2010 at the Gulhane Military Medical Academy Haydarpasa Training Hospital. Thirty-nine of the patients had an anomalous pulmonary return, and the single pericardial patch technique had been performed in 32 of these patients. The mean (±SD) postoperative extubation time was 5 ± 1.6 hours. The mean drainage volume was 384 ± 137 mL. All patients were discharged from the hospital at a mean of 4.6 ± 1.1 days after their operation and were prescribed anticoagulants for 3 months. No perioperative or late-term mortality was observed. Patients were followed up for 6 months to 2 years. There were no residual shunts and no stenosis-related findings in the pulmonary venous system or the SVC. Use of the single pericardial patch plasty technique might lower complication rates in patients with SVASD, especially those who have not completed their growth.

  3. Duration of Hemodialysis Following Peritoneal Dialysis Cessation in Australia and New Zealand: Proposal for a Standardized Definition of Technique Failure.

    PubMed

    Lan, Patrick G; Clayton, Philip A; Johnson, David W; McDonald, Stephen P; Borlace, Monique; Badve, Sunil V; Sud, Kamal; Boudville, Neil

    ♦ BACKGROUND: Although technique failure is a key outcome in peritoneal dialysis (PD), there is currently no agreement on a uniform definition. We explored different definitions of PD technique failure using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. ♦ METHODS: We included 16,612 incident PD patients in Australia and New Zealand from January 1998 to December 2012. Different definitions of technique failure were applied according to the minimum number of days (30, 60, 90, 180, or 365) the patient received hemodialysis after cessation of PD. ♦ RESULTS: Median technique survival varied from 2.0 years with the 30-day definition to 2.4 years with the 365-day definition. For all definitions, the most common causes of technique failure were death, followed by infectious complications. The likelihood of a patient returning to PD within 12 months of technique failure was highest in the 30-day definition (24%), and was very small when using the 180- and 365-day definitions (3% and 0.8%, respectively). Patients whose technique failed due to mechanical reasons were the most likely to return to PD (46% within 12 months using the 30-day definition). ♦ CONCLUSIONS: Both 30- and 180-day definitions have clinical relevance but offer different perspectives with very different prognostic implications for further PD. Therefore, we propose that PD technique failure be defined by a composite endpoint of death or transfer to hemodialysis using both 30-day and 180-day definitions. Copyright © 2016 International Society for Peritoneal Dialysis.

  4. Patch nearfield acoustic holography combined with sound field separation technique applied to a non-free field

    NASA Astrophysics Data System (ADS)

    Bi, ChuanXing; Jing, WenQian; Zhang, YongBin; Xu, Liang

    2015-02-01

    The conventional nearfield acoustic holography (NAH) is usually based on the assumption of free-field conditions, and it also requires that the measurement aperture should be larger than the actual source. This paper is to focus on the problem that neither of the above-mentioned requirements can be met, and to examine the feasibility of reconstructing the sound field radiated by partial source, based on double-layer pressure measurements made in a non-free field by using patch NAH combined with sound field separation technique. And also, the sensitivity of the reconstructed result to the measurement error is analyzed in detail. Two experiments involving two speakers in an exterior space and one speaker inside a car cabin are presented. The experimental results demonstrate that the patch NAH based on single-layer pressure measurement cannot obtain a satisfied result due to the influences of disturbing sources and reflections, while the patch NAH based on double-layer pressure measurements can successfully remove these influences and reconstruct the patch sound field effectively.

  5. [Indication and technique of human fibrinogen/thrombin-coated collagen patch use in mucogingival surgery].

    PubMed

    Zorina, O A; Molchanov, A M; Balykin, R A

    2014-01-01

    The aim of the study was to assess the effectiveness of fibrinogen/thrombin-coated collagen patch by mucogingival operations in patients with somatic diseases. Twenty-seven patients aged 25 to 45 (15 males and 12 females) with somatic diseases such as arterial hypertension (11 patients), diabetes (8 patients), bleeding disorders (8 patients) underwent Edlan-Mejcher vestibuloplasty. Using fibrinogen/thrombin-coated collagen patch as wound dressing caused marked hemostatic effect in 3 to 5 minutes even in hypertension and bleeding disorder patients. Wound heeling was observed 14 days post-op with no excessive scarring.

  6. The Role of Liquid Based Cytology and Ancillary Techniques in the Peritoneal Washing Analysis: Our Institutional Experience

    PubMed Central

    Rossi, Esther; Bizzarro, Tommaso; Martini, Maurizio; Longatto-Filho, Adhemar; Schmitt, Fernando; Fagotti, Anna; Scambia, Giovanni; Zannoni, Gian Franco

    2017-01-01

    Background The cytological analysis of peritoneal effusions serves as a diagnostic and prognostic aid for either primary or metastatic diseases. Among the different cytological preparations, liquid based cytology (LBC) represents a feasible and reliable method ensuring also the application of ancillary techniques (i.e immunocytochemistry-ICC and molecular testing). Methods We recorded 10348 LBC peritoneal effusions between January 2000 and December 2014. They were classified as non-diagnostic (ND), negative for malignancy-NM, atypical-suspicious for malignancy-SM and positive for malignancy-PM. Results The cytological diagnosis included 218 ND, 9.035 NM, 213 SM and 882 PM. A total of 8048 (7228 NM, 115SM, 705 PM) cases with histological follow-up were included. Our NM included 21 malignant and 7207 benign histological diagnoses. Our 820 SMs+PMs were diagnosed as 107 unknown malignancies (30SM and 77PM), 691 metastatic lesions (81SM and 610PM), 9 lymphomas (2SM and 7PM), 9 mesotheliomas (1SM and 8SM), 4 sarcomas (1SM and 3PM). Primary gynecological cancers contributed with 64% of the cases. We documented 97.4% sensitivity, 99.9% specificity, 98% diagnostic accuracy, 99.7% negative predictive value (NPV) and 99.7% positive predictive value (PPV). Furthermore, the morphological diagnoses were supported by either 173 conclusive ICC results or 50 molecular analyses. Specifically the molecular testing was performed for the EGFR and KRAS mutational analysis based on the previous or contemporary diagnoses of Non Small Cell Lung Cancer (NSCLC) and colon carcinomas. We identified 10 EGFR in NSCCL and 7 KRAS mutations on LBC stored material. Conclusions Peritoneal cytology is an adjunctive tool in the surgical management of tumors mostly gynecological cancers. LBC maximizes the application of ancillary techniques such as ICC and molecular analysis with feasible diagnostic and predictive yields also in controversial cases. PMID:28099523

  7. Influence of peritoneal dialysis solution biocompatibility on long-term survival of patients on continuous ambulatory peritoneal dialysis and the technique itself.

    PubMed

    Stanković-Popović, Verica; Popović, Dragan; Dimković, Nada; Maksić, Djoko; Vasilijić, Sasa; Colić, Miodrag; Vucinić, Zarko; Radjen, Slavica; Milicić, Biljana

    2013-04-01

    Morbidity and mortality of continous ambulatory peritoneal dialysis (CAPD) patients is still very high. The aim of the study was to evaluate the effects of peritoneal dialysis (PD) solutions (standard vs biocompatible) on long-term patients' and the techique survival. A total of 42 stable patients on CAPD participated in this cross-sectional study. They were prospectively followed-up during the twelve years. Patients with severe anemia (Hb < 10 g/L) and malignant disease ware excluded. Twenty one (50%/0) patients were treated with the standard PD solutions (CAPDP-1) while the other 21 (500/0) were treated with biocompatible PD solutions [(lower level of glucose degradation products, lower concentration of Ca(2+) and neutral pH (CAPDP-2)]. All patients were analyzed for a presence of vascular calcification, nutrition status, and parameters of inflammation after 2.5 +/- 0.6 years of starting CAPD, and these variables considered in the analysis as risk factors. The patients from the group CAPDP-2 compared to those from the group CAPDP-1 had lower level of high-sensitivity C-reactive protein (hs-CRP) (p = 0.003), and better nutritional status as confirmed by the mid-arm circumference (p = 0.015), and mid-arm muscle circumference (p = 0.002) and subjective global assessment (p = 0.000). Also, they had lower vascular calcifications as confirmed by intima media thickness (IMT) (p = 0.003), degree of carotid narrowing (p = 0.001) and calcified plaques of common carotid arteries (CCA) (p = 0.008). Kaplan-Meier analysis confirmed better survival of patients from the group CAPDP-2 than those from the group CAPDP-1 (1-, 5-, and 10-year patients survival rate was: 100%, 61.9% and 14.3% for the group CAPDP-1, and 100%, 85.7%, and 52.4% for the group CAPDP-2, respectively; p = 0.0345). The 1-, 5-, and 10-year technique survival rate was: 100%, 71.4%, and 38.1% for the group CAPDP-1, and 100%, 85.7%, and 76.2% for the group CAPDP-2, respectively; (p = 0.0719). Duration of dialysis

  8. Study of Surface-Patch Techniques for Modeling Three-Dimensional Radiating or Scattering Objects.

    DTIC Science & Technology

    1980-01-01

    32 13. Comparison of the computed radar cross section of a conducting box with other known data ... ........... .. 33 14...Comparison of the computed radar cross section of a conducting rectangular cylinder with other known data. . 34 15. An arbitrary triangular current patch...variation of the radar cross - section versus frequency. Because of the slight frequency shift and the narrowness of the resonance bandwidth, this resonance

  9. Synthetic bioabsorbable hernia plug for plug and patch inguinal herniorrhaphy implantation technique.

    PubMed

    Doerhoff, Carl

    2012-12-01

    New products have led the way in advancements of inguinal hernia repair. None is more impressive than the evolution of the plug patch. In 1968 Irving Lichtenstein introduced the first Marlex mesh plug repair when he rolled a piece of flat polypropylene into the shape of a cigarette to fill a femoral defect. He later expanded his use of the "cigarette plug" to repair recurrent hernias. Today, a wide array of mesh plugs, ranging from nonabsorbable to partially and fully absorbable biomaterials, are available from manufacturers. While some surgeons have used the plug alone for repair, most believe the overlay patch is of greater importance for the durability of the repair. With larger overlays, it is questionable whether a plug should be a permanent, nonabsorbable material. Heavyweight plugs have been reported to erode, migrate, or cause vocational-limiting inguinodynia. Using a fully absorbable plug in inguinal hernia repair minimizes the risk of these complications. This article focuses on the technical refinements associated with using the completely absorbable GORE BIO-A Hernia Plug (W.L. Gore & Associates, Inc, Elkton, MD) in combination with macroporous polypropylene or polyester. Additionally, this paper describes the use of GORE BIO-A Tissue Reinforcement as an alternative for repair following removal of prior polypropylene plug-patch herniorrhaphy that cause inguinodynia.

  10. Comparison of two laparoscopic peritoneal vaginoplasty techniques in patients with Mayer-Rokitansky-Küster-Hauser syndrome.

    PubMed

    Zhao, Xiwa; Wang, Ruixue; Wang, Yanxiu; Li, Li; Zhang, Haibo; Kang, Shan

    2015-08-01

    The aim of this study was to compare the technical feasibility and long-term anatomical and functional outcomes of a novel laparoscopic vaginoplasty using single peritoneal flap (SPF) and Davydov's laparoscopic technique in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. From September 2004 to September 2013, a comparative study was conducted of 98 patients with MRKH syndrome who underwent either laparoscopic vaginoplasty using SPF (SPF group, 62 cases) or Davydov's laparoscopic technique (Davydov group, 36 cases) in a university-based tertiary care hospital. Intraoperative and postoperative parameters and anatomical examination findings of the two groups were compared. Functional results were assessed using the Female Sexual Function Index (FSFI). All surgical procedures were performed successfully, with no intraoperative complications in either group. Patients in the SPF group had a significantly shorter operative time and less intraoperative blood loss than patients in the Davydov group. The postoperative course was identical for all patients in the two groups. The mean length and width of the neovagina in the two groups at hospital discharge, the 6-month follow-up, and the 12-month follow-up did not differ significantly. There were no significant differences between the groups with regard to the postoperative FSFI scores at 12 months after surgery. Although the long-term anatomical and functional outcomes of the two laparoscopic peritoneal vaginoplasty techniques are similar, laparoscopic vaginoplasty using SPF, which has many advantages and is easily performed by the gynecologist, is a more feasible and effective approach to creating a neovagina in patients with MRKH syndrome.

  11. Laparoscopic-assisted catheter insertion for continuous ambulatory peritoneal dialysis: A case report of simple technique for optimal placement

    PubMed Central

    Hori, Tomohide; Nakauchi, Masaya; Nagao, Kazuhiro; Oike, Fumitaka; Tanaka, Takahiro; Gunji, Daigo; Okada, Noriyuki

    2013-01-01

    A 40-year-old male underwent tube placement surgery for continuous ambulatory peritoneal dialysis (CAPD). A 2-cm skin incision was made, and the peritoneum was reflected enough to perform secure fixation. A swan-necked, double-felted silicone CAPD catheter was inserted, and the felt cuff was sutured to the peritoneum to avoid postoperative leakage. An adequate gradient for tube fixation to the abdominal wall was confirmed. The CAPD tube was passed through a subcutaneous tunnel. Aeroperitoneum was induced to confirm that there was no air leakage from the sites of CAPD insertion. Two trocars were placed, and we confirmed that the CAPD tube led to the rectovesical pouch. Tip position was reliably observed laparoscopically. Optimal patency of the CAPD tube was confirmed during surgery. Placement of CAPD catheters by laparoscopic-assisted surgery has clear advantages in simplicity, safety, flexibility, and certainty. Laparoscopic technique should be considered the first choice for CAPD tube insertion. PMID:24179625

  12. Peritoneal Disorders

    MedlinePlus

    ... peritoneal fluid, lubricates the surface of this tissue. Disorders of the peritoneum are not common. They include ... fluid to diagnose the problem. Treatment of peritoneal disorders depends on the cause.

  13. Ammonia volatilization from artificial dung and urine patches measured by the equilibrium concentration technique (JTI method)

    NASA Astrophysics Data System (ADS)

    Saarijärvi, K.; Mattila, P. K.; Virkajärvi, P.

    The aim of this study was to investigate the dynamics of ammonia (NH 3) volatilization from intensively managed pastures on a soil type typical of the dairy production area in Finland and to clarify the effect of rainfall on NH 3 volatilization. The study included two experiments. In Experiment 1 the total amount of NH 3-N emitted was calculated based on the annual surface coverage of dung (4%) and urine (17%). The application rate of total N in the simulated dung and urine patches was approximately 47 g N m -2 and 113 g N m -2, respectively. In Experiment 1 the general level of NH 3 emissions from the urine patches was high and the peak volatilization rate was 0.54 g NH 3-N m -2 h -1. As expected, emissions from the dung pats were clearly lower with a maximum rate of 0.10 g NH 3-N m -2 h -1. The total emission calculated for the whole pasture area (stocking rate four cows ha -1 y -1, urine coverage 17% and dung coverage 4%) was 16.1 kg NH 3-N ha -1. Approximately 96% of the total emission originated from urine. In Experiment 2 we measured the emissions from urine only and the treatments on the urine patches were: (1) no irrigation, (2) 5+5 mm and (3) 20 mm irrigation. The peak emission rates were 0.13, 0.09 and 0.04 g NH 3-N m -2 h -1 and the total emissions were 6.9, 3.0 and 1.7 kg NH 3-N ha -1, for treatments (1), (2) and (3), respectively. In both measurements over 80% of the total emission occurred during the first 48 h and there was a clear diurnal rhythm. Increasing rainfall markedly decreased NH 3 emission. Volatilization was highest with dry and warm soil. The JTI method appeared to be suitable for measuring NH 3 volatilization in this kind of experiment. According to our results, the importance of pastures as a source of NH 3 emission in Finland is minor.

  14. Predicting technique and patient survival over 12 months in peritoneal dialysis: the role of anxiety and depression.

    PubMed

    Griva, Konstadina; Kang, Augustine W C; Yu, Zhen Li; Lee, Vanessa Y W; Zarogianis, Sotiris; Chan, Moong Chen; Foo, Marjorie

    2016-05-01

    Emotional distress is common in dialysis patients, but its role on clinical outcomes for patients on peritoneal dialysis (PD) is uncertain. To evaluate the effect of depression and anxiety on 1-year prognosis in PD patients. A total of N = 201 PD patients (58.9 ± 12.59 years) completed the Hospital Anxiety Depression Scale and measures of social support at baseline and were followed up for CC technique and actuarial patient survival. Mortality and technique failure rates were 9.9 and 5.97 %, respectively. Carer-assisted PD, anxiety, comorbid burden and albumin were significant univariate predictors. Multivariate proportional hazard model to adjust for confounders indicated that anxiety remained significant with HR of 2.145 [95 % CI 1.03, 4.49, p = 0.043] for death/technique failure. Anxiety is an important predictor of actuarial and technique survival in PD. Effective treatment for symptoms of anxiety may represent an easily achievable means of improving the clinical outcome of PD patients.

  15. Icodextrin increases technique survival rate in peritoneal dialysis patients with diabetic nephropathy by improving body fluid management: a randomized controlled trial.

    PubMed

    Takatori, Yuji; Akagi, Shigeru; Sugiyama, Hitoshi; Inoue, Junko; Kojo, Shoichiro; Morinaga, Hiroshi; Nakao, Kazushi; Wada, Jun; Makino, Hirofumi

    2011-06-01

    There are still controversies whether peritoneal dialysis (PD) with icodextrin preserves residual renal and peritoneal membrane functions in patients with diabetes. However, there are no randomized controlled and long-term clinical trials in newly started PD patients with diabetic nephropathy. Forty-one patients with diabetic nephropathy with ESRD were enrolled and randomly assigned to the glucose group (GLU) treated with 8 L of 1.5% or 2.5% glucose or an icodextrin group (ICO) treated with 1.5 or 2.0 L of 7.5% icodextrin-containing solutions. Technique failure, body fluid management, glucose and lipid metabolism, and residual renal and peritoneal functions and were evaluated over 2 years. The technique survival rate was 71.4% in ICO and 45.0% in GLU, with most of the technique failure due to volume overload. ICO showed significantly better cumulative technique survival. Net ultrafiltration volume was significantly higher in ICO throughout the study period. There were no beneficial effects of icodextrin on hemoglobin A1c, glycoalbumin, and lipid profile at 24 months. Urine volume and residual renal function declined faster in ICO, but there were no significant differences between the two groups. For peritoneal function, no differences were observed in dialysis-to-plasma creatinine ratios during the observation. In PD therapy for diabetic nephropathy, the use of icodextrin-containing solutions has a beneficial effect on technique survival, but there are no apparent benefits or disadvantages in residual renal and peritoneal functions compared with conventional PD with glucose solution.

  16. Icodextrin Increases Technique Survival Rate in Peritoneal Dialysis Patients with Diabetic Nephropathy by Improving Body Fluid Management: A Randomized Controlled Trial

    PubMed Central

    Takatori, Yuji; Akagi, Shigeru; Sugiyama, Hitoshi; Inoue, Junko; Kojo, Shoichiro; Morinaga, Hiroshi; Nakao, Kazushi; Makino, Hirofumi

    2011-01-01

    Summary Background and objectives There are still controversies whether peritoneal dialysis (PD) with icodextrin preserves residual renal and peritoneal membrane functions in patients with diabetes. However, there are no randomized controlled and long-term clinical trials in newly started PD patients with diabetic nephropathy. Design, setting, participants, & measurements Forty-one patients with diabetic nephropathy with ESRD were enrolled and randomly assigned to the glucose group (GLU) treated with 8 L of 1.5% or 2.5% glucose or an icodextrin group (ICO) treated with 1.5 or 2.0 L of 7.5% icodextrin-containing solutions. Technique failure, body fluid management, glucose and lipid metabolism, and residual renal and peritoneal functions and were evaluated over 2 years. Results The technique survival rate was 71.4% in ICO and 45.0% in GLU, with most of the technique failure due to volume overload. ICO showed significantly better cumulative technique survival. Net ultrafiltration volume was significantly higher in ICO throughout the study period. There were no beneficial effects of icodextrin on hemoglobin A1c, glycoalbumin, and lipid profile at 24 months. Urine volume and residual renal function declined faster in ICO, but there were no significant differences between the two groups. For peritoneal function, no differences were observed in dialysis-to-plasma creatinine ratios during the observation. Conclusions In PD therapy for diabetic nephropathy, the use of icodextrin-containing solutions has a beneficial effect on technique survival, but there are no apparent benefits or disadvantages in residual renal and peritoneal functions compared with conventional PD with glucose solution. PMID:21493740

  17. Effect of Tubal Sterilization Technique on Risk of Serous Ovarian and Primary Peritoneal Carcinoma

    PubMed Central

    LESSARD-ANDERSON, Collette R.; HANDLOGTEN, Kathryn S.; MOLITOR, Rochelle J.; DOWDY, Sean C.; CLIBY, William A.; WEAVER, Amy L.; SAUVER, Jennifer ST.; BAKKUM-GAMEZ, Jamie N.

    2014-01-01

    Objective To determine the effect of excisional tubal sterilization on subsequent development of serous epithelial ovarian cancer (EOC) or primary peritoneal cancer (PPC). Methods We performed a population-based, nested case-control study using the Rochester Epidemiology Project. We identified all patients with a diagnosis of serous EOC or PPC from 1966 through 2009. Each case was age-matched to 2 controls without either diagnosis. Odds ratios (ORs) and corresponding 95% CIs were estimated from conditional logistic regression models. Models were adjusted for prior hysterectomy, prior salpingo-oophorectomy, oral contraceptive use, endometriosis, infertility, gravidity, and parity. Results In total, we identified 194 cases of serous EOC and PPC during the study period and matched them with 388 controls (mean [SD] age, 61.4 [15.2] years). Fourteen cases (7.2%) and 46 controls (11.9%) had undergone tubal sterilization. Adjusted risk of serous EOC or PPC was slightly lower after any tubal sterilization (OR, 0.59 [95% CI, 0.29–1.17]; P=.13). The rate of excisional tubal sterilization was lower in cases than controls (2.6% vs 6.4%). Adjusted risk of serous EOC and PPC was decreased by 64% after excisional tubal sterilization (OR, 0.36 [95% CI, 0.13–1.02]; P=.054) compared with those without sterilization or with nonexcisional tubal sterilization. Conclusions We present a population-based investigation of the effects of excisional tubal sterilization on the risk of serous EOC and PPC. Excisional methods may confer greater risk reduction than other sterilization methods. PMID:25316178

  18. Nondestructive technique based on vibration measurements and piezoelectric patches for monitoring corrosion phenomena

    NASA Astrophysics Data System (ADS)

    Monaco, Ernesto; Fontana, Mauro; De Rosa, Luca; Bellucci, Francesco; Lecce, Leonardo

    2002-07-01

    The paper presents a new application of a NDT based on vibrations measurements which has been developed by the authors and already tested for analyzing damages of many structural elements. The proposed method is based on the acquisition and comparison of Frequency Response Functions (FRFs) of the monitored structure before and after a damage occurred. Structural damages modify the dynamical behavior of the structure and consequently its FRFs making possible to calculate a representative Damage Index. Main target of this work was to test the developed NDT for identifying and analyzing typical corrosive phenomena. A thin aluminium plate, typical for aeronautical employ, was chosen as test-article; an array of piezoelectric patches has been employed for both exciting the test article and acquiring the structural response in many points of it. Both homogeneous and localized corrosion phenomena have been recreated on the plate surface in laboratory environment. Two expressions of Damage Indices were calculated and statistically analyzed. Very small percentages of thickness variations have been detected and localized using the proposed methodology and it has been possible to follow corrosion dynamics (in terms of mass and stiffness variations of the test-article) by monitoring the values of the experimental Damage Indices.

  19. A novel adaptation of laparoscopic Tenckhoff catheter insertion technique to enhance catheter stability and function in automated peritoneal dialysis.

    PubMed

    Meier, Clemens M; Poppleton, Aaron; Fliser, Danilo; Klingele, Matthias

    2014-04-01

    Automated peritoneal dialysis (APD) normally takes place overnight. Maintaining a stable PD catheter position, independent of body position, omental wrapping or catheter displacement secondary to bowel movements is essential in maintaining effective catheter function. We developed a new procedure of catheter placement through combining and adapting several previously described operative techniques including laparoscopic placement of a curled double cuff Tenckhoff catheter with subcutaneous tunneling superior to the rectus sheet, an oblique course through the abdominal wall, deep entry into the pelvic peritoneum and directed placement of the curled tip within the pouch of Douglas. Retrospective analysis of catheter function was conducted, evaluating catheter position, function, complication rate and catheter survival against findings for current insertion techniques described within literature. Between March 2009 and November 2011, 54 patients underwent PD catheter insertion. The observation period was an average of 343 ± 273 days. All patients received abdominal plain film showing optimal catheter position in 89 %. Reported catheter function was very good in 85.2 %, with no or few alarms per week during APD, moderate in 9.3 % with occasional minor dysfunctions (≤ 2 alarms per night), and poor in 5.6 %, with regular alarm disturbance. In one case, primary dysfunction led to catheter replacement. At completion, stable catheter function with occasional minor dysfunction was achieved in 52 of 54 cases. Catheter-related complications (leakage, hydrocele formation, infection and need for replacement) were observed in 14.8 %. At the end of the observation period, 55.6 % of catheters remained in use. Patient dropout occurred through death (18.5 %), renal transplantation (7.4 %), renal recovery (1.9 %), removal secondary to infection or dysfunction (9.3 %) and conversion to HD due to poor dialysis quality (7.4 %). The above technique combines and optimises previously

  20. Relationship between uric acid and technique failure in patients on continuous ambulatory peritoneal dialysis: a long-term observational cohort study.

    PubMed

    Hsieh, Yao-Peng; Chang, Chia-Chu; Kor, Chew-Teng; Yang, Yu; Wen, Yao-Ko; Chiu, Ping-Fang; Lin, Chi-Chen

    2017-04-07

    Uric acid (UA) is the product of purine or nucleotide metabolism via the pathway of xanthine oxidase or xanthine dehydrogenase. Although epidemiological studies assessing the role of UA in cardiovascular disease or mortality have produced inconsistent results, the correlation between UA and technique failure in patients on continuous ambulatory peritoneal dialysis (CAPD) remains to be assessed. A retrospective cohort study. Patients starting CAPD between 2001 and 2009 in a single centre in Taiwan. A total of 371 patients on CAPD. All-cause and peritonitis-related technique failure. A cohort of 371 participants (43.9% male) was enrolled in the study with a mean age of 55.7±15.9 years at the start of CAPD. During the study period, technique failure occurred in 41 (34.4%) patients in the hyperuricaemia group compared with 49 (19.4%) in the normouricaemia group (p=0.003). In the multivariate Cox regression models, hyperuricaemia at baseline was significantly associated with both a higher risk of technique failure (HR 1.24; 95% CI 1.09 to 1.42, p=0.001) and peritonitis-related technique failure (HR 1.29; 95% CI 1.07 to 1.57, p=0.008). UA was shown to be associated with all-cause and peritonitis-related technique failure in our study. Patients on CAPD with hyperuricaemia should be closely monitored and strategies of increasing survival on CAPD should be taken. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Relationship between uric acid and technique failure in patients on continuous ambulatory peritoneal dialysis: a long-term observational cohort study

    PubMed Central

    Hsieh, Yao-Peng; Chang, Chia-Chu; Kor, Chew-Teng; Yang, Yu; Wen, Yao-Ko; Chiu, Ping-Fang; Lin, Chi-Chen

    2017-01-01

    Objectives Uric acid (UA) is the product of purine or nucleotide metabolism via the pathway of xanthine oxidase or xanthine dehydrogenase. Although epidemiological studies assessing the role of UA in cardiovascular disease or mortality have produced inconsistent results, the correlation between UA and technique failure in patients on continuous ambulatory peritoneal dialysis (CAPD) remains to be assessed. Design A retrospective cohort study. Setting Patients starting CAPD between 2001 and 2009 in a single centre in Taiwan. Participants A total of 371 patients on CAPD. Primary outcome measures All-cause and peritonitis-related technique failure. Results A cohort of 371 participants (43.9% male) was enrolled in the study with a mean age of 55.7±15.9 years at the start of CAPD. During the study period, technique failure occurred in 41 (34.4%) patients in the hyperuricaemia group compared with 49 (19.4%) in the normouricaemia group (p=0.003). In the multivariate Cox regression models, hyperuricaemia at baseline was significantly associated with both a higher risk of technique failure (HR 1.24; 95% CI 1.09 to 1.42, p=0.001) and peritonitis-related technique failure (HR 1.29; 95% CI 1.07 to 1.57, p=0.008). Conclusions UA was shown to be associated with all-cause and peritonitis-related technique failure in our study. Patients on CAPD with hyperuricaemia should be closely monitored and strategies of increasing survival on CAPD should be taken. PMID:28389481

  2. A new open anterior tension-free onlay patch technique for inguinofemoral hernia repair.

    PubMed

    Reyes-Devesa, Hugo Enrique; Martinez-Dejesús, Fermín; Martínez-Mier, Gustavo; Viñas-Dozal, Julio Cesar

    2005-07-01

    The high rate of misdiagnosed, coincident, or recurrent femoral hernias while or after mesh herniorrhaphy suggests its systematic search. We introduced a new open anterior tension-free mesh herniorrhaphy with a novel design. A description of the operative technique and patients demographics is presented. Two hundred sixty-eight hernias were repaired with this technique in a 5-year period. Two hundred twelve patients had a primary inguinal hernia. An unsuspected femoral hernia was discovered in 39 patients with a preoperatively diagnosed inguinal hernia. Operative time was 45 minutes, most patients were discharged in less than 24 hours, no recurrence has been noted, and minor complications were present. Most patients had minimal pain and returned to their normal activities within 10 days after surgery. This technique has the same advantages of open tension-free repairs, allows identification of femoral hernias, and protects a herniorrhaphy for recurrence.

  3. PATIENTS' AND RELATIVES' EXPERIENCES OF PERITONITIS WHEN USING PERITONEAL DIALYSIS.

    PubMed

    Baillie, Jessica; Lankshear, Annette

    2015-09-01

    Internationally, increasing numbers of patients are requiring treatment for end-stage kidney disease and greater use of peritoneal dialysis is thus being promoted. However, peritonitis can be a significant problem in this population. It is the leading cause of technique failure in patients using peritoneal dialysis and results in considerable morbidity and mortality. There is a dearth of research exploring patients' and their families' experiences of peritonitis. The aim of this paper is to explore patients' and their families' perspectives and experiences of peritonitis. An ethnographic study was conducted in 2011 in the United Kingdom. Sixteen patients and nine of their relatives were recruited through purposive and convenience sampling. In-depth interviews were undertaken with patients and their families, who were also observed using peritoneal dialysis in their homes. The data were analysed thematically using Wolcott's (1994) three-stage approach. This article describes four themes: learning about the risk of peritonitis; measures taken to prevent the infection; how participants monitored continuously for signs and symptoms of the infection; how they then identified and intervened once peritonitis was suspected. Overall, peritonitis was associated with fear and uncertainty, pain and learning from episodes of the infection. Overall, peritonitis was a distressing experience that participants sought to prevent. However, there was some confusion amongst participants about the signs and symptoms of the infection and further education for patients and their families is thus crucial. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  4. Viridans streptococci in peritoneal dialysis peritonitis: clinical courses and long-term outcomes.

    PubMed

    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

    2015-01-01

    The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear. We conducted a retrospective analysis of all PD patients in a single center with gram-positive cocci (GPC) peritonitis between 2005 and 2011, and divided them into 3 groups: VS, other streptococci and other GPC (apart from VS). Clinical characteristics and outcomes of the VS group were compared with the other streptococci and other GPC groups, with prognostic factors determined. A total of 140 patients with 168 episodes of GPC peritonitis (44% of all peritonitis) were identified over 7 years. Among these, 18 patients (13%) developed VS peritonitis, while 14 patients (10%) developed other streptococcal peritonitis. Patients with VS peritonitis had a high cure rate by antibiotic alone (94%), despite a high polymicrobial yield frequency (28%). We found that VS peritonitis carried a lower risk of Tenckhoff catheter removal and relapsing episodes than other GPC peritonitis (6% vs 11%), and a lower mortality than other streptococci peritonitis (0% vs 7%). However, after the index peritonitis episodes, VS, other streptococci, and other GPC group had a significantly increased peritonitis incidence compared with the period before the index peritonitis (all p < 0.01). Patients with VS peritonitis had a significantly higher incidence of refractory peritonitis compared with other streptococci or other GPC peritonitis in the long term (both p < 0.01). VS poses a higher risk of subsequent refractory peritonitis after the index episode as compared with other streptococcal or GPC peritonitis. It might be prudent to monitor the technique of these patients with VS peritonitis closely to avoid further peritonitis episodes. Copyright © 2015 International Society for Peritoneal Dialysis.

  5. Comparison of the radioiodinated serum albumin (RISA) dilution technique with direct volumetric measurements in animal models of peritoneal dialysis.

    PubMed

    Van Biesen, Wim; De Vriese, An S; Carlsson, Ola; Van Landschoot, Mike; Dheuvaert, Tomy; Lameire, Norbert H; Devriese, An S

    2002-01-01

    Rat models of peritoneal dialysis (PD) are useful for studying the physiology of peritoneal transport and evaluating new osmotic agents. Intraperitoneal (IP) solute concentrations and their evolution over time are easy to measure, but IP volume (IPV) is not. Direct volumetric measurements are the "gold standard:" but they are expensive and do not allow for repetitive measurements in the same animal. The Indicator dilution technique is therefore used as an alternative. However, that technique is based on assumptions that are not always valid. The present study compares direct volume measurement with the Indicator dilution technique [radioiodinated serum albumin (RISA)] to determine the IPV over time curves In a rat model of PD. In series 1, 17 Sprague-Dawley rats were instilled IP with 25 mL 1.36% glucose dialysate through a Teflon catheter. In 9 animals, 0.35 mL dialysate was sampled and discarded at time points 0, 3,15, 30, 60, 180, and 240 minutes. In the other 8 animals, no sampling was performed. At 240 minutes, all 12 animals were humanely killed, and direct volumetric measurements of IPV were performed. In series 2, rats were instilled IP with 25 mL 1.36% glucose dialysate containing 18.5 kBq 1311 RISA. In 9 animals, dialysate was sampled at 0, 3, 15, 30, 60, 90, 120,180, and 240 minutes for the construction of the RISA concentration-over-time curve, and to calculate the elimination constant Ke. At 30, 60, 180, and 240 minutes, dialysate was sampled in 6 different animals (total n = 24) to calculate IPV using the RISA dilution technique. Immediately afterward, the animals were humanely killed, and direct volumetric measurements of IPV were performed. In series 1, after 240 minutes' dwell time, the IPV was lower in the sampled animals as compared with the non sampled animals (27.11 +/- 1.85 mL vs 30.75 +/- 0.59 mL, p = 0.001). In series 2, the evolution of RISA activity in the dialysate over time was described by piecewise linear regression, yielding 3

  6. Patch-clamp techniques for time-resolved capacitance measurements in single cells.

    PubMed

    Lindau, M; Neher, E

    1988-02-01

    Two methods are described for estimation of passive cell parameters such as membrane capacitance, membrane conductance and access resistance in tight-seal whole cell recording. Both methods are restricted in their application to cases where the cell under study can be approximated by a simple three-component network with linear properties over some voltage range. One method, referred to as the time domain technique, requires only standard electrophysiological equipment and a computer. Parameters are derived from an analysis of capacitive transients during square wave stimulation. It is readily adaptable to wide variations in experimental parameters. Particularly, it is equally applicable to the "slow whole-cell" configuration (access resistance in the range 100 M omega to 1 G omega) and to normal whole-cell measurements (access resistance typically 10 M omega). The other method applies a sine wave command signal to the cell and employs a lock-in amplifier to analyse the resulting current signal. Two modes of operating the lock-in amplifier are described. One mode provides an output signal directly proportional to small changes in capacitance at maximum resolution (1-10 fF). The other mode, in conjunction with a digital computer, supplies estimates of all passive cell parameters, as does the time domain technique, but with a large amount of data reduction performed by the lock-in amplifier itself. Due to the special hardware, however, this method is not as flexible as the time domain technique.

  7. Peritoneal Dialysis–Related Peritonitis Due to Abiotrophia defectiva

    PubMed Central

    Shah, Nikhil; Naidu, Prenilla; Pauly, Robert P.

    2016-01-01

    Background: Abiotrophia defectiva is a fastidious aerobic gram-positive bacterium which is part of the normal flora of the human oral cavity. It is an unusual cause of peritoneal dialysis–related peritonitis. Case Presentation: We present a case of a man in his fifties with end-stage renal failure secondary to polycystic kidney disease who presented with a cloudy peritoneal fluid effluent and a cell count of 35 620 × 106 cells/L with 90% polymorphonuclear cells. The fluid was cultured per unit protocol, and the organism was identified as Abiotrophia defectiva. Post–peritonitis dialysis technique review revealed frequent lapses in the use of facemask and hand washing during cycler connection and disconnection. The patient responded well to vancomycin; however, he subsequently developed ultrafiltration failure and symptoms of fluid overload and uremia and was transferred to home hemodialysis. Conclusions: Abiotrophia defectiva is an unusual cause of peritoneal dialysis–related peritonitis. The organism is a normal commensal of the oral cavity and may cause peritonitis in patients with nonadherence to dialysis technique. In our case, the infection was followed by peritoneal membrane failure and transfer to hemodialysis. It remains to be seen if peritonitis with Abiotrophia defectiva heralds a worse outcome. PMID:28270927

  8. Peritoneal Dialysis

    MedlinePlus

    Peritoneal dialysis Overview By Mayo Clinic Staff Peritoneal dialysis (per-ih-toe-NEE-ul die-AL-uh-sis) is a way to remove waste products from your blood when your kidneys can no longer do the job adequately. A cleansing fluid flows through a tube (catheter) into part of your abdomen and filters waste ...

  9. A novel technique for studying F-region ionization patches with the Resolute Bay Incoherent Scatter Radar - North

    NASA Astrophysics Data System (ADS)

    Perry, G. W.; Hosokawa, K.; St-Maurice, J.; Shiokawa, K.

    2013-12-01

    The northward facing Resolute Bay Incoherent Scatter Radar - North (RISR-N) and the soon to be operational southward facing RISR-Canada (RISR-C) systems are both exceptional platforms for investigating F-region ionization patches and the polar ionosphere. To advance patch research using these systems, an algorithm has been developed for detecting F-region ionization patches with the RISR-N system. The algorithm is based on the definition of a patch put forward by Crowley [1996]: a volume of F-region plasma with a density that is twice that of the background ionosphere. In this work, the algorithm is applied to the sizeable RISR-N dataset, providing valuable insight into the prevalence of patches over Resolute Bay over a time frame of several years. Additional questions concerning patches are also addressed using the algorithm, including: when compared to each other, do the occurrence rates of patches identified by the Optical Mesosphere and Thermosphere Imagers (OMTI), Polar Dual Auroral Radar Network (PolarDARN) and RISR-N instruments (whose fields-of-view overlap over Resolute Bay) agree? Namely, for every patch that is detected with RISR-N and/or PolarDARN, is there a corresponding patch seen optically? Lastly, using the algorithm, is it possible to advance our ability to distinguish patches from other coherent backscatter echoes detected by PolarDARN? Crowley, G. (1996), Critical review of ionospheric patches and blobs, in Review of Radio Science: 1993-1996, edited by W. R. Stone, pp. 619 648, Oxford Univ. Press, Oxford, U. K.

  10. Viridans Streptococci in Peritoneal Dialysis Peritonitis: Clinical Courses and Long-Term Outcomes

    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

    2015-01-01

    ♦ Background: The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear. ♦ Methods: We conducted a retrospective analysis of all PD patients in a single center with gram-positive cocci (GPC) peritonitis between 2005 and 2011, and divided them into 3 groups: VS, other streptococci and other GPC (apart from VS). Clinical characteristics and outcomes of the VS group were compared with the other streptococci and other GPC groups, with prognostic factors determined. ♦ Results: A total of 140 patients with 168 episodes of GPC peritonitis (44% of all peritonitis) were identified over 7 years. Among these, 18 patients (13%) developed VS peritonitis, while 14 patients (10%) developed other streptococcal peritonitis. Patients with VS peritonitis had a high cure rate by antibiotic alone (94%), despite a high polymicrobial yield frequency (28%). We found that VS peritonitis carried a lower risk of Tenckhoff catheter removal and relapsing episodes than other GPC peritonitis (6% vs 11%), and a lower mortality than other streptococci peritonitis (0% vs 7%). However, after the index peritonitis episodes, VS, other streptococci, and other GPC group had a significantly increased peritonitis incidence compared with the period before the index peritonitis (all p < 0.01). Patients with VS peritonitis had a significantly higher incidence of refractory peritonitis compared with other streptococci or other GPC peritonitis in the long term (both p < 0.01). ♦ Conclusions: VS poses a higher risk of subsequent refractory peritonitis after the index episode as compared with other streptococcal or GPC peritonitis. It might be prudent to monitor the technique of these patients with VS peritonitis closely to avoid further peritonitis episodes. PMID:24497584

  11. [Analysis of mortality in acute diffuse peritonitis].

    PubMed

    Bondarev, V I; Tatarenko, L D; Golovnia, P F; Sviridov, N V

    1990-01-01

    The causes were studied and the analysis was performed of the lethality in 329 patients with acute diffuse peritonitis (ADP). The incidence of lethal outcome of ADP directly depended on the time of hospitalization, age of the patients, source of peritonitis, and as well on the technique of operative intervention. Progressive peritonitis caused death in 71 (92.2%) of 77 patients.

  12. [Peritoneal gliomatosis].

    PubMed

    Sánchez-Cifuentes, Angela; Gonzalez-Valverde, Francisco Miguel; Vicente-Ruiz, María; Peña-Ros, Emilio; Pastor-Quirante, Francisco; Albarracín-Marín-Blázquez, Antonio; Escamilla-Segade, Concepción

    2014-01-01

    Peritoneal gliomatosis is characterized by the presence of miliary implants of mature glia on the peritoneum of patients with ovarian teratomas, usually immature. We report the case of a woman operated on 5 years earlier due to a right mature ovarian teratoma. When she was operated on due to left ovarian tumor she presented a miliary glial dissemination in omentum and peritoneum. The association of peritoneal gliomatosis ovarian teratomas is rare. Although the primary treatment and patient monitoring is focused on the teratoma, control should be maintained of peritoneal implants because of the possibility of malignancy. We believe it would be beneficial to establish a protocol for monitoring these lesions.

  13. Determination of dextrose in peritoneal dialysis solution by localized surface plasmon resonance technique based on silver nanoparticles formation

    NASA Astrophysics Data System (ADS)

    Masrournia, Mahboube; Montazarolmahdi, Maliheh; Sani, Faramarz Aliasghari

    2017-07-01

    Determination of dextrose in peritoneal dialysis with a method based on silver nanoparticles (AgNPs) formation was investigated. In a green chemistry method, silver nanoparticles (AgNPs) were synthesized in the natural polymeric matrix of gelatin. The nanoparticles were characterized with UV-Vis spectroscopy and transmission electron microscopy (TEM). Absorbance signal of AgNPs could be applied to determine the various concentrations of dextrose solutions. Drop wise and ultrasonic methods were used and compared with each other. The dynamic range of methods with limit of detection and relative standard deviations were obtained. Results for real sample (peritoneal dialysis) were satisfied.

  14. New illumination technique for IR-video guided patch-clamp recording from neurons in slice cultures on biomembrane.

    PubMed

    Alix, Philippe; Winterer, Jochen; Müller, Wolfgang

    2003-09-30

    Slice cultures on biomembrane are the method of choice for studying Ca2+-dependent plastic changes occurring over several days to weeks. Using IR-differential interference contrast, good visualization of neurons in biomembrane slice cultures has been achieved despite a negative optical effect of the biomembrane, but epifluorescence imaging requires removal of a Wollaston prism and the analyzer. Here, we describe a novel illumination method to overcome this problem. Using optic fiber illumination at a shallow angle from the top of the slice culture, with or without additional illumination from the bottom, we obtained good cellular resolution of neurons in biomembrane slice cultures as well as in acute slices with an infrared-video camera. With this technique, we demonstrate visually guided whole-cell patch-clamp recording of Na+- and K+-currents as well as combination of whole-cell recording with fluorescence imaging of hippocampal and entorhinal cortex neurons in biomembrane slice cultures. Our inexpensive method should prove very useful for studying in vitro effects of long-term manipulations on membrane currents and intracellular Ca2+-signaling.

  15. Outcomes of single organism peritonitis in peritoneal dialysis: gram negatives versus gram positives in the Network 9 Peritonitis Study.

    PubMed

    Bunke, C M; Brier, M E; Golper, T A

    1997-08-01

    The use of the "peritonitis rate" in the management of patients undergoing peritoneal dialysis is assuming importance in comparing the prowess of facilities, care givers and new innovations. For this to be a meaningful outcome measure, the type of infection (causative pathogen) must have less clinical significance than the number of infections during a time interval. The natural history of Staphylococcus aureus, pseudomonas, and fungal peritonitis would not support that the outcome of an episode of peritonitis is independent of the causative pathogen. Could this concern be extended to other more frequently occurring pathogens? To address this, the Network 9 Peritonitis Study identified 530 episodes of single organism peritonitis caused by a gram positive organism and 136 episodes caused by a single non-pseudomonal gram negative (NPGN) pathogen. Coincidental soft tissue infections (exit site or tunnel) occurred equally in both groups. Outcomes of peritonitis were analyzed by organism classification and by presence or absence of a soft tissue infection. NPGN peritonitis was associated with significantly more frequent catheter loss, hospitalization, and technique failure and was less likely to resolve regardless of the presence or absence of a soft tissue infection. Hospitalization and death tended to occur more frequently with enterococcal peritonitis than with other gram positive peritonitis. The outcomes in the NPGN peritonitis group were significantly worse (resolution, catheter loss, hospitalization, technique failure) compared to coagulase negative staphylococcal or S. aureus peritonitis, regardless of the presence or absence of a coincidental soft tissue infection. Furthermore, for the first time, the poor outcomes of gram negative peritonitis are shown to be independent of pseudomonas or polymicrobial involvement or soft tissue infections. The gram negative organism appears to be the important factor. In addition, the outcome of peritonitis caused by S. aureus

  16. Peritoneal catheters and related infections.

    PubMed

    Thodis, Elias; Passadakis, Ploumis; Lyrantzopooulos, Nikolaos; Panagoutsos, Stelios; Vargemezis, Vassilis; Oreopoulos, Dimitrios

    2005-01-01

    Catheter related infectious complications (exit-site infections, tunnel infections, and peritonitis) remain the major reasons for technique failure during the three decades since, continuous ambulatory peritoneal dialysis (CAPD) treatment has been first established. Despite improvements in catheter's survival rates, catheter related complications result in an increase in the cumulative patients' morbidity and often leading to the catheter removal. The ideal catheter provides reliable and rapid dialysate flow rates without leaks or infections. Among several types, the double-cuff straight Tenckhoff catheter, developed in 1968, is still the most widely used, although its use is decreasing in favour of swanneck catheters. Although there are only few well-designed trials comparing catheters and catheters related infectious complications, controlling for all other important variables, no difference in these complications among the main types of catheters was seen. The single cuff catheters have been associated with a shorter survival rate and time to the first peritonitis episode than the double-cuff catheters. Also exit-site infections were found to be more frequent and significantly more resistant to treatment with single-cuff compared to double-cuff ones. Finally, better results have been reported with the latest developed presternal peritoneal dialysis catheter both regarding survival rates and exit-site infection and peritonitis rates. Recently a renewed interest in continuous flow peritoneal dialysis stimulated inventions of imaginative, double-lumen catheters since a suitable peritoneal access is a sine qua non condition for the development of this new technique of peritoneal dialysis.

  17. Influence of Surgical Technique, Performance Status, and Peritonitis Exposure on Surgical Site Infection in Acute Complicated Diverticulitis: A Matched Case-Control Study.

    PubMed

    Zonta, Sandro; De Martino, Michela; Podetta, Michele; Viganò, Jacopo; Dominioni, Tommaso; Picheo, Roberto; Cobianchi, Lorenzo; Alessiani, Mario; Dionigi, Paolo

    2015-10-01

    Acute generalized peritonitis secondary to complicated diverticulitis is a life-threatening condition; the standard treatment is surgery. Despite advances in peri-operative care, this condition is accompanied by a high peri-operative complication rate (22%-25%). No definitive evidence is available to recommend a preferred surgical technique in patients with Hinchey stage III/IV disease. A matched case-control study enrolling patients from four surgical units at Italian university hospital was planned to assess the most appropriate surgical treatment on the basis of patient performance status and peritonitis exposure, with the aim of minimizing the surgical site infection (SSI). A series of 1,175 patients undergoing surgery for Hinchey III/IV peritonitis in 2003-2013 were analyzed. Cases (n=145) were selected from among those patients who developed an SSI. control ratio was 1:3. Cases and control groups were matched by age, gender, body mass index, and Hinchey grade. We considered three surgical techniques: T1=Hartman's procedure; T2=sigmoid resection, anastomosis, and ileostomy; and T3=sigmoid resection and anastomosis. Six scoring systems were analyzed to assess performance status; subsequently, patients were divided into low, mild, and high risk (LR, MR, HR) according to the system producing the highest area under the curve. We classified peritonitis exposition as P1=<12 h; P2=12-24 h; P3=>24 h. Univariable and multivariable analyses were performed. The Apgar scoring system defined the risk groups according to performance status. Lowest SSI risk was expected when applying T3 in P1 (OR=0.22), P2 (OR=0.5) for LR and in P1 (OR=0.63) for MR; T2 in P2 (OR=0.5) in LR and in P1 (OR=0.61) in MR; T1 in P3 (OR=0.56) in LR; in P2 (OR=0.63) and P3 (OR=0.54) in MR patients, and in each P subgroup (OR=0.93;0.97;1.01) in HR. Pre-operative assessment based on Apgar scoring system integrated with peritonitis exposure in complicated diverticulitis may offer a ready-to-use tool

  18. F1FO ATPase vesicle preparation and technique for performing patch clamp recordings of submitochondrial vesicle membranes.

    PubMed

    Sacchetti, Silvio; Alavian, Kambiz N; Lazrove, Emma; Jonas, Elizabeth A

    2013-05-04

    Mitochondria are involved in many important cellular functions including metabolism, survival(1), development and, calcium signaling(2). Two of the most important mitochondrial functions are related to the efficient production of ATP, the energy currency of the cell, by oxidative phosphorylation, and the mediation of signals for programmed cell death(3). The enzyme primarily responsible for the production of ATP is the F1FO-ATP synthase, also called ATP synthase(4-5). In recent years, the role of mitochondria in apoptotic and necrotic cell death has received considerable attention. In apoptotic cell death, BCL-2 family proteins such as Bax enter the mitochondrial outer membrane, oligomerize and permeabilize the outer membrane, releasing pro-apoptotic factors into the cytosol(6). In classic necrotic cell death, such as that produced by ischemia or excitotoxicity in neurons, a large, poorly regulated increase in matrix calcium contributes to the opening of an inner membrane pore, the mitochondrial permeability transition pore or mPTP. This depolarizes the inner membrane and causes osmotic shifts, contributing to outer membrane rupture, release of pro-apoptotic factors, and metabolic dysfunction. Many proteins including Bcl-xL(7) interact with F1FO ATP synthase, modulating its function. Bcl-xL interacts directly with the beta subunit of F1FO ATP synthase, and this interaction decreases a leak conductance within the F1FOATPasecomplex, increasing the net transport of H+ by F1FO during F1FO ATPase activity(8) and thereby increasing mitochondrial efficiency. To study the activity and modulation of the ATP synthase, we isolated from rodent brain submitochondrial vesicles (SMVs) containing F1FO ATPase. The SMVs retain the structural and functional integrity of the F1FO ATPase as shown in Alavian et al. Here, we describe a method that we have used successfully for the isolation of SMVs from rat brain and we delineate the patch clamp technique to analyze channel activity (ion

  19. The Negative Impact of Early Peritonitis on Continuous Ambulatory Peritoneal Dialysis Patients

    PubMed Central

    Hsieh, Yao-Peng; Wang, Shu-Chuan; Chang, Chia-Chu; Wen, Yao-Ko; Chiu, Ping-Fang; Yang, Yu

    2014-01-01

    ♦ Background: Peritonitis rate has been reported to be associated with technique failure and overall mortality in previous literatures. However, information on the impact of the timing of the first peritonitis episode on continuous ambulatory peritoneal dialysis (CAPD) patients is sparse. The aim of this research is to study the influence of time to first peritonitis on clinical outcomes, including technique failure, patient mortality and dropout from peritoneal dialysis (PD). ♦ Methods: A retrospective observational cohort study was conducted over 10 years at a single PD unit in Taiwan. A total of 124 patients on CAPD with at least one peritonitis episode comprised the study subjects, which were dichotomized by the median of time to first peritonitis into either early peritonitis patients or late peritonitis patients. Cox proportional hazard model was used to analyze the correlation of the timing of first peritonitis with clinical outcomes. ♦ Results: Early peritonitis patients were older, more diabetic and had lower serum levels of creatinine than the late peritonitis patients. Early peritonitis patients were associated with worse technique survival, patient survival and stay on PD than late peritonitis patients, as indicated by Kaplan-Meier analysis (log-rank test, p = 0.04, p < 0.001, p < 0.001, respectively). In the multivariate Cox regression model, early peritonitis was still a significant predictor for technique failure (hazard ratio (HR), 0.54; 95% confidence interval (CI), 0.30 - 0.98), patient mortality (HR, 0.34; 95% CI, 0.13 - 0.92) and dropout from PD (HR, 0.50; 95% CI, 0.30 - 0.82). In continuous analyses, a 1-month increase in the time to the first peritonitis episode was associated with a 2% decreased risk of technique failure (HR, 0.98; 95% CI, 0.97 - 0.99), a 3% decreased risk of patient mortality (HR, 0.97; 95% CI, 0.95 - 0.99), and a 2% decreased risk of dropout from PD (HR, 98%; 95% CI, 0.97 - 0.99). Peritonitis rate was inversely

  20. Citrobacter Peritoneal Dialysis Peritonitis: Rare Occurrence with Poor Outcomes

    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

    2013-01-01

    Introduction: Non-Pseudomonas gram-negative bacteria are responsible for an increasing proportion of cases of peritoneal dialysis (PD)-related peritonitis. The role of Citrobacter species in the etiology of PD-related peritonitis is often underestimated. In the present study, we aimed to describe the clinical features, laboratory findings, and short- and long-term outcomes in PD-related peritonitis caused by Citrobacter. Methods: A retrospective review of all episodes of PD-related peritonitis caused by Citrobacter from a single center between 1990 and 2010 was performed. Clinical features, microbiological data, and outcomes of these episodes were analyzed. Results: Citrobacter species was responsible for 11 PD-related episodes (1.8% of all peritonitis episodes) in 8 patients. Citrobacter freundii was the most common etiologic species (73%), and mixed growth was found in the other 3 episodes (27%). Approximately half (46%) of the episodes were associated with constipation and/or diarrhea. Of the Citrobacter isolates from all episodes, 54% were resistant to cefazolin, and only 18% were susceptible to cefmetazole. All isolates were susceptible to ceftazidime, cefepime, carbapenem, and aminoglycosides. More than half of the patients (54%) were hospitalized for index peritonitis, and 27% of the episodes involved a change in antibiotic medication. One patient had relapsing peritonitis caused by C. koseri (9%). The mortality rate of PD-related peritonitis caused by Citrobacter was 18%, and 89% of surviving patients developed technique failure requiring a modality switch after an average of 12 months of follow-up (range 1.2-31.2 months). Conclusion: PD-related peritonitis caused by Citrobacter is associated with poor outcomes, including high rates of antibiotic resistance, a high mortality rate, and a high rate of technique failure among survivors during the follow-up period. PMID:23869184

  1. Pathophysiological Changes to the Peritoneal Membrane during PD-Related Peritonitis: The Role of Mesothelial Cells

    PubMed Central

    Yung, Susan; Chan, Tak Mao

    2012-01-01

    The success of peritoneal dialysis (PD) is dependent on the structural and functional integrity of the peritoneal membrane. The mesothelium lines the peritoneal membrane and is the first line of defense against chemical and/or bacterial insult. Peritonitis remains a major complication of PD and is a predominant cause of technique failure, morbidity and mortality amongst PD patients. With appropriate antibiotic treatment, peritonitis resolves without further complications, but in some PD patients excessive peritoneal inflammatory responses lead to mesothelial cell exfoliation and thickening of the submesothelium, resulting in peritoneal fibrosis and sclerosis. The detrimental changes in the peritoneal membrane structure and function correlate with the number and severity of peritonitis episodes and the need for catheter removal. There is evidence that despite clinical resolution of peritonitis, increased levels of inflammatory and fibrotic mediators may persist in the peritoneal cavity, signifying persistent injury to the mesothelial cells. This review will describe the structural and functional changes that occur in the peritoneal membrane during peritonitis and how mesothelial cells contribute to these changes and respond to infection. The latter part of the review discusses the potential of mesothelial cell transplantation and genetic manipulation in the preservation of the peritoneal membrane. PMID:22577250

  2. Peritoneal Dialysis

    PubMed Central

    Al-Natour, Mohammed; Thompson, Dustin

    2016-01-01

    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

  3. 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

  4. Predictors of Peritonitis and the Impact of Peritonitis on Clinical Outcomes of Continuous Ambulatory Peritoneal Dialysis Patients in Taiwan—10 Years’ Experience in a Single Center

    PubMed Central

    Hsieh, Yao-Peng; Chang, Chia-Chu; Wen, Yao-Ko; Chiu, Ping-Fang; Yang, Yu

    2014-01-01

    ♦ Objective: Peritoneal dialysis (PD) has become more prevalent as a treatment modality for end-stage renal disease, and peritonitis remains one of its most devastating complications. The aim of the present investigation was to examine the frequency and predictors of peritonitis and the impact of peritonitis on clinical outcomes. ♦ Methods: Our retrospective observational cohort study enrolled 391 patients who had been treated with continuous ambulatory PD (CAPD) for at least 90 days. Relevant demographic, biochemical, and clinical data were collected for an analysis of CAPD-associated peritonitis, technique failure, drop-out from PD, and patient mortality. ♦ Results: The peritonitis rate was 0.196 episodes per patient-year. Older age (>65 years) was the only identified risk factor associated with peritonitis. A multivariate Cox regression model demonstrated that technique failure occurred more often in patients experiencing peritonitis than in those free of peritonitis (p < 0.001). Kaplan-Meier analysis revealed that the group experiencing peritonitis tended to survive longer than the group that was peritonitis-free (p = 0.11). After multivariate adjustment, the survival advantage reached significance (hazard ratio: 0.64; 95% confidence interval: 0.46 to 0.89; p = 0.006). Compared with the peritonitis-free group, the group experiencing peritonitis also had more drop-out from PD (p = 0.03). ♦ Conclusions: The peritonitis rate was relatively low in the present investigation. Elderly patients were at higher risk of peritonitis episodes. Peritonitis independently predicted technique failure, in agreement with other reports. However, contrary to previous studies, all-cause mortality was better in patients experiencing peritonitis than in those free of peritonitis. The underlying mechanisms of this presumptive “peritonitis paradox” remain to be clarified. PMID:24084840

  5. A study of the bovine adrenal chromaffin nicotinic receptor using patch clamp and concentration-jump techniques.

    PubMed Central

    Maconochie, D J; Knight, D E

    1992-01-01

    1. Voltage clamp records have been obtained from bovine adrenal chromaffin cells in the outside-out and whole-cell configurations, in response to step changes of acetylcholine (ACh) concentration. The concentrations used ranged from 50 nM to 20 mM. 2. At high acetylcholine concentrations, the activation and desensitization kinetics of the nicotinic receptor, as observed in outside-out patches, may be described by a model incorporating a single, fast agonist binding step, and relatively slow isomerization to the open state. The affinity of the closed receptor for ACh is 310 microM, the channel opening rate constant is 460 s-1, and the closing rate constant is 29 s-1. 3. Single channel events, observed when nanomolar ACh concentrations are applied to whole cells, have two distinct channel lifetimes: 0.6 ms and 11-15 ms. The variation of the frequencies of the events with ACh concentration, suggests that the short lifetimes are openings of a singly liganded receptor and the longer lifetimes are openings of a doubly liganded receptor. 4. Only a single exponential associated with receptor desensitization is seen with outside-out patches, but two are seen with whole cells. It is postulated that there are two nicotinic receptor types present on adrenal chromaffin cells. 5. The rate of desensitization (9 s-1 and 26 s-1, whole cells; 24 s-1, patches), is fast enough to be significant in determining the open channel lifetime. 6. A sudden increase in current (rebound) is observed when a high concentration of ACh is abruptly removed from outside-out patches. This is evidence for a blocked state. The affinity of the blocking site for ACh is 1400 microM (outside-out patches). 7. The total number of activatable nicotinic channels per whole cell is estimated to be 2600. PMID:1282154

  6. Evaluation of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in cases of invasive bladder cancer complicated by peritoneal metastasis

    PubMed Central

    LIU, ZAN; TIAN, QIUYE; XIA, SHUNYAO; YIN, HUAIFU; YAO, DAYONG; XIU, YOUCHENG

    2016-01-01

    Radical cystectomy, as the most common surgical treatment for patients with invasive bladder cancer (IBC) complicated by peritoneal metastasis, is usually accompanied by a urinary diversion procedure. In this study, we evaluated the improved tubeless cutaneous ureterostomy technique by comparing the resulting clinical effects with either a traditional ureterostomy and an ileal conduit urinary diversion. Clinical data from 85 patients who underwent 1 of the 3 procedures between April 2012 and April 2015 were analyzed retrospectively. In total, 30 patients underwent improved tubeless cutaneous ureterostomy, 28 patients underwent a traditional cutaneous ureterostomy and 27 underwent an ileal conduit urinary diversion following radical cystectomy. The incidence of complications, including stoma infection, nipple atrophy, terminal necrosis, urine leakage, external orifice stenosis, uronephrosis and ureterectasia in the group of patients treated with the improved tubeless ureterostomy technique was significantly lower than that of the patients in the other 2 groups, and the difference was statistically significant (P<0.05). In addition, the duration of the surgery, intra-operative bleeding, the duration of the hospitalization period and the time to extubation in the patients treated with the improved tubeless ureterostomy technique were significantly decreased (P<0.05) compared with the patients in the other 2 groups. Finally, the health-related quality of life of the patients treated with the improved tubeless ureterostomy technique was significantly higher (P<0.05) than that of the patients in the other 2 groups. The findings of our study demonstrated that the use of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in patients with IBC complicated by peritoneal metastasis resulted in improved clinical effects. Thus, improved tubeless cutaneous ureterostomy may be a promising alternative for enhancing the quality of life of patients

  7. Risk factors and outcomes of high peritonitis rate in continuous ambulatory peritoneal dialysis patients

    PubMed Central

    Tian, Yuanshi; Xie, Xishao; Xiang, Shilong; Yang, Xin; Zhang, Xiaohui; Shou, Zhangfei; Chen, Jianghua

    2016-01-01

    Abstract Peritonitis remains a major complication of peritoneal dialysis (PD). A high peritonitis rate (HPR) affects continuous ambulatory peritoneal dialysis (CAPD) patients’ technique survival and mortality. Predictors and outcomes of HPR, rather than the first peritonitis episode, were rarely studied in the Chinese population. In this study, we examined the risk factors associated with HPR and its effects on clinical outcomes in CAPD patients. This is a single center, retrospective, observational cohort study. A total of 294 patients who developing at least 1 episode of peritonitis were followed up from March 1st, 2002, to July 31, 2014, in our PD center. Multivariate logistic regression was used to determine the factors associated with HPR, and the Cox proportional hazard model was conducted to assess the effects of HPR on clinical outcomes. During the study period of 2917.5 patient-years, 489 episodes of peritonitis were recorded, and the total peritonitis rate was 0.168 episodes per patient-year. The multivariate analysis showed that factors associated with HPR include a quick occurrence of peritonitis after CAPD initiation (shorter than 12 months), and a low serum albumin level at the start of CAPD. In the Cox proportional hazard model, HPR was a significant predictor of technique failure. There were no differences between HPR and low peritonitis rate (LPR) group for all-cause mortality. However, when the peritonitis rate was considered as a continuous variable, a positive correlation was observed between the peritonitis rate and mortality. We found the quick peritonitis occurrence after CAPD and the low serum albumin level before CAPD were strongly associated with an HPR. Also, our results verified that HPR was positively correlated with technique failure. More importantly, the increase in the peritonitis rate suggested a higher risk of all-cause mortality. These results may help to identify and target patients who are at higher risk of HPR at the start

  8. Sperm Patch-Clamp

    PubMed Central

    Lishko, Polina; Clapham, David E.; Navarro, Betsy; Kirichok, Yuriy

    2014-01-01

    Sperm intracellular pH and calcium concentration ([Ca2+]i) are two central factors that control sperm activity within the female reproductive tract. As such, the ion channels of the sperm plasma membrane that alter intracellular sperm [Ca2+] and pH play important roles in sperm physiology and the process of fertilization. Indeed, sperm ion channels regulate sperm motility, control sperm chemotaxis toward the egg in some species, and may trigger the acrosome reaction. Until recently, our understanding of these important molecules was rudimentary due to the inability to patch-clamp spermatozoa and directly record the activity of these ion channels under voltage clamp. Recently, we overcame this technical barrier and developed a method for reproducible application of the patch-clamp technique to mouse and human spermatozoa. This chapter covers important aspects of application of the patch-clamp technique to spermatozoa, such as selection of the electrophysiological equipment, isolation of spermatozoa for patch-clamp experiments, formation of the gigaohm seal with spermatozoa, and transition into the whole-cell mode of recording. We also discuss potential pitfalls in application of the patch-clamp technique to flagellar ion channels. PMID:23522465

  9. Genetic Polymorphisms and Peritoneal Membrane Function

    PubMed Central

    Siddique, Imad; Brimble, K. Scott; Walkin, Louise; Summers, Angela; Brenchley, Paul; Herrick, Sarah; Margetts, Peter J.

    2015-01-01

    ♦ Background: Outcomes for peritoneal dialysis (PD) patients are affected by the characteristics of the peritoneal membrane, which may be determined by genetic variants. We carried out a systematic review of the literature to identify studies which assessed the association between genetic polymorphisms, peritoneal membrane solute transport, and clinical outcomes for PD patients. ♦ Methods: The National Library of Medicine was searched using a variety of strategies. Studies which met our inclusion criteria were reviewed and data abstracted. Our outcomes of interest included: high transport status peritoneal membrane, risk for peritonitis, encapsulating peritoneal sclerosis (EPS), patient and technique survival. We combined data from studies which evaluated the same genetic polymorphism and the same outcome. ♦ Results: We evaluated 18 relevant studies. All studies used a candidate gene approach. Gene polymorphisms in the interleukin (IL)-6 gene were associated with peritoneal membrane solute transport in several studies in different ethnic populations. Associations with solute transport and polymorphisms in endothelial nitric oxide synthase and receptor for advanced glycation end product genes were also identified. There was evidence of a genetic predisposition for peritonitis found in 2 studies, and for EPS in 1 study. Survival was found to be associated with a polymorphism in vascular endothelial growth factor and technique failure was associated with a polymorphism in the IL-1 receptor antagonist. ♦ Conclusions: There is evidence that characteristics of the peritoneal membrane and clinical outcomes for PD patients have genetic determinants. The most consistent association was between IL-6 gene polymorphisms and peritoneal membrane solute transport. PMID:25395500

  10. [Application of recording SK2 current in human atrial myocytes by perforated patch clamp techniques with the mix of beta-escin and amphotericin B].

    PubMed

    Wang, Hua; Li, Tao; Lei, Ming; Li, Miao-ling; Ding, Yin-yuan; Yang, Yan; Zeng, Xiao-rong

    2012-05-01

    To establish a perforated patch-clamp technology with amphotericin B and beta-escin and to research the regulation of small conductance calcium-activated potassium channel SK2 currents by calcium ions. Single human atrial myocytes were enzymatically isolated from the right atrial appendage. Amphotericin B and / or beta-escin were used by perforated electrode liquid. The regulation of SK2 current by calcium ions in human atrial myocytes was performed with the perforated patch-clamp technique. The intracellular calcium changes were measured by the intracellular calcium test system. Mixed perforated electrode liquid compared with 150 microg/ml amphotericin B or 6.88 microg/ml beta-escin alone, it was easy to seal cells and activate SK2 current by the former method. Moreover, the ration of F340/380 was consistent with the change of intracellular free calcium ion concentration increase after the formation of perforation. The ration of F340/380 was measured by intracellular calcium test system. The appropriate concentration of amphotericin B mixed with beta-escin can form a stable whole-cell patch recording technology that is appropriate for the research of SK2 current regulation by intracellular calcium.

  11. Automated patch-clamp technique: increased throughput in functional characterization and in pharmacological screening of small-conductance Ca2+ release-activated Ca2+ channels.

    PubMed

    Schrøder, Rikke L; Friis, Søren; Sunesen, Morten; Mathes, Chris; Willumsen, Niels J

    2008-08-01

    The suitability of an automated patch clamp for the characterization and pharmacological screening of calcium release-activated calcium (CRAC) channels endogenously expressed in RBL-2H3 cells was explored with the QPatch system. CRAC currents (I( CRAC)) are small, and thus precise recordings require high signal-to-noise ratios obtained by high seal resistances. Automated whole-cell establishment resulted in membrane resistances of 1728 +/- 226 MOmega (n = 44). CRAC channels were activated by a number of methods that raise intracellular calcium concentration, including EGTA, ionomycin, Ins(1,4,5)P3, and thapsigargin. I(CRAC) whole-cell currents ranged from 30 to 120 pA with rise times of 40 to 150 s. An initial delay in current activation was observed in particular when I(CRAC) was activated by passive store depletion using EGTA. Apparent rundown of I(CRAC) was commonly observed, and the current could be reactivated by subsequent addition of thapsigargin. I(CRAC) was blocked by SKF-96365 and 2-APB with IC50 values of 4.7 +/- 1.1 microM (n = 9) and 7.5 +/- 0.7 (n = 9) microM, respectively. The potencies of these blockers were similar to values reported for I(CRAC) in similar conventional patch-clamp experiments. The study demonstrates that CRAC channels can be rapidly and efficiently targeted with automated patch-clamp techniques for characterization of physiological and pharmacological properties.

  12. PERITONEAL ABSORPTION

    PubMed Central

    Hahn, P. F.; Miller, L. L.; Robscheit-Robbins, F. S.; Bale, W. F.; Whipple, G. H.

    1944-01-01

    The absorption of red cells from the normal peritoneum of the dog can be demonstrated by means of red cells labeled with radio-iron incorporated in the hemoglobin of these red cells. Absorption in normal dogs runs from 20 to 100 per cent of the amount given within 24 hours. Dogs rendered anemic by bleeding absorb red cells a little less rapidly—ranging from 5 to 80 per cent of the injected red cells. Doubly depleted dogs (anemic and hypoproteinemic) absorb even less in the three experiments recorded. This peritoneal absorption varies widely in different dogs and even in the same dog at different times. We do not know the factors responsible for these variations but there is no question about active peritoneal absorption. The intact red cells pass readily from the peritoneal cavity into lymph spaces in diaphragm and other areas of the peritoneum. The red cells move along the lymphatics and through the lymph glands with little or no phagocytosis and eventually into the large veins through the thoracic ducts. PMID:19871404

  13. Peritoneal carcinomatosis

    PubMed Central

    Coccolini, Federico; Gheza, Federico; Lotti, Marco; Virzì, Salvatore; Iusco, Domenico; Ghermandi, Claudio; Melotti, Rita; Baiocchi, Gianluca; Giulini, Stefano Maria; Ansaloni, Luca; Catena, Fausto

    2013-01-01

    Several gastrointestinal and gynecological malignancies have the potential to disseminate and grow in the peritoneal cavity. The occurrence of peritoneal carcinomatosis (PC) has been shown to significantly decrease overall survival in patients with liver and/or extraperitoneal metastases from gastrointestinal cancer. During the last three decades, the understanding of the biology and pathways of dissemination of tumors with intraperitoneal spread, and the understanding of the protective function of the peritoneal barrier against tumoral seeding, has prompted the concept that PC is a loco-regional disease: in absence of other systemic metastases, multimodal approaches combining aggressive cytoreductive surgery, intraperitoneal hyperthermic chemotherapy and systemic chemotherapy have been proposed and are actually considered promising methods to improve loco-regional control of the disease, and ultimately to increase survival. The aim of this review article is to present the evidence on treatment of PC in different tumors, in order to provide patients with a proper surgical and multidisciplinary treatment focused on optimal control of their locoregional disease. PMID:24222942

  14. TWEAK Promotes Peritoneal Inflammation

    PubMed Central

    Sanz, Ana Belen; Aroeira, Luiz Stark; Bellon, Teresa; del Peso, Gloria; Jimenez-Heffernan, Jose; Santamaria, Beatriz; Sanchez-Niño, Maria Dolores; Blanco-Colio, Luis Miguel; Lopez-Cabrera, Manuel; Ruiz-Ortega, Marta; Egido, Jesus; Selgas, Rafael; Ortiz, Alberto

    2014-01-01

    Peritoneal dialysis (PD) is complicated by peritonitis episodes that cause loss of mesothelium and eventually sclerosing peritonitis. An improved understanding of the molecular contributors to peritoneal injury and defense may increase the therapeutic armamentarium to optimize peritoneal defenses while minimizing peritoneal injury. There is no information on the expression and function of the cytokine TWEAK and its receptor Fn14 during peritoneal injury. Fn14 expression and soluble TWEAK levels were measured in human PD peritoneal effluent cells or fluids with or without peritonitis. Fn14 expression was also analyzed in peritoneal biopsies from PD patients. Actions of intraperitoneal TWEAK were studied in mice in vivo. sTWEAK levels were increased in peritoneal effluent in PD peritonitis. Effluent sTWEAK levels correlated with the number of peritoneal macrophages (r = 0.491, p = 0.002). Potential TWEAK targets that express the receptor Fn14 include mesothelial cells and macrophages, as demonstrated by flow cytometry of peritoneal effluents and by analysis of peritoneal biopsies. Peritoneal biopsy Fn14 correlated with mesothelial injury, fibrosis and inflammation, suggesting a potential deleterious effect of TWEAK/Fn14. In this regard, intraperitoneal TWEAK administration to mice promoted peritoneal inflammation characterized by increased peritoneal effluent MCP-1, Fn14 and Gr1+ macrophages, increased mesothelial Fn14, MCP-1 and CCL21 expression and submesothelial tissue macrophage recruitment. Taken together these data suggest that the TWEAK/Fn14 system may promote inflammation and tissue injury during peritonitis and PD. PMID:24599047

  15. 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

  16. The NLRP3 Inflammasome Has a Critical Role in Peritoneal Dialysis-Related Peritonitis.

    PubMed

    Hautem, Nicolas; Morelle, Johann; Sow, Amadou; Corbet, Cyril; Feron, Olivier; Goffin, Eric; Huaux, François; Devuyst, Olivier

    2017-07-01

    Bacterial peritonitis remains the main cause of technique failure in peritoneal dialysis (PD). During peritonitis, the peritoneal membrane undergoes structural and functional alterations that are mediated by IL-1β The NLRP3 inflammasome is a caspase-1-activating multiprotein complex that links sensing of microbial and stress products to activation of proinflammatory cytokines, including IL-1β The potential roles of the NLRP3 inflammasome and IL-1β in the peritoneal membrane during acute peritonitis have not been investigated. Here, we show that the NLRP3 inflammasome is activated during acute bacterial peritonitis in patients on PD, and this activation associates with the release of IL-1β in the dialysate. In mice, lipopolysaccharide- or Escherichia coli-induced peritonitis led to IL-1β release in the peritoneal membrane. The genetic deletion of Nalp3, which encodes NLRP3, abrogated defects in solute transport during acute peritonitis and restored ultrafiltration. In human umbilical vein endothelial cells, IL-1β treatment directly enhanced endothelial cell proliferation and increased microvascular permeability. These in vitro effects require endothelial IL-1 receptors, shown by immunofluorescence to be expressed in peritoneal capillaries in mice. Furthermore, administration of the IL-1β receptor antagonist, anakinra, efficiently decreased nitric oxide production and vascular proliferation and restored peritoneal function in mouse models of peritonitis, even in mice treated with standard-of-care antibiotherapy. These data demonstrate that NLRP3 activation and IL-1β release have a critical role in solute transport defects and tissue remodeling during PD-related peritonitis. Blockade of the NLRP3/IL-1β axis offers a novel method for rescuing morphologic alterations and transport defects during acute peritonitis. Copyright © 2017 by the American Society of Nephrology.

  17. Mini-Open Suture Bridge Repair with Porcine Dermal Patch Augmentation for Massive Rotator Cuff Tear: Surgical Technique and Preliminary Results

    PubMed Central

    Lee, Sung-Moon; Lee, Young-Kuk; Shin, Hong-Kwan

    2014-01-01

    Background The aim of this study was to describe the mini-open suture bridge technique with porcine dermal patch augmentation for massive rotator cuff tear and to assess preliminary clinical and radiological results. Methods Five patients with massive rotator cuff tear for which it was not possible to restore the anatomical footprint underwent mini-open suture bridge repair using a porcine dermal patch. The patients' average age was 53.4 years (range, 45 to 57 years), and the average duration of follow-up was 20.6 months (range, 14 to 26 months). Patients were evaluated with preoperative and postoperative outcome measures, including a visual analog scale (VAS) for pain, the University of California Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons (ASES) score. The structural integrity of repaired rotator cuffs was assessed by magnetic resonance imaging 6 months postoperatively. Results The average VAS pain score, UCLA score, and ASES score improved from 6.8, 15.4, and 39.4 preoperatively to 0.8, 31.2, and 86.4 postoperatively (p = 0.041, 0.042, and 0.043, respectively). Magnetic resonance images obtained at an average of 8 months after surgery showed that four patients had intact repair integrity with graft incorporation. One patient had a re-tear with partial healing but still had a satisfactory clinical outcome. There was no intraoperative or postoperative complication in any patient. Conclusions Mini-open suture bridge repair with porcine dermal patch augmentation can be an option in young patients with high physical demands and massive rotator cuff tears for which it is not possible to restore the anatomical footprint. PMID:25177460

  18. Recent advances in the management of peritoneal dialysis patients

    PubMed Central

    2015-01-01

    Peritoneal dialysis is a form of kidney dialysis that is used to remove accumulated metabolic waste products and water in patients with end stage kidney disease. Long-term exposure to high concentrations of glucose and its by-products, both found in peritoneal dialysis fluid, has been implicated in contributing to peritoneal damage over time, in turn limiting long-term use of the technique. Newer peritoneal dialysis solutions have been developed in the hope of reducing the unfavorable effects of peritoneal dialysis solutions. In vitro and in vivo studies have suggested that newer peritoneal dialysis fluids have salutary effects on the peritoneal membrane. Short-term clinical studies have also found some metabolic benefits of glucose-sparing regimens in chronic peritoneal dialysis. Mixed results have been found in studies examining whether newer peritoneal dialysis fluids reduce peritonitis rates. Long-term studies are needed to investigate whether newer peritoneal dialysis fluids provide better peritoneal dialysis technique and/or patient survival, compared to standard glucose-based peritoneal dialysis fluids. PMID:26097730

  19. Peritoneal dialysis outcomes after temporary haemodialysis transfer for peritonitis.

    PubMed

    Cho, Yeoungjee; Badve, Sunil V; Hawley, Carmel M; McDonald, Stephen P; Brown, Fiona G; Boudville, Neil; Clayton, Philip; Johnson, David W

    2014-10-01

    There has not been a comprehensive examination to date of peritoneal dialysis (PD) outcomes after temporary haemodialysis (HD) transfer for peritonitis. The study included all incident Australian patients who experienced peritonitis between 1 October 2003, and 31 December 2011, using Australia and New Zealand Dialysis and Transplant Registry data. Patients were grouped into three categories: Interim HD, Permanent HD and Never HD based on HD transfer status after the first peritonitis. The independent predictors of HD transfer and subsequent return to PD were determined by multivariable, multilevel mixed-effects logistic regression analysis. Matched case-control analyses were performed to compare clinical outcomes (e.g. patient survival) between groups. Of the 3305 patients who experienced peritonitis during the study period, 553 episodes (16.7%) resulted in transfer to HD and 101 patients subsequently returned to PD. HD transfer was significantly and independently predicted by inpatient treatment of peritonitis [odds ratio (OR) 11.45, 95% confidence interval (CI) 7.14-18.36] and the recovered microbiologic profile of organisms recognized to be associated with moderate (20-40%) to high (>40%) rates of catheter removal (moderate: OR 2.45, 95% CI 1.89-3.17; high: OR 8.63, 95% CI 6.44-11.57). Matched case-control analyses yielded comparable results among Interim, Permanent and Never HD groups in terms of patient survival (P = 0.28), death-censored technique survival [hazard ratio (HR) 0.87, 95% CI 0.59-1.28; P = 0.48] and peritonitis-free survival (HR 0.84, 95% CI 0.50-1.39, P = 0.49). In an observational registry study of first peritonitis episodes, temporary HD transfer was not associated with inferior patient-level clinical outcomes when compared with others who either never required HD transfer or remained on HD permanently if all patient-level and peritonitis-related factors were considered equal. Therefore, return to PD after a temporary HD due to peritonitis

  20. Luminal non-specific cationic channels in cultured strial marginal cells of guinea pig and gerbil as determined by patch clamp technique.

    PubMed

    Liu, D S; Achouche, J; Wu, A H; Trotier, D; Tran Ba Huy, P

    1991-01-01

    Using primary cultures of marginal cells of stria vascularis from guinea pig and gerbil, ionic channels located on the luminal membrane were investigated by means of patch clamp technique. Recordings were performed in cell-attached and inside-out configurations. In cell-attached configuration, single channel activity was identified with a conductance of about 25 pS. I-V curve was linear. The probability of opening was increased upon depolarization. Up to 7 channels could be present in the same patch, indicating a rather high density. In inside-out configuration, the reversal potential was 0 mV, suggesting a non-specific cationic channel. These luminal non-specific cationic channels would allow the passive K+ efflux and Na+ influx across the apical membrane of marginal cells. This finding is consistent with the "one-pump" model of strial activity. The present study suggests that culture of strial marginal cells may be a suitable model for in-depth investigation of endolymph physiology.

  1. Role of peritoneal absorption in ascites.

    PubMed

    Luttwak, E M; Fabian, R P; Mordochovich, D

    1975-11-01

    The movement of water, electrolytes and protein across the peritoneum was studied experimentally and clinically in ascites. In the experimental and clinically in ascites. In the experimental studies, large amounts of solutions of various osmolar and colloid osmolar concentrations were infused rapidly into the peritoneal cavities of 32 dogs. In 26 of these dogs, the ureters were ligated before the experiment was begun; the other six dogs served as controls. The clinical studies were done in five patients with ascites. Tritium, 35S and RISA dilution techniques were used to study the kinetics of the different components of peritoneal fluid. Osmolarity changes were measured in plasma and peritoneal fluid by the freezing point depression method. Volume changes of peritoneal fluid were measured serially up to 24 hours for the assessment of the peritoneal absorption rate. The rate of fluid movement across the peritoneal membrane seems to be influenced, among others, by the composition of the intraperitoneal fluid, as well as by the properties of the membrane itself. An asymmetric pattern of peritoneal absorption rate of the different compositional elements of ascitic fluid was observed in this study which seems to interrelate with dynamic equilibrium which develops between ascites and the physiologic body fluid compartments. No cessation of peritoneal fluid absorption or a maximal reabsorption rate was observed in this study; nevertheless, variations in the rate of peritoneal absorption due to miscellaneous influences are possible.

  2. Asaia bogorensis peritonitis identified by 16S ribosomal RNA sequence analysis in a patient receiving peritoneal dialysis.

    PubMed

    Snyder, Richard W; Ruhe, Jorg; Kobrin, Sidney; Wasserstein, Alan; Doline, Christa; Nachamkin, Irving; Lipschutz, Joshua H

    2004-08-01

    Here the authors report a case of refractory peritonitis leading to multiple hospitalizations and the loss of peritoneal dialysis access in a patient on automated peritoneal dialysis, caused by Asaia bogorensis, a bacterium not previously described as a human pathogen. This organism was identified by sequence analysis of the 16S ribosomal RNA gene. Unusual microbial agents may cause peritonitis, and molecular microbiological techniques are important tools for identifying these agents.

  3. Peritoneal dialysis-related peritonitis due to Halomonas hamiltonii

    PubMed Central

    Yeo, Se Hwan; Kwak, Jae Hoon; Kim, Yeo Un; Lee, Jin Suk; Kim, Hyo Jin; Park, Kyoung Hwa; Lee, Jung Sook; Ha, Gyoung Yim; Lee, Jeong Ho; Lee, Jun Yeop; Yoo, Kyung Don

    2016-01-01

    Abstract Introduction: Halomonas hamiltonii is a Gram-negative, halophilic, motile, and nonspore-forming rod bacterium. Although most Halomonas sp. are commonly found in saline environments, it has rarely been implicated as a cause of human infection. Herein, the authors present a case report of continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis attributed to H hamiltonii. Case presentation: An 82-year-old male patient who had been receiving CAPD therapy presented to an emergency department with complaints of abdominal pain and cloudy dialysate that had persisted for 2 days. The peritoneal dialysate was compatible with CAPD peritonitis, with white blood cell count of peritoneal effluent of 810/mm3 and neutrophils predominated (60%). Two days after culture on blood agar medium, nonhemolytic pink mucoid colonies showed, with cells showing Gram-negative, nonspore-forming rods with a few longer and larger bacilli than usual were found. We also performed biochemical tests and found negative responses in K/K on the triple sugar iron test and H2S and equivocal (very weak) response in the motility test, but positive responses to catalase, oxidase, and urease tests. The partial sequence of the 16S rRNA gene of a bacterium detected by peritoneal fluid culture was utilized for a Basic Local Alignment Search Tool search, which revealed that the organism was H hamiltonii. Intraperitoneal antibiotics were administered for 21 days, and the patient was discharged without clinical problems. Conclusion: We present here the first case report of CAPD-related peritonitis caused by H hamiltonii, which was identified using molecular biological techniques. Although guidelines do not exist for the treatment of infections caused by this organism, conventional treatment for Gram-negative organisms could be effective. PMID:27893682

  4. [Peritonitis in pediatric patients receiving peritoneal dialysis].

    PubMed

    Jellouli, Manel; Ferjani, Meriem; Abidi, Kamel; Hammi, Yosra; Boutiba, Ilhem; Naija, Ouns; Zarrouk, Chokri; Ben Abdallah, Taieb; Gargah, Tahar

    2015-12-01

    Peritonitis on catheter of dialysis represents the most frequent complication of the peritoneal dialysis (PD) in the pediatric population. It remains a significant cause of morbidity and mortality. In this study, we investigated the risk factors for peritonitis in children. In this study, we retrospectively collected the records of 85 patients who were treated with PD within the past ten years in the service of pediatrics of the University Hospital Charles-Nicolle of Tunis. Peritonitis rate was 0.75 episode per patient-year. Notably, peritonitis caused by Gram-positive organisms were more common. Analysis of infection risk revealed three significant independent factors: the poor weight (P=0.0045), the non-automated PD (P=0.02) and the short delay from catheter insertion to starting PD (P=0.02). The early onset peritonitis was significantly associated with frequent peritonitis episodes (P=0.0008). The mean duration between the first and second episode of peritonitis was significantly shorter than between PD commencement and the first episode of peritonitis. We revealed a significant association between Gram-negative peritonitis and the presence of ureterostomy (0.018) and between Gram-positive peritonitis and the presence of exit-site and tunnel infections (0.02). Transition to permanent hemodialysis was needed in many children but no death occurred in patients with peritonitis. Considering the important incidence of peritonitis in our patients, it is imperative to establish a targeted primary prevention. Nutritional care must be provided to children to avoid poor weight. The automated dialysis has to be the modality of choice. Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  5. 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

  6. Determination and compensation of series resistances during whole-cell patch-clamp recordings using an active bridge circuit and the phase-sensitive technique.

    PubMed

    Riedemann, Therese; Polder, Hans Reiner; Sutor, Bernd

    2016-10-01

    We present a technique which combines two methods in order to measure the series resistance (R S) during whole-cell patch-clamp recordings from excitable and non-excitable cells. R S is determined in the amplifier's current-clamp mode by means of an active bridge circuit. The correct neutralization of the electrode capacitance and the adjustment of the bridge circuit is achieved by the so-called phase-sensitive method: Short sine wave currents with frequencies between 3 and 7 kHz are injected into the cells. Complete capacitance neutralization is indicated by the disappearance of the phase lag between current and voltage, and correct bridge balance is indicated by a minimized voltage response to the sine wave current. The R S value determined in the current-clamp mode then provides the basis for R S compensation in the voltage-clamp recording mode. The accuracy of the procedure has been confirmed on single-compartment cell models where the error amounted to 2-3 %. Similar errors were observed during dual patch clamp recordings from single neocortical layer 5 pyramidal cells where one electrode was connected to the bridge amplifier and the other one to a time-sharing, single-electrode current- and voltage-clamp amplifier with negligible R S. The technique presented here allows R S compensation for up to 80-90 %, even in cells with low input resistances (e.g., astrocytes). In addition, the present study underlines the importance of correct R S compensation by showing that significant series resistances directly affect the determination of membrane conductances as well as the kinetic properties of spontaneous synaptic currents with small amplitudes.

  7. A new, innovative, lengthening surgical procedure for Peyronie's disease by penile prosthesis implantation with double dorsal-ventral patch graft: the "sliding technique".

    PubMed

    Rolle, Luigi; Ceruti, Carlo; Timpano, Massimiliano; Sedigh, Omidreza; Destefanis, Paolo; Galletto, Elisa; Falcone, Marco; Fontana, Dario

    2012-09-01

    Peyronie's disease is the result of the formation of fibrous plaques in the tunica albuginea of the penis; typical presentations of the disease are represented by pain during erection, erectile dysfunction, and penile deformities, such as curvature, narrowing, and penile shortening. The most complex treatment is related to penile shortening. To find a safe procedure in penile shortening due to Peyronie's disease providing a satisfactory lengthening, allowing an early stabilization of the penis, and preventing axial tension on the neurovascular bundles during dilation. We describe a new lengthening surgical procedure based on a ventro-dorsal incision of the tunica albuginea, penile prosthesis implantation, and double dorsal-ventral patch grafting with porcine small intestinal submucosa. Three patients, affected by Peyronie's disease with penile shortening and erectile dysfunction, underwent this procedure with approval of our local ethical committee. We evaluated the penis lengthening, intraoperative and postoperative complications, patient's preoperative and postoperative sexual life satisfaction (International Index of Erectile Function [IIEF] questionnaire). The average operative time was 2 hours and 50 minutes. No major intraoperative nor postoperative complications occurred. No significant bleedings were recorded. Patients were discharged after 48-72 hours. The average increase in length obtained was 3.2 cm. All patients resumed sexual intercourses with satisfaction; no significant loss of sensitivity or any sign of vascular distress of the glans was recorded. The follow-up is 13 months. The average IIEF score is 60. The lengthening of the penis by a double dorsal-ventral patch graft is an innovative procedure that is based on current techniques of plaque incision and grafting, and that can easily resolve severe shortening of the penis due to Peyronie's disease. In the cases presented, this procedure resulted easily, effectively, and safely. Nevertheless, the

  8. 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

  9. Prevention of peritonitis in children: emerging concepts.

    PubMed

    Bakkaloglu, Sevcan A

    2009-02-01

    Peritoneal dialysis (PD) is the modality of choice for pediatric patients in all over the world. Peritonitis, still the main complication of PD, causes significant morbidity and mortality. Therefore, prevention of peritonitis is of particular importance. Pre-implantation antibiotic prophylaxis, catheter-related interventions (catheter selection, implantation technique, exit-site orientation), acute and chronic exit-site care (dressing protocols and application of an exit-site antibiotic such as mupirocin or gentamicin), antifungal prophylaxis during peritonitis, contamination protocols and prevention of touch contamination, patient and trainer training, tracking and root-cause analysis of infections, and continuous quality improvement programs are all essential for the prevention of peritonitis episodes. In the present review, all those issues and emerging concepts are discussed.

  10. Employment of synthetic patch with augmentation of the long head of the biceps tendon in irreparable lesions of the rotator cuff: our technique applied to 60 patients.

    PubMed

    Vitali, Matteo; Cusumano, Andrea; Pedretti, Alberto; Naim Rodriguez, Nadim; Fraschini, Gianfranco

    2015-03-01

    The aim of our study was to evaluate the effectiveness of both clinical and functional benefits after the surgical repair of the rotator cuff in irreparable lesions using a synthetic patch with augmentation of the long head of the biceps (LHB) tendon. This is a retrospective study analysis of a randomized series of 60 patients (45 women and 15 men; average age 66 y) who underwent open repair of irreparable rotator cuff tear with synthetic patch using LHB tendon augmentation between 1999 and 2008.The inclusion criteria were: patients painful symptomatology, presenting a deficit in elevation, who are not responsive to physiotherapy, irreparable tear size, minimum follow-up of 36 months after surgery, and active and motivated patients. We used a control group of 60 patients treated without employment of the synthetic patch and LHB tendon augmentation.Patients were evaluated preoperatively and after 36 months with a Visual Analog Scale (VAS) and the University of California, Los Angeles (UCLA) shoulder rating scale and by measuring elevation of the scapular plane and strength with a dynamometer. All the patients were assessed preoperatively also with plain radiographs (anteroposterior and axillary views), ultrasound, and NMRI of the shoulder. The VAS and UCLA scores were also obtained 3 months postoperatively. Tendon integrity was assessed after 1 year by NMRI. Statistical analysis was conducted by 1-way analysis of variance between groups of treatment, with Dunnett post hoc correction for multiple comparisons. P-values ≤ 0.05 were considered as statistically significant. This surgical technique consisted in a short deltoid splitting, irreparable lesion evaluation, and, after tenodesis, the proximal segment of the LHB tendon was sutured to the remaining cuff tendons to fill the gap of the corresponding lesion. To shield the repaired rotator cuff we inserted a synthetic patch. Satisfactory results were achieved in 52 of the patients treated with this procedure; after

  11. 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 ...

  12. Peritoneal fluid culture

    MedlinePlus

    Culture - peritoneal fluid ... sent to the laboratory for Gram stain and culture. The sample is checked to see if bacteria ... The peritoneal fluid culture may be negative, even if you have ... diagnosis of peritonitis is based on other factors, in addition ...

  13. History of peritoneal access development.

    PubMed

    Twardowski, Zbylut J

    2006-01-01

    The first peritoneal accesses were devices that had been used in other fields (general surgery, urology, or gynecology): trocars, rubber catheters, and sump drains. In the period after World War II, numerous papers were published with various modifications of peritoneal dialysis. The majority of cases were treated with the continuous flow technique; rubber catheters for inflow and sump drains for outflow were commonly used. At the end of the 1940s, intermittent peritoneal dialysis started to be more frequently used. Severe complications of peritoneal accesses created incentive to design accesses specifically for peritoneal dialysis. The initial three, in the late 1940s, were modified sump drains; however, Ferris and Odel for the first time designed a soft, polyvinyl intraperitoneal tube with metal weights to keep the catheter tip in the pelvic gutter where the conditions for drain are the best. In the 1950s, intermittent peritoneal dialysis was established as the preferred technique; polyethylene and nylon catheters became commercially available and peritoneal dialysis was established as a valuable method for treatment of acute renal failure. The major breakthrough came in the 1960s. First of all, it was discovered that the silicone rubber was less irritating to the peritoneal membrane than other plastics. Then, it was found that polyester velour allowed an excellent tissue ingrowth creating a firm bond with the tissue. When a polyester cuff was glued to the catheter, it restricted catheter movement and created a closed tunnel between the integument and the peritoneal cavity. In 1968, Tenckhoff and Schechter combined these two features and designed a silicone rubber catheter with a polyester cuff for treatment of acute renal failure and two cuffs for treatment of chronic renal failure. This was the most important development in peritoneal access. Technological evolution never ends. Multiple attempts have been made to eliminate remaining complications of the

  14. Granisetron Transdermal Patch

    MedlinePlus

    ... patch. Each patch is stuck onto a thin plastic liner and a separate rigid plastic film. Do not open the pouch in advance, ... cut the patch into pieces. Peel the thin plastic liner off of the printed side of the ...

  15. Methylphenidate Transdermal Patch

    MedlinePlus

    ... still remove the patch at your regular patch removal time. Do not apply extra patches to make ... room temperature and away from excess heat and moisture (not in the bathroom). Do not refrigerate or ...

  16. Cabbage Patch

    NASA Technical Reports Server (NTRS)

    1997-01-01

    This Sojourner rover image of the Cabbage Patch shows small rounded objects on the surface that are about 3-4 cm across. Some of these are within excavations, which are about 0.5 cm wide. Several questions arise about the pebbles: Why are they rounded? Where did they come from? What do they mean?

    Geologists use MULTIPLE WORKING HYPOTHESES when attempting to explain observations. Some hypotheses that could account for the pebbles are: They were rounded during transport by waters of catastrophic floods and deposited on the Ares Vallis floodplain They were rounded by wave action on an ancient Martian beach They were rounded during glacial transport They are glasses that were produced by melting during impact cratering. The glass was first ejected from the crater, then molded into spherical shapes or drops as it traveled through the atmosphere, and finally was deposited at the sites They are spatter from lava flows They are nodules brought up from the deep Martian interior by lava flows or pyroclastic eruptions. They are concretions formed in sedimentary rocks They came from ancient conglomerate rocks. The pebbles were rounded by water action and subsequently lithified into conglomerate rocks. Later, the waters of catastrophic floods transported the conglomerates and deposited them on the Ares floodplain. The pebbles were then freed from the rocks by weathering. A combination of the above

    Mars Pathfinder is the second in NASA's Discovery program of low-cost spacecraft with highly focused science goals. The Jet Propulsion Laboratory, Pasadena, CA, developed and manages the Mars Pathfinder mission for NASA's Office of Space Science, Washington, D.C. JPL is a division of the California Institute of Technology (Caltech).

  17. Foil Patches Seal Small Vacuum Leaks

    NASA Technical Reports Server (NTRS)

    Spiegel, Kirk W.; Reed, David W.

    1995-01-01

    Report discloses technique to patch holes in nickel-alloy rocket-engine nozzle parts prior to vacuum brazing. Technique involves lightly spot-welding nickel foil 0.002 in. thick over hole patched, then spot-welding corrosion-resistant steel foil of same thickness over nickel foil. Once patches subject to pressure and temperature of vacuum brazing, nickel foil diffuses to bond with nickel-alloy nozzle, making vacuum-tight seal.

  18. Foil Patches Seal Small Vacuum Leaks

    NASA Technical Reports Server (NTRS)

    Spiegel, Kirk W.; Reed, David W.

    1995-01-01

    Report discloses technique to patch holes in nickel-alloy rocket-engine nozzle parts prior to vacuum brazing. Technique involves lightly spot-welding nickel foil 0.002 in. thick over hole patched, then spot-welding corrosion-resistant steel foil of same thickness over nickel foil. Once patches subject to pressure and temperature of vacuum brazing, nickel foil diffuses to bond with nickel-alloy nozzle, making vacuum-tight seal.

  19. Peritoneal Fluid Titer Test for Peritoneal Dialysis-Related Peritonitis

    PubMed Central

    Strijack, Christine; Harding, Godfrey K. M.; Ariano, Robert E.; Zelenitsky, Sheryl A.

    2004-01-01

    Standard microbiological tests (i.e., MIC) do not account for the unique factors of peritoneal dialysis (PD)-related peritonitis which can significantly influence treatment response. Our goals were to develop a peritoneal fluid titer (PFT) test and to conduct a pilot study of its association with clinical outcome. The methodology was developed by using spent dialysate collected from patients with bacterial PD-related peritonitis prior to the initiation of antibiotics. Dialysate was processed and spiked with antibiotic to simulate two standard intraperitoneal regimens: cefazolin plus tobramycin and cefazolin alone. Thirty-six clinical isolates, including Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Pseudomonas aeruginosa, were tested. In the pilot study, dialysate was collected from 14 patients with bacterial PD-related peritonitis. Titers were determined by using each patient's dialysate and infecting pathogen. Titers were highly reproducible, with discrepancies in only 1% of cases. Overall, PFTs were notably higher against gram-positive bacteria (P < 0.0001). The addition of tobramycin increased titers significantly from zero to values of 1/16 to 1/64 against E. cloacae and P. aeruginosa (P < 0.0001). In the pilot study, peritoneal fluid inhibitory titers were significantly associated with clinical outcome, with a median value of 1/96 for patients who were cured compared to 1/32 for those who failed treatment (P = 0.036). In conclusion, this study provides preliminary support for the PFT as a pharmacodynamic index specific to the treatment of PD-related peritonitis. With further characterization and validation in patients, the PFT test may advance the study of antibiotic therapies for PD-related peritonitis. PMID:15105126

  20. 32 Years’ Experience of Peritoneal Dialysis-Related Peritonitis in a University Hospital

    PubMed Central

    van Esch, Sadie; Krediet, Raymond T.; Struijk, Dirk G.

    2014-01-01

    ♦ Background: Peritonitis in peritoneal dialysis (PD) patients can lead to technique failure and contributes to infection-related mortality. Peritonitis prevention and optimization of treatment are therefore important in the care for PD patients. In the present study, we analyzed the incidence of peritonitis, causative pathogens, clinical outcomes, and trends in relation to three major treatment changes that occurred from 1979 onward: use of a disconnect system since 1988, daily mupirocin at the exit-site since 2001, and exclusive use of biocompatible dialysis solutions since 2004. ♦ Methods: In this analysis of prospectively collected data, we included peritonitis episodes from the start of PD at our center in August 1979 to July 2010. Incident PD patients were allocated to one of four groups: Group 1 - 182 patients experiencing 148 first peritonitis episodes between 1979 and 1987, before the introduction of the disconnect system; Group 2 - 352 patients experiencing 239 first episodes of peritonitis between 1988 and 2000, before implementation of daily mupirocin application at the catheter exit-site; Group 3 - 79 patients experiencing 50 first peritonitis episodes between 2001 and 2003, before the switch to biocompatible solutions; and Group 4-118 patients experiencing 91 first peritonitis episodes after 2004. Cephradine was used as initial antibiotic treatment. ♦ Results: In 32 years, 731 adult patients started PD, and 2234 episodes of peritonitis in total were diagnosed and treated. Of those episodes, 88% were cured with medical treatment only, and 10% resulted in catheter removal. In 3% of the episodes, the patient died during peritonitis. Median time to a first peritonitis episode increased from 40 days for group 1 to 150 for group 2, 269 for group 3, and 274 for group 4. The overall peritonitis rate and the gram-positive and gram-negative peritonitis rates showed a time-trend of decline. However, the duration of antibiotic treatment increased over time

  1. Demonstration of an instrumented patch

    NASA Astrophysics Data System (ADS)

    Martinez, M.; Renaud, G.; Backman, D.; Genest, M.; Delannoy, M.

    2007-04-01

    The primary objective of this study was to demonstrate the effectiveness of various strain measurement techniques at detecting the disbonding of a composite repair patch and then using this information to validate a new capacitance based disbond detection technique. The instrumented repair patch was parametrically designed with the help of Finite Element Analysis (FEA) software to have a stress concentration at its tip. This stress concentration was designed to produce a disbond during fatigue testing, without the need for the introduction of any foreign material to create an artificial disbond condition. The aluminum substrate was grit blasted and the instrumented patch was bonded using FM ®73 adhesive, and was cured following the recommendations of the manufacturer. The geometric characteristics of the patch followed standard repair guidelines for such variables as material selection, taper angles and loading conditions, with the exception of the area designed for premature disbond. All test specimens were inspected using non-destructive testing technique (ultrasound pulse echo) to guarantee that no disbonding had occurred during curing of the specimen. The specimens were placed under fatigue loading to induce a disbond condition between the aluminum substrate and the patch. The specimens were cyclically loaded and strain gauges bonded to strategic locations on the aluminum and composite patch surface to be able to measure changes in surface strains as the disbond progressed. A Digital Image Correlation (DIC) system was also used to measure full field strains over the gauge length of the coupon. The DIC results were compared with the strain gauge data and were used to provide a qualitative measure of the load transfer in the bonded specimen, which clearly demonstrated the change in surface strain that occurred as the composite patch disbonded from the aluminum substrate. Thermoelastic Stress Analysis (TSA) was also used to measure surface strains on the

  2. Shewanella algae Peritonitis in Patients on Peritoneal Dialysis.

    PubMed

    Shanmuganathan, Malini; Goh, Bak Leong; Lim, Christopher; NorFadhlina, Zakaria; Fairol, Ibrahim

    Patients with peritonitis present with abdominal pain, diarrhea, fever, and turbid peritoneal dialysis (PD) fluid. Shewanella algae peritonitis has not yet been reported in PD patients in the literature. We present the first 2 cases of Shewanella algae peritonitis in PD patients. Mupirocin cream is applied on the exit site as prophylactic antibiotic therapy. Copyright © 2016 International Society for Peritoneal Dialysis.

  3. Pulmonary artery closure in combination with patch technique for treating congenital heart disease combined with large patent ductus arteriosus: A clinical study of 9 cases.

    PubMed

    Wen, Bing; Yang, Junya; Liu, Huiruo; Jiao, Zhouyang; Zhao, Wenzeng

    2016-01-01

    To document clinical experience of treating congenital heart disease combined with large patent ductus arteriosus with pulmonary artery closure in combination with patch technique. Thirty-six patients (8 males and 28 females) who suffered from congenital heart disease and underwent hybrid surgery in the First Affiliated Hospital of Zhengzhou University from October 2010 to February 2014 were selected for this study. They aged 14 to 39 years and weighed 32.20 to 61.50 kg. Diameter of arterial duct was between 10 mm and 13 mm; 28 cases were tube type, 4 cases were funnel type and four cases were window type. All patients had moderate or severe pulmonary arterial hypertension; besides, there were 28 cases of ventricular septal defect, 16 cases of atrial septal defect, eight cases of aortic insufficiency, four cases of mitral stenosis and insufficiency and four cases of infectious endocarditis. Cardz Pulmonary Bypass (CPB) was established after chest was opened along the middle line. With the help of Transesophageal echocardiography, large patent ductus arteriosus was blocked off through pulmonary artery. Pulmonary artery was cut apart after blocking of heart. Large patent ductus arteriosus on the side of pulmonary artery was strengthened with autologous pericardial patch. Of 36 patients, 32 patients had patent ductus arteriosus closure device and four patients had atrial septal defect closure device. Pulmonary arteries of 36 cases were all successfully closed. Systolic pressure declined after closure ((54.86±19.23) mmHg vs (96.05±23.07) mmHg, p<0.05); average pulmonary arterial pressure also declined after closure ((39.15±14.83) mmHg vs (72.88±15.76) mmHg, p<0.05). The patients were followed up for one to fifty one months (average 11.5 months). Compared to before surgery, left atrial diameter, left ventricular diameter and pulmonary artery diameter all narrowed after surgery. Besides, clinical symptoms were relieved and cardiac function of the patients also

  4. Pulmonary artery closure in combination with patch technique for treating congenital heart disease combined with large patent ductus arteriosus: A clinical study of 9 cases

    PubMed Central

    Wen, Bing; Yang, Junya; Liu, Huiruo; Jiao, Zhouyang; Zhao, Wenzeng

    2016-01-01

    Objective: To document clinical experience of treating congenital heart disease combined with large patent ductus arteriosus with pulmonary artery closure in combination with patch technique. Methods: Thirty-six patients (8 males and 28 females) who suffered from congenital heart disease and underwent hybrid surgery in the First Affiliated Hospital of Zhengzhou University from October 2010 to February 2014 were selected for this study. They aged 14 to 39 years and weighed 32.20 to 61.50 kg. Diameter of arterial duct was between 10 mm and 13 mm; 28 cases were tube type, 4 cases were funnel type and four cases were window type. All patients had moderate or severe pulmonary arterial hypertension; besides, there were 28 cases of ventricular septal defect, 16 cases of atrial septal defect, eight cases of aortic insufficiency, four cases of mitral stenosis and insufficiency and four cases of infectious endocarditis. Cardz Pulmonary Bypass (CPB) was established after chest was opened along the middle line. With the help of Transesophageal echocardiography, large patent ductus arteriosus was blocked off through pulmonary artery. Pulmonary artery was cut apart after blocking of heart. Large patent ductus arteriosus on the side of pulmonary artery was strengthened with autologous pericardial patch. Results: Of 36 patients, 32 patients had patent ductus arteriosus closure device and four patients had atrial septal defect closure device. Pulmonary arteries of 36 cases were all successfully closed. Systolic pressure declined after closure ((54.86±19.23) mmHg vs (96.05±23.07) mmHg, p<0.05); average pulmonary arterial pressure also declined after closure ((39.15±14.83) mmHg vs (72.88±15.76) mmHg, p<0.05). The patients were followed up for one to fifty one months (average 11.5 months). Compared to before surgery, left atrial diameter, left ventricular diameter and pulmonary artery diameter all narrowed after surgery. Besides, clinical symptoms were relieved and cardiac

  5. The Influence of Initial Peritoneal Transport Characteristics, Inflammation, and High Glucose Exposure on Prognosis for Peritoneal Membrane Function

    PubMed Central

    Fernández-Reyes, M. José; Bajo, M. Auxiliadora; Del Peso, Gloria; Ossorio, Marta; Díaz, Raquel; Carretero, Beatriz; Selgas, Rafael

    2012-01-01

    ♦ Background: Fast transport status, acquired with time on peritoneal dialysis (PD), is a pathology induced by peritoneal exposure to bioincompatible solutions. Fast transport has important clinical consequences and should be prevented. ♦ Objective: We analyzed the repercussions of initial peritoneal transport characteristics on the prognosis for peritoneal membrane function, and also whether the influence of peritonitis and high exposure to glucose are different according to the initial peritoneal transport characteristics or the moment when such events occur. ♦ Methods: The study included 275 peritoneal dialysis patients with at least 2 peritoneal function studies (at baseline and 1 year). Peritoneal kinetic studies were performed at baseline and annually. Those studies consist of a 4-hour dwell with glucose (1.5% during 1981 - 1990, and 2.27% during 1991 - 2002) to calculate the peritoneal mass transfer coefficients of urea and creatinine (milliliters per minute) using a previously described mathematical model. ♦ Results: Membrane prognosis and technique survival were independent of baseline transport characteristics. Fast transport and ultrafiltration (UF) failure are reversible conditions, provided that peritonitis and high glucose exposure are avoided during the early dialysis period. The first year on PD is a main determining factor for the membrane’s future, and the mass transfer coefficient of creatinine at year 1 is the best functional predictor of future PD history. After 5 years on dialysis, permeability frequently increases, and UF decreases. Icodextrin is associated with peritoneal protection. ♦ Conclusions: Peritoneal membrane prognosis is independent of baseline transport characteristics. Intrinsic fast transport and low UF are reversible conditions when peritonitis and high glucose exposure are avoided during the early dialysis period. Icodextrin helps in glucose avoidance and is associated with peritoneal protection. PMID:22473036

  6. Surgical management of peritoneal dialysis peritonitis: the impact of peritoneal sclerosis.

    PubMed

    Yates, Phillip J; Kitchen, Jessica P A; Kaushik, Monica; Nicholson, Michael L

    2009-07-01

    Peritonitis is a life-threatening complication of peritoneal dialysis. Peritoneal sclerosis is associated with long-term peritoneal dialysis. The aim of this study was to assess the effect of peritoneal sclerosis on outcomes following laparotomy for peritoneal dialysis peritonitis. A series of 63 consecutive patients underwent laparotomy for peritoneal dialysis peritonitis. Patients were divided into two groups, those with and those without simple peritoneal sclerosis identified at laparotomy. Medical, anaesthetic, and surgical notes were used for data collection. Patients with known encapsulating peritoneal sclerosis were excluded from the study. Patients with simple peritoneal sclerosis had a statistically significant longer duration of peritoneal dialysis. They also had a significantly higher risk of major complications postoperatively and a greater relative risk for mortality. There is an increased prevalence of simple peritoneal sclerosis with long-term peritoneal dialysis. Patients with simple peritoneal sclerosis have higher incidence of postlaparotomy complications. Patients on long-term peritoneal dialysis should be treated aggressively for peritoneal dialysis peritonitis to reduce complication/mortality rates. Evidence of simple peritoneal sclerosis at laparotomy should preclude further peritoneal dialysis.

  7. RF MEMS reconfigurable triangular patch antenna.

    SciTech Connect

    Nordquist, Christopher Daniel; Christodoulou, Christos George; Feldner, Lucas Matthew

    2005-01-01

    A Ka-band RF MEMS enabled frequency reconfigurable triangular microstrip patch antenna has been designed for monolithic integration with RF MEMS phase shifters to demonstrate a low-cost monolithic passive electronically scanned array (PESA). This paper introduces our first prototype reconfigurable triangular patch antenna currently in fabrication. The aperture coupled patch antenna is fabricated on a dual-layer quartz/alumina substrate using surface micromachining techniques.

  8. RF MEMS reconfigurable triangular patch antenna.

    SciTech Connect

    Christodoulou, Christos George; Nordquist, Christopher Daniel; Feldner, Lucas Matthew

    2005-07-01

    A Ka-band RF MEMS enabled frequency reconfigurable triangular microstrip patch antenna has been designed for monolithic integration with RF MEMS phase shifters to demonstrate a low-cost monolithic passive electronically scanned array (PESA). This paper introduces our first prototype reconfigurable triangular patch antenna currently in fabrication. The aperture coupled patch antenna is fabricated on a dual-layer quartz/alumina substrate using surface micromachining techniques.

  9. Treatment for peritoneal dialysis-associated peritonitis.

    PubMed

    Wiggins, K J; Craig, J C; Johnson, D W; Strippoli, G F

    2008-01-23

    Peritonitis is a common complication of peritoneal dialysis (PD) and is associated with significant morbidity. Adequate treatment is essential to reduce morbidity and recurrence. To evaluate the benefits and harms of treatments for PD-associated peritonitis. We searched the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL, in The Cochrane Library), MEDLINE, EMBASE and reference lists without language restriction. Date of search: February 2005 All randomised controlled trials (RCTs) and quasi-RCTs assessing the treatment of peritonitis in peritoneal dialysis patients (adults and children) evaluating: administration of an antibiotic(s) by different routes (e.g. oral, intraperitoneal, intravenous); dose of an antibiotic agent(s); different schedules of administration of antimicrobial agents; comparisons of different regimens of antimicrobial agents; any other intervention including fibrinolytic agents, peritoneal lavage and early catheter removal were included. Two authors extracted data on study quality and outcomes. Statistical analyses were performed using the random effects model and the dichotomous results were expressed as relative risk (RR) with 95% confidence intervals (CI) and continuous outcomes as mean difference (WMD) with 95% CI. We identified 36 studies (2089 patients): antimicrobial agents (30); urokinase (4), peritoneal lavage (1) intraperitoneal (IP) immunoglobulin (1). No superior antibiotic agent or combination of agents were identified. Primary response and relapse rates did not differ between IP glycopeptide-based regimens compared to first generation cephalosporin regimens, although glycopeptide regimens were more likely to achieve a complete cure (3 studies, 370 episodes: RR 1.66, 95% CI 1.01 to 3.58). For relapsing or persistent peritonitis, simultaneous catheter removal/replacement was superior to urokinase at reducing treatment failure rates (1 study, 37 patients: RR 2.35, 95% CI 1.13 to

  10. Micromachined patch-clamp apparatus

    SciTech Connect

    Okandan, Murat

    2012-12-04

    A micromachined patch-clamp apparatus is disclosed for holding one or more cells and providing electrical, chemical, or mechanical stimulation to the cells during analysis with the patch-clamp technique for studying ion channels in cell membranes. The apparatus formed on a silicon substrate utilizes a lower chamber formed from silicon nitride using surface micromachining and an upper chamber formed from a molded polymer material. An opening in a common wall between the chambers is used to trap and hold a cell for analysis using the patch-clamp technique with sensing electrodes on each side of the cell. Some embodiments of the present invention utilize one or more electrostatic actuators formed on the substrate to provide mechanical stimulation to the cell being analyzed, or to provide information about mechanical movement of the cell in response to electrical or chemical stimulation.

  11. [Characteristics of postoperative peritonitis].

    PubMed

    Lock, J F; Eckmann, C; Germer, C-T

    2016-01-01

    Postoperative peritonitis is still a life-threatening complication after abdominal surgery and approximately 10,000 patients annually develop postoperative peritonitis in Germany. Early recognition and diagnosis before the onset of sepsis has remained a clinical challenge as no single specific screening test is available. The aim of therapy is a rapid and effective control of the source of infection and antimicrobial therapy. After diagnosis of diffuse postoperative peritonitis surgical revision is usually inevitable after intestinal interventions. Peritonitis after liver, biliary or pancreatic surgery is managed as a rule by means of differentiated therapy approaches depending on the severity.

  12. Image-guided peritoneal access and management of complications in peritoneal dialysis.

    PubMed

    Taylor, Paul M

    2002-01-01

    The principal complications of continuous ambulatory peritoneal dialysis (CAPD), namely malposition of the dialysis catheter, peritonitis, exit site infection, leakage of dialysis fluid, sclerosing peritonitis, and renal cysts and tumors, are considered in this article. The techniques that are used to reposition displaced dialysis catheters and extend the duration of dialysis are described. The role of imaging in establishing the diagnosis of peritonitis is relatively small. However, both computed tomography (CT) and ultrasound may be used to identify loculation of fluid and localized sites of sepsis, and permit percutaneous drainage. Ultrasonography of the catheter track through the percutaneous tissues allows identification of pericatheter collections in patients with exit-site infection. The technique of CT peritoneography is helpful in establishing sites of dialysis fluid leakage. These commonly occur at the site of entry of the dialysis catheter, through abdominal incisions, or along the patent tunica vaginalis into the scrotum. The appearances on CT of sclerosing peritonitis reflect pathologic changes and are characterized by the presence of peritoneal thickening and calcification. Bowel obstruction, which may develop in sclerosing peritonitis, can be identified on abdominal radiographs or barium studies of the gastrointestinal tract. Acquired renal cystic disease and renal carcinomas occur in a significant proportion of patients undergoing CAPD. Ultrasound is the investigation of first choice in the identification and clarification of the pathology (cystic or solid) of suspected renal masses.

  13. SafePatch

    SciTech Connect

    Kelley, M.; Elko, S.

    2000-10-01

    Authenticating and upgrading system software plays a critical role in information security, yet practical tools for assessing and installing software are lacking in today's marketplace. The SafePatch tool provides the mechanism of performing automated analysis, notification, distribution, and installation of security patches and related software to network-based computer systems in a vendor-independent fashion. SafePatch assists in the authentication of software by comparing the system's objects with the patch's objects. SafePatch will monitor vendor's sites to determine when new patches are released and will upgrade system software on target systems automatically. This paper describes the design of SafePatch, motivations behind the project and the advantages of SafePatch over existing tools.

  14. Estradiol Transdermal Patch

    MedlinePlus

    Most brands of estradiol transdermal patches are used to treat hot flushes (hot flashes; sudden strong feelings of heat ... different medication that does not contain estrogen. Most brands of estradiol transdermal patches are also sometimes used ...

  15. Metal Patch Antenna

    NASA Technical Reports Server (NTRS)

    Chamberlain, Neil F. (Inventor); Hodges, Richard E. (Inventor); Zawadzki, Mark S. (Inventor)

    2012-01-01

    Disclosed herein is a patch antenna comprises a planar conductive patch attached to a ground plane by a support member, and a probe connector in electrical communication with the conductive patch arranged to conduct electromagnetic energy to or from the conductive patch, wherein the conductive patch is disposed essentially parallel to the ground plane and is separated from the ground plane by a spacing distance; wherein the support member comprises a plurality of sides disposed about a central axis oriented perpendicular to the conductive patch and the ground plane; wherein the conductive patch is solely supported above the ground plane by the support member; and wherein the support member provides electrical communication between the planer conductive patch and the ground plane.

  16. Lack of motivation: a new modifiable risk factor for peritonitis in patients undergoing peritoneal dialysis?

    PubMed

    Paudel, Klara; Namagondlu, Girish; Samad, Nasreen; McKitty, Khadija; Fan, Stanley L

    2015-03-01

    Can we identify modifiable risk factors for peritonitis in patients undergoing peritoneal dialysis (PD)? We aimed to determine whether housing standard, PD exchange technique or patient motivation might be modifiable risks for peritonitis. We also explored the relationship between lack of motivation and depression. Nurse home visits assessed PD exchange technique, environment and patient motivation. Motivation scores were correlated separately with an Apathy Evaluation Score and a depression score using PHQ-9 questionnaires. Home hygiene, exchange technique and motivation were above average in 53%, 56% and 60%, respectively in 104 patients undergoing PD. After 15 months, 25.9% patients developed peritonitis but nurses' ratings of homes and exchange techniques were not predictive. Low patient motivation was predictive. Patients rated to have above or below median motivation had significantly different Apathy Scores (p = 0.0002). Unmotivated depressed patients were significantly more likely to develop peritonitis compared to motivated depressed patients. Lack of motivation predicted peritonitis particularly if associated with depression. Further studies are required focusing on specific motivation scoring schemes and the psychosocial support that might lead to better outcomes. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  17. Tiling motion patches.

    PubMed

    Hyun, Kyunglyul; Kim, Manmyung; Hwang, Youngseok; Lee, Jehee

    2013-11-01

    Simulating multiple character interaction is challenging because character actions must be carefully coordinated to align their spatial locations and synchronized with each other. We present an algorithm to create a dense crowd of virtual characters interacting with each other. The interaction may involve physical contacts, such as hand shaking, hugging, and carrying a heavy object collaboratively. We address the problem by collecting deformable motion patches, each of which describes an episode of multiple interacting characters, and tiling them spatially and temporally. The tiling of motion patches generates a seamless simulation of virtual characters interacting with each other in a nontrivial manner. Our tiling algorithm uses a combination of stochastic sampling and deterministic search to address the discrete and continuous aspects of the tiling problem. Our tiling algorithm made it possible to automatically generate highly complex animation of multiple interacting characters. We achieve the level of interaction complexity far beyond the current state of the art that animation techniques could generate, in terms of the diversity of human behaviors and the spatial/temporal density of interpersonal interactions.

  18. Tiling Motion Patches.

    PubMed

    Hyun, Kyunglyul; Kim, Manmyung; Hwang, Youngseok; Lee, Jehee

    2013-05-08

    Simulating multiple character interaction is challenging because character actions must be carefully coordinated to align their spatial locations and synchronized with each other. We present an algorithm to create a dense crowd of virtual characters interacting with each other. The interaction may involve physical contacts, such as hand shaking, hugging, and carrying a heavy object collaboratively. We address the problem by collecting deformable motion patches, each of which describes an episode of multiple interacting characters, and tiling them spatially and temporally. The tiling of motion patches generates a seamless simulation of virtual characters interacting with each other in a non-trivial manner. Our tiling algorithm uses a combination of stochastic sampling and deterministic search to address the discrete and continuous aspects of the tiling problem. Our tiling algorithm made it possible to automatically generate highly-complex animation of multiple interacting characters. We achieved the level of complexity far beyond the current state-of-the-art animation techniques could generate, in terms of the diversity of human behaviors and the spatial/temporal density of interpersonal interactions.

  19. Statistics for Patch Observations

    NASA Astrophysics Data System (ADS)

    Hingee, K. L.

    2016-06-01

    In the application of remote sensing it is common to investigate processes that generate patches of material. This is especially true when using categorical land cover or land use maps. Here we view some existing tools, landscape pattern indices (LPI), as non-parametric estimators of random closed sets (RACS). This RACS framework enables LPIs to be studied rigorously. A RACS is any random process that generates a closed set, which encompasses any processes that result in binary (two-class) land cover maps. RACS theory, and methods in the underlying field of stochastic geometry, are particularly well suited to high-resolution remote sensing where objects extend across tens of pixels, and the shapes and orientations of patches are symptomatic of underlying processes. For some LPI this field already contains variance information and border correction techniques. After introducing RACS theory we discuss the core area LPI in detail. It is closely related to the spherical contact distribution leading to conditional variants, a new version of contagion, variance information and multiple border-corrected estimators. We demonstrate some of these findings on high resolution tree canopy data.

  20. Birth Control Patch

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Birth Control Patch KidsHealth > For Teens > Birth Control Patch Print A A A What's in this ... Much Does It Cost? What Is It? The birth control patch is a thin, beige, 1¾-inch (4½- ...

  1. Birth Control Patch

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Birth Control Patch KidsHealth > For Teens > Birth Control Patch A A A What's in this article? ... Much Does It Cost? What Is It? The birth control patch is a thin, beige, 1¾-inch (4½- ...

  2. 33 Years of Peritoneal Dialysis-Associated Peritonitis: A Single-Center Study in Japan.

    PubMed

    Nakao, Masatsugu; Yamamoto, Izumi; Maruyama, Yukio; Nakashima, Akio; Matsuo, Nanae; Tanno, Yudo; Ohkido, Ichiro; Ikeda, Masato; Yamamoto, Hiroyasu; Yokoyama, Keitaro; Yokoo, Takashi

    2016-02-01

    Peritoneal dialysis-associated peritonitis (PD-associated peritonitis) could influence the outcome of PD patients, including technique survival. Although the use of the twin-bag system has decreased the incidence of peritonitis, the effects of biocompatible PD solutions are controversial. Additionally, since both infection-causing microorganisms and antimicrobial therapies have changed over time, the duration of treatment of peritonitis (the duration of peritonitis) seems to have changed. The study included 527 patients who received PD between January 1980 and December 2012 at a single center. We divided patients undergoing PD into three groups according to the type of PD system used, namely single-bag and conventional PD solutions (S+C group, N = 145), twin-bag and conventional PD solutions (T+C group, N = 171) and twin-bag and biocompatible PD solutions (T+B group, N = 211), and analyzed PD-associated peritonitis incidences. Incidences of PD-associated peritonitis (times per patient-months) and peritonitis-free time were 1/59.4, 1/70.6 and 1/103.1, and 52, 97, and 100 months for the S+C, T+C and T+B groups, respectively. The duration of peritonitis, has thus, become dramatically shorter in recent years. Streptococcus sp. were associated with shortest and fungi with longest durations of peritonitis. Staphylococcus sp. and Pseudomonas aeruginosa were predominant in the S+C group. The twin-bag system has made a greater contribution to reductions in PD-associated peritonitis than biocompatible PD solutions. Furthermore, changes in microorganisms, antimicrobial therapies, patient education and improved PD system devices have presumably affected the reduction in the duration of peritonitis. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  3. Association of Alternative Approaches to Normalizing Peritoneal Dialysis Clearance with Mortality and Technique Failure: A Retrospective Analysis Using the United States Renal Data System-Dialysis Morbidity and Mortality Study, Wave 2.

    PubMed

    Boyle, Suzanne M; Li, Yimei; Wilson, F Perry; Glickman, Joel D; Feldman, Harold I

    ♦ BACKGROUND: Total body water (V) is an imprecise metric for normalization of dialytic urea clearance (Kt). This poses a risk of early mortality/technique failure (TF). We examined differences in the distribution of peritoneal Kt/V when V was calculated with actual weight (AW), ideal weight (IW), and adjusted weight (ADW). We also examined the associations of these Kt/V measurements, Kt/body surface area (BSA), and non-normalized Kt with mortality and TF. ♦ METHODS: This is a retrospective cohort study of 534 incident peritoneal dialysis (PD) patients from the Dialysis Morbidity and Mortality Study Wave 2 linked with United States Renal Data System through 2010. Using Cox-proportional hazard models, we examined the relationship of several normalization strategies for peritoneal urea clearance, including Kt/VAW, Kt/VIW, Kt/VADW, Kt/BSA, and non-normalized Kt, with the outcomes of mortality and TF. Harrell's c-statistics were used to assess the relative predictive ability of clearance metrics for mortality and TF. The distributions of Kt/VAW, KT/VIW, and KT/VADW were compared within and between body mass index (BMI) strata. ♦ RESULTS: Median patient age: 59 (54% male; 72% white; 91% continuous ambulatory PD [CAPD]). Median 24-hour urine volume: 700 mL; median estimated glomerular filtration rate (eGFR) at initiation: 7.15 mL/min/1.73 m(2). Technique failure and transplant-censored mortality at 5 years: 37%. Death and transplant-censored TF at 5 years: 60%. There were no significant differences in initial eGFR and 24-hour urine volume across BMI strata. There were statistically significant differences in each Kt/V calculation within the underweight, overweight, and obese strata. After adjustment, there were no significant differences in the hazard ratios (HRs) for TF/mortality for each clearance calculation. Harrell's c-statistics for mortality for each clearance calculation were 0.78, and for TF, 0.60 - 0.61. ♦ CONCLUSIONS: Peritoneal urea clearances are

  4. Multiple hepatic vein reconstruction using an all-in-one sleeve patch graft technique in living donor liver transplantation: a case report.

    PubMed

    Shimizu, S; Onoe, T; Ishiyama, K; Ide, K; Ohira, M; Tahara, H; Saeki, Y; Kobayashi, T; Kuroda, S; Tashiro, H; Ohdan, H

    2014-04-01

    Maintaining hepatic inflow and appropriate venous drainage is important for maximizing the capacity of the retrieved graft in liver transplantation. Here, we report a successful case of multiple hepatic vein (HV) reconstruction using an all-in-one sleeve patch graft of the autologous great saphenous vein to ensure adequate blood flow through the HV. A patient with hepatocellular carcinoma caused by hepatitis C virus-induced cirrhosis underwent living donor liver transplantation using a right lobe graft. A preoperative dynamic computed tomography scan and intraoperative findings revealed that the graft had three middle HV tributaries, a superficial vein, segment VIII HV (V8), and segment V HV (V5). The openings of the superficial vein and V8 were located very close to that of the right hepatic vein (RHV) in the cutting surface. Each HV had significant diameter and drainage territory requiring reconstruction. An autologous great saphenous vein was used to create a sleeve patch to incorporate the close-packed HV openings. The autologous sleeve patch graft was sutured to the openings of the RHV and the superficial vein and the hole created on the sleeve patch graft was anastomosed to the openings of V8 directly on the back table to create an all-in-one sleeve patch. For the V5 reconstruction, the recipient's intrahepatic portal vein graft was used to create an interpositional conduit from the recipient's V5 to the inferior vena cava. The postoperative course was uneventful and postoperative studies revealed good graft function with excellent blood flow in the HV. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Avoiding harm in peritoneal dialysis patients.

    PubMed

    Bender, Filitsa H

    2012-05-01

    This review is focused on minimizing complications and avoiding harm in peritoneal dialysis (PD) patients. Issues related to planning for PD are covered first, with emphasis on PD versus hemodialysis outcomes. Catheter types and insertion techniques are described next, including relevant recommendations by the International Society for Peritoneal Dialysis. A brief review of both noninfectious and infectious complications follows, with emphasis on cardiovascular and metabolic complications. Finally, recommendations for preventing PD-related infections are provided. In conclusion, with proper catheter insertion technique, good training, and attention to detail during the tenure in PD, excellent outcomes can be obtained in a well-informed motivated patient.

  6. Intraperitoneal chemotherapy hyperthermia (HIPEC) for peritoneal carcinomatosis of ovarian cancer origin by fluid and CO2 recirculation using the closed abdomen technique (PRS-1.0 Combat): A clinical pilot study.

    PubMed

    Sánchez-García, Susana; Villarejo-Campos, Pedro; Padilla-Valverde, David; Amo-Salas, Mariano; Martín-Fernández, Jesús

    2016-08-01

    Background This paper reports a study of 21 patients with peritoneal carcinomatosis from ovarian cancer who underwent cytoreductive surgery and HIPEC by means of PRS-1.0 Combat®, a new model for closed abdomen HIPEC aimed at improving fluid distribution with assistance from a CO2 recirculation system. This new technology has been previously shown to be successful in an experimental study (pig model) performed by our group, and has been approved for use in our hospital. Methods Twenty-one patients with peritoneal carcinomatosis of ovarian cancer origin were included in the study. Cytoreductive surgery and HIPEC were performed by a closed abdomen fluid and CO2 recirculation technique using the PRS-1.0 Combat(®) model. We analysed the intraoperative safety tolerance and post-operative morbidity and mortality during the first 30 days. Results Between November 2011 and March 2014 21 patients with epithelial ovarian cancer, International Federation of Gynecology and Obstetrics stage II-IV, were included in the study. During the procedure there were no significant haemodynamic or analytical disturbances. Complication rates were 38.1% and 57.14% for grade III/IV and minor (grade I/II) complications, respectively. Post-operative mortality was 4.76% (one patient). Complete cytoreductive surgery and intraperitoneal chemotherapy improved overall survival and disease-free survival in women with advanced ovarian cancer. The association of intra-abdominal hyperthermia with chemotherapy (HIPEC) increased the therapeutic benefit. Conclusions This study has shown that closed abdomen intraperitoneal chemohyperthermia by a fluid and CO2 recirculation system (PRS-1.0 Combat(®)) can be a safe and feasible model for the treatment of peritoneal carcinomatosis of ovarian cancer origin.

  7. The Role of NGAL in Peritoneal Dialysis Effluent in Early Diagnosis of Peritonitis: Case-Control Study in Peritoneal Dialysis Patients.

    PubMed

    Martino, Francesca; Scalzotto, Elisa; Giavarina, Davide; Rodighiero, Maria Pia; Crepaldi, Carlo; Day, Sonya; Ronco, Claudio

    2015-01-01

    Peritoneal dialysis (PD) is frequently complicated by high rates of peritonitis, which result in hospitalization, technique failure, transfer to hemodialysis, and increased mortality. Early diagnosis, and identification of contributing factors are essential components to increasing effectiveness of care. In previous reports, neutrophil gelatinase-associated lipocalin (NGAL), a lipocalin which is a key player in innate immunity and rapidly detectable in peritoneal dialysis effluent (PDE), has been demonstrated to be a useful tool in the early diagnosis of peritonitis. This study investigates predictive value of PDE NGAL concentration as a prognostic indicator for PD-related peritonitis. A case-control study with 182 PD patients was conducted. Plasma and PDE were analyzed for the following biomarkers: C-reactive protein (CRP), blood procalcitonin (PCT), leucocytes and NGAL in PDE. The cases consisted of patients with suspected peritonitis, while controls were the patients who came to our ambulatory clinic for routine visits without any sign of peritonitis. The episodes of peritonitis were defined in agreement with International Society for Peritoneal Dialysis guidelines. Continuous variables were presented as the median values and interquartile range (IQR). Mann-Whitney U test was used to compare continuous variables. Univariate and multivariate logistic regression were used to evaluate the association of biomarkers with peritonitis. Receiver operating characteristic (ROC) curve analysis was used to calculate area under curve (AUC) for biomarkers. Finally we evaluated sensitivity, and specificity for each biomarker. All statistical analyses were performed with SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). During the 19-month study, of the 182 patients, 80 had a clinical diagnosis of peritonitis. C-reactive protein levels (p < 0.001), PCT (p < 0.001), NGAL in PDE (p < 0.001), and white blood cells (WBC) in PDE (p < 0.001) were all significantly different in

  8. 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

  9. Multicystic peritoneal mesothelioma.

    PubMed

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

    2012-01-01

    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. 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. Complete cytoreductive surgery in combination with hyperthermic intraoperative intraperitoneal chemotherapy appears to be a rational therapeutic approach in multicystic peritoneal mesothelioma.

  10. Transdiaphragmatic peritoneal hernia complicating peritoneal dialysis: demonstration with spiral computed tomography peritoneography and peritoneal scintigraphy.

    PubMed

    Coche, Emmanuel; Lonneux, Max; Goffin, Eric

    2005-08-01

    The authors describe a rare case of peritoneal transdiaphragmatic hernia discovered immediately after a car accident in a young male patient on peritoneal dialysis. The potential role of CT peritoneography and peritoneal scintigraphy to demonstrate and understand thoracic complications of ambulatory peritoneal dialysis is discussed.

  11. The first peritonitis episode alters the natural course of peritoneal membrane characteristics in peritoneal dialysis patients.

    PubMed

    van Diepen, Anouk T N; van Esch, Sadie; Struijk, Dirk G; Krediet, Raymond T

    2015-01-01

    Little or no evidence is available on the impact of the first peritonitis episode on peritoneal transport characteristics. The objective of this study was to investigate the importance of the very first peritonitis episode and distinguish its effect from the natural course by comparison of peritoneal transport before and after infection. We analyzed prospectively collected data from 541 incident peritoneal dialysis (PD) patients, aged > 18 years, between 1990 and 2010. Standard Peritoneal Permeability Analyses (SPA) within the year before and within the year after (but not within 30 days) the first peritonitis were compared. In a control group without peritonitis, SPAs within the first and second year of PD were compared. SPA data included the mass transfer area coefficient of creatinine, glucose absorption and peritoneal clearances of β-2-microglobulin (b2m), albumin, IgG and α-2-macroglobulin (a2m). From these clearances, the restriction coefficient to macromolecules (RC) was calculated. Also, parameters of fluid transport were determined: transcapillary ultrafiltration rate (TCUFR), lymphatic absorption (ELAR), and free water transport. Crude and adjusted linear mixed models were used to compare the slopes of peritoneal transport parameters in the peritonitis group to the control group. Adjustments were made for age, sex and diabetes. Of 541 patients, 367 experienced a first peritonitis episode within a median time of 12 months after the start of PD. Of these, 92 peritonitis episodes were preceded and followed by a SPA within one year. Forty-five patients without peritonitis were included in the control group. Logistic reasons (peritonitis group: 48% vs control group: 83%) and switch to hemodialysis (peritonitis group: 22% vs control group: 3%) were the main causes of missing SPA data post-peritonitis and post-control. When comparing the slopes of peritoneal transport parameters in the peritonitis group and the control group, a first peritonitis episode was

  12. A multi-technique characterization of the stability of surfactant containing solid dispersion based buccal patches prepared by hot melt injection moulding.

    PubMed

    Alhijjaj, Muqdad; Belton, Peter; Qi, Sheng

    2017-08-07

    This study investigates the stability of typically complex multi-component hydrophilic solid dispersions that could be used in a clinical application. Felodipine solid dispersions in two types of blends consisting of PEG, PEO and Tween 80 or Vit E TPGS were prepared by hot melt-injection moulding (HMIM) across a range of drug loadings and subjected to a range of storage conditions. Microscopy, thermal analysis, spectroscopy and powder X-ray diffraction were used to characterize the systems. The semi-solid surfactant TPGS showed a better solubilizing effect on the drug than the liquid surfactant Tween 80 in the fresh state and offered some degree of protection over the chemical degradation of PEG/PEO. Better storage stability was observed for the systems with low drug loading. Crystallization of a new metastable polymorphic form of felodipine in the patches with drug loadings at and above the saturation point was observed. Quantitative comparison of the data sets was achieved by a normalisation process and calculation of statistical variance. TPGS containing patches were more sensitive to the aging process than Tween containing patches. For both surfactants, such instability is more responsive to the storage temperature than humidity. This study established a methodology for probing the complex stabilities of multi-component dispersions. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Brucella canis peritonitis.

    PubMed

    Javeri, H; Jamieson, S; Sehgal, R; Cadena, J

    2014-02-01

    Although brucellosis is a common zoonotic disease worldwide, infection with Brucella canis is rare and often difficult to diagnose. We describe the clinical and epidemiological aspects of a case of B. canis peritonitis.

  14. The First Peritonitis Episode Alters the Natural Course of Peritoneal Membrane Characteristics in Peritoneal Dialysis Patients

    PubMed Central

    van Diepen, Anouk T.N.; van Esch, Sadie; Struijk, Dirk G.; Krediet, Raymond T.

    2015-01-01

    ♦ Objective: Little or no evidence is available on the impact of the first peritonitis episode on peritoneal transport characteristics. The objective of this study was to investigate the importance of the very first peritonitis episode and distinguish its effect from the natural course by comparison of peritoneal transport before and after infection. ♦ Participants: We analyzed prospectively collected data from 541 incident peritoneal dialysis (PD) patients, aged > 18 years, between 1990 and 2010. Standard Peritoneal Permeability Analyses (SPA) within the year before and within the year after (but not within 30 days) the first peritonitis were compared. In a control group without peritonitis, SPAs within the first and second year of PD were compared. ♦ Main outcome measurements: SPA data included the mass transfer area coefficient of creatinine, glucose absorption and peritoneal clearances of β-2-microglobulin (b2m), albumin, IgG and α-2-macroglobulin (a2m). From these clearances, the restriction coefficient to macromolecules (RC) was calculated. Also, parameters of fluid transport were determined: transcapillary ultrafiltration rate (TCUFR), lymphatic absorption (ELAR), and free water transport. Crude and adjusted linear mixed models were used to compare the slopes of peritoneal transport parameters in the peritonitis group to the control group. Adjustments were made for age, sex and diabetes. ♦ Results: Of 541 patients, 367 experienced a first peritonitis episode within a median time of 12 months after the start of PD. Of these, 92 peritonitis episodes were preceded and followed by a SPA within one year. Forty-five patients without peritonitis were included in the control group. Logistic reasons (peritonitis group: 48% vs control group: 83%) and switch to hemodialysis (peritonitis group: 22% vs control group: 3%) were the main causes of missing SPA data post-peritonitis and post-control. When comparing the slopes of peritoneal transport parameters in

  15. Tsukamurella peritonitis associated with continuous ambulatory peritoneal dialysis.

    PubMed

    Shaer, A J; Gadegbeku, C A

    2001-09-01

    A case of Tsukamurella peritonitis associated with peritoneal dialysis in a 23-year-old woman is described. The organism was difficult to identify and was mistaken for Corynebacterium and atypical mycobacteria. Despite prolonged, multidrug, antimicrobial therapy with conventional antibiotics including vancomycin, ciprofloxacin, rifampin, gentamicin and ceftazidime, catheter removal was required to successfully treat peritonitis. Human infection due to this organism is rare and has been previously reported in only 13 cases, 1 of which was peritonitis. We describe here the second case of Tsukamurella peritonitis associated with peritoneal dialysis.

  16. Risk factors and outcomes of high peritonitis rate in continuous ambulatory peritoneal dialysis patients: A retrospective study.

    PubMed

    Tian, Yuanshi; Xie, Xishao; Xiang, Shilong; Yang, Xin; Zhang, Xiaohui; Shou, Zhangfei; Chen, Jianghua

    2016-12-01

    Peritonitis remains a major complication of peritoneal dialysis (PD). A high peritonitis rate (HPR) affects continuous ambulatory peritoneal dialysis (CAPD) patients' technique survival and mortality. Predictors and outcomes of HPR, rather than the first peritonitis episode, were rarely studied in the Chinese population. In this study, we examined the risk factors associated with HPR and its effects on clinical outcomes in CAPD patients.This is a single center, retrospective, observational cohort study. A total of 294 patients who developing at least 1 episode of peritonitis were followed up from March 1st, 2002, to July 31, 2014, in our PD center. Multivariate logistic regression was used to determine the factors associated with HPR, and the Cox proportional hazard model was conducted to assess the effects of HPR on clinical outcomes.During the study period of 2917.5 patient-years, 489 episodes of peritonitis were recorded, and the total peritonitis rate was 0.168 episodes per patient-year. The multivariate analysis showed that factors associated with HPR include a quick occurrence of peritonitis after CAPD initiation (shorter than 12 months), and a low serum albumin level at the start of CAPD. In the Cox proportional hazard model, HPR was a significant predictor of technique failure. There were no differences between HPR and low peritonitis rate (LPR) group for all-cause mortality. However, when the peritonitis rate was considered as a continuous variable, a positive correlation was observed between the peritonitis rate and mortality.We found the quick peritonitis occurrence after CAPD and the low serum albumin level before CAPD were strongly associated with an HPR. Also, our results verified that HPR was positively correlated with technique failure. More importantly, the increase in the peritonitis rate suggested a higher risk of all-cause mortality.These results may help to identify and target patients who are at higher risk of HPR at the start of CAPD and to

  17. Pharmacological inhibition of outwardly rectifying Cl- currents in rat peritoneal mast cells: a comparison of different stilbene derivatives.

    PubMed

    Roloff, Tim; Ziegler, Albrecht; Heber, Dieter; Seebeck, Jörg

    2003-10-08

    Diethylstilbestrol and other stilbene derivatives can provide some inhibition of the outwardly rectifying Cl- current (I(Cl-,OR)) in rat peritoneal mast cells. In order to elucidate structure-activity relationships of diethylstilbestrol, 12 stilbenes as well as 17beta-estradiol and hexestrol were tested in rat peritoneal mast cells using the nystatin-perforated patch approach of the whole-cell patch-clamp technique. Since trans-stilbene showed no effect, the substituents of diethylstilbestrol must be of importance. The introduction of only one hydroxy group in trans-stilbene produced potent inhibition of the I(Cl-,OR) (IC50: 3.3 microM). But in contrast, resveratrol with hydroxy groups at positions 4, 3', and 5' as well as methoxy substituted stilbene derivatives and 17beta-estradiol were ineffective. On the other hand, hexestrol potently inhibited I(Cl-,OR) indicating that the aromatic ring systems can also be connected by an ethyl bridge. In summary, a hydroxy group at position 4 (or 4') is a prerequisite for diethylstilbestrol-mediated inhibition of I(Cl-,OR).

  18. Intra-peritoneal chronic loculation in peritoneal dialysis patients - a new medical management approach.

    PubMed

    Mitoiu, Dan; David, Cristiana; Peride, Ileana; Niculae, Andrei; Mureşan, Alin; Ciocâlteu, Alexandru; Geavlete, Bogdan Florin; Checheriţă, Ionel Alexandru

    2014-01-01

    Peritoneal dialysis (PD) limitation as renal replacement therapy is mostly due to peritonitis and complications. Formation and persistence of intra-abdominal loculations is often under-diagnosed. Encapsulated peritoneal sclerosis (EPS) is a life-threatening complication, but malnutrition, recurrent peritonitis and early membrane failure are insidious enemies that need to be emphasized. It is important to highlight the persistence of intra-abdominal fluid collection after clinical resolution of peritonitis in PD patients and to indicate a new medical management approach for an early diagnosis. During five years, we selected PD peritonitis cases followed by a six months interval free of infections. Ninety-seven subjects were followed at six months and one year after the first peritonitis. Tomography had been performed to patients presenting a positive inflammatory state without a specific infectious cause. Subjects presenting documented localized fluid collection (31 cases) were divided into: drug-treated group and those undergoing laparoscopy by a new surgery technique (seven patients); a comparison regarding the clinical state and biohumoral parameters was assessed in both groups. The prevalence of intra-abdominal loculation following an apparent resolved peritonitis was high (31.9%). The cases undergoing laparoscopy presented a better evolution - improved clinical status (p=0.001), higher hemoglobin values (p=0.06), significant lower doses of erythropoietin requirement (p=0.03), improved dialysis adequacy (p=0.005) and inflammatory state. In cases with confirmed fluid encapsulated loculation, an active attitude (screening imaging protocol and laparoscopic exploration) appears to be mandatory, decreasing the risk of EPS, a serious complication which pathology and treatment are incompletely understood.

  19. Benefits of a continuous ambulatory peritoneal dialysis (CAPD) technique with one icodextrin-containing and two biocompatible glucose-containing dialysates for preservation of residual renal function and biocompatibility in incident CAPD patients.

    PubMed

    Yoon, Hye Eun; Chang, Yoon Kyung; Shin, Seok Joon; Choi, Bum Soon; Kim, Byung Soo; Park, Cheol Whee; Song, Ho Cheol; Yoon, Sun Ae; Jin, Dong Chan; Kim, Yong-Soo

    2014-09-01

    In a prospective randomized controlled study, the efficacy and safety of a continuous ambulatory peritoneal dialysis (CAPD) technique has been evaluated using one icodextrin-containing and two glucose-containing dialysates a day. Eighty incident CAPD patients were randomized to two groups; GLU group continuously using four glucose-containing dialysates (n=39) and ICO group using one icodextrin-containing and two glucose-containing dialysates (n=41). Variables related to residual renal function (RRF), metabolic and fluid control, dialysis adequacy, and dialysate effluent cancer antigen 125 (CA125) and interleukin 6 (IL-6) levels were measured. The GLU group showed a significant decrease in mean renal urea and creatinine clearance (-Δ1.2 ± 2.9 mL/min/1.73 m(2), P=0.027) and urine volume (-Δ363.6 ± 543.0 mL/day, P=0.001) during 12 months, but the ICO group did not (-Δ0.5 ± 2.7 mL/min/1.73 m(2), P=0.266; -Δ108.6 ± 543.3 mL/day, P=0.246). Peritoneal glucose absorption and dialysate calorie load were significantly lower in the ICO group than the GLU group. The dialysate CA125 and IL-6 levels were significantly higher in the ICO group than the GLU group. Dialysis adequacy, β2-microglobulin clearance and blood pressure did not differ between the two groups. The CAPD technique using one icodextrin-containing and two glucose-containing dialysates tends to better preserve RRF and is more biocompatible, with similar dialysis adequacy compared to that using four glucose-containing dialysates in incident CAPD patients. [Clincal Trial Registry, ISRCTN23727549].

  20. Benefits of a Continuous Ambulatory Peritoneal Dialysis (CAPD) Technique with One Icodextrin-Containing and Two Biocompatible Glucose-Containing Dialysates for Preservation of Residual Renal Function and Biocompatibility in Incident CAPD Patients

    PubMed Central

    2014-01-01

    In a prospective randomized controlled study, the efficacy and safety of a continuous ambulatory peritoneal dialysis (CAPD) technique has been evaluated using one icodextrin-containing and two glucose-containing dialysates a day. Eighty incident CAPD patients were randomized to two groups; GLU group continuously using four glucose-containing dialysates (n=39) and ICO group using one icodextrin-containing and two glucose-containing dialysates (n=41). Variables related to residual renal function (RRF), metabolic and fluid control, dialysis adequacy, and dialysate effluent cancer antigen 125 (CA125) and interleukin 6 (IL-6) levels were measured. The GLU group showed a significant decrease in mean renal urea and creatinine clearance (-Δ1.2±2.9 mL/min/1.73 m2, P=0.027) and urine volume (-Δ363.6±543.0 mL/day, P=0.001) during 12 months, but the ICO group did not (-Δ0.5±2.7 mL/min/1.73 m2, P=0.266; -Δ108.6±543.3 mL/day, P=0.246). Peritoneal glucose absorption and dialysate calorie load were significantly lower in the ICO group than the GLU group. The dialysate CA125 and IL-6 levels were significantly higher in the ICO group than the GLU group. Dialysis adequacy, β2-microglobulin clearance and blood pressure did not differ between the two groups. The CAPD technique using one icodextrin-containing and two glucose-containing dialysates tends to better preserve RRF and is more biocompatible, with similar dialysis adequacy compared to that using four glucose-containing dialysates in incident CAPD patients. [Clincal Trial Registry, ISRCTN23727549] Graphical Abstract PMID:25246739

  1. Recurrent peritoneal dialysis-related peritonitis caused by Microbacterium resistens.

    PubMed

    Gallois, Emmanuelle; Lamy, Thomas; Fines-Guyon, Marguerite; Lobbedez, Thierry; Cattoir, Vincent

    2014-05-01

    We report a case of a recurrent peritonitis due to Microbacterium resistens in a 71-year-old male patient undergoing peritoneal dialysis (PD). Importantly, this Gram-positive rod was intrinsically resistant to cephalosporins and vancomycin, classically used in PD-related peritonitis treatment. His infection resolved after several weeks of appropriate therapy (amoxicillin plus gentamicin) and PD catheter removal.

  2. [Characteristics of peritoneal exudate microflora in children with appendicular peritonitis].

    PubMed

    Bodnar, B M

    1997-01-01

    Bacteriological investigation of peritoneal exudate was conducted in 131 children with peritonitis. The greatest quantity of pathogenic and conventionally pathogenic Escherichias and bacteroids was revealed in March, April and September. In summer peritonitis was caused by pathogenic and conventionally pathogenic Escherichias in association with enterobacterias, staphylococci and other microorganisms.

  3. [Spontaneous bacterial peritonitis].

    PubMed

    Velkey, Bálint; Vitális, Eszter; Vitális, Zsuzsanna

    2017-01-01

    Spontaneous bacterial peritonitis occurs most commonly in cirrhotic patients with ascites. Pathogens get into the circulation by intestinal translocation and colonize in peritoneal fluid. Diagnosis of spontaneous bacterial peritonitis is based on elevated polymorphonuclear leukocyte count in the ascites (>0,25 G/L). Ascites culture is often negative but aids to get information about antibiotic sensitivity in positive cases. Treatment in stable patient can be intravenous then orally administrated ciprofloxacin or amoxicillin/clavulanic acid, while in severe cases intravenous III. generation cephalosporin. Nosocomial spontaneous bacterial peritonitis often caused by Gram-positive bacteria and multi-resistant pathogens can also be expected thus carbapenem should be the choice of the empiric treatment. Antibiotic prophylaxis should be considered. Norfloxacin is used most commonly, but changes are expected due to increase in quinolone resistance. As a primary prophylaxis, a short-term antibiotic treatment is recommended after gastrointestinal bleeding for 5 days, while long-term prophylaxis is for patients with low ascites protein, and advanced disease (400 mg/day). Secondary prophylaxis is recommended for all patients recovered from spontaneous bacterial peritonitis. Due to increasing antibiotic use of antibiotics prophylaxis is debated to some degree. Orv. Hetil., 2017, 158(2), 50-57.

  4. Performance Analysis of Coaxial Fed Stacked Patch Antennas

    NASA Astrophysics Data System (ADS)

    Jain, Satish K.; Jain, Shobha

    2014-01-01

    A performance analysis of coaxial fed stacked dual patch electromagnetic-coupled microstrip antenna useful for satellite communication working in X/Ku band is presented. A simplified structure of stacked dual patch antenna is proposed with adjustable foam-gap between patches. Few important geometrical parameters were chosen on which the performance of stacked dual patch antenna mainly depends. Dimension of lower square patch, upper square patch and height of foam-gap between two patches are the parameters, which were varied one by one keeping other parameters constant. The performance was observed through the reflection coefficient (dB) and smith chart impedance plot, obtained from the numerical simulator (IE3D) for the dual resonance frequency and bandwidth. Proposed geometry of stacked dual patch antenna was also analyzed with cavity model and artificial neural network modeling technique. Dual resonance frequencies and associated bandwidth were calculated through them and results were cross checked in the laboratory with a few experimental findings.

  5. Microbiology of Peritonitis in Peritoneal Dialysis Patients with Multiple Episodes

    PubMed Central

    Nessim, Sharon J.; Nisenbaum, Rosane; Bargman, Joanne M.; Jassal, Sarbjit V.

    2012-01-01

    ♦ Background: Peritoneal dialysis (PD)–associated peritonitis clusters within patients. Patient factors contribute to peritonitis risk, but there is also entrapment of organisms within the biofilm that forms on PD catheters. It is hypothesized that this biofilm may prevent complete eradication of organisms, predisposing to multiple infections with the same organism. ♦ Methods: Using data collected in the Canadian multicenter Baxter POET (Peritonitis, Organism, Exit sites, Tunnel infections) database from 1996 to 2005, we studied incident PD patients with 2 or more peritonitis episodes. We determined the proportion of patients with 2 or more episodes caused by the same organism. In addition, using a multivariate logistic regression model, we tested whether prior peritonitis with a given organism predicted the occurrence of a subsequent episode with the same organism. ♦ Results: During their time on PD, 558 patients experienced 2 or more peritonitis episodes. Of those 558 patients, 181 (32%) had at least 2 episodes with the same organism. The organism most commonly causing repeat infection was coagulase-negative Staphylococcus (CNS), accounting for 65.7% of cases. Compared with peritonitis caused by other organisms, a first CNS peritonitis episode was associated with an increased risk of subsequent CNS peritonitis within 1 year (odds ratio: 2.1; 95% confidence interval: 1.5 to 2.8; p < 0.001). Among patients with repeat CNS peritonitis, 48% of repeat episodes occurred within 6 months of the earlier episode. ♦ Conclusions: In contrast to previous data, we did not find a high proportion of patients with multiple peritonitis episodes caused by the same organism. Coagulase-negative Staphylococcus was the organism most likely to cause peritonitis more than once in a given patient, and a prior CNS peritonitis was associated with an increased risk of CNS peritonitis within the subsequent year. PMID:22215659

  6. Patching for corneal abrasion.

    PubMed

    Lim, Chris H L; Turner, Angus; Lim, Blanche X

    2016-07-26

    Published audits have demonstrated that corneal abrasions are a common presenting eye complaint. Eye patches are often recommended for treating corneal abrasions despite the lack of evidence for their use. This systematic review was conducted to determine the effects of the eye patch when used to treat corneal abrasions. The objective of this review was to assess the effects of patching for corneal abrasion on healing and pain relief. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2016), EMBASE (January 1980 to May 2016), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to May 2016), System for Information on Grey Literature in Europe (OpenGrey) (January 1995 to May 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 9 May 2016. We also searched the reference lists of included studies, unpublished 'grey' literature and conference proceedings and contacted pharmaceutical companies for details of unpublished trials. We included randomised and quasi-randomised controlled trials that compared patching the eye with no patching to treat simple corneal abrasions. Two authors independently assessed the risk of bias and extracted data. Investigators were contacted for further information regarding the quality of trials. The primary outcome was healing at 24, 48 and 72 hours while secondary outcomes included measures of pain, quality of life and adverse effects. We graded the certainty of the evidence using GRADE. We included 12 trials which

  7. STS-121 Mission Patch

    NASA Image and Video Library

    2005-06-01

    STS121-S-001 (June 2005) --- The STS-121 patch depicts the space shuttle docked with the International Space Station (ISS) in the foreground, overlaying the astronaut symbol with three gold columns and a gold star. The ISS is shown in the configuration that it will be in during the STS-121 mission. The background shows the nighttime Earth with a dawn breaking over the horizon. STS-121, ISS mission ULF1.1, is the final Shuttle Return to Flight test mission. This utilization and logistics flight will bring a multipurpose logistics module (MPLM) to the ISS with several thousand pounds of new supplies and experiments. In addition, some new orbital replacement units (ORUs) will be delivered and stowed externally on ISS on a special pallet. These ORUs are spares for critical machinery located on the outside of the ISS. During this mission the crew will also carry out testing of shuttle inspection and repair hardware, as well as evaluate operational techniques and concepts for conducting on-orbit inspection and repair. The NASA insignia design for space shuttle flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced. Photo credit: NASA

  8. Olopatadine inhibits exocytosis in rat peritoneal mast cells by counteracting membrane surface deformation.

    PubMed

    Baba, Asuka; Tachi, Masahiro; Maruyama, Yoshio; Kazama, Itsuro

    2015-01-01

    Besides its anti-allergic properties as a histamine receptor antagonist, olopatadine stabilizes mast cells by inhibiting the release of chemokines. Since olopatadine bears amphiphilic features and is preferentially partitioned into the lipid bilayers of the plasma membrane, it would induce some morphological changes in mast cells and thus affect the process of exocytosis. Employing the standard patch-clamp whole-cell recording technique, we examined the effects of olopatadine and other anti-allergic drugs on the membrane capacitance (Cm) in rat peritoneal mast cells during exocytosis. Using confocal imaging of a water-soluble fluorescent dye, lucifer yellow, we also examined their effects on the deformation of the plasma membrane. Low concentrations of olopatadine (1 or 10 µM) did not significantly affect the GTP-γ-S-induced increase in the Cm. However, 100 µM and 1 mM olopatadine almost totally suppressed the increase in the Cm. Additionally, these doses completely washed out the trapping of the dye on the cell surface, indicating that olopatadine counteracted the membrane surface deformation induced by exocytosis. As shown by electron microscopy, olopatadine generated inward membrane bending in mast cells. This study provides electrophysiological evidence for the first time that olopatadine dose-dependently inhibits the process of exocytosis in rat peritoneal mast cells. Such mast cell stabilizing properties of olopatadine may be attributed to its counteracting effects on the plasma membrane deformation in degranulating mast cells. © 2015 S. Karger AG, Basel.

  9. The Mutual Relationship Between Peritonitis and Peritoneal Transport.

    PubMed

    van Esch, Sadie; van Diepen, Anouk T N; Struijk, Dirk G; Krediet, Raymond T

    2016-01-01

    ♦ Preservation of the peritoneum is required for long-term peritoneal dialysis (PD). We investigated the effect of multiple peritonitis episodes on peritoneal transport. ♦ Prospectively collected data from 479 incident PD patients treated between 1990 and 2010 were analyzed, using strict inclusion criteria: follow-up of at least 3 years with the availability of a Standard Peritoneal Permeability Analysis (SPA) in the first year after start of PD and within the third year of PD, without peritonitis preceding the first SPA. For the purpose of the study, we only included patients who remained peritonitis-free (n = 28) or who experienced 3 or more peritonitis episodes (n = 16). ♦ At baseline the groups were similar with regard to small solute and fluid transport. However, the frequent peritonitis group had lower peritoneal protein clearances compared to the no peritonitis group, resulting in lower dialysate concentrations of proteins: albumin 196.5 mg/L vs 372.5 mg/L, IgG 36.4 mg/L vs 65.0 mg/L, and α-2-macroglobulin (A2M) 1.9 mg/L vs 3.6 mg/L, p <0.01. No differences in serum concentrations were present. A comparison between the transport slopes over time in both groups showed a positive time trend of mass transfer area coefficient (MTAC) creatinine (p = 0.03) and glucose absorption (p = 0.09) and a negative trend of transcapillary ultrafiltration (p = 0.06), when compared to the no peritonitis group. Frequent peritonitis did not affect free water transport. ♦ Slow initial peritoneal transport rates of serum proteins result in lower dialysate concentrations, and likely a lower opsonic activity, which is a risk factor for peritonitis. Patients with frequent peritonitis show an increase in small solute transport and a concomitant decrease of ultrafiltration. In long-term peritonitis-free PD patients, small solute transport decreased, while ultrafiltration increased. This suggests that frequent peritonitis leads to an increase of the vascular peritoneal surface

  10. 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

  11. Bright Patches on Ariel

    NASA Image and Video Library

    1998-12-05

    Distinct bright patches are visible on Ariel, the brightest of Uranus five largest satellites. NASA Voyager 2 obtained this image Jan. 22, 1986, from a distance of 2.52 million kilometers 1.56 million miles.

  12. Gemini 6 patch

    NASA Image and Video Library

    1965-01-01

    The Gemini 6 patch is hexagonal in shape, reflecting the mission number; and the spacecraft trajectory also traces out the number "6". The Gemini 6 spacecraft is shown superimposed on the "twin stars" Castor and Pollux, for "Gemini".

  13. Lidocaine Transdermal Patch

    MedlinePlus

    Lidocaine patches are used to relieve the pain of post-herpetic neuralgia (PHN; the burning, stabbing pains, ... for months or years after a shingles infection). Lidocaine is in a class of medications called local ...

  14. Rotigotine Transdermal Patch

    MedlinePlus

    ... that causes difficulties with movement, muscle control, and balance) including shaking of parts of the body, stiffness, slowed movements, and problems with balance. Rotigotine transdermal patches are also used to treat ...

  15. Benign multicystic peritoneal mesothelioma.

    PubMed

    Uzüm, Nüket; Ozçay, Necdet; Ataoğlu, Omür

    2009-06-01

    Benign multicystic peritoneal mesothelioma is a rare tumor that occurs mainly in women in their reproductive age. It is characterized by the formation of multiple, thin-walled, multilocular cysts that frequently produce large, intra-abdominal masses. The short follow-ups and possible etiologies based on the published reports make it difficult to draw any firm conclusions.

  16. Diagnostic peritoneal lavage - slideshow

    MedlinePlus

    ... Indication URL of this page: //medlineplus.gov/ency/presentations/100159.htm Diagnostic peritoneal lavage - series—Indication To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  17. Brevibacillus brevis peritonitis.

    PubMed

    Parvez, Najma; Cornelius, Lisa K; Fader, Robert

    2009-04-01

    We present what we believe is the first case of Brevibacillus (Bacillus) brevis peritonitis in a patient with hepatocellular carcinoma, possibly caused by the ingestion of fermented foods containing B. brevis spores. This case also demonstrates a pattern of antibiotic susceptibility with differing in vitro and in vivo bactericidal efficacy.

  18. FNAL system patching design

    SciTech Connect

    Schmidt, Jack; Lilianstrom, Al; Romero, Andy; Dawson, Troy; Sieh, Connie; /Fermilab

    2004-01-01

    FNAL has over 5000 PCs running either Linux or Windows software. Protecting these systems efficiently against the latest vulnerabilities that arise has prompted FNAL to take a more central approach to patching systems. Due to different levels of existing support infrastructures, the patching solution for linux systems differs from that of windows systems. In either case, systems are checked for vulnerabilities by Computer Security using the Nessus tool.

  19. [Benign multicystic peritoneal mesothelioma in a patient with Crohn disease].

    PubMed

    Fluxá, Daniela; Kronberg, Udo; Lubascher, Jaime; O'Brien, Andrés; Las Heras, Facundo; Ibáñez, Patricio; Quera, Rodrigo

    2016-12-01

    Benign multicystic peritoneal mesothelioma is an uncommon lesion arising from the peritoneal mesothelium. It is asymptomatic or presents with unspecific symptoms. Imaging techniques may reveal it, however the final diagnosis can only be made by histopathology. Surgery is the only effective treatment considering its high recurrence rate. We report a 19 years old male with Crohn’s disease. Due to persistent abdominal pain, an abdominal magnetic resonance imaging was performed, showing a complex cystic mass in the lower abdomen. The patient underwent surgery and the lesion was completely resected. The pathological study reported a benign multicystic peritoneal mesothelioma.

  20. The Association between Peritoneal Dialysis Modality and Peritonitis

    PubMed Central

    Johnson, David W.; McDonald, Stephen P.; Boudville, Neil; Borlace, Monique; Badve, Sunil V.; Sud, Kamal; Clayton, Philip A.

    2014-01-01

    Background and objectives There is conflicting evidence comparing peritonitis rates among patients treated with continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD). This study aims to clarify the relationship between peritoneal dialysis (PD) modality (APD versus CAPD) and the risk of developing PD-associated peritonitis. Design, setting, participants, & measurements This study examined the association between PD modality (APD versus CAPD) and the risks, microbiology, and clinical outcomes of PD-associated peritonitis in 6959 incident Australian PD patients between October 1, 2003, and December 31, 2011, using data from the Australia and New Zealand Dialysis and Transplant Registry. Median follow-up time was 1.9 years. Results Patients receiving APD were younger (60 versus 64 years) and had fewer comorbidities. There was no association between PD modality and time to first peritonitis episode (adjusted hazard ratio [HR] for APD versus CAPD, 0.98; 95% confidence interval [95% CI], 0.91 to 1.07; P=0.71). However, there was a lower hazard of developing Gram-positive peritonitis with APD than CAPD, which reached borderline significance (HR, 0.90; 95% CI, 0.80 to 1.00; P=0.05). No statistically significant difference was found in the risk of hospitalizations (odds ratio, 1.12; 95% CI, 0.93 to 1.35; P=0.22), but there was a nonsignificant higher likelihood of 30-day mortality (odds ratio, 1.33; 95% CI, 0.93 to 1.88; P=0.11) at the time of the first episode of peritonitis for patients receiving APD. For all peritonitis episodes (including subsequent episodes of peritonitis), APD was associated with lower rates of culture-negative peritonitis (incidence rate ratio [IRR], 0.81; 95% CI, 0.69 to 0.94; P=0.002) and higher rates of gram-negative peritonitis (IRR, 1.28; 95% CI, 1.13 to 1.46; P=0.01). Conclusions PD modality was not associated with a higher likelihood of developing peritonitis. However, APD was associated with a borderline

  1. Rates and causes of peritonitis in a National Multicenter Continuous Ambulatory Peritoneal Dialysis program in Sudan: first-year experience.

    PubMed

    Abu-Aisha, Hasan; Elhassan, Elwaleed A; Khamis, Ammar H; Fedail, Haleema; Kaballo, Babikir; Abdelraheem, M Babbikir; Ali, Tigani; Medani, Safaa; Tammam, Layla; Basheir, Ihsan

    2007-11-01

    This is a cumulative report of all patients in six centers in Greater Khartoum, all three cities that comprise the capital of Sudan, covering the first year of operation of the National Program. This study evaluates the rates, mechanisms, causative agents and clinical outcomes of peritonitis. We included the data of all 60 patients who underwent CAPD from June 2005 to June 2006. There were 15 episodes of peritonitis in 323 patient-months, which equates to an overall peritonitis rate of one episode every 21.5 months (0.55 episodes per year at risk). The individual center rates varied. There was a statistically significant age difference, with peritonitis being more common in the youngsters. All patients presented with abdominal pain and had cloudy effluents but none had a significant exit site or tunnel infection. Fluid cultures were available in 11 out of the 15 episodes of peritonitis. The cultures were positive for organisms in only 3 out of 11 (27%) cases. Two patients were infected by Pseudomonas aerogenosa and one patient by Staphylococcus aureus. Thus, the culture-negative peritonitis rate was 8/11 (73%). Touch contamination was the likely mechanism in 7/15 (46.7%) of the episodes. There were three cases of refractory peritonitis and only one case of relapsing peritonitis. None of the patients had a catheter removed because of peritonitis. We conclude that the first year of operation of the Sudan National Multi-centered PD program has proven that it is a promising project with multifaceted success. The cumulative peritonitis incidence is acceptable although there are several areas for improvement. Standardized laboratory techniques need to be implemented and pursued, particularly in the microbiology area.

  2. Scattering from arbitrarily shaped microstrip patch antennas

    NASA Technical Reports Server (NTRS)

    Shively, David G.; Deshpande, Manohar D.; Cockrell, Capers R.

    1992-01-01

    The scattering properties of arbitrarily shaped microstrip patch antennas are examined. The electric field integral equation for a current element on a grounded dielectric slab is developed for a rectangular geometry based on Galerkin's technique with subdomain rooftop basis functions. A shape function is introduced that allows a rectangular grid approximation to the arbitrarily shaped patch. The incident field on the patch is expressed as a function of incidence angle theta(i), phi(i). The resulting system of equations is then solved for the unknown current modes on the patch, and the electromagnetic scattering is calculated for a given angle. Comparisons are made with other calculated results as well as with measurements.

  3. Development and evaluation of a tampering resistant transdermal fentanyl patch.

    PubMed

    Cai, Bing; Engqvist, Håkan; Bredenberg, Susanne

    2015-07-05

    With the increasing number of misuse and abuse of opioids, the resistance to tampering becomes an important attribute for transdermal opioid patches. In this study, drug-containing geopolymer granules were integrated into an adhesive matrix to improve the resistance of fast drug release against some common abuse techniques. Bench testing showed that fentanyl loaded geopolymer granules had better resistance to tampering compared to a commercial fentanyl patch. Moreover, in a pilot in vivo study on a few rats, the granules showed potential to give similar drug plasma concentrations as the commercial fentanyl patch. After integrating geopolymer granules into an adhesive matrix, the new patch showed a better resistance against the investigated tampering tests compared with the commercially available patch. In this study, we showed that incorporating drug loaded geopolymer granules into a patch adhesive has potential to improve the resistance of the fentanyl patch against tampering without compromising the drug release.

  4. Peritoneal Dialysis in Chronic Renal Failure

    PubMed Central

    Edelbaum, David N.; Sokol, Albert; Gaynor, Sanford; Rubini, Milton E.

    1968-01-01

    The long-term results of intermittent peritoneal dialysis in long-term treatment of renal disease have yet to equal those of intermittent hemodialysis. However, further exploration and refinement of this technique is justified. Performed in acute stages of disease, both peritoneal dialysis and hemodialysis relieve the symptoms of uremia and specifically “buy time” for the patient so that proper medical or surgical therapy may be instituted. In acute situations, peritoneal dialysis is the procedure of choice, and is an important adjunct to more conventional treatment for chronic renal disease. It may be useful sometimes even in chronically hemodialyzed patients—for example, when the hemodialysis cannula for one reason or another is inaccessible because of clots, replacement, or infection. It is especially valuable when the hemorrhagic complications of uremia contraindicate hemodialysis treatment. Its use in chronic uremia remains sharply limited in time, but for brief periods chronic peritoneal dialysis appears to be a reasonably satisfactory means of prolonging life while awaiting homotransplant or decision for maintenance hemodialysis therapy. PMID:5639945

  5. Biocompatible Peritoneal Dialysis Fluids: Clinical Outcomes

    PubMed Central

    Cho, Yeoungjee; Badve, Sunil V.; Hawley, Carmel M.; Wiggins, Kathryn; Johnson, David W.

    2012-01-01

    Peritoneal dialysis (PD) is a preferred home dialysis modality and has a number of added advantages including improved initial patient survival and cost effectiveness over haemodialysis. Despite these benefits, uptake of PD remains relatively low, especially in developed countries. Wider implementation of PD is compromised by higher technique failure from infections (e.g., PD peritonitis) and ultrafiltration failure. These are inevitable consequences of peritoneal injury, which is thought to result primarily from continuous exposure to PD fluids that are characterised by their “unphysiologic” composition. In order to overcome these barriers, a number of more biocompatible PD fluids, with neutral pH, low glucose degradation product content, and bicarbonate buffer have been manufactured over the past two decades. Several preclinical studies have demonstrated their benefit in terms of improvement in host cell defence, peritoneal membrane integrity, and cytokine profile. This paper aims to review randomised controlled trials assessing the use of biocompatible PD fluids and their effect on clinical outcomes. PMID:23251801

  6. Multidisciplinary Treatment for Colorectal Peritoneal Metastases: Review of the Literature

    PubMed Central

    2016-01-01

    Peritoneum is one of the common sites of metastasis in advanced stage colorectal cancer patients. Colorectal cancer patients with peritoneal metastases (PM) are traditionally believed to have poor prognosis, which indicates it is of no value to adopt surgical treatment. With the advancement of surgical techniques, hyperthermic intraperitoneal chemotherapy (HIPEC), and multidisciplinary treatment in recent years, the cognition and treatment strategies of colorectal peritoneal metastases (CPM) have changed dramatically. In terms of prognosis, CPM under the palliative systemic treatment shows an inferior outcome compared with nonperitoneal metastasis. Nevertheless, some CPM patients amenable to the complete peritoneal cytoreductive surgery (CRS) combined with HIPEC may achieve long-term survival. The prognostic factors of CPM comprise peritoneal carcinomatosis index (PCI), completeness of cytoreduction score (CC score), the presence of extraperitoneal metastasis (liver, etc.), Peritoneal Surface Disease Severity Score (PSDSS), Japanese peritoneal staging, and so forth. Taken together, literature data suggest that a multimodality approach combining complete peritoneal CRS plus HIPEC, systemic chemotherapy, and targeted therapy may be the best treatment option for PM from colorectal cancer. PMID:28105045

  7. Renal replacement therapy in elderly patients: peritoneal dialysis.

    PubMed

    Catizone, Luigi; Malacarne, Franco; Bortot, Alessia; Annaloro, Mariangela; Russo, Giorgia; Barillà, Antonio; Storari, Alda

    2010-01-01

    Management of chronic uremia in elderly patients presents several clinic and organizational difficulties. Hemodialysis (HD) and chronic peritoneal dialysis (CPD) are both available for the elderly, and the choice depends on the individual, clinical and familial conditions. Several reports have compared the outcomes for older patients treated by HD or peritoneal dialysis, with those for younger or older patients undergoing peritoneal dialysis. CPD is a successful dialysis option for elderly patients, in both patient and technique survival terms. All nutritional parameters are of pivotal importance. Several barriers, such as medical and social factors, physician bias, late referral and education irrespective of the needs of older patients, influence the choice of CPD. The development of assisted peritoneal dialysis, using community-based nurses or health care assistants, can overcome some of the barriers and enable frail older patients to have home-based dialysis treatment. Increasing age is associated with higher peritonitis rates among patients who started CPD in the 1990s, while age is not associated with peritonitis in more recent CPD cohorts, and no greater frequency of adverse outcomes of peritonitis has been seen among those who began CPD after the year 2000. In elderly dialysis patients, the management of quality of life (QOL) is important as well as adequacy of dialysis, nutritional status and survival rate. To obtain a good standard of QOL, it is essential to select carers who are properly educated and who can access an adequate support system, both physical and psychological, to help them cope with their burden.

  8. Tuberculous peritonitis in no risk patients: diagnostic approach.

    PubMed

    Tazzioli, Giovanni; Farinetti, Alberto; Gelmini, Roberta; Longo, Giuseppe; Barbolini, Giuseppe; Saviano, Massimo

    2005-04-01

    Incidence of tubercoulosis is increasing in Western countries particularly in immigrants from endemic areas and in patients with HIV or immunocompromised. The disease is unusual in patients without risk factors. In these conditions the diagnosis of tuberculous peritonitis is often delayed, resulting in high morbidity and mortality. We describe a case of tuberculous peritonitis in a man suffering from ascites referred for presumed peritoneal carcinosis. The finding of no malignancies in the peritoneal fluid must rise the suspect of tuberculosis that, if misdiagnosed, is fatal. The patient was submitted to diagnostic videolaparoscopy and multiple biopsies were done. The definitive histological diagnosis was chronic granulomatous flogosis with giant cells, focally necrotizing, caused by peritoneal tubercolosis. The patient was submitted to chemotherapy with isoniazide, rifampicine, piazafoline, ethambutol and streptomycine which determined the resolution of the clinical picture. We believe the diagnostic procedure of choice is videolaparoscopy when tubercolous peritonitis is suspected. This technique allows to obtain selective biopsies of peritoneal nodules and to collect samples for specific cultural and cytohistological exams. The operation is safe, reliable with few complications and permits a prompt diagnosis necessary to cure the patient.

  9. The effect of apelin on the functions of peritoneal macrophages.

    PubMed

    Izgüt-Uysal, V N; Gemici, B; Birsen, I; Acar, N; Üstünel, I

    2017-07-18

    Apelin, the endogenous ligand of the G protein-coupled receptor (APJ), plays an important role in the physiological response to homeostatic perturbations. The aim of the present study was to investigate the effect of apelin on the functions of peritoneal macrophages. A double staining immunofluorescence technique was used to determine the expression of APJ in peritoneal macrophages. Rat peritoneal macrophages were randomly divided into three groups: control, apelin and apelin+F13A. A significant decrease in phagocytic and chemotactic activity of peritoneal macrophages resulted when the macrophages were incubated with [Pry(1)]-Apelin-13 (10 ng/ml). Incubation of peritoneal macrophages with the APJ receptor antagonist, F13A (20 ng/ml) prevented the suppressive effect of apelin on phagocytosis and chemotaxis. Peritoneal macrophages incubated with [Pry(1)]-Apelin-13 exhibited a decrease in the production of TNF-alpha and IL-6 compared to the control macrophages. Incubation of peritoneal macrophages with [Pry(1)]-Apelin-13 plus F13A prevented the decrease in the production of proinflammatory cytokines produced by [Pry(1)]-Apelin-13. In conclusion, apelin may be a mediator that inhibits the functions of activated macrophages.

  10. Pressure wall patch

    NASA Technical Reports Server (NTRS)

    Williamsen, Joel E. (Inventor); Weddendorf, Bruce C. (Inventor)

    1994-01-01

    A rigid patch body for placing over a damaged portion (hole) of an external wall of a pressurized vessel, such as a space vehicle or a habitat, is discussed. The rigid patch body allows an astronaut to make temporary repairs to the pressurized vessel from the exterior of the vessel, which enables more permanent repairs to be made from the interior of the vessel. The pressure wall patch of the present invention includes a floor surrounded by four side members. Each side member includes a threaded screw for anchoring the patch body to the external wall of the pressurized vessel and a recess in its lower surface for supporting an inflatable bladder for surrounding the damaged portion (hole) of the external wall to seal the area surrounding the damaged portion. This allows the vessel to be repressurized. The floor of the rigid patch body supports a source of gas that is connected to the gas supply valve and a gas supply gauge in communication with the gas supply valve and the inflatable bladder.

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

    PubMed

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

    2015-01-01

    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. 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. 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). 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 in APD patients.

  12. Influence of peritoneal transport characteristics on nutritional status and clinical outcome in Chinese diabetic nephropathy patients on peritoneal dialysis.

    PubMed

    Guan, Ji-Chao; Bian, Wei; Zhang, Xiao-Hui; Shou, Zhang-Fei; Chen, Jiang-Hua

    2015-04-05

    High peritoneal transport status was previously thought to be a poor prognostic factor in peritoneal dialysis (PD) patients. However, its effect on diabetic nephropathy PD patients is unclear in consideration of the adverse impact of diabetes itself. The purpose of this study was to investigate the influence of peritoneal transport characteristics on nutritional status and clinical outcome in diabetic nephropathy patients on PD. One hundred and two diabetic nephropathy patients on PD were enrolled in this observational cohort study. According to the initial peritoneal equilibration test result, patients were divided into two groups: Higher transport group (HT, including high and high average transport) and lower transport group (LT, including low and low-average transport). Demographic characteristics, biochemical data, dialysis adequacy, and nutritional status were evaluated. Clinical outcomes were compared. Risk factors for death-censored technique failure and mortality were analyzed. Compared with LT group (n = 37), serum albumin was significantly lower and the incidence of malnutrition by subjective global assessment was significantly higher in HT group (n = 65) (P < 0.05). Kaplan-Meier analyses showed that death-censored technique failure and mortality were significantly increased in HT group compared with that in LT group. On multivariate Cox analyses, higher peritoneal transport status and lower residual renal function (RRF) were independent predictors of death-censored technique failure when adjusted for serum albumin and total weekly urea clearance (Kt/V). Independent predictors of mortality were advanced age, anemia, hypoalbuminemia, and lower RRF, but not higher peritoneal transport status. Higher peritoneal transport status has an adverse influence on nutrition for diabetic nephropathy patients on PD. Higher peritoneal transport status is a significant independent risk factor for death-censored technique failure, but not for mortality in diabetic

  13. Influence of Peritoneal Transport Characteristics on Nutritional Status and Clinical Outcome in Chinese Diabetic Nephropathy Patients on Peritoneal Dialysis

    PubMed Central

    Guan, Ji-Chao; Bian, Wei; Zhang, Xiao-Hui; Shou, Zhang-Fei; Chen, Jiang-Hua

    2015-01-01

    Background: High peritoneal transport status was previously thought to be a poor prognostic factor in peritoneal dialysis (PD) patients. However, its effect on diabetic nephropathy PD patients is unclear in consideration of the adverse impact of diabetes itself. The purpose of this study was to investigate the influence of peritoneal transport characteristics on nutritional status and clinical outcome in diabetic nephropathy patients on PD. Methods: One hundred and two diabetic nephropathy patients on PD were enrolled in this observational cohort study. According to the initial peritoneal equilibration test result, patients were divided into two groups: Higher transport group (HT, including high and high average transport) and lower transport group (LT, including low and low-average transport). Demographic characteristics, biochemical data, dialysis adequacy, and nutritional status were evaluated. Clinical outcomes were compared. Risk factors for death-censored technique failure and mortality were analyzed. Results: Compared with LT group (n = 37), serum albumin was significantly lower and the incidence of malnutrition by subjective global assessment was significantly higher in HT group (n = 65) (P < 0.05). Kaplan–Meier analyses showed that death-censored technique failure and mortality were significantly increased in HT group compared with that in LT group. On multivariate Cox analyses, higher peritoneal transport status and lower residual renal function (RRF) were independent predictors of death-censored technique failure when adjusted for serum albumin and total weekly urea clearance (Kt/V). Independent predictors of mortality were advanced age, anemia, hypoalbuminemia, and lower RRF, but not higher peritoneal transport status. Conclusions: Higher peritoneal transport status has an adverse influence on nutrition for diabetic nephropathy patients on PD. Higher peritoneal transport status is a significant independent risk factor for death-censored technique

  14. [Benign multicystic peritoneal mesothelioma. A case report].

    PubMed

    Lari, Federico; Castelli, Giuliano; Bragagni, Gianpaolo

    2012-02-01

    Benign multicystic peritoneal mesothelioma is a rare malignancy with unknown etiology, first described in 1980, which have been reported to date about 150 cases in the literature. Although the term "benign", used mainly to distinguish it from the classic malignant mesothelioma, a more aggressive cancer, is considered "borderline" in terms of aggression: it tends to local recurrence but cases of lymph node metastases or in other locations at a distance are not described. The symptoms are often vague and nonspecific (abdominal pain, enlarged abdomen and ascites). The common diagnostic imaging techniques (CT, MRI) may appear similar to ovarian or peritoneal cancer by more aggressive mesenchymal neoplasms. Histological examination, accurately with the aid of immunohistochemical techniques, is therefore essential for diagnosis. Treatment is surgical and consists of peritonectomy. After surgery, the prognosis is generally good. In 50% of cases may have local recurrences; so rigorous follow-up is indicated.

  15. Cytology of benign multicystic peritoneal mesothelioma in peritoneal washings.

    PubMed

    Assaly, M; Bongiovanni, M; Kumar, N; Egger, J-F; Pelte, M-F; Genevay, M; Finci, V; Tschanz, E; Pache, J-C

    2008-08-01

    To describe the cytological aspect of peritoneal washings in benign multicystic peritoneal mesothelioma (BMPM). Three peritoneal washing specimens stained by standard cytological and histological procedures and analysed by light microscopy. The specimens showed an abundance of monomorphous mesothelial cells devoid of atypia or mitoses. The mesothelial cells were calretinin positive. They also showed numerous squamous metaplastic cells arranged in flat sheets or isolated cells. The background contained some inflammatory cells. The combination of cytology of the peritoneal washing, histology (cell block and surgical specimen) and clinical history allow differentiation of BMPM from other cystic lesions (cystic lymphangioma and malignant mesothelioma).

  16. Results of patch tests

    SciTech Connect

    Pontius, D.H.

    1994-10-01

    The objectives of this work were to construct, install, and operate a patch testing unit on a hot gas stream at a coal-fired fluidized-bed boiler. A 2,000-hour patch test was conducted on ceramic disks of materials used in the fabrication of ceramic candles and ceramic cross-flow filters. The primary issues addressed in these tests were the long-term physical, thermal, and chemical stability of the ceramic materials; long-term pressure drop and filtration characteristics of the ceramic filters; potential for irreversible blinding of filter elements; and long-term performance and reliability of auxiliary hardware, such as the tube sheet and pulse-cleaning systems. Results on three samples, or patches, 10 cm in diameter are given.

  17. Analysis of a Slot Coupled Coplanar Waveguide Fed Patch Antenna

    NASA Technical Reports Server (NTRS)

    Cheng, Jui-Ching; Dib, Nihad I.; Katehi, Linda P. B.; Simons, Rainee N.; Lee, Richard Q.

    1994-01-01

    A slot-coupled CPW fed patch antenna is analyzed using two different techniques: the Spectral Domain Method and the Finite Difference Time Domain Method. The results from both techniques are in good agreement with experimentally obtained data.

  18. Peritoneal Mesothelioma: A Review

    PubMed Central

    Bridda, Alessio; Padoan, Ilaria; Mencarelli, Roberto; Frego, Mauro

    2007-01-01

    Background Malignant peritoneal mesothelioma (MPM) is a rare aggressive tumor of the peritoneum, regarded as a universally fatal disease. It is poorly described and the knowledge of its natural history is very limited. Occupational and environmental asbestos exposure still remains a public health problem around the world. The incidence has increased in the past 2 decades. Only 20% to 33% of all mesotheliomas arise from the peritoneum itself; the pleura is the most common site of origin. PMID:17955087

  19. Sclerosing Encapsulating Peritonitis: Review.

    PubMed

    Machado, Norman O

    2016-05-01

    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%).

  20. 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

  1. Diagnostic accuracy of a 16S ribosomal DNA gene-based molecular technique (RT-PCR, microarray, and sequencing) for bacterial meningitis, early-onset neonatal sepsis, and spontaneous bacterial peritonitis.

    PubMed

    Esparcia, Oscar; Montemayor, Michel; Ginovart, Gemma; Pomar, Virginia; Soriano, Germán; Pericas, Roser; Gurgui, Mercedes; Sulleiro, Elena; Prats, Guillem; Navarro, Ferran; Coll, Pere

    2011-02-01

    The diagnostic accuracy of a 16S ribosomal DNA (rDNA) gene-based molecular technique for bacterial meningitis (BM), early-onset neonatal sepsis (EONS), and spontaneous bacterial peritonitis (SBP) is evaluated. The molecular approach gave better results for BM diagnosis: sensitivity (S) was 90.6% compared to 78.1% for the bacterial culture. Percentages of cases correctly diagnosed (CCD) were 91.7% and 80.6%, respectively. For EONS diagnosis, S was 60.0% for the molecular approach and 70.0% for the bacterial culture; and CCD was 95.2% and 96.4%, respectively. For SPB diagnosis, the molecular approach gave notably poorer results than the bacterial cultures. S and CCD were 48.4% and 56.4% for the molecular approach and 80.6% and 89.1% for bacterial cultures. Nevertheless, bacterial DNA was detected in 53.3% of culture-negative samples. Accuracy of the 16S rDNA PCR approach differs depending on the sample, the microorganisms involved, the expected bacterial load, and the presence of bacterial DNA other than that from the pathogen implied in the infectious disease.

  2. Serum immunoglobulin G levels and peritonitis in peritoneal dialysis patients.

    PubMed

    Courivaud, Cécile; Bardonnet, Karine; Crepin, Thomas; Bresson-Vautrin, Catherine; Rebibou, Jean-Michel; Ducloux, Didier

    2015-08-01

    Peritonitis is a frequent and serious complication of peritoneal dialysis (PD). Whether low immunoglobulin level is associated with PD-related peritonitis is unknown. We conducted a prospective study to assess whether immunoglobulin levels at PD onset could predict the occurrence of peritonitis. All patients starting peritoneal dialysis between 01/2005 and 12/2010 at the University hospital of Besançon, France, were included in the study. Of 240 consecutive PD patients enrolled (mean follow-up 25 ± 12 months), 76 (32%) had at least one episode of peritonitis. Mean immunoglobulin (Ig)G level at PD start was lower in patients who subsequently experienced peritonitis (7.9 + 3.4 vs. 9.7 + 3.4 g/l, p = 0.005). An increased IgG level at PD onset was associated with a reduced risk of peritonitis [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.80-0.97 for each increase of 1 g/l in IgG, p = 0.008]. IgG level ≤6.4 g/l ("low IgG") was the best predictive value for the occurrence of subsequent peritonitis: 52 patients (24%) had low IgG levels. At multivariate analysis, both low IgG level (HR 2.49, 95% CI 1.32-4.69, p = 0.005) and diabetes (HR 2.78, 95% CI 1.49-5.20, p = 0.001) were predictive of the occurrence of peritonitis. Low IgG levels predict the occurrence of PD-related peritonitis. Randomized studies should determine whether such patients could benefit from intravenous immunoglobulin administration.

  3. Peritoneal dialysis peritonitis by anaerobic pathogens: a retrospective case series

    PubMed Central

    2013-01-01

    Background Bacterial infections account for most peritoneal dialysis (PD)-associated peritonitis episodes. However, anaerobic PD peritonitis is extremely rare and intuitively associated with intra-abdominal lesions. In this study, we examined the clinical characteristics of PD patients who developed anaerobic peritonitis. Methods We retrospectively identified all anaerobic PD peritonitis episodes from a prospectively collected PD registry at a single center between 1990 and 2010. Only patients receiving more than 3 months of PD were enrolled. We analyzed clinical features as well as outcomes of anaerobic PD peritonitis patients. Results Among 6 patients, 10 episodes of PD-associated peritonitis were caused by anaerobic pathogens (1.59% of all peritonitis episodes during study the period), in which the cultures from 5 episodes had mixed growth. Bacteroides fragilis was the most common species identified (4 isolates). Only 3 episodes were associated with gastrointestinal lesions, and 4 episodes were related to a break in sterility during exchange procedures. All anaerobic pathogens were susceptible to clindamycin and metronidazole, but penicillin resistance was noted in 4 isolates. Ampicillin/sulbactam resistance was found in 2 isolates. In 5 episodes, a primary response was achieved using the first-generation cephalosporin and ceftazidime or aminoglycoside. In 3 episodes, the first-generation cephalosporin was replaced with aminoglycosides. Tenckhoff catheter removal was necessary in 2 episodes. Only one episode ended with mortality (due to a perforated bowel). Conclusion Anaerobic PD-associated peritonitis might be predominantly caused by contamination, rather than intra-abdominal events. Half of anaerobic PD-associated peritonitis episodes had polymicrobial growth. The overall outcome of anaerobic peritonitis is fair, with a high catheter survival rate. PMID:23705895

  4. Intra-operative peritoneal lavage for colorectal cancer

    PubMed Central

    Passot, Guillaume; Mohkam, Kayvan; Cotte, Eddy; Glehen, Olivier

    2014-01-01

    Free cancer cells can be detected in peritoneal fluid at the time of colorectal surgery. Peritoneal lavage in colorectal surgery for cancer is not used in routine, and the prognostic significance of intraperitoneal free cancer cells (IPCC) remains unclear. Data concerning the technique of peritoneal lavage to detect IPCC and its timing regarding colorectal resection are scarce. However, positive IPCC might be the first step of peritoneal spread in colorectal cancers, which could lead to early specific treatments. Because of the important heterogeneity of IPCC determination in reported studies, no treatment have been proposed to patients with positive IPCC. Herein, we provide an overview of IPCC detection and its impact on recurrence and survival, and we suggest further multi-institutional studies to evaluate new treatment strategies. PMID:24616569

  5. Intra-operative peritoneal lavage for colorectal cancer.

    PubMed

    Passot, Guillaume; Mohkam, Kayvan; Cotte, Eddy; Glehen, Olivier

    2014-02-28

    Free cancer cells can be detected in peritoneal fluid at the time of colorectal surgery. Peritoneal lavage in colorectal surgery for cancer is not used in routine, and the prognostic significance of intraperitoneal free cancer cells (IPCC) remains unclear. Data concerning the technique of peritoneal lavage to detect IPCC and its timing regarding colorectal resection are scarce. However, positive IPCC might be the first step of peritoneal spread in colorectal cancers, which could lead to early specific treatments. Because of the important heterogeneity of IPCC determination in reported studies, no treatment have been proposed to patients with positive IPCC. Herein, we provide an overview of IPCC detection and its impact on recurrence and survival, and we suggest further multi-institutional studies to evaluate new treatment strategies.

  6. Long-term therapy for heart failure with continuous ambulatory peritoneal dialysis.

    PubMed

    McKinnie, J J; Bourgeois, R J; Husserl, F E

    1985-06-01

    This article reports the treatment with continuous ambulatory peritoneal dialysis of a patient with intractable congestive heart failure secondary to an ischemic cardiomyopathy. Although the use of peritoneal dialysis to treat refractory heart failure is not new, the advent of an effective continuous peritoneal dialysis system has allowed its use over prolonged periods of time. The two-year treatment interval described herein represents the longest reported application of this technique, to the best of our knowledge.

  7. Image inpainting by patch propagation using patch sparsity.

    PubMed

    Xu, Zongben; Sun, Jian

    2010-05-01

    This paper introduces a novel examplar-based inpainting algorithm through investigating the sparsity of natural image patches. Two novel concepts of sparsity at the patch level are proposed for modeling the patch priority and patch representation, which are two crucial steps for patch propagation in the examplar-based inpainting approach. First, patch structure sparsity is designed to measure the confidence of a patch located at the image structure (e.g., the edge or corner) by the sparseness of its nonzero similarities to the neighboring patches. The patch with larger structure sparsity will be assigned higher priority for further inpainting. Second, it is assumed that the patch to be filled can be represented by the sparse linear combination of candidate patches under the local patch consistency constraint in a framework of sparse representation. Compared with the traditional examplar-based inpainting approach, structure sparsity enables better discrimination of structure and texture, and the patch sparse representation forces the newly inpainted regions to be sharp and consistent with the surrounding textures. Experiments on synthetic and natural images show the advantages of the proposed approach.

  8. Selegiline Transdermal Patch

    MedlinePlus

    ... you can use baby oil or a medical adhesive removal pad to remove residue that will not come off with soap and water. Do not use alcohol, nail polish remover, or other solvents. Apply a new patch to a different area immediately by following steps 1 to 6.

  9. Oxybutynin Transdermal Patch

    MedlinePlus

    ... you can use baby oil or a medical adhesive removal pad to remove residue that will not come off with soap and water. Do not use alcohol, nail polish remover, or other solvents. Apply a new patch to a different area immediately by following steps 1–5.

  10. Nitroglycerin Transdermal Patch

    MedlinePlus

    ... press down on its center to lift the edges away from the skin. Hold the edge gently and slowly peel the patch away from ... your medications or monitor you carefully for side effects.tell your doctor if you think you may ...

  11. 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

  12. [Surgical reoperations for postoperative peritonitis].

    PubMed

    Stătescu, G; Cărăuşu, Mihaela

    2011-01-01

    In our clinical study postoperative peritonitis represent 17.01% by operations for neglected peritonitis. The other abdominal complications are eviscerations, postoperative oclusions and residual abscesses. We have to analize the incidence, etiology, diagnosis and surgical management of 25 cases by postoperative peritonitis which appears after operations of 147 cases by neglected peritonitis. The semiology of a postoperative peritonitis it is easy to recognize in young pacients with reactions which appear in a few days after operations : pain localised to the abdominal area well localised in an area in which palpation show contraction. In a few hours the pain became flow. It appears fever,nausea,vommiting and all the clinical signs of peritonitis. The highest prevalence of postoperative peritonitis for which we perform reoperations it appears after appendectomy in 18 cases with fatality 11.11%; next are coming reoperations on stomac and duodenum 4 cases with rate of fatality by 50%, reoperations on small bowell in 2 cases with fatality by 50% and reoperations of big bowell (1 case). On our series of postoperative peritonitis we have a global rate of fatality by 20% from all cases. We have considered this level well in comparison with the dates from another similar experience which show us a rate of fatality which are gone until 90%. Our media of reoperations were about three operations on each cases. If we compare with first operation for neglected peritonitis we have observe that in reoperations we change our plans in the way of making faster minimum necesary because of high risk to dead of this cases. Clinical diagnosis by postoperative peritonitis is difficult to establish and only follow up very care clinical signs of this cases beneath laboratory findings (leucogram, uree, ionogram) and with radiological examination (CT) can tell us about postoperative peritonitis.

  13. Patch choice under predation hazard.

    PubMed

    Krivan, V; Vrkoc, I

    2000-12-01

    In this paper we study optimal animal movement in heterogeneous environments consisting of several food patches in which animals trade-off energy gain versus predation risk. We derive a myopic optimization rule describing optimal animal movements by fitness maximization assuming an animal state is described by a single quantity (such as weight, size, or energy reserves). This rule predicts a critical state at which an animal should switch from a more dangerous and more profitable patch to a less dangerous and less profitable patch. Qualitatively, there are two types of behavior: either the animal switches from one patch to another and stays in the new patch for some time before it switches again, or the animal switches between two patches instantaneously. The former case happens if animal state growth is positive in all patches, while the latter case happens if animal state growth is negative in one patch. In particular, this happens if one patch is a refuge. We consider in detail two special cases. The first one assumes a linear animal state growth while the second assumes a saturating animal state growth described by the von Bertalanffy curve. For the first model the proportion of time spent in the more profitable and more risky patch increases with profitability of this patch when state growth is positive in both patches. On contrary, if state growth is negative in the less profitable and safer patch, animals spend proportionally less time in the more profitable and more risky patch as its profitability increases. As a function of the predation risk in the more profitable patch the time spent there proportionally decreases. When animal state growth is described by the saturating curve, time spent in the more risky patch is a hump-shaped curve if state growth is positive in both patches. Our results extend the mu/f rule, which predicts that animals should behave in such a way as to minimize mortality risk to resource intake ratio.

  14. Lower Education Level Is a Major Risk Factor for Peritonitis Incidence in Chronic Peritoneal Dialysis Patients: A Retrospective Cohort Study with 12-Year Follow-Up

    PubMed Central

    Chern, Yahn-Bor; Ho, Pei-Shan; Kuo, Li-Chueh; Chen, Jin-Bor

    2013-01-01

    ♦ Background: Peritoneal dialysis (PD)-related peritonitis remains an important complication in PD patients, potentially causing technique failure and influencing patient outcome. To date, no comprehensive study in the Taiwanese PD population has used a time-dependent statistical method to analyze the factors associated with PD-related peritonitis. ♦ Methods: Our single-center retrospective cohort study, conducted in southern Taiwan between February 1999 and July 2010, used time-dependent statistical methods to analyze the factors associated with PD-related peritonitis. ♦ Results: The study recruited 404 PD patients for analysis, 150 of whom experienced at least 1 episode of peritonitis during the follow-up period. The incidence rate of peritonitis was highest during the first 6 months after PD start. A comparison of patients in the two groups (peritonitis vs null-peritonitis) by univariate analysis showed that the peritonitis group included fewer men (p = 0.048) and more patients of older age (≥65 years, p = 0.049). In addition, patients who had never received compulsory education showed a statistically higher incidence of PD-related peritonitis in the univariate analysis (p = 0.04). A proportional hazards model identified education level (less than elementary school vs any higher education level) as having an independent association with PD-related peritonitis [hazard ratio (HR): 1.45; 95% confidence interval (CI): 1.01 to 2.06; p = 0.045). Comorbidities measured using the Charlson comorbidity index (score >2 vs ≤2) showed borderline statistical significance (HR: 1.44; 95% CI: 1.00 to 2.13; p = 0.053). ♦ Conclusions: A lower education level is a major risk factor for PD-related peritonitis independent of age, sex, hypoalbuminemia, and comorbidities. Our study emphasizes that a comprehensive PD education program is crucial for PD patients with a lower education level. PMID:23547277

  15. 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

  16. Disseminated peritoneal leiomyomatosis.

    PubMed

    Momtahan, Mozhdeh; Nemati, Maryam; Safaei, Akbar

    2011-03-01

    Leiomyomatosis peritonealis disseminata is a very rare condition characterized by the development of multiple smooth muscle-like nodules in the peritoneal cavity. It is associated with increased serum levels of gonadal steroids. The present report describes a 29-year-old patient underwent transabdominal hysterectomy and Bilateral Salpingo oophorectomy six years ago because of leiomyomatosis peritonealis disseminata. After six years she referred to us again because of retroperitoneal fibroma, another rare entity, during hormone replacement therapy inspite of lack of uterus and previous castration.

  17. Feline infectious peritonitis.

    PubMed

    Goodson, Teresa; Randell, Susan; Moore, Lisa

    2009-10-01

    Feline infectious peritonitis (FIP) frequently results in death in cats. It is caused by a mutated, highly contagious coronavirus, and it is more common in indoor cats in multicat households. A complex interaction between the coronavirus and the feline immune system causes disseminated vasculitis, which is the hallmark of FIP. New tests are being developed, but the antemortem diagnosis of FIP continues to be difficult and frustrating. Current treatments are crude and involve supportive care and immunosuppression. Minimizing exposure is the best method of preventing infection.

  18. Disseminated Peritoneal Leiomyomatosis

    PubMed Central

    Momtahan, Mozhdeh; Nemati, Maryam; Safaei, Akbar

    2011-01-01

    Leiomyomatosis peritonealis disseminata is a very rare condition characterized by the development of multiple smooth muscle-like nodules in the peritoneal cavity. It is associated with increased serum levels of gonadal steroids. The present report describes a 29-year-old patient underwent transabdominal hysterectomy and Bilateral Salpingo oophorectomy six years ago because of leiomyomatosis peritonealis disseminata. After six years she referred to us again because of retroperitoneal fibroma, another rare entity, during hormone replacement therapy inspite of lack of uterus and previous castration. PMID:23365481

  19. Peritoneal dialysis glossary 2009.

    PubMed

    Liakopoulos, Vassilios; Stefanidis, Ioannis; Dombros, Nicholas V

    2010-06-01

    A number of attempts to create a commonly accepted terminology regarding definitions and terms used for clinical entities, methods, problems, and materials encountered by health professionals involved in peritoneal dialysis (PD) were undertaken in the past, the last one in 1990. Later on, some relevant sporadic attempts in a number of textbooks have been made, but they did not include the whole spectrum of PD. This glossary is an attempt to address the need for a universally accepted PD terminology including the latest advances in PD connection systems and fluids.

  20. Studying mechanosensitive ion channels with an automated patch clamp.

    PubMed

    Barthmes, Maria; Jose, Mac Donald F; Birkner, Jan Peter; Brüggemann, Andrea; Wahl-Schott, Christian; Koçer, Armağan

    2014-03-01

    Patch clamp electrophysiology is the main technique to study mechanosensitive ion channels (MSCs), however, conventional patch clamping is laborious and success and output depends on the skills of the operator. Even though automated patch systems solve these problems for other ion channels, they could not be applied to MSCs. Here, we report on activation and single channel analysis of a bacterial mechanosensitive ion channel using an automated patch clamp system. With the automated system, we could patch not only giant unilamellar liposomes but also giant Escherichia coli (E. coli) spheroplasts. The tension sensitivity and channel kinetics data obtained in the automated system were in good agreement with that obtained from the conventional patch clamp. The findings will pave the way to high throughput fundamental and drug screening studies on mechanosensitive ion channels.

  1. Effect of Eye Patching in Rehabilitation of Hemispatial Neglect

    PubMed Central

    Smania, Nicola; Fonte, Cristina; Picelli, Alessandro; Gandolfi, Marialuisa; Varalta, Valentina

    2013-01-01

    Eye patching (EP; monocular or right hemifield) has been proposed to improve visuospatial attention to the ignored field in patients with hemispatial neglect. The aim of this paper is to review the literature on the effects of EP in hemispatial neglect after stroke in order to convey evidence-based recommendations to clinicians in stroke rehabilitation. Thirteen intervention studies were selected from the Medline, EMBASE, Scopus, Cochrane Library, CINAHL, PsychINFO, EBRSR, and Health Star databases. Methodological quality was defined according to the Physiotherapy Evidence Database. Overall, seven studies used monocular EP, five used right hemifield patching, and one compared right monocular with right hemifield patching. Seven studies compared normal viewing to monocular or hemifield patching conditions. Six studies included a period of treatment. As to the monocular EP, four studies reported positive effects of right monocular patching. One study showed an improvement in hemispatial neglect with left monocular patching. Two studies found no superiority of right vs. left monocular patching. One study found no effects of right monocular patching. As to the right hemifield EP, one study showed improvements in neglect after right hemifield patching. Three studies found that right hemifield patching combined with another rehabilitation technique was more effective than that treatment alone. One study found no differences between right hemifield patching combined with another treatment and that treatment alone. One study found the same effect between right hemifield patching alone and another rehabilitation technique. Our results globally tend to support the usefulness of right hemifield EP in clinical practice. In order to define a level of evidence with the standard rehabilitation evidence rating tools, further properly powered randomized controlled trials or meta-analysis are needed. PMID:24032011

  2. Perioperative Systemic Therapy and Surgery Versus Surgery Alone for Resectable Colorectal Peritoneal Metastases.

    ClinicalTrials.gov

    2017-05-05

    Colorectal Cancer; Colorectal Neoplasms; Colorectal Carcinoma; Colorectal Adenocarcinoma; Colorectal Cancer Metastatic; Peritoneal Carcinoma; Peritoneal Neoplasms; Peritoneal Cavity Cancer; Peritoneal Carcinomatosis; Peritoneal Metastases

  3. Spin Glass Patch Planting

    NASA Technical Reports Server (NTRS)

    Wang, Wenlong; Mandra, Salvatore; Katzgraber, Helmut G.

    2016-01-01

    In this paper, we propose a patch planting method for creating arbitrarily large spin glass instances with known ground states. The scaling of the computational complexity of these instances with various block numbers and sizes is investigated and compared with random instances using population annealing Monte Carlo and the quantum annealing DW2X machine. The method can be useful for benchmarking tests for future generation quantum annealing machines, classical and quantum mechanical optimization algorithms.

  4. Polymer concrete patching manual

    NASA Astrophysics Data System (ADS)

    Fontana, J. J.; Bartholomew, J.

    1982-06-01

    The practicality of using polymer concrete to repair deteriorated portland cement concrete bridge decks and pavements was demonstrated. This manual outlines the procedures for using polymer concrete as a rapid patching material to repair deteriorated concrete. The process technology, materials, equipment, and safety provisions used in manufacturing and placing polymer concrete are discussed. Potential users are informed of the various steps necessary to insure successful field applications of the material.

  5. exp 19 patch-1

    NASA Image and Video Library

    2008-12-03

    ISS019-S-001 (December 2008) --- Expedition 19 marks the final planned period of three person occupancy, prior to increasing the crew size to 6, and occurs in the final stages of International Space Station assembly. The patch emphasizes the earth, one of the major focuses of attention and study from the orbital research outpost. The design is stylized to highlight the beauty of the home planet and the station orbiting it, next to the sun now the unquestioned

  6. exp 19 patch-1

    NASA Image and Video Library

    2009-12-29

    ISS019-S-001A (December 2008) --- Expedition 19 marks the final planned period of three person occupancy, prior to increasing the crew size to 6, and occurs in the final stages of International Space Station assembly. The patch emphasizes the earth, one of the major focuses of attention and study from the orbital research outpost. The design is stylized to highlight the beauty of the home planet and the station orbiting it, next to the sun now the unquestioned

  7. Effects of Biocompatible versus Standard Fluid on Peritoneal Dialysis Outcomes

    PubMed Central

    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; Tan, Seng H.; Voss, David

    2012-01-01

    The clinical benefits of using “biocompatible” neutral pH solutions containing low levels of glucose degradation products for peritoneal dialysis compared with standard solutions are uncertain. In this multicenter, open-label, parallel-group, randomized controlled trial, we randomly assigned 185 incident adult peritoneal dialysis patients with residual renal function to use either biocompatible or conventional solution for 2 years. The primary outcome measure was slope of renal function decline. Secondary outcome measures comprised time to anuria, fluid volume status, peritonitis-free survival, technique survival, patient survival, and adverse events. We did not detect a statistically significant difference in the rate of decline of renal function between the two groups as measured by the slopes of GFR: −0.22 and −0.28 ml/min per 1.73 m2 per month (P=0.17) in the first year in the biocompatible and conventional groups, respectively, and, −0.09 and −0.10 ml/min per 1.73 m2 per month (P=0.9) in the second year. The biocompatible group exhibited significantly longer times to anuria (P=0.009) and to the first peritonitis episode (P=0.01). This group also had fewer patients develop peritonitis (30% versus 49%) and had lower rates of peritonitis (0.30 versus 0.49 episodes per year, P=0.01). In conclusion, this trial does not support a role for biocompatible fluid in slowing the rate of GFR decline, but it does suggest that biocompatible fluid may delay the onset of anuria and reduce the incidence of peritonitis compared with conventional fluid in peritoneal dialysis. PMID:22440906

  8. The Effects of Biocompatible Compared with Standard Peritoneal Dialysis Solutions on Peritonitis Microbiology, Treatment, and Outcomes: 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: A multicenter, multi-country randomized controlled trial (the balANZ study) recently reported that peritonitis rates significantly improved with the use of neutral-pH peritoneal dialysis (PD) solutions low in glucose degradation products (“biocompatible”) compared with standard solutions. The present paper reports a secondary outcome analysis of the balANZ trial with respect to peritonitis microbiology, treatment, and outcomes. ♦ Methods: Adult incident PD patients with residual renal function were randomized to receive either biocompatible or conventional (control) PD solutions for 2 years. ♦ Results: The safety population analysis for peritonitis included 91 patients in each group. The unadjusted geometric mean peritonitis rates in those groups were 0.30 [95% confidence interval (CI): 0.22 to 0.41] episodes per patient-year for the biocompatible group and 0.49 (95% CI: 0.39 to 0.62) episodes per patient-year for the control group [incidence rate ratio (IRR): 0.61; 95% CI: 0.41 to 0.90; p = 0.01]. When specific causative organisms were examined, the rates of culture-negative, gram-positive, gram-negative, and polymicrobial peritonitis episodes were not significantly different between the biocompatible and control groups, although the biocompatible group did experience a significantly lower rate of non-pseudomonal gram-negative peritonitis (IRR: 0.41; 95% CI: 0.18 to 0.92; p = 0.03). Initial empiric antibiotic regimens were comparable between the groups. Biocompatible fluid use did not significantly reduce the risk of peritonitis-associated hospitalization (adjusted odds ratio: 0.80; 95% CI: 0.48 to 1.34), but did result in a shorter median duration of peritonitis-associated hospitalization (6 days vs 11 days, p = 0.05). Peritonitis severity was more likely to be rated as mild in the biocompatible group (37% vs 10%, p = 0.001). Overall peritonitis-associated technique failures and peritonitis-related deaths were comparable in the two groups

  9. Research and analysis of patch shape on microstrip patch antenna

    NASA Astrophysics Data System (ADS)

    Ji, Ai-guo; Wang, Peng

    2017-01-01

    The shape of the radiating patch in the microstrip patch antenna is one of the many factors that affect the performance of the microstrip antenna.In this paper, on the premise of center frequency of 2.45 GHz, rectangular, circular and triangular microstrip patch antennas are designed and simulated respectively.The simulation results of the three microstrip patch antenna are analyzed, such as feed point position, return loss and radiation patterns.The influence of the shape of the radiation patch on the impedance bandwidth, gain and directivity of microstrip antennas is discussed.The simulation results show that the comprehensive performance of rectangular microstrip patch antenna is better than the other two, the comprehensive performance of triangular microstrip patch antenna is poor.

  10. Global Patch Matching

    NASA Astrophysics Data System (ADS)

    Huang, X.; Hu, K.; Ling, X.; Zhang, Y.; Lu, Z.; Zhou, G.

    2017-09-01

    This paper introduces a novel global patch matching method that focuses on how to remove fronto-parallel bias and obtain continuous smooth surfaces with assuming that the scenes covered by stereos are piecewise continuous. Firstly, simple linear iterative cluster method (SLIC) is used to segment the base image into a series of patches. Then, a global energy function, which consists of a data term and a smoothness term, is built on the patches. The data term is the second-order Taylor expansion of correlation coefficients, and the smoothness term is built by combing connectivity constraints and the coplanarity constraints are combined to construct the smoothness term. Finally, the global energy function can be built by combining the data term and the smoothness term. We rewrite the global energy function in a quadratic matrix function, and use least square methods to obtain the optimal solution. Experiments on Adirondack stereo and Motorcycle stereo of Middlebury benchmark show that the proposed method can remove fronto-parallel bias effectively, and produce continuous smooth surfaces.

  11. Biocide patch tests.

    PubMed

    Andersen, K E; Veien, N K

    1985-02-01

    Routine patch testing with a series of 6 industrial biocides containing methylene-bis-thiocyanate (Cytox 3522), benzisothiazolin-3-one (BIT), chlorocresol (Preventol CMK), 2-n-octyl-4-isothiazolin-3-one (Kathon 893), polyhydroxymethylene monobenzylether (Preventol D2) or 1,3,5-tris (hydroxy-ethyl) hexahydrotriazine (Grotan BK) was carried out in 6 Danish out-patient clinics to evaluate guinea pig allergy test results with the same compounds. A total of 1652 consecutive patients with dermatitis were tested. The usefulness of this patch test battery was limited. There were a few positive reactions to Cytox 3522, BIT and the 2 formaldehyde releasers, Preventol D2 and Grotan BK. These reactions could not, however, be explained. The MOAHL-index (% of Male patients, Occupational cases, Atopic patients, Hand eczemas, and Leg ulcers/stasis dermatitis) for patients from the 6 clinics showed equal frequencies of male patients and atopics, but significant differences in the frequencies of occupational cases, hand eczemas, and leg ulcers/stasis dermatitis, indicating possible variations in referral patterns, use of patch tests, and/or environmental factors.

  12. Exp 36 Patch Final

    NASA Image and Video Library

    2012-08-10

    ISS036-S-001 (January 2012) --- The dynamic design of the Expedition 36 patch portrays the International Space Station?s (ISS) iconic solar arrays. The slanted angles denote a kinetic energy leading from the Earth in the lower right to the upper left tip of the triangular shape of the patch, representing the infinite scientific research, education, and long-duration spaceflight capabilities the ISS provides with each mission, as well as our goal for future exploration beyond the Space Station. The numbers 3 and 6 harmoniously intertwine to form expedition number 36 and its gray coloration signifies the unity and neutrality among all of the international partners of the ISS. The blue and gold color scheme of the patch represents the subtle way the central gold orbit wraps around the number 36 to form a trident at its lower right tip. The trident also symbolizes the sea, air, and land, all of which make up the Earth from where the trident originates in the design. The NASA insignia design for shuttle and space station flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the form of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, it will be publicly announced. Photo credit: NASA

  13. Peritoneal Phosphate Clearance is Influenced by Peritoneal Dialysis Modality, Independent of Peritoneal Transport Characteristics

    PubMed Central

    Badve, Sunil V.; Zimmerman, Deborah L.; Knoll, Greg A.; Burns, Kevin D.; McCormick, Brendan B.

    2008-01-01

    Background and objectives: Hyperphosphatemia is an independent risk factor for mortality in ESRD, but factors regulating phosphate clearance on peritoneal dialysis (PD) are incompletely understood. The objective of this study was to test the hypothesis that peritoneal phosphate clearance is better with continuous ambulatory PD (CAPD) as compared with continuous cyclic PD (CCPD) after adjusting for membrane transport status. Design, setting, participants, & measurements: In this cross-sectional and retrospective study, measurements of peritoneal phosphate clearance of 129 prevalent PD patients were reviewed. Patients were divided according to membrane transport status (high, high average, low average-low categories) and PD modality (CAPD or CCPD). Results: Among high transporters, peritoneal phosphate clearances were comparable in both modalities. However, treatment with CAPD was associated with increased peritoneal phosphate clearance compared with CCPD among high-average transporters (42.4 ± 11.4 versus 36.4 ± 8.3 L/wk/1.73 m2, P = 0.01), and low-average-low transporters (35.6 ± 5.9 versus 28.9 ± 11 L/wk/1.73 m2, P = 0.034). On multivariate linear regression, PD modality, membrane transport category, and peritoneal creatinine clearance, but not Kt/V urea, were independently associated with peritoneal phosphate clearance. Conclusions: Peritoneal phosphate clearance is determined by PD modality and membrane transport category, suggesting that PD regimes with longer dwell times may help control hyperphosphatemia in lower transporters. PMID:18815242

  14. Diagnostic peritoneal lavage for identification of blastomycosis in a dog with peritoneal involvement.

    PubMed

    Nielsen, Cheri; Olver, Christine S; Schutten, Melissa M; Twedt, David C

    2003-12-01

    A 6-year-old castrated male Dalmatian was evaluated because of hematemesis. The dog had lived its entire life in South Dakota and Wyoming and had never traveled outside of these states. Results of laboratory testing were compatible with iatrogenic acute renal failure and gastrointestinal tract ulceration secondary to previous nonsteroidal anti-inflammatory drug and corticosteroid administration. Differential diagnoses for clinical signs and laboratory abnormalities that existed prior to these treatments included multisystemic infectious or inflammatory disease and neoplasia. Four-quadrant abdominocentesis did not yield any fluid, but because intra-abdominal disease was still suspected, diagnostic peritoneal lavage was performed. Fluid that was obtained was markedly cellular, and there were numerous extracellular structures with a round to oval shape; a 1-microm-thick, clear-staining capsule; a basophilic interior; and broad-based budding. Organisms were consistent with Blastomyces spp, and fungal culture yielded Blastomyces dermatitidis. Treatment with liposomal amphotericin B and itraconazole was recommended but could not be initiated because of the client's financial constraints. At necropsy, disseminated blastomycosis involving the stomach, small intestines, urinary bladder, omentum, mesentery of the small intestine, and abdominal wall musculature was seen. To our knowledge, peritoneal involvement has not been reported in dogs with blastomycosis, and gastrointestinal tract involvement has only rarely been reported. Findings in this dog suggest that diagnostic peritoneal lavage may be a useful technique in determining the cause of infectious peritonitis when the amount of abdominal fluid is below the limit of detection for abdominocentesis.

  15. Con-Patch: When a Patch Meets Its Context.

    PubMed

    Romano, Yaniv; Elad, Michael

    2016-09-01

    Measuring the similarity between the patches in images is a fundamental building block in various tasks. Naturally, the patch size has a major impact on the matching quality and on the consequent application performance. Under the assumption that our patch database is sufficiently sampled, using large patches (e.g., 21 × 21 ) should be preferred over small ones (e.g., 7 × 7 ). However, this dense-sampling assumption is rarely true; in most cases, large patches cannot find relevant nearby examples. This phenomenon is a consequence of the curse of dimensionality, stating that the database size should grow exponentially with the patch size to ensure proper matches. This explains the favored choice of small patch size in most applications. Is there a way to keep the simplicity and work with small patches while getting some of the benefits that large patches provide? In this paper, we offer such an approach. We propose to concatenate the regular content of a conventional (small) patch with a compact representation of its (large) surroundings-its context. Therefore, with a minor increase of the dimensions (e.g., with additional ten values to the patch representation), we implicitly/softly describe the information of a large patch. The additional descriptors are computed based on a self-similarity behavior of the patch surrounding. We show that this approach achieves better matches, compared with the use of conventional-size patches, without the need to increase the database-size. Also, the effectiveness of the proposed method is tested on three distinct problems: 1) external natural image denoising; 2) depth image super-resolution; and 3) motion-compensated frame-rate up conversion.

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

    PubMed

    Apostolovic, B L; Velickovic-Radovanovic, R M; Andjelkovic-Apostolovic, M R; Cvetkovic, T P; Dinic, M M; Radivojevic, J D

    2015-06-01

    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.

  17. 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

  18. 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

  19. Simultaneous peritoneal dialysis catheter insertion and removal in catheter-related infections without interruption of peritoneal dialysis.

    PubMed

    Posthuma, N; Borgstein, P J; Eijsbouts, Q; ter Wee, P M

    1998-03-01

    Catheter-related infections result in high patient morbidity, the need for temporary haemodialysis, and high costs. These infections are the main cause of limited technique survival in peritoneal dialysis. We introduced a protocol for the simultaneous peritoneoscopic insertion and removal of peritoneal catheters in patients with catheter-related infections. Peritoneal dialysis was continued the day after surgery using low-volume dwells and a dry abdomen during the daytime. The dialysate leukocyte count had to be below 100/mm3 before exchanging catheters, which was performed under antibiotic therapy based on culture sensitivity. The old catheter was removed after the new catheter had been inserted in the opposite abdominal region. CAPD patients were switched to APD for 1 week, which made prolonged hospitalization necessary. Simultaneous catheter insertion and removal was performed 25 times in 22 patients on CCPD and 15 times in 14 patients on CAPD. In CCPD patients, peritoneal dialysis was restarted after 1.0+/-0.1 days in 24 cases. One patient had sufficient residual renal function and discontinued CCPD until day 10. In 10 CAPD patients (11 procedures) APD was started 1.3+/-0.2 days after the procedure with CAPD beginning 7.1+/-0.6 days thereafter. Three CAPD patients preferred haemodialysis and restarted CAPD 10.0+/-2.1 days after surgery. One patient continued CAPD the day after surgery. In addition to minor complications (e.g. position-dependent outflow problems), dialysate leakage occurred in two patients. Two patients developed peritonitis within the first 30 days after surgery, one of which was procedure related. One patient had severe lower gastrointestinal bleeding 2 weeks after the procedure, which was not related to the catheter replacement. Ultimately, in 38 of 40 procedures the patients could successfully continue peritoneal dialysis. We conclude that simultaneous insertion and removal of a peritoneal dialysis catheter without interruption of peritoneal

  20. Patch Test Negative Generalized Dermatitis.

    PubMed

    Spiker, Alison; Mowad, Christen

    2016-01-01

    Allergic contact dermatitis is a common condition in dermatology. Patch testing is the criterion standard for diagnosis. However, dermatitis is not always caused by an allergen, and patch testing does not identify a culprit in every patient. Generalized dermatitis, defined as eczematous dermatitis affecting greater than 3 body sites, is often encountered in dermatology practice, especially patch test referral centers. Management for patients with generalized dermatitis who are patch test negative is challenging. The purpose of this article is to outline an approach to this challenging scenario and summarize the paucity of existing literature on patch test negative generalized dermatitis.

  1. [Intermittent peritoneal dialysis: a 6 years' experience].

    PubMed

    García-Ortiz, R; Gómez, M; Olea, C

    1989-09-01

    We show our experience, results and complications with Intermittent Peritoneal Dialysis (IPD). We treated with this technique 28 patients with end stage renal disease (ESRD), between 1981-1988; (24 adults, 8 of them with diabetic nephropathy (6 non insulin dependent diabetic patients and 4 children) for 3 to 36 months. IPD was well tolerated. The extracellular volume control, haematocrit and plasma protein values, as well as, ac-base equilibrium nutritional status, ureic nitrogen and creatinine plasma levels, were fully satisfactory. There was statistical difference only in the Na+ (p less than 0.001), alkaline phosphatases (p less than 0.005), glucose (p less than 0.05) plasma values and glycosylated hemoglobin (p less than 0.05), between diabetics and non diabetics group. The peritonitis rate was 0.065 and 0.074 peritonitis/patients-month; respectively (NS) and were caused by Gram (-) bacteria. St Aureus and St Epidermides. The survival curves of patients and method, in both groups, were similar (NS). We conclude IPD is a good alternative of therapy for ESRD, also for diabetics patients, whom haven't got more infection rate than non diabetics patients.

  2. 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.

  3. Peritoneal mucormycosis in a patient receiving continuous ambulatory peritoneal dialysis.

    PubMed

    Polo, J R; Luño, J; Menarguez, C; Gallego, E; Robles, R; Hernandez, P

    1989-03-01

    A 48-year-old man receiving maintenance hemodialysis for 3 years and continuous ambulatory peritoneal dialysis for 1 year developed a clinical picture compatible with peritonitis. Three successive fluid cultures were negative, and only after filtration of a large volume of peritoneal fluid a fungus identified as a Rhizopus sp was isolated in cultures of the filtering devices. The same fungus was also isolated from the peritoneal catheter cuff. Intravenous amphotericin B was administered and both the abdominal and general conditions of the patient improved transiently. Twenty days after initiation of antifungal treatment, a clinical suspicion of intestinal perforation arose and an exploratory laparotomy was scheduled, but the patient died during the anesthetic induction. The patient never received deferoxamine; any conditions predisposing to mucormycosis, such as diabetes or immunosuppression, were also absent.

  4. Tuberculous peritonitis in a child undergoing continuous ambulatory peritoneal dialysis.

    PubMed

    Tsai, T C; Hsu, J C; Chou, L H; Lee, M L

    1994-01-01

    We present a 13-year-old girl with Arnold-Chiari syndrome and uremia secondary to neurogenic bladder. She had been treated with continuous ambulatory peritoneal dialysis (CAPD) for 13 months prior to the development of peritonitis. The patient demonstrated no improvement with a 3-day therapy of intraperitoneal vancomycin and netilmicin. Meanwhile, smear of centrifuged dialysate revealed acid fast bacilli on two occasions. We, then, started anti-TB therapy with oral isoniazid (INAH), rifampin and ethambutal. The symptoms subsided within three days. In the first week, the patient lost her peritoneal ultrafiltration and needed daytime automatic peritoneal dialysis. At the last follow-up examination, 12 months after treatment, she remained well on standard CAPD.

  5. [Multicystic peritoneal mesothelioma].

    PubMed

    Horling, E W; Albert, C; Bassermann, R; Stiegler, H

    1996-01-01

    We report on a 31-year-old man with a 29 x 15 x 15 cm large abdominal tumor who came to surgery under suspicion of echinococcus cyst of the liver. Histologically, the neoplasm could identified as multicystic peritoneal mesothelioma (synonyma: benign cystic mesothelioma). Additionally some cysts were located in the greater omentum and mesocolon. In contrast to our case the benign cystic mesotheliomas most commonly occur in young women, localized in the pelvis and abdomen and often complicated by postoperative local recurrence. We performed a resection of the right hemicolon and the omentum. Postoperatively no further therapy was necessary because of the benign appearance of the lesion. Close follow-up is required in these patients due to the disposition for recurrences.

  6. Malignant peritoneal mesothelioma

    PubMed Central

    Munkholm-Larsen, Stine; Cao, Christopher Q; Yan, Tristan D

    2009-01-01

    Malignant mesothelioma is a highly aggressive neoplasm. The incidence of malignant mesothelioma is increasing worldwide. Diffuse malignant peritoneal mesothelioma (DMPM) represents one-fourth of all mesotheliomas. Association of asbestos exposure with DMPM has been observed, especially in males. The great majority of patients present with abdominal pain and distension, caused by accumulation of tumors and ascitic fluid. In the past, DMPM was considered a pre-terminal condition; therefore attracted little attention. Patients invariably died from their disease within a year. Recently, several prospective trials have demonstrated a median survival of 40 to 90 mo and 5-year survival of 30% to 60% after combined treatment using cytoreductive surgery and perioperative intraperitoneal chemotherapy. This remarkable improvement in survival has prompted new search into the medical science related to DMPM, a disease previously ignored as uninteresting. This review article focuses on the key advances in the epidemiology, diagnosis, staging, treatments and prognosis of DMPM that have occurred in the past decade. PMID:21160794

  7. 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

  8. Peritoneal dialysis solutions

    PubMed Central

    Gault, M. H.

    1973-01-01

    Certain preventable complications in the treatment of renal failure, in part related to the composition of commercially prepared peritoneal dialysis solutions, continue to occur. Solutions are advocated which would contain sodium 132, calcium 3.5, magnesium 1.5, chloride 102 and lactate or acetate 35 mEq./1., and dextrose 1.5% or about 4.25%. Elimination of 7% dextrose solutions and a reduction of the sodium and lactate concentrations should reduce complications due to hypovolemia, hyperglycemia, hypernatremia and alkalosis. Reduction in the number of solutions should simplify the procedure and perhaps reduce costs. It is anticipated that some of the changes discussed will soon be introduced by industry. PMID:4691094

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

    PubMed

    Kahveci, Arzu; Asicioglu, Ebru; Tigen, Elif; Ari, Elif; Arikan, Hakki; Odabasi, Zekaver; Ozener, Cetin

    2011-04-10

    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.

  10. Patch antenna terahertz photodetectors

    SciTech Connect

    Palaferri, D.; Todorov, Y. Chen, Y. N.; Madeo, J.; Vasanelli, A.; Sirtori, C.; Li, L. H.; Davies, A. G.; Linfield, E. H.

    2015-04-20

    We report on the implementation of 5 THz quantum well photodetector exploiting a patch antenna cavity array. The benefit of our plasmonic architecture on the detector performance is assessed by comparing it with detectors made using the same quantum well absorbing region, but processed into a standard 45° polished facet mesa. Our results demonstrate a clear improvement in responsivity, polarization insensitivity, and background limited performance. Peak detectivities in excess of 5 × 10{sup 12} cmHz{sup 1/2}/W have been obtained, a value comparable with that of the best cryogenic cooled bolometers.

  11. [Laparotomy closure in advanced peritonitis].

    PubMed

    Bensman, V M; Savchenko, Yu P; Shcherba, S N; Golikov, I V; Triandafilov, K V; Chaykin, V V; Pyatakov, S N; Saakyan, A S; Saakyan, E A

    to improve the results of advanced peritonitis management. 743 patients with advanced peritonitis were studied. Patients were divided into 2 groups depending on treatment strategy. Programmed relaparotomy combined with removable draining musculoaponeurotic seams during laparotomy closure decreased mortality from 47.8±2.7% to 24.1±2.3% (p<0.001) and provided 4-fold reduction of postoperative suppuration incidence (p<0.001). Refusal from removable draining musculoaponeurotic seams and use of only cutaneous seams in persistent abdominal hypertension were associated with further decrease of mortality to 15.8±2.7% (p<0.05). Programmed relaparotomy combined with removable draining musculoaponeurotic seams are advisable for advanced peritonitis management. Laparotomy closure with only cutaneous seams is indicated in case of persistent abdominal hypertension. Large eventration always requires abdominal wall repair. APACHE-III scale scores have significant prognostic value in patients with advanced peritonitis.

  12. Expedition 17 Patch

    NASA Image and Video Library

    2007-08-01

    ISS017-S-001B (Oct. 2007) --- The Expedition 17 patch is meant to celebrate current human achievements in space as well as symbolize the future potential for continuing exploration. The Earth, represented at the bottom of the patch, is the base from which all space exploration activities initiate. The International Space Station (ISS), shown in low Earth orbit, illustrates the current level of space operations. The arrow and star point outwards, away from the Earth, towards the wider universe indicating the direction of future activities as human beings build on what has already been accomplished. The flags, representing the home countries of the crew members, Russia and the United States, are touching, highlighting the cooperative nature of the space program and symbolizing the merger of science and technical knowledge of these two experienced space-faring nations. The NASA insignia design for space station flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the form of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, it will be publicly announced.

  13. Expedition 17 Patch

    NASA Image and Video Library

    2007-10-01

    ISS017-S-001D (Oct. 2007) --- The Expedition 17 patch is meant to celebrate current human achievements in space as well as symbolize the future potential for continuing exploration. The Earth, represented at the bottom of the patch, is the base from which all space exploration activities initiate. The International Space Station (ISS), shown in low Earth orbit, illustrates the current level of space operations. The arrow and star point outwards, away from the Earth, towards the wider universe indicating the direction of future activities as human beings build on what has already been accomplished. The flags, representing the home countries of the crew members, Russia and the United States, are touching, highlighting the cooperative nature of the space program and symbolizing the merger of science and technical knowledge of these two experienced space-faring nations. The NASA insignia design for space station flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the form of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, it will be publicly announced.

  14. Expedition 17 Patch

    NASA Image and Video Library

    2007-10-01

    ISS017-S-001C (Oct. 2007) --- The Expedition 17 patch is meant to celebrate current human achievements in space as well as symbolize the future potential for continuing exploration. The Earth, represented at the bottom of the patch, is the base from which all space exploration activities initiate. The International Space Station (ISS), shown in low Earth orbit, illustrates the current level of space operations. The arrow and star point outwards, away from the Earth, towards the wider universe indicating the direction of future activities as human beings build on what has already been accomplished. The flags, representing the home countries of the crew members, Russia and the United States, are touching, highlighting the cooperative nature of the space program and symbolizing the merger of science and technical knowledge of these two experienced space-faring nations. The NASA insignia design for space station flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the form of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, it will be publicly announced.

  15. Patched Conic Trajectory Code

    NASA Technical Reports Server (NTRS)

    Park, Brooke Anderson; Wright, Henry

    2012-01-01

    PatCon code was developed to help mission designers run trade studies on launch and arrival times for any given planet. Initially developed in Fortran, the required inputs included launch date, arrival date, and other orbital parameters of the launch planet and arrival planets at the given dates. These parameters include the position of the planets, the eccentricity, semi-major axes, argument of periapsis, ascending node, and inclination of the planets. With these inputs, a patched conic approximation is used to determine the trajectory. The patched conic approximation divides the planetary mission into three parts: (1) the departure phase, in which the two relevant bodies are Earth and the spacecraft, and where the trajectory is a departure hyperbola with Earth at the focus; (2) the cruise phase, in which the two bodies are the Sun and the spacecraft, and where the trajectory is a transfer ellipse with the Sun at the focus; and (3) the arrival phase, in which the two bodies are the target planet and the spacecraft, where the trajectory is an arrival hyperbola with the planet as the focus.

  16. STS-62 crew patch

    NASA Image and Video Library

    1993-10-01

    STS062-S-001 (October 1993) --- The crew patch depicts the world's first reusable spacecraft on its sixteenth flight. The space shuttle Columbia is in its entry-interface attitude as it prepares to return to Earth. The primary mission objectives of STS-62 include the United States Microgravity Payload (USMP-2) and the NASA Office of Aeronautics and Space Technology (OAST-2) payloads. These payloads represent a multifaceted array of space science and engineering experiments. The varied hues of the rainbow on the horizon connote the varied, but complementary, nature of all the payloads united on this mission. The upward-pointing vector shape of the patch is symbolic of America's reach for excellence in its in its unswerving pursuit to explore the frontiers of space. The brilliant sunrise just beyond Columbia suggests the promise that research in space holds for the hopes and dreams of future generations. The STS-62 insignia was designed by Mark Pestana. The NASA insignia design for space shuttle flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced. Photo credit: NASA

  17. Expedition 13 crew patch

    NASA Image and Video Library

    2006-01-01

    ISS013-S-001 (January 2006) --- This patch commemorates the thirteenth expeditionary mission to the International Space Station (ISS) which continues the permanent human presence in space. The ISS is depicted in its configuration at the start of the six-month expedition with trailing elements from the country flags representing both of the crew members--cosmonaut Pavel V. Vinogradov and astronaut Jeffrey N. Williams. The crew members made the following statement about their patch: "The dynamic trajectory of the space station against the background of the Earth, Mars, and the Moon symbolizes the vision for human space exploration beyond Earth orbit and the critical role that the ISS plays in the fulfillment of that vision." The NASA insignia design for shuttle flights and station increments is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced.

  18. STS-128 patch Pathd

    NASA Image and Video Library

    2009-04-14

    STS128-S-001 (April 2009) --- The STS-128 patch symbolizes the 17A mission and represents the hardware, people and partner nations that contribute to the flight. The Space shuttle Discovery is shown in the orbit configuration with the Multi-Purpose Logistics Module (MPLM) Leonardo in the payload bay. Earth and the International Space Station wrap around the Astronaut Office symbol reminding us of the continuous human presence in space. The names of the STS-128 crew members border the patch in an unfurled manner. Included in the names is the expedition crew member who will launch on STS-128 and remain on board ISS, replacing another Expedition crew member who will return home with STS-128. The banner also completes the Astronaut Office symbol and contains the U.S. and Swedish flags representing the countries of the STS-128 crew. The NASA insignia design for space shuttle flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced. Photo credit: NASA

  19. Peritoneal dialysis catheter placement as a mode of renal replacement therapy: Long-term results from a tertiary academic institution.

    PubMed

    Haskins, Ivy N; Schreiber, Martin; Prabhu, Ajita S; Krpata, David M; Perez, Arielle J; Tastaldi, Luciano; Tu, Chao; Rosen, Michael J; Rosenblatt, Steven

    2017-08-31

    Peritoneal dialysis as a mode of renal replacement therapy still has not been embraced widely as an alternative to hemodialysis. Furthermore, there is marked variability in peritoneal dialysis catheter insertion techniques and perioperative management within the United States. After the publication of best-demonstrated practices for peritoneal dialysis catheter placement, the utilization of peritoneal dialysis has increased significantly at our institution. We detail the long-term success of peritoneal dialysis catheter placement after the adoption of best-demonstrated practices. Retrospective chart review was performed on all patients who underwent laparoscopic peritoneal dialysis catheter placement using the best-demonstrated practice technique from January 2005 through December 2015. Preoperative patient demographic information, intraoperative variables, 30-day morbidity and mortality, and long-term catheter durability outcomes were investigated. A total of 457 patients met inclusion criteria. Four (0.9%) patients experienced an immediate postoperative complication requiring return to the operating room. There were no perioperative mortalities. A total of 298 (65.2%) patients were available for long-term follow-up; 221 (74.2%) patients are still alive, 76 (25.6%) patients are still undergoing peritoneal dialysis, 63 (21.1%) patients transitioned from peritoneal dialysis to hemodialysis, and 88 (29.5%) patients have undergone kidney transplantation. Based on Kaplan-Meier survival plots, 30% of patients will transition from peritoneal dialysis to hemodialysis after 5.5 years of peritoneal dialysis and the median time from commencing peritoneal dialysis to kidney transplantation is 5.6 years. Based on our institutional data, the adoption of best-demonstrated practices should provide long-term and reliable access to the peritoneal cavity. We recommend the adoption of these techniques to facilitate long-term peritoneal dialysis catheter survival. Copyright © 2017

  20. Ambulatory setting for peritoneal dialysis catheter placement.

    PubMed

    Maya, Ivan D

    2008-01-01

    A modified fluoroscopic technique by adding ultrasound-assistance ensuring entry into the abdominal cavity and avoiding the risk of epigastric artery injury under direct ultrasound visualization was recently published. This study demonstrated that the technique was minimally invasive and allowed for accurate assessment of entry into the abdominal cavity and avoidance of vascular injury. In the current analysis, we report the impact of this technique on hospital stay during a peritoneal dialysis (PD) catheter insertion. Twenty-six PD catheters have been placed on an outpatient basis using this technique. All catheter insertions were successful. Patients were discharge on the same day of the procedure. There were no procedure-related complication or related to short hospital stay. An ambulatory setting allows for a short hospital stay without compromising patient care. This brief paper explains in detail the pre, peri and postoperative period and follow-up.

  1. Improved Gain Microstrip Patch Antenna

    DTIC Science & Technology

    2015-08-06

    08-2015 Publication Improved Gain Microstrip Patch Antenna David A. Tonn Naval Under Warfare Center Division, Newport 1176 Howell St., Code 00L...Distribution A An antenna for mounting on a ground plane includes a dielectric substrate for mounting on the ground plane. A conductive patch...GAIN MICROSTRIP PATCH ANTENNA STATEMENT OF GOVERNMENT INTEREST [0001] The invention described herein may be manufactured and used by or for the

  2. Bovine Pericardium Patch Wrapping Intestinal Anastomosis Improves Healing Process and Prevents Leakage in a Pig Model

    PubMed Central

    Testini, Mario; Gurrado, Angela; Portincasa, Piero; Scacco, Salvatore; Marzullo, Andrea; Piccinni, Giuseppe; Lissidini, Germana; Greco, Luigi; De Salvia, Maria Antonietta; Bonfrate, Leonilde; Debellis, Lucantonio; Sardaro, Nicola; Staffieri, Francesco; Carratù, Maria Rosaria; Crovace, Antonio

    2014-01-01

    Failure of intestinal anastomosis is a major complication following abdominal surgery. Biological materials have been introduced as reinforcement of abdominal wall hernia in contaminated setting. An innovative application of biological patch is its use as reinforcement of gastrointestinal anastomosis. The aim of study was to verify whether the bovine pericardium patch improves the healing of anastomosis, when in vivo wrapping the suture line of pig intestinal anastomosis, avoiding leakage in the event of deliberately incomplete suture. Forty-three pigs were randomly divided: Group 1 (control, n = 14): hand-sewn ileo-ileal and colo-colic anastomosis; Group 2 (n = 14): standard anastomosis wrapped by pericardium bovine patch; Group 3 (n = 1) and 4 (n = 14): one suture was deliberately incomplete and also wrapped by patch in the last one. Intraoperative evaluation, histological, biochemical, tensiometric and electrophysiological studies of intestinal specimens were performed at 48 h, 7 and 90 days after. In groups 2 and 4, no leak, stenosis, abscess, peritonitis, mesh displacement or shrinkage were found and adhesion rate decreased compared to control. Biochemical studies showed mitochondrial function improvement in colic wrapped anastomosis. Tensiometric evaluations suggested that the patch preserves the colic contractility similar to the controls. Electrophysiological results demonstrated that the patch also improves the mucosal function restoring almost normal transport properties. Use of pericardium bovine patch as reinforcement of intestinal anastomosis is safe and effective, significantly improving the healing process. Data of prevention of acute peritonitis and leakage in cases of iatrogenic perforation of anastomoses, covered with patch, is unpublished. PMID:24489752

  3. Encapsulating peritoneal sclerosis in a peritoneal dialysis patient presenting with complicated Mycobacterium fortuitum peritonitis.

    PubMed

    Simbli, Mohammed Amin; Niaz, Faraz A; Al-Wakeel, Jamal S

    2012-05-01

    Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication seen in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysisAPD after prolonged duration on dialysis. Patients usally present with vague complaints of abdominal pain, vomitting, diarrhea, weight loss and change in peritoneal transport characte-ristics. High degree of suspicion is needed in PD patients who have been on dialysis for prolonged duration and have been using high-concentrated dialysis fluid. Mycobacterium fortuitum (MF) is a rapidly growing, non-tuberculous mycobacterium that has rarely been reported as a pathogen causing peritonits in patients on PD. We report a case of CAPD presenting with culture-negative peritonits, which, on specific culture, grew MF and, on radiological evaluation, showed diagnostic features of EPS.

  4. STS-102 Crew Patch

    NASA Image and Video Library

    2001-04-24

    STS102-S-001 (January 2001) --- The central image on the STS-102 crew patch depicts the International Space Station (ISS) in the build configuration that it will have at the time of the arrival and docking of Discovery during the STS-102 mission, the first crew exchange flight to the space station. The station is shown along the direction of the flight as will be seen by the shuttle crew during their final approach and docking, the so-called V-bar approach. The names of the shuttle crew members are depicted in gold around the top of the patch, and surnames of the Expedition crew members being exchanged are shown in the lower banner. The three ribbons swirling up to and around the station signify the rotation of these ISS crew members. The number two is for the Expedition Two crew who fly up to the station, and the number one is for the Expedition One crew who then return down to Earth. In conjunction with the face of the Lab module of the station, these Expedition numbers create the shuttle mission number 102. Shown mated below the ISS is the Italian-built Multi-Purpose Logistics Module, Leonardo, that will fly for the first time on this flight, and which will be attached to the station by the shuttle crew during the docked phase of the mission. The flags of the countries that are the major contributors to this effort, the United States, Russia, and Italy are also shown in the lower part of the patch. The build-sequence number of this flight in the overall station assembly sequence, 5A.1, is captured by the constellations in the background. The NASA insignia design for space shuttle flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced. Photo credit: NASA

  5. A method for detecting hydrophobic patches on protein surfaces.

    PubMed

    Lijnzaad, P; Berendsen, H J; Argos, P

    1996-10-01

    A method for the detection of hydrophobic patches on the surfaces of protein tertiary structures is presented. It delineates explicit contiguous pieces of surface of arbitrary size and shape that consist solely of carbon and sulphur atoms using a dot representation of the solvent-accessible surface. The technique is also useful in detecting surface segments with other characteristics, such as polar patches. Its potential as a tool in the study of protein-protein interactions and substrate recognition is demonstrated by applying the method to myoglobin, Leu/IIe/Val-binding protein, lipase, lysozyme, azurin, triose phosphate isomerase, carbonic anhydrase, and phosphoglycerate kinase. Only the largest patches, having sizes exceeding random expectation, are deemed meaningful. In addition to well-known hydrophobic patches on these proteins, a number of other patches are found, and their significance is discussed. The method is simple, fast, and robust. The program text is obtainable by anonymous ftp.

  6. Ultrastructural Changes in Murine Peritoneal Cells Following Cyclophosphamide Administration

    PubMed Central

    Chin, K. N.; Hudson, G.

    1974-01-01

    Peritoneal cells were studied at intervals of between 6 h and 30 days following a single intravenous injection of a sublethal dose of cyclophosphamide. With the electron microscope, evidence of cell damage and death could be seen at 6 h, and by 12 h large numbers of dead cells were noted, either lying free or within the cytoplasm of macrophages. Most of the damaged cells were lymphocytes but degenerating blast cells, eosinophils, neutrophils and mast cells were also identified. Nuclei were seen in which margination of chromatin had occurred but nuclei of uniform density were also prominent and showed irregular shape and lobulation. Macrophages exhibited all stages of phagocytosis and digestion and a few phagocytes of atypical appearance were noted. By 24 h most of the dead cells lay within the cytoplasm of macrophages which showed many phagocytic inclusions as well as lipid droplets. By 6 days, the peritoneal cells had regained normal appearances although the proportion of lymphoid cells was still reduced. By the 18th day, all features were indistinguishable from normal. The changes observed showed a general similarity to those noted previously in the lymphoreticular cells of the Peyer's patch; they provide no evidence that the environment of the peritoneal cavity protects cells against the action of cyclophosphamide. ImagesFigs. 4-6Figs. 7-9Figs. 10-12Figs. 1-3 PMID:4447790

  7. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes.

    PubMed

    Borzych-Duzalka, Dagmara; Aki, T Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A

    2017-01-06

    Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1.10 to 1.65; P=0.003). Access dysfunction due to mechanical causes doubled the risk

  8. A Case Report of Neisseria Mucosa Peritonitis in a Chronic Ambulatory Peritoneal Dialysis Patient

    PubMed Central

    Awdisho, Alan; Bermudez, Maria

    2016-01-01

    Peritonitis is a leading complication of chronic ambulatory peritoneal dialysis. However, very rarely does Neisseria mucosa cause peritonitis. We describe an unusual case of N. mucosa peritonitis in a chronic ambulatory peritoneal dialysis patient. A 28-year-old Hispanic male presents with diffuse abdominal pain exacerbated during draining of the peritoneal fluid. Peritoneal fluid examination was remarkable for leukocytosis and gramnegative diplococci. Bacterial cultures were positive for N. mucosa growth. The patient was treated with ciprofloxacin with preservation of the dialysis catheter. This case highlights the rarity and importance of Neisseria mucosa causing peritonitis in chronic ambulatory peritoneal dialysis patients’. There seems to be a unique association between N. mucosa peritonitis and chronic ambulatory peritoneal dialysis patients’. The patient was successfully managed with ciprofloxacin along with salvaging of the dialysis catheter. PMID:28191300

  9. Novel Predictors of Peritonitis-Related Outcomes in the BRAZPD Cohort

    PubMed Central

    de Moraes, Thyago Proença; Olandoski, Marcia; Caramori, Jaqueline C.T.; Martin, Luis C.; Fernandes, Natália; Divino-Filho, José Carolino; Pecoits-Filho, Roberto; Barretti, Pasqual

    2014-01-01

    ♦ Introduction: Peritonitis remains the main cause of peritoneal dialysis (PD) technique failure worldwide, despite significant reductions in infection rates observed over the past decades. Several studies have described risk factors for peritonitis, technique failure and mortality. However, there are scarce data regarding predictors of complications during and after a peritonitis episode. The aim of our study was to analyze predictors of peritonitis-related outcome in the Brazilian Peritoneal Dialysis study (BRAZPD) cohort. ♦ Methods: All adult incident patients recruited in the BRAZPD Study between December 2004 and October 2007, who remained at least 90 days on PD and presented their first peritonitis episode (n = 474 patients) were included in the study. The endpoints analyzed were non-resolution, death due to a peritonitis episode and long-term technique survival after a peritonitis episode. ♦ Results: In the multivariable regression, non-resolution was independently associated with older age (odds ratio (OR) 1.02; p < 0.01), collagenosis as the primary renal disease (OR 4.6; p < 0.05) and Pseudomonas spp as etiological agent (OR 2.9; p < 0.05). Patients who were transferred from APD to CAPD during peritonitis therapy presented a higher risk of non-response (OR 2.5; p < 0.05). The only factor associated with death during a peritonitis episode was older age (OR 1.04; p < 0.05). Exposure to vancomycin and male gender were the independent predictors of long-term technique failure (OR 2.2; p < 0.01). ♦ Conclusion: Apart from confirming previous observations of the negative impact of older age and Pseudomonas spp peritonitis on outcomes, we observed that collagenosis may negatively impact response to treatment and exposure to vancomycin may possibly reduce long-term technique survival. It is important to emphasize that the association of vancomycin with technique failure does not prove causality. These findings shed light on new factors predicting outcome

  10. Expedition Seven patch

    NASA Image and Video Library

    2003-03-01

    ISS007-S-001 (March 2003) --- The International Space Station (ISS) Expedition Seven patch consists of two elliptical orbits which evoke the histories of the two space programs from which the crew is drawn. The Russian and American flags are intersecting, representing the peaceful cooperation of the many countries contributing to the ISS. Two stars indicate the station's goals of contributing to life on Earth through science and commerce. The NASA insignia design for station space flights is reserved for use by the crew members and other official use as the NASA Administrator may authorize. Public availability has been approved only in the form of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, such will be publicly announced.

  11. Expedition 10 patch

    NASA Image and Video Library

    2004-05-01

    ISS010-S-001 (May 2004) --- The Expedition 10 patch uses simple symbolism to describe the mission. The large Roman numeral "X," formed by the American and Russian flags, symbolizes the joint nature of this mission, as well as the fact that this flight is the 10th mission to stay on the International Space Station (ISS). The current configuration of the ISS is next to the name of the ISS Commander, while the Soyuz vehicle is placed next to the name of the Soyuz Commander. The single star and the black background signify this is a space mission. The NASA insignia design for shuttle flights and station increments is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced.

  12. sts-135patch only

    NASA Image and Video Library

    2011-01-25

    STS135-S-001 (27 Jan. 2011) --- The STS-135 patch represents the space shuttle Atlantis embarking on its mission to resupply the International Space Station. Atlantis is centered over elements of the NASA emblem depicting how the space shuttle has been at the heart of NASA for the last 30 years. It also pays tribute to the entire NASA and contractor team that made possible all the incredible accomplishments of the space shuttle. Omega, the last letter in the Greek alphabet, recognizes this mission as the last flight of the Space Shuttle Program. The NASA insignia design for space shuttle flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced. Photo credit: NASA

  13. Sorbent regeneration of peritoneal dialysate: an approach to ambulatory dialysis.

    PubMed

    Gordon, A; Maxwell, M H; Lewin, A J

    Sorbent regeneration of peritoneal dialysate has been shown to be feasible in experimental and preliminary clinical studies and provides a realistic basis for the optimization of dialysis therapy and the potential development of an ambulatory dialysis system. Peritoneal dialysis efficiency can be significantly enhanced by continuous dialysate flow techniques and the mass transfer of uremic solutes can be theoretically augmented by the increased dialysis time made possible by a wearable design. Further optimization of end stage renal failure therapy may be achieved by the combined use of various methods for blood purification.

  14. Rapid automatic segmentation of the human cerebellum and its lobules (RASCAL)--implementation and application of the patch-based label-fusion technique with a template library to segment the human cerebellum.

    PubMed

    Weier, Katrin; Fonov, Vladimir; Lavoie, Karyne; Doyon, Julien; Collins, D Louis

    2014-10-01

    Reliable and fast segmentation of the human cerebellum with its complex architecture of lobes and lobules has been a challenge for the past decades. Emerging knowledge of the functional integration of the cerebellum in various sensori-motor and cognitive-behavioral circuits demands new automatic segmentation techniques, with accuracies similar to manual segmentations, but applicable to large subject numbers in a reasonable time frame. This article presents the development and application of a novel pipeline for rapid automatic segmentation of the human cerebellum and its lobules (RASCAL) combining patch-based label-fusion and a template library of manually labeled cerebella of 16 healthy controls from the International Consortium for Brain Mapping (ICBM) database. Leave-one-out experiments revealed a good agreement between manual and automatic segmentations (Dice kappa = 0.82). Intraclass correlation coefficients (ICC) were calculated to test reliability of segmented volumes and were highest (ICC > 0.9) for global measures (total and hemispherical grey and white matter) followed by larger lobules of the posterior lobe (ICC > 0.8). Further we applied the pipeline to all 152 young healthy controls of the ICBM database to look for hemispheric and gender differences. The results demonstrated larger native space volumes in men then women (mean (± SD) total cerebellar volume in women = 217 cm(3) (± 26), men = 259 cm(3) (± 29); P < 0.001). Significant gender-by-hemisphere interaction was only found in stereotaxic space volumes for white matter core (men > women) and anterior lobe volume (women > men). This new method shows great potential for the precise and efficient analysis of the cerebellum in large patient cohorts.

  15. Gravity Survey of the Rye Patch KGRA, Rye Patch, Nevada

    NASA Astrophysics Data System (ADS)

    Mcdonald, M. R.; Gosnold, W. D.

    2011-12-01

    The Rye Patch Known Geothermal Resource Area (KGRA) is located in Pershing County Nevada on the west side of the Humboldt Range and east of the Rye Patch Reservoir approximately 200 km northeast of Reno, Nevada. Previous studies include an earlier gravity survey, 3-D seismic reflection, vertical seismic profiling (VSP) on a single well, 3-D seismic imaging, and a report of the integrated seismic studies. Recently, Presco Energy conducted an aeromagnetic survey and is currently in the process of applying 2-D VSP methods to target exploration and production wells at the site. These studies have indicated that geothermal fluid flow primarily occurs along faults and fractures and that two potential aquifers include a sandstone/siltstone member of the Triassic Natchez Pass Formation and a karst zone that occurs at the interface between Mesozoic limestone and Tertiary volcanics. We hypothesized that addition of a high-resolution gravity survey would better define the locations, trends, lengths, and dip angles of faults and possible solution cavity features. The gravity survey encompassed an area of approximately 78 km2 (30 mi2) within the boundary of the KGRA along with portions of 8 sections directly to the west and 8 sections directly to the east. The survey included 203 stations that were spaced at 400 m intervals. The simple Bouguer anomaly patterns were coincident with elevation, and those patterns remained after terrain corrections were performed. To remove this signal, the data were further processed using wave-length (bandpass) filtering techniques. The results of the filtering and comparison with the recent aeromagnetic survey indicate that the location and trend of major fault systems can be identified using this technique. Dip angles can be inferred by the anomaly contour gradients. By further reductions in the bandpass window, other features such as possible karst solution channels may also be recognizable. Drilling or other geophysical methods such as a

  16. [Pathophysiology of peritonitis].

    PubMed

    Beyer, K; Menges, P; Keßler, W; Heidecke, C-D

    2016-01-01

    Despite intensive research efforts peritonitis leading to subsequent sepsis remains associated with a high mortality. The initial effector cells are the locally residing cells of the peritoneum, such as mesothelial cells, mast cells, macrophages and lymphocytes. Through the secretion of chemokines, an influx of neutrophils initially takes place followed by monocytes. The latter can differentiate into inflammatory macrophages. The non-directed activity of neutrophilic granulocytes is limited by the induction of apoptotic programs. Through the breaching of cytokines, bacteria and microbial products into the circulation, a systemic reaction in the sense of systemic inflammatory response syndrome (SIRS) or sepsis arises. This is viewed as a concomitant derailing of inflammatory as well as anti-inflammatory responses, which leads to extensive apoptosis of lymphocytes. The presentation of apoptotic cells leads to a strong immunosuppression. Due to the coexistence of hyperinflammation and immunosuppression, exact knowledge of the current immune status of the patient is a prerequisite in the development of immunotherapies for the treatment of sepsis.

  17. Palliative peritoneal dialysis: Implementation of a home care programme for terminal patients treated with peritoneal dialysis (PD).

    PubMed

    Gorrin, Maite Rivera; Teruel-Briones, José Luis; Vion, Victor Burguera; Rexach, Lourdes; Quereda, Carlos

    2015-01-01

    Terminal-stage patients on peritoneal dialysis (PD) are often transferred to haemodialysis as they are unable to perform the dialysis technique themselves since their functional capacities are reduced. We present our experience with five patients on PD with a shortterm life-threatening condition, whose treatment was shared by primary care units and who were treated with a PD modality adapted to their circumstances, which we call Palliative Peritoneal Dialysis. Copyright © 2015. Published by Elsevier España, S.L.U.

  18. 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

  19. Mapped Plot Patch Size Estimates

    Treesearch

    Paul C. Van Deusen

    2005-01-01

    This paper demonstrates that the mapped plot design is relatively easy to analyze and describes existing formulas for mean and variance estimators. New methods are developed for using mapped plots to estimate average patch size of condition classes. The patch size estimators require assumptions about the shape of the condition class, limiting their utility. They may...

  20. Catch and Patch: A Pipette-Based Approach for Automating Patch Clamp That Enables Cell Selection and Fast Compound Application.

    PubMed

    Danker, Timm; Braun, Franziska; Silbernagl, Nikole; Guenther, Elke

    2016-03-01

    Manual patch clamp, the gold standard of electrophysiology, represents a powerful and versatile toolbox to stimulate, modulate, and record ion channel activity from membrane fragments and whole cells. The electrophysiological readout can be combined with fluorescent or optogenetic methods and allows for ultrafast solution exchanges using specialized microfluidic tools. A hallmark of manual patch clamp is the intentional selection of individual cells for recording, often an essential prerequisite to generate meaningful data. So far, available automation solutions rely on random cell usage in the closed environment of a chip and thus sacrifice much of this versatility by design. To parallelize and automate the traditional patch clamp technique while perpetuating the full versatility of the method, we developed an approach to automation, which is based on active cell handling and targeted electrode placement rather than on random processes. This is achieved through an automated pipette positioning system, which guides the tips of recording pipettes with micrometer precision to a microfluidic cell handling device. Using a patch pipette array mounted on a conventional micromanipulator, our automated patch clamp process mimics the original manual patch clamp as closely as possible, yet achieving a configuration where recordings are obtained from many patch electrodes in parallel. In addition, our implementation is extensible by design to allow the easy integration of specialized equipment such as ultrafast compound application tools. The resulting system offers fully automated patch clamp on purposely selected cells and combines high-quality gigaseal recordings with solution switching in the millisecond timescale.

  1. Closed suction drainage for treatment of septic peritonitis of confirmed gastrointestinal origin in 20 dogs.

    PubMed

    Adams, Robert J; Doyle, Ronan S; Bray, Jonathan P; Burton, Carolyn A

    2014-10-01

    To determine survival rate in dogs with septic peritonitis of confirmed gastrointestinal origin treated with closed suction drainage. Retrospective case series. Dogs (n = 20) with septic peritonitis. Medical records (2007-2010) of dogs with septic peritonitis of confirmed gastrointestinal origin treated by closed suction drainage were reviewed. Information on signalment, clinicopathologic abnormalities, underlying cause, surgical procedure performed, postoperative management, complications, and outcome was obtained. Dehiscence of a previous anastomosis was the most common source of contamination (80%). Drains remained in place, collecting fluid produced within the abdomen, for a median of 6 days (range, 2-11 days). Eighteen dogs received nutritional support, and 14 received plasma transfusions. Seventeen dogs (85%) survived to discharge. Closed suction drainage together with resolution of the underlying cause of peritonitis and appropriate postoperative management is an effective technique for treatment of septic peritonitis of confirmed gastrointestinal origin in dogs. © Copyright 2014 by The American College of Veterinary Surgeons.

  2. Uremic toxins and peritoneal dialysis.

    PubMed

    Lameire, N; Vanholder, R; De Smet, R

    2001-02-01

    Uremic toxicity is related in part to the accumulation of toxic substances, the nature of which has only partly been characterized. Because of the use of a highly permeable membrane and better preservation of the residual renal function, it could be anticipated that some of these uremic toxins are more efficiently cleared across the peritoneal membrane, and that the plasma and tissue levels of these compounds are lower than in hemodialysis patients. This article analyzes the generation and removal of several uremic toxins in peritoneal dialysis patients. The following uremic toxins are discussed: beta2-microglobulin, advanced glycation end products, advanced oxidation protein products, granulocyte inhibitory proteins, p-Cresol, and hyperhomocysteinemia. Some recent studies are reviewed suggesting that uremic toxins are involved in the progression of renal failure and are at least partially removed by peritoneal dialysis. We conclude that, although the plasma levels of some of these compounds are lower in peritoneal dialysis versus hemodialysis patients, it does not mean that the peritoneal dialysis patient is "better" protected against the numerous disturbances caused by these toxins.

  3. Epidemic of Chemical Peritonitis in Patients on Continuous Ambulatory Peritoneal Dialysis: A Report from Western India.

    PubMed

    Jamale, Tukaram; Dhokare, Aniruddha; Satpute, Kushal; Kulkarni, Renu; Usulumarty, Deepa; Vishwanath, Billa; Noronha, Santosh; Hase, Niwrutti

    2016-01-01

    While non-infectious etiologies like chemical irritants are rare causes of epidemics of peritonitis, this possibility should be considered when one encounters an unusual clustering of peritonitis cases. We describe here an epidemic of chemical peritonitis at our center. Copyright © 2016 International Society for Peritoneal Dialysis.

  4. Genetic-Based Dissection Unveils the Inputs and Outputs of Striatal Patch and Matrix Compartments.

    PubMed

    Smith, Jared B; Klug, Jason R; Ross, Danica L; Howard, Christopher D; Hollon, Nick G; Ko, Vivian I; Hoffman, Hilary; Callaway, Edward M; Gerfen, Charles R; Jin, Xin

    2016-09-07

    The striatum contains neurochemically defined compartments termed patches and matrix. Previous studies suggest patches preferentially receive limbic inputs and project to dopamine neurons in substantia nigra pars compacta (SNc), whereas matrix neurons receive sensorimotor inputs and do not innervate SNc. Using BAC-Cre transgenic mice with viral tracing techniques, we mapped brain-wide differences in the input-output organization of the patch/matrix. Findings reveal a displaced population of striatal patch neurons termed "exo-patch," which reside in matrix zones but have neurochemistry, connectivity, and electrophysiological characteristics resembling patch neurons. Contrary to previous studies, results show patch/exo-patch and matrix neurons receive both limbic and sensorimotor information. A novel inhibitory projection from bed nucleus of the stria terminalis to patch/exo-patch neurons was revealed. Projections to SNc were found to originate from patch/exo-patch and matrix neurons. These findings redefine patch/matrix beyond traditional neurochemical topography and reveal new principles about their input-output connectivity, providing a foundation for future functional studies. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The role of peritoneal scintigraphy in the detection of continuous ambulatory peritoneal dialysis complications.

    PubMed

    Tokmak, Handan; Mudun, Ayşe; Türkmen, Cuneyt; Sanli, Yasemin; Cantez, Sema; Bozfakioğlu, Semra

    2006-01-01

    While continuous ambulatory peritoneal dialysis (CAPD) offers several advantages over hemodialysis in patients with end-stage renal disease, several complications have been recognized. The intraperitoneal instillation of dialysate increases intra-abdominal pressure and consequently predisposes the patient to leaks and herniations through defects in the abdominal wall. The use of an intraperitoneal radiolabeled colloid has been previously described to image entities such as hernias, patent processus vaginalis, abdominal wall, and diaphragmatic leakage. This study shows a simple, non-invasive method of determining the site of dialysate leak and its importance to assist further patient management. There has been a continuing increase in the number of end stage renal disease patients maintained on chronic peritoneal dialysis (CPD). Many patients choose CPD as their preferred chronic dialysis treatment, though approximately 20% of patients who drop out transfer to hemodialysis annually.[1] Although peritonitis remains the major reason for transfer to hemodialysis, other factors such as exit site infections, catheter-related problems, abdominal wall and inguinal hernias, loss of ultrafiltrations, and poor clearance contribute to CPD technique failure.[2] In order to permit the continuation of long-term therapy with CPD, these complications should be resolved. Routine laboratory evaluation or physical examination can detect some CPD-related problems; however, some patients require more complicated investigations to evaluate their problems properly.

  6. [Exploration of ultrafiltration failure in peritoneal dialysis].

    PubMed

    Bellavia, Salvatore; Coche, Emmanuel; Goffin, Eric

    2008-12-01

    Ultrafiltration failure (UFF) is a common complication of peritoneal dialysis (PD). It may be due to a technical problem (PD catheter obstruction or migration, peritoneal leaks or intraperitoneal adhesions) or because of a peritoneal membrane alteration (hyperpermeability, aquaporin dysfunction, peritoneal sclerosis or enhanced lymphatic reabsorption). We, here, present the case of a patient who developed several consecutive PD complications that eventually led to UFF. We also present an algorithm, which may help clinicians to establish a precise etiological diagnosis of UFF.

  7. Cryptococcal peritonitis in a CAPD patient.

    PubMed

    Morris, B; Chan, Y F; Reddy, J; Woodgyer, A

    1992-01-01

    A 50-year-old diabetic woman with end-stage renal disease, who had been on continuous ambulatory peritoneal dialysis for 8 months, developed peritonitis caused by Cryptococcus neoformans var. neoformans. The patient was completely asymptomatic and infection was confirmed by detection of budding yeast cells in Gram-stained smears of turbid peritoneal fluid. The infection was cleared after intravenous fluconazole with delayed removal of the catheter. Fluconazole may be a suitable alternative drug in treating cryptococcal peritonitis.

  8. Intraperitoneal therapy for peritoneal cancer

    PubMed Central

    Lu, Ze; Wang, Jie; Wientjes, M Guillaume; Au, Jessie L-S

    2011-01-01

    Cancers originating from organs in the peritoneal cavity (e.g., ovarian, pancreatic, colorectal, gastric and liver) account for approximately 250,000 new cancer cases annually in the USA. Peritoneal metastases are common owing to locoregional spread and distant metastases of extraperitoneal cancers. A logical treatment is intraperitoneal therapy, as multiple studies have shown significant targeting advantage for this treatment, including significant survival benefits in stage III, surgically debulked ovarian cancer patients. However, the clinical use of intraperitoneal therapy has been limited, in part, by toxicity, owing to the use of indwelling catheters or high drug exposure, by inadequate drug penetration into bulky tumors (>1 cm) and by the lack of products specifically designed and approved for intraperitoneal treatments. This article provides an overview on the background of peritoneal metastasis, clinical research on intraperitoneal therapy, the pharmacokinetic basis of drug delivery in intraperitoneal therapy and our development of drug-loaded tumor-penetrating microparticles. PMID:21062160

  9. Peritoneal transport with icodextrin solution.

    PubMed

    Heimbürger, Olof

    2006-01-01

    Icodextrin is the only large molecular weight osmotic agent available in peritoneal dialysis solutions. Icodextrin (compared to glucose) has a prolonged positive ultrafiltration because of the slow absortion of icodextrin due to its large molecular weight. As icodextrin induces transcapillary ultrafiltration by a mechanism resembling 'colloid' osmosis (with the ultrafiltration occurring mainly through the small pores) almost no sieving of solutes is observed with icodextrin-based solution resulting in increased convective transport and clearance of small solutes. In general, the transport characteristics of the peritoneal membrane are similar with glucose- and icodextrin-based solution, but results from the EAPOS study suggests that use of icodextrin-based solution may be associated with less changes in peritoneal transport with time.

  10. The Use of Incremental Peritoneal Dialysis in a Large Contemporary Peritoneal Dialysis Program.

    PubMed

    Ankawi, Ghada A; Woodcock, Nancy I; Jain, Arsh K; Garg, Amit X; Blake, Peter G

    2016-01-01

    The use of an incremental peritoneal dialysis (PD) strategy in a large contemporary patient population has not been described. We report the use of this strategy in clinical practice, the prescriptions required, and the clearances achieved in a large center which has routinely used this approach for more than 10 years. This is a cross-sectional observational study. A single large Canadian academic center. This study collected data on 124 prevalent PD patients at a single Canadian academic center. The proportion of patients who achieve the clearance target on a low clearance or incremental PD prescription; the actual PD prescriptions and consequent total, peritoneal, and renal urea clearances [Kt/V] achieved; and patient and technique survival and peritonitis rate in comparison with national and international reports. Of the 124 prevalent PD patients in this PD unit, 106 (86%) were achieving the Kt/V target, and of these, 54 (44% of all patients) were doing so using incremental PD prescriptions. Fifty of these incremental PD patients were using automated PD (APD) with either no day dwell (68%) or less than 7 days a week treatment (12%) or both (20%). Patient survival in our PD unit was not different from that reported in Canada as a whole. Peritonitis rates were better than internationally recommended standards. This is an observational study with no randomized control group. Incremental PD is feasible in a contemporary PD population treated mainly with APD. Almost half of the patients were able to achieve clearance targets while receiving less onerous and less costly low clearance prescriptions. We suggest that incremental PD should be widely used as a cost-effective strategy in PD.

  11. The Use of Incremental Peritoneal Dialysis in a Large Contemporary Peritoneal Dialysis Program

    PubMed Central

    Ankawi, Ghada A.; Woodcock, Nancy I.; Jain, Arsh K.; Garg, Amit X.; Blake, Peter G.

    2016-01-01

    Background: The use of an incremental peritoneal dialysis (PD) strategy in a large contemporary patient population has not been described. Objective: We report the use of this strategy in clinical practice, the prescriptions required, and the clearances achieved in a large center which has routinely used this approach for more than 10 years. Design: This is a cross-sectional observational study. Setting: A single large Canadian academic center. Patients: This study collected data on 124 prevalent PD patients at a single Canadian academic center. Methods and Measurements: The proportion of patients who achieve the clearance target on a low clearance or incremental PD prescription; the actual PD prescriptions and consequent total, peritoneal, and renal urea clearances [Kt/V] achieved; and patient and technique survival and peritonitis rate in comparison with national and international reports. Results: Of the 124 prevalent PD patients in this PD unit, 106 (86%) were achieving the Kt/V target, and of these, 54 (44% of all patients) were doing so using incremental PD prescriptions. Fifty of these incremental PD patients were using automated PD (APD) with either no day dwell (68%) or less than 7 days a week treatment (12%) or both (20%). Patient survival in our PD unit was not different from that reported in Canada as a whole. Peritonitis rates were better than internationally recommended standards. Limitations: This is an observational study with no randomized control group. Conclusions: Incremental PD is feasible in a contemporary PD population treated mainly with APD. Almost half of the patients were able to achieve clearance targets while receiving less onerous and less costly low clearance prescriptions. We suggest that incremental PD should be widely used as a cost-effective strategy in PD. PMID:28781885

  12. Expedition 11 patch

    NASA Image and Video Library

    2005-01-01

    ISS011-S-001 (January 2005) --- The emblem of the eleventh expedition to the International Space Station (ISS) emphasizes the roles of the United States and the Russian Federation in the multinational ISS partnership. The two rocket plumes, in the style of the flags of these two nations, represent the Russian Soyuz vehicles and the American space shuttles. The ISS image shows the configuration of the orbiting station at the start of the expedition, with docked Soyuz and Progress vehicles and the huge American solar panels. The names of the two crew members are shown on the margin of the patch. ISS Commander Sergei Krikalev and John Phillips, NASA ISS science officer and flight engineer, are expected to launch on a Soyuz vehicle and to be in orbit during the return to flight of the space shuttle. The crew explains, “The beauty of our home planet and the vivid contrasts of the space environment are shown by the blue and green Earth with the space station orbiting overhead, and by the bright stars, dark sky, and dazzling sun.” The NASA insignia design for shuttle flights and station increments is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced.

  13. Exp 45 Patch - FINALai

    NASA Image and Video Library

    2014-02-05

    ISS045-S-001 (July 2014) --- The Expedition 45 crew will conduct its journey of exploration and discovery from a summit whose foundation was built by past generations of pioneers, scientists, engineers and explorers. This foundation is represented by the book of knowledge at the bottom of the patch. Curves radiate from the book representing the flow of knowledge - and the hard work, sacrifice and innovation that makes human spaceflight possible. The pages written during Expedition 45 will serve to benefit humanity on Earth and in space. The International Space Station is represented by a single bright star soaring over the Earth, illuminating a path to future, more distant destinations. Note: The NASA insignia design for shuttle and space station flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the form of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, it will be publicly announced.

  14. Expedition 12 patch

    NASA Image and Video Library

    2005-09-01

    ISS012-S-001 (September 2005) --- The Expedition 12 patch represents both mankind’s permanent presence in space and future dreams of exploration. The International Space Station (ISS), featured prominently in the center, will continue to grow in its capability as a world-class laboratory and test bed for exploration. The vision of exploration is depicted by the moon and Mars. The star symbolizes mankind's destiny in space and is a tribute to the space explorers who have been lost in its pursuit. The Roman numeral XII in the background signifies the 12th expeditionary mission to the ISS. The NASA insignia design for Shuttle flights and Space Station increments is reserved for use by the astronauts and cosmonauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the form of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, it will be publicly announced.

  15. Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients.

    PubMed

    Campbell, Denise; Mudge, David W; Craig, Jonathan C; Johnson, David W; Tong, Allison; Strippoli, Giovanni Fm

    2017-04-08

    Peritoneal dialysis (PD) is an important therapy for patients with end-stage kidney disease and is used in more than 200,000 such patients globally. However, its value is often limited by the development of infections such as peritonitis and exit-site and tunnel infections. Multiple strategies have been developed to reduce the risk of peritonitis including antibiotics, topical disinfectants to the exit site and antifungal agents. However, the effectiveness of these strategies has been variable and are based on a small number of randomised controlled trials (RCTs). The optimal preventive strategies to reduce the occurrence of peritonitis remain unclear.This is an update of a Cochrane review first published in 2004. To evaluate the benefits and harms of antimicrobial strategies used to prevent peritonitis in PD patients. We searched the Cochrane Kidney and Transplant's Specialised Register to 4 October 2016 through contact with the Information Specialist using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE, and EMBASE; handsearching conference proceedings; and searching the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. RCTs or quasi-RCTs in patients receiving chronic PD, which evaluated any antimicrobial agents used systemically or locally to prevent peritonitis or exit-site/tunnel infection were included. Two authors independently assessed risk of bias and extracted data. Summary estimates of effect were obtained using a random-effects model, and results were expressed as risk ratio (RR) with 95% confidence intervals (CI). Thirty-nine studies, randomising 4435 patients, were included. Twenty additional studies have been included in this update. The risk of bias domains were often unclear or high; risk of bias was judged to be low in 19 (49%) studies for random sequence generation, 12 (31%) studies for

  16. Isolation of bacterial DNA followed by sequencing and differing cytokine response in peritoneal dialysis effluent help in identifying bacteria in culture negative peritonitis.

    PubMed

    Prasad, Narayan; Singh, Kamini; Gupta, Amit; Prasad, Kashi Nath

    2016-11-16

    The treatment of peritoneal dialysis related culture negative peritonitis is empirical which increases the cost of therapy and moreover antibiotic resistance. We aimed the study to isolate bacterial DNA from PD effluent and indentify bacteria causing peritonitis in culture negative situations. We have also studied the cytokine response with different bacteria causing peritonitis. We have isolated bacterial DNA from PD effluent of culture negative and culture positive peritonitis patients. Bacterial DNA was subjected to polymerase chain reaction using universal bacteria specific primers and subsequently to Gram type specific primers for the differentiation of the etiologic agents into Gram positive and Gram negative. The amplified products were sequenced and subjected to blast search to identify agent at genus/ species level. Of the 30 molecular method positive samples, 16 (53.33%) samples were positive for Gram negative bacteria and 4 (13.33%) for Gram positive while remaining10 (33.33%) were positive for both Gram positive and Gram negative bacteria. We have found organisms which usually do not grow on normal culture methods. TNF- α was significantly associated with Gram positive peritonitis and regulatory cytokine IL-10 with Gram negative peritonitis. The molecular techniques are helpful in detecting and identifying organisms from culture negative PD effluent. This article is protected by copyright. All rights reserved.

  17. [Ultrastructure of peritoneal mesothelial cells].

    PubMed

    Obradovic, M M; Stojimirovic, B B; Trpinac, D P; Milutinovic, D D; Obradovic, D I; Nesic, V B

    2001-01-01

    The introduction of peritoneal dialysis (PD) as a respectable modality of renal replacement therapy some three decades ago, suddenly drew attention of many authors to peritoneal membrane as insufficiently investigated structure. In order to explain the pathological changes in peritoneum due to renal diseases, it became necessary to explore the normal peritoneal structure. The aim of this study was to examine the morphology of peritoneal lining cells in healthy persons. Biopsies of the peritoneum were performed on 20 volunteer kidney donors. Tissue samples were taken during renal transplantation. Special care was taken in getting appropriate samples without artificial damage because of the extreme fragility of the peritoneal tissue. The preparing procedure was standard for routine HE staining and for plastic embedded semifine and fine sections studies. Semifine sections were made on ultramicrotome, stained with Toluidin blue and studied by light microscope, while fine sections were made by ultramicrotome and studied by transmission electron microscope. One layer of cuboidal or flattened lining cells present over the lamina propria connective tissue presented mesothelium. The cells were overlapped like tiles on the roof. Lateral parts of their interdigitated membranes were interconnected with different types of cell junctions: unpermeable, adhesion and communication junctions; inhibiting intercellular transport. Cell surface was often covered with great number of microvilli and lamellar bodies. A single kinocilia was also often present on apical cell surface. Nuclei were euchromatic with well developed nucleoli. Cytoplasm was filled with a great number of ribosomes, mitochondria, cisterns of rough endoplasmatic reticulum and Golgi apparatus, lamellar bodies and lipid inclusions. Numerous pinocytic vesicles on all parts of the membrane as well as in the cytoplasm indicating active endocytosis, egsocytosis and transcytosys in the process of secretion and reabsorption

  18. Humicola sp. as a Cause of Peritoneal Dialysis-Associated Peritonitis

    PubMed Central

    Burns, Nathan; Arthur, Ian; Leung, Michael; Ketharanathan, Selva; Gené, Josepa; Guarro, Josep

    2015-01-01

    Peritoneal dialysis is the renal replacement modality used by ∼20% of patients with end-stage kidney disease (S. McDonald, P. Clayton, and K. Hurst, p. 6.2–6.27, in ANZDATA 2012 Annual Report, 35th ed., 2012). A major complication of peritoneal dialysis is the development of peritonitis. We describe a case of Humicola sp. causing peritoneal dialysis (PD)-associated peritonitis, successfully treated with a prolonged course of antifungal therapy. PMID:26157153

  19. Taro corms mucilage/HPMC based transdermal patch: an efficient device for delivery of diltiazem hydrochloride.

    PubMed

    Sarkar, Gunjan; Saha, Nayan Ranjan; Roy, Indranil; Bhattacharyya, Amartya; Bose, Madhura; Mishra, Roshnara; Rana, Dipak; Bhattacharjee, Debashis; Chattopadhyay, Dipankar

    2014-05-01

    The aim of this work is to examine the effectiveness of mucilage/hydroxypropylmethylcellulose (HPMC) based transdermal patch (matrix type) as a drug delivery device. We have successfully extracted mucilage from Colocasia esculenta (Taro) corms and prepared diltiazem hydrochloride incorporated mucilage/HPMC based transdermal patches using various wt% of mucilage by the solvent evaporation technique. Characterization of both mucilage and transdermal patches has been done by several techniques such as Molisch's test, organoleptic evaluation of mucilage, mechanical, morphological and thermal analysis of transdermal patches. Skin irritation test is studied on hairless Albino rat skin showing that transdermal patches are apparently free of potentially hazardous skin irritation. Fourier transform infrared analysis shows that there is no interaction between drug, mucilage and HPMC while scanning electron microscopy shows the surface morphology of transdermal patches. In vitro drug release time of mucilage-HPMC based transdermal patches is prolonged with increasing mucilage concentration in the formulation.

  20. Mesh saliency with adaptive local patches

    NASA Astrophysics Data System (ADS)

    Nouri, Anass; Charrier, Christophe; Lézoray, Olivier

    2015-03-01

    3D object shapes (represented by meshes) include both areas that attract the visual attention of human observers and others less or not attractive at all. This visual attention depends on the degree of saliency exposed by these areas. In this paper, we propose a technique for detecting salient regions in meshes. To do so, we define a local surface descriptor based on local patches of adaptive size and filled with a local height field. The saliency of mesh vertices is then defined as its degree measure with edges weights computed from adaptive patch similarities. Our approach is compared to the state-of-the-art and presents competitive results. A study evaluating the influence of the parameters establishing this approach is also carried out. The strength and the stability of our approach with respect to noise and simplification are also studied.

  1. Automated ion channel screening: patch clamping made easy.

    PubMed

    Farre, Cecilia; Stoelzle, Sonja; Haarmann, Claudia; George, Michael; Brüggemann, Andrea; Fertig, Niels

    2007-04-01

    Efficient high resolution techniques are required for screening efforts and research targeting ion channels. The conventional patch clamp technique, a high resolution but low efficiency technique, has been established for 25 years. Recent advances have opened up new possibilities for automated patch clamping. This new technology meets the need of drug developers for higher throughput and facilitates new experimental approaches in ion channel research. Specifically, Nanion's electrophysiology workstations, the Port-a-Patch and the Patchliner, have been successfully introduced as high-quality automated patch clamp platforms for industry as well as academic users. Both platforms give high quality patch clamp recordings, capable of true giga-seals and stable recordings, accessible to the user without the need for years of practical training. They also offer sophisticated experimental possibilities, such as accurate and fast ligand application, temperature control and internal solution exchange. This article describes the chip-based patch clamp technology and its usefulness in ion channel drug screening and academic research.

  2. Formulation study of oxybutynin patches.

    PubMed

    Minghetti, Paola; Cilurzo, Francesco; Pagani, Stefania; Casiraghi, Antonella; Assandri, Riccardo; Montanari, Luisa

    2007-01-01

    The present feasibility study was designed to obtain a monolayer patch containing oxybutynin (OXY) avoiding chemical permeation enhancers. The highest flux was obtained with a polydimethylsiloxane matrix patch. Because OXY crystals were detected in the matrix within a week, two amino methylmethacrylate copolymers (Eudragit E or Eudragit RS) were used as OXY crystallization inhibitors. A preliminary in vivo study indicated that flux from the stabilized patches had to be increased about 30-40%. This goal was reached by occlusion with a polyethylene layer.

  3. Sexual dimorphism in between and within patch movements of a monophagous insect: Tetraopes (Coleoptera: Cerambycidae).

    PubMed

    Lawrence, W S

    1982-01-01

    Movements of milkweed beetles (Tetraopes tetraophthalmus and Tetraopes femoratus) were monitored using mark-release-recapture techniques to compare the within- and between-patch movement patterns of individuals in a naturally occurring population. Within-patch and between-patch movement patterns differ in both frequency and distance traveled for males and females of both study species. Males move farther than females and are more likely to move between patches. Individuals recognize and alter movement upon encountering patch edges. Results suggest that laboratory estimates of Tetraopes vagility give a misleading indication of actual dispersal.

  4. Large-conductance channel formation mediated by P2X7 receptor activation is regulated through distinct intracellular signaling pathways in peritoneal macrophages and 2BH4 cells.

    PubMed

    Faria, R X; Cascabulho, C M; Reis, R A M; Alves, Luiz Anastácio

    2010-07-01

    The P2X(7) receptor (P2X7R) is a ligand-gated ATP receptor that acts as a low- and large-conductance channel (pore) and is known to be coupled to several downstream effectors. Recently, we demonstrated that the formation of a large-conductance channel associated with the P2X(7) receptor is induced by increasing the intracellular Ca(2+) concentration (Faria et al., Am J Physiol Cell Physiol 297:C28-C42, 2005). Here, we investigated the intracellular signaling pathways associated with P2X(7) large-conductance channel formation using the patch clamp technique in conjunction with fluorescent imaging and flow cytometry assays in 2BH4 cells and peritoneal macrophages. Different antagonists were applied to investigate the following pathways: Ca(2+)-calmodulin, phospholipase A, phospholipase D, phospholipase C, protein kinase C (PKC), mitogen-activated protein kinase (MAPK), MAPK/extracellular signal-regulated kinase, phosphoinositide 3-kinase (PI3K), and cytoskeletal proteins. Macroscopic ionic currents induced by 1 mM ATP were reduced by 85% in the presence of PKC antagonists. The addition of antagonists for MAPK, PI3K, and the cytoskeleton (actin, intermediary filament, and microtubule) blocked 92%, 83%, and 95% of the ionic currents induced by 1 mM ATP, respectively. Our results show that PKC, MAPK, PI3K, and cytoskeletal components are involved in P2X(7) receptor large-channel formation in 2BH4 cells and peritoneal macrophages.

  5. Treatment with oral active vitamin D is associated with decreased risk of peritonitis and improved survival in patients on peritoneal dialysis.

    PubMed

    Kerschbaum, Julia; Vychytil, Andreas; Lhotta, Karl; Prischl, Friedrich C; Wiesholzer, Martin; Machhold-Fabrizii, Veronika; Kopriva-Altfahrt, Gertrude; Schwarz, Christoph; Balcke, Peter; Oberbauer, Rainer; Kramar, Reinhard; König, Paul; Rudnicki, Michael

    2013-01-01

    Peritonitis is a major complication of peritoneal dialysis (PD) being associated with hospitalization, catheter loss, technique failure, and increased mortality. Data on incidence rates and risk factors for peritonitis episodes vary between centers. In seven Austrian PD units clinical and laboratory data on each peritonitis episode were collected from all patients (n = 726) who performed PD between January 2000 and December 2009. The peritonitis incidence rate was 0.32 episodes/patient-year. In a multivariate analysis the risk of peritonitis was decreased by 57% in patients treated with oral active vitamin D (HR 0.43; 95% CI 0.28-0.64). Renal disease classified as "other or unknown" (HR 1.65; 95% CI 1.08-2.53) and serum albumin <3500 mg/dl (HR 1.49; 95% CI 1.04-2.15) were also associated with an increased risk of peritonitis. Albumin levels <3500 mg/dl (HR 1.89; 95% CI 1.13-3.17), age (HR 1.06 per year; 95% CI 1.03-1.09), and cardiomyopathy (HR 3.01; 95% CI 1.62-5.59) were associated with increased mortality, whereas treatment with oral active vitamin D was associated with a significantly lower risk of death (HR 0.46; 95% CI 0.27-0.81). In this retrospective multi-center study we identified several factors being related to increased risk of peritonitis in PD patients. Treatment with oral active vitamin D was identified as being independently associated with decreased risk of peritonitis, and decreased all-cause mortality in PD patients.

  6. Treatment with Oral Active Vitamin D Is Associated with Decreased Risk of Peritonitis and Improved Survival in Patients on Peritoneal Dialysis

    PubMed Central

    Kerschbaum, Julia; Vychytil, Andreas; Lhotta, Karl; Prischl, Friedrich C.; Wiesholzer, Martin; Machhold-Fabrizii, Veronika; Kopriva-Altfahrt, Gertrude; Schwarz, Christoph; Balcke, Peter; Oberbauer, Rainer; Kramar, Reinhard; König, Paul; Rudnicki, Michael

    2013-01-01

    Peritonitis is a major complication of peritoneal dialysis (PD) being associated with hospitalization, catheter loss, technique failure, and increased mortality. Data on incidence rates and risk factors for peritonitis episodes vary between centers. In seven Austrian PD units clinical and laboratory data on each peritonitis episode were collected from all patients (n = 726) who performed PD between January 2000 and December 2009. The peritonitis incidence rate was 0.32 episodes/patient-year. In a multivariate analysis the risk of peritonitis was decreased by 57% in patients treated with oral active vitamin D (HR 0.43; 95% CI 0.28–0.64). Renal disease classified as “other or unknown” (HR 1.65; 95% CI 1.08–2.53) and serum albumin <3500 mg/dl (HR 1.49; 95% CI 1.04–2.15) were also associated with an increased risk of peritonitis. Albumin levels <3500 mg/dl (HR 1.89; 95% CI 1.13–3.17), age (HR 1.06 per year; 95% CI 1.03–1.09), and cardiomyopathy (HR 3.01; 95% CI 1.62–5.59) were associated with increased mortality, whereas treatment with oral active vitamin D was associated with a significantly lower risk of death (HR 0.46; 95% CI 0.27–0.81). In this retrospective multi-center study we identified several factors being related to increased risk of peritonitis in PD patients. Treatment with oral active vitamin D was identified as being independently associated with decreased risk of peritonitis, and decreased all-cause mortality in PD patients. PMID:23844107

  7. Temporal Characteristics and Energy Deposition of Pulsating Auroral Patches

    NASA Technical Reports Server (NTRS)

    Humberset, B. K.; Gjerloev, J. W.; Samara, M.; Michell, R. G.; Mann, I. R.

    2016-01-01

    We present a careful statistical analysis of pulsating aurora (PA) using all-sky green line (557.7 nm) images obtained at 3.3 Hz. Six well-defined individual PA patches are identified and extracted using a contouring technique. Quantitative parameters such as the patch duration (on-time and off-time), peak intensity, and integrated intensity are determined for each patch and each pulsation. The resulting characteristics serve as strict observational constraints that any of the many competing theories attempting to explain PA must predict. The purpose of this paper is to determine the characteristics of PA patches in order to provide better observational constraints on the suggested mechanisms. All aspects of the temporal behavior of the individual patches appear to be erratic. Historically, PA has been defined very loosely and we argue that the use of the term pulsating is inappropriate since our findings and other published results are not regularly periodic and thus a more appropriate term may be fluctuating aurora. Further, we find that the observational constraints do not fit well with the flow cyclotron maser theory, which in particular is suggested to create PA patches. There is no clear candidate of the suggested mechanisms and drivers to explain the observational constraints set by the PA patches in a satisfactory manner.

  8. Temporal characteristics and energy deposition of pulsating auroral patches

    NASA Astrophysics Data System (ADS)

    Humberset, B. K.; Gjerloev, J. W.; Samara, M.; Michell, R. G.; Mann, I. R.

    2016-07-01

    We present a careful statistical analysis of pulsating aurora (PA) using all-sky green line (557.7 nm) images obtained at 3.3 Hz. Six well-defined individual PA patches are identified and extracted using a contouring technique. Quantitative parameters such as the patch duration (on-time and off-time), peak intensity, and integrated intensity are determined for each patch and each pulsation. The resulting characteristics serve as strict observational constraints that any of the many competing theories attempting to explain PA must predict. The purpose of this paper is to determine the characteristics of PA patches in order to provide better observational constraints on the suggested mechanisms. All aspects of the temporal behavior of the individual patches appear to be erratic. Historically, PA has been defined very loosely and we argue that the use of the term "pulsating" is inappropriate since our findings and other published results are not regularly periodic and thus a more appropriate term may be fluctuating aurora. Further, we find that the observational constraints do not fit well with the flow cyclotron maser theory, which in particular is suggested to create PA patches. There is no clear candidate of the suggested mechanisms and drivers to explain the observational constraints set by the PA patches in a satisfactory manner.

  9. Temporal Characteristics and Energy Deposition of Pulsating Auroral Patches

    NASA Technical Reports Server (NTRS)

    Humberset, B. K.; Gjerloev, J. W.; Samara, M.; Michell, R. G.; Mann, I. R.

    2016-01-01

    We present a careful statistical analysis of pulsating aurora (PA) using all-sky green line (557.7 nm) images obtained at 3.3 Hz. Six well-defined individual PA patches are identified and extracted using a contouring technique. Quantitative parameters such as the patch duration (on-time and off-time), peak intensity, and integrated intensity are determined for each patch and each pulsation. The resulting characteristics serve as strict observational constraints that any of the many competing theories attempting to explain PA must predict. The purpose of this paper is to determine the characteristics of PA patches in order to provide better observational constraints on the suggested mechanisms. All aspects of the temporal behavior of the individual patches appear to be erratic. Historically, PA has been defined very loosely and we argue that the use of the term pulsating is inappropriate since our findings and other published results are not regularly periodic and thus a more appropriate term may be fluctuating aurora. Further, we find that the observational constraints do not fit well with the flow cyclotron maser theory, which in particular is suggested to create PA patches. There is no clear candidate of the suggested mechanisms and drivers to explain the observational constraints set by the PA patches in a satisfactory manner.

  10. Strategies to improve clinical outcomes in peritoneal dialysis patients: delivered dose and membrane transport.

    PubMed

    Churchill, D N

    1998-12-01

    For patients with end-stage renal disease treated with peritoneal dialysis, prospective cohort studies using multivariate statistical analysis have shown an association between greater urea clearance and a decreased relative risk for death. The recommended weekly Kt/V for urea is 2.0, with the corresponding creatinine clearance (CrCl) of 60 L/1.73 m2. This is considered adequate dialysis but fails to define optimum urea and CrCl targets. The assumption that renal and peritoneal clearances are equivalent has been challenged by circumstantial data and is probably untenable. The relative importance of these clearances requires definition. The suggestion that CrCl is a more important indicator of adequacy of dialysis is confounded by association with renal, rather than peritoneal, clearance and perhaps by the early referral and initiation of dialysis. Recent reports have shown an association between increased peritoneal membrane transport and an increased relative risk for technique failure and/or death. Patients with higher peritoneal transport should have greater clearance of urea and creatinine and better clinical outcomes. Possible explanations for this apparent contradiction include the adverse effects of increased glucose absorption, malnutrition, and fluid overload, the latter caused by decreased ultrafiltration. Available data suggest an important role for the failure of ultrafiltration among patients treated with continuous ambulatory peritoneal dialysis (CAPD). Strategies to improve the clearance of urea and creatinine include the preservation of residual renal function and increased peritoneal clearance. Loss of residual renal function may be delayed by the avoidance of nephrotoxic drugs and angiographic dye. Peritoneal clearance can be enhanced by a combination of increased volume and frequency of peritoneal dialysis cycles. Ultrafiltration failure, but not protein loss, can be addressed with shorter cycles with nocturnal peritoneal dialysis. Development of

  11. Peritoneal dialysis patient selection: characteristics for success.

    PubMed

    Li, Philip Kam-Tao; Chow, Kai Ming

    2009-05-01

    This review focuses on the strategy of patient selection for peritoneal dialysis (PD) based on published epidemiology studies and observational data. With the success of the PD first model in Hong Kong, experience shows that there is no particular patient group that cannot be put on PD except those who have major problems in the abdomen. Incident patients should be offered the choice to receive PD at the start of dialysis in order to preserve better the residual renal function. Concern has also been expressed for a time-dependent negative impact of PD on survival, although PD in general provides survival advantage at least during the first few years after the start of dialysis. Regular patient review is essential to allow prompt adjustment of the dialysis regimen and modality when required. Accumulating research suggests that center size has a significant effect on the patient and technique survival of patients undergoing PD. Comorbid diabetes, large and small body size, peritoneal membrane transport status, elderly age group, and socioeconomic status are important patient factors to consider. Good clinical and psychosocial care of the PD patients are essential as well as the attention to their compliance. Enhanced training to medical and nursing personnel on PD is one of the key success factors for improving its utilization and outcome.

  12. [Peritoneal dialysis in obstetric patients].

    PubMed

    Briones-Garduño, Jesús Carlos; Díaz de León-Ponce, Manuel Antonio; Rodríguez-Roldán, Martín; Briones-Vega, Carlos Gabriel; Torres-Pérez, Juan

    2006-01-01

    The prevalence of acute renal failure (ARF) in obstetric patients in our country is estimated to be between 3 and 42.8%. The most important causes are preeclampsia, especially when associated with thrombotic microangiopathy and hemolysis and less frequently to hemorrhagic shock. Early peritoneal dialysis (EPD) is the temporary treatment. For these patients, 100 % recovery in renal function was observed. When ARF is associated with multiple organ failure (MOF), the reported mortality ranges between 0 and 20 %. To describe clinical features and medical outcomes of patients treated with early peritoneal dialysis in pregnancy complicated by ARF. A case series was conducted at the Research Unit of the Instituto Materno Infantil del Estado de México. We reviewed the cases of patients admitted to the ICU matching the criteria for ARF. They were divided into two groups: those who received EPD vs. those who did not require EPD. The most important national series were included describing the association with preeclampsia and thrombotic microangiopathy with hemolysis. In a 5-year period, 1272 patients were admitted to the ICU; in 38 patients ARF was documented requiring peritoneal dialysis. In nine cases ARF was associated with thrombotic microangiopathy with hemolysis, two cases of stillbirth, and one case of mortality with MOF. A 100% recovery in renal function was observed in all cases, using 1.5% solution with an average of 34 dialysis treatments. The early use of peritoneal dialysis in obstetric patients with ARF has a good prognosis.

  13. Creation of polar cap patches

    NASA Astrophysics Data System (ADS)

    Hosokawa, K.; Taguchi, S.; Ogawa, Y.

    2014-12-01

    Polar cap patches, which are islands of enhanced plasma density drifting anti-sunward, are one of the outstanding phenomena in the polar cap F region ionosphere. In the last decade, data from all-sky airglow imagers have been extensively used for better understanding the propagation of patches in the central polar cap region. But still, it has been rather difficult to capture the birth of patches in their generation region near the dayside cusp, because, in most places, the dayside part of the polar cap ionosphere is sunlit even in winter. In Longyearbyen (78.1N, 15.5E), Norway, however, optical observations are possible near the dayside cusp region in a limited period around the winter solstice. This enables us to directly image how polar cap patches are born in the cusp. In this paper, we present a few intervals of daytime optical observations, during which polar cap patches were generated within the field-of-view of an all-sky imager in Longyearbyen. During all the intervals studied here, we identified several signatures of poleward moving auroral forms (PMAF) in the equatorward half of the field-of-view, which are known as ionospheric manifestations of dayside reconnection. Interestingly, patches were directly produced from such poleward moving auroral signatures and propagated poleward along the anti-sunward convection near the cusp. In the literature, Lorentzen et al. (2012) first reported such a direct production of patches from PMAFs. During the current observations, however, we succeeded in tracking the propagation of patches until they reached the poleward edge of the field-of-view of the imager. This confirms that the faint airglow structures produced from PMAFs were actually transported for a long distance towards the central polar cap area; thus, polar cap patches were produced. From this set of observations, we suggest that polar cap patches during moderately disturbed conditions (i.e, non-storm time conditions) can be directly produced by the

  14. Formulation Optimization of Arecoline Patches

    PubMed Central

    Wu, Pao-Chu; Tsai, Pi-Ju; Lin, Shin-Chen; Huang, Yaw-Bin

    2014-01-01

    The response surface methodology (RSM) including polynomial equations has been used to design an optimal patch formulation with appropriate adhesion and flux. The patch formulations were composed of different polymers, including Eudragit RS 100 (ERS), Eudragit RL 100 (ERL) and polyvinylpyrrolidone K30 (PVP), plasticizers (PEG 400), and drug. In addition, using terpenes as enhancers could increase the flux of the drug. Menthol showed the highest enhancement effect on the flux of arecoline. PMID:24707220

  15. Formulation optimization of arecoline patches.

    PubMed

    Wu, Pao-Chu; Tsai, Pi-Ju; Lin, Shin-Chen; Huang, Yaw-Bin

    2014-01-01

    The response surface methodology (RSM) including polynomial equations has been used to design an optimal patch formulation with appropriate adhesion and flux. The patch formulations were composed of different polymers, including Eudragit RS 100 (ERS), Eudragit RL 100 (ERL) and polyvinylpyrrolidone K30 (PVP), plasticizers (PEG 400), and drug. In addition, using terpenes as enhancers could increase the flux of the drug. Menthol showed the highest enhancement effect on the flux of arecoline.

  16. [Anemia in peritoneal dialysis patients].

    PubMed

    Lausević, Mirjana; Nesić, Vidosava; Jovanović, Natasa; Stojimirović, Biljana

    2006-01-01

    A normocytic normochromic anemia is one of the first signs of renal failure. Since anemia increases morbidity and mortality, its elimination is one of the essential objectives of the treatment. Human recombinant erythropoietin (rHuEPO) has changed the therapeutical approach to anemia. The aim of the present study was to compare efficacy of anemia correction in peritoneal dialysis patients depending on treatment and dialysis modality. The study is the retrospective analysis of 64 patients who presented to our Clinic in 2003. Eighteen (28.13%) patients were treated with rHuEPO, 14 (28%) underwent continuous ambulatory peritoneal dialysis (CAPD), 2 (100%)--automated peritoneal dialysis (APD) and 2 (33.3%)--intermittent peritoneal dialysis (IPD). Mean hemoglobin level was 98.6 +/- 17.82 g/l in patients treated with rHuEPO versus 98.81 +/- 15.14 g/l in patients without rHuEPO treatment. Erythropoietin requirements were 3392.85 +/- 1211.77 IU/week All patients received iron supplementation during rHuEPO therapy. Mean serum ferritin levels were 463.41 +/- 360 ug/l. Transferrin saturation (TSAT) was 0.35 +/- 0.16%. No difference of serum iron and TSAT levels was found between CAPD and IPD patients. The degree of anemia significantly differed between CAPD and IPD patients. A total of 17.11% of PD patients were given blood transfusions, most frequently during the first three months after the onset of dialysis. Our conclusion is that the number of patients receiving rHuEPO should be increased, as 50% of our patients should be substituted, while only 28% are being treated. As 50% of patients receiving rHuEPO failed to reach target Hgb levels, higher EPO doses should be considered. Iron stores should be continuously monitored, particularly in patients receiving rHuEPO, since iron deficiency is an important problem for patients undergoing peritoneal dialysis, especially during erythropoietin therapy. Oral iron supplementation is satisfactory in the majority of patients, and iron

  17. Fungal Peritonitis Due to Fusarium solani Species Complex Sequential Isolates Identified with DNA Sequencing in a Kidney Transplant Recipient in Brazil.

    PubMed

    da Silva-Rocha, Walicyranison Plinio; Zuza-Alves, Diana Luzia; Melo, Analy Salles de Azevedo; Chaves, Guilherme Maranhão

    2015-12-01

    Fungal peritonitis is a rare serious complication most commonly observed in immunocompromised patients under peritoneal dialysis. Nevertheless, this clinical condition is more difficult to treat than bacterial peritonitis. Bacterial peritonitis followed by the use of antibiotics is the main risk factor for developing fungal peritonitis. Candida spp. are more frequently isolated, and the isolation of filamentous fungi is only occasional. Here we describe a case of Fusarium solani species complex peritonitis associated with bacterial peritonitis in a female kidney transplant recipient with previous history of nephrotic syndrome. The patient has had Enterobacter sp. endocarditis and was hypertensive and diabetic. Two sequential isolates of F. solani were recovered from cultures and identified with different molecular techniques. She was successfully treated with 50 mg daily amphotericin B for 4 weeks.

  18. 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

  19. Sound attenuation in ducts using locally resonant periodic aluminum patches.

    PubMed

    Farooqui, Maaz; Elnady, Tamer; Akl, Wael

    2016-06-01

    In recent years, the control of low frequency noise has received a lot of attention for several applications. Traditional passive noise control techniques using Helmholtz resonators have size limitations in the low frequency range because of the long wavelength. Promising noise reductions, with flush mounted aluminum patches with no size problems can be obtained using local resonance phenomenon implemented in acoustic metamaterial techniques. The objective of this work is to introduce locally resonant thin aluminum patches flush mounted to a duct walls aiming at creating frequency stop bands in a specific frequency range. Green's function is used within the framework of interface response theory to predict the amount of attenuation of the local resonant patches. The two-port theory and finite elements are also used to predict the acoustic performance of these patches. No flow measurements were conducted and show good agreement with the models. The effect of varying the damping and the masses of the patches are used to expand the stop bandwidth and the effect of both Bragg scattering and the locally resonant mechanisms was demonstrated using mathematical models. The effect of the arrays of patches on the effective dynamic density and bulk modulus has also been investigated.

  20. Broadband Plasmonic Microlenses based on Patches of Nanoholes

    PubMed Central

    Gao, Hanwei; Hyun, Jerome K.; Lee, Min Hyung; Yang, Jiun-Chan; Lauhon, Lincoln J.; Odom, Teri W.

    2010-01-01

    This paper reports a new type of diffractive microlens based on finite-areas of 2D arrays of circular nanoholes (patches). The plasmonic microlenses can focus single wavelengths of light across the entire visible spectrum as well as broadband white light with little divergence. The focal length is determined primarily by the overall size of the patch and is tolerant to significant changes in patch substructure, including lattice geometry and local order of the circular nanoholes. The optical throughput, however, depends sensitively on the patch substructure and is determined by the wavelengths of surface plasmon resonances. This simple diffractive lens design enables millions of broadband plasmonic microlenses to be fabricated in parallel using soft nanolithographic techniques. PMID:20839781

  1. Analysis of microstrip patch antennas with nonzero surface resistance

    NASA Technical Reports Server (NTRS)

    Shively, David G.; Bailey, M. C.

    1993-01-01

    The scattering properties of a microstrip patch antenna with nonzero surface impedance are examined. The electric field integral equation for a current element on a grounded dielectric slab is developed for a rectangular geometry by using Galerkin's technique with subdomain piecewise linear basis functions. The integral equation includes a resistive boundary condition on the surface of the patch. The incident field on the patch is expressed as a function of incidence angle. The resulting system of equations is then solved for the unknown current modes on the patch, and the radar cross section is calculated for a given scattering angle. Theoretical results in the form of radar cross section as a function of frequency are compared with results measured at the NASA Langley Research Center.

  2. Endoscopic ultrasound-assisted direct peritoneal visualization with a small-caliber scope: A proof of concept study in a swine model

    PubMed Central

    Suzuki, Rei; Bhutani, Manoop S.; Shin, Dongsuk; Irisawa, Atsushi; Fleming, Jason B.; Richards-Kortum, Rebecca; Ohira, Hiromasa

    2014-01-01

    Background: Laparoscopic and natural orifice transluminal endoscopic surgery techniques can diagnose peritoneal findings that suggest tumor cell dissemination. However, they have not been incorporated into routine practice, mainly owing to their complexity. To develop a minimally invasive endoscopic technique for the diagnosis of peritoneal findings, we conducted feasibility study using an acute swine model. Materials and Methods: This study involved six domestic pigs. Trans-gastric access to the peritoneal cavity was performed utilizing an endoscopic ultrasound fine needle aspiration (EUS-FNA) technique. After dilation of the needle hole with a biliary dilatation catheter and balloon, a small-caliber scope was inserted into the peritoneal cavity. Peritoneal images were obtained with the scope and a high-resolution microendoscope (HRME). Main outcome measurements were technical feasibility and time needed to access the peritoneal cavity. Results: Direct visualization of the peritoneum was successful in all six pigs and gained access to the gross appearance of the peritoneal cavity. HRME imaging with topical contrast agent also obtained reasonable quality images representing nuclei of the peritoneal mesothelium. Average operation time from the initiation of EUS-FNA to acquiring peritoneal images was 26.5 min (range 15-40 min). Autopsy found no damage to the adjacent organs, and stomach wall defects were tightly closed with hemostasis clips. Conclusion: EUS-assisted direct peritoneal visualization with small-caliber scope is technically feasible. HRME may assist in the diagnosis of findings on the peritoneum. PMID:25485270

  3. Oral administration of lipopolysaccharides activates B-1 cells in the peritoneal cavity and lamina propria of the gut and induces autoimmune symptoms in an autoantibody transgenic mouse

    PubMed Central

    1994-01-01

    About a half of the antierythrocyte autoantibody transgenic (autoAb Tg) mice, in which almost all B cells are detected in the spleen, lymph nodes, and Peyer's patches, but not in the peritoneal cavity, suffer from autoimmune hemolytic anemia. The occurrence of this disease is strongly linked to production of autoAb by activated peritoneal B-1 cells in the Tg mice. In this study, we have shown that oral administration of lipopolysaccharides (LPS) activated B-1 cells in the lamina propria of the gut as well as the peritoneal cavity in the healthy Tg mice and induced the autoimmune symptoms in all the Tg mice. The activation of peritoneal and lamina propria B-1 cells by enteric LPS is found not only in the anti-RBC autoAb Tg mice and normal mice but also in the aly mice which congenitally lack lymph nodes and Peyer's patches. These results suggest that B-1 cells in the two locations may form a common pool independent of Peyer's patches and lymph nodes, and can be activated by enteric thymus-independent antigens or polyclonal activators such as LPS. The induction of autoimmune hemolytic anemia in the Tg mice by enteric LPS through the activation of B-1 cells in the lamina propria of gut and in the peritoneal cavity suggests that B-1 cells and bacterial infection may play a pathogenic role in the onset of autoimmune diseases. PMID:8006578

  4. Patch forest: a hybrid framework of random forest and patch-based segmentation

    NASA Astrophysics Data System (ADS)

    Xie, Zhongliu; Gillies, Duncan

    2016-03-01

    The development of an accurate, robust and fast segmentation algorithm has long been a research focus in medical computer vision. State-of-the-art practices often involve non-rigidly registering a target image with a set of training atlases for label propagation over the target space to perform segmentation, a.k.a. multi-atlas label propagation (MALP). In recent years, the patch-based segmentation (PBS) framework has gained wide attention due to its advantage of relaxing the strict voxel-to-voxel correspondence to a series of pair-wise patch comparisons for contextual pattern matching. Despite a high accuracy reported in many scenarios, computational efficiency has consistently been a major obstacle for both approaches. Inspired by recent work on random forest, in this paper we propose a patch forest approach, which by equipping the conventional PBS with a fast patch search engine, is able to boost segmentation speed significantly while retaining an equal level of accuracy. In addition, a fast forest training mechanism is also proposed, with the use of a dynamic grid framework to efficiently approximate data compactness computation and a 3D integral image technique for fast box feature retrieval.

  5. Peritoneal Dialysis in Western Countries

    PubMed Central

    Struijk, Dirk G.

    2015-01-01

    Background Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and similar results in patient survival between PD and HD, the penetration of PD is decreasing in the Western world. Summary First the major events in the history of the development of PD are described. Then important insights into the physiology of peritoneal transport are discussed and linked to the changes in time observed in biopsies of the peritoneal membrane. Furthermore, the developments in peritoneal access, more biocompatible dialysate solutions, automated PD at home, the establishment of parameters for dialysis adequacy and strategies to prevent infectious complications are mentioned. Finally non-medical issues responsible for the declining penetration in the Western world are analyzed. Key Messages Only after introduction of the concept of continuous ambulatory PD by Moncrief and Popovich has this treatment evolved in time to a renal replacement therapy. Of all structures present in the peritoneal membrane, the capillary endothelium offers the rate-limiting hindrance for solute and water transport for the diffusive and convective transport of solutes and osmosis. The functional and anatomical changes in the peritoneal membrane in time can be monitored by the peritoneal equilibrium test. Peritonitis incidence decreased by introduction of the Y-set and prophylaxis using mupirocin on the exit site. The decrease in the proportion of patients treated with PD in the Western world can be explained by non-medical issues such as inadequate predialysis patient education, physician experience and training, ease of HD initiation, overcapacity of in-center HD, lack of adequate infrastructure for PD treatment, costs and reimbursement issues of the treatment. Facts from

  6. Benefits of preserving residual renal function in peritoneal dialysis.

    PubMed

    Marrón, B; Remón, C; Pérez-Fontán, M; Quirós, P; Ortíz, A

    2008-04-01

    Residual renal function (RRF) is of paramount importance in patients with end-stage renal disease, with benefits that go beyond contributing to achievement of adequacy targets. Several studies have found that RRF rather than overall adequacy (as estimated from total small solute removal rates) is an essential marker of patient and, to a lesser extent, technique survival during chronic peritoneal dialysis (PD) therapy. In addition, RRF is associated with a reduction in blood pressure and left ventricular hypertrophy, increased sodium removal and improved fluid status, lower serum beta(2)-microglobulin, phosphate and uric acid levels, higher serum hemoglobin and bicarbonate levels, better nutritional status, a more favorable lipid profile, decreased circulating inflammatory markers, and lower risk for peritonitis in PD. As compared with conventional hemodialysis, PD is associated with a slower decrease in RRF. This highlights the usefulness of strategies oriented to preserve both RRF and the long-term viability of the peritoneal membrane. Several factors contributing to the loss of RRF have been identified and should be avoided. Renoprotective drugs and new glucose-sparing, more biocompatible PD regimes may prove useful tools to preserve RRF and peritoneal membrane function in the near future.

  7. Structural health monitoring of composite repair patches in bridge rehabilitation

    NASA Astrophysics Data System (ADS)

    Wu, Zhanjun; Ghosh, Kumar; Qing, Xinlin; Karbhari, Vistasp; Chang, Fu-Kuo

    2006-03-01

    and deck slabs were clearly revealed by the active sensing system. It was demonstrated that the active sensing system employed is prompt, robust and a precise technique to monitor the debond process of the composite repair patches for structural rehabilitation. Besides the study of the mechanism of debond between repair patch and host structures, an on line health monitoring system can give the user an indication of the structural health status and alert technicians when it approaches the failure capacity.

  8. An opportunistic pathogen in a peritoneal dialysis patient: Ochrobactrum anthropi.

    PubMed

    Alparslan, Caner; Yavascan, Onder; Kose, Engin; Sanlioglu, Pinar; Aksu, Nejat

    2013-01-01

    The authors report a case of chronic peritoneal dialysis-related peritonitis from Ochrobactrum anthropi. O. anthropi is an emerging pathogen in immunocompromised patients. O. anthropi-related peritonitis in peritoneal dialysis patients has rarely been reported. To the authors' knowledge, no pediatric case of O. anthropi peritonitis has been reported to date in the literature.

  9. [The history of peritoneal dialysis at the Molinette Hospital in Turin, Italy].

    PubMed

    Pacitti, Alfonso; Maffei, S; Segoloni, G P

    2009-01-01

    In the Renal Unit of the Molinette Hospital of Turin, peritoneal dialysis (PD) was introduced in the mid 1960s to treat patients suffering from acute renal failure. The peritoneal catheter, which was then a stiff catheter, was inserted by a surgeon at each dialysis session. Between 1966 and 1970 there were a series of improvements, such as the first cycler for intermittent PD, fast-shift DP, and a homemade machine for automatic PD. During the early 1970s, a new type of stiff peritoneal catheter was introduced, which was used also for patients suffering from chronic renal failure. Towards the end of the 1970s the soft Tenckhoff peritoneal catheter started to be used, as well as continuous ambulatory peritoneal dialysis (CAPD), which made it possible to treat a large number of patients at home. The 1980s brought a new surgical technique for the insertion of the catheter, and in the 1990s new peritoneal catheters were introduced which reduced the number of early and late complications. Around the turn of the century, the PD service was reorganized and improved, with dedicated personnel and facilities. Moreover, automated PD was introduced and the treatment of peritonitis was standardized according to international guidelines.

  10. Membrane and functional characterization of lymphoid and macrophage populations of Peyer's patches from adult and aged mice.

    PubMed Central

    Vĕtvicka, V; Tlaskalová-Hogenová, H; Fornůsek, L; Ríhová, B; Holán, V

    1987-01-01

    Properties of macrophages isolated from Peyer's patches were compared with properties of peritoneal macrophages. We found a very low expression of all types of Fc receptors as well as a low expression of Ia antigens on Peyer's patch macrophages. No substantial changes in the levels of FcR and Ia antigen expression were found during the process of ageing. The investigation of phagocytic activity showed the activated state of Peyer's patch macrophages. Comparing the surface markers of lymphocytes obtained from Peyer's patches of mice of different ages, we found no differences in the numbers of sIg+, Thy-+ or L3T4+ lymphocytes. The numbers of FcR+ and Lyt 2.2+ lymphocytes decreased markedly with age. PMID:3477526

  11. Diagnosis of bacterial pathogens in the dialysate of peritoneal dialysis patients with peritonitis using surface-enhanced Raman spectroscopy.

    PubMed

    Tien, Ni; Chen, Hung-Chih; Gau, Shiow-Lan; Lin, Tzu-Hsien; Lin, Hsiu-Shen; You, Bang-Jau; Tsai, Po-Chuan; Chen, I-Ru; Tsai, Ming-Fan; Wang, I-Kuan; Chen, Chao-Jung; Chang, Chiz-Tzung

    2016-10-01

    Bacterial peritonitis is the most common cause of peritoneal dialysis (PD) therapy drop-out. A quick and accurate diagnosis of the bacterial pathogen can reduce the PD drop-out rate. Surface-enhanced Raman spectroscopy (SERS) can rapidly identify bacteria using chips coated with nano-sized metal particles. Known bacteria were loaded in the SERS-chips and illuminated with laser light to establish a reference Raman spectra library. Dialysate from PD peritonitis patients was concentrated by centrifuge and examined with the same SERS, and the resulting Raman spectra were compared with library spectra for bacteria identification. Principal component analysis was used for further confirmation. The same batches of dialysate were sent to routine culture as a reference bacteria identification method. The results of the 2 identification methods were compared. A total of 43 paired-samples were sent for study. There were 37 samples with bacteria identified but 6 were culture-negative by the reference method. 31 bacteria were identified in paired-samples by SERS, among which, 29 bacteria were exactly the same as those identified by the reference method. Bacteria not included in the reference library spectra cannot be identified. SERS techniques can rapidly identify bacterial pathogens in the dialysate of PD peritonitis patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. The short peritoneal equilibration test in pediatric peritoneal dialysis.

    PubMed

    Cano, Francisco; Sanchez, Lorena; Rebori, Anabella; Quiroz, Lily; Delucchi, Angela; Delgado, Iris; Aguilar, Maria Alejandra; Azócar, Marta; Castro, Florencia; Ibacache, Maria José; Cuevas, Mónica; Esquivel, Maria

    2010-10-01

    The peritoneal equilibration test (PET) is the gold standard method for defining peritoneal membrane permeability and for prescribing peritoneal dialysis (PD) therapy on an individual basis. However, it is laborious, consumes nursing time, and requires many hours to be performed. Therefore, several authors have attempted to validate a short PET protocol, with controversial results. To evaluate the concordance between the 2-h (short) and 4-h (classical) peritoneal equilibrium test, a prospective observational protocol was applied in three PD centers (Mexico, Chile, and Uruguay) between July 1, 2008 and July 31 2009. PET protocol: the night prior to the test, each patient received five exchanges, 1 h each, at the same glucose concentration as previously used. Afterwards, a 2.5% glucose dialysis solution was used for a dwell time of 4 h. Exchange fill volume was 1,100 ml/m2 body surface area. The next morning, the 4-h dwell was drained, and Dianeal 2.5% was infused. Three dialysate samples at 0, 2, and 4 h were obtained. A single blood sample was obtained at 120 min. Creatinine D/P and glucose D/D0 ratios were calculated at hours 0, 2, and 4. Patients were categorized as low, low average, high average, or high transporters according creat D/P and gluc D/D0 results. Pearson and Kappa test were used for numerical and categorical correlations, respectively, and p<0.05 was considered significant. Eighty-seven PET studies were evaluated in 74 patients, 33 males, age 11.1+/-5.05 years old. A positive linear correlation of 92% between 2 and 4-h creat D/P and 80% between 2 and 4-h gluc D/D0 (p<0.001) was founded. The Kappa test showed a significant concordance between creat D/P and gluc D/D0 categories at 2 and 4 h (p<0.001). When analyzing cut-off-value categories, creat D/P was founded to be lower and gluc D/D0 higher than other experiences. This multicentric prospective study strongly suggests that PET obtained at 2 h and 4 h, based on either creatinine or glucose

  13. Peritoneal tuberculosis versus peritoneal carcinomatosis: Distinction based on CT findings

    SciTech Connect

    Rodriguez, E.; Pombo, F.

    1996-03-01

    The purpose of this study was to determine the utility of CT in distinguishing peritoneal tuberculosis (PT) from peritoneal carcinomatosis (PC). CT scans were retrospectively reviewed in 19 patients known to have PT and compared with scans in 19 patients known to have PC. CT images were evaluated for thickening (smooth versus irregular), enhancement, presence of nodules, and site of involvement on the parietal peritoneum. The existence of oriental caking, nodules, and smudged patterns in the omentum, mesentery, and gastrocolic ligament was noted. The presence, distribution, and loculation of ascites were also evaluated. Ascites was present in all cases of PT and PC, loculated in 10 cases (PT = 4, PC = 6), and located in the greater peritoneal sac (PT = 15, PC = 10) or in the greater and lesser sacs (PT = 4, PC = 9). Slight smooth thickening and pronounced enhancement of the parietal peritoneum were seen in 15 of 19 PT patients and in 5 of 19 PC patients (p < 0.001), whereas irregular thickening was found in only 9 of 19 PC patients (p < 0.001). Peritoneal nodules were present exclusively in PC (7/19) (p < 0.01). The sites of the parietal peritoneum involvement were the pelvic (PT = 9, PC 3) (p < 0.05), paracolic gutters (PT = 5, PC = 6), juxtadiaphragmatic (PT 0, PC = 9) (p < 0.001), and peri- hepatic (PT = 6, PC = 8) regions. Oriental cakes were found in 4 of 19 PT and in 7 of 19 PC patients. The smudged pattern was the most common abnormality in the omentum (PT = 9/19, PC = 11/19), gastrocolic ligament (PT = 5/19, PC = 11/19) (p < 0.01), and mesentery (PT = 7/19, PC = 11/19). Isolated and discrete well defined nodules were exclusively found in the mesentery (PT 5/19, PC = 3/19). The most useful CT findings for distinguishing PT from PC were observed in the parietal peritoneum. The presence of a smooth peritoneum with minimal thickening and pronounced enhancement suggests PT, whereas nodular implants and irregular peritoneal thickening suggest PC.

  14. 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.

  15. 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

  16. 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

    2016-04-26

    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. 2016 BMJ Publishing Group Ltd.

  17. Is Peritonitis Risk Increased in Elderly Patients on Peritoneal Dialysis? Report from the French Language Peritoneal Dialysis Registry (RDPLF).

    PubMed

    Duquennoy, Simon; Béchade, Clémence; Verger, Christian; Ficheux, Maxence; Ryckelynck, Jean-Philippe; Lobbedez, Thierry

    2016-01-01

    ♦ This study was carried out to examine whether or not elderly patients on peritoneal dialysis (PD) had an increased risk of peritonitis. ♦ This was a retrospective cohort study based on data from the French Language Peritoneal Dialysis Registry. We analyzed 8,396 incident patients starting PD between January 2003 and December 2010. The end of the observation period was 31 December 2012. Patients were separated into 2 age groups: up to 75 and over of 75 years old. ♦ Among 8,396 patients starting dialysis there were 3,173 patients older than 75. When using a Cox model, no association was found between age greater than 75 years and increased risk of peritonitis (hazard ratio [HR]: 0.97 [0.88 - 1.07]). Diabetes (HR: 1.14 [1.01 - 1.28] and continuous ambulatory PD (HR: 1.13 [1.04 - 1.23]) were significantly associated with a higher risk of peritoneal infection whereas nurse-assisted PD was associated with a lower risk of peritonitis (HR: 0.85 [0.78 - 0.94]. In the analysis restricted to the 3,840 self-care PD patients, there was no association between age older than 75 years and risk of peritonitis. ♦ The risk of peritonitis is not increased in elderly patients on PD in a country where assisted PD is available. Copyright © 2016 International Society for Peritoneal Dialysis.

  18. Intraperitoneal pressure in peritoneal dialysis.

    PubMed

    Pérez Díaz, Vicente; Sanz Ballesteros, Sandra; Hernández García, Esther; Descalzo Casado, Elena; Herguedas Callejo, Irene; Ferrer Perales, Cristina

    2017-07-21

    The measure of intraperitoneal pressure in peritoneal dialysis is easy and provides clear therapeutic benefits. However it is measured only rarely in adult peritoneal dialysis units. This review aims to disseminate the usefulness of measuring intraperitoneal pressure. This measurement is performed in supine before initiating the drain of a manual exchange with "Y" system, by raising the drain bag and measuring from the mid-axillary line the height of the liquid column that rises from the patient. With typical values of 10-16 cmH2O, intraperitoneal pressure should never exceed 18 cmH2O. With basal values that depend on body mass index, it increases 1-3 cmH2O/L of intraperitoneal volume, and varies with posture and physical activity. Its increase causes discomfort, sleep and breathing disturbances, and has been linked to the occurrence of leaks, hernias, hydrothorax, gastro-esophageal reflux and enteric peritonitis. Less known and valued is its ability to decrease the effectiveness of dialysis significantly counteracting ultrafiltration and decreasing solute clearance to a smaller degree. Because of its easy measurement and potential utility, should be monitored in case of ultrafiltration failure to rule out its eventual contribution in some patients. Although not yet mentioned in the clinical practice guidelines for PD, its clear benefits justify its inclusion among the periodic measurements to consider for prescribing and monitoring peritoneal dialysis. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Peritoneal lavage efficiently eliminates protease-alpha-2-macroglobulin complexes and components of the contact system from the peritoneal cavity in patients with severe acute pancreatitis.

    PubMed

    Aasen, A O; Ruud, T E; Roeise, O; Bouma, B N; Stadaas, J O

    1989-01-01

    Trypsin (Try), plasma kallikrein (KK) and plasmin activities together with coagulation factor XII (F XII, Hageman factor), high-molecular-weight kininogen (HMWK), plasma prekallikrein (PKK), alpha 2-macroglobulin (alpha 2-M), C1 inhibitor (C1Inh), and functional plasma kallikrein inhibition (KKI) values were studied in peritoneal fluid and lavage taps of 9 patients with severe acute pancreatitis treated with peritoneal lavage. Both immunochemical methods and functional techniques based on chromogenic peptide substrate assays were used. In the exudate obtained before peritoneal lavage was performed, F XII was 52%, HMWK was 30%, PKK was 40%, alpha 2-M was 29% and C1Inh was 57% of standard plasma pool values, determined by immunochemical technique. Functional plasma KKI values were zero, whereas Try activities determined by chromogenic peptide substrate technique were markedly elevated in the exudate. Using a prepacked HR 10/30 Superose Tm 12 column (Pharmacia, Uppsala, Sweden) and chromogenic peptide substrate assays, Try and KK activities were detected in the alpha 2-M containing fractions of the peritoneal exudate demonstrating KK-alpha 2-M and Try-alpha 2-M complex formation. The peritoneal lavage procedure efficiently eliminated components of the contact system and protease activities. In the first lavage tap, Try activities were markedly reduced compared to values found in the exudate and concentrations of F XII, HMWK, PKK, alpha 2-M and C1Inh were all zero. In consecutive lavage taps Try values were also zero. The study shows that the lavage procedures efficiently clears the peritoneal cavity for protease-alpha 2-M complexes generated during acute pancreatitis. Also, components of the contact system found in peritoneal exudate, and which might serve as substrates for the protease-alpha 2-M complexes, are rapidly eliminated by the procedure.

  20. Mls presentation by peritoneal cavity B cells.

    PubMed

    Riggs, James E; Howell, Koko F; Taylor, Justin; Mahjied, Tazee; Prokopenko, Nataliya; Alvarez, John; Coleman, Clenton

    2004-01-01

    DBA/2J spleen and peritoneal cells were compared for their ability to present the minor lymphocyte stimulatory superantigen Mls-1a. Although capable of Mls presentation in vivo, peritoneal cells were less effective than spleen cells in vitro. This difference was not due to cell concentration or culture duration. Flow cytometric comparison of spleen and peritoneal B cells revealed no significant differences in cell surface markers needed for cognate interaction with T cells. Resolution of peritoneal B cell subsets by cell sorting revealed that even though B-1 cells were capable of Mls presentation, they were less effective than B-2 cells. Mixing experiments showed that B-1 cells did not inhibit B-2 cell presentation of Mls. In contrast, total peritoneal cells inhibited T cell responses to Mls presented by spleen cells. The peritoneal cavity harbors B cells that can present Mls as well as other cells that can suppress this response.

  1. Metabolic consequences of peritoneal dialysis.

    PubMed

    Burkart, John

    2004-01-01

    Optimization of the peritoneal dialysis (PD) prescription includes attempts to normalize the patient's blood pressure and extracellular volume. To do so, one must utilize crystalloid or colloid osmotic agents to achieve ultrafiltration. These osmotic agents are systemically absorbed and thus have both potential benefits and adverse effects. With glucose-based dialysate solutions, the average patient absorbs 300-450 kcal of glucose per day on either continuous ambulatory peritoneal dialysis (CAPD) or the cycler. The amount of glucose absorbed varies based on peritoneal transport characteristics, prescription, and tonicity of fluids used. Alternative osmotic agents such as amino acids and macromolecular solutions, including polypeptides and polyglucose (icodextrin) solutions, have a different rate of systemic absorption and thus a different caloric load profile. In addition, there are protein losses that average about 10 g/day with glucose-based solutions and glucose losses with either amino acid or icodextrin dialysate solutions. There are also potential advantages of these alternative solutions with regard to ultrafiltration. Glucose-based solutions require the development of significant crystalloid osmotic forces, which are dissipated as glucose is absorbed systemically. In contrast, macromolecular solutions achieve ultrafiltration via differences in colloid osmotic pressure, and the absorption of these agents is of a lesser magnitude than glucose-based solutions. Further research is needed to determine other potential risks and benefits of these alternative dialysate solutions.

  2. Acute dialysis-associated peritonitis in children with D+ hemolytic uremic syndrome.

    PubMed

    Adragna, Marta; Balestracci, Alejandro; García Chervo, Laura; Steinbrun, Silvina; Delgado, Norma; Briones, Liliana

    2012-04-01

    Acute peritoneal dialysis (PD) is the preferred therapy for renal replacement in children with post-diarrheal hemolytic uremic syndrome (D+ HUS), but peritonitis remains a frequent complication of this procedure. We reviewed data from 149 patients with D+ HUS who had undergone acute PD with the aim of determining the prevalence and risk factors for the development of peritonitis. A total of 36 patients (24.2%) presented peritonitis. The median onset of peritonitis manifestations was 6 (range 2-18) days after the initiation of dialysis treatment, and Gram-positive microorganisms were the predominant bacterial type isolated (15/36 patients). The patients were divided into two groups: with or without peritonitis, respectively. Univariate analysis revealed that a longer duration of the oligoanuric period, more days of dialysis, catheter replacement, stay in the intensive care unit, and hypoalbuminemia were significantly associated to the development of peritonitis. The multivariate analysis, controlled by duration of PD, identified the following independent risk factors for peritonitis: catheter replacement [p = 0.037, odds ratio (OR) 1.33, 95% confidence interval (CI) 1.02-1.73], stay in intensive care unit (p = 0.0001, OR 2.62, 95% CI 1.65-4.19), and hypoalbuminemia (p = 0.0076, OR 1.45, 95% CI 1.10-1.91). Based on these findings, we conclude that the optimization of the aseptic technique during catheter manipulation and early nutritional support are targets for the prevention of peritonitis, especially in critically ill patients.

  3. Intra-abdominal benign multicystic peritoneal mesothelioma.

    PubMed

    Jouvin, I; Dohan, A; Gergi, P; Pocard, M

    2014-04-01

    Benign multicystic peritoneal mesotheliomas are rare: pre-operative diagnosis relies on proper imaging. The differential diagnosis includes pseudomyxoma peritonei and other peritoneal cysts. Absence of previous surgical resection offers the best chance of success when complete resection is performed in a specialized center. We report the case of a 43 year-old man with benign multicystic peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  4. 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

  5. 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

  6. Recent Peritonitis Associates with Mortality among Patients Treated with Peritoneal Dialysis

    PubMed Central

    Kemp, Anna; Clayton, Philip; Lim, Wai; Badve, Sunil V.; Hawley, Carmel M.; McDonald, Stephen P.; Wiggins, Kathryn J.; Bannister, Kym M.; Brown, Fiona G.; Johnson, David W.

    2012-01-01

    Peritonitis is a major complication of peritoneal dialysis, but the relationship between peritonitis and mortality among these patients is not well understood. In this case-crossover study, we included the 1316 patients who received peritoneal dialysis in Australia and New Zealand from May 2004 through December 2009 and either died on peritoneal dialysis or within 30 days of transfer to hemodialysis. Each patient served as his or her own control. The mean age was 70 years, and the mean time receiving peritoneal dialysis was 3 years. In total, there were 1446 reported episodes of peritonitis with 27% of patients having ≥2 episodes. Compared with the rest of the year, there were significantly increased odds of peritonitis during the 120 days before death, although the magnitude of this association was much greater during the 30 days before death. Compared with a 30-day window 6 months before death, the odds for peritonitis was six-fold higher during the 30 days immediately before death (odds ratio, 6.2; 95% confidence interval, 4.4–8.7). In conclusion, peritonitis significantly associates with mortality in peritoneal dialysis patients. The increased odds extend up to 120 days after an episode of peritonitis but the magnitude is greater during the initial 30 days. PMID:22626818

  7. Ciprofloxacin Treatment of Bacterial Peritonitis Associated with Chronic Ambulatory Peritoneal Dialysis Caused by Neisseria cinerea

    PubMed Central

    Taegtmeyer, M.; Saxena, R.; Corkill, J. E.; Anijeet, H.; Parry, C. M.

    2006-01-01

    Bacterial peritonitis is a well-recognized complication of chronic ambulatory peritoneal dialysis (CAPD) in patients with end-stage renal failure. We present a case of peritonitis due to an unusual pathogen, Neisseria cinerea, unresponsive to the standard intraperitoneal (i.p.) vancomycin and gentamicin, which responded rapidly to oral ciprofloxacin. PMID:16891538

  8. Ciprofloxacin treatment of bacterial peritonitis associated with chronic ambulatory peritoneal dialysis caused by Neisseria cinerea.

    PubMed

    Taegtmeyer, M; Saxena, R; Corkill, J E; Anijeet, H; Parry, C M

    2006-08-01

    Bacterial peritonitis is a well-recognized complication of chronic ambulatory peritoneal dialysis (CAPD) in patients with end-stage renal failure. We present a case of peritonitis due to an unusual pathogen, Neisseria cinerea, unresponsive to the standard intraperitoneal (i.p.) vancomycin and gentamicin, which responded rapidly to oral ciprofloxacin.

  9. 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

  10. Laboratory diagnostics of spontaneous bacterial peritonitis.

    PubMed

    Lippi, Giuseppe; Danese, Elisa; Cervellin, Gianfranco; Montagnana, Martina

    2014-03-20

    The term peritonitis indicates an inflammatory process involving the peritoneum that is most frequently infectious in nature. Primary or spontaneous bacterial peritonitis (SBP) typically occurs when a bacterial infection spreads to the peritoneum across the gut wall or mesenteric lymphatics or, less frequently, from hematogenous transmission in combination with impaired immune system and in absence of an identified intra-abdominal source of infection or malignancy. The clinical presentation of SBP is variable. The condition may manifest as a relatively insidious colonization, without signs and symptoms, or may suddenly occur as a septic syndrome. Laboratory diagnostics play a pivotal role for timely and appropriate management of patients with bacterial peritonitis. It is now clearly established that polymorphonuclear leukocyte (PMN) in peritoneal fluid is the mainstay for the diagnosis, whereas the role of additional biochemical tests is rather controversial. Recent evidence also suggests that automatic cell counting in peritoneal fluid may be a reliable approach for early screening of patients. According to available clinical and laboratory data, we have developed a tentative algorithm for efficient diagnosis of SBP, which is based on a reasonable integration between optimization of human/economical resources and gradually increasing use of invasive and expensive testing. The proposed strategy entails, in sequential steps, serum procalcitonin testing, automated cell count in peritoneal fluid, manual cell count in peritoneal fluid, peritoneal fluid culture and bacterial DNA testing in peritoneal fluid.

  11. Novel speed-up strategies for non-local means denoising with patch and edge patch based dictionaries.

    PubMed

    Bhujle, Hemalata; Chaudhuri, Subhasis

    2014-01-01

    In this paper, a novel technique to speed-up a nonlocal means (NLM) filter is proposed. In the original NLM filter, most of its computational time is spent on finding distances for all the patches in the search window. Here, we build a dictionary in which patches with similar photometric structures are clustered together. Dictionary is built only once with high resolution images belonging to different scenes. Since the dictionary is well organized in terms of indexing its entries, it is used to search similar patches very quickly for efficient NLM denoising. We achieve a substantial reduction in computational cost compared with the original NLM method, especially when the search window of NLM is large, without much affecting the PSNR. Second, we show that by building a dictionary for edge patches as opposed to intensity patches, it is possible to reduce the dictionary size; thus, further improving the computational speed and memory requirement. The proposed method preclassifies similar patches with the same distance measure as used by NLM method. The proposed algorithm is shown to outperform other prefiltering based fast NLM algorithms computationally as well as qualitatively.

  12. New directions in peritoneal dialysis patient training.

    PubMed

    Hall, Gayle; Bogan, Amy; Dreis, Sandra; Duffy, AnnMarie; Greene, Suzanne; Kelley, Karen; Lizak, Holly; Nabut, Jose; Schinker, Vicky; Schwartz, Netta

    2004-01-01

    To study the effect of training methods on selected patient outcomes in peritoneal dialysis patients. Multi-center, longitudinal prospective quasi-experimental design study conducted over a 2-year period. Thirty-two Gambro Healthcare peritoneal dialysis (PD) home training programs in the United States. New patients starting PD were trained on PD technique and diet using either an adult learning theory-based curriculum in the experimental group (PG) or non-standardized conventional training programs in the control group (CG). Excluded were patients who were non-English speaking, legally blind without sighted caregiver, nursing home residents, and those with previous exposure to PD training. Information was collected by means of manual data collection tools and though the use of Gambro Healthcare computer system and was analyzed for statistical significance by Gambro Healthcare biostatistician. Compared with the CG, initial training took longer in the PG (PG = 29 hrs; CG = 22.6 hrs; p < .0001), and time required for retraining was less but not statistically significant (PG = 8.7 hrs; CG = 12.5 hrs; p = .1324). The peritonitis rate was less in the PG (28.2 per 1000 patient months) than in the CG (36.7 per 1000 patient months), but did not achieve statistical significance (p = .09783). Exit site infections (ESIs) were less in the PG than the CG (PG = 18.5; CG = 31.8; p = .00349). Dropout from PD to hemodialysis secondary to infection was less in the PG (1.6%) than in the CG (5.6%) (p = .0069). Measured on a scale with 4 being the best score, mean fluid balance scores in the PG were 3.41 compared to 3.25 in the CG (p < .0001), and mean compliance scores for the PG versus the CG were 3.62 and 3.52, respectively (p < .0001). Laboratory parameters between the two groups were significantly different only for Kt/V (PG = 2.4; CG = 2.3; p = 0.0107). Use of the adult learning theory-based training method curriculum was positively associated with improved patient outcomes in the

  13. 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

    . This minimally invasive staged approach should be considered for patients without systemic toxicity and in centers experienced in minimally invasive surgery techniques. Further evidence is needed, and the ongoing RCTs will better define the role of the laparoscopic peritoneal lavage/drainage in the treatment of patients with complicated diverticulitis. PMID:25569649

  14. Effect of bile on growth, peritoneal absorption, and blood clearance of Escherichia coli in E coli peritonitis

    SciTech Connect

    Andersson, R.; Schalen, C.; Tranberg, K.G. )

    1991-06-01

    The effect of intraperitoneal bile on growth, peritoneal absorption, and clearance of Escherichia coli was determined in E coli peritonitis in the rat. In E coli peritonitis, intraperitoneal bacterial counts gradually decreased, whereas they increased (after 2 hours) with subsequent development of bacteremia in E coli plus bile peritonitis. After an intraperitoneal injection of labeled bacteria, blood radioactivity was only initially lower in E coli plus bile peritonitis compared with E coli peritonitis. Clearance from blood was lower in E coli plus bile peritonitis than in E coli peritonitis. Organ localization was similar in E coli peritonitis and E coli plus bile peritonitis with decreased splenic, increased pulmonary, and unchanged hepatic uptakes compared with controls. Impaired peritoneal absorption of bacteria, together with impaired local host defense, is likely to enhance the noxious effect of bile in E coli peritonitis.

  15. Smart patch piezoceramic actuator issues

    NASA Technical Reports Server (NTRS)

    Griffin, Steven F.; Denoyer, Keith K.; Yost, Brad

    1993-01-01

    The Phillips Laboratory is undertaking the challenge of finding new and innovative ways to integrate sensing, actuation, and the supporting control and power electronics into a compact self-contained unit to provide vibration suppression for a host structure. This self-contained unit is commonly referred to as a smart patch. The interfaces to the smart patch will be limited to standard spacecraft power and possibly a communications line. The effort to develop a smart patch involves both contractual and inhouse programs which are currently focused on miniaturization of the electronics associated with vibrational control using piezoceramic sensors and actuators. This paper is comprised of two distinct parts. The first part examines issues associated with bonding piezoceramic actuators to a host structure. Experimental data from several specimens with varying flexural stiffness are compared to predictions from two piezoelectric/substructure coupling models, the Blocked Force Model and the Uniform Strain Model with Perfect Bonding. The second part of the paper highlights a demonstration article smart patch created using the insights gained from inhouse efforts at the Phillips Laboratory. This demonstration article has self contained electronics on the same order of size as the actuator powered by a voltage differential of approximately 32 volts. This voltage is provided by four rechargeable 8 volt batteries.

  16. Specific characteristics of peritoneal leucocyte populations during sterile peritonitis associated with icodextrin CAPD fluids.

    PubMed

    Glorieux, Griet; Lameire, Norbert; Van Biesen, Wim; Dequidt, Clement; Vanholder, Raymond

    2003-08-01

    Icodextrin dialysate used for peritoneal dialysis contains an iso-molar glucose polymer solution, which provides sustained ultrafiltration over long dwell times and is considered a valuable approach to reduce intraperitoneal glucose exposure. However, several side effects have been described, including abdominal pain and allergic and hypersensitivity reactions. Also, reactions compatible with chemical peritonitis have been reported. Over the period of a few months (January 2002-May 2002), a remarkable increase in the number of continuous ambulatory peritoneal dialysis (CAPD) patients using icodextrin dialysate diagnosed with sterile peritonitis was observed in our unit. Five of the CAPD patients using icodextrin dialysate in our unit and diagnosed with sterile peritonitis were screened for leucocyte count and leucocyte differentiation during a follow-up period of 77 +/- 23 days. In addition, expression of CD14, a receptor for lipopolysaccharide (LPS), on the peripheral and peritoneal monocyte population was analysed. These results were compared to CAPD patients suffering from bacterial peritonitis. The peritoneal leucocyte count of CAPD patients using icodextrin dialysate and diagnosed with sterile peritonitis did not decrease significantly before treatment with icodextrin dialysate was interrupted, whereas it currently disappeared within 2-4 days in proven bacterial peritonitis. The sterile, cloudy icodextrin effluent contained an excess of macrophages on the day of diagnosis, whereas in bacterial peritonitis essentially an increase in the granulocyte population was observed. No elevation in the eosinophil population was observed. In contrast to bacterial peritonitis, we observed no increase in CD14 expression on the peripheral and peritoneal macrophages on the day of presentation and during the follow-up period. Specific batches of the icodextrin CAPD fluids contain a macrophage chemotactic agent, which causes a sustained inflammatory state in the peritoneal

  17. Icodextrin-induced peritonitis: study of five cases and comparison with bacterial peritonitis.

    PubMed

    Touré, Fatouma; Lavaud, Sylvie; Mohajer, Mehdi; Lavaud, François; Canivet, Eric; Nguyen, Philippe; Chanard, Jacques; Rieu, Philippe

    2004-02-01

    An epidemic of aseptic peritonitis related to the presence of peptidoglycan contaminant in some batches of icodextrin solution (Extraneal, Baxter Healthcare Corporation) occurred in Europe in the first six months of 2002. By case-control study we examined the clinical and biologic features of 5 patients with icodextrin-induced peritonitis (group AP) and compared them with 7 patients with bacterial peritonitis (group BP) recruited in our clinical center between January and June 2002. Diagnosis of icodextrin-induced peritonitis was confirmed in all cases by a positive reintroduction test with contaminated batches of icodextrin. No recurrence was observed on re-exposure to icodextrin free of peptidoglycan. Skin tests were positive with contaminated icodextrin in 2 of 5 patients, while they were negative with icodextrin solution free of peptidoglycan (<0.6 ng/mL). During peritonitis, serum level of C-reactive protein (CRP) was lower in group AP (42.4 +/- 34 mg/L) than in group BP (135 +/- 59 mg/L) (P= 0.01). Leukocyte number in peritoneal dialysis effluent was lower in group AP (284 +/- 101/mm3), with a lower neutrophil/monocyte ratio (N/M = 0.67) than in group BP (1410 +/- 973/mm3; N/M = 4) (P < 0.05). A low number of peritoneal fluid eosinophilia (11 +/- 8%) was detected in group AP. Icodextrin-induced peritonitis was associated with a burst of intraperitoneal cytokines. The phenotype of peritoneal neutrophils was different between aseptic and bacterial peritonitis, indicating that inflammatory stimuli that activate neutrophils in both types of peritonitis are clearly distinct. Finally, peritoneal injury measured by weight gain, peritoneal permeability, and CA125 concentration seemed to be less severe during icodextrin-induced peritonitis than during bacterial peritonitis.

  18. [Peritoneal catheter placement into the suprahepatic space: a report of 2 cases with abdominal complications of ventriculoperitoneal shunts].

    PubMed

    Ishi, Yukitomo; Ito, Masaki; Terasaka, Shunsuke; Motegi, Hiroaki; Shinbo, Daisuke; Kaneko, Sadahiro; Houkin, Kiyohiro

    2011-11-01

    Complications arising from the placement of ventriculoperitoneal shunts are common. These complications may be related to a number of causes and present with various symptoms. Of these, abdominal complications such as formation of intraperitoneal pseudocysts and abdominal abscesses possibly recur, but, alternative sites for placing the peritoneal catheter of ventriculoperitoneal shunts are limited. We present two cases of ventriculoperitoneal shunt malfunctioning due to repeated abdominal complications. The location of the peritoneal end of the shunt was successfully revised to the suprahepatic space in the peritoneal cavity. We describe the clinical course of these two cases in this report, along with a precise technique of placing the peritoneal end of the shunt into the suprahepatic space. In addition, we will discuss the validity of this space as an alternative site for the placement of the peritoneal end of the ventriculoperitoneal shunt.

  19. Pleuro-peritoneal or pericardio-peritoneal leak in children on chronic peritoneal dialysis-A survey from the European Paediatric Dialysis Working Group.

    PubMed

    Dufek, Stephanie; Holtta, Tuula; Fischbach, Michel; Ariceta, Gema; Jankauskiene, Augustina; Cerkauskiene, Rimante; Schmitt, Claus Peter; Schaefer, Betti; Aufricht, Christoph; Wright, Elizabeth; Stefanidis, Constantinos J; Ekim, Mesiha; Bakkaloglu, Sevcan; Klaus, Günter; Zurowska, Aleksandra; Vondrak, Karel; Vande Walle, Johan; Edefonti, Alberto; Shroff, Rukshana

    2015-11-01

    Pleural or pericardial effusions secondary to pleuro-peritoneal fistula (PPF) and pericardio-peritoneal fistula (PcPF) are rare but serious complications of peritoneal dialysis (PD). We conducted a 10-year survey across all participating centres in the European Paediatric Dialysis Working Group to review the incidence, diagnostic techniques, therapeutic options and outcome of children on chronic PD with PPF and/or PcPF. Of 1506 children on PD there were ten cases (8 of PPF, 1 each of PcPF and PPF + PcPF), with a prevalence of 0.66%. The median age at presentation was 1.5 [inter-quartile range (IQR) 0.4-2.4] years, and nine children were <3 years. The time on PD before onset of symptoms was 4.3 (IQR 1.3-19.8) months. Eight children had herniae and seven had abdominal surgery in the preceding 4 weeks. Symptoms at presentation were respiratory distress, reduced ultrafiltration and tachycardia. PD was stopped in all children; three were managed conservatively and thoracocentesis was performed in seven (with pleurodesis in 3). PD was restarted in only three children, in two of them with success. In conclusion, PPF and PcPF are rare in children on chronic PD, but are associated with significant morbidity, requiring a change of dialysis modality in all cases. Risk factors for PPF development include age of <3 years, herniae and recent abdominal surgery.

  20. Evaluation of continuous ambulatory peritoneal dialysis fluid C-reactive protein in patients with peritonitis.

    PubMed

    Ramanathan, Kumaresan; Padmanabhan, Giri; Vijayaraghavan, Bhooma

    2016-05-01

    Severe peritonitis causing death is one of the most devastating complications of peritoneal dialysis (PD). Since the predictive value of C-reactive protein (CRP) in PD fluid has not been assessed, the objective of the present study is to evaluate its predictive value and clinical correlation in patients on PD with peritonitis. One hundred and twenty patients on continuous ambulatory PD (CAPD) were enrolled and their serum and fluid CRP (Fl. CRP) were evaluated at the start of CAPD. All patients who developed peritonitis were further evaluated for serum and fluid CRP. The patients were categorized into four groups, namely: normal patients (control group), patients with peritonitis, patients with peritonitis leading to catheter removal, and death due to peritonitis. Sixty-five patients developed peritonitis of whom, catheter removal was performed in eight patients. Five patients died due to peritonitis-related complications. Fl. CRP showed a significant difference among the three groups, unlike S. CRP. Estimation of CRP in the peritoneal fluid may be a useful marker to monitor the onset of peritonitis.

  1. 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.

  2. Aortic aneurysm formation following coarctation repair by Dacron patch aortoplasty

    PubMed Central

    Walhout, R.J.; Braam, R.L.; Schepens, M.A.; Mulder, B.J.M.; Plokker, H.W.M.

    2010-01-01

    We describe the finding of an aortic aneurysm in an asymptomatic 43-year-old male, who was managed by Dacron patch aortoplasty for native coarctation of the aorta 25 years before. The role of magnetic resonance angiography as standard imaging technique in lifelong postoperative surveillance is discussed subsequently. (Neth Heart J 2010;18:376-7.) PMID:20730007

  3. Aortic aneurysm formation following coarctation repair by Dacron patch aortoplasty.

    PubMed

    Walhout, R J; Braam, R L; Schepens, M A; Mulder, B J M; Plokker, H W M

    2010-08-01

    We describe the finding of an aortic aneurysm in an asymptomatic 43-year-old male, who was managed by Dacron patch aortoplasty for native coarctation of the aorta 25 years before. The role of magnetic resonance angiography as standard imaging technique in lifelong postoperative surveillance is discussed subsequently. (Neth Heart J 2010;18:376-7.).

  4. Temporary patching of damaged UF{sub 6} cylinders

    SciTech Connect

    Cardenas, A.L.

    1991-12-31

    Patching techniques based on application of epoxy resins have been developed for temporarily repairing UF{sub 6} cylinders which have sustained relatively minor damage and must be safely emptied. The method is considerably faster and simpler than metallurgical weld repairs. Laboratory tests, detailed operational procedures, and case histories of experience at the Portsmouth Gaseous Diffusion Plant are described.

  5. Coplanar waveguide aperture-coupled microstrip patch antenna

    NASA Technical Reports Server (NTRS)

    Lee, Richard Q.; Simons, Rainee N.

    1992-01-01

    The performance characteristics of a coplanar waveguide (CPW) aperture-coupled microstrip patch antenna was investigated experimentally. A grounded CPW with a series gap in the center strip conductor was used to couple microwave power to the antenna through an aperture in the common ground plane. Results indicate good coupling efficiency and confirms the feasibility of this feeding technique.

  6. NEB in Analysis of Optical Flow 4 x 4 and 6 x 6-Patches

    NASA Astrophysics Data System (ADS)

    Xia, Shengxiang; Liang, Di

    2017-01-01

    We apply the nudged elastic band technique to non-lineal high-dimensional datasets, we analyze spaces of 4 x 4 and 6 x 6 optical flow patches and detect their topological properties. We experimentally prove that subsets of 4 x 4 and 6 x 6 optical flow patches can be modeled a circle, which confirm some results of 4 x 4 and 6 x 6 optical flow patches by using a new method-NEB, and expend Adams et al's result to larger patches of optical flow.

  7. Peritoneal blastomycosis: a hidden mystery unfolds itself.

    PubMed

    Kapila, Aaysha; Motiani, Rishika; Chhabra, Lovely; Kalra, Amit; Khanna, Atul; Moorman, Jonathan P; Myers, James W

    2014-10-01

    Blastomycosis is a disease caused by the fungus Blastomyces dermatitidis. Pulmonary blastomycosis is the most common form of blastomycosis. Disseminated blastomycosis is the fulminant form of the disease, with rare reports of peritoneal cavity involvement. We report a case of extensive form of the disease presenting initially as abdominal pain and mimicking peritoneal carcinomatosis.

  8. 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

  9. Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma.

    PubMed

    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.

  10. 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

  11. The changing trends of peritoneal dialysis related peritonitis and novel risk factors.

    PubMed

    Ozisik, Lale; Ozdemir, Fatma Nurhan; Tanriover, Mine Durusu

    2015-07-01

    Continuous ambulatory peritoneal dialysis (PD) has become a treatment modality for end stage renal disease with a peak of its use in 1990 s. The aim of this study was to examine the peritonitis rates, causative organisms and the risk factors of peritonitis in a large group of patients in our center. The study was conducted in the Nephrology Department of a University Hospital in Turkey. Patients in the PD programme between January 2000 and January 2006 were included. Cohort-specific and subject specific peritonitis incidence, and peritonitis-free survival were calculated. Causative organisms and risk factors were evaluated. Totally 620 episodes of peritonitis occurred in 440 patients over the six years period. Peritonitis rates showed a decreasing trend through the years (0.79 episodes/patient-year 2000-2003 and 0.46 episodes/patient-year 2003-2006). Cohort-specific peritonitis incidence was 0.62 episodes/patient-years and median subject-specific peritonitis incidence was 0.44 episodes/patient-years. The median peritonitis-free survival was 15.25 months (%95 CI, 9.45-21.06 months). The proportion of gram-negative organisms has increased from 9.8% to 17.3%. There was a significant difference in the percentage of culture negative peritonitis between the first three and the last three years (53.1% vs. 43.2%, respectively). Peritonitis incidence was higher in patients who had been transferred from HD, who had catheter related infection and who had HCV infection without cirrhosis. Our study showed significant trends in the peritonitis rates, causative organisms and antibiotic resistance. Prior HD therapy, catheter related infections and HCV infection were found to be risk factors for peritonitis.

  12. 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

  13. A circularly polarized Ka-band stacked patch antenna with increased gain

    NASA Technical Reports Server (NTRS)

    Zawadzki, M.

    2002-01-01

    Stacking layers of microstrip patches is a technique often used to improve the bandwidth of a patch antenna, but rarely used to increase its gain. The work presented here scales the three-layer S-band work done in to Ka-band.

  14. Bye-Bye Flu Shot, Hello Patch?

    MedlinePlus

    ... medlineplus.gov/news/fullstory_166897.html Bye-Bye Flu Shot, Hello Patch? Early results look promising for ... TUESDAY, June 27, 2017 (HealthDay News) -- An experimental flu vaccine patch with dissolving microneedles appears safe and ...

  15. MEMS-based electrostatically tunable microstrip patch antenna using flexible polyimide film

    NASA Astrophysics Data System (ADS)

    Goteti, Raghav Venkat; Ramadoss, Ramesh

    2005-05-01

    This paper reports a MEMS-based electrostatically tunable microstrip patch antenna fabricated using printed circuit processing techniques. The microstrip patch is patterned on the top side of the flexible kapton polyimide film, which is suspended above the fixed ground plane using a spacer. The air gap between the microstrip patch and the ground plane is decreased by applying a DC bias voltage between the patch and the ground plane. A decrease in air gap increases the effective permittivity of the antenna resulting in a downward shift in the resonant frequency. The microstrip patch is excited by a slot in the ground plane, which is inductively coupled by a coplanar waveguide (CPW) feed line. A 6 mm x 6 mm microstrip patch antenna tunable from 18.34 GHz at 0 V to 17.95 GHz at 268 V (with a tuning range of 390 MHz) is discussed.

  16. Outcomes of Peritoneal Dialysis Patients and Switching to Hemodialysis: A Competing Risks Analysis

    PubMed Central

    Pajek, Jernej; Hutchison, Alastair J.; Bhutani, Shiv; Brenchley, Paul E.C.; Hurst, Helen; Perme, Maja Pohar; Summers, Angela M.; Vardhan, Anand

    2014-01-01

    ♦ Background: We performed a review of a large incident peritoneal dialysis cohort to establish the impact of current practice and that of switching to hemodialysis. ♦ Methods: Patients starting peritoneal dialysis between 2004 and 2010 were included and clinical data at start of dialysis recorded. Competing risk analysis and Cox proportional hazards model with time-varying covariate (technique failure) were used. ♦ Results: Of 286 patients (median age 57 years) followed for a median of 24.2 months, 76 were transplanted and 102 died. Outcome probabilities at 3 and 5 years respectively were 0.69 and 0.53 for patient survival (or transplantation) and 0.33 and 0.42 for technique failure. Peritonitis caused technique failure in 42%, but ultrafiltration failure accounted only for 6.3%. Davies comorbidity grade, creatinine and obesity (but not residual renal function or age) predicted technique failure. Due to peritonitis deaths, technique failure was an independent predictor of death hazard. When successful switch to hemodialysis (surviving more than 60 days after technique failure) and its timing were analyzed, no adverse impact on survival in adjusted analysis was found. However, hemodialysis via central venous line was associated with an elevated death hazard as compared to staying on peritoneal dialysis, or hemodialysis through a fistula (adjusted analysis hazard ratio 1.97 (1.02 - 3.80)). ♦ Conclusions: Once the patients survive the first 60 days after technique failure, the switch to hemodialysis does not adversely affect patient outcomes. The nature of vascular access has a significant impact on outcome after peritoneal dialysis failure. PMID:24497601

  17. Enteral nutrition in patients with an open peritoneal cavity.

    PubMed

    Tsuei, Betty J; Magnuson, Barbara; Swintosky, Marjorie; Flynn, Julie; Boulanger, Bernard R; Ochoa, Juan B; Kearney, Paul A

    2003-06-01

    Recent surgical advances have led to the increased survival of critically ill patients requiring postoperative nutritional supplementation. One technique, which has been increasingly used, is that of the open peritoneal cavity. In these cases, the peritoneum is left open, and the viscera are protected with a temporary dressing until the abdomen can be closed. The aim of this study was to evaluate the efficacy and tolerance of enteral nutrition in patients who need open peritoneal cavity management techniques. Patients at a tertiary referral center requiring the use of open peritoneal cavity management who received at least 4 days of enteral nutrition were included in the study. Retrospective data were collected on patients admitted between January 1999 and December 2000, and prospective data were collected on patients between January and May 2001. Energy expenditure and actual caloric and protein intake were determined in all patients. Prealbumin levels and nitrogen balance studies were analyzed when available. Intolerance, defined as diarrhea or gastric reflux, was also evaluated. Average daily total caloric intake was 77 +/- 27%, and average daily protein intake was 68 +/- 24% of estimated needs. Initial serum prealbumin levels were low and remained below normal but increased in some patients during the study. Average nitrogen balance studies from 3 patients was -15 +/- 9.7 g/d. Diarrhea and gastric reflux occurred in 42% and 36% of patients, respectively, and were easily treated. Enteral nutrition can be effectively used in patients requiring open peritoneal cavity management after laparotomy. Overall, enteral nutrition is relatively well tolerated in this patient population.

  18. Peritoneal carcinoma in a male patient.

    PubMed

    Jermann, Monika; Vogt, Peter; Pestalozzi, Bernhard C

    2003-01-01

    Peritoneal carcinoma is a rare primary tumor, described in the literature almost exclusively in women. This report describes our clinicopathological findings in a 51-year-old male patient with peritoneal carcinoma and ascites. Pathologic studies included routine histology, immunohistochemistry and electron microscopy on biopsy and autopsy tumor tissue. After chemotherapy, the patient achieved a complete remission twice, lasting for 14 months and 8 months, respectively, and died after 3 years. His clinical course was similar to that of female patients with peritoneal carcinoma or advanced ovarian cancer. Our case confirms the existence of primary peritoneal carcinoma in males. In addition, it shows that this entity responds to the same chemotherapy as used for ovarian cancer and primary peritoneal carcinoma in females.

  19. 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. Celsius.

  20. SAHA Suppresses Peritoneal Fibrosis in Mice.

    PubMed

    Io, Kumiko; Nishino, Tomoya; Obata, Yoko; Kitamura, Mineaki; Koji, Takehiko; Kohno, Shigeru

    2015-01-01

    Long-term peritoneal dialysis causes peritoneal fibrosis in submesothelial areas. However, the mechanism of peritoneal fibrosis is unclear. Epigenetics is the mechanism to induce heritable changes without any changes in DNA sequences. Among epigenetic modifications, histone acetylation leads to the transcriptional activation of genes. Recent studies indicate that histone acetylation is involved in the progression of fibrosis. Therefore, we examined the effect of suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor, on the progression of peritoneal fibrosis in mice. Peritoneal fibrosis was induced by the injection of chlorhexidine gluconate (CG) into the peritoneal cavity of mice every other day for 3 weeks. SAHA, or a dimethylsulfoxide and saline vehicle, was administered subcutaneously every day from the start of the CG injections for 3 weeks. Morphologic peritoneal changes were assessed by Masson's trichrome staining, and fibrosis-associated factors were assessed by immunohistochemistry. In CG-injected mice, a marked thickening of the submesothelial compact zone was observed. In contrast, the administration of SAHA suppressed the progression of submesothelial thickening and type III collagen accumulation in CG-injected mice. The numbers of fibroblast-specific protein-1-positive cells and α-smooth muscle actin α-positive cells were significantly decreased in the CG + SAHA group compared to that of the CG group. The level of histone acetylation was reduced in the peritoneum of the CG group, whereas it was increased in the CG + SAHA group. Our results indicate that SAHA can suppress peritoneal thickening and fibrosis in mice through up-regulation of histone acetylation. These results suggest that SAHA may have therapeutic potential for treating peritoneal fibrosis. Copyright © 2015 International Society for Peritoneal Dialysis.

  1. Smart patches: self-monitoring composite patches for the repair of aircraft

    NASA Astrophysics Data System (ADS)

    Crossley, Samuel D.; Marioli-Riga, Zaira; Tsamasphyros, George; Kanderakis, George; Furnarakis, Nikos; Ikiades, Aris; Konstantaki, Mary

    2004-03-01

    Conventional aircraft repair techniques employ bolted or riveted metallic reinforcements, which frequently introduce additional stress concentrations leading to further cracking and creating areas difficult or impossible to inspect. Bonded composite repairs ("patches") result in the elimination of stress concentrations caused by additional fastener holes, improved strength to weight ratio and present a sealed interface. This reduces even further the danger of corrosion and fretting under the repair, gives greater flexibility in design and lessens application time while lengthening fatigue life. Embedding optical fibres and sensors into the patch, and combining this with advanced data collection and processing systems, creating a so-called "smart patch", will enable the real-time assessment of aircraft structural integrity resulting in reliable prediction of maintenance requirements for repaired structures. This paper describes the current state of the art in smart patch technology, and includes a detailed description of the measurement problem and of the work being undertaken to solve it, at both the component and system level. An analysis of typical crack behaviour, based on FE modelling is presented and this demonstrates the need for optical strain sensors having a very short gauge length. The paper discusses the advantages and limitations of very short Fibre Bragg Gratings (FBGs) in this context and also provides early experimental data from 1mm and 2mm gratings which have been fabricated for this purpose. The paper also describes the impact of the measurement and environmental constraints on the design of the FBG interrogation system and presents the results of initial trials. The work is being undertaken in the framework of a collaborative project (ACIDS) which is co-funded by the European Commission.

  2. Patch-clamping Drosophila sensory neurons.

    PubMed

    Kucher, Volodymyr; Eaton, Benjamin A; Stockand, James D; Boiko, Nina

    2013-01-01

    Electrophysiological studies provide essential clues about the regulation and physiological function of ion channel proteins. Probing ion channel activity in vivo, though, often is challenging. This can limit the usefulness of such model organisms as Drosophila for electrophysiological studies. This is unfortunate because these genetically tractable organisms represent powerful research tools that facilitate elaboration of complex questions of physiology. Here, we describe a recently developed method for recording ion channel activity in Drosophila sensory neurons. This approach is based on patch-clamping primary neuron cultures from Drosophila embryos. Such cultures allow the study of ion channels in different genetic backgrounds. In addition to describing how to prepare a primary neuronal cell culture from Drosophila embryos, we discuss, as an example of utility, analysis of Na(+) currents in cultured class IV multidendritic (md) sensory neurons with the patch clamp technique. Excitability of md sensory neurons, manifested as action potential firing, is revealed with whole-cell current-clamping. Voltage-clamping class IV md neurons revealed the activity of the voltage-gated Na(+) channel, paralytic. Moreover, challenging class IV md neurons with acidic pH activates acid-sensing inward Na(+) currents. Genetic manipulation of Drosophila combined with this electrophysiological readout of activity identifies pickpocket1 (Ppk1), a member of the Deg/ENaC channel family, as responsible for conducting an acid-sensing Na(+) current in class IV md sensory neurons.

  3. Wireless link design using a patch antenna

    SciTech Connect

    Hall, E

    2000-08-11

    A wireless link was designed using a patch antenna. In the process, several different models were tested. Testing proved a patch antenna was a viable solution for building a wireless link within the design specifications. Also, this experimentation provided a basis for future patch antenna design.

  4. Characteristics and outcomes of fungal peritonitis in a modern North American cohort.

    PubMed

    Nadeau-Fredette, Annie-Claire; Bargman, Joanne M

    2015-01-01

    Peritonitis remains a common complication of peritoneal dialysis (PD). Although representing only 1 - 12% of overall peritonitis in dialysis patients, fungal peritonitis (FP) is associated with serious complications, including technique failure and death. Only scarce data have been published regarding FP outcomes in modern cohorts in North America. In this study we evaluated the rates, characteristics and outcomes of FP in a major North American PD center. We conducted a retrospective cohort study including all fungal peritonitis episodes among peritoneal dialysis patients followed in a large PD center between January 2000 and February 2013. Our pre-specified endpoints included rates of FP, characteristics, outcomes and determinants of death. Thirty-six episodes of FP were identified during the follow-up period (one episode per 671 patient-months), representing 4.5% of the total peritonitis events. Patients' mean age and peritoneal dialysis vintage were 61.3 ± 15.5 and 2.9 (1.5 - 4.8) years, respectively. Of the 36 episodes of FP, seven (19%) resulted in death and 17 (47%) led to technique failure with permanent transfer to hemodialysis. Surprisingly, PD was eventually resumed in 33% of cases with a median delay of 15 weeks (interquartile range 8 - 23) between FP and catheter reinsertion. In a univariable analysis, a higher Charlson comorbidity index (Odds ratio [OR] 3.25 per unit increase, 95% confidence interval [CI] 1.23 - 8.58) and PD fluid white blood cell (WBC) count greater than 3,000/mm(3) at presentation (OR 6.56, 95% CI 1.05 - 40.95) predicted death. While fungal peritonitis is still associated with a high frequency of death and technique failure, one third of our patients eventually returned to PD. Patients with a high burden of comorbidities appear at higher risk of death. We postulate that the high mortality associated with FP is partially related to the severity of comorbidity among patients with FP, rather than the infection per se. Importantly, PD

  5. Image superresolution of cytology images using wavelet based patch search

    NASA Astrophysics Data System (ADS)

    Vargas, Carlos; García-Arteaga, Juan D.; Romero, Eduardo

    2015-01-01

    Telecytology is a new research area that holds the potential of significantly reducing the number of deaths due to cervical cancer in developing countries. This work presents a novel super-resolution technique that couples high and low frequency information in order to reduce the bandwidth consumption of cervical image transmission. The proposed approach starts by decomposing into wavelets the high resolution images and transmitting only the lower frequency coefficients. The transmitted coefficients are used to reconstruct an image of the original size. Additional details are added by iteratively replacing patches of the wavelet reconstructed image with equivalent high resolution patches from a previously acquired image database. Finally, the original transmitted low frequency coefficients are used to correct the final image. Results show a higher signal to noise ratio in the proposed method over simply discarding high frequency wavelet coefficients or replacing directly down-sampled patches from the image-database.

  6. Patch-clamp experiments under micro-gravity.

    PubMed

    Meissner, Klaus; Hanke, Wolfgang

    2002-07-01

    For human based space research it is of high importance to understand the influence of gravity on the properties of single ion channels in biological membranes, as these are involved in about all biological processes. The patch clamp technique is the best established method to investigate electrophysiological properties of single ion channels in detail. Consequently, a patch clamp set-up was designed for the drop tower in Bremen, Germany. Using this set-up among others, successfully leech neurons have been patched under micro-gravity, delivering data about ion channel behaviour, which were compared to results from bilayer experiments in the drop tower and to results from lab controls under 1 g and under higher gravity.

  7. 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.

  8. Polar cap hot patches: Enhanced density structures different from the classical patches in the ionosphere

    NASA Astrophysics Data System (ADS)

    Zhang, Q.-H.; Ma, Y.-Z.; Jayachandran, P. T.; Moen, J.; Lockwood, M.; Zhang, Y.-L.; Foster, J. C.; Zhang, S.-R.; Wang, Y.; Themens, D. R.; Zhang, B.-C.; Xing, Z. Y.

    2017-08-01

    Based on in situ and ground-based observations, a new type of "polar cap hot patch" has been identified that is different from the classical polar cap enhanced density structure (cold patches). Comparing with the classical polar cap patches, which are transported from the dayside sunlit region with dense and cold plasma, the polar cap hot patches are associated with particle precipitations (therefore field-aligned currents), ion upflows, and flow shears. The hot patches may have the same order of density enhancement as classical patches in the topside ionosphere, suggesting that the hot patches may be produced by transported photoionization plasma into flow channels. Within the flow channels, the hot patches have low-energy particle precipitation and/or ion upflows associated with field-aligned currents and flow shears. Corresponding Global Navigation Satellite System (GNSS) signal scintillation measurements indicate that hot patches may produce slightly stronger radio signal scintillation in the polar cap region than classical patches. A new type of polar cap patches, "polar cap hot patches," is identified to differentiate enhanced density structures from classical patches. Hot patches are associated with particle precipitations, ion upflows, field-aligned currents, and shear flows in the polar cap. Hot patches may lead to slightly stronger ionospheric scintillations of GNSS signals in the polar cap region than classical patches.

  9. Bilateral patching in retinal detachment: fluid mechanics and retinal "settling".

    PubMed

    Foster, William J

    2011-07-20

    When a patient suffers a retinal detachment and surgery is delayed, it is known clinically that bilaterally patching the patient may allow the retina to partially reattach or "settle." Although this procedure has been performed since the 1860s, there is still debate as to how such a maneuver facilitates the reattachment of the retina. Finite element calculations using commercially available analysis software are used to elucidate the influence of reduction in eye movement caused by bilateral patching on the flow of subretinal fluid in a physical model of retinal detachment. It was found that by coupling fluid mechanics with structural mechanics, a physically consistent explanation of increased retinal detachment with eye movements can be found in the case of traction on the retinal hole. Large eye movements increase vitreous traction and detachment forces on the edge of the retinal hole, creating a subretinal vacuum and facilitating increased subretinal fluid. Alternative models, in which intraocular fluid flow is redirected into the subretinal space, are not consistent with these simulations. The results of these simulations explain the physical principles behind bilateral patching and provide insight that can be used clinically. In particular, as is known clinically, bilateral patching may facilitate a decrease in the height of a retinal detachment. The results described here provide a description of a physical mechanism underlying this technique. The findings of this study may aid in deciding whether to bilaterally patch patients and in counseling patients on pre- and postoperative care.

  10. Patch diameter limits for tiered subaperture SAR image formation algorithms

    SciTech Connect

    Doerry, A.W.

    1994-12-31

    Synthetic Aperture Radar image formation algorithms typically use transform techniques that often requires trading between image resolution, algorithm efficiency, and focussed image scene size limits. This is due to assumptions for the data such as simplified (often straight-line) flight paths, simplified imaging geometry, and simplified models for phase functions. Many errors in such assumptions are typically untreatable due to their dependence on both data domain positions and image domain positions. The result is that large scenes often require inefficient multiple image formation iterations, followed by a mosaicking operation of the focussed image patches. One class of image formation algorithms that performs favorably divides the spatial and frequency apertures into subapertures, and perhaps those subapertures into sub-subapertures, and so on, in a tiered subaperture fashion. This allows a gradual shift from data domain into image domain that allows correcting many types of errors that limit other image formation algorithms, even in a dynamic motion environment, thereby allowing larger focussed image patches without mosaicking. This paper presents and compares focussed patch diameter limits for tiered subaperture (TSA) image formation algorithms, for various numbers of tiers of subapertures. Examples are given that show orders-of-magnitude improvement in non-mosaicked focussed image patch size over traditional polar format processing, and that patch size limits increase with the number of tiers of subapertures, although with diminishing returns.

  11. Ultrafiltration capacity and peritoneal fluid kinetics in continuous ambulatory peritoneal dialysis patients.

    PubMed

    Zhe, Xing-wei; Tian, Xin-kui; Cheng, Lei; Wang, Tao

    2008-01-01

    Volume control is critical for peritoneal dialysis. Although peritoneal equilibration test (PET) has been used to clarify the peritoneal membrane characteristics, it is not able to adequately predict peritoneal fluid removal and optimize appropriately the dwell time. In the present study, we applied computer simulation and performed a more detailed evaluation of the fluid kinetics in patients with different ultrafiltration (UF) capacity. Patients who used three to four exchanges of 2.27% glucose dialysate per day (poor UF capacity group), and patients who used three to four exchanges of 1.36% glucose dialysate per day (good UF capacity group) to achieve adequate amount of peritoneal fluid removal were included in the present analysis. All included patients were asked to record appropriately their dialysis exchanges for the assessment of their peritoneal fluid transport characteristics. Seventeen continuous ambulatory peritoneal dialysis patients were selected in the present study, nine in poor UF capacity group and eight in good UF capacity group. Patients in poor UF capacity group had significantly higher daily glucose exposure, higher dialysate-to-plasma ratio of creatinine (D/P creatinine) values, and higher peritoneal fluid absorption rate, K(e), as compared to patients with good UF capacity. Our results suggest that patients with poor UF capacity have significant higher peritoneal small solute transport rate, and more importantly, higher peritoneal fluid absorption rate as compared to patients with good UF capacity.

  12. Pleiotrophin triggers inflammation and increased peritoneal permeability leading to peritoneal fibrosis.

    PubMed

    Yokoi, Hideki; Kasahara, Masato; Mori, Kiyoshi; Ogawa, Yoshihisa; Kuwabara, Takashige; Imamaki, Hirotaka; Kawanishi, Tomoko; Koga, Kenichi; Ishii, Akira; Kato, Yukiko; Mori, Keita P; Toda, Naohiro; Ohno, Shoko; Muramatsu, Hisako; Muramatsu, Takashi; Sugawara, Akira; Mukoyama, Masashi; Nakao, Kazuwa

    2012-01-01

    Long-term peritoneal dialysis induces peritoneal fibrosis with submesothelial fibrotic tissue. Although angiogenesis and inflammatory mediators are involved in peritoneal fibrosis, precise molecular mechanisms are undefined. To study this, we used microarray analysis and compared gene expression profiles of the peritoneum in control and chlorhexidine gluconate (CG)-induced peritoneal fibrosis mice. One of the 43 highly upregulated genes was pleiotrophin, a midkine family member, the expression of which was also upregulated by the solution used to treat mice by peritoneal dialysis. This growth factor was found in fibroblasts and mesothelial cells within the underlying submesothelial compact zones of mice, and in human peritoneal biopsy samples and peritoneal dialysate effluent. Recombinant pleiotrophin stimulated mitogenesis and migration of mouse mesothelial cells in culture. We found that in wild-type mice, CG treatment increased peritoneal permeability (measured by equilibration), increased mRNA expression of TGF-β1, connective tissue growth factor and fibronectin, TNF-α and IL-1β expression, and resulted in infiltration of CD3-positive T cells, and caused a high number of Ki-67-positive proliferating cells. All of these parameters were decreased in peritoneal tissues of CG-treated pleiotrophin-knockout mice. Thus, an upregulation of pleiotrophin appears to play a role in fibrosis and inflammation during peritoneal injury.

  13. 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

  14. Relation of demographic, clinic and biochemical parameters to peritonitis in peritoneal dialysis.

    PubMed

    Dogan, Sevel; Ekiz, Serpil; Yucel, Lamia; Ozturk, Savas; Kazancioglu, Rumeyza

    2008-03-01

    The relation of various demographic, clinical and biochemical parameters of peritoneal dialysis patients with peritonitis and other infections was evaluated. The age, gender, peritoneal dialysis (PD) period, educational status, peritonitis, exit site score, serum albumin, C-reactive protein (CRP), and triglyceride levels at the beginning and the last visit were recorded. Mean age of 32 patients was 45.1 years; PD period was 13.1 months. Albumin level was inversely proportional to the frequency of peritonitis. Patients with peritonitis had albumin levels that were lower at the last visit, and were independent of the CRP values at the start of PD and during follow-up. Significant correlation was detected between females and exit site scores. There was significant correlation between educational status and peritonitis. Albumin level at first visit was a factor that reduced the likelihood of peritonitis, and low levels obtained during follow-up constituted a risk for peritonitis. It was also shown that peritonitis risk tended to decrease inversely with education level.

  15. Outcomes of Peritonitis in Children on Peritoneal Dialysis: A 25-Year Experience at Severance Hospital

    PubMed Central

    Lee, Kyong Ok; Park, Se Jin; Kim, Ji Hong; Lee, Jae Seung; Kim, Pyung Kil

    2013-01-01

    Purpose Relatively little is known on the microbiology, risk factors and outcomes of peritoneal dialysis (PD)-associated peritonitis in Korean children. We performed this study in order to evaluate the incidence, treatment and clinical outcomes of peritonitis in pediatric PD patients at Severance Hospital. Materials and Methods We analyzed data from 57 PD patients younger than 18 years during the period between June 1, 1986 and December 31, 2011. The collected data included gender, age at commencement of PD, age at peritonitis, incidence of peritonitis, underlying causes of end stage renal disease, microbiology of peritonitis episodes, antibiotics sensitivity, modality and outcomes of PD. Results We found 56 episodes of peritonitis in 23 of the 57 PD patients (0.43 episodes/patient-year). Gram-positive bacteria were the most commonly isolated organisms (40 episodes, 71.4%). Peritonitis developed in 17 patients during the first 6 months following initiation of PD (73.9%). Peritonitis episodes rarely resulted in relapse or the need for permanent hemodialysis and no patient deaths were directly attributable to peritonitis. Antibiotic regimens included cefazolin+tobramycin from the years of 1986 to 2000 and cefazolin+ceftazidime from the years of 2001 to 2011. While antibiotic therapy was successful in 48 episodes (85.7%), the treatment was ineffective in 8 episodes (14.3%). The rate of continuous ambulatory PD (CAPD) peritonitis was statistically higher than that of automated PD (APD) (p=0.025). Conclusion Peritonitis was an important complication of PD therapy and we observed a higher incidence of PD peritonitis in patients with CAPD when compared to APD. PMID:23709435

  16. The Natural Time Course of Membrane Alterations During Peritoneal Dialysis Is Partly Altered by Peritonitis.

    PubMed

    van Esch, Sadie; Struijk, Dirk G; Krediet, Raymond T

    2016-01-01

    ♦ The quality of the peritoneal membrane can deteriorate over time. Exposure to glucose-based dialysis solutions is the most likely culprit. Because peritonitis is a common complication of peritoneal dialysis (PD), distinguishing between the effect of glucose exposure and a possible additive effect of peritonitis is difficult. The aim of the present study was to compare the time-course of peritoneal transport characteristics in patients without a single episode of peritonitis-representing the natural course-and in patients who experienced 1 or more episodes of peritonitis during long-term follow-up. ♦ This prospective, single-center cohort study enrolled incident adult PD patients who started PD during 1990-2010. A standard peritoneal permeability analysis was performed in the first year of PD treatment and was repeated every year. The results in patients without a single episode of peritonitis ("no-peritonitis group") were compared with the results obtained in patients who experienced 1 or more peritonitis episodes ("peritonitis group") during a follow-up of 4 years. ♦ The 124 patients analyzed included 54 in the no-peritonitis group and 70 in the peritonitis group. The time-course of small-solute transport was different in the groups, with the peritonitis group showing an earlier and more pronounced increase in the mass transfer area coefficient for creatinine (p = 0.07) and in glucose absorption (p = 0.048). In the no-peritonitis group, the net ultrafiltration rate (NUFR) and the transcapillary ultrafiltration rate (TCUFR) both showed a steep increase from the 1st to the 2nd year of PD that was absent in the peritonitis group. Both groups showed a decrease in the NUFR after year 3. A decrease in the TCUFR occurred only in the peritonitis group. That decrease was already present after the year 1 in patients with severe peritonitis. The time-course of free water transport showed a continuous increase in the patients without peritonitis, but a decrease in the

  17. Black macular patches on parietal peritoneum and other extraintestinal sites from intraperitoneal spillage and spread of India ink from preoperative endoscopic tattooing: an endoscopic, surgical, gross pathologic, and microscopic study.

    PubMed

    Cappell, Mitchell S; Courtney, James T; Amin, Mitual

    2010-09-01

    Three cases, including one case report and two clinical images, have been reported of extraintestinal or peritoneal black maculae detected at laparoscopy after colonoscopic tattooing, presumably from intraperitoneal spillage of India ink during tattooing. Report three cases of inadvertent extraintestinal tattooing from endoscopic tattooing of intestinal lesions, provide histologic evidence for the presumed pathophysiology, and promulgate recommendations to prevent this complication. Three patients underwent endoscopic tattooing of intestinal lesions using India ink, surgery for lesion removal, and pathologic analysis. Three patients had black macular patches or streaks identified intraoperatively at extraintestinal sites after endoscopic tattooing of intestinal lesions with India ink: (1) black patches on peritoneum 7 days after colonoscopic tattooing of cecal cancer, (2) black streaks on band connecting cecum to peritoneum 13 days after colonoscopic tattooing of cecal cancer, and (3) blackish band on jejunal mesentery 28 days after tattooing presumptive bleeding jejunal lesion. Pigmentation was detected at both injection and extraintestinal sites in all patients by (1) surgery, (2) gross pathology, and (3) microscopic examination demonstrating intracellular black pigmentation within mesothelial cells and macrophages. Special histologic stains were consistent with a carbon-based pigment, and inconsistent with iron or melanin as the pigment. The proposed mechanism is intraperitoneal India ink spillage from deep intestinal injection, as supported by histologic findings of subserosal pigment accumulation. An alternative histologic mechanism is migration of pigment-laden macrophages via lymphovascular channels. Endoscopic injection of India ink using standard sclerotherapy needles can inadvertently tattoo extraintestinal sites in addition to tattooing the primary lesion. Despite its striking appearance, this intraoperative, gross, and microscopic finding is likely not

  18. Palmar herald patch in pityriasis rosea.

    PubMed

    Polat, Mualla; Yildirim, Yasemin; Makara, Anil

    2012-08-01

    Pityriasis rosea is an acute self-limited inflammatory disorder of the skin. The initial clinical features of typical cases are the appearance of a herald patch. The herald patch is commonly located on the thigh, upper arm, trunk or neck; rarely the patch may be on the face, scalp or penis. There are no reports of a palmar herald patch in pityriasis rosea. In this article we present a 14-year-old male patient who had a palmar herald patch with truncal lesions of pityriasis rosea. © 2012 The Authors. Australasian Journal of Dermatology © 2012 The Australasian College of Dermatologists.

  19. Improved method for bacteriological diagnosis of spontaneous bacterial peritonitis.

    PubMed Central

    Bobadilla, M; Sifuentes, J; Garcia-Tsao, G

    1989-01-01

    The definitive diagnosis of spontaneous bacterial peritonitis is made by a positive ascitic fluid culture. Causative organisms cannot be isolated in up to 65% of patients with well-defined spontaneous bacterial peritonitis, probably due to inadequate ascites culture techniques. We prospectively compared two ascites culture methods: conventional (on chocolate agar and thioglycolate broth) and modified (inoculation of 10 ml of ascites in a tryptic soy broth blood culture bottle at the patient's bedside). In a 10-month period, 31 cirrhotic patients met our diagnostic criteria for spontaneous bacterial peritonitis; both culture methods were performed on their ascitic fluid. The conventional method grew bacteria in only 16 of the 31 episodes (52%), whereas the modified method grew bacteria in 25 (81%), a significantly higher sensitivity (P less than 0.05). The modified method also shortened significantly the time for detection of bacterial growth. We conclude that ascites inoculation into a blood culture bottle at the patient's bedside should be the routine method for ascites culture. PMID:2685014

  20. Patching. Restitching business portfolios in dynamic markets.

    PubMed

    Eisenhardt, K M; Brown, S L

    1999-01-01

    In turbulent markets, businesses and opportunities are constantly falling out of alignment. New technologies and emerging markets create fresh opportunities. Converging markets produce more. And of course, some markets fade. In this landscape of continuous flux, it's more important to build corporate-level strategic processes that enable dynamic repositioning than it is to build any particular defensible position. That's why smart corporate strategists use patching, a process of mapping and remapping business units to create a shifting mix of highly focused, tightly aligned businesses that can respond to changing market opportunities. Patching is not just another name for reorganizing; patchers have a distinctive mindset. Traditional managers see structure as stable; patching managers believe structure is inherently temporary. Traditional managers set corporate strategy first, but patching managers keep the organization focused on the right set of business opportunities and let strategy emerge from individual businesses. Although the focus of patching is flexibility, the process itself follows a pattern. Patching changes are usually small in scale and made frequently. Patching should be done quickly; the emphasis is on getting the patch about right and fixing problems later. Patches should have a test drive before they're formalized but then be tightly scripted after they've been announced. And patching won't work without the right infrastructure: modular business units, fine-grained and complete unit-level metrics, and companywide compensation parity. The authors illustrate how patching works and point out some common stumbling blocks.

  1. "Patch"ing up our tumor signaling knowledge.

    PubMed

    Atwood, Scott X; Whitson, Ramon J; Oro, Anthony E

    2013-05-01

    The tumor suppressor Patched1 (Ptch1) possesses well-described roles in regulating sonic hedgehog (SHH) signaling in the skin and preventing the formation of basal cell carcinomas (BCCs). In this issue, Kang et al. extend their previous work to show that a naturally occurring allele of Ptch1 found in FVB mice promotes early squamous cell carcinoma (SCC) growth without aberrant activation of the SHH pathway. The study reveals new roles for Ptch1 that lie at the nexus between BCC and SCC formation.

  2. Analysis of Stub Loaded Microstrip Patch Antennas

    NASA Technical Reports Server (NTRS)

    Bailey, M. C.; Deshpande, M. D.

    1997-01-01

    A microstrip patch antenna fed by a coaxial probe and reactively loaded by a open circuited microstrip line has been used previously to produce circular polarization[ l] and also as a building block for a series fed microstrip patch array [2]. Rectangular and circular patch antennas loaded with a microstrip stub were previously analyzed using the generalized Thevenin theorem [2,3]. In the Thevenin theorem approach, the mutual coupling between the patch current and the surface current on the stub was not taken into account. Also, the Thevenin theorem approach neglects continuity of current at the patch-stub junction. The approach in this present paper includes the coupling between the patch and stub currents as well as continuity at the patch-stub junction.

  3. SAHA Suppresses Peritoneal Fibrosis in Mice

    PubMed Central

    Io, Kumiko; Nishino, Tomoya; Obata, Yoko; Kitamura, Mineaki; Koji, Takehiko; Kohno, Shigeru

    2015-01-01

    ♦ Objective: Long-term peritoneal dialysis causes peritoneal fibrosis in submesothelial areas. However, the mechanism of peritoneal fibrosis is unclear. Epigenetics is the mechanism to induce heritable changes without any changes in DNA sequences. Among epigenetic modifications, histone acetylation leads to the transcriptional activation of genes. Recent studies indicate that histone acetylation is involved in the progression of fibrosis. Therefore, we examined the effect of suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor, on the progression of peritoneal fibrosis in mice. ♦ Methods: Peritoneal fibrosis was induced by the injection of chlorhexidine gluconate (CG) into the peritoneal cavity of mice every other day for 3 weeks. SAHA, or a dimethylsulfoxide and saline vehicle, was administered subcutaneously every day from the start of the CG injections for 3 weeks. Morphologic peritoneal changes were assessed by Masson’s trichrome staining, and fibrosis-associated factors were assessed by immunohistochemistry. ♦ Results: In CG-injected mice, a marked thickening of the submesothelial compact zone was observed. In contrast, the administration of SAHA suppressed the progression of submesothelial thickening and type III collagen accumulation in CG-injected mice. The numbers of fibroblast-specific protein-1-positive cells and α-smooth muscle actin α-positive cells were significantly decreased in the CG + SAHA group compared to that of the CG group. The level of histone acetylation was reduced in the peritoneum of the CG group, whereas it was increased in the CG + SAHA group. ♦ Conclusions: Our results indicate that SAHA can suppress peritoneal thickening and fibrosis in mice through up-regulation of histone acetylation. These results suggest that SAHA may have therapeutic potential for treating peritoneal fibrosis. PMID:24584598

  4. The truth on current peritoneal dialysis: state of the art.

    PubMed

    Krediet, R T; Abrahams, A C; de Fijter, C W H; Betjes, M G H; Boer, W H; van Jaarsveld, B C; Konings, C J A M; Dekker, F W

    2017-06-01

    The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased markedly in the Netherlands in the last 15 years. Consequently, the knowledge of nephrologists and nursing staff on PD has declined leading to a negative spiral in which loss of experience resulted in loss of enthusiasm to offer PD to patients and also in less interest in the new PD developments. All these changes took place while the results of PD improved and patient survival was at least similar to that on haemodialysis. The aim of this review is first to give a summary of the principles and practice of patient and staff education and to describe the role of the medical contribution in decision-making. On this basis, the second aim is to update internist-nephrologists on a number of issues that have been underexposed in the past. Recent patient and technique survival data of PD patients is reviewed, and also the new insights into dialysis adequacy. The presence of residual renal function is the main determinant of patient survival together with prevention of overhydration. Urea and creatinine removal are not important at all when patients are still passing urine. Many early problems with PD are due to the peritoneal catheter and suggestions are made for improvement of its function. The prevention and management of infections is reviewed, and also the regular assessment of peritoneal function. Free water transport is a predictor of encapsulating peritoneal sclerosis (EPS), which should be assessed regularly. The pathogenesis of EPS, treatment and the decreasing incidence are discussed.

  5. Mycobacterium fortuitum peritonitis in peritoneal dialysis and its effects on the peritoneum.

    PubMed

    Zewinger, Stephen; Meier, Clemens-Magnus; Fliser, Danilo; Klingele, Matthias

    2014-11-01

    Mycobacterium fortuitum peritonitis is a rare complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). A 47-year-old patient was admitted to our tertiary hospital because of culture-negative peritonitis with persisting signs of infection despite adequate empirical antibiotic treatment. Although M. fortuitum was detected and the antibiotic regime subsequently amended, catheter removal was inevitable and the dialysis modality converted to hemodialysis (HD). After long-term antibiotic treatment and an additional latency of 4 months without signs of residual infection, reinitiation of CAPD was planned. Explorative laparoscopy prior to catheter reinsertion revealed multiple adhesions within the peritoneal cavity, preventing adequate catheter function. The clinical course of M. fortuitum peritonitis, the need for catheter removal and the description of peritoneal changes are discussed regarding to recent literature.

  6. Peritoneal Dialysis Can Be an Option for Dominant Polycystic Kidney Disease: an Observational Study.

    PubMed

    Janeiro, Darío; Portolés, Jose; Tato, Ana María; López-Sánchez, Paula; Del Peso, Gloria; Rivera, Maite; Castellano, Inés; Fernández-Reyes, Maria J; Pérez-Gómez, Vanessa; Ortega, Mayra; Martínez-Miguel, Patricia; Felipe, Carmen; Caparrós, Guadalupe; Ortiz, Alberto; Selgas, Rafael

    2015-01-01

    Autosomal dominant polycystic kidney disease (ADPKD) has been considered a relative contraindication for peritoneal dialysis (PD), although there are few specific studies available. A multicenter historical prospective matched-cohort study was conducted to describe the outcome of ADPKD patients who have chosen PD. All ADPKD patients starting PD (n = 106) between January 2003 and December 2010 and a control group (2 consecutive patients without ADPKD) were studied. Mortality, PD-technique failure, peritonitis, abdominal wall leaks and cyst infections were compared. Patients with ADPKD had similar age but less comorbidity at PD inclusion: Charlson comorbidity index (CCI) 4.3 (standard deviation [SD] 1.6) vs 5.3 (SD 2.5) p < 0.001, diabetes mellitus 5.7% vs 29.2%, p < 0.001 and previous cardiovascular events 10.4% vs 27.8%, p < 0.001. No differences were observed in clinical events that required transient transfer to hemodialysis, nor in peritoneal leakage episodes or delivered dialysis dose. The cyst infection rate was low (0.09 episodes per patient-year) and cyst infections were not associated to peritonitis episodes. Overall technique survival was similar in both groups. Permanent transfer to hemodialysis because of surgery or peritoneal leakage was more frequent in ADPKD. More ADPKD patients were included in the transplant waiting list (69.8 vs 58%, p = 0.04) but mean time to transplantation was similar (2.08 [1.69 - 2.47] years). The mortality rate was lower (2.5 vs 7.6 deaths/100 patient-year, p = 0.02) and the median patient survival was longer in ADPKD patients (6.04 [5.39 - 6.69] vs 5.57 [4.95 - 6.18] years, p = 0.024). Peritoneal dialysis is a suitable renal replacement therapy option for ADPKD patients. Copyright © 2015 International Society for Peritoneal Dialysis.

  7. Multicystic peritoneal mesothelioma: report of three cases.

    PubMed

    Charfi, S; Chetaille, B; Marcy, M; Turrini, O; Chaise De Maison, C; Delpero, J R; Viret, F; Xerri, L; Monges, G

    2008-10-01

    Multicystic peritoneal mesothelioma is a rare lesion occurring mainly in women in a reproductive age. Its pathogenesis is unclear. We report three cases of multicystic peritoneal mesothelioma in patients that were 28, 38 and 47 years of age (one male, two females). A history of abdominal surgery was reported in two cases. Explorative laparotomy was presumptive of a pseudomyxoma peritoni in two cases, and hyperthermic intraperitoneal chemotherapy was performed. Histological examination demonstrated multicystic lesions with mesothelial cells lining confirmed by immunohistochemical analysis. Unusual findings such as hyperplasia, hobnail features, cytoplasmic vacuolisation and papillary pattern were occasionally noted. The clinical presentation, pathogenesis and pathologic features including differential diagnosis of multicystic peritoneal mesothelioma are discussed.

  8. [Results of noxythiolin use in acute peritonitis].

    PubMed

    Migliori, G; Codinach, F; Marsan, A; Inglésakis, J A

    1978-01-01

    The authors present a series of 30 cases of acute supra- and inframesocolic peritonitis which, in addition to the treatment of their organic causes, benefitted from medical treatment by noxythioline, used as a peritoneal lavage, an irrigation with aspiration, or an instillation. A marked amelioration in the postoperative course was noted, particularly in those cases with infra-mesocolic peritonitis, with the absence of adhesions and suppurative collections on reintervention, and a rapid return to negativity of the positive bacteriological investigations performed systematically on the pe ritoneal fluid and on the drainage.

  9. [The specific nutritionnal care in peritoneal dialysis].

    PubMed

    Castrale, Cindy; Azar, Raymond; Piquet, Marie-Astrid; Lobbedez, Thierry

    2016-07-01

    Protein energy wasting is a major complication in peritoneal dialysis. It is leading to a poor quality of life and increasing mortality. Diagnosis must be early, according to criteria defined by the International society of renal nutrition and metabolism. It is necessary to appropriate the diagnostic tools with dialysis method. The nutritional care is difficult in peritoneal dialysis. Indeed, studies are limited and practical nutrition is complex. In this point of view, we propose to treat guidelines for protein energy wasting, in peritoneal dialysis patients. Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  10. 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.

  11. Single-Layer, All-Metal Patch Antenna Element with Wide Bandwidth

    NASA Technical Reports Server (NTRS)

    Chamberlain, Neil F.; Hodges, Richard E.; Zawardzki, Mark S.

    2012-01-01

    It is known that the impedance at the center of a patch antenna element is a short circuit, implying that a wire or post can be connected from the patch to the groundplane at this point without impacting radiation performance. In principle, this central post can be used to support the patch element, thus eliminating the need for dielectric. In spaceborne applications, this approach is problematic because a patch element supported by a single, thin post is highly susceptible to acoustic loads during launch. The technology reported here uses a large-diameter center post as its supporting structure. The supporting structure allows for the fabrication of a sufficiently rigid antenna element that can survive launch loads. The post may be either hollow or solid, depending on fabrication approach and/or mass constraints. The patch antenna element and support post are envisioned as being fabricated (milled) from a single piece of aluminum or other metal. Alternately, the patch plate and support column can be fabricated separately and then joined using fasteners, adhesive, or welding. Casting and electroforming are also viable techniques for manufacturing the metal patch part(s). The patch structure is then either bonded or fastened to the supporting groundplane. Arrays of patch elements can be fabricated by attaching several structures to a common groundplane/support structure.

  12. Ultrasound/fluoroscopy-assisted placement of peritoneal dialysis catheters.

    PubMed

    Maya, Ivan D

    2007-01-01

    Peritoneal dialysis (PD) catheters may be inserted blindly, surgically, and either by laparoscopic, peritoneoscopic, or fluoroscopic approach. A modified fluoroscopic technique by adding ultrasound-assistance was performed in the present study to ensure entry into the abdominal cavity under direct ultrasound visualization. From March 2005 to May 2007, ultrasound-fluoroscopic guided placement of PD catheters was attempted in 32 end-stage renal disease (ESRD) patients. Preoperative evaluation was performed on all patients prior to the procedure. After initial dissection of the subcutaneous tissue anterior to the anterior rectus sheath, the needle was inserted into the abdominal cavity under the guidance of ultrasound. The position of the epigastric artery was also examined using ultrasonography to avoid the risk of arterial injury. PD catheters were successfully placed in 31 of the 32 ESRD patients using this technique. In all of these patients, the needle could be seen entering the abdominal cavity using an ultrasound. In one patient the procedure was abandoned because of bowel puncture by the micro-puncture needle that was inadvertently advanced into a loop of bowel. This patient did not develop acute abdomen nor needed any intervention. One patient died 4 days after placement of the catheter of unrelated causes. One patient was started on acute peritoneal dialysis the same day of catheter placement without any complications. The rest of the patients started peritoneal dialysis within 2-6 weeks of catheter placement. None of the patients had bleeding related to arterial injury as ultrasound was able to visualize the epigastric artery. Our experience shows that ultrasound-fluoroscopic technique is minimally invasive and allows for accurate assessment of the entry into the abdominal cavity. This technique can avoid the risk of vascular injury altogether.

  13. A Rare Case of Peritoneal Dialysis-Associated Peritonitis with Sphingomonas koreensis.

    PubMed

    Wallner, Julia; Frei, Reno; Burkhalter, Felix

    2016-01-01

    Sphingomonas species are ubiquitous gram-negative, aerobic bacteria frequently found in aquatic environments such as drinking water and very seldom in hemodialysis fluids or supposedly sterile drug solutions. Human infections with the gram-negative Sphingomonas species are rare and peritonitis with these organisms even rarer. Here we report a case of polymicrobial peritonitis due to Sphingomonas koreensis and Escherichia coli in a patient undergoing peritoneal dialysis (PD).

  14. Genetic background of Escherichia coli isolates from peritoneal dialysis patients with peritonitis and uninfected control subjects.

    PubMed

    Li, Y F; Su, N; Chen, S Y; Hu, W X; Li, F F; Jiang, Z P; Yu, X Q

    2016-03-28

    Escherichia coli is the most common cause of Gram-negative peritonitis resulting in peritoneal function deterioration as well as poor clinical outcome in continuous ambulatory peritoneal dialysis (PD) patients. In this study, we analyzed the phylogenetic background and genetic profile of the E. coli isolates and sought to determine the characteristics of specific bacteria associated with peritonitis. E. coli isolates from 56 episodes of peritonitis in 46 PD patient cases and rectal isolates from 57 matched PD control patient cases were compared for both phylogenetic groups and the presence of virulence factors (VFs). There were no significant differences in terms of demographic data between the peritonitis and control groups. Peritonitis isolates exhibited a significantly greater prevalence of 8 VFs. In multivariate logistic regression analysis, kpsMT II (group 2 capsule synthesis) was the strongest VF predictor of peritonitis (OR = 8.02; 95%CI = 3.18-20.25; P < 0.001), followed by traT (serum-resistance-associated outer membrane protein) (OR = 3.83; 95%CI = 1.33-11.03; P = 0.013). The pathogenic groups of E. coli contained a higher concentration of individual VFs compared to the commensal groups. The prevalence of pathogenic E. coli was much higher in peritoneal isolates than rectal isolates (64.3 vs 31.6%, P = 0.001). Our results indicate that the E. coli peritonitis and rectal isolates are different in PD patients. The specific VFs associated with peritonitis isolates may directly contribute to the pathogenesis of peritonitis.

  15. A model of the peritoneal cavity for use in internal dosimetry

    SciTech Connect

    Watson, E.E.; Stabin, M.G.; Davis, J.L.; Eckerman, K.F. )

    1989-12-01

    Several therapeutic and diagnostic techniques involve injection of radioactive material into the peritoneal cavity. Estimation of the radiation dose to the surface of the peritoneum or to surrounding organs is hampered by the lack of a suitable source region in the phantom commonly used for such calculations. We have modified the Fisher-Snyder phantom to include a region representing the peritoneal cavity which may be employed to estimate such radiation doses. A geometric model is described which is coordinated with the existing organ regions in the phantom. Specific absorbed fractions (derived by Monte Carlo techniques) for photon emissions originating within the cavity are listed. Photon S-values for several radionuclides which have been administered intraperitoneally are shown. Dose conversion factors for electrons irradiating the peritoneal cavity wall, from either a thin plane or volume source of activity within the cavity, are also given for several nuclides.

  16. Slot-coupled patch antenna with coplanar waveguide feed

    NASA Technical Reports Server (NTRS)

    Lee, Richard Q.; Simons, Rainee N.

    1993-01-01

    Two slot-coupled feeding techniques for exciting a patch antenna with a coplanar waveguide (CPW) were experimentally investigated. In the first technique, a CPW with two notches on both sides of the slot lines is used to couple power to the antenna through a narrow rectangular slot. In the second technique, a grounded CPW with a series gap in the center strip conductor is used to couple power to the antenna through a 'dumbbell' slot. Results indicated that both techniques are feasible and yield high coupling efficiency.

  17. Tidal peritoneal dialysis: preliminary experience.

    PubMed

    Flanigan, M J; Doyle, C; Lim, V S; Ullrich, G

    1992-01-01

    To determine the feasibility of home tidal peritoneal dialysis (TPD) and to assess whether eight hours of TPD can achieve uremia control and urea removal equal to that of continuous cycling peritoneal dialysis (CCPD). An open enrollment pilot study. The Home Dialysis Training Center of the University of Iowa Hospitals and Clinics, a tertiary care teaching hospital. Nine patients experienced with CCPD and living 80 km to 280 km from the dialysis center began TPD, because they wished to decrease their dialysis time. Following baseline measurements, each patient was taught to perform TPD. TPD consisted of an initial fill volume of 40 mL/kg, a residual volume approximately 20 mL/kg, and tidal exchanges of 10 to 20 mL/kg to achieve the desired hourly flow rate. Clinic assessments took place every four to six weeks, and prescriptions were subsequently altered to attain urea removal equal to that of CCPD. Patient interviews were used to determine TPD acceptance. Prior to each clinic visit, dialysate effluent volume and dialysis duration were recorded, and a sterile sample of the effluent was obtained for urea, creatinine, and total nitrogen measurement. Urea and creatinine clearances increased with dialysate flow. Dialysate nonurea nitrogen was 3.0 +/- 0.2 mmol/kg/D and changed minimally with increasing dialysate volumes. Eight hours of TPD (initial fill: 40 mL/kg; residual volume: 20 mL/kg; tidal inflow: 20 mL/kg) with hourly tidal flow exceeding 40 mL/kg/hr and no daytime volume achieved urea removal equal to that of the patient's prior CCPD prescription. TPD can provide dialysis equal to that of CCPD within a shorter amount of time (eight vs ten hours), but uses a greater volume of dialysate (16.0 L for TPD vs 9.5 L for CCPD).

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

    ClinicalTrials.gov

    2017-05-31

    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

  19. Polymicrobial outbreak of intermittent peritoneal dialysis peritonitis during external wall renovation at a dialysis center.

    PubMed

    Cheng, V C; Lo, W K; Woo, P C; Chan, S B; Cheng, S W; Ho, M; Yuen, K Y

    2001-01-01

    To investigate an outbreak of peritonitis in intermittent peritoneal dialysis (IPD) patients. An outbreak investigation was performed to identify the etiology of the polymicrobial outbreak, and a retrospective case-control study was conducted to assess the risk factors for development of peritonitis. Renal dialysis center. Ten episodes of peritonitis occurred in 8 of 61 patients over a 6-month period in which 669 IPD procedures were analyzed. Field visit to renal dialysis center to examine the entire IPD procedure, inspect the hospital environment, and perform air bacterial count. The environmental factors and risk factors contributing to the polymicrobial peritonitis outbreak in IPD patients. The incidence of IPD peritonitis was determined before and after interventions. The causative organisms included Acinetobacter baumanii (6), Stenotrophomonas maltophilia (2), Pseudomonas aeruginosa (1), Candida albicans (1), C. tropicalis (1), Enterococcus (3), and Enterobacteriaceae (2). Four episodes of peritonitis involved infection by more than one organism. Air sampling of the environment detected a median of 110 colony forming units of bacteria per cubic meter of air, 10% of which were found to be Acinetobacter baumanii. The source of this polymicrobial outbreak was attributed to the bamboo scaffolding structure covering the external wall of the hospital during renovation. A retrospective case-control study indicated that the absence of the flush-before-fill step was a risk factor for development of peritonitis. In addition to invasive aspergillosis in transplant or oncology patients, Acinetobacter peritonitis in dialysis patients should be considered another microbial cause of outbreak associated with hospital renovation.

  20. Campylobacter jejuni: A rare agent in a child with peritoneal dialysis-related peritonitis.

    PubMed

    Tural Kara, Tugce; Yilmaz, Songul; Ozdemir, Halil; Birsin Ozcakar, Zeynep; Derya Aysev, Ahmet; Ciftci, Ergin; Ince, Erdal

    2016-10-01

    La peritonitis es un problema grave en los niños que reciben diálisis peritoneal. La bacteria Campylobacter jejuni es una causa infrecuente de peritonitis. Un niño de 10 años de edad con insuficiencia renal terminal causada por síndrome urémico hemolítico atípico ingresó a nuestro hospital con dolor abdominal y fiebre. El líquido de la diálisis peritoneal era turbio; en el examen microscópico se observaron leucocitos abundantes. Se inició tratamiento con cefepime intraperitoneal. En el cultivo del líquido peritoneal se aisló Campylobacter jejuni, por lo que se agregó claritromicina oral al tratamiento. Al finalizar el tratamiento, el resultado del cultivo del líquido peritoneal era negativo. Hasta donde sabemos, no se había informado previamente peritonitis por C. jejuni en niños. Conclusión. Si bien la peritonitis por C. jejuni es rara en los niños, debe considerarse como factor etiológico de la peritonitis.

  1. Peritoneal Protein Clearance Rather than Faster Transport Status Determines Outcomes in Peritoneal Dialysis Patients

    PubMed Central

    Rajakaruna, Gayathri; Caplin, Ben; Davenport, Andrew

    2015-01-01

    Faster peritoneal transport has been associated with an increased risk of therapy failure and patient mortality. However, faster transport can the result of many factors. Peritoneal protein clearance (PPC) has been proposed to distinguish faster peritoneal transport attributable to inflammatory conditions, as protein clearance reflects large-pore flow, which increases during inflammation. We followed a cohort of 300 peritoneal dialysis patients, and after adjustments for age and comorbidity, higher PPC was associated with increased risk of death (hazard ratio: 1.81; 95% confidence interval: 1.11 to 2.95), even after patients underwent transplantation or transferred to hemodialysis. PMID:25082839

  2. 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

  3. [Peritoneal blood flow and peritoneal transfer parameters during intermittent peritoneal dialyses performed with administration of sodium nitroprusside or chlorpromazine].

    PubMed

    Grzegorzewska, A; Barcz, M; Kriczi, M; Antoniewicz, K

    1996-01-01

    Effective peritoneal capillary blood flow (EPBF) was evaluated by calculation of diffusive mass transport coefficient of CO2 during intermittent peritoneal dialysis performed with intraperitoneal administration of sodium nitroprusside (NP, 5 mg/l of dialysis solution) or chlorpromazine (Cl-Prom, 2.5 mg/l of dialysis solution). Peritoneal transfer rates of substances of different molecular size and charge were simultaneously examined and compared with EPBF. During NP or Cl-Prom administration, EPBF was respectively 220 +/- 40 (n = 11) and 224 +/- 29 (n = 10) ml/min. These values were insignificantly higher than those obtained during dialyses without drugs (169 +/- 16 ml/min, n = 10). NP and Cl-Prom did not cause any significant changes in peritoneal transfer of CO2. Transfer rates of HCO3 and tCO2 were increased only with NP. Both drugs enhanced peritoneal removal of Na+, K+, urea, uric acid and total protein, but with similar EPBF during the use of both drugs, the effect of NP was more pronounced. The obtained results indicate that EPBF is not a major factor responsible for enhanced peritoneal transfer rates during dialyses performed with NP or Cl-Prom.

  4. Q&A: using Patch-seq to profile single cells.

    PubMed

    Cadwell, Cathryn R; Sandberg, Rickard; Jiang, Xiaolong; Tolias, Andreas S

    2017-07-06

    Individual neurons vary widely in terms of their gene expression, morphology, and electrophysiological properties. While many techniques exist to study single-cell variability along one or two of these dimensions, very few techniques can assess all three features for a single cell. We recently developed Patch-seq, which combines whole-cell patch clamp recording with single-cell RNA-sequencing and immunohistochemistry to comprehensively profile the transcriptomic, morphologic, and physiologic features of individual neurons. Patch-seq can be broadly applied to characterize cell types in complex tissues such as the nervous system, and to study the transcriptional signatures underlying the multidimensional phenotypes of single cells.

  5. 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.

  6. A spectrum domain analysis for the microstrip patch antenna loaded by conducting posts

    NASA Astrophysics Data System (ADS)

    Zhang, W.-X.; Cheng, C.-H.

    Some samples of microstrip patch antennas, loaded or unloaded, with rectangular or equilateral triangle patches are analyzed and computed using the moment method and the spectrum domain method (SDM). A flexible technique for using SDM to analyze a perpendicular current in layered structures is introduced, and an integration technique to improve the convergence is suggested. The results show that loading posts cause a decrease rather than an increase in the resonant frequency.

  7. Design and fabrication of a planar patch-clamp substrate using a silicon-on-insulator wafer

    NASA Astrophysics Data System (ADS)

    Zhenlong, Zhang; Xiangyang, Liu; Yanli, Mao

    2009-09-01

    The planar patch-clamp technique has been applied to high throughput screening in drug discovery. The key feature of this technique is the fabrication of a planar patch-clamp substrate using appropriate materials. In this study, a planar patch-clamp substrate was designed and fabricated using a silicon-on-insulator (SOI) wafer. The access resistance and capacitance of SOI-based planar patch-clamp substrates are smaller than those of bulk silicon-based planar substrates, which will reduce the distributed RC noise.

  8. Exp 41 Patch - Final Approved

    NASA Image and Video Library

    2013-05-14

    ISS041-S-001 (July 2013) --- The Expedition 41 crew members have released their patch and have written some text to go along with it: ?Portraying the road of human exploration into our vastly unknown universe, all elements of the Expedition 41 patch build from the foundation, our Earth, to the stars beyond our solar system. The focus of our six-month expedition to the International Space Station (ISS) is Earth and its inhabitants as well as a scientific look out into our universe. The distinguishing ISS solar arrays reach onward and serve as the central element, with the icon of an atom underneath representing the multitude of research onboard that will bring new discoveries for the benefit of humanity. The sun is rising over Earth?s horizon, spreading its light along the road of human exploration. Equipped with the knowledge and inspiration gained from ISS, our successful multinational cooperation will lead human space exploration to the moon, Mars, and ultimately, the stars. We are Expedition 41. Join us for the adventure.? Photo credit: NASA Note: The NASA insignia design for shuttle and space station flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the form of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, it will be publicly announced.

  9. STS_134_patch_OL

    NASA Image and Video Library

    2010-03-09

    STS134-S-001 (March 2010) --- The design of the STS-134 crew patch highlights research on the International Space Station (ISS) focusing on the fundamental physics of the universe. On this mission, the crew of the space shuttle Endeavour will install the Alpha Magnetic Spectrometer (AMS) experiment - a cosmic particle detector. By studying subatomic particles in the background cosmic radiation and searching for antimatter, dark-matter, and dark energy, it will help scientists better understand the evolution and properties of our universe. The shape of the patch is inspired by the international atomic symbol, and represents the atom with orbiting electrons around the nucleus. The burst near the center refers to the origin of the universe. The space shuttle Endeavour and ISS fly together into the sunrise over the limb of the Earth, representing the dawn of a new age?understanding the nature of the universe. The NASA insignia design for space shuttle flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced. Photo credit: NASA

  10. Hospitalization Rates for Patients on Assisted Peritoneal Dialysis Compared with In-Center Hemodialysis

    PubMed Central

    Al-Jaishi, Ahmed A.; Dixon, Stephanie N.; Perl, Jeffrey; Jain, Arsh K.; Lavoie, Susan D.; Nash, Danielle M.; Paterson, J. Michael; Lok, Charmaine E.; Quinn, Robert R.

    2016-01-01

    peritoneal dialysis who experienced peritonitis and technique failure had high rates of hospitalization. PMID:27464838

  11. [Unusual location of peritoneal inclusion cysts].

    PubMed

    Fronticelli Baldelli, C M; Seghesio, R M; Giaccone, M; Scuderi, S; Senetta, R

    2009-10-01

    The peritoneal inclusion cyst is a rare, probably congenital, pathology of the mesothelium that develops on coelomatic residues. A case is reported of an unusual location of peritoneal cyst, in which the increase in volume, associated with the patient's concern and the presumed anatomic site of the lesion led to its removal by the laparoscopic route. The type of location and the relative inaccuracy of preoperative imaging are discussed.

  12. Malignant peritoneal mesothelioma after remote abdominal radiation

    SciTech Connect

    Gilks, B.; Hegedus, C.; Freeman, H.; Fratkin, L.; Churg, A.

    1988-05-15

    Peritoneal mesothelioma in a 61-year-old man, occurred 26 years after abdominal radiotherapy for a testicular seminoma. The patient had no history of asbestos exposure. After asbestos, radiation is the second most frequent defined cause of mesothelioma in North America, but the number of well-documented cases is small; this case represents only the fifth example of peritoneal mesothelioma after therapeutic irradiation of the abdomen. 16 references.

  13. Nebivolol, a β1-adrenergic blocker, protects from peritoneal membrane damage induced during peritoneal dialysis

    PubMed Central

    Abensur, Hugo; Albar-Vizcaino, Patricia; Parra, Emilio González; Sandoval, Pilar; Ramírez, Laura García; del Peso, Gloria; Acedo, Juan Manuel; Bajo, María A.; Selgas, Rafael; Tomero, José A. Sánchez; López-Cabrera, Manuel; Aguilera, Abelardo

    2016-01-01

    Peritoneal dialysis (PD) is a form of renal replacement treatment, which employs the peritoneal membrane (PM) to eliminate toxins that cannot be removed by the kidney. The procedure itself, however, contributes to the loss of the PM ultrafiltration capacity (UFC), leading consequently to the technique malfunction. β-blockers have been considered deleterious for PM due to their association with loss of UFC and induction of fibrosis. Herein we analyzed the effects of Nebivolol, a new generation of β1-blocker, on PM alterations induced by PD fluids (PDF). In vitro: We found that mesothelial cells (MCs) express β1-adrenergic receptor. MCs were treated with TGF-β to induce mesothelial-to-mesenchymal transition (MMT) and co-treated with Nebivolol. Nebivolol reversed the TGF-β effects, decreasing extracellular matrix synthesis, and improved the fibrinolytic capacity, decreasing plasminogen activator inhibitor-1 (PAI-1) and increasing tissue-type plasminogen activator (tPA) supernatant levels. Moreover, Nebivolol partially inhibited MMT and decreased vascular endothelial growth factor (VEGF) and IL-6 levels in supernatants. In vivo: Twenty-one C57BL/6 mice were divided into 3 groups. Control group carried a catheter without PDF infusion. Study group received intraperitoneally PDF and oral Nebivolol during 30 days. PDF group received PDF alone. Nebivolol maintained the UFC and reduced PM thickness, MMT and angiogenesis promoted by PDF. It also improved the fibrinolytic capacity in PD effluents decreasing PAI-1 and IL-8 and increased tPA levels. Conclusion: Nebivolol protects PM from PDF-induced damage, promoting anti-fibrotic, anti-angiogenic, anti-inflammatory and pro-fibrinolytic effects. PMID:27102153

  14. 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

  15. Malignant peritoneal mesothelioma and Crohn disease.

    PubMed

    Butnor, Kelly J; Pavlisko, Elizabeth N; Sporn, Thomas A; Roggli, Victor L

    2017-03-01

    Mesothelial reaction simulating peritoneal diffuse malignant mesothelioma (MM) has been reported in the setting of Crohn ileitis. To our knowledge, peritoneal MM arising in patients with inflammatory bowel disease (IBD) has not been reported. The purpose of this study is to report the clinicopathological characteristics of patients with peritoneal MM and IBD. A database of approximately 3800 MM was reviewed for cases of MM in patients with IBD. Three patients (0.08%) with peritoneal MM and Crohn disease (CD) were identified, including two women and one man ranging in age from 56 to 65 years. All had a long-standing history of diarrhoea and an established diagnosis of CD of 3 years or greater duration. Two had epithelial MM and one had biphasic MM. Only one had documented asbestos exposure. Peritoneal MM occurs rarely in patients with IBD, but interestingly, has only been observed in the setting of CD and not in patients with ulcerative colitis. Chronic inflammation has been associated with the development of MM in rare instances and these three cases suggest that CD with transmural inflammation may also be a precursor. The precise role of CD-related transmural inflammation in the carcinogenesis of peritoneal MM remains to be determined. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. 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

  17. Continuous ambulatory peritoneal dialysis: Indian scenario.

    PubMed

    Abraham, Georgi; Mathew, Milli; Hinduja, Anish; Padma, G

    2002-03-01

    Chronic peritoneal dialysis (CPD) has been initiated as a treatment modality for chronic renal failure patients in the Indian subcontinent since 1990. Over a period of 9 years both continuous ambulatory peritoneal dialysis (CAPD) and continuous cyclic peritoneal dialysis (CCPD) have emerged as accepted forms of renal replacement therapy in our country. Although there were government restrictions on import of dialysis fluid until 1993, the availability of locally manufactured fluid in collapsible bags had facilitated the expansion of the programme to the far corners of the country and in neighbouring countries. Initially majority (78%) of the patients who were started on this programme were diabetics with other comorbid conditions who were drop-outs from haemodialysis and unfit for transplantation. Both CAPD and CCPD have been used for all age groups and for men and women. Majority of the patients do 3 x 2 l exchanges a day on CAPD; 8-10 l using a cycler at night those who are onCCPD. Peritonitis rate was 1 episode every 18 patient months. With the introduction of new connection and disposable sets the incidence of peritonitis is dropping down. The major cause of drop-out is cardiovascular death followed by peritonitis. Malnutrition is a major problem in both CAPD and haemodialysis patients. The programme has been expanded and there are over one thousand patients on this treatment in the country. The introduction of CPD had a major impact on the treatment of renal failure in India.

  18. Aquaporin-1 in the peritoneal membrane: Implications for water transport across capillaries and peritoneal dialysis.

    PubMed

    Devuyst, Olivier; Ni, Jie

    2006-08-01

    Peritoneal dialysis (PD) is an established mode of renal replacement therapy, based on the exchange of fluid and solutes between blood in peritoneal capillaries and a dialysate that has been introduced in the peritoneal cavity. The dialysis involves diffusive and convective transports and osmosis through the highly vascularized peritoneal membrane. Computer simulations predicted that the membrane contains ultrasmall pores (radius < 3 A) responsible for the transport of solute-free water across the capillary endothelium during crystalloid osmosis. The distribution of the water channel aquaporin-1 (AQP1), as well as its molecular structure ensuring an exquisite selectivity for water perfectly fit with the characteristics of the ultrasmall pore. Treatment with corticosteroids induces the expression of AQP1 in peritoneal capillaries and increases water permeability and ultrafiltration in rats, without affecting the osmotic gradient and the permeability for small solutes. Studies in knockout mice provided further evidence that osmotically-driven water transport across the peritoneal membrane is mediated by AQP1. AQP1 and endothelial NO synthase (eNOS) show a distinct regulation within the endothelium lining peritoneal capillaries. In acute peritonitis, the upregulation of eNOS and increased release of NO dissipate the osmotic gradient and result in ultrafiltration failure, despite the unchanged expression of AQP1. These data illustrate the potential of the peritoneal membrane to investigate the role and regulation of AQP1 in the endothelium. They also emphasize the critical role of AQP1 during peritoneal dialysis and suggest that manipulating AQP1 expression may be used to increase water permeability across the peritoneal membrane.

  19. Pentraxin 3 as a new biomarker of peritoneal injury in peritoneal dialysis patients.

    PubMed

    Kanda, Reo; Hamada, Chieko; Kaneko, Kayo; Nakano, Takanori; Wakabayashi, Keiichi; Io, Hiroaki; Horikoshi, Satoshi; Tomino, Yasuhiko

    2013-03-01

    It is well known that bioincompatible peritoneal dialysate plays a central role in the development of peritoneal fibrosis. Peritoneal inflammation continues even after the cessation of peritoneal dialysate stimulation. It is important to establish the definition of persistent inflammation in the peritoneal cavity at the cessation of peritoneal dialysis (PD). The objective of the present study was to determine whether pentraxin 3 (PTX3) in peritoneal effluent (PE) may be a new biomarker in PD patients. Serum, PE, and peritoneal specimens were obtained from 50 patients with end-stage kidney disease at Juntendo University Hospital. Samples of 19 patients were obtained at the initiation of PD and those of 31 patients at the cessation of PD. PTX3, high-sensitivity CRP, and MMP-2 and IL-6 were analyzed. An immunohistological examination using an anti-PTX3 antibody was performed. Expressions of PTX3 were observed in endothelial cells, fibroblasts, and mesothelial cells in the peritoneum. The PTX3 level in PE at the cessation of PD was significantly higher than that at the initiation of PD. Effluent PTX3 levels in patients with a history of peritonitis or a PD duration of more than 8 years were significantly higher than those in patients without peritonitis or patients with a PD duration of <8 years. The PTX3 level was significantly correlated with MMP-2 and IL-6 levels in PE, as well as the thickness of the submesothelial compact zone and the vasculopathy. It appears that PTX3 may be a new biomarker of peritoneal inflammation and progressive fibrosis.

  20. Does the risk of peritoneal dialysis-associated peritonitis vary by time on treatment?

    PubMed

    Perl, Jeffrey; Parpia, Sameer; Nessim, Sharon J

    2016-04-01

    Early retraining of patients/caregivers at 3 months after peritoneal dialysis (PD) initiation is recommended to prevent peritonitis. We sought to better understand if the risk of peritonitis was highest early after the initiation of PD and if the risk varied by time on therapy and by organism. Using the multicenter Canadian Baxter POET database, we studied 4,247 incident PD patients. Time on dialysis was divided into 3-month intervals over the first 2 years on PD, with 0 - 3 months serving as the reference period. After creating several organism categories (all organisms, coagulase-negative staphylococcus (CNS), Staphylococcus aureus, streptococcus, Gramnegative, culture-negative, and yeast), time to first peritonitis was analyzed by Kaplan-Meier analysis and using smooth hazard plots. The risk of peritonitis for each of these categories over time was then analyzed in a multivariable model after adjusting for potential confounding variables. The overall risk of peritonitis (all organisms) was greatest in the first 3 months on PD compared with all subsequent 3-month intervals (p = 0.001). Organism-specific analyses revealed an increased risk of culture-negative peritonitis in the first 3 months (p < 0.001) but no increased risk of CNS peritonitis or any of the other pre-specified organism categories. The overall risk of peritonitis was greatest in the first 3 months on PD and was largely driven by an increased risk of culture-negative peritonitis but not by CNS. Better understanding of this increased early peritonitis risk is warranted in order to develop strategies aimed at its prevention.

  1. Adaptation of prey and predators between patches.

    PubMed

    Wang, Wendi; Takeuchi, Yasuhiro

    2009-06-21

    Mathematical models are proposed to simulate migrations of prey and predators between patches. In the absence of predators, it is shown that the adaptation of prey leads to an ideal spatial distribution in the sense that the maximal capacity of each patch is achieved. With the introduction of co-adaptation of predators, it is proved that both prey and predators achieve ideal spatial distributions when the adaptations are weak. Further, it is shown that the adaptation of prey and predators increases the survival probability of predators from the extinction in both patches to the persistence in one patch. It is also demonstrated that there exists a pattern that prey and predators cooperate well through adaptations such that predators are permanent in every patch in the case that predators become extinct in each patch in the absence of adaptations. For strong adaptations, it is proved that the model admits periodic cycles and multiple stability transitions.

  2. Peritoneal Cell-free DNA: an innovative method for determining acute cell damage in peritoneal membrane and for monitoring the recovery process after peritonitis.

    PubMed

    Virzì, Grazia Maria; Milan Manani, Sabrina; Brocca, Alessandra; Cantaluppi, Vincenzo; de Cal, Massimo; Pastori, Silvia; Tantillo, Ilaria; Zambon, Roberto; Crepaldi, Carlo; Ronco, Claudio

    2016-02-01

    Cell-free DNA (cfDNA) is present in the peritoneal effluent of stable peritoneal dialysis (PD) patients, but there are no data on cfDNA in PD patients with peritonitis. We investigated the variation of peritoneal cfDNA levels subsequent to peritonitis in PD patients. We enrolled 53 PD patients: 30 without any history of systemic inflammation or peritonitis in the last 3 months (group A) and 23 with acute peritonitis (group B). CfDNA was quantified in the peritoneal effluent. Peritoneal samples on days 1, 3, 10, 30 and until day 120 from the start of peritonitis were collected for white blood cells (WBC) count and cfDNA evaluation in group B. Quantitative analysis of cfDNA showed significantly higher levels in group B on day 1, 3, 10 and 30 compared with group A (p < 0.05). A significant positive correlation was observed between cfDNA concentration and WBC on day 1 (rho = 0.89) and day 3 (rho = 0.5) (both, p < 0.05). However, no significant correlation was observed between cfDNA and WBC on days 10 and 30. In group B, peritoneal cfDNA levels tended to progressively decline during follow-up of peritonitis. From this decreasing curve, we estimated that 49 days are necessary to reach the value of 51 genome equivalents (GE)/ml (75th percentile in controls) and 63 days to reach 31 GE/ml (median). Our results demonstrate that cfDNA increases in peritoneal effluent of PD patients with peritonitis and tends to progressively decline in step with peritonitis resolution and membrane repair process. Peritoneal cfDNA quantification could be an innovative method to determine acute damage and an inverse index of the repair process.

  3. Suction test to demonstrate the peritoneal edge during laparoscopic extraperitoneal inguinal hernia repair.

    PubMed

    Nahm, Christopher; Free, Jason; Gananadha, Sivakumar; Hugh, Thomas J; Samra, Jaswinder S

    2013-11-01

    Inadequate peritoneal dissection from retroperitoneal structures may account for a large number of hernia recurrences amongst surgeons and trainees who are new to totally extraperitoneal (TEP) laparoscopic inguinal hernia repair. In this paper, we describe a simple dynamic test that allows surgeons to better appreciate the peritoneal edge during the initial dissection phase of TEP inguinal hernia repair, allowing for more adequate dissection of the peritoneum from retroperitoneal structures before placement of mesh. Data from a single surgeon was collected on 113 consecutive patients who underwent laparoscopic TEP inguinal hernia repair at the Royal North Shore Hospital in Sydney. The data was retrospectively reviewed to determine the number of cases in which the suction test led to further peritoneal dissection prior to mesh placement. After balloon dissection of the pre-peritoneal space and initial dissection of peritoneum and sac from retroperitoneal structures, a laparoscopic suction device is used to aspirate the insufflated gas from the pre-peritoneal space to cause the peritoneum to bulge anteriorly, thus demonstrating the edge of the peritoneal reflection. Further dissection is performed if deemed necessary at this point, and the mesh is placed over the hernia defect. 136 TEP hernia repairs were performed in 113 patients. In 26 (23 %) of patients, the abovementioned technique was of particular value resulting in further dissection of peritoneum prior to mesh placement. There were no complications as a direct result of the test. This dynamic suction test is a risk-free and useful operative tool for surgeons and trainees who are new to TEP inguinal hernia repair, and provides a definitive way of identifying the peritoneal reflection to ensure the peritoneum has been dissected adequately prior to mesh placement.

  4. Compliance and patching and atropine amblyopia treatments.

    PubMed

    Wang, Jingyun

    2015-09-01

    In the past 20 years, there has been a great advancement in knowledge pertaining to compliance with amblyopia treatments. The occlusion dose monitor introduced quantitative monitoring methods in patching, which sparked our initial understanding of the dose-response relationship for patching amblyopia treatment. This review focuses on current compliance knowledge and the impact it has on patching and atropine amblyopia treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Multi-Mode Broadband Patch Antenna

    NASA Technical Reports Server (NTRS)

    Romanofsky, Robert R. (Inventor)

    2001-01-01

    A multi-mode broad band patch antenna is provided that allows for the same aperture to be used at independent frequencies such as reception at 19 GHz and transmission at 29 GHz. Furthermore, the multi-mode broadband patch antenna provides a ferroelectric film that allows for tuning capability of the multi-mode broadband patch antenna over a relatively large tuning range. The alternative use of a semiconductor substrate permits reduced control voltages since the semiconductor functions as a counter electrode.

  6. Measurement and control of electrostatic patch potentials

    NASA Astrophysics Data System (ADS)

    Garrett, Joseph L.; Munday, Jeremy N.

    Electrostatic patch potentials hinder many precision measurements, particularly measurements of the Casimir force. Despite the improved force sensitivity achieved over the last decade, only recently have attempts been made to measure and quantify the effects of patch potentials. Here we present an analysis of patch potentials measured by Kelvin probe force microscopy (KPFM) and discuss methods to control these potentials (e.g. humidity, material choice, etc).

  7. Patch definition in metapopulation analysis: a graph theory approach to solve the mega-patch problem.

    PubMed

    Cavanaugh, Kyle C; Siegel, David A; Raimondi, Peter T; Alberto, Filipe

    2014-02-01

    The manner in which patches are delineated in spatially realistic metapopulation models will influence the size, connectivity, and extinction and recolonization dynamics of those patches. Most commonly used patch-definition methods focus on identifying discrete, contiguous patches of habitat from a single temporal observation of species occurrence or from a model of habitat suitability. However, these approaches are not suitable for many metapopulation systems where entire patches may not be fully colonized at a given time. For these metapopulation systems, a single large patch of habitat may actually support multiple, interacting subpopulations. The interactions among these subpopulations will be ignored if the patch is treated as a single unit, a situation we term the "mega-patch problem." Mega-patches are characterized by variable intra-patch synchrony, artificially low inter-patch connectivity, and low extinction rates. One way to detect this problem is by using time series data to calculate demographic synchrony within mega-patches. We present a framework for identifying subpopulations in mega-patches using a combination of spatial autocorrelation and graph theory analyses. We apply our approach to southern California giant kelp (Macrocystis pyrifera) forests using a new, long-term (27 years), satellite-based data set of giant kelp canopy biomass. We define metapopulation patches using our method as well as several other commonly used patch delineation methodologies and examine the colonization and extinction dynamics of the metapopulation under each approach. We find that the relationships between patch characteristics such as area and connectivity and the demographic processes of colonizations and extinctions vary among the different patch-definition methods. Our spatial-analysis/graph-theoretic framework produces results that match theoretical expectations better than the other methods. This approach can be used to identify subpopulations in metapopulations

  8. Glibenclamide transdermal patches: physicochemical, pharmacodynamic, and pharmacokinetic evaluations.

    PubMed

    Mutalik, S; Udupa, N

    2004-06-01

    In the present study, matrix type transdermal patches containing glibenclamide were prepared using different ratios of ethyl cellulose (EC)/polyvinylpyrrolidone (PVP) and Eudragit RL-100 (ERL)/Eudragit RS-100 (ERS) by solvent evaporation technique. The possible drug and polymer interaction was studied by infrared spectroscopy, differential scanning calorimetry, and HPTLC analysis. All the prepared formulations were subjected to physicochemical studies (thickness, weight variation, drug content, moisture content and uptake, and flatness), in vitro release and in vitro permeation studies through mouse skin. The results suggested that there was no interaction between drug and polymers. Variations in drug release/permeation profiles among the formulations studied were observed. The microphotographs obtained by scanning electron microscopy showed the formation of pores on the surface of the patches after in vitro skin permeation studies. Based on physicochemical and in vitro skin permeation studies, the formulations with EC:PVP (3:2) and ERL:ERS (4:1) were selected for in vivo experiments. The hypoglycemic activity of the patches in comparison with oral glibenclamide administration was studied for acute (24 h) and long-term (6 weeks) effect in both normal and streptozotocin-induced diabetic mice. Various biochemical parameters (serum levels of high-density lipoprotein-cholesterol, triglycerides, total cholesterol, alanine transaminase, aspertate transaminase, urea, and creatinine and liver protein and glycogen content) and histopathological (liver, pancreas and stomach) studies were carried out in diabetic mice after treating for 6 weeks. The patches were subjected to skin irritation test (by both visual observation and histopathological evaluation), oral glucose tolerance test and pharmacokinetic evaluation in mice. The results revealed that the patches successfully prevented the severe hypoglycemia in the initial hours, which is the major side effect associated with

  9. Reconfigurable Wideband Circularly Polarized Microstrip Patch Antenna for Wireless Applications

    NASA Astrophysics Data System (ADS)

    Khidre, Ahmed

    In this thesis, developments of rectangular microstrip patch antenna to have circular polarization agility with wideband performance, for wireless applications are presented. First, a new technique to achieve circularly polarized (CP) probe feed single-layer microstrip patch antenna with wideband characteristics is proposed. The antenna is a modified form of the popular E-shaped patch, used to broaden the impedance bandwidth of a basic rectangular patch antenna. This is established by letting the two parallel slots of the E-patch unequal. Thus, by introducing asymmetry two orthogonal currents on the patch are excited and circularly polarized fields are realized. The proposed technique exhibits the advantage of the simplicity inherent in the E-shaped patch design. It requires only slot lengths, widths, and position parameters to be determined. Also, it is suitable for later adding the reconfigurable capability. With the aid of full-wave simulator Ansoft HFSS, investigations on the effect of various dimensions of the antenna have been carried out via parametric analysis. Based on these investigations, a design procedure for a CP E-shaped patch is summarized. Various design examples with different substrate thicknesses and material types are presented and compared, with CP U-slot patch antennas, recently proposed in the literature. A prototype has been constructed following the suggested design procedure to cover the IEEE 802.11b/g WLAN band. The performance of the fabricated antenna was measured and compared with the simulation results for the reflection coefficient, axial ratio, radiation pattern, and antenna gain. Good agreement is achieved between simulation and measured results demonstrating a high gain and wideband performance. Second, a polarization reconfigurable single feed E-shaped patch antenna with wideband performance is proposed. The antenna is capable of switching from right-hand circular polarization (RHCP) to left-hand circular polarization (LHCP) and

  10. Usefulness of diagnostic laparoscopy with 5-aminolevulinic acid (ALA)-mediated photodynamic diagnosis for the detection of peritoneal micrometastasis in advanced gastric cancer after chemotherapy.

    PubMed

    Kishi, Kentaro; Fujiwara, Yoshiyuki; Yano, Masahiko; Motoori, Masaaki; Sugimura, Keijiro; Takahashi, Hidenori; Ohue, Masayuki; Sakon, Masato

    2016-12-01

    Successful cases have shown that conversion surgery after chemotherapy improves the prognosis of advanced gastric cancer. However, it is necessary to carefully select patients who have no unresectable factors prior to surgery. We recently reported that diagnostic laparoscopy with photodynamic diagnosis using oral 5-aminolevulinic acid (ALA-PDD) is a promising tool for diagnosing early peritoneal metastasis in gastric cancer. We herein evaluated the usefulness of this technique for detecting peritoneal metastases of advanced gastric cancer after chemotherapy. Diagnostic laparoscopy using sequential white light (WL) and ALA-PDD observations was performed in 38 patients with advanced gastric cancer after chemotherapy. The sensitivity of ALA-PDD for detecting peritoneal disease was compared with that of WL. The relationship between the state of peritoneal metastasis assessed by ALA-PDD and a cytological examination of the peritoneal fluid was evaluated. Twelve of the 38 patients (32 %) were diagnosed with peritoneal metastases by conventional laparoscopy. However, laparoscopy with ALA-PDD detected peritoneal metastases in 4 (11 %) of the 26 remaining patients. Three of these 4 patients had negative cytological results from the evaluation of the peritoneal fluid. Diagnostic laparoscopy using ALA-PDD is a useful technique for detecting metastases and determining treatment strategies to select patients with advanced gastric cancer who have received chemotherapy.

  11. Impact of icodextrin on clinical outcomes in peritoneal dialysis: a systematic review of randomized controlled trials.

    PubMed

    Cho, Yeoungjee; Johnson, David W; Badve, Sunil; Craig, Jonathan C; Strippoli, Giovanni F K; Wiggins, Kathryn J

    2013-07-01

    Although icodextrin has been shown to augment peritoneal ultrafiltration in peritoneal dialysis (PD) patients, its impact upon other clinical end points, such as technique survival, remains uncertain. This systematic review evaluated the effect of icodextrin use on patient level clinical outcomes. The Cochrane CENTRAL Registry, MEDLINE, Embase and reference lists were searched (last search 13 September 2012) for randomized controlled trials of icodextrin versus glucose in the long dwell exchange. Summary estimates of effect were obtained using a random effects model. Eleven eligible trials (1222 patients) were identified. There was a significant reduction in episodes of uncontrolled fluid overload [two trials; 100 patients; relative risk (RR) 0.30, 95% confidence interval (CI) 0.15-0.59] and improvement in peritoneal ultrafiltration [four trials; 102 patients; mean difference (MD) 448.54 mL/day, 95% CI 289.28-607.80] without compromising residual renal function [four trials; 114 patients; standardized MD (SMD) 0.12, 95% CI -0.26 to 0.49] or urine output (three trials; 69 patients; MD -88.88, 95% CI -356.88 to 179.12) with icodextrin use for up to 2 years. There was no significant effect on peritonitis incidence (five trials; 607 patients; RR 0.97, 95% CI 0.76-1.23), peritoneal creatinine clearance (three trials; 237 patients; SMD 0.36, 95% CI -0.24 to 0.96), technique failure (three trials; 290 patients; RR 0.58, 95% CI 0.28-1.20), patient survival (six trials; 816 patients; RR 0.82, 95% CI 0.32-2.13) or adverse events. Icodextrin prescription improved peritoneal ultrafiltration, mitigated uncontrolled fluid overload and was not associated with increased risk of adverse events. No effects of icodextrin on technique or patient survival were observed, although trial sample sizes and follow-up durations were limited.

  12. Patch testing for noncontact dermatitis: the atopy patch test for food and inhalants.

    PubMed

    Wollenberg, Andreas; Vogel, Sandra

    2013-10-01

    The atopy patch test (APT) is defined as a patch test procedure to assess delayed type hypersensitivity reactions against those protein allergens known to elicit IgE-mediated type I reactions in atopic patients. This patch test procedure uses intact protein allergens instead of haptens in an optimized test setting and with a special reading key. It may be clinically useful especially for atopic dermatitis, as the currently available test procedures either target the wrong reaction type (type I and not type IV) or use the wrong allergens (haptens and not protein allergen). A positive APT reaction correlates with a positive lymphocyte transformation test and allergen-specific Th2 cells in the peripheral blood. As even small changes in the test procedure influence the sensitivity, specificity, and reproducibility of the APT, the European Task Force on Atopic Dermatitis (ETFAD) has developed a standardized APT technique: Intact protein allergens, purified in petrolatum, are applied in 12-mm-diameter Finn chambers mounted on Scanpor tape for 48 h to non-irritated, non-abraded, or tape-stripped skin of the upper back for 48 h; the evaluation of the test reaction is done after 48 and 72 h using the ETFAD reading key, assessing erythema as well as number and distribution pattern of the papules. The APT may reveal type IV sensitization in patients who are negative for the respective type I tests. Limited availability of the expensive test substances and limited reimbursement is among the factors restricting the routine use of the APT.

  13. Hierarchical patch dynamics and animal movement pattern.

    PubMed

    Fauchald, Per; Tveraa, Torkild

    2006-09-01

    In hierarchical patch systems, small-scale patches of high density are nested within large-scale patches of low density. The organization of multiple-scale hierarchical systems makes non-random strategies for dispersal and movement particularly important. Here, we apply a new method based on first-passage time on the pathway of a foraging seabird, the Antarctic petrel (Thalassoica antarctica), to quantify its foraging pattern and the spatial dynamics of its foraging areas. Our results suggest that Antarctic petrels used a nested search strategy to track a highly dynamic hierarchical patch system where small-scale patches were congregated within patches at larger scales. The birds searched for large-scale patches by traveling fast and over long distances. Once within a large-scale patch, the birds concentrated their search to find smaller scale patches. By comparing the pathway of different birds we were able to quantify the spatial scale and turnover of their foraging areas. On the largest scale we found foraging areas with a characteristic scale of about 400 km. Nested within these areas we found foraging areas with a characteristic scale of about 100 km. The large-scale areas disappeared or moved within a time frame of weeks while the nested small-scale areas disappeared or moved within days. Antarctic krill (Euphausia superba) is the dominant food item of Antarctic petrels and we suggest that our findings reflect the spatial dynamics of krill in the area.

  14. Collection of analytes from microneedle patches.

    PubMed

    Romanyuk, Andrey V; Zvezdin, Vasiliy N; Samant, Pradnya; Grenader, Mark I; Zemlyanova, Marina; Prausnitz, Mark R

    2014-11-04

    Clinical medicine and public health would benefit from simplified acquisition of biological samples from patients that can be easily obtained at point of care, in the field, and by patients themselves. Microneedle patches are designed to serve this need by collecting dermal interstitial fluid containing biomarkers without the dangers, pain, or expertise needed to collect blood. This study presents novel methods to collect biomarker analytes from microneedle patches for analysis by integration into conventional analytical laboratory microtubes and microplates. Microneedle patches were made out of cross-linked hydrogel composed of poly(methyl vinyl ether-alt-maleic acid) and poly(ethylene glycol) prepared by micromolding. Microneedle patches were shown to swell with water up to 50-fold in volume, depending on degree of polymer cross-linking, and to collect interstitial fluid from the skin of rats. To collect analytes from microneedle patches, the patches were mounted within the cap of microcentrifuge tubes or formed the top of V-bottom multiwell microplates, and fluid was collected in the bottom of the tubes under gentle centrifugation. In another method, microneedle patches were attached to form the bottom of multiwell microplates, thereby enabling in situ analysis. The simplicity of biological sample acquisition using microneedle patches coupled with the simplicity of analyte collection from microneedles patches integrated into conventional analytical equipment could broaden the reach of future screening, diagnosis, and monitoring of biomarkers in healthcare and environmental/workplace settings.

  15. The "edge effect" with patch test materials.

    PubMed

    Fyad, A; Masmoudi, M L; Lachapelle, J M

    1987-03-01

    A positive "edge effect", i.e., the accumulation on the skin of a chemical solution (such as fluorescein 0.01% in a 50/50 water-ethanol solution) at the periphery of the patch test sites has been demonstrated. It occurs with different test materials (Finn Chamber; Silver Patch Test; Patch Test Chamber). Practical implications are discussed: this observation could be important when discussing results of laboratory investigations. In clinical practice, it could explain the occurrence of "ring-shaped" positive allergic patch test reactions to chemicals used in solution, i.e., Kathon CG or hydrocortisone.

  16. [Glossodynia--indication for patch testing?].

    PubMed

    Bäurle, G; Schönberger, A

    1986-08-15

    100 patients suffering from glossodynia without pathologic changes of the oral mucosa and 16 patients with suspected allergic contact stomatitis underwent patch testing using standard patch test and dental materials. The results were compared with those of patients in dental occupations suffering from hand eczema. As there is no clinical relevance of allergens in patients with glossodynia, patch testing seems to be unnecessary. On the other hand, patch test results of patients with stomatitis and dentures often suggest a causal allergy. In most of those cases, this was confirmed by complete healing after changing the denture bases, whereas in glossodynia such replacements never brought about a convincing improvement of the symptoms.

  17. Collection of Analytes from Microneedle Patches

    PubMed Central

    2015-01-01

    Clinical medicine and public health would benefit from simplified acquisition of biological samples from patients that can be easily obtained at point of care, in the field, and by patients themselves. Microneedle patches are designed to serve this need by collecting dermal interstitial fluid containing biomarkers without the dangers, pain, or expertise needed to collect blood. This study presents novel methods to collect biomarker analytes from microneedle patches for analysis by integration into conventional analytical laboratory microtubes and microplates. Microneedle patches were made out of cross-linked hydrogel composed of poly(methyl vinyl ether-alt-maleic acid) and poly(ethylene glycol) prepared by micromolding. Microneedle patches were shown to swell with water up to 50-fold in volume, depending on degree of polymer cross-linking, and to collect interstitial fluid from the skin of rats. To collect analytes from microneedle patches, the patches were mounted within the cap of microcentrifuge tubes or formed the top of V-bottom multiwell microplates, and fluid was collected in the bottom of the tubes under gentle centrifugation. In another method, microneedle patches were attached to form the bottom of multiwell microplates, thereby enabling in situ analysis. The simplicity of biological sample acquisition using microneedle patches coupled with the simplicity of analyte collection from microneedles patches integrated into conventional analytical equipment could broaden the reach of future screening, diagnosis, and monitoring of biomarkers in healthcare and environmental/workplace settings. PMID:25367229

  18. Tuberculous peritonitis in a case receiving continuous ambulatory peritoneal dialysis(CAPD) treatment

    PubMed Central

    Sahin, Garip; Kiraz, Nuri; Sahin, Ilknur; Soydan, Mehmet; Akgün, Yurdanur

    2004-01-01

    Background Tuberculosis continues to be an important health problem in the world. Besides pulmonary involvement extrapulmonary involvement becomes an affair in developing countries, even in developed countries. Case presentation A thirty-six year old male patient was admitted with abdominal pain, diarrhea, nausea, vomiting and fever which had started one week before. The patient had been followed up with predialisis Chronic Renal Failure(CRF) diagnosis for 4 years and receiving continuous ambulatory peritoneal dialysis (CAPD) treatment for 4 months. In peritoneal fluid, 1600/mm3 cells were detected and 70% of them were polymorphonuclear leukocytosis. The patient begun nonspesific antibiotherapy but no benefit was obtained after 12 days and peritoneal fluid bacterial cultures remained negative. Peritoneal smear was positive for Asid-fast basilli (AFB), and antituberculosis therapy was started with isoniazid, rifampicine, ethambutol and pyrazinamide. After 15 days his peritoneal fluid cell count was decreased and his symptoms were relieved. Peritoneal fluid tuberculosis culture was found positive. Conclusion Considering this case, we think that in patients with CAPD catheter and peritonitis; when peritoneal fluid leukocytes are high and PMNL are dominant, AFB and tuberculosis culture must be investigated besides bacterial culture routinely. PMID:15461815

  19. Peritonitis Due to Roseomonas fauriae in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

    PubMed Central

    Bibashi, Evangelia; Sofianou, Danai; Kontopoulou, Konstantina; Mitsopoulos, Efstathios; Kokolina, Elisabeth

    2000-01-01

    Roseomonas is a newly described genus of pink-pigmented, nonfermentative, gram-negative bacteria that have been recognized as a cause of human infections. Roseomonas fauriae is a species rarely isolated from clinical specimens. We report the first known case of peritonitis caused by R. fauriae in a patient receiving continuous ambulatory peritoneal dialysis. PMID:10618142

  20. Theory of patch inverse boundary element method (IBEM)

    NASA Astrophysics Data System (ADS)

    Valdivia, Nicholas; Williams, Earl G.; Herdic, Peter; Klos, Jacob; Palumbo, Daniel; Silcox, Richard; Slanka, Bernard

    2005-09-01

    Near-field acoustical holography (NAH) based on boundary element methods require the measurement of the near-field pressure field over a conformal and close surface in order to recover the acoustic field on a nearby surface. In this work a new technique called patch IBEM is introduced. This new technique eliminates the need to measure over an entire closed surface, but instead the measurements are taken over a small area to reconstruct the acoustic field. Patch IBEM is used for the reconstruction of the acoustic field over a fuselage panel in a Boeing 757 aircraft, using measurement taken at Boeing's interior noise test facility (INTF). The measurements taken include a 120 mikes planar array positioned conformal to the fuselage panel surface and a 50 mikes spherical array. Results will be showed when the fuselage panel is excited by a shaker. [Work supported by ONR and NASA.

  1. Impulse Testing of Corporate-Fed Patch Array Antennas

    NASA Technical Reports Server (NTRS)

    Chamberlain, Neil F.

    2011-01-01

    This paper discusses a novel method for detecting faults in antenna arrays. The method, termed Impulse Testing, was developed for corporate-fed patch arrays where the element is fed by a probe and is shorted at its center. Impulse Testing