WorldWideScience

Sample records for assisted automated peritoneal

  1. Patients in assisted automated peritoneal dialysis develop strategies for selfcare

    DEFF Research Database (Denmark)

    Holch, Kirsten

    Henderson's areas of need and Dorothea Orem's self - care theory combined with problems and symptoms in End Stage Renal Disease (ESRD) patients. Results The results showed that patients in their own home improve their self-care capacity in the period between three and six months after starting AAPD......  Patients in Assisted Automated Peritoneal Dialysis develop strategies for self-care Background: Since 2000 a model for Assisted Automated Peritoneal Dialysis (AAPD) in the patients own home has been developed at Aarhus University Hospital, Skejby. The patient group consists of physically...

  2. [Assisted peritoneal dialysis].

    Science.gov (United States)

    Klarić, Dragan; Prkačin, Ingrid

    2014-04-01

    According to the National Registry of Renal Replacement Therapy (RRT), the incidence of chronic kidney disease (end-stage renal disease) and the need of RRT have declined in the last decade renal. One of the reasons for this tendency certainly is transplantation as the best choice. However, transplant procedure has limitations in elderly patients due to the number of comorbidities. This study was designed as retrospective analysis of outcomes in patients treated with peritoneal dialysis for a period of eleven years. Patients were divided into those who had been assisted or unassisted. Out of 100 patients treated with peritoneal dialysis (PD), 77 completed the treatment, including 26 assisted and 51 unassisted patients. Peritonitis was recorded in 20 assisted and 26 unassisted patients. Peritonitis was more common in unassisted patients, who were more frequently lost from PD. Assisted PD could be a good and safe choice of RRT in this special group of patients.

  3. Automated peritoneal dialysis in Brunei Darussalam.

    Directory of Open Access Journals (Sweden)

    Ishrat KAMAL

    2011-04-01

    Full Text Available Introduction: Chronic kidney disease in Brunei Darussalam is a growing problem. The number of patients reaching end stage kidney failure has increased dramatically in the last ten years. Currently, most are managed with haemodialysis while a smaller proportion is managed with continuous ambulatory peritoneal dialysis (CAPD. Automated peritoneal dialysis (APD is a form of peritoneal dialysis and has been used in Brunei Darussalam since May 2008. Materials and Methods: Eight patients participated in this prospective clinical trial. As all APD patients were previously on CAPD, comparisons are made between the outcomes of APD against CAPD. Results: The median and mean age of APD patients were 42 and 45.5 ± 12.73 years respectively. After switching to APD, the serum haemoglobin and albumin improved from 10.56 ± 1.95 gm/L and 27.88 ± 7.71 gm/dL to 12.26 ± 1.82 gm/L and 33.63 ± 6.89 gm/dL respectively (p values <0.05. This corresponded to improvements in seven (87.5% and six (75% patients respectively in both parameters. Erythropoietin requirement was reduced in six (75% patients, including three (37.5% patients who were able to stop erythropoietin completely. There was no peritonitis encountered. All patients reported improved quality of life with better sleep, appetite and general well-being. Conclusions: Our study showed that APD was as good as CAPD with improvement seen in both laboratory and quality of life parameters. There was also reduction in erythropoietin requirement. Based on these findings, we will actively encourage and promote APD usage as oppose to CAPD usage in our population.

  4. Evolution of technology for automated peritoneal dialysis.

    Science.gov (United States)

    Ronco, Claudio; Amerling, Richard; Dell'aquila, Roberto; Rodighiero, Maria Pia; Di Loreto, Pierluigi

    2006-01-01

    Automated peritoneal dialysis (APD) is important for the further penetration of PD in the dialysis marketplace. Long dwell, equilibration PD (CAPD) has limited applicability in many patients due to inadequate solute clearance or fast membrane transport characteristics. Providing large volumes of dialysate over circumscribed hours is highly labor intensive without an automated system. Early attempts at APD were crude but effective in reducing labor, which was generally provided by nursing staff. Later evolution of PD technology has been greatly accelerated by the microchip, and by miniaturization of components. Current generation machines allow individualized fill volumes, variable tidal volumes and additional daytime automated exchanges, teledialysis, memorized delivery control, and full portability. The ideal machine should not only be able to perform all treatment schedules, but it should also optimize the performance of a selected treatment strategy. Biocompatible solutions, improved osmotic agents, and sorbent technology are all adaptable to APD. The eventual evolution toward continuous flow PD will resolve many of the current problems with both CAPD and APD.

  5. Peritonitis caused by Roseomonas in a patient undergoing automated peritoneal dialysis: case report and literature review.

    Science.gov (United States)

    Tsai, Shang-Feng; Chen, Chen-Hsu; Shu, Kuo-Hsiung; Wu, Ming-Ju

    2012-01-01

    A 48-year-old man was admitted with cloudy dialysate and diagnosed as peritoneal dialysis (PD)-related peritonitis caused by Roseomonas infection. This is the third case of PD-related peritonitis due to Roseomonas species and also the first case of peritonitis in automated peritoneal dialysis. Despite its low virulence and rare incidence in peritoneal dialysis, clinicians should be alert to the possibility of Roseomonas infection due to its high resistance to antibiotics. Literature on Roseomonas infection is also reviewed. The current guidelines for empirical peritonitis in PD patients do not adequately cover such infection. Refractory treatment in high risk cases should alert clinicians to upgrade antibiotics even for a vague manifestation.

  6. Dialysate as food as an option for automated peritoneal dialysis

    OpenAIRE

    Tjiong, Hoey Lan; Swart, Roel; Berg, Willem; Fieren, Marien

    2008-01-01

    textabstractProtein-energy malnutrition is frequently found in dialysis patients. Many factors play a role in its development including deficient nutrient intake as a result of anorexia. Peritoneal dialysis (PD) solutions containing a mixture of amino acids and glucose in an appropriate ratio could serve as a source of food. The authors of this article found that such a dialysis solution when administered to fasting patients who were on nightly automated peritoneal dialysis (APD), as part of ...

  7. Peritonitis

    Science.gov (United States)

    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). ...

  8. Gangrenous appendicitis presenting as acute abdominal pain in a patient on automated peritoneal dialysis: a case report

    Directory of Open Access Journals (Sweden)

    Ekart Robert

    2012-09-01

    Full Text Available Abstract Introduction Presentations of abdominal pain in patients on peritoneal dialysis deserve maximal attention and careful differential diagnosis on admittance to medical care. In this case report a gangrenous appendicitis in a patient on automated peritoneal dialysis is presented. Case presentation We report the case of a 38-year-old Caucasian man with end-stage renal disease who was on automated peritoneal dialysis and developed acute abdominal pain and cloudy peritoneal dialysate. Negative microbiological cultures of the peritoneal dialysis fluid and an abdominal ultrasonography misleadingly led to a diagnosis of culture negative peritonitis. It was decided to remove the peritoneal catheter but the clinical situation of the patient did not improve. An explorative laparotomy was then carried out; diffuse peritonitis and gangrenous appendicitis were found. An appendectomy was performed. Myocardial infarction and sepsis developed, and the outcome was fatal. Conclusion A peritoneal dialysis patient with abdominal pain that persists for more than 48 hours after the usual antibiotic protocol for peritoneal dialysis-related peritonitis should immediately alert the physician to the possibility of peritonitis caused by intra-abdominal pathology. Not only peritoneal catheter removal is indicated in patients whose clinical features worsen or fail to resolve with the established intra-peritoneal antibiotic therapy but, after 72 hours, an early laparoscopy should be done and in a case of correct indication (intra-abdominal pathology an early explorative laparotomy.

  9. Dialysate as food as an option for automated peritoneal dialysis

    NARCIS (Netherlands)

    H.L. Tjiong (Hoey Lan); R. Swart (Roel); J.W.O. van den Berg (Willem); M.W.J.A. Fieren (Marien)

    2008-01-01

    textabstractProtein-energy malnutrition is frequently found in dialysis patients. Many factors play a role in its development including deficient nutrient intake as a result of anorexia. Peritoneal dialysis (PD) solutions containing a mixture of amino acids and glucose in an appropriate ratio could

  10. Peritoneal

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008071 Effect of overexpression of Smad7 on epithelial-mesenchymal transition of mesothelial cells in rat peritoneal fibrosis model. SUN Yanyan(孙艳艳), et al. Dept Nephrol, 1st Affili Hosp, Sun Yat-sen Univ, Guangzhou 510080. Chin J Nephrol 2007;23(12):784-788. Objective To explore the effect of overexpression of Smad7 on epithelial-mesenehymal transition (EMT) of mesothelial cells in rat peritoneal fibrosis model. Methods Thirty rats were randomly

  11. Use of home automated intermittent peritoneal dialysis in the treatment of end stage renal failure.

    Science.gov (United States)

    Li, P K; Wang, A Y; Leung, C B; Lui, S F; Lai, K N

    1994-01-01

    We report our retrospective analysis of 16 uraemic patients who were treated with home automated intermittent peritoneal dialysis (IPD) from 1988 to 1993. Six patients were diabetic. The mean age was 58.5 years. The reasons for home automated IPD were: old age, poor eyesight, low intelligence or poor dexterity, family or patient request and old stroke. It took an average of 8.8 sessions to train the helper. The mean frequency of the home IPD was once every 5.8 days with a mean volume of 48 litres of dialysate used during each dialysis. There were 3 peritonitis episodes making the peritonitis rate once every 93 patient months. Four patients were still on home IPD and two were transplanted. Ten patients died of stroke, myocardial infarction, tuberculosis, chronic obstructive lung disease or suicide. A low plasma albumin is the only significant parameter in the early mortality group. Such high mortality can be accounted for by the fact that patients were older and forty per cent were diabetic. We conclude that home automated IPD can be an alternative for some patients in whom other modes of dialysis are difficult.

  12. Accuracy of the automated cell counters for management of spontaneous bacterial peritonitis

    Institute of Scientific and Technical Information of China (English)

    Oliviero Riggio; Stefania Angeloni; Antonella Parente; Cinzia Leboffe; Giorgio Pinto; Teresa Aronne; Manuela Merli

    2008-01-01

    AIM: To evaluate the accuracy of automated blood cell counters for ascitic polymorphonuclear (PMN)determination for: (1) diagnosis,(2) efficacy of the ongoing antibiotic therapy,and (3) resolution of spontaneous bacterial peritonitis (SBP).METHODS: One hundred and twelve ascitic fluid samples were collected from 52 consecutive cirrhotic patients,16 of them with SBR The agreement between the manual and the automated method for PMN count was assessed.The sensitivity/specificity and the positive/negative predictive value of the automated blood cell counter were also calculated by considering the manual method as the "gold standard"RESULTS: The mean + SD of the difference between manual and automated measurements was 7.8±58cells/mm3,while the limits of agreement were +124 cells/mm3 [95% confidence interval (CI): +145 to +103] and -108 cells/mm3 (95% CI: -87 to -129).The automated cell counter had a sensitivity of 100% and a specificity of 97.7% in diagnosing SBP,and a sensitivity of 91% and a specificity of 100% for the efficacy of the ongoing antibiotic therapy.The two methods showed a complete agreement for the resolution of infection.CONCLUSION: Automated cell counters not only have a good diagnostic accuracy,but are also very effective in monitoring the antibiotic treatment in patients with SBP.Because of their quicker performance,they should replace the manual counting for PMN determination in the ascitic fluid of patients with SBR

  13. A skeptical view of assisted home peritoneal dialysis.

    Science.gov (United States)

    Mendelssohn, D C

    2007-04-01

    While assisted PD may prove helpful for a subset of new patients, its overall effect will be small. A trend towards a small increase in incident PD rate will not translate directly into an equivalent rise in PD prevalence. Important questions about cost effectiveness and about long-term impact of home PD assistance on modality distribution remain unanswered.

  14. [Vacuum-assisted laparostomy in complex treatment of patient with peritonitis and internal biliary fistula].

    Science.gov (United States)

    Obolenskiĭ, V N; Ermolov, A A; Oganesian, K S; Aronov, L S

    2013-01-01

    Negative pressure wound therapy (NPWT) is one of the newest methods used in the treatment of wounds. It allows speeding up and optimizing the healing process and reducing the cost of treatment. Negative pressure stimulates proliferation of granulation tissue, provides a continuous evacuation of fluid and effectively cleans wound surface. The authors introduce the reader to the results of treatment of patient with peritonitis and internal duodenal fistula using a vacuum-assisted laparostomy.

  15. Outcome of patients treated with automated peritoneal dialysis: Effects of selection of patients

    Directory of Open Access Journals (Sweden)

    Ayman Karkar

    2011-01-01

    Full Text Available To determine the effect of selection of peritoneal dialysis patients who used auto-mated PD (APD as a first renal replacement therapy (RRT option, we studied two groups of adult chronic kidney disease (CKD patients treated with APD over a period of 4 years: group 1 included 30 patients in whom APD was the first choice for RRT and group 2 included 40 patients transferred from failed hemodialysis (HD treatment. Both groups were matched for the original causes of CKD and comorbid conditions. However, group 1 had significantly higher residual renal function (RRF than group 2 [glomerular filtration rate (GFR 11.85 ± 4 mL/min and urine output 995 ± 465 mL/day vs. 3.69 ± 3.7 mL/min and 340 ± 447 mL/day, respectively, P = 0.0001] and Kt/v (2.7 ± 0.7 vs. 1.9 ± 0.4, respectively, P = 0.006. Most of the patients were compliant with their APD prescription, performed ideal PD techniques, achieved adequate dialysis and fluid ultra-filtration, and experienced much less than average infectious and non-infectious complications. However, group 1 achieved better clinical outcome than group 2, including relatively higher sur-vival rate and kidney transplantation, significantly fewer episodes of peritonitis per year (0.09 vs. 0.14, respectively, P = 0.0001, higher serum albumin (2.95 ± 0.3 vs. 2.7 ± 0.27 g/dL, respectively, P = 0.035, hemoglobin (11.5 ± 0.9 vs. 10.6 ± 0.7 g/dL, respectively, P = 0.022 and lower para-thormone levels (283 ± 117 vs. 389 ± 269 pg/mL, respectively, P = 0.02. They also maintained significantly higher total fluid removal compared to group 2 (1120 ± 330 vs. 560 ± 300 mL/day, respectively, P = 0.004, higher RRF (GFR 8 ± 2.6 mL/min vs. 1.8 ± 2.4 mL/min, respectively, P = 0.0001, and urine output (556 ± 447 mL/day vs. 240 ± 347 mL/day, respectively, P = 0.004, and significantly higher Kt/v (2.8 ± 0.7 vs. 1.9 ± 0.4, respectively, P = 0.2. In conclusion, in CKD patients, PD is a viable initial modality of RRT, and with better

  16. Sleep disorders in patients with end-stage renal disease undergoing dialysis: comparison between hemodialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis.

    Science.gov (United States)

    Losso, Ricardo L M; Minhoto, Gisele R; Riella, Miguel C

    2015-02-01

    Sleep disorders for patients on dialysis are significant causes of a poorer quality of life and increased morbidity and mortality. No study has evaluated patients undergoing automated peritoneal dialysis (APD) to assess their sleep disorders compared to hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). A total of 166 clinically stable patients who had been on dialysis for at least 3 months were randomly selected for the study and divided into HD, CAPD or APD. Socio-demographic, clinical and laboratory parameters and self-administered questionnaires were collected for the investigation of insomnia, restless legs syndrome (RLS), bruxism, rapid eye movement sleep behavior disorder, excessive daytime sleepiness (EDS), obstructive sleep apnea syndrome (OSAS), sleepwalking, sleep hygiene, depression and anxiety. Insomnia was detected in more than 80 % of patients on the three modalities. OSAS was lower for patients on HD (36 %) than on CAPD (65 %) (p dialysis modalities studied had a high prevalence of sleep disorders. Patients on HD had a lower proportion of OSAS than those on CAPD and APD, which is most likely attributed to their lower body mass indices. The possible causes of higher RLS rates in APD patients have not been established.

  17. Renal Replacement Therapy: Purifying Efficiency of Automated Peritoneal Dialysis in Diabetic versus Non-Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Nicanor Vega-Diaz

    2015-07-01

    Full Text Available Background: In order to reduce the cardiovascular risk, morbidity and mortality of peritoneal dialysis (PD, a minimal level of small-solute clearances as well as a sodium and water balance are needed. The peritoneal dialysis solutions used in combination have reduced the complications and allow for a long-time function of the peritoneal membrane, and the preservation of residual renal function (RRF in patients on peritoneal dialysis (PD is crucial for the maintenance of life quality and long-term survival. This retrospective cohort study reviews our experience in automatic peritoneal dialysis (APD patients, with end-stage renal disease (ESRD secondary to diabetic nephropathy (DN in comparison to non-diabetic nephropathy (NDN, using different PD solutions in combination. Design: Fifty-two patients, 29 diabetic and 23 non-diabetic, were included. The follow-up period was 24 months, thus serving as their own control. Results: The fraction of renal urea clearance (Kt relative to distribution volume (V (or total body water (Kt/V, or creatinine clearance relative to the total Kt/V or creatinine clearance (CrCl decreases according to loss of RRF. The loss of the slope of RRF is more pronounced in DN than in NDN patients, especially at baseline time interval to 12 months (loss of 0.29 mL/month vs. 0.13 mL/month, respectively, and is attenuated in the range from 12 to 24 months (loss of 0.13 mL/month vs. 0.09 mL/month, respectively. Diabetic patients also experienced a greater decrease in urine output compared to non-diabetic, starting from a higher baseline urine output. The net water balance was adequate in both groups during the follow up period. Regarding the balance sodium, no inter-group differences in sodium excretion over follow up period was observed. In addition, the removal of sodium in the urine output decreases with loss of renal function. The average concentration of glucose increase in the cycler in both groups (DN: baseline 1.44 ± 0

  18. 全自动腹膜透析机的设计%Design of automated peritoneal dialysis machine

    Institute of Scientific and Technical Information of China (English)

    汪辉; 何建忠; 赵曼曼

    2014-01-01

    Peritoneal dialysis machine is the treatment of acute renal failure , chronic renal failure and uremia medical equipment .This article describes the LPC1768 processor and μC/OS-Ⅱ real-time operating system for smart peritoneal dialysis machine .The system realizes the automatic control timing quantitative infusion timing drain , guide the user to set the parameters of dialysis overweight , over-temperature , flow rate automatic alarm .The dialysis process design is more reasonable security , good real-time performance .Especially suitable for home dialysis , the dialysis machine has obvious advantages in automation and intelligent direction .%腹膜透析机是治疗急性肾功能衰竭、慢性肾功能衰竭和尿毒症的医疗设备。文中介绍了基于LPC1768处理器和μC/OS-Ⅱ实时操作系统的智能腹膜透析机。该系统实现了全自动控制定时定量输液、定时排液、引导用户设置透析参数、过温过重、流速不足自动报警。透析流程设计更加合理安全,实时性良好。特别适用于家庭透析,该腹透机在自动化和智能化方向优势明显。

  19. Automated telephone reminder messages can assist electronic diabetes care.

    Science.gov (United States)

    Mollon, Brent; Holbrook, Anne M; Keshavjee, Karim; Troyan, Sue; Gaebel, Kathryn; Thabane, Lehana; Perera, Gihan

    2008-01-01

    Telephone reminder systems have been used to assist in the treatment of many chronic diseases. However, it is unclear if these systems can increase medication and appointment adherence in patients with diabetes without direct patient-provider telephone contact. We tested the feasibility of using an automated telephone reminder system (ATRS) to deliver reminder messages to 253 adults with diabetes enrolled in a randomized controlled trial. Eighty-four percent of the patients were able to register using voice recognition and at least one reminder was delivered to 95% of registered patients over a period of 7.5 months. None of the demographic features studied predicted a patient's ability to enroll or to receive reminder calls. At the end of the study, 63% of patients indicated that they wished to continue to receive ATRS calls. The level of system use as determined by the number of received reminder calls was not associated with a change in the number of physician visits or diabetes-related laboratory tests during follow-up. The clinical benefits and sustainability of ATRS remain unproven, but our results indicate that an automated reminder system can be effective for providing messages to a large group of older patients with diabetes.

  20. Diálisis peritoneal automática adaptada: un método de prescripción eficaz, eficiente y seguro

    Directory of Open Access Journals (Sweden)

    Sergi Aragó Sorrosal

    Full Text Available El objetivo del trabajo es analizar los resultados obtenidos tras la introducción de la modalidad de diálisis peritoneal automática adaptada, usando bicarbonato puro como agente tampón, en un grupo de pacientes en programa de diálisis peritoneal automática convencional. Estudio de diseño cuasi experimental, que se realizó entre los meses de febrero y diciembre de 2013, en la unidad de diálisis peritoneal del Hospital Clínic de Barcelona. Los sujetos de estudio fueron 12 pacientes, 7 mujeres y 5 hombres, de dicha unidad en modalidad de diálisis peritoneal automática convencional. Edad media 58±12 años (rango: 34-71. El estudio consistió en comparar dos modalidades de diálisis peritoneal automática. Se inició el estudio con prescripción de diálisis convencional, durante tres meses, para cambiar a modalidad de diálisis adaptada durante el mismo intervalo de tiempo. Y finalizarlo, con tres meses de pauta de diálisis convencional. Se prescribió el mismo volumen total de líquido de diálisis y tiempo de sesión, para cada paciente en ambas modalidades, variando los volúmenes y tiempos de permanencia en función de la modalidad. Se utilizó solución de diálisis con bicarbonato puro y glucosa 1,5%. Todos los pacientes, con día seco. Se monitorizaron las variables al inicio del estudio, y en cada cambio de prescripción. Los resultados obtenidos en diálisis convencional: Kt/v=2,3±0,2, aclaramiento de creatinina=63±8litros/semana, y ultrafiltración=842±110ml. En diálisis adaptada, Kt/v=2,8±0,2, aclaramiento de creatinina=74±9litros/semana, y ultrafiltración=982±123ml. La diálisis adaptada permite obtener una adecuada eficacia de tratamiento, mejora los parámetros de adecuación de diálisis y ultrafiltración; siendo segura y cómoda para el paciente.

  1. Comparison of peritoneal free gastric cancer cells' detecting rates between laparoscopically assisted and open radical gastrectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To compare laparoscopic gastrectomy and conventional surgery on the dissemination and seeding of tumor cells. Methods:Intraoperative peritoneal lavage cytologic examination was performed in 65 patients with gastric cancer, during laparoscopic gastrectomy (n=34) and conventional surgery (n=31). Cytology was examined twice, immediately after opening the peritoneal cavity and just before closing the abdomen. Saline was poured into the peritoneal cavity, and 100 ml fluid was retrieved after irrigation. Laparoscopic instruments were lavaged after surgery with 100 ml saline. Carbon dioxide (CO2) was derived through the trocar side orifice after pneumoperitoneum during laparoscopic gastrectomy and filtered through 100 ml saline. Cytologic examination of the filtrate was performed after the filtration process. Results: The incidence of positive cytology during laparoscopic surgery was 32.26% in the preoperative lavage and 22.58% in the postoperative lavage. The incidence of positive cytology during conventional surgery was 41.18% before lavage and 26.47% after lavage. Only one positive cytology was detected in the CO2 filtrate gas. The incidence of positive cytology in the lavage of the instruments during laparoscopic surgery was 6.45%. Conclusion: During gastric laparoscopic surgery, CO2 pneumoperitoneum does not affect tumor cell dissemination and seeding. In this study, laparoscopic techniques used in gastric cancer surgery were not associated with a higher risk for intraperitoneal dissemination of cancer cells than the conventional surgery.

  2. Patients in assisted automated peritoneal dialysis develop strategies for self-care

    DEFF Research Database (Denmark)

    Holch, Kirsten

    2008-01-01

    with aAPD. The starting point of the second interview was a preliminary analysis of the first interview. The interview guide was inspired by  Henderson's areas of need and Orem's self care theory combined with problems and symptoms in End Stage Renal Disease patients. Results The results of the study...... their needs and in which areas? Which self-care capacity and which strategies do patients use to satisfy their needs?   Methods A qualitative research design was chosen. Inclusion criteria: Patients who started aAPD treatment in the period between June and November 2006 at Aarhus University Hospital, Skejby...... show that patients in their own home strengthen their self-care capacity in the period between three and six months after starting aAPD treatment. Examples of this are initiatives concerning promotion of appetite, sleep, dressing, social contact and prevention of infection and fall. Conclusion Elderly...

  3. Peritonitis - spontaneous bacterial

    Science.gov (United States)

    Spontaneous bacterial peritonitis (SBP); Ascites - peritonitis; Cirrhosis - peritonitis ... who are on peritoneal dialysis for kidney failure. Peritonitis may have other causes . These include infection from ...

  4. Rapid and convenient semi-automated microwave-assisted solid-phase synthesis of arylopeptoids

    DEFF Research Database (Denmark)

    Rasmussen, Jakob Ewald; Boccia, Marcello Massimo; Nielsen, John

    2014-01-01

    A facile and expedient route to the synthesis of arylopeptoid oligomers (N-alkylated aminomethyl benz-amides) using semi-automated microwave-assisted solid-phase synthesis is presented. The synthesis was optimized for the incorporation of side chains derived from sterically hindered or unreactive...

  5. Semi-automated microwave assisted solid-phase peptide synthesis

    DEFF Research Database (Denmark)

    Pedersen, Søren Ljungberg

    Despite the development of new coupling reagents and solid supports, SPPS is still often faced with difficulties in the assembly of long or ‘difficult' sequences, e.g. due to aggregation and steric hindrance giving rise to incomplete reactions. The use of convenient and precise heating with micro......Despite the development of new coupling reagents and solid supports, SPPS is still often faced with difficulties in the assembly of long or ‘difficult' sequences, e.g. due to aggregation and steric hindrance giving rise to incomplete reactions. The use of convenient and precise heating...... Biotage Initiator microwave instrument, which is available in many laboratories, with a modified semi-automated peptide synthesizer from MultiSynTech. A custom-made reaction vessel is placed permanently in the microwave oven, thus the reactor does not have to be moved between steps. Mixing is achieved...

  6. Automated 3D ultrasound image segmentation for assistant diagnosis of breast cancer

    Science.gov (United States)

    Wang, Yuxin; Gu, Peng; Lee, Won-Mean; Roubidoux, Marilyn A.; Du, Sidan; Yuan, Jie; Wang, Xueding; Carson, Paul L.

    2016-04-01

    Segmentation of an ultrasound image into functional tissues is of great importance to clinical diagnosis of breast cancer. However, many studies are found to segment only the mass of interest and not all major tissues. Differences and inconsistencies in ultrasound interpretation call for an automated segmentation method to make results operator-independent. Furthermore, manual segmentation of entire three-dimensional (3D) ultrasound volumes is time-consuming, resource-intensive, and clinically impractical. Here, we propose an automated algorithm to segment 3D ultrasound volumes into three major tissue types: cyst/mass, fatty tissue, and fibro-glandular tissue. To test its efficacy and consistency, the proposed automated method was employed on a database of 21 cases of whole breast ultrasound. Experimental results show that our proposed method not only distinguishes fat and non-fat tissues correctly, but performs well in classifying cyst/mass. Comparison of density assessment between the automated method and manual segmentation demonstrates good consistency with an accuracy of 85.7%. Quantitative comparison of corresponding tissue volumes, which uses overlap ratio, gives an average similarity of 74.54%, consistent with values seen in MRI brain segmentations. Thus, our proposed method exhibits great potential as an automated approach to segment 3D whole breast ultrasound volumes into functionally distinct tissues that may help to correct ultrasound speed of sound aberrations and assist in density based prognosis of breast cancer.

  7. Qualidade de Vida: comparação entre diálise peritoneal automatizada e hemodiálise Calidad de vida: comparación entre diálisis peritoneal automatizada y hemodiálisis Quality of Life: comparison between patients on automated peritoneal dialysis and patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Valquiria Greco Arenas

    2009-01-01

    Full Text Available OBJETIVO: Avaliar a Qualidade de Vida relacionada à saúde em pacientes submetidos à Diálise Peritoneal Automatizada (DPA e Hemodiálise em um centro de diálise satélite no Município de São Paulo. MÉTODOS: Este estudo observacional transversal, incluiu 101 pacientes com idade entre 18-75 anos, em terapia há mais de 90 dias e que compreenderam o questionário. RESULTADOS: O grupo em Hemodiálise (n=79 estava em terapia há mais tempo (p=0.001 e tinha albumina sérica maior (pOBJETIVO: Evaluar la Calidad de Vida relacionada a la salud de pacientes sometidos a Diálisis Peritoneal Automatizada (DPA y Hemodiálisis en un centro de diálisis del Municipio de Sao Paulo. MÉTODOS: Este estudio observacional transversal, incluyó a 101 pacientes con edades comprendidas entre los 18 y 75 años, que se encontraban en terapia hace más de 90 días y que comprendieran el cuestionario. RESULTADOS: El grupo en Hemodiálisis (n=79 estaba en terapia hace más de un tiempo (p=0.001 y tenía albúmina sérica mayor (pOBJECTIVE: To evaluate the health-related quality of life in patients from a satellite dialysis center in São Paulo city undergoing Automated Peritoneal Dialysis (APD or Hemodialysis. METHODS: This cross-sectional descriptive study included 101 patients with ages ranging from 18 to 75 years-old, who were in dialysis treatment over 90 days and able to understand the items of the SF-36 questionnaire in Portuguese. RESULTS: The Hemodialysis group (n=79 had been in dialysis treatment longer (p=0.001 and had higher serum albumin level (p<0.001 than the APD group (n=22. The SF-36 scores of the two groups were similar in all dimensions, except for the physical functioning dimension, on which the hemodialysis group had higher scores than the APD group (p=0.03. There were no statistically significant interactions between the SF-36 score and the other variables of the study. CONCLUSION: There were no differences in quality of life between patients on

  8. Automated design of gravity-assist trajectories to Mars and the outer planets

    Science.gov (United States)

    Longuski, James M.; Williams, Steve N.

    1991-01-01

    In this paper, a new approach to planetary mission design is described which automates the search for gravity-assist trajectories. This method finds all conic solutions given a range of launch dates, a range of launch energies and a set of target planets. The new design tool is applied to the problems of finding multiple encounter trajectories to the outer planets and Venus gravity-assist trajectories to Mars. The last four-planet grand tour opportunity (until the year 2153) is identified. It requires an earth launch in 1996 and encounters Jupiter, Uranus, Neptune, and Pluto. Venus gravity-assist trajectories to Mars for the 30 year period 1995-2024 are examined. It is shown that in many cases these trajectories require less launch energy to reach Mars than direct ballistic trajectories.

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

    Science.gov (United States)

    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.

  10. Evaluation of Peritonitis Incidence, Etiology, Associated Factors and Prognosis of Continuous Ambulatory Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Nefise ÖZBALCI

    2013-05-01

    Full Text Available OBJECTIVE: Peritonitis is the most important complication of peritoneal dialysis (PD. We evaluated the incidence of peritonitis, active microorganisms and their susceptibility profile and determine prognosis. MATERIAL and METHODS: One hundred fifty three PD patients were evaluated for aetiology, drug usage, accompanying disease, type, duration and personal preference for PD, care-giver, protein catabolic rate (PCR, residual urine volume, ultrafiltration volume, type of peritoneal membrane transport and baseline laboratory values. RESULTS: The incidence of peritonitis was 0,284 attack/patient/year. The most common organisms were coagulase negative staphylococci (18.3% followed by S. aureus (14.8% and gram-negative bacillus (13.1%. Peritonitis was more common in elderly, those with longer PD duration, low residual urine volume, patients with low PCR and hepatitis C. However, patients using erythropoietin and automated PD had low incidence of peritonitis compared to others. Mortality rate was higher in gram-negative and fungal peritonitis and prognosis was worse in gramnegative peritonitis CONCLUSION: Peritonitis incidence and aetiology were compatible with literature. One must be careful to protect residual renal function (RRF as peritonitis incidence was significantly reduced in patients with RRF. PCR values were significantly lower in peritonitis. Adequate protein intake and nutritional support may be important in this respect.

  11. A feasibility assessment of automated FISH image and signal analysis to assist cervical cancer detection

    Science.gov (United States)

    Wang, Xingwei; Li, Yuhua; Liu, Hong; Li, Shibo; Zhang, Roy R.; Zheng, Bin

    2012-02-01

    Fluorescence in situ hybridization (FISH) technology provides a promising molecular imaging tool to detect cervical cancer. Since manual FISH analysis is difficult, time-consuming, and inconsistent, the automated FISH image scanning systems have been developed. Due to limited focal depth of scanned microscopic image, a FISH-probed specimen needs to be scanned in multiple layers that generate huge image data. To improve diagnostic efficiency of using automated FISH image analysis, we developed a computer-aided detection (CAD) scheme. In this experiment, four pap-smear specimen slides were scanned by a dual-detector fluorescence image scanning system that acquired two spectrum images simultaneously, which represent images of interphase cells and FISH-probed chromosome X. During image scanning, once detecting a cell signal, system captured nine image slides by automatically adjusting optical focus. Based on the sharpness index and maximum intensity measurement, cells and FISH signals distributed in 3-D space were projected into a 2-D con-focal image. CAD scheme was applied to each con-focal image to detect analyzable interphase cells using an adaptive multiple-threshold algorithm and detect FISH-probed signals using a top-hat transform. The ratio of abnormal cells was calculated to detect positive cases. In four scanned specimen slides, CAD generated 1676 con-focal images that depicted analyzable cells. FISH-probed signals were independently detected by our CAD algorithm and an observer. The Kappa coefficients for agreement between CAD and observer ranged from 0.69 to 1.0 in detecting/counting FISH signal spots. The study demonstrated the feasibility of applying automated FISH image and signal analysis to assist cyto-geneticists in detecting cervical cancers.

  12. Peritoneal dialysis peritonitis: risk factors and effects

    Directory of Open Access Journals (Sweden)

    Alikari V.

    2013-07-01

    Full Text Available Introduction: Peritonitis is the most frequent complication of peritoneal dialysis. It is the main cause of failure of the method and inclusion of patients in hemodialysis Purpose: The purpose of this study is to explore the risk factors of peritoneal dialysis peritonitis as well as the acute and long-term effects of peritonitis on peritoneal membrane function and success of the method. Methods: Literature review of relevant articles in the database Pubmed as well as the official website of the International Society of Peritoneal Dialysis (ISPD was carried out. The search included articles published during the period 1986 -2012.Results: Lack of patient compliance with the peritoneal changes protocol, lack of social support, systemic diseases and connection systems are risk factors of peritonitis. Peritonitis causes transient increase of peritoneum permeability, loss of the ability of the peritoneum for ultrafiltration and, consequently, overhydration. Long-term, recurrent episodes of peritonitis resulting in permanent loss of peritoneum capacity for ultrafiltration even fibrosis that leads to failure of the method. Finally, its effect on the reduction of the residual renal function seems to be remarkable. Conclusions: Peritonitis is the most common infectious complication of peritoneal dialysis and the main cause of morbidity associated with the method. Moreover, it is the major cause of failure of the method and patients accession in hemodialysis. Any attempt to prevent peritonitis passes through the careful patient selection and effective patient education on compliance with the rules of asepsis during peritoneal changes.

  13. TWEAK Promotes Peritoneal Inflammation

    Science.gov (United States)

    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

  14. Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis

    Directory of Open Access Journals (Sweden)

    Mehmet Akce

    2014-01-01

    Full Text Available A 67-year-old male presented with fatigue, abdominal pain , and 30-pound weight loss over 3 months. Computerized tomography (CT abdomen displayed ascites with thickening and enhancement of the peritoneum and mottled nodular appearing as soft tissue consistent with omental caking worrisome for peritoneal carcinomatosis. A paracentesis revealed white blood cell count of 2,500 with 98% lymphocytes and serum ascites albumin gradient of 0.9 g/L. No acid-fast bacilli were seen by microscopic exam and culture was negative. Purified protein derivative skin test (PPD was negative and CXR did not reveal any infiltrates. Esophagogastroduodenoscopy (EGD and colonoscopy were unrevealing. The patient underwent exploratory laparotomy with round ligament and peritoneal biopsies that revealed numerous necrotizing granulomas. Acid-fast bacteria Ziehl-Neelsen stain (AFB of the biopsy specimen revealed single acid-fast bacilli. Treatment for M. tuberculosis was initiated and final culture revealed that mycobacterium tuberculosis was sensitive to Isoniazid, Rifampin, Ethambutol, and Pyrazinamide. After 6 months of treatment, the ascites and peritoneal carcinomatosis resolved.

  15. IceVal DatAssistant: An Interactive, Automated Icing Data Management System

    Science.gov (United States)

    Levinson, Laurie H.; Wright, William B.

    2008-01-01

    As with any scientific endeavor, the foundation of icing research at the NASA Glenn Research Center (GRC) is the data acquired during experimental testing. In the case of the GRC Icing Branch, an important part of this data consists of ice tracings taken following tests carried out in the GRC Icing Research Tunnel (IRT), as well as the associated operational and environmental conditions documented during these tests. Over the years, the large number of experimental runs completed has served to emphasize the need for a consistent strategy for managing this data. To address the situation, the Icing Branch has recently elected to implement the IceVal DatAssistant automated data management system. With the release of this system, all publicly available IRT-generated experimental ice shapes with complete and verifiable conditions have now been compiled into one electronically-searchable database. Simulation software results for the equivalent conditions, generated using the latest version of the LEWICE ice shape prediction code, are likewise included and are linked to the corresponding experimental runs. In addition to this comprehensive database, the IceVal system also includes a graphically-oriented database access utility, which provides reliable and easy access to all data contained in the database. In this paper, the issues surrounding historical icing data management practices are discussed, as well as the anticipated benefits to be achieved as a result of migrating to the new system. A detailed description of the software system features and database content is also provided; and, finally, known issues and plans for future work are presented.

  16. Automation-assisted cervical cancer screening in manual liquid-based cytology with hematoxylin and eosin staining.

    Science.gov (United States)

    Zhang, Ling; Kong, Hui; Ting Chin, Chien; Liu, Shaoxiong; Fan, Xinmin; Wang, Tianfu; Chen, Siping

    2014-03-01

    Current automation-assisted technologies for screening cervical cancer mainly rely on automated liquid-based cytology slides with proprietary stain. This is not a cost-efficient approach to be utilized in developing countries. In this article, we propose the first automation-assisted system to screen cervical cancer in manual liquid-based cytology (MLBC) slides with hematoxylin and eosin (H&E) stain, which is inexpensive and more applicable in developing countries. This system consists of three main modules: image acquisition, cell segmentation, and cell classification. First, an autofocusing scheme is proposed to find the global maximum of the focus curve by iteratively comparing image qualities of specific locations. On the autofocused images, the multiway graph cut (GC) is performed globally on the a* channel enhanced image to obtain cytoplasm segmentation. The nuclei, especially abnormal nuclei, are robustly segmented by using GC adaptively and locally. Two concave-based approaches are integrated to split the touching nuclei. To classify the segmented cells, features are selected and preprocessed to improve the sensitivity, and contextual and cytoplasm information are introduced to improve the specificity. Experiments on 26 consecutive image stacks demonstrated that the dynamic autofocusing accuracy was 2.06 μm. On 21 cervical cell images with nonideal imaging condition and pathology, our segmentation method achieved a 93% accuracy for cytoplasm, and a 87.3% F-measure for nuclei, both outperformed state of the art works in terms of accuracy. Additional clinical trials showed that both the sensitivity (88.1%) and the specificity (100%) of our system are satisfyingly high. These results proved the feasibility of automation-assisted cervical cancer screening in MLBC slides with H&E stain, which is highly desirable in community health centers and small hospitals.

  17. Test-Retest Reliability of an Automated Infrared-Assisted Trunk Accelerometer-Based Gait Analysis System.

    Science.gov (United States)

    Hsu, Chia-Yu; Tsai, Yuh-Show; Yau, Cheng-Shiang; Shie, Hung-Hai; Wu, Chu-Ming

    2016-07-23

    The aim of this study was to determine the test-retest reliability of an automated infrared-assisted, trunk accelerometer-based gait analysis system for measuring gait parameters of healthy subjects in a hospital. Thirty-five participants (28 of them females; age range, 23-79 years) performed a 5-m walk twice using an accelerometer-based gait analysis system with infrared assist. Measurements of spatiotemporal gait parameters (walking speed, step length, and cadence) and trunk control (gait symmetry, gait regularity, acceleration root mean square (RMS), and acceleration root mean square ratio (RMSR)) were recorded in two separate walking tests conducted 1 week apart. Relative and absolute test-retest reliability was determined by calculating the intra-class correlation coefficient (ICC3,1) and smallest detectable difference (SDD), respectively. The test-retest reliability was excellent for walking speed (ICC = 0.87, 95% confidence interval = 0.74-0.93, SDD = 13.4%), step length (ICC = 0.81, 95% confidence interval = 0.63-0.91, SDD = 12.2%), cadence (ICC = 0.81, 95% confidence interval = 0.63-0.91, SDD = 10.8%), and trunk control (step and stride regularity in anterior-posterior direction, acceleration RMS and acceleration RMSR in medial-lateral direction, and acceleration RMS and stride regularity in vertical direction). An automated infrared-assisted, trunk accelerometer-based gait analysis system is a reliable tool for measuring gait parameters in the hospital environment.

  18. Peritoneal Fluid Analysis

    Science.gov (United States)

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

  19. Peritoneal fluid culture

    Science.gov (United States)

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

  20. Anemia in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Laušević Mirjana

    2006-01-01

    Full Text Available 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/I in patients without rHuEPO treatment. Erythropoietin requirements were 3392.85±1211.77 IU/week. AII patients received iron supplementation during rHuEPO therapy. Mean serum ferritin levels were 463.41 ±360 μg/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

  1. Fungal peritonitis in children on peritoneal dialysis.

    NARCIS (Netherlands)

    Raaijmakers, R.; Schroder, C.; Monnens, L.A.H.; Cornelissen, E.A.M.; Warris, A.

    2007-01-01

    Fungal peritonitis is a rare but serious complication in children on peritoneal dialysis (PD). In this study, risk factors were evaluated, and therapeutic measures were reviewed. A retrospective, multi-centre study was performed in 159 Dutch paediatric PD patients, between 1980 and 2005 (3,573 month

  2. Peritoneal tuberculosis: radiographic diagnosis

    Directory of Open Access Journals (Sweden)

    Carolina Ospina-Moreno

    2014-12-01

    Full Text Available Peritoneal tuberculosis (TB is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy.

  3. Test-Retest Reliability of an Automated Infrared-Assisted Trunk Accelerometer-Based Gait Analysis System

    Directory of Open Access Journals (Sweden)

    Chia-Yu Hsu

    2016-07-01

    Full Text Available The aim of this study was to determine the test-retest reliability of an automated infrared-assisted, trunk accelerometer-based gait analysis system for measuring gait parameters of healthy subjects in a hospital. Thirty-five participants (28 of them females; age range, 23–79 years performed a 5-m walk twice using an accelerometer-based gait analysis system with infrared assist. Measurements of spatiotemporal gait parameters (walking speed, step length, and cadence and trunk control (gait symmetry, gait regularity, acceleration root mean square (RMS, and acceleration root mean square ratio (RMSR were recorded in two separate walking tests conducted 1 week apart. Relative and absolute test-retest reliability was determined by calculating the intra-class correlation coefficient (ICC3,1 and smallest detectable difference (SDD, respectively. The test-retest reliability was excellent for walking speed (ICC = 0.87, 95% confidence interval = 0.74–0.93, SDD = 13.4%, step length (ICC = 0.81, 95% confidence interval = 0.63–0.91, SDD = 12.2%, cadence (ICC = 0.81, 95% confidence interval = 0.63–0.91, SDD = 10.8%, and trunk control (step and stride regularity in anterior-posterior direction, acceleration RMS and acceleration RMSR in medial-lateral direction, and acceleration RMS and stride regularity in vertical direction. An automated infrared-assisted, trunk accelerometer-based gait analysis system is a reliable tool for measuring gait parameters in the hospital environment.

  4. Peritoneal dialysis in Asia.

    Science.gov (United States)

    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

  5. Prophylactic antibiotics for endoscopy-associated peritonitis in peritoneal dialysis patients.

    Directory of Open Access Journals (Sweden)

    Hsin-Hsu Wu

    Full Text Available INTRODUCTION: Continuous ambulatory peritoneal dialysis (CAPD peritonitis may develop after endoscopic procedures, and the benefit of prophylactic antibiotics is unclear. In the present study, we investigated whether prophylactic antibiotics reduce the incidence of peritonitis in these patients. PATIENTS AND METHODS: We retrospectively reviewed all endoscopic procedures, including esophagogastroduodenoscopy (EGD, colonoscopy, sigmoidoscopy, cystoscopy, hysteroscopy, and hysteroscopy-assisted intrauterine device (IUD implantation/removal, performed in CAPD patients at Chang Gung Memorial Hospital, Taiwan, between February 2001 and February 2012. RESULTS: Four hundred and thirty-three patients were enrolled, and 125 endoscopies were performed in 45 patients. Eight (6.4% peritonitis episodes developed after the examination. Antibiotics were used in 26 procedures, and none of the patients had peritonitis (0% vs. 8.1% without antibiotic use; p=0.20. The peritonitis rate was significantly higher in the non-EGD group than in the EGD group (15.9% [7/44] vs. 1.2% [1/81]; p<0.005. Antibiotic use prior to non-EGD examinations significantly reduced the endoscopy-associated peritonitis rate compared to that without antibiotic use (0% [0/16] vs. 25% [7/28]; p<0.05. Peritonitis only occurred if invasive procedures were performed, such as biopsy, polypectomy, or IUD implantation, (noninvasive procedures, 0% [0/20] vs. invasive procedures, 30.4% [7/23]; p<0.05. No peritonitis was noted if antibiotics were used prior to examination with invasive procedures (0% [0/10] vs. 53.8% [7/13] without antibiotic use; p<0.05. Although not statistically significant, antibiotics may play a role in preventing gynecologic procedure-related peritonitis (antibiotics, 0% [0/4] vs. no antibiotics, 55.6% [5/9]; p=0.10. CONCLUSION: Antibiotic prophylaxis significantly reduced endoscopy-associated PD peritonitis in the non-EGD group. Endoscopically assisted invasive procedures, such

  6. Learning-Assisted Automated Planning: Looking Back, Taking Stock, Going Forward

    OpenAIRE

    Zimmerman, Terry; Kambhampati, Subbarao

    2003-01-01

    This article reports on an extensive survey and analysis of research work related to machine learning as it applies to automated planning over the past 30 years. Major research contributions are broadly characterized by learning method and then descriptive subcategories. Survey results reveal learning techniques that have extensively been applied and a number that have received scant attention. We extend the survey analysis to suggest promising avenues for future research in learning based on...

  7. Feasibility of mesothelial transplantation during experimental peritoneal dialysis and peritonitis

    NARCIS (Netherlands)

    Hekking, L. H. P.; van den Born, J.

    2007-01-01

    The mesothelial cell layer lining the peritoneum orchestrates peritoneal homeostasis. Continuous exposure to peritoneal dialysis fluids and episodes of peritonitis may damage the monolayer irreversibly, eventually leading to adhesion formation and fibrosis/sclerosis of the peritoneum. Autologous mes

  8. Peritoneal membrane characteristics in patients on peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Jamal Al-wakeel

    2011-01-01

    Full Text Available Peritoneal dialysis (PD is a well-established modality for treatment of patients with end-stage renal disease, giving excellent patient and technique survival rates. In Saudi Arabia, data collected by the Saudi Center for Organ Transplantation showed that in 2008, patients on PD accounted for a mere 4.8% of total patients on renal replacement therapy, including hemodialysis and renal transplantation. This study was conducted to identify the characteristics of membrane per-meability in the Saudi population and to assess the role of various factors affecting solute transport across the peritoneal membrane. We followed up a total of 52 patients on Continuous Ambulatory Peritoneal Dialysis (CAPD as well as Automated Peritoneal Dialysis (APD, being treated in the PD unit of the King Khalid University Hospital, Riyadh. There were 30 female and 22 male patients; 14 patients were using CAPD while 38 patients were on APD. The mean age of the patients was 50.5 years, with a range of 14-86 years. The average body mass index (BMI was 27.1 kg/m 2 and the mean body surface area (BSA of the study patients was 1.71 m 2 . A standardized PET test was performed on all patients, 4-6 weeks after initiation of regular PD. The Kt/V and creatinine clearance measured 6-8 weeks after initiation of dialysis were 1.96 and 56.59 L/week, respectively. Residual renal function was assessed on the basis of daily urine output, using 24-hour urine collection. The mean serum urea con-centration was 16.91 mmol/L and mean serum creatinine was 702 μmol/L. According to the Peritoneal Equiliberation Test (PET, 8% of the subjects belonged to the high trans-porter category, 44% patients belonged to the high-average transport group, 46% to the low-average category and 2% came in the low transporter category. Our study suggests that the patient characteristics and demographic para-meters seen in the Saudi population are comparable to those seen in other studies from the Middle East and

  9. Self Assistive Technology for Disabled People – Voice Controlled Wheel Chair and Home Automation System

    Directory of Open Access Journals (Sweden)

    R. Puviarasi

    2014-07-01

    Full Text Available This paper describes the design of an innovative and low cost self-assistive technology that is used to facilitate the control of a wheelchair and home appliances by using advanced voice commands of the disabled people. This proposed system will provide an alternative to the physically challenged people with quadriplegics who is permanently unable to move their limbs (but who is able to speak and hear and elderly people in controlling the motion of the wheelchair and home appliances using their voices to lead an independent, confident and enjoyable life. The performance of this microcontroller based and voice integrated design is evaluated in terms of accuracy and velocity in various environments. The results show that it could be part of an assistive technology for the disabled persons without any third person’s assistance.

  10. Peritoneal Dialysis Registry With 2012 Survey Report.

    Science.gov (United States)

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

    2015-12-01

    Since 2009, the peritoneal dialysis (PD) registry survey has been carried out as part of the annual nationwide survey conducted by the Statistical Survey Committee of the Japanese Society for Dialysis Therapy with the cooperation of the Japanese Society for Peritoneal Dialysis. In this report, the current status of PD patients is presented on the basis of the results of the survey conducted at the end of 2012. The subjects were PD patients who lived in Japan and participated in the 2012 survey. Descriptive analysis of various items was performed, which included the current status of the combined use of PD and another dialysis method such as hemodialysis (HD) or hemodiafiltration (HDF), the method of exchanging dialysate, the use of an automated peritoneal dialysis (APD) machine, and the rates of peritonitis and catheter exit-site infection. From the results of the facility survey in 2012, the number of PD patients was 9514, a decrease of 128 from 2011. Among the entire dialysis patient population, 3.1% were PD patients, a decrease of 0.1%. Among the studied patients, 347 had a peritoneal catheter and underwent peritoneal lavage, 175 were started on PD in 2012 but introduced to other blood purification methods in the same year, and 1932 underwent both PD and another dialysis method such as HD or HDF. The percentage of patients who underwent PD and another dialysis method increased with PD vintage: vintage of ≥2 years. The mean rate of peritonitis was 0.22 per patient per year. The mean rate of catheter exit-site infections was 0.36 per patient per year.

  11. [Characteristics of postoperative peritonitis].

    Science.gov (United States)

    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. Towards the Development of an Automated Learning Assistant for Vector Calculus: Integration over Planar Regions

    Science.gov (United States)

    Yaacob, Yuzita; Wester, Michael; Steinberg, Stanly

    2010-01-01

    This paper presents a prototype of a computer learning assistant ILMEV (Interactive Learning-Mathematica Enhanced Vector calculus) package with the purpose of helping students to understand the theory and applications of integration in vector calculus. The main problem for students using Mathematica is to convert a textbook description of a…

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

    Directory of Open Access Journals (Sweden)

    Susan Yung

    2011-01-01

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

  14. REAS: An Interactive Semi-Automated System for Software Requirements Elicitation Assistance

    Directory of Open Access Journals (Sweden)

    Hanan Hamed Elazhary

    2010-05-01

    Full Text Available Faulty requirements specifications lead to developing a faulty software system. This may require repeating the whole software engineering cycle wasting time and money. This paper presents an interactive semi-automated system that is a compromise between two approaches. The first tries to avoid the introduction of imprecision while the software requirements are being written. The other attempts to detect and possibly correct many types of imprecision after the software requirements are written. This is achieved by imposing the use of a good writing style and by interactively emulating a conversation between the requirements engineer and the user. This helps free the requirements engineer from such a systematic task, helps in processing many ill-structured statements, and helps maintain consistency in the used terminology. Explanations produced by the system helps in detecting and correcting any missed imprecision. The proposed techniques are easy enough to be used by non-technical stakeholders in different domains

  15. Selecting a computer-assisted retrieval system: one answer to office automation.

    Science.gov (United States)

    Bogue, D T

    1983-11-01

    Computer-assisted retrieval (CAR) systems combine computers with microfilm to create a cost-effective, productive method of managing information. CAR systems range in size from large computerized mass-storage systems utilizing image scanning and digitized technologies to small, tabletop, standalone microprocessor-driven systems. When properly configured, a CAR system can not only provide vital information today, but will also be able to grow and expand into a total office system.

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

    Science.gov (United States)

    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.

  17. Resistant Yersinia Enterocolitica Peritonitis in a Peritoneal Dialysis Patient

    Directory of Open Access Journals (Sweden)

    Mehmet ÖZDEN

    2012-09-01

    Full Text Available Peritonitis is an important problem of peritoneal dialysis patients. Although Gram (+ bacteria are more frequent, Gram (- bacteria can rarely be the cause of peritonitis. Yersinia enterocolitica is a Gram (- enteric bacteria that especially causes gastrointestinal infections via contaminated food intake in immunosuppressive situations such as haemochromatosis, desferroxamine therapy or chronic hepatitis. We report a 51-year-old man who had been undergoing SAPD because of chronic renal failure for 2 years. We evaluated his peritoneal fl uid because of symptoms of peritonitis. His peritoneal cellular composition was consistent with peritonitis and after the microbiological culture of the fl uid we determined Yersinia enterocolitica as the pathogenic agent. The peritonitis persisted despite the administration of long term combined antibiotherapy and we removed the peritoneal catheter. In conclusion, Yersinia enterocolitica peritonitis is resistant to conventional antibiotic therapy and an indication for catheter removal.

  18. Intelligent remote health monitoring using evident-based DSS for automated assistance.

    Science.gov (United States)

    Serhani, Mohamed Adel; Benharref, Abdelghani; Nujum, Al Ramzana

    2014-01-01

    The shift from common diagnosis practices to continuous monitoring based on body sensors has transformed healthcare from hospital-centric to patient-centric. Continuous monitoring generates huge and continuous amount of data revealing changing insights. Existing approaches to analyze streams of data in order to produce validated decisions relied mostly on static learning and analytics techniques. In this paper, we propose an incremental learning and adaptive analytics scheme relying on evident data and rule-based Decision Support System (DSS). The later continuously enriches its knowledge base with incremental learning information impacting the decision and proposing up-to-date recommendations. Some intelligent features augmented the monitoring scheme with data pre-processing and cleansing support, which helped empowering data analytics efficiency. Generated assistances are viewable to users on their mobile devices and to physician via a portal. We evaluate our incremental learning and analytics scheme using seven well-known learning techniques. The set of experimental scenarios of continuous heart rate and ECG monitoring demonstrated that the incremental learning combined with rule-based DSS afforded high classification accuracy, evidenced decision, and validated assistance.

  19. Automated anatomical description of pleural thickening towards improvement of its computer-assisted diagnosis

    Science.gov (United States)

    Chaisaowong, Kraisorn; Jiang, Mingze; Faltin, Peter; Merhof, Dorit; Eisenhawer, Christian; Gube, Monika; Kraus, Thomas

    2016-03-01

    Pleural thickenings are caused by asbestos exposure and may evolve into malignant pleural mesothelioma. An early diagnosis plays a key role towards an early treatment and an increased survival rate. Today, pleural thickenings are detected by visual inspection of CT data, which is time-consuming and underlies the physician's subjective judgment. A computer-assisted diagnosis system to automatically assess pleural thickenings has been developed, which includes not only a quantitative assessment with respect to size and location, but also enhances this information with an anatomical description, i.e. lung side (left, right), part of pleura (pars costalis, mediastinalis, diaphragmatica, spinalis), as well as vertical (upper, middle, lower) and horizontal (ventral, dorsal) position. For this purpose, a 3D anatomical model of the lung surface has been manually constructed as a 3D atlas. Three registration sub-steps including rigid, affine, and nonrigid registration align the input patient lung to the 3D anatomical atlas model of the lung surface. Finally, each detected pleural thickening is assigned a set of labels describing its anatomical properties. Through this added information, an enhancement to the existing computer-assisted diagnosis system is presented in order to assure a higher precision and reproducible assessment of pleural thickenings, aiming at the diagnosis of the pleural mesothelioma in its early stage.

  20. Modeling and control of tissue compression and temperature for automation in robot-assisted surgery.

    Science.gov (United States)

    Sinha, Utkarsh; Li, Baichun; Sankaranarayanan, Ganesh

    2014-01-01

    Robotic surgery is being used widely due to its various benefits that includes reduced patient trauma and increased dexterity and ergonomics for the operating surgeon. Making the whole or part of the surgical procedure autonomous increases patient safety and will enable the robotic surgery platform to be used in telesurgery. In this work, an Electrosurgery procedure that involves tissue compression and application of heat such as the coaptic vessel closure has been automated. A MIMO nonlinear model characterizing the tissue stiffness and conductance under compression was feedback linearized and tuned PID controllers were used to control the system to achieve both the displacement and temperature constraints. A reference input for both the constraints were chosen as a ramp and hold trajectory which reflect the real constraints that exist in an actual surgical procedure. Our simulations showed that the controllers successfully tracked the reference trajectories with minimal deviation and in finite time horizon. The MIMO system with controllers developed in this work can be used to drive a surgical robot autonomously and perform electrosurgical procedures such as coaptic vessel closures.

  1. Clinical application of the ureteroscope assistant placement of peritoneal dialysis catheters%输尿管镜辅助下腹膜透析管置入技术的应用

    Institute of Scientific and Technical Information of China (English)

    朱微; 燕翔; 蒋春明; 张苗

    2012-01-01

    To evaluate the clinical feasibility,safety and effect of the ureteroscope assistant placement of peritoneal dialysis catheters in patients with end stage renal disease (ESRD). Methodology: Thirty two consecutive ESRD patients underwent ureteroscope assistant placement of peritoneal dialysis catheters. Informed consent form was signed by patients under principle of voluntary. All patients were eligible to receive local infiltration anesthesia. Ureteroscopic monitoring was performed via a peer-away sheath through an incision near the umbilicus. A catheter was passed through the peer-away sheath into the true pelvis. A subcutaneous tunnel was created and a point in left lower quadrant was selected as the exit site of the catheter. Results; All the catheters were successfully placed and the mean time of operation was (42 ±15) minutes. The dose of additional local anesthetics during procedure is 20% lidocaine (13 ±5) milliliter. Blood loss was very little in operation. Only 4 cases presented the ascites with little red blood cells which lasted (16 ±5) hours. During mean follow-up period of 12 months, there were no catheter-related complications, such as catheter migration, obstruction,and dialysate leakage. Conclusion:The ureteroscope assistant placement of peritoneal dialysis catheters is worthy to be popularized for it's safty and effectiveness in end stage renal disease ( ESRD) patients.%目的:探讨输尿管镜辅助下腹膜透析管置人技术的临床应用安全性和疗效. 方法:自愿选择腹膜透析替代治疗的终末期肾病患者32例,局麻下采用经皮微创穿刺技术,使用Peer-Away鞘建立腹腔通道,以输尿管镜进入腹腔内定位,并引导腹膜透析管置于膀胱直肠窝或子宫直肠窝,近端建立皮下隧道并经左下腹戳洞引出.结果:全部患者腹膜透析管均放置成功,手术时间(42±15) min,术中用20%盐酸利多卡因(13±5)ml,出血极少,仅4例术后出现淡血

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

    Energy Technology Data Exchange (ETDEWEB)

    Coche, Emmanuel [Universite Catholique de Louvain, Department of Radiology, Cliniques Universitaires St-Luc, Brussels (Belgium); Lonneux, Max [Universite Catholique de Louvain, Department of Nuclear Medicine, Cliniques Universitaires St-Luc, Brussels (Belgium); Goffin, Eric [Universite Catholique de Louvain, Department of Nephrology, Cliniques Universitaires St-Luc, Brussels (Belgium)

    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. (orig.)

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

    Science.gov (United States)

    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.

  4. An automated tool for evaluating compliance and providing assistance with building energy standards during design

    Energy Technology Data Exchange (ETDEWEB)

    Quadrel, R.W.; Brambley, M.R.; Stratton, R.C.

    1992-04-30

    In an effort to encourage the maximum cost-effective level of energy efficiency in new building design, energy-efficiency standards have become more location-specific and performance-based. As a result, standards often provide more than one path for ensuring and demonstrating that a design complies, but at the cost of increased complexity. In addition, the burden of remedying a noncompliant design rests on the designers' knowledge and experience, with only general guidance provided by the standards. As part of efforts in the US Department of Energy's (DOE's) Advanced Energy Design and Operation Technologies (AEDOT) project, a team at DOE's Pacific Northwest Laboratory is developing a computer program known as the Energy Standards Intelligent Design Tool (ES-IDT). The ES-IDT is one component of a prototype computer-based building design environment. It performs automatic compliance checking for parts of ASHRAE/IES Standard 90.1-1989 and provides designers assistance in bringing noncomplying designs into compliance. This paper describes the ES-IDT, the functions it provides, and how it is integrated into the design process via the AEDOT prototype building design environment. 9 refs.

  5. An automated tool for evaluating compliance and providing assistance with building energy standards during design

    Energy Technology Data Exchange (ETDEWEB)

    Quadrel, R.W.; Brambley, M.R.; Stratton, R.C.

    1992-04-30

    In an effort to encourage the maximum cost-effective level of energy efficiency in new building design, energy-efficiency standards have become more location-specific and performance-based. As a result, standards often provide more than one path for ensuring and demonstrating that a design complies, but at the cost of increased complexity. In addition, the burden of remedying a noncompliant design rests on the designers` knowledge and experience, with only general guidance provided by the standards. As part of efforts in the US Department of Energy`s (DOE`s) Advanced Energy Design and Operation Technologies (AEDOT) project, a team at DOE`s Pacific Northwest Laboratory is developing a computer program known as the Energy Standards Intelligent Design Tool (ES-IDT). The ES-IDT is one component of a prototype computer-based building design environment. It performs automatic compliance checking for parts of ASHRAE/IES Standard 90.1-1989 and provides designers assistance in bringing noncomplying designs into compliance. This paper describes the ES-IDT, the functions it provides, and how it is integrated into the design process via the AEDOT prototype building design environment. 9 refs.

  6. Acute hydrothorax complicating peritoneal dialysis: a case report

    Directory of Open Access Journals (Sweden)

    Ranganathan Dwarkanathan

    2010-11-01

    Full Text Available Abstract Introduction Acute hydrothorax is an uncommon but a well-recognized complication of peritoneal dialysis. No single test is definitive for diagnosis. Although it is not a life-threatening condition, hydrothorax often requires abandonment of peritoneal dialysis. Delay in diagnosis can lead to worsening of the clinical status. Case Presentation A 33-year-old Caucasian woman with lupus, who was successfully treated with temporary peritoneal dialysis 17 years previously, presented with acute dyspnea and a right pleural effusion after recommencing peritoneal dialysis. Investigations eliminated infective, cardiac, and primary respiratory causes. Peritoneal dialysis-related hydrothorax was suggested by biochemistry, and a pleuroperitoneal leak was definitively confirmed by using a Tc-99 m DTPA (diethylene triamine penta-acetic acid scintigraphy scan. Subsequently, she underwent video-assisted thoracoscopy-guided talc pleurodesis and was able to return successfully to peritoneal dialysis. Conclusion Although our case is not the first report that describes the occurrence of acute hydrothorax in peritoneal dialysis, it is an important condition to recognize for the wider general medical community. Furthermore, this case demonstrates that peritoneal dialysis can be continued with a hydrothorax, provided the underlying cause can be corrected. We review the literature pertaining to the utility and reliability of different diagnostic approaches to hydrothorax.

  7. The Milling Assistant, Case-Based Reasoning, and machining strategy: A report on the development of automated numerical control programming systems at New Mexico State University

    Energy Technology Data Exchange (ETDEWEB)

    Burd, W. [Sandia National Labs., Albuquerque, NM (United States); Culler, D.; Eskridge, T.; Cox, L.; Slater, T. [New Mexico State Univ., Las Cruces, NM (United States)

    1993-08-01

    The Milling Assistant (MA) programming system demonstrates the automated development of tool paths for Numerical Control (NC) machine tools. By integrating a Case-Based Reasoning decision processor with a commercial CAD/CAM software, intelligent tool path files for milled and point-to-point features can be created. The operational system is capable of reducing the time required to program a variety of parts and improving product quality by collecting and utilizing ``best of practice`` machining strategies.

  8. Peritoneal dialysis and inflammation.

    Science.gov (United States)

    Velloso, Marina Souza Silva; Otoni, Alba; de Paula Sabino, Adriano; de Castro, Whocely Victor; Pinto, Sérgio Wyton Lima; Marinho, Maria Aparecida Silva; Rios, Danyelle Romana Alves

    2014-03-20

    Peritoneal dialysis (PD) is a kidney replacement therapy for end stage renal disease (ESRD) patients. Despite being a lifesaving treatment, the rate of mortality in patients under PD is elevated, mainly due to the chronic peritoneal dysfunction which is characterized by inflammation, peritoneal fibrosis and neoangiogenesis. The inflammatory process is trigged and modulated by the type of the peritoneal dialysis solutions (PDSs) used during PD. Currently, different PDSs are commercially available: (i) the conventional solutions; (ii) solutions of neutral pH containing low concentration of glucose degradation products (GDPs); (iii) solutions with icodextrin; and (iv) solutions containing taurine. Therefore, the aim of this review is to describe the different types of peritoneal dialysis solutions used during PD and their relationship with systemic and intraperitoneal inflammation. Some studies suggested that solutions of neutral pH containing low concentration of GDPs, icodextrin and taurine have better biocompatibility and lower influence on the inflammatory process compared to the conventional one. On the other hand, the studies, in general, were performed with a small population and for a short period of time. Therefore, further well-designed and -controlled clinical trials with larger number of individuals are required in order to better understand the role of different peritoneal dialysis solution types in the development of inflammation in patients with chronic peritoneal dialysis. Accordingly, studies that are more well-designed, well-controlled and with a larger number of patients are needed to explain and define the role of different types of PDS in the inflammation development in patients with chronic peritoneal dialysis.

  9. Peritonitis: laparoscopic approach

    Directory of Open Access Journals (Sweden)

    Agresta Ferdinando

    2006-03-01

    Full Text Available Abstract Background Laparoscopy has became as the preferred surgical approach to a number of different diseases because it allows a correct diagnosis and treatment at the same time. In abdominal emergencies, both components of treatment – exploration to identify the causative pathology and performance of an appropriate operation – can often be accomplished via laparoscopy. There is still a debate of peritonitis as a contraindication to this kind of approach. Aim of the present work is to illustrate retrospectively the results of a case-control experience of laparoscopic vs. open surgery for abdominal peritonitis emergencies carried out at our institution. Methods From January 1992 and January 2002 a total of 935 patients (mean age 42.3 ± 17.2 years underwent emergent and/or urgent surgery. Among them, 602 (64.3% were operated on laparoscopically (of whom 112 -18.7% – with peritonitis, according to the presence of a surgical team trained in laparoscopy. Patients with a history of malignancy, more than two previous major abdominal surgeries or massive bowel distension were not treated Laparoscopically. Peritonitis was not considered contraindication to Laparoscopy. Results The conversion rate was 23.2% in patients with peritonitis and was mainly due to the presence of dense intra-abdominal adhesions. Major complications ranged as high as 5.3% with a postoperative mortality of 1.7%. A definitive diagnosis was accomplished in 85.7% (96 pat. of cases, and 90.6% (87 of these patients were treated successfully by Laparoscopy. Conclusion Even if limited by its retrospective feature, the present experience let us to consider the Laparoscopic approach to abdominal peritonitis emergencies a safe and effective as conventional surgery, with a higher diagnostic yield and allows for lesser trauma and a more rapid postoperative recovery. Such features make Laparoscopy a challenging alternative to open surgery in the management algorithm for abdominal

  10. Peritonitis in peritoneal dialysis patients after renal transplantation

    NARCIS (Netherlands)

    Bakir, N; Surachno, S; Sluiter, WJ; Struijk, DG

    1998-01-01

    Background. The occurrence of peritonitis in peritoneal dialysis patients after renal transplantation during immunosuppression might increase morbidity and mortality. Hence the timing of catheter removal is still controversial. The associated risk factors of this complication have not been analyzed.

  11. Clinical reports for peritoneal dialysis-related peritonitis

    Institute of Scientific and Technical Information of China (English)

    任海滨

    2014-01-01

    Objective To investigate causes and risk factors of peritoneal dialysis-related peritonitis,explore the pathogenic bacteria and drug sensitivity.Methods CAPD patients suffered peritoneal dialysis-related peritonitis were recruited in the First Affiliated Hospital of Nanjing Medical University in 2012.Gender,age and possible risk factors were analyzed by unvaried and multivariate logistic regression analysis.The causes,pathogenic bacteria,

  12. Diαgnostic approaches of peritoneal dialysis in peritonitis

    Directory of Open Access Journals (Sweden)

    Alikari V.

    2014-03-01

    Full Text Available Introduction: Peritonitis is the most important and frequent infectious complication of peritoneal dialysis. It is the most common cause of failure of the method and inclusion of patients in hemodialysis. Purpose: Τhe purpose of this study is to explore the diagnostic approaches of peritoneal dialysis peritonitis. Methods: Literature review of relevant articles in the database Pubmed as well as the official website of the International Society of Peritoneal Dialysis (ISPD was carried out. The search included articles published during 1996-2013. Results: According to the International Society of Peritoneal Dialysis, peritonitis requires the presence of two of the following criteria: (a cloudy peritoneal fluid, (b symptoms of inflammation of the peritoneum and (c the presence of microorganisms in the peritoneal fluid (> 100 leukocytes / μL of the solution of which most (> 50 % are polymorphnuclear. Some rules of sampling peritoneal fluid for culture and Gram staining are important for the right and immediate treatment of peritonitis: a the first cloudy peritoneal bag is the best sample b sending of the first bag for cultures should be done as early as possible in order to begin the appropriate antibiotic therapy. Gram stain, although in most cases is negative, it is particularly useful for the diagnosis of fungal peritonitis. Conclusions: Patient education, mainly of new Peritoneal Dialysis patients, about the early recognizing of cloudy fluids and exit-site infection, must be the primary concern of a Peritoneal Dialysis Unit. Careful use of antibiotics will reduce the frequency of negative cultures in order not to exceed the limit of 20% of the tests, as recommended by the International Society of Peritoneal Dialysis.

  13. Congenital peritoneal encapsulation

    Institute of Scientific and Technical Information of China (English)

    Diana; Teixeira; Vítor; Costa; Paula; Costa; Carlos; Alpoim; Pinto; Correia

    2015-01-01

    Peritoneal encapsulation(PE) is a rare congenital malformation, characterized by a thin accessory peritoneal membrane which covers all or part of the small bowel, forming an accessory peritoneal sac. Most cases areasymptomatic and diagnosed incidentally during surgery and/or autopsy. Clinical presentation with intestinal obstruction is extremely rare and we report a case. A 25-year-old male, referred to emergency department with diffuse abdominal pain, crampy, with 8 h evolution, associated with nausea, vomiting and constipation in the last 48 h. The abdominal examination revealed an asymmetric and fixed distension, with hard consistency on palpation of lower abdominal quadrants. The abdominal radiography reveals a small bowel distension and fluid levels. Submitted to laparoscopic surgery that recourse to conversion because there is a total peritoneal encapsulation of the small bowel. After opening the peritoneal sac, we find a rotation of mesentery, at its root, conditioning twisting of small bowel and consequently occlusion. Uneventful postoperative with discharged at the 6th day. The PE is a very rare congenital anomaly characterized by abnormal bowel back into the abdominal cavity in the early stages of development. Your knowledge becomes important because, although rare, it might be diagnosis in patients with intestinal obstruction, in the absence of other etiologic factors.

  14. Clinical outcome of 371 episodes of peritoneal dialysis related peritonitis

    Institute of Scientific and Technical Information of China (English)

    唐碧雯

    2014-01-01

    Objective To analyze the clinical outcome of PD related peritonitis in our center.Methods All patients who developed PD related peritonitis between January 2004and December 2010 in Renji Hospital of Shanghai Jiao Tong University School of Medicine were included.Outcomes of PD related peritonitis were analyzed.Results A total of 220 patients developed 371

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

    Science.gov (United States)

    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.

  16. Automated radioanalytical system incorporating microwave-assisted sample preparation, chemical separation, and online radiometric detection for the monitoring of total 99Tc in nuclear waste processing streams.

    Science.gov (United States)

    Egorov, Oleg B; O'Hara, Matthew J; Grate, Jay W

    2012-04-03

    An automated fluidic instrument is described that rapidly determines the total (99)Tc content of aged nuclear waste samples, where the matrix is chemically and radiologically complex and the existing speciation of the (99)Tc is variable. The monitor links microwave-assisted sample preparation with an automated anion exchange column separation and detection using a flow-through solid scintillator detector. The sample preparation steps acidify the sample, decompose organics, and convert all Tc species to the pertechnetate anion. The column-based anion exchange procedure separates the pertechnetate from the complex sample matrix, so that radiometric detection can provide accurate measurement of (99)Tc. We developed a preprogrammed spike addition procedure to automatically determine matrix-matched calibration. The overall measurement efficiency that is determined simultaneously provides a self-diagnostic parameter for the radiochemical separation and overall instrument function. Continuous, automated operation was demonstrated over the course of 54 h, which resulted in the analysis of 215 samples plus 54 hly spike-addition samples, with consistent overall measurement efficiency for the operation of the monitor. A sample can be processed and measured automatically in just 12.5 min with a detection limit of 23.5 Bq/mL of (99)Tc in low activity waste (0.495 mL sample volume), with better than 10% RSD precision at concentrations above the quantification limit. This rapid automated analysis method was developed to support nuclear waste processing operations planned for the Hanford nuclear site.

  17. [Postoperative biliary peritonitis].

    Science.gov (United States)

    Kurbonov, K M; Daminova, N M; Mukhiddinov, N D

    2008-01-01

    An analysis of results of surgical treatment of 91 patients with postoperative biliary peritonitis has shown that frequency of postoperative biliary peritonitis depended on the volume and character of operative interventions, as well as on technical errors made at the preoperative period and during operation. The presence of latent hepatic insufficiency made for the development of polyorganic insufficiency, had negative influence on the course of the disease and might be one of the causes of high postoperative lethality (up to 23.1%) in this category of patients.

  18. French National Registry of Rare Peritoneal Surface Malignancies

    Science.gov (United States)

    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

  19. KinoHaptics: An Automated, Wearable, Haptic Assisted, Physio-therapeutic System for Post-surgery Rehabilitation and Self-care.

    Science.gov (United States)

    Rajanna, Vijay; Vo, Patrick; Barth, Jerry; Mjelde, Matthew; Grey, Trevor; Oduola, Cassandra; Hammond, Tracy

    2016-03-01

    A carefully planned, structured, and supervised physiotherapy program, following a surgery, is crucial for the successful diagnosis of physical injuries. Nearly 50 % of the surgeries fail due to unsupervised, and erroneous physiotherapy. The demand for a physiotherapist for an extended period is expensive to afford, and sometimes inaccessible. Researchers have tried to leverage the advancements in wearable sensors and motion tracking by building affordable, automated, physio-therapeutic systems that direct a physiotherapy session by providing audio-visual feedback on patient's performance. There are many aspects of automated physiotherapy program which are yet to be addressed by the existing systems: a wide classification of patients' physiological conditions to be diagnosed, multiple demographics of the patients (blind, deaf, etc.), and the need to pursue patients to adopt the system for an extended period for self-care. In our research, we have tried to address these aspects by building a health behavior change support system called KinoHaptics, for post-surgery rehabilitation. KinoHaptics is an automated, wearable, haptic assisted, physio-therapeutic system that can be used by a wide variety of demographics and for various physiological conditions of the patients. The system provides rich and accurate vibro-haptic feedback that can be felt by the user, irrespective of the physiological limitations. KinoHaptics is built to ensure that no injuries are induced during the rehabilitation period. The persuasive nature of the system allows for personal goal-setting, progress tracking, and most importantly life-style compatibility. The system was evaluated under laboratory conditions, involving 14 users. Results show that KinoHaptics is highly convenient to use, and the vibro-haptic feedback is intuitive, accurate, and has shown to prevent accidental injuries. Also, results show that KinoHaptics is persuasive in nature as it supports behavior change and habit building

  20. Getting it right first time in a patient with Candida peritonitis

    NARCIS (Netherlands)

    de Lange, D. W.

    2011-01-01

    Here a patient is presented with a mediastinitis, pleural empyema and peritonitis with Candida glabrata and Enterococcus faecium after a complicated robot-assisted thoracolaparoscopic oesophagolymphadectomy esophagectomy. This case description highlights some of the therapeutic dilemmas that physici

  1. Sclerosing encapsulating peritonitis

    Directory of Open Access Journals (Sweden)

    Jen-Jung Pan

    2012-03-01

    Full Text Available Sclerosing encapsulating peritonitis (SEP is a rare cause of intestinal obstruction. This entity has been reported as either primary idiopathic or secondary to other diseases. We report SEP in 2 cirrhotic patients and review the literature. Both patients had decompensated cirrhosis and episodes of spontaneous bacterial peritonitis. One patient underwent a Denver shunt placement before developing SEP. This patient remains alive and is managed conservatively. The other patient deceased from multi-organ failure after the resection of gangrened small bowel. The manifestations of SEP are often nonspecific that leads to misdiagnosis and/or delayed diagnosis. Early diagnosis of SEP is difficult but not impossible. Surgical treatment is often required when intestinal obstruction is present. Nevertheless, patients with this problem can be treated conservatively with immunosuppressive therapy with or without total parenteral nutrition (TPN before going for surgery.

  2. CT features of peritonitis associated with continuous ambulatory peritoneal dialysis

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Ji Young; Byun, Jae Young; Lee, Sang Hoon; Kwon, Tae Ahn; Kim, Yeon Kil; Kim, Young Ok; Song, Kyung Sup [The Catholic Univ. of Korea College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    To evaluate the CT findings of peritonitis associated with continuous ambulatory peritoneal dialysis(CAPD). We retrospectively analyzed CT scans of 14 symptomatic patients with peritonitis after CAPD. Diffuse abdominal pain was present in 11, fever in two, and abdominal mass with vomiting in one. The mean duration of CAPD ranged from 10 months to 5 years(mean : 3.9 years). On abdominal CT, we evaluated the presence and location of ascites, bowel wall thickening, cocoon formation, the pattern of enhancement of peritoneal thickening, the presence of calcifications in the peritoneum, and mesenteric and omental change. On enhanced CT, multiloculated ascites was observed in all cases(n=14) ; it was located mainly in the pelvic cavity with small multi-loculated fluid collections in the peritoneal cavity(n=13), including the lesser sac(n=3). In one patient, ascites was located in the space between the greater omentum and anterior peritoneal surface. CT showed ileus in 12 cases, small bowel wall thickening in 11, and cocoon formation in five. Uneven but smooth thickening of the peritoneum, with contrast enhancement, was seen in eight cases, and in five of these, peritoneal thickening was more prominent in the anterior peritoneum. Other findings included reticular opacity in two cases, hematoma of the rectus muscle in one, and umbilical hernia in one. Multiloculated fluid collection, ileus, small bowel wall thickening, uneven but smooth peritoneal thickening, and cocoon formation appear to be CT features of CAPD peritonitis.

  3. Spontaneous bacterial peritonitis

    OpenAIRE

    Al Amri Saleh

    1995-01-01

    Spontaneous bacterial peritonitis (SBP) is an infection of the ascitic fluid without obvious intra-abdominal source of sepsis; usually complicates advanced liver disease. The pathogenesis of the disease is multifactorial: low ascitic protein-content, which reflects defi-cient ascitic fluid complement and hence, reduced opsonic activity is thought to be the most important pathogenic factor. Frequent and prolonged bacteremia has been considered as another pertinent cause of SBP. This disease is...

  4. Sclerosing Encapsulating Peritonitis; Review

    Directory of Open Access Journals (Sweden)

    Norman O. Machado

    2016-05-01

    Full Text Available 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 nonspecific 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%.

  5. Automated Computer-Assisted Diagnosis of Obstructive Coronary Artery Disease in Emergency Department Patients Undergoing 256-Slice Coronary Computed Tomography Angiography for Acute Chest Pain.

    Science.gov (United States)

    Hashoul, Sharbell; Gaspar, Tamar; Halon, David A; Lewis, Basil S; Shenkar, Yuval; Jaffe, Ronen; Peled, Nathan; Rubinshtein, Ronen

    2015-10-01

    A 256-slice coronary computed tomography angiography (CCTA) is an accurate method for detection and exclusion of obstructive coronary artery disease (OBS-CAD). However, accurate image interpretation requires expertise and may not be available at all hours. The purpose of this study was to evaluate the usefulness of a fully automated computer-assisted diagnosis (COMP-DIAG) tool for exclusion of OBS-CAD in patients in the emergency department (ED) presenting with chest pain. Three hundred sixty-nine patients in ED without known coronary disease underwent 256-slice CCTA as part of the assessment of chest pain of uncertain origin. COMP-DIAG (CorAnalyzer II) automatically reported presence or exclusion of OBS-CAD (>50% stenosis, ≥1 vessel). Performance characteristics of COMP-DIAG for exclusion and detection of OBS-CAD were determined using expert reading as the reference standard. Seventeen (5%) studies were unassessable by COMP-DIAG software, and 352 patients (1,056 vessels) were therefore available for analysis. COMP-DIAG identified 33% of assessable studies as having OBS-CAD, but the prevalence of OBS-CAD on CCTA was only 18% (66 of 352 patients) by standard expert reading. However, COMP-DIAG correctly identified 61 of the 66 patients (93%) with OBS-CAD with 21 vessels (2%) with OBS-CAD misclassified as negative. In conclusion, compared to expert reading, automated computer-assisted diagnosis using the CorAnalyzer showed high sensitivity but only moderate specificity for detection of obstructive coronary disease in patients in ED who underwent 256-slice CCTA. The high negative predictive value of this computer-assisted algorithm may be useful in the ED setting.

  6. Capnocytophaga cynodegmi peritonitis in a peritoneal dialysis patient

    DEFF Research Database (Denmark)

    Pers, Charlotte; Tvedegaard, Erling; Christensen, Jens Jørgen

    2007-01-01

    The first reported case of peritonitis caused by Capnocytophaga cynodegmi is presented. The patient was treated with peritoneal dialysis and had contact with a cat. C. cynodegmi is part of the normal oral flora of dogs and cats but is very rarely isolated in clinical specimens from humans....

  7. Bidirectional peritoneal transport of albumin in continuous ambulatory peritoneal dialysis

    DEFF Research Database (Denmark)

    Joffe, P; Henriksen, Jens Henrik Sahl

    1995-01-01

    The present study was undertaken in order to assess bidirectional peritoneal kinetics of albumin after simultaneous i.v. and i.p. injection of radioiodinated albumin tracers (125I-RISA and 131I-RISA) in eight clinically stable uraemic patients undergoing continuous ambulatory peritoneal dialysis...... (CAPD). The plasma volume, intravascular albumin mass (IVM), and overall extravasation rate of albumin were not significantly different from that found in healthy controls. Albumin flux from the plasma into the peritoneal cavity was 3.71 +/- 0.82 (SD) mumol/h, which was only 3% of the overall...... extravasation rate (137 +/- 52 mumol/h). Albumin flux from the peritoneal cavity into the plasma was substantially lower (0.22 +/- 0.07 mumol/h, P peritoneal accumulation of the albumin from plasma over 4 h was 14 +/- 3.2 mumol, which was significantly lower than the intraperitoneal albumin...

  8. Spontaneous bacterial peritonitis

    Directory of Open Access Journals (Sweden)

    Al Amri Saleh

    1995-01-01

    Full Text Available Spontaneous bacterial peritonitis (SBP is an infection of the ascitic fluid without obvious intra-abdominal source of sepsis; usually complicates advanced liver disease. The pathogenesis of the disease is multifactorial: low ascitic protein-content, which reflects defi-cient ascitic fluid complement and hence, reduced opsonic activity is thought to be the most important pathogenic factor. Frequent and prolonged bacteremia has been considered as another pertinent cause of SBP. This disease is associated with high mortality and recurrence. Therefore, orompt recognition and institution of therapy and plan of prophylaxis is vital.

  9. Feline infectious peritonitis.

    Science.gov (United States)

    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.

  10. A fully automated effervescence assisted dispersive liquid–liquid microextraction based on a stepwise injection system. Determination of antipyrine in saliva samples

    Energy Technology Data Exchange (ETDEWEB)

    Medinskaia, Kseniia; Vakh, Christina; Aseeva, Darina [Department of Analytical Chemistry, Institute of Chemistry, Saint Petersburg State University, RU-198504 Saint Petersburg (Russian Federation); Andruch, Vasil, E-mail: vasil.andruch@upjs.sk [Department of Analytical Chemistry, University of P.J. Šafárik, SK-04154 Košice (Slovakia); Moskvin, Leonid [Department of Analytical Chemistry, Institute of Chemistry, Saint Petersburg State University, RU-198504 Saint Petersburg (Russian Federation); Bulatov, Andrey, E-mail: bulatov_andrey@mail.ru [Department of Analytical Chemistry, Institute of Chemistry, Saint Petersburg State University, RU-198504 Saint Petersburg (Russian Federation)

    2016-01-01

    A first attempt to automate the effervescence assisted dispersive liquid–liquid microextraction (EA-DLLME) has been reported. The method is based on the aspiration of a sample and all required aqueous reagents into the stepwise injection analysis (SWIA) manifold, followed by simultaneous counterflow injection of the extraction solvent (dichloromethane), the mixture of the effervescence agent (0.5 mol L{sup −1} Na{sub 2}CO{sub 3}) and the proton donor solution (1 mol L{sup −1} CH{sub 3}COOH). Formation of carbon dioxide microbubbles generated in situ leads to the dispersion of the extraction solvent in the whole aqueous sample and extraction of the analyte into organic phase. Unlike the conventional DLLME, in the case of EA-DLLME, the addition of dispersive solvent, as well as, time consuming centrifugation step for disruption of the cloudy state is avoided. The phase separation was achieved by gentle bubbling of nitrogen stream (2 mL min{sup −1} during 2 min). The performance of the suggested approach is demonstrated by determination of antipyrine in saliva samples. The procedure is based on the derivatization of antipyrine by nitrite-ion followed by EA-DLLME of 4-nitrosoantipyrine and subsequent UV–Vis detection using SWIA manifold. The absorbance of the yellow-colored extract at the wavelength of 345 nm obeys Beer's law in the range of 1.5–100 µmol L{sup −1} of antipyrine in saliva. The LOD, calculated from a blank test based on 3σ, was 0.5 µmol L{sup −1}. - Highlights: • First attempt to automate the effervescence assisted dispersive liquid–liquid microextraction. • Automation based on Stepwise injection analysis manifold in flow batch system. • Counterflow injection of extraction solvent and the effervescence agent. • Phase separation performed by gentle bubbling of nitrogen. • Application for the determination of antipyrine in saliva samples.

  11. Sclerosing peritonitis with gross calcification: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Cheung Sook; Kim, Young Jae; Min, Seon Jeong; Cho, Seong Whi; Lee, Gyung Kyu; Lee, Eil Seong; Kang, Ik Won [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-09-01

    Sclerosing peritonitis is an uncommon complication of continuous ambulatory peritoneal dialysis (CAPD) and can lead to small bowel dysfunction involving abdominal pain, progressive loss of ultrafiltration, and small intestinal obstruction. Peritoneal thickening, in which calcification can develop, often starts as al small plaque which gradually becomes larger. We report a case of CAPD-related calcifying peritonitis.

  12. Increased peritoneal permeability at peritoneal dialysis initiation is a potential cardiovascular risk in patients using biocompatible peritoneal dialysis solution

    OpenAIRE

    Hamasaki, Yoshifumi; Doi, Kent; Tanaka, Mototsugu; Kume, Haruki; Ishibashi, Yoshitaka; Enomoto, Yutaka; Fujita, Toshiro; Homma, Yukio; Nangaku, Masaomi; Noiri, Eisei

    2014-01-01

    Background Cardiovascular disease is a frequent cause of death in peritoneal dialysis patients. Biocompatible peritoneal dialysis solutions with neutral pH have been anticipated to reduce cardiovascular disease more than conventional peritoneal dialysis solutions with low pH, but it remains unclear which factors at peritoneal dialysis initiation increase cardiovascular risk in patients using biocompatible peritoneal dialysis solutions. This study was undertaken to investigate which clinical f...

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

    Science.gov (United States)

    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.

  14. Malignant Peritoneal Mesothelioma

    Directory of Open Access Journals (Sweden)

    Zhong-Yi Lin

    2015-03-01

    Full Text Available Malignant peritoneal mesothelioma (MPM is rare. It is difficult to diagnose early and responds poorly to treatment. There is no optimal and effective treating consensus so far. We report three patients of MPM treated at Mackay Memorial Hospital in recent 3 years. They were two men and one woman without asbestos exposure related to their occupations. Due to failure in early diagnosis of MPM, none of them survived for more than 5 months. We make a brief review from the previous literature. These three cases were compared with the reviewing data in many aspects including the risk factor, clinical presentation, diagnostic options, and management. Besides, some latest clinical trials are introduced in this report.

  15. Lumbar peritoneal shunt

    Directory of Open Access Journals (Sweden)

    Yadav Yad

    2010-01-01

    Full Text Available A lumbar peritoneal (LP shunt is a technique of cerebrospinal fluid (CSF diversion from the lumbar thecal sac to the peritoneal cavity. It is indicated under a large number of conditions such as communicating hydrocephalus, idiopathic intracranial hypertension, normal pressure hydrocephalus, spinal and cranial CSF leaks, pseudomeningoceles, slit ventricle syndrome, growing skull fractures which are difficult to treat by conventional methods (when dural defect extends deep in the cranial base or across venous sinuses and in recurrent cases after conventional surgery, raised intracranial pressure following chronic meningitis, persistent bulging of craniotomy site after operations for intracranial tumors or head trauma, syringomyelia and failed endoscopic third ventriculostomy with a patent stoma. In spite of the large number of indications of this shunt and being reasonably good, safe, and effective, very few reports about the LP shunt exist in the literature. This procedure did not get its due importance due to some initial negative reports. This review article is based on search on Google and PubMed. This article is aimed to review indications, complications, results, and comparison of the LP shunt with the commonly practiced ventriculoperitoneal (VP shunt. Shunt blocks, infections, CSF leaks, overdrainage and acquired Chiari malformation (ACM are some of the complications of the LP shunt. Early diagnosis of overdrainage complications and ACM as well as timely appropriate treatment especially by programmable shunts could decrease morbidity. Majority of recent reports suggest that a LP shunt is a better alternative to the VP shunt in communicating hydrocephalus. It has an advantage over the VP shunt of being completely extracranial and can be used under conditions other than hydrocephalus when the ventricles are normal sized or chinked. More publications are required to establish its usefulness in the treatment of wide variety of indications.

  16. Risk Factors Associated with Peritoneal-Dialysis-Related Peritonitis

    Directory of Open Access Journals (Sweden)

    Julia Kerschbaum

    2012-01-01

    Full Text Available Background. Peritonitis represents a major complication of peritoneal dialysis (PD. The aim of this paper was to systematically collect data on patient-related risk factors for PD-associated peritonitis, to analyze the methodological quality of these studies, and to summarize published evidence on the particular risk factors. Methods. Studies were identified by searches of Pubmed (1990–2012 and assessed for methodological quality by using a modified form of the STROBE criteria. Results. Thirty-five methodologically acceptable studies were identified. The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function. We also identified the following modifiable, valid risk factors for peritonitis: malnutrition, overweight, smoking, immunosuppression, no use of oral active vitamin D, psychosocial factors, low socioeconomic status, PD against patient’s choice, and haemodialysis as former modality. Discussion. Modifiable and nonmodifiable risk factors analyzed in this paper might serve as a basis to improve patient care in peritoneal dialysis.

  17. Gene delivery in peritoneal dialysis related peritoneal fibrosis research

    Institute of Scientific and Technical Information of China (English)

    LI Xie-jia; SUN Lin; XIAO Li; LIU Fu-you

    2012-01-01

    Objective To summarize the development of gene delivery vectors in peritoneal fibrosis research and discuss the feasibility and superiority of lentiviral vectors.Data sources The data in this article were collected from PubMed database with relevant English articles published from 1995 to 2011.Study selection Articles regarding the gene therapy in peritoneal fibrosis research using non-viral vectors,adenoviral vectors,ratroviral vectors,and lentiviral vectors were selected.Data were mainly extracted from 60 articles,which are listed in the reference section of this review.Results Non-viral vector-mediated gene delivery (including naked DNA for ex vivo,oligonucleotides,ultrasoundcontrast agent mediated naked gene delivery,etc.) and viral vector-mediated gene delivery (including adenovirus,helper-dependant adenovirus,and retrovirus vectors) have been successfully applied both in the mechanistic investigation and the potential prevention and treatment of peritoneal fibrosis.Conclusions Peritoneal fibrosis is a major complication of peritoneal dialysis (PD).Recently,the wide use of the gene delivery technique made it possible to access and further research peritoneal fibrosis.The use of lentiviral vector is expected to be widely used in PD research in the future due to its advantages in gene delivery.

  18. Celecoxib treatment reduces peritoneal fibrosis and angiogenesis and prevents ultrafiltration failure in experimental peritoneal dialysis

    NARCIS (Netherlands)

    Fabbrini, Paolo; Schilte, Margot N.; Zareie, Mammad; ter Wee, Piet M.; Keuning, Eelco D.; Beelen, Robert H. J.; van den Born, Jaap

    2009-01-01

    Background. Daily peritoneal exposure to peritoneal dialysis fluid (PDF) induces severe morphological alterations including fibrosis and angiogenesis that lead to a loss of peritoneal ultrafiltration (UF) capacity. Since cyclooxygenase (COX)-2 is involved in fibrosis and angiogenesis, we investigate

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

    Science.gov (United States)

    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.

  20. Comparison of incidence of shunt system failure between neuroendoscope-laparoscope assisted and non-endoscope-assisted ventricular-peritoneal shunt for hydrocephalus%神经内镜加腹腔镜辅助与常规的脑室腹腔分流术后分流系统失效率比较

    Institute of Scientific and Technical Information of China (English)

    林发牧; 许小兵

    2014-01-01

    Objective To compare the incidence of shunt system failure between neuroendoscope-laparoscope assisted and non-endoscope-assisted ventricular-peritoneal shunt (VPS) for hydrocephalus.Methods A retrospective analysis was performed in the incidence of shunt system failure of 141 hydrocephalus patients accepted neuroendoscope-laparoscope assisted VPS,admitted to our hospital from January 2007 to August 2012,and 167 hydrocephalus patients with non-endoscope assisted VPS,admitted to our hospital from January 2001 to December 2006.All these patients were followed up for 1 to 72 months and the incidence rate of shunt system failure was compared between the two groups.Results Five patients failed in follow-up in patients accepted neuroendoscope-laparoscope assisted VPS; the incidence rate of shunt system failure in neuroendoscope-laparoscope assisted VPS was 5.1%,including 3 in ventricular end blockage and 4 in intraperitoneal end blockage; shunt valve was not noted.Twelve patients failed in follow-up in patients accepted neuroendoscope-laparoscope assisted VPS; the incidence rate of shunt system failure in neuroendoscope-laparoscope assisted VPS was 30.3%,including 31 in ventricular end blockage and 15 in intraperitoneal end blockage; shunt valve was noted in one patient.The incidence rate of shunt system failure in neuroendoscope-laparoscope assisted VPS was significantly lower than that in non-endoscope assisted group (x2=30.379,P=0.000).Conclusion In contrast to the non-endoscope assisted VPS surgery,the incidence of shunt system failure has been reduced significantly by neuroendoscope plus laparoscope assisted VPS surgery.%目的 探讨神经内镜加腹腔镜综合辅助脑室腹腔分流术在降低术后分流系统失效率中的应用价值. 方法 对佛山市顺德区第一人民医院神经外科自2007年1月至2012年8月进行的141例神经内镜加腹腔镜综合辅助脑室腹腔分流术(内镜辅助组)以及自2001年1月至2006年12

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

    Science.gov (United States)

    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.

  2. In-syringe magnetic stirring-assisted dispersive liquid-liquid microextraction for automation and downscaling of methylene blue active substances assay.

    Science.gov (United States)

    Suárez, Ruth; Horstkotte, Burkhard; Cerdà, Victor

    2014-12-01

    A simple and rapid method for the determination of the methylene blue active substances assay based on in-syringe automation of magnetic stirring-assisted dispersive liquid-liquid microextraction was developed. The proposed method proved to be valid for the determination of anionic surfactant in waste, pond, well, tap, and drinking water samples. Sample mixing with reagents, extraction and phase separation were performed within the syringe of an automated syringe pump containing a magnetic stirring bar for homogenization and solvent dispersion. The syringe module was used upside-down to enable the use of chloroform as an extraction solvent of higher density than water. The calibration was found to be linear up to 0.3mg/L using only 200 µL of solvent and 4 mL of sample. The limits of detection (3σ) and quantification (10σ) were 7.0 µg/L and 22 µg/L, respectively. The relative standard deviation for 10 replicate determinations of 0.1mg/L SBDS was below 3%. Concentrations of anionic surfactants in natural water samples were in the range of 0.032-0.213 mg/L and no significant differences towards the standard method were found. Standard additions gave analyte recoveries between 95% and 106% proving the general applicability and adequateness of the system to MBSA index determination. Compared to the tedious standard method requiring up to 50 mL of chloroform, the entire procedure took only 345 s using 250-times less solvent.

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

    Directory of Open Access Journals (Sweden)

    Janusz Witowski

    2015-01-01

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

  4. Beneficios del descanso peritoneal

    Directory of Open Access Journals (Sweden)

    Jesús Lucas Martín Espejo

    Full Text Available Introducción: Valorar si el descanso peritoneal, de al menos un día semanal, ha supuesto mejoras en la rehabilitación de los pacientes y el impacto clínico que puede suponer. Nos planteamos además cuantificar el beneficio económico. Material y Método: Se realizó un estudio longitudinal, retrospectivo, descriptivo. De los pacientes atendidos en nuestra unidad desde el 1 de enero de 2014 al 31 de diciembre de 2014, se estudiaron los pacientes que cumplieran todo el año de seguimiento y que no procedieran de otras técnicas de depuración como la hemodiálisis o trasplante renal. La muestra de estudio estuvo compuesta por 40 pacientes, de los que 21 tuvieron prescrito al menos 1 día semanal de descanso peritoneal y 19 pacientes sin descanso. Se recogieron las siguientes variables al inicio del periodo de estudio y a los 12 meses: Variables demográficas, variables relacionadas con el estado de volumen, datos clínicos relacionados con la técnica, se pasó una encuesta de satisfacción a todos los pacientes estudiados, y se recogieron los importes del coste mensual de cada tipo de tratamiento. Resultados: Las diferencias iniciales entre los grupos, eran esperables ya que son los valores en los cuales se ha basado la prescripción del día de descanso. La exposición a la glucosa, al comienzo y al final fue menor en el grupo con descanso. Al año, no se encontró diferencias en los parámetros estudiados. Una encuesta de satisfacción nos reveló a que dedican los pacientes el día de descanso y los que no lo tienen a que lo dedicarían. Conclusiones: El descanso peritoneal no ha supuesto una peor evolución de los parámetros clínicos estudiados al año de seguimiento, cumpliendo las recomendaciones de adecuación de diálisis de las guías clínicas. La exposición a la glucosa, aun sin llegar a ser significativa por la duración del estudio, ha sido menor en el grupo con descanso. El día de descanso ha facilitado a los pacientes

  5. A Large-Sample Test of a Semi-Automated Clavicle Search Engine to Assist Skeletal Identification by Radiograph Comparison.

    Science.gov (United States)

    D'Alonzo, Susan S; Guyomarc'h, Pierre; Byrd, John E; Stephan, Carl N

    2017-01-01

    In 2014, a morphometric capability to search chest radiograph databases by quantified clavicle shape was published to assist skeletal identification. Here, we extend the validation tests conducted by increasing the search universe 18-fold, from 409 to 7361 individuals to determine whether there is any associated decrease in performance under these more challenging circumstances. The number of trials and analysts were also increased, respectively, from 17 to 30 skeletons, and two to four examiners. Elliptical Fourier analysis was conducted on clavicles from each skeleton by each analyst (shadowgrams trimmed from scratch in every instance) and compared to the search universe. Correctly matching individuals were found in shortlists of 10% of the sample 70% of the time. This rate is similar to, although slightly lower than, rates previously found for much smaller samples (80%). Accuracy and reliability are thereby maintained, even when the comparison system is challenged by much larger search universes.

  6. Submicrometric Magnetic Nanoporous Carbons Derived from Metal-Organic Frameworks Enabling Automated Electromagnet-Assisted Online Solid-Phase Extraction.

    Science.gov (United States)

    Frizzarin, Rejane M; Palomino Cabello, Carlos; Bauzà, Maria Del Mar; Portugal, Lindomar A; Maya, Fernando; Cerdà, Víctor; Estela, José M; Turnes Palomino, Gemma

    2016-07-19

    We present the first application of submicrometric magnetic nanoporous carbons (μMNPCs) as sorbents for automated solid-phase extraction (SPE). Small zeolitic imidazolate framework-67 crystals are obtained at room temperature and directly carbonized under an inert atmosphere to obtain submicrometric nanoporous carbons containing magnetic cobalt nanoparticles. The μMNPCs have a high contact area, high stability, and their preparation is simple and cost-effective. The prepared μMNPCs are exploited as sorbents in a microcolumn format in a sequential injection analysis (SIA) system with online spectrophotometric detection, which includes a specially designed three-dimensional (3D)-printed holder containing an automatically actuated electromagnet. The combined action of permanent magnets and an automatically actuated electromagnet enabled the movement of the solid bed of particles inside the microcolumn, preventing their aggregation, increasing the versatility of the system, and increasing the preconcentration efficiency. The method was optimized using a full factorial design and Doehlert Matrix. The developed system was applied to the determination of anionic surfactants, exploiting the retention of the ion-pairs formed with Methylene Blue on the μMNPC. Using sodium dodecyl sulfate as a model analyte, quantification was linear from 50 to 1000 μg L(-1), and the detection limit was equal to 17.5 μg L(-1), the coefficient of variation (n = 8; 100 μg L(-1)) was 2.7%, and the analysis throughput was 13 h(-1). The developed approach was applied to the determination of anionic surfactants in water samples (natural water, groundwater, and wastewater), yielding recoveries of 93% to 110% (95% confidence level).

  7. [Pathophysiology of peritonitis].

    Science.gov (United States)

    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.

  8. Spontaneous bacterial peritonitis

    Institute of Scientific and Technical Information of China (English)

    Anastasios Koulaouzidis; Shivaram Bhat; Athar A Saeed

    2009-01-01

    Since its initial description in 1964, research has transformed spontaneous bacterial peritonitis (SBP) from a feared disease (with reported mortality of 90%) to a treatable complication of decompensated cirrhosis,albeit with steady prevalence and a high recurrence rate. Bacterial translocation, the key mechanism in the pathogenesis of SBP, is only possible because of the concurrent failure of defensive mechanisms in cirrhosis.Variants of SBP should be treated. Leucocyte esterase reagent strips have managed to shorten the 'tap-toshot' time, while future studies should look into their combined use with ascitic fluid pH. Third generation cephalosporins are the antibiotic of choice because they have a number of advantages. Renal dysfunction has been shown to be an independent predictor of mortality in patients with SBP. Albumin is felt to reduce the risk of renal impairment by improving effective intravascular volume, and by helping to bind proinflammatory molecules. Following a single episode of SBP, patients should have long-term antibiotic prophylaxis and be considered for liver transplantation.

  9. Peritonitis in children. Peritonitis en el niño.

    Directory of Open Access Journals (Sweden)

    Eduardo Labrada Arjona

    Full Text Available The peritonitis is a general or localized inflammatory process of peritoneal membrane caused by chemical irritation, bacterial invasion, local necrosis or direct injuries of peritoneum. It is frequent cause of morbility in surgical patient and complication of many abdominals surgical interventions. It causes increased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. We presented the Good Clinical Practices Guideline for Peritonitis, approved by consensus in the 3th National Good Clinical Practices Workshop in Pediatric Surgery (Camagüey, Cuba; February 23 – 26, 2004

    La peritonitis es un proceso inflamatorio general o localizado de la membrana peritoneal causada por una irritación química, invasión bacteriana, necrosis local o contusión directa del peritoneo. Es causa frecuente de morbilidad en el paciente quirúrgico y complicación de muchas intervenciones intraabdominales. Ocasiona prolongadas estadías hospitalarias, incremento de los costos de la atención médica y serios inconvenientes a los pacientes y sus familiares. Se presenta la Guía de Buenas Prácticas Clínicas para Profilaxis antibiótica perioperatoria, aprobada por consenso en el 3er Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Camagüey, 23 al 26 de febrero de 2004.

  10. A fully automated effervescence assisted dispersive liquid-liquid microextraction based on a stepwise injection system. Determination of antipyrine in saliva samples.

    Science.gov (United States)

    Medinskaia, Kseniia; Vakh, Christina; Aseeva, Darina; Andruch, Vasil; Moskvin, Leonid; Bulatov, Andrey

    2016-01-01

    A first attempt to automate the effervescence assisted dispersive liquid-liquid microextraction (EA-DLLME) has been reported. The method is based on the aspiration of a sample and all required aqueous reagents into the stepwise injection analysis (SWIA) manifold, followed by simultaneous counterflow injection of the extraction solvent (dichloromethane), the mixture of the effervescence agent (0.5 mol L(-1) Na2CO3) and the proton donor solution (1 mol L(-1) CH3COOH). Formation of carbon dioxide microbubbles generated in situ leads to the dispersion of the extraction solvent in the whole aqueous sample and extraction of the analyte into organic phase. Unlike the conventional DLLME, in the case of EA-DLLME, the addition of dispersive solvent, as well as, time consuming centrifugation step for disruption of the cloudy state is avoided. The phase separation was achieved by gentle bubbling of nitrogen stream (2 mL min(-1) during 2 min). The performance of the suggested approach is demonstrated by determination of antipyrine in saliva samples. The procedure is based on the derivatization of antipyrine by nitrite-ion followed by EA-DLLME of 4-nitrosoantipyrine and subsequent UV-Vis detection using SWIA manifold. The absorbance of the yellow-colored extract at the wavelength of 345 nm obeys Beer's law in the range of 1.5-100 µmol L(-1) of antipyrine in saliva. The LOD, calculated from a blank test based on 3σ, was 0.5 µmol L(-1).

  11. Automated LC-HRMS(/MS) approach for the annotation of fragment ions derived from stable isotope labeling-assisted untargeted metabolomics.

    Science.gov (United States)

    Neumann, Nora K N; Lehner, Sylvia M; Kluger, Bernhard; Bueschl, Christoph; Sedelmaier, Karoline; Lemmens, Marc; Krska, Rudolf; Schuhmacher, Rainer

    2014-08-05

    Structure elucidation of biological compounds is still a major bottleneck of untargeted LC-HRMS approaches in metabolomics research. The aim of the present study was to combine stable isotope labeling and tandem mass spectrometry for the automated interpretation of the elemental composition of fragment ions and thereby facilitate the structural characterization of metabolites. The software tool FragExtract was developed and evaluated with LC-HRMS/MS spectra of both native (12)C- and uniformly (13)C (U-(13)C)-labeled analytical standards of 10 fungal substances in pure solvent and spiked into fungal culture filtrate of Fusarium graminearum respectively. Furthermore, the developed approach is exemplified with nine unknown biochemical compounds contained in F. graminearum samples derived from an untargeted metabolomics experiment. The mass difference between the corresponding fragment ions present in the MS/MS spectra of the native and U-(13)C-labeled compound enabled the assignment of the number of carbon atoms to each fragment signal and allowed the generation of meaningful putative molecular formulas for each fragment ion, which in turn also helped determine the elemental composition of the precursor ion. Compared to laborious manual analysis of the MS/MS spectra, the presented algorithm marks an important step toward efficient fragment signal elucidation and structure annotation of metabolites in future untargeted metabolomics studies. Moreover, as demonstrated for a fungal culture sample, FragExtract also assists the characterization of unknown metabolites, which are not contained in databases, and thus exhibits a significant contribution to untargeted metabolomics research.

  12. Value of {sup 18}F-FDG PET in the detection of peritoneal carcinomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Akiko; Kawano, Tsuyoshi; Takahashi, Nobukazu; Lee, Jin; Nakagami, Yoshihiro; Inoue, Tomio [Yokohama City University, Department of Radiology, School of Medicine, Yokohama-shi, Kanagawa-ken (Japan); Miyagi, Etsuko; Hirahara, Fumiki [Yokohama City University, Department of Obstetrics and Gynecology, School of Medicine, Yokohama-shi, Kanagawa-ken (Japan); Togo, Shinji; Shimada, Hiroshi [Yokohama City University, Department of Gastroenterological Surgery, School of Medicine, Yokohama-shi, Kanagawa-ken (Japan)

    2004-10-01

    Peritoneal carcinomatosis can be difficult to diagnose using computed tomography (CT). The purpose of this study was to evaluate the role of 2-(fluorine 18) fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the detection of peritoneal carcinomatosis. We reviewed the CT and FDG PET radiological reports and clinical charts of 18 patients with peritoneal carcinomatosis and 17 cancer patients without peritoneal carcinomatosis. We also assessed FDG PET scans from 20 healthy volunteers as a baseline study. The maximum standardised uptake values (SUV{sub max}) over peritoneal lesions in cancer patients and over the area of most intense intestinal uptake in healthy volunteers and cancer patients without peritoneal carcinomatosis were measured. The sensitivity and positive predictive value (PPV) of combined FDG PET and CT were superior to those of CT alone for the detection of peritoneal lesions (sensitivity: 66.7% vs 22.2%, p<0.025; PPV: 92.3% vs 50.0%, p<0.05). The most frequent pattern of FDG uptake in patients with peritoneal carcinomatosis was abnormally intense focal uptake near the abdominal wall. An SUV{sub max} threshold of 5.1 produced a diagnostic accuracy of combined FDG PET and CT of 78%. The additional information provided by FDG PET allowed a more accurate diagnosis in 14 patients (40.0%), and led to alteration of the therapeutic strategy in five (14.3%) of the enrolled cancer patients. We found that use of an intra-abdominal FDG uptake cut-off value for SUV{sub max} of >5.1 assists in the diagnosis of peritoneal carcinomatosis. FDG PET may play an important role in the clinical management of patients with suspected peritoneal carcinomatosis. (orig.)

  13. Water channels in peritoneal dialysis.

    Science.gov (United States)

    Devuyst, Olivier

    2010-01-01

    Peritoneal dialysis involves diffusive and convective transports and osmosis through the highly vascularized peritoneal membrane. Several lines of evidence have demonstrated that the water channel aquaporin-1 (AQP1) corresponds to the ultrasmall pore predicted by the modelization of peritoneal transport. Proof-of-principle studies have shown that up-regulation of the expression of AQP1 in peritoneal capillaries is reflected by increased water permeability and ultrafiltration, without affecting the osmotic gradient and the permeability for small solutes. Inversely, studies in Aqp1 mice have shown that haploinsufficiency in AQP1 is reflected by significant attenuation of water transport. Recent studies have identified lead compounds that could act as agonists of aquaporins, as well as putative binding sites and potential mechanisms of gating the water channel. By modulating water transport, these pharmacological agents could have clinically relevant effects in targeting specific tissues or disease states. These studies on the peritoneal membrane also provide an experimental framework to investigate the role of water channels in the endothelium and various cell types.

  14. Altering user' acceptance of automation through prior automation exposure.

    Science.gov (United States)

    Bekier, Marek; Molesworth, Brett R C

    2016-08-22

    Air navigation service providers worldwide see increased use of automation as one solution to overcome the capacity constraints imbedded in the present air traffic management (ATM) system. However, increased use of automation within any system is dependent on user acceptance. The present research sought to determine if the point at which an individual is no longer willing to accept or cooperate with automation can be manipulated. Forty participants underwent training on a computer-based air traffic control programme, followed by two ATM exercises (order counterbalanced), one with and one without the aid of automation. Results revealed after exposure to a task with automation assistance, user acceptance of high(er) levels of automation ('tipping point') decreased; suggesting it is indeed possible to alter automation acceptance. Practitioner Summary: This paper investigates whether the point at which a user of automation rejects automation (i.e. 'tipping point') is constant or can be manipulated. The results revealed after exposure to a task with automation assistance, user acceptance of high(er) levels of automation decreased; suggesting it is possible to alter automation acceptance.

  15. Iterative Decomposition of Water and Fat with Echo Asymmetric and Least—Squares Estimation (IDEAL (Reeder et al. 2005 Automated Spine Survey Iterative Scan Technique (ASSIST (Weiss et al. 2006

    Directory of Open Access Journals (Sweden)

    Kenneth L. Weiss

    2008-01-01

    Full Text Available Background and Purpose: Multi-parametric MRI of the entire spine is technologist-dependent, time consuming, and often limited by inhomogeneous fat suppression. We tested a technique to provide rapid automated total spine MRI screening with improved tissue contrast through optimized fat-water separation.Methods: The entire spine was auto-imaged in two contiguous 35 cm field of view (FOV sagittal stations, utilizing out-of-phase fast gradient echo (FGRE and T1 and/or T2 weighted fast spin echo (FSE IDEAL (Iterative Decomposition of Water and Fat with Echo Asymmetric and Least-squares Estimation sequences. 18 subjects were studied, one twice at 3.0T (pre and post contrast and one at both 1.5 T and 3.0T for a total of 20 spine examinations (8 at 1.5 T and 12 at 3.0T. Images were independently evaluated by two neuroradiologists and run through Automated Spine Survey Iterative Scan Technique (ASSIST analysis software for automated vertebral numbering.Results: In all 20 total spine studies, neuroradiologist and computer ASSIST labeling were concordant. In all cases, IDEAL provided uniform fat and water separation throughout the entire 70 cm FOV imaged. Two subjects demonstrated breast metastases and one had a large presumptive schwannoma. 14 subjects demonstrated degenerative disc disease with associated Modic Type I or II changes at one or more levels. FGRE ASSIST afforded subminute submillimeter in-plane resolution of the entire spine with high contrast between discs and vertebrae at both 1.5 and 3.0T. Marrow signal abnormalities could be particularly well characterized with IDEAL derived images and parametric maps.Conclusion: IDEAL ASSIST is a promising MRI technique affording a rapid automated high resolution, high contrast survey of the entire spine with optimized tissue characterization.

  16. Analysis of microbial spectrum and antibiotic resistance in patients of peritoneal dialysis related peritonitis

    Institute of Scientific and Technical Information of China (English)

    詹周兵

    2014-01-01

    Objective To investigate the microbial spectrum and antibiotic resistance of continuous ambulatory peritoneal dialysis(CAPD)related peritonitis and guide the clinical rational use of antimicrobial agents.Methods A retrospective analysis was made of CAPD related peritonitis in236 cases with peritoneal dialysate culture results in the

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

    Science.gov (United States)

    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.

  18. Análise da implantação do sistema fechado simplificado durante a assistência de enfermagem aos clientes em diálise peritoneal intermitente manual

    Directory of Open Access Journals (Sweden)

    Rosângela Aguilar Carrilho Guimarães

    1990-12-01

    Full Text Available A autora relata a experiência realizada numa unidade de depuração extra-corpórea de um hospital militar, na cidade do Rio de Janeiro com a criação do Sistema Fechado Simplificado em diálise peritoneal intermitente (DPI manual, a partir do antigo e convencional equipo de DPI manual. O novo sistema fechado simplificado foi testado pela enfermeira, em um grupo de 17 clientes no período de 1986 a 1989. O antigo equipo convencional foi usado em 11 clientes no período de 1982 a 1985. São apresentados e comentados os benefícios oriundos do novo sistema em comparação ao sistema antigo.

  19. The Cognitive Onboard Operator Assistant Architecture Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose a cognitively inspired architecture for deploying an automated intelligent onboard operator assistant. This assistant facilitates the onboard control...

  20. Granulomatous peritonitis caused by glove starch.

    OpenAIRE

    Michowitz, M.; Stavorovsky, M.; Ilie, B.

    1983-01-01

    Corn starch particles are used as a surgical glove lubricant. At present there is no better alternative for this lubricant. Implantation of corn starch particles into the peritoneal cavity can induce foreign body reactions, starch peritonitis and starch granulomata, and may cause adhesions and intestinal obstruction. Starch peritonitis should be treated conservatively.

  1. Hydrophobicity of peritoneal tissues in the rat

    NARCIS (Netherlands)

    Gomez-Suarez, C; Bruinsma, GM; Rakhorst, G; van der Mei, HC; Busscher, HJ

    2002-01-01

    In this study, an inventory of the hydrophobicity of peritoneal tissues in the living rat was made. Peritoneal tissues were divided into mesentery (i.e., omentum) and parietal and visceral peritoneum and their hydrophobicity was determined by the sessile drop method. All peritoneal tissues were hydr

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

    Science.gov (United States)

    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.

  3. Peritoneal Dialysis-Related Peritonitis with Acinetobacter baumannii: A Review of Seven Cases

    OpenAIRE

    Zhang, Wei; Wu, Yong-Gui; Qi, Xiang-Ming; Dai, Hong; Lu, Wen; Zhao, Min

    2014-01-01

    Peritonitis is still known as an important complication of continuous ambulatory peritoneal dialysis (CAPD). Multi-drug resistant (MDR) Acinetobacter baumannii is an increasing problem worldwide. Moreover, the increasing reports of carbapenem-resistant A. baumannii strains is common. Although peritoneal dialysis-related peritonitis with MDR A. baumannii is rarely reported, infection with this organism always results in serious peritonitis and increases the possibility of dropout or mortality....

  4. Imaging features of encapsulating peritoneal sclerosis in continuous ambulatory peritoneal dialysis patients.

    LENUS (Irish Health Repository)

    Ti, Joanna P

    2010-07-01

    OBJECTIVE: The purpose of this article is to present the spectrum of radiologic findings of encapsulating peritoneal sclerosis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). CONCLUSION: Although a rare diagnosis, encapsulating peritoneal sclerosis in patients undergoing CAPD has a high morbidity and mortality. Diagnosis is often delayed because clinical features are insidious and nonspecific. Radiologic imaging may be helpful in the early diagnosis of encapsulating peritoneal sclerosis and in facilitating timely intervention for CAPD patients with encapsulating peritoneal sclerosis.

  5. Curvularia lunata, a rare fungal peritonitis in continuous ambulatory peritoneal dialysis (CAPD); a rare case report

    Science.gov (United States)

    Subramanyam, Haritha; Elumalai, Ramprasad; Kindo, Anupma Jyoti; Periasamy, Soundararajan

    2016-01-01

    Peritonitis is an inflammation of the peritoneum that occurs in patients with end-stage renal disease (ESRD) treated by peritoneal dialysis. Fungal peritonitis is a dreaded complication of peritoneal dialysis. Curvularia lunata is known to cause extra renal disease like endocarditis, secondary allergic bronchopulmonary aspergillosis and endophthalmitis. This case report presents a case of continuous ambulatory peritoneal dialysis peritonitis with this disease and its management. This case is of a 45-year-old man, presented with ESRD, secondary to diabetic nephropathy. After 3 months of hemodialysis the patient was put on continuous ambulatory peritoneal dialysis (CAPD). Local Examination at catheter site showed skin excoriation and purulent discharge. Further peritoneal dialysis (PD) fluid analysis showed neutrophilic leukocytosis and diagnosis of Curvularia lunata PD peritonitis.

  6. Curvularia lunata, a rare fungal peritonitis in continuous ambulatory peritoneal dialysis (CAPD; a rare case report

    Directory of Open Access Journals (Sweden)

    Subramanyam Haritha

    2016-01-01

    Full Text Available Peritonitis is an inflammation of the peritoneum that occurs in patients with end-stage renal disease (ESRD treated by peritoneal dialysis. Fungal peritonitis is a dreaded complication of peritoneal dialysis. Curvularia lunata is known to cause extra renal disease like endocarditis, secondary allergic bronchopulmonary aspergillosis and endophthalmitis. This case report presents a case of continuous ambulatory peritoneal dialysis peritonitis with this disease and its management. This case is of a 45-year-old man, presented with ESRD, secondary to diabetic nephropathy. After 3 months of hemodialysis the patient was put on continuous ambulatory peritoneal dialysis (CAPD. Local Examination at catheter site showed skin excoriation and purulent discharge. Further peritoneal dialysis (PD fluid analysis showed neutrophilic leukocytosis and diagnosis of Curvularia lunata PD peritonitis.

  7. The Effect of Ligustrazine on Peritoneal Transport in Peritoneal Dialysis

    Institute of Scientific and Technical Information of China (English)

    朱忠华; 彭维毅; 王玉梅; 朱红艳; 杨晓; 邓安国

    2002-01-01

    Summary: In order to investigate the effect of ligustrazine (Lig) i.p. on peritoneal permeability inperitoneal dialysis and its side effects, creatinine was given intravenously and continuously tomaintain the high plasma creatinine level. All the rabbits were divided into three groups: normalcontrol group (group A), group B treated with 0. 12 % Lig and group C treated with 0. 24 % Lig.The peritoneal dialysis of all rabbits lasted 2 h. The plasma and dialysate levels of glucose, proteinand creatinine were observed immediate, 30 min, 60 min, 90 min,120 min after dialysis. Creasti-nine dialysate/plasma ratio (D/P), protein D/P ratio, glucose D/Do at different time points afterdialysis and creatinine mass transfer area coefficient (MTAC) at 120 min were calculated. Thestructures of peritoneum were observed under optical microscope and electron microscope aftercontinuously intraperitoneal injection of Lig for 14 days. The results showed that the 90-min and120-min creatinine D/P ratios in the group C were higher than in the group A. The 120-min creatinine MATC in the group C was higher than in the group A. The rabbits treated with Lig did notshow significant structure changes of peritoneum and signs of peritoneal irritation. It was suggest-ed that Lig could increase mass transfer ability of peritoneum without significant side effects.

  8. Warehouse automation

    OpenAIRE

    Pogačnik, Jure

    2017-01-01

    An automated high bay warehouse is commonly used for storing large number of material with a high throughput. In an automated warehouse pallet movements are mainly performed by a number of automated devices like conveyors systems, trolleys, and stacker cranes. From the introduction of the material to the automated warehouse system to its dispatch the system requires no operator input or intervention since all material movements are done automatically. This allows the automated warehouse to op...

  9. Automated Accounting. Instructor Guide.

    Science.gov (United States)

    Moses, Duane R.

    This curriculum guide was developed to assist business instructors using Dac Easy Accounting College Edition Version 2.0 software in their accounting programs. The module consists of four units containing assignment sheets and job sheets designed to enable students to master competencies identified in the area of automated accounting. The first…

  10. A Comparison of Fully Automated Methods of Data Analysis and Computer Assisted Heuristic Methods in an Electrode Kinetic Study of the Pathologically Variable [Fe(CN) 6 ] 3–/4– Process by AC Voltammetry

    KAUST Repository

    Morris, Graham P.

    2013-12-17

    Fully automated and computer assisted heuristic data analysis approaches have been applied to a series of AC voltammetric experiments undertaken on the [Fe(CN)6]3-/4- process at a glassy carbon electrode in 3 M KCl aqueous electrolyte. The recovered parameters in all forms of data analysis encompass E0 (reversible potential), k0 (heterogeneous charge transfer rate constant at E0), α (charge transfer coefficient), Ru (uncompensated resistance), and Cdl (double layer capacitance). The automated method of analysis employed time domain optimization and Bayesian statistics. This and all other methods assumed the Butler-Volmer model applies for electron transfer kinetics, planar diffusion for mass transport, Ohm\\'s Law for Ru, and a potential-independent Cdl model. Heuristic approaches utilize combinations of Fourier Transform filtering, sensitivity analysis, and simplex-based forms of optimization applied to resolved AC harmonics and rely on experimenter experience to assist in experiment-theory comparisons. Remarkable consistency of parameter evaluation was achieved, although the fully automated time domain method provided consistently higher α values than those based on frequency domain data analysis. The origin of this difference is that the implemented fully automated method requires a perfect model for the double layer capacitance. In contrast, the importance of imperfections in the double layer model is minimized when analysis is performed in the frequency domain. Substantial variation in k0 values was found by analysis of the 10 data sets for this highly surface-sensitive pathologically variable [Fe(CN) 6]3-/4- process, but remarkably, all fit the quasi-reversible model satisfactorily. © 2013 American Chemical Society.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    DEFF Research Database (Denmark)

    Magnussen, Eyð Tausen; Vang, Amanda Gratton; á Steig, Torkil

    2016-01-01

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

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

    Science.gov (United States)

    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

  15. Spontaneous biliary peritonitis in children.

    Science.gov (United States)

    Kohli, Supreethi; Singhal, Anu; Arora, Anita; Singhal, Sanjeev

    2013-01-01

    Pediatric Spontaneous Bile duct perforation is a rare clinical condition with only around 150 cases reported worldwide. Early management gives excellent prognosis but the condition often presents a diagnostic dilemma. Hepato-biliary Technetium-99m-iminodiacetic acid scintiscan is the diagnostic investigation of choice but its availability in third world countries is limited. We present two cases of spontaneous biliary peritonitis in children, which were diagnosed without scintiscanning. The first case was a one-and -a half-year-old child, who was diagnosed with biliary peritonitis without pneumoperitoneum by a combination of Ultrasound (USG), Contrast enhanced computed tomography (CECT), and Magnetic Resonance Imaging (MRI). The child underwent USG-guided drainage and subsequent cholecystectomy with hepatico-jejunostomy. The second child also had biliary peritonitis without pneumoperitoneum, which was initially suspected on USG. CECT revealed dilated gall bladder and fluid collection in sub-hepatic space and pelvis. Abdominal paracentesis revealed presence of bile. The child responded to conservative therapy. Both are doing well on two-year follow-up. In a patient with jaundice, biliary tract abnormalities and/or free fluid, either generalized or localized to peri-cholecystic/sub-hepatic space on USG/CT/MRI, in the absence of pneumoperitoneum, suggest a diagnosis of biliary perforation even in the absence of scintiscanning.

  16. Spontaneous Biliary Peritonitis in Children

    Directory of Open Access Journals (Sweden)

    Supreethi Kohli

    2013-01-01

    Full Text Available Pediatric Spontaneous Bile duct perforation is a rare clinical condition with only around 150 cases reported worldwide. Early management gives excellent prognosis but the condition often presents a diagnostic dilemma. Hepato-biliary Technetium-99m-iminodiacetic acid scintiscan is the diagnostic investigation of choice but its availability in third world countries is limited. We present two cases of spontaneous biliary peritonitis in children, which were diagnosed without scintiscanning. The first case was a one-and -a half-year-old child, who was diagnosed with biliary peritonitis without pneumoperitoneum by a combination of Ultrasound (USG, Contrast enhanced computed tomography (CECT, and Magnetic Resonance Imaging (MRI. The child underwent USG-guided drainage and subsequent cholecystectomy with hepatico-jejunostomy. The second child also had biliary peritonitis without pneumoperitoneum, which was initially suspected on USG. CECT revealed dilated gall bladder and fluid collection in sub-hepatic space and pelvis. Abdominal paracentesis revealed presence of bile. The child responded to conservative therapy. Both are doing well on two-year follow-up. In a patient with jaundice, biliary tract abnormalities and/or free fluid, either generalized or localized to peri-cholecystic/sub-hepatic space on USG/CT/MRI, in the absence of pneumoperitoneum, suggest a diagnosis of biliary perforation even in the absence of scintiscanning.

  17. Peritoneal amyloidosis: unusual localization of gastrointestinal amyloidosis.

    Science.gov (United States)

    Karoui, Sami; Haddad, Wafa; Serghini, Meriem; Ghorbel, Imed Ben; Chebbi, Faouzi; Azzouz, Heifa; Haouet, Slim; Houmen, Habib; Safta, Zoubeir Ben; Boubaker, Jalel; Filali, Azza

    2011-08-01

    Amyloidosis is a rare disease that results from the extracellular deposition of amorphous fibrillar protein. It is usually observed in a systemic form. Gastrointestinal involvement is frequent but peritoneal localization is unusual. A 43-year-old male was investigated for nephritic colic. Morphologic explorations revealed small intestine agglomerans in the periumbilical region, infiltration of peritoneal fat and multiple coelio-mesenteric lymph nodes. There were no clinical or biological abnormalities and endoscopic examinations were normal. The patient then underwent an exploratory laparoscopy. Macroscopically false membranes were seen throughout the peritoneum and small bowel without ascites. Anatomopathologic examination diagnosed peritoneal amyloidosis. After several investigations a diagnosis of a primary peritoneal amyloidosis was confirmed. The patient was treated with melphalan and prednisone with a favorable outcome. Our case illustrates a particular presentation of peritoneal amyloidosis. Despite improved imaging methods, peritoneal biopsy remains essential for diagnosis.

  18. Biliary atresia associated with meconium peritonitis.

    Science.gov (United States)

    Chung, Mei-Yung; Ko, Tan-Yung; Huang, Chung-Bin; Lee, Chiang-Hsuan; Hsieh, Chih-Sung

    2006-01-01

    Biliary atresia, malrotation, meconium peritonitis and transient hypothyroidism are occasionally seen in neonatal infants. Biliary atresia associated with malrotation has been reported in some patients with polysplenia syndrome, but biliary atresia associated with meconium peritonitis has only been described by a few investigators. Here we present a case of meconium peritonitis due to malrotation with volvulus, followed by biliary atresia and transient hypothyroidism during early infancy.

  19. Sclerosing encapsulating peritonitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Candido, Paula de Castro Menezes; Werner, Andrea de Freitas; Pereira, Izabela Machado Flores; Matos, Breno Assuncao; Pfeilsticker, Rudolf Moreira; Silva Filho, Raul, E-mail: paulacmcandido@yahoo.com.br [Hospital Felicio Rocho, Belo Horizonte, MG (Brazil)

    2015-01-15

    Sclerosing encapsulating peritonitis, a rare cause of bowel obstruction, was described as a complication associated with peritoneal dialysis which is much feared because of its severity. The authors report a case where radiological findings in association with clinical symptoms have allowed for a noninvasive diagnosis of sclerosing encapsulating peritonitis, emphasizing the high sensitivity and specificity of computed tomography to demonstrate the characteristic findings of such a condition. (author)

  20. Pasteurella Species Peritoneal Dialysis-Associated Peritonitis: Household Pets as a Risk Factor

    Directory of Open Access Journals (Sweden)

    Philippe Guillaume Poliquin

    2015-01-01

    Full Text Available BACKGROUND: Pasteurella species are Gram-negative coccobacilli that are a part of the normal oropharyngeal flora of numerous domestic animals. They have been recognized as a rare but significant cause of peritonitis in patients undergoing peritoneal dialysis (PD. A consensus about management strategies for PD-associated peritonitis caused by Pasteurella species currently does not exist.

  1. Genetic background of Escherichia coli isolates from peritoneal dialysis patients with peritonitis and uninfected control subjects.

    Science.gov (United States)

    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 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.

  2. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa : epidemiology and risks

    NARCIS (Netherlands)

    Raaijmakers, R.; Gajjar, P.; Schroder, C.; Nourse, P.

    2010-01-01

    Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and perit

  3. Raoultella planticola peritonitis in a patient on continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Kim, Sun Woo; Kim, Ji Eun; Hong, Yu Ah; Ko, Gang Jee; Pyo, Heui Jung; Kwon, Young Joo

    2015-12-01

    A 65-year-old man on continuous ambulatory peritoneal dialysis was admitted with peritonitis. Empirical antibiotic therapy was initiated, and Raoultella planticola was identified in the peritoneal fluid culture. We treated the patient with intraperitoneally administered ciprofloxacin and ceftazidime according to the antibiotic susceptibility. His condition improved, and he was well treated with a 2-week antibiotic course.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Arikan Hakki

    2011-04-01

    Full Text Available Abstract 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.

  6. Pathophysiology and prevention of postoperative peritoneal adhesions

    Institute of Scientific and Technical Information of China (English)

    Willy Arung1; Michel Meurisse; Olivier Detry

    2011-01-01

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

  7. Computed tomography appearances of sclerosing encapsulating peritonitis

    Energy Technology Data Exchange (ETDEWEB)

    George, C. [Department of Radiology, Hull Royal Infirmary, Hull (United Kingdom)]. E-mail: cheriangeorge@hotmail.com; Al-Zwae, K. [Department of Radiology, Hull Royal Infirmary, Hull (United Kingdom); Nair, S. [Department of Radiology, Hull Royal Infirmary, Hull (United Kingdom); Cast, J.E.I. [Department of Radiology, Hull Royal Infirmary, Hull (United Kingdom)

    2007-08-15

    Sclerosing encapsulating peritonitis (SEP) is a serious complication of peritoneal dialysis (PD) characterized by thickened peritoneal membranes, which lead to decreased ultra-filtration and intestinal obstruction. Its early clinical features are nonspecific, and it is often diagnosed late following laparotomy and peritoneal biopsy, when the patient develops small bowel obstruction, which can be a life-threatening complication. However, this is changing with increasing awareness of computed tomography (CT) findings in SEP. CT can yield an early, non-invasive diagnosis that may improve patient outcome. We present a review of the CT appearances of SEP.

  8. Peritoneal tuberculosis: how to obtain a confident diagnosis?; Tuberculose peritoneal: como diagnosticar?

    Energy Technology Data Exchange (ETDEWEB)

    Peixoto Filho, Anibal Araujo Alves; Peixoto, Mila Correia Gois [Hospital Sao Luiz, Sao Paulo, SP (Brazil). Setor de US/TC/RM; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: giuseppe_dr@uol.com.br

    2007-07-01

    The peritoneum is a frequent site of involvement by peritoneal tuberculosis. Generally, computed tomography appears to be the imaging modality of choice in the detection and assessment of abdominal tuberculosis. The computed tomography findings can help in the diagnosis of peritoneal tuberculosis, that is confirmed by a positive culture or hystologic analysis of biopsy obtained through laparoscopic examination. Peritoneal carcinomatosis is the main differential diagnosis. In this article we present the spectrum of tomographic manifestation of peritoneal tuberculosis and how we can differentiate it from peritoneal carcinomatosis. (author)

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

    Science.gov (United States)

    Shah, Shreena; Robson, Natalie; Sajid, Salman

    2015-01-01

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

  10. Morganella Morganii - A Rare Cause of Continuous Ambulatory Peritoneal Dialysis Peritonitis

    Directory of Open Access Journals (Sweden)

    Savaş SİPAHİ

    2014-05-01

    Full Text Available Nephrology professionals have selected continuous ambulatory peritoneal dialysis (CAPD as the best initial therapy for patients who have chronic renal failure. Among complications, peritonitis continues to be one of the most important complications of CAPD. The typical spectrum of organisms causing peritonitis include Gram-positives (67%, Gram-negative rods (28%, fungi (2.5%, and anaerobics (2.5 %. Among Gram-negative bacterial species, Escherichia coli, Acinetobacter species, and Enterobacter are the most seen pathogens. In this report, we present a case of CAPD peritonitis due to Morganella morganii. To our knowledge, this presentation is the second report of CAPD peritonitis due to M. morganii.

  11. A mathematical model for antibiotic control of bacteria in peritoneal dialysis associated peritonitis.

    Science.gov (United States)

    Calmelet, Colette; Hotchkiss, John; Crooke, Philip

    2014-12-01

    A study of the process of pharmacokinetics-pharmacodynamics (PKPD) of antibiotics and their interaction with bacteria during peritoneal dialysis associated peritonitis (PDAP) is presented. We propose a mathematical model describing the evolution of bacteria population in the presence of antibiotics for different peritoneal dialysis regimens. Using the model along with experimental data, clinical parameters, and physiological values, we compute variations in PD fluid distributions, drug concentrations, and number of bacteria in peritoneal and extra-peritoneal cavities. Scheduling algorithms for the PD exchanges that minimize bacteria count are investigated.

  12. Accounting Automation

    OpenAIRE

    Laynebaril1

    2017-01-01

    Accounting Automation   Click Link Below To Buy:   http://hwcampus.com/shop/accounting-automation/  Or Visit www.hwcampus.com Accounting Automation” Please respond to the following: Imagine you are a consultant hired to convert a manual accounting system to an automated system. Suggest the key advantages and disadvantages of automating a manual accounting system. Identify the most important step in the conversion process. Provide a rationale for your response. ...

  13. Home Automation

    OpenAIRE

    Ahmed, Zeeshan

    2010-01-01

    In this paper I briefly discuss the importance of home automation system. Going in to the details I briefly present a real time designed and implemented software and hardware oriented house automation research project, capable of automating house's electricity and providing a security system to detect the presence of unexpected behavior.

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

    Science.gov (United States)

    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.

  15. The Role of Peritoneal Alternatively Activated Macrophages in the Process of Peritoneal Fibrosis Related to Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2013-05-01

    Full Text Available It has been confirmed that alternatively activated macrophages (M2 participate in tissue remodeling and fibrosis occurrence, but the effect of M2 on peritoneal fibrosis related to peritoneal dialysis (PD hasn’t been elucidated. This study was therefore conducted to assess the association between M2 and peritoneal fibrosis related to PD. In this study, peritoneal fibrosis was induced by intraperitoneal (i.p. injection of Lactate-4.25% dialysate (100 mL/kg to C57BL/6J mice for 28 days, and liposome-encapsulated clodronate (LC, the specific scavenger of macrophages was used to treat the peritoneal fibrosis mice model by i.p. injection at day 18 and day 21. All animals were sacrificed at day 29. Parietal peritonea were stained with Masson’s trichrome, and the expression of type I collagen (Col-I, fibronectin, mannose receptor (CD206, transforming growth factor beta (TGF-β, chemokine receptor 7 (CCR7, chitinase 3-like 3 (Ym-1 and arginase-1 (Arg-1 was determined by Western blotting, immunofluorescence and quantitative real-time PCR. Our results revealed that peritoneal thickness, Col-I, fibronectin, CD206, TGF-β, Ym-1 and Arg-1 were upregulated in the peritoneal fibrosis mice model, and all of these indexes were downregulated in those treated with LC. Additionally, there was no difference in the level of CCR7 between the model and treatment group. Our study indicated that peritoneal M2 played an important role in the process of peritoneal fibrosis related to PD and might be a potential target for intervention therapy of peritoneal fibrosis.

  16. Peritoneal dialysis-related peritonitis with Acinetobacter baumannii: a review of seven cases.

    Science.gov (United States)

    Zhang, Wei; Wu, Yong-Gui; Qi, Xiang-Ming; Dai, Hong; Lu, Wen; Zhao, Min

    2014-05-01

    Peritonitis is still known as an important complication of continuous ambulatory peritoneal dialysis (CAPD). Multi-drug resistant (MDR) Acinetobacter baumannii is an increasing problem worldwide. Moreover, the increasing reports of carbapenem-resistant A. baumannii strains is common. Although peritoneal dialysis-related peritonitis with MDR A. baumannii is rarely reported, infection with this organism always results in serious peritonitis and increases the possibility of dropout or mortality. Here, we present 7 cases of peritonitis caused by A. baumannii species. Among those 7 cases, 2 involved MDR A. baumannii, and 1 involved a carbapenem-resistant strain. All the MDR bacterial infections failed treatment. We also review the literature about Acinetobacter peritonitis and current treatment protocols.

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

    Science.gov (United States)

    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.

  18. Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma.

    Science.gov (United States)

    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.

  19. Peritoneal tuberkulose kan diagnosticeres med laparoskopi

    DEFF Research Database (Denmark)

    Schwensen, Jakob Ferløv; Bulut, Mustafa; Nordholm-Carstensen, Andreas

    2014-01-01

    and widespread pale nodules were found throughout the peritoneum. Consequently, the patient was diagnosed with peritoneal tuberculosis. This case demonstrates that atypical manifestations of tuberculosis exist in Denmark and that laparoscopy with biopsy can be performed to obtain the diagnosis when suspecting...... peritoneal tuberculosis....

  20. Sclerosing peritonitis and mortality after liver transplantation.

    Science.gov (United States)

    Mekeel, Kristin; Moss, Adyr; Reddy, Kunam Sudhakar; Douglas, David; Mulligan, David

    2009-04-01

    Sclerosing peritonitis describes the development of a peel or rind of fibrosis that spreads over the peritoneal surface and can lead to recalcitrant ascites, bowel obstruction, and sepsis. It is well described as a complication of peritoneal dialysis, especially with episodes of bacterial peritonitis. It is also a complication of end-stage liver disease with ascites and liver transplantation. This article describes 3 cases of sclerosing peritonitis present at the time of liver transplantation or soon after. All 3 patients had massive refractory ascites with episodes of spontaneous bacterial peritonitis prior to transplantation. Two patients had evidence of a fibrous peel at the time of transplantation. Postoperatively, all 3 patients continued to have refractory ascites and episodes of peritonitis, along with partial small bowel obstructions, abdominal pain, and malnutrition. Two patients also had constriction of the graft, including biliary obstruction and inferior vena cava and outflow obstruction, which has not been previously described. All 3 patients eventually died from complications related to the sclerosing peritonitis.

  1. 75 FR 22846 - Norgren Automation Solutions, Including Workers Whose Unemployment Insurance (UI) Wages Are Paid...

    Science.gov (United States)

    2010-04-30

    ... Employment and Training Administration Norgren Automation Solutions, Including Workers Whose Unemployment Insurance (UI) Wages Are Paid Through Syron Engineering Erie Engineering and Automation Division, A... Adjustment Assistance on January 29, 2010, applicable to workers of Norgren Automation Solutions,...

  2. 76 FR 81986 - Honeywell International, Inc., Automation and Control Solutions Division, Including On-Site...

    Science.gov (United States)

    2011-12-29

    ... Employment and Training Administration Honeywell International, Inc., Automation and Control Solutions... Assistance on July 30, 2010, applicable to workers of Honeywell International, Inc., Automation and Control... location of Honeywell International, Inc., Automation and Control Solutions Division. The Department...

  3. Collagen markers in peritoneal dialysis patients

    DEFF Research Database (Denmark)

    Graff, J; Joffe, P; Fugleberg, S

    1995-01-01

    Possible relationships between the dialysate-to-plasma creatinine equilibration ratio (D/Pcreatinine 4 hour), duration of peritoneal dialysis treatment, number of peritonitis episodes, and mass appearance rates of three connective tissue markers [carboxyterminal propeptide of type I procollagen...... (PICP), aminoterminal propeptide of type III procollagen (PIIINP), and carboxyterminal telopeptide of type I collagen (ICTP)] were studied in 19 nondiabetic peritoneal dialysis patients. The absence of correlation between the mass appearance rates of the markers and the duration of dialysis treatment...... as well as the number of peritonitis episodes supports the concept that peritoneal dialysis does not cause persistent changes in the deposition and degradation rates of collagen. A correlation between the D/Pcreatinine 4 hr and the PICP mass appearance rates was found. Since it is unlikely...

  4. Postnatal Treatment in Antenatally Diagnosed Meconium Peritonitis.

    Science.gov (United States)

    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.

  5. Peritoneal carcinoma in a male patient.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Jacek Waniewski

    2016-01-01

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

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

    Science.gov (United States)

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

    Directory of Open Access Journals (Sweden)

    Gilberto Baroni

    2012-01-01

    Full Text Available 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.

  9. Streptococcal peritonitis in Australian peritoneal dialysis patients: predictors, treatment and outcomes in 287 cases

    Directory of Open Access Journals (Sweden)

    McDonald Stephen P

    2009-07-01

    Full Text Available Abstract Background There has not been a comprehensive, multi-centre study of streptococcal peritonitis in patients on peritoneal dialysis (PD to date. Methods The predictors, treatment and clinical outcomes of streptococcal peritonitis were examined by binary logistic regression and multilevel, multivariate poisson regression in all Australian PD patients involving 66 centres between 2003 and 2006. Results Two hundred and eighty-seven episodes of streptococcal peritonitis (4.6% of all peritonitis episodes occurred in 256 individuals. Its occurrence was independently predicted by Aboriginal or Torres Strait Islander racial origin. Compared with other organisms, streptococcal peritonitis was associated with significantly lower risks of relapse (3% vs 15%, catheter removal (10% vs 23% and permanent haemodialysis transfer (9% vs 18%, as well as a shorter duration of hospitalisation (5 vs 6 days. Overall, 249 (87% patients were successfully treated with antibiotics without experiencing relapse, catheter removal or death. The majority of streptococcal peritonitis episodes were treated with either intraperitoneal vancomycin (most common or first-generation cephalosporins for a median period of 13 days (interquartile range 8–18 days. Initial empiric antibiotic choice did not influence outcomes. Conclusion Streptococcal peritonitis is a not infrequent complication of PD, which is more common in indigenous patients. When treated with either first-generation cephalosporins or vancomycin for a period of 2 weeks, streptococcal peritonitis is associated with lower risks of relapse, catheter removal and permanent haemodialysis transfer than other forms of PD-associated peritonitis.

  10. Ultrafiltration capacity and peritoneal fluid kinetics in continuous ambulatory peritoneal dialysis patients.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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 thickness and Hb, BP, LVMI and ROD parameters. In conclusion, ultrasonographic measurement of peritoneal membrane thickness is a simple and non-invasive method in chronic PD children. This diagnostic tool likely enables to assess peritoneal structure and function in these patients.

  12. Daytime sleepiness and quality of life in peritoneal dialysis patients.

    Science.gov (United States)

    Bilgic, Ayse; Akman, Beril; Sezer, Siren; Arat, Zubeyde; Ozelsancak, Ruya; Ozdemir, Nurhan

    2011-12-01

    We aimed to compare automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) therapy with regard to patients' excessive daytime sleepiness (EDS) and quality of life (QOL). EDS was assessed with the Epworth Sleepiness Scale (ESS) and QOL with the Medical Outcomes Study 36-Item Short Form (SF-36) health survey. We included 59 patients (CAPD/APD, 30/29; male/female, 33/26; age, 45.3±15.8 years; dialysis duration, 42.0±33.6 months). The CAPD and APD groups were similar with respect to factors that affected sleep quality (age, sex, duration of PD), smoking, alcohol intake, socioeconomic status, body mass index, comorbid disease, and various laboratory parameters. Although one patient (3.3%) treated with CAPD and four patients (13.8%) treated with APD experienced EDS, there was no significant differences in ESS scores between the CAPD and APD patients. There was no difference in the SF-36 total and subscale scores when APD patients were compared with CAPD patients. The independent predictors of ESS were the serum albumin level (β= -2.04, P<0.01), total SF-36 score (β= 0.08, P=0.02), social functioning score (β= -2.47, P=0.01), and role-emotional subscale score (β= -1.12, P=0.05). The incidence of EDS was slightly higher in APD patients, but it did not negatively affect daily activities or QOL.

  13. Status of renal replacement therapy and peritoneal dialysis in Mexico.

    Science.gov (United States)

    Cueto-Manzano, Alfonso M; Rojas-Campos, Enrique

    2007-01-01

    Mexico is struggling to gain a place among developed countries; however, there are many socioeconomic and health problems still waiting for resolution. While Mexico has the twelfth largest economy in the world, a large portion of its population is impoverished. Treatment for end-stage renal disease (377 patients per million population) is determined by the individual's access to resources such as private medical care (approximately 3%) and public sources (Social Security System: approximately 40%; Health Secretariat: approximately 57%). With only 6% of the gross national product spent on healthcare and most treatment providers being public health institutions that are often under economic restrictions, it is not surprising that many Mexican patients do not receive renal replacement therapy. Mexico is still the country with the largest utilization of peritoneal dialysis (PD) in the world, with 18% on automated PD, 56% on continuous ambulatory PD (CAPD), and 26% on hemodialysis. Results of PD (patient morbi-mortality, peritonitis rate, and technique survival) in Mexico are comparable to other countries. However, malnutrition and diabetes mellitus are highly prevalent in Mexican patients on CAPD programs, and these conditions are among the most important risk factors for a poor outcome in our setting.

  14. Cooperative Control and Active Interfaces for Vehicle Assitsance and Automation

    OpenAIRE

    Flemisch, Frank; Kelsch, Johann; Löper, Christan; Schieben, Anna; Schindler, Julian; Heesen, Matthias

    2008-01-01

    Enabled by scientific, technological and societal progress, and pulled by human demands, more and more aspects of our life can be assisted or automated by technical artefacts. One example is the transportation domain, where in the sky commercial aircraft are flying highly automated most of the times and where on the roads a gradual revolution takes place towards assisted, highly automated or even fully automated cars and trucks. Automobiles and mobility are changing gradually t...

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

    Science.gov (United States)

    2010-04-01

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

  16. Morganella morganii Peritonitis Associated with Continuous Ambulatory Peritoneal Dialysis (CAPD) after Colonoscopy.

    Science.gov (United States)

    Kimura, Yukihiro; Ito, Ayano; Miyamoto, Kanyu; Suga, Norihiro; Miura, Naoto; Kasagi, Tomomichi; Yamagishi, Yuka; Mikamo, Hiroshige; Imai, Hirokazu

    2016-01-01

    A 79-year-old man on continuous ambulatory peritoneal dialysis (CAPD) developed abdominal pain and cloudy peritoneal fluid two days after colonoscopy that revealed multiple diverticula. The white blood cell count was 9,000 cells/μL, C-reactive protein level was 6.86 mg/dL, and the white blood cell count of the peritoneal fluid was 7,800 cells/μL, suggesting acute peritonitis. Empiric therapy consisting of cefazolin and ceftazidime slowly improved the patient's symptoms. The initial microbiological examination of the peritoneal fluid demonstrated Morganella morganii. He was changed from CAPD to hemodialysis. It is important to consider M. morganii peritonitis in patients with colonic diverticula.

  17. Spontaneous Bacterial Peritonitis in Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Dalip Gupta

    2013-11-01

    Full Text Available Hypothyroidism is an uncommon cause of ascites. Here we describe a case of a 75 year-old female patient with spontaneous bacterial peritonitis and subclinical hypothyroidism that resolved with thyroid replacement and antibiotic therapy respectively. Ascitic fluid analysis revealed a gram-positive bacterium on gram staining. A review of the literature revealed just one other reported case of myxoedema ascites with concomitant spontaneous bacterial peritonitis and no case has till been reported of spontaneous bacterial peritonitis in subclinical hypothyroidism.

  18. Microbiologic structure of diffuse peritonitis

    Directory of Open Access Journals (Sweden)

    Aziz Ermetov

    2011-05-01

    Full Text Available 99 patients with diagnosis of diffuse peritonitis (DP were examined. There were 64 (64.6% males and 35 (35.4% females, an average age was 44.07±19.15 (±SD, range - 15-83 years. Systemic inflammatory reaction manifesting in clinic of DP and abdominal sepsis were provoked first of all by Klebsiella spp. (20, 20.2% and Ваcteroides fragilis (24, 24.2% possessing the greatest virulence compared with other intestinal bacteria. Exudates of the died patients differed from the survived ones by prevalence of gram-negative microflora (60.6% in association with gram-positive microflora (24.2% and anaerobes (48.5%. Though specific weight of these microorganisms was higher by 3.07, 1.45 and 2.46 times from survived patients.

  19. Primary leiomyosarcoma of peritoneal cavity

    Directory of Open Access Journals (Sweden)

    Jyotsna Naresh Bharti

    2014-03-01

    Full Text Available Leiomyosarcomas of soft tissue are the rare tumors and the retroperitoneum is the most common site involved. We report a case of primary leiomyosarcoma of the peritoneal cavity which clinically presented with suprapubic, freely mobile, nontender mass which measured 10×10 cm in size. Contrast enhanced computed tomography revealed well defined heterogenous hypodense solid cystic mass. The mass was surgically excised out in its entirety. The histopathological examination revealed spindle cells arranged in alternating fascicles having pleomorphic nuclei, indistinct margin and eosinophilic cytoplasm with foci of haemorrhage, necrosis and 5-6 mitosis/HPF. The spindle cells were immunoreactive for smooth muscle actin, desmin and negative for S-100, CD-34 and c-kit. Histopathology and immunohistochemistry were helpful in making the final confirmatory diagnosis. Leiomyosarcomas are aggressive tumors, with poor prognosis and often difficult to treat. The survival rates are lowest among all soft tissue sarcomas.

  20. Aspergillus niger peritonitis in a patient on continuous ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Usha Kalawat

    2013-07-01

    Full Text Available Fungal peritonitis is an uncommon condition which is associated with high morbidity and mortality in patients on continuous ambulatory peritoneal dialysis (CAPD. It is associated with several complications and many of the patients who develop this condition are unable to resume CAPD treatment and have to shift to haemodialysis. Here we report the rare occurrence of fungal peritonitis due to Aspergillus niger in a patient on CAPD.

  1. A Rare Case of Peritoneal Dialysis-Associated Peritonitis with Sphingomonas koreensis.

    Science.gov (United States)

    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).

  2. Calcification of peritoneum and peritoneal fluid perfusion malfunction in carcinomatosis of serous membranes of peritoneal cavity

    Directory of Open Access Journals (Sweden)

    Gantsev SK

    2016-09-01

    Full Text Available The article describes the peritoneal calcification in peritoneal carcinomatosis, as well as its possible role in the development of carcinomatosis within the frames of the authors’ alternative theory. The analysis of the "serous-lymph hatches" condition of the intact peritoneum and peritoneum in carcinomatosis was carried out. Also the elemental quantitative calcium determination in the intact peritoneum and the peritoneum in peritoneal carcinomatosis was carried out using the atomic emission spectrometry.

  3. Efluente peritoneal turbio sin peritonitis en pacientes con insuficiencia cardiaca refractaria en programa de ultrafiltración peritoneal

    Directory of Open Access Journals (Sweden)

    Mónica Fernández Pérez

    Full Text Available En los pacientes con insuficiencia cardiaca refractaria en programa de ultrafiltración peritoneal no es infrecuente la presencia de líquido turbio en ausencia de otros criterios de infección peritoneal. El objetivo del estudio fue analizar si la presencia de drenado peritoneal turbio se corresponde con la presencia de infección peritoneal. Se realizó un estudio observacional prospectivo entre Diciembre de 2014 y Marzo de 2015, en el que se incluyeron pacientes con insuficiencia cardiaca refractaria. Se analizaron 4 muestras de cada paciente, separadas por 15 días, de forma programada. Los cultivos bacteriológicos se realizaron en las muestras que presentaban un recuento leucocitario superior a 100 leucocitos/μl. Se recogieron datos epidemiológicos y clínicos de los pacientes, como la patología de base responsable de la insuficiencia cardiaca y las proteínas presentes en el efluente peritoneal. Se evaluaron 13 pacientes, 77% varones, edad media de 71±8 años. Se recogieron un total de 51 muestras; de ellas, en 5 muestras (9.8% procedentes de 4 pacientes (31% del total de pacientes, el efluente peritoneal era turbio. En 2 de ellos el recuento leucocitario fue inferior a 100 leucocitos/μl mientras que en los otros 2 pacientes el recuento fue superior, con polimorfonucleares por debajo del 50% y cultivos sin crecimiento bacteriano. No hubo relación entre la celularidad y las enfermedades de base. Consideramos que la presencia de turbidez en el efluente peritoneal de los pacientes con Insuficiencia Cardiaca no siempre se corresponde con la existencia de infección peritoneal.

  4. Difficult peritonitis cases in children undergoing chronic peritoneal dialysis: relapsing, repeat, recurrent and zoonotic episodes.

    Science.gov (United States)

    Bakkaloglu, Sevcan A; Warady, Bradley A

    2015-09-01

    Despite technological improvements in dialysis connectology and dialysis technique, peritonitis remains the most common and most significant complication of peritoneal dialysis (PD) in children. Most children undergoing chronic PD experience none or only one peritonitis episode, while others have multiple episodes or episodes secondary to unusual organisms. Knowledge of potential risk factors and likely patient outcome is imperative if treatment is to be optimized. In this review we will, in turn, describe episodes of peritonitis that are characterized as either relapsing, recurrent, repeat or zoonosis-related to highlight the clinical issues that are commonly encountered by clinicians treating these infections.

  5. microRNA Regulation of Peritoneal Cavity Homeostasis in Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Melisa Lopez-Anton

    2015-01-01

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

  6. Optimising intraperitoneal gentamicin dosing in peritoneal dialysis patients with peritonitis (GIPD study

    Directory of Open Access Journals (Sweden)

    Lipman Jeffrey

    2009-12-01

    Full Text Available Abstract Background Antibiotics are preferentially delivered via the peritoneal route to treat peritonitis, a major complication of peritoneal dialysis (PD, so that maximal concentrations are delivered at the site of infection. However, drugs administered intraperitoneally can be absorbed into the systemic circulation. Drugs excreted by the kidneys accumulate in PD patients, increasing the risk of toxicity. The aim of this study is to examine a model of gentamicin pharmacokinetics and to develop an intraperitoneal drug dosing regime that maximises bacterial killing and minimises toxicity. Methods/Design This is an observational pharmacokinetic study of consecutive PD patients presenting to the Royal Brisbane and Women's Hospital with PD peritonitis and who meet the inclusion criteria. Participants will be allocated to either group 1, if anuric as defined by urine output less than 100 ml/day, or group 2: if non-anuric, as defined by urine output more than 100 ml/day. Recruitment will be limited to 15 participants in each group. Gentamicin dosing will be based on the present Royal Brisbane & Women's Hospital guidelines, which reflect the current International Society for Peritoneal Dialysis Peritonitis Treatment Recommendations. The primary endpoint is to describe the pharmacokinetics of gentamicin administered intraperitoneally in PD patients with peritonitis based on serial blood and dialysate drug levels. Discussion The study will develop improved dosing recommendations for intraperitoneally administered gentamicin in PD patients with peritonitis. This will guide clinicians and pharmacists in selecting the most appropriate dosing regime of intraperitoneal gentamicin to treat peritonitis. Trial Registration ACTRN12609000446268

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

    Science.gov (United States)

    2012-03-29

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

  8. Campylobacter jejuni: A rare agent in a child with peritoneal dialysis-related peritonitis.

    Science.gov (United States)

    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.

  9. Advanced glycation end-products in the peritoneal fluid and in the peritoneal membrane of continuous ambulant peritoneal dialysis patients.

    Science.gov (United States)

    Mahiout, A; Ehlerding, G; Brunkhorst, R

    1996-01-01

    In patients on continuous ambulant peritoneal dialysis (CAPD) treatment, the peritoneal membrane is continuously exposed to the high glucose concentration contained in the dialysate. This may lead to the local generation of advanced glycation end-products (AGEs). To test this hypothesis we evaluated the plasma and dialysate AGE concentrations in five CAPD patients. The dialysate was measured after a 1 h and after a 12 h dwell time. Additionally, in two patients an immunohistochemical investigation of the peritoneal membrane for AGE was performed. For the determination of AGE an ELISA using a polyclonal antibody against AGE bovine serum albumin was used; the immunohistochemical staining was performed using the streptavidin-biotin complex method. We found only low concentrations of AGE in the dialysate after a 1 h dwell time; after 12 h, however, the dialysate AGE was even greater than the plasma concentration. In both peritoneal specimens we found positive staining for AGE in the interstitium of the mesothelial layer. The dialysate AGE contained a high proportion of high-molecular-weight AGE proteins and low-molecular-weight AGE was found to be in the same concentration range as the total serum AGE. We conclude that there is local generation of AGE in the peritoneal membrane and a 'washing out' of AGE from the peritoneal membrane during longer dwell times. We speculate that the accumulation of AGE might lead to some of the functional and morphological alterations observed after long-term CAPD.

  10. A Boolean Consistent Fuzzy Inference System for Diagnosing Diseases and Its Application for Determining Peritonitis Likelihood

    Directory of Open Access Journals (Sweden)

    Ivana Dragović

    2015-01-01

    Full Text Available Fuzzy inference systems (FIS enable automated assessment and reasoning in a logically consistent manner akin to the way in which humans reason. However, since no conventional fuzzy set theory is in the Boolean frame, it is proposed that Boolean consistent fuzzy logic should be used in the evaluation of rules. The main distinction of this approach is that it requires the execution of a set of structural transformations before the actual values can be introduced, which can, in certain cases, lead to different results. While a Boolean consistent FIS could be used for establishing the diagnostic criteria for any given disease, in this paper it is applied for determining the likelihood of peritonitis, as the leading complication of peritoneal dialysis (PD. Given that patients could be located far away from healthcare institutions (as peritoneal dialysis is a form of home dialysis the proposed Boolean consistent FIS would enable patients to easily estimate the likelihood of them having peritonitis (where a high likelihood would suggest that prompt treatment is indicated, when medical experts are not close at hand.

  11. A Boolean Consistent Fuzzy Inference System for Diagnosing Diseases and Its Application for Determining Peritonitis Likelihood.

    Science.gov (United States)

    Dragović, Ivana; Turajlić, Nina; Pilčević, Dejan; Petrović, Bratislav; Radojević, Dragan

    2015-01-01

    Fuzzy inference systems (FIS) enable automated assessment and reasoning in a logically consistent manner akin to the way in which humans reason. However, since no conventional fuzzy set theory is in the Boolean frame, it is proposed that Boolean consistent fuzzy logic should be used in the evaluation of rules. The main distinction of this approach is that it requires the execution of a set of structural transformations before the actual values can be introduced, which can, in certain cases, lead to different results. While a Boolean consistent FIS could be used for establishing the diagnostic criteria for any given disease, in this paper it is applied for determining the likelihood of peritonitis, as the leading complication of peritoneal dialysis (PD). Given that patients could be located far away from healthcare institutions (as peritoneal dialysis is a form of home dialysis) the proposed Boolean consistent FIS would enable patients to easily estimate the likelihood of them having peritonitis (where a high likelihood would suggest that prompt treatment is indicated), when medical experts are not close at hand.

  12. A Boolean Consistent Fuzzy Inference System for Diagnosing Diseases and Its Application for Determining Peritonitis Likelihood

    Science.gov (United States)

    Dragović, Ivana; Turajlić, Nina; Pilčević, Dejan; Petrović, Bratislav; Radojević, Dragan

    2015-01-01

    Fuzzy inference systems (FIS) enable automated assessment and reasoning in a logically consistent manner akin to the way in which humans reason. However, since no conventional fuzzy set theory is in the Boolean frame, it is proposed that Boolean consistent fuzzy logic should be used in the evaluation of rules. The main distinction of this approach is that it requires the execution of a set of structural transformations before the actual values can be introduced, which can, in certain cases, lead to different results. While a Boolean consistent FIS could be used for establishing the diagnostic criteria for any given disease, in this paper it is applied for determining the likelihood of peritonitis, as the leading complication of peritoneal dialysis (PD). Given that patients could be located far away from healthcare institutions (as peritoneal dialysis is a form of home dialysis) the proposed Boolean consistent FIS would enable patients to easily estimate the likelihood of them having peritonitis (where a high likelihood would suggest that prompt treatment is indicated), when medical experts are not close at hand. PMID:27069500

  13. Assessing the performance of novel software Strain Solution on automated discrimination of Escherichia coli serotypes and their mixtures using matrix-assisted laser desorption ionization-time of flight mass spectrometry.

    Science.gov (United States)

    Ojima-Kato, Teruyo; Yamamoto, Naomi; Iijima, Yoshio; Tamura, Hiroto

    2015-12-01

    O157, O26, and O111 are the most important O serogroups of enterohemorrhagic Escherichia coli worldwide. Recently we reported a strategy for discriminating these serotypes from the others using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) based on the S10-spc-alpha operon gene-encoded ribosomal protein mass spectrum (S10-GERMS) method. To realize the fully automated identification of microorganisms at species- or serotype-level with the concept of S10-GERMS method, novel software named Strain Solution for MALDI-TOF MS was developed. In this study, the Strain Solution was evaluated with a total of 45 E. coli isolates including O26, O91, O103, O111, O115, O121, O128, O145, O157, O159, and untyped serotypes. The Strain Solution could accurately discriminate 92% (11/12) of O157 strains, 100% (13/13) of O26 and O111 strains from the others with three biomarkers in an automated manner. In addition, this software could identify 2 different E. coli strains (K-12 as a non-O157 representative and O157) in mixed samples. The results suggest that Strain Solution will be useful for species- or serotype-level classification of microorganisms in the fields of food safety and diagnostics.

  14. Peritoneal mesothelioma; Radiologic appearances correlated with histology

    Energy Technology Data Exchange (ETDEWEB)

    Ros, P.R.; Yuschok, T.J.; Buck, J.L.; Shekitka, K.M.; Kaude, J.V. (Florida Univ. Coll. of Medicine, Gainesville, FL (United States). Dept. of Radiology Armed Forces Inst. of Pathology, Washington, DC (United States). Depts. of Radiologic Pathology and Gastrointestinal Pathology)

    1991-09-01

    Previous imaging reports of peritoneal mesothelioma have described a variety of radiologic appearances, but have not included its pathologic classification. We retrospectively reviewed 10 cases of peritoneal mesothelioma representing the following histologic categories: 7 epithelial, 2 sarcomatoid, and one biphasic. By imaging, epithelial mesotheliomas demonstrated diffuse thickening of the peritoneum and mesentery and/or multiple small nodules. The sarcomatoid-type appeared as a mass and the biphasic-type had radiologic and gross pathologic features of both sarcomatoid and epithelial types. We conclude that peritoneal mesothelioma presents with a wide spectrum of radiographic appearances and should therefore be included in the differential diagnoses of diffuse as well as localized peritoneal processes. (orig.).

  15. Library Automation

    OpenAIRE

    Dhakne, B. N.; Giri, V. V.; Waghmode, S. S.

    2010-01-01

    New technologies library provides several new materials, media and mode of storing and communicating the information. Library Automation reduces the drudgery of repeated manual efforts in library routine. By use of library automation collection, Storage, Administration, Processing, Preservation and communication etc.

  16. Omphalolith presented with peritonitis: a case report

    OpenAIRE

    Mahdi, Hijran R; El Hennawy, Hany M

    2009-01-01

    Omphalolith is a hard, smooth, almost black bolus found in the umbilicus, resembling a malignant melanoma. It is often accompanied by seborrhea which may lead to abscess formation. It may be related to poor hygiene. Patient is usually complaining of umbilical discharge and pain. This report describes a rare case of omphalolith (umbilical stone) induced peritonitis, in a patient who presented as acute appendicitis. In our case the two umbilical stones found their way to the peritoneal cavity a...

  17. The use of peritoneal dialysis in newborns

    Directory of Open Access Journals (Sweden)

    Stojanović Vesna

    2007-01-01

    Full Text Available Introduction. Acute renal failure is a common complication in critically ill newborn infants. The therapy of acute renal failure is conservative and etiological. Patients not responding to this kind of therapy require peritoneal dialysis. Material and methods. This retrospective study included 6 newborn infants undergoing peritoneal dialysis during the period from January 2004 to June 2006, at the Nephrology Department of the Institute of Child and Youth Health Care in Novi Sad. All patients presented with complications of acute renal failure including hypercalemia and uremic encephalopathy. Results. Complete restoration of kidney function was evident in four patients on peritoneal dialysis. Three patients are still alive, but in one patient acute renal failure progressed to chronic renal failure. One patient died in the third month of life due to multiple organ dysfunction, after just two days of dialysis. Several complications were reported: intra-abdominal hemorrhage, dialysate leakage, peritonitis and dialysis catheter obstruction. Discussion. Periotoneal dialysis catheter placement is a great problem due to the size of the newborn. If it is estimated that it will be a long-lasting dialysis, Tenckhoff catheter is recommended. In very low birth weight newborn infants, in poor overall condition, general anesthesia is too risky, and acute peritoneal dialysis catheter should be placed (i.v. cannula, venous catheter. Conclusion. Peritoneal dialysis is the method of choice in newborns with acute renal failure, and it is used in the treatment of neonatal asphyxia till the restoration of kidney function is achieved. .

  18. Continuous ambulatory peritoneal dialysis: Indian scenario.

    Science.gov (United States)

    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.

  19. Peritoneal taurolidine lavage in children with localised peritonitis due to appendicitis.

    Science.gov (United States)

    Schneider, Axel; Sack, Ulrich; Rothe, Karin; Bennek, Joachim

    2005-06-01

    Despite aggressive surgical treatment, rational antibiotic therapy, and modern intensive care, generalised peritonitis remains a major threat in the paediatric age group. Several adjuvant strategies such as peritoneal saline lavage and peritoneal drainage have been utilised. Taurolidine, derived from the amino acid taurine, has bactericidic, antiendotoxic, and antiinflammatory properties. It has been introduced previously for intraoperative peritoneal lavage in treating peritonitis in adults. The aim of our study was to evaluate the effect of peritoneal taurolidine lavage on the clinical course and serological inflammation markers in children with perforated appendicitis and localised peritonitis. A series of 27 children presenting with appendicitis between January 1999 and July 2001 were included in the study after parental informed consent. All patients underwent open appendectomy. Taurolidine peritoneal lavage was applied in 15 randomly selected children (eight girls and seven boys; mean age 10 years and 10 months). Twelve children received saline peritoneal lavage and served as the control group (six girls and six boys; mean age 9 years and 7 months). Blood was taken preoperatively and on postoperative days 1, 3, 7, and 14. Full blood cell count, C-reactive protein, endotoxin, interleukin-1, interleukin-6, soluble interleukin-2 receptor, tumour necrosis factor alpha, and procalcitonin were investigated to evaluate the serological course of inflammation. Both groups initially presented with severe inflammation as evidenced clinically and serologically. The clinical postoperative course was uneventful in 13/15 patients in the treatment group and 10/12 patients in the control group. The remaining patients presented complications: intraperitoneal abscess or early postoperative bowel obstruction. With regard to the serological inflammatory parameters, no significant differences were found between the two groups except for the soluble interleukin-2-receptor on the 7

  20. Automation or De-automation

    Science.gov (United States)

    Gorlach, Igor; Wessel, Oliver

    2008-09-01

    In the global automotive industry, for decades, vehicle manufacturers have continually increased the level of automation of production systems in order to be competitive. However, there is a new trend to decrease the level of automation, especially in final car assembly, for reasons of economy and flexibility. In this research, the final car assembly lines at three production sites of Volkswagen are analysed in order to determine the best level of automation for each, in terms of manufacturing costs, productivity, quality and flexibility. The case study is based on the methodology proposed by the Fraunhofer Institute. The results of the analysis indicate that fully automated assembly systems are not necessarily the best option in terms of cost, productivity and quality combined, which is attributed to high complexity of final car assembly systems; some de-automation is therefore recommended. On the other hand, the analysis shows that low automation can result in poor product quality due to reasons related to plant location, such as inadequate workers' skills, motivation, etc. Hence, the automation strategy should be formulated on the basis of analysis of all relevant aspects of the manufacturing process, such as costs, quality, productivity and flexibility in relation to the local context. A more balanced combination of automated and manual assembly operations provides better utilisation of equipment, reduces production costs and improves throughput.

  1. The automated Palomar 60 inch telescope

    OpenAIRE

    Cenko, S Bradley; Fox, Derek B.; Moon, Dae-Sik; Harrison, Fiona A.; Kulkarni, S.R.; Henning, John R.; Guzman, C. Dani; Bonati, Marco; Smith, Roger M.; Thicksten, Robert P.; Doyle, Michael W.; Petrie, Hal L.; Gal-Yam, Avishay; Soderberg, Alicia M.; Anagnostou, Nathaniel L.

    2006-01-01

    We have converted the Palomar 60-inch telescope (P60) from a classical night assistant-operated telescope to a fully robotic facility. The automated system, which has been operational since September 2004, is designed for moderately fast (t

  2. The Association Between Peritoneal Charge Barrier Dysfunction and Protein Lost During Continuous Ambulatory Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Guo-Qing Yu

    2013-07-01

    Full Text Available Background/Aims: The main purpose of the present study was to determine the effect of peritoneal charge barrier dysfunction on hypoalbuminemia during CAPD. Methods: We measured the association of dialysis dose, peritoneal equilibration test (PET results (ratio of dialysate and plasma creatinine, and peritoneal charge barrier index (ratio of pancreatic and salivary α-amylase clearance on protein loss in 33 patients on maintenance CAPD. All patients were from a single institution and were diagnosed with chronic nephritis (n = 18 cases, diabetic nephropathy (n = 8, hypertension (n = 5, and hepatitis B virus-associated glomerulonephritis (n = 2. Results: The mean (± SD dialysate protein loss was 4.04 g (± 1.97 per day. Protein loss was positively correlated with dialysis dose (r = 0.438, p = 0.01 but was not significantly correlated with PET results. The mean (± SD peritoneal charge barrier index was 6.12 (± 21.20 and was inversely correlated with protein loss into the peritoneal dialysate (r = -0.532, p Conclusions: Taken together, our study of CAPD patients indicates that protein loss into the peritoneal dialysate increases with peritoneal dialysis dose and with disruption of the peritoneal charge barrier.

  3. Peritonitis and catheter exit-site infection in patients on peritoneal dialysis at home

    Directory of Open Access Journals (Sweden)

    Ana Cristina Freire Abud

    2015-10-01

    Full Text Available 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.

  4. [Encapsulating peritoneal sclerosis in a patient who had previously been in peritoneal dialysis].

    Science.gov (United States)

    Duus, Rasmus Møller; Brodersen, Louise Aarup; Colic, Edin

    2014-12-15

    Encapsulating peritoneal sclerosis (EPS) is a rare but potentially fatal complication to long-term peritoneal dialysis (PD). We describe a case of EPS in a 58-year-old patient who had formerly had PD. The interdisciplinary approach for diagnosis and possible treatments in this condition is discussed.

  5. Peritonitis Due to Roseomonas fauriae in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

    OpenAIRE

    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.

  6. Peritonitis due to Roseomonas fauriae in a patient undergoing continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Bibashi, E; Sofianou, D; Kontopoulou, K; Mitsopoulos, E; Kokolina, E

    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.

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

    Directory of Open Access Journals (Sweden)

    Ichiro Hirahara

    2015-01-01

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

  8. Infections in peritoneal dialysis patients: Incidence, determinants and the association with peritoneal transport

    NARCIS (Netherlands)

    van Diepen, A.T.N.

    2015-01-01

    The research reported in this thesis aimed to contribute to the knowledge about the epidemiology of infections in peritoneal dialysis (PD) patients and its subsequent impact on peritoneal transport. Incidence: This thesis provides evidence that PD patients carry a higher baseline risk of infections

  9. Approaches to automated protein crystal harvesting

    Energy Technology Data Exchange (ETDEWEB)

    Deller, Marc C., E-mail: mdeller@scripps.edu; Rupp, Bernhard, E-mail: mdeller@scripps.edu

    2014-01-28

    Approaches to automated and robot-assisted harvesting of protein crystals are critically reviewed. While no true turn-key solutions for automation of protein crystal harvesting are currently available, systems incorporating advanced robotics and micro-electromechanical systems represent exciting developments with the potential to revolutionize the way in which protein crystals are harvested.

  10. Sclerosing encapsulating peritonitis in chronic ambulatory peritoneal dialysis;preoperative catheter drainage : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hoon [Dankook Univ. Hospital, Seoul (Korea, Republic of)

    1996-10-01

    Sclerosing encapsulating peritonitis is a well recognized, but uncommon, complication of chronic ambulatory peritoneal dialysis. I report a case of sclerosing encapsulating peritonitis in which percutaneous catheter drainage was performed preoperatively. Ultrasonography(US) and computed tomography(CT) showed a large multi-septated cystic mass which occupied nearly all the peritoneal cavity. Percutaneous drainage with two 8.5 French catheters was preoperatively performed under fluoroscopy and about 2100 ml of bloody fluid was drained for 20 days. On follow-up CT, the size of the cyst had significantly decreased and anoperation was performed. It is considered that percutaneous catheter drainage is useful in the preoperative decompression of sclerosing encapsulating peritonitis.

  11. Preclinical assessment of adjunctive tPA and DNase for peritoneal dialysis associated peritonitis.

    Directory of Open Access Journals (Sweden)

    Amanda L McGuire

    Full Text Available A major complication of peritoneal dialysis is the development of peritonitis, which is associated with reduced technique and patient survival. The inflammatory response elicited by infection results in a fibrin and debris-rich environment within the peritoneal cavity, which may reduce the effectiveness of antimicrobial agents and predispose to recurrence or relapse of infection. Strategies to enhance responses to antimicrobial agents therefore have the potential to improve patient outcomes. This study presents pre-clinical data describing the compatibility of tPA and DNase in combination with antimicrobial agents used for the treatment of PD peritonitis. tPA and DNase were stable in standard dialysate solution and in the presence of antimicrobial agents, and were safe when given intraperitoneally in a mouse model with no evidence of local or systemic toxicity. Adjunctive tPA and DNase may have a role in the management of patients presenting with PD peritonitis.

  12. A case of peritoneal dialysis-associated peritonitis caused by Sphingomonas paucimobilis

    Directory of Open Access Journals (Sweden)

    Jae Un Lee

    2013-06-01

    Full Text Available Sphingomonas paucimobilis is an aerobic Gram-negative bacillus found in soil and water. Knowledge regarding the role of this infectious agent is limited because it is rarely isolated from human material. Furthermore, it is an unusual pathogen in cases of peritoneal dialysis (PD-associated peritonitis. The clinical courses and outcomes of peritonitis caused by S. paucimobilis are variable. Whereas some patients were cured with appropriate antibiotic therapy, others required catheter removal. Cases of PD-associated peritonitis caused by S. paucimobilis have been reported worldwide, and there was a case report of coinfection with S. paucimobilis and Chryseobacterium indologenes in Korea. However, there has been no case caused by S. paucimobilis as a single pathogen. We report a case of PD-associated peritonitis due to S. paucimobilis in which the patient recovered after catheter removal.

  13. Periton Diyalizi Hastasında Kolonoskopi Sonrası Gelişen Peritonit

    Directory of Open Access Journals (Sweden)

    Ali TAMER

    2012-01-01

    Full Text Available Peritonitis in peritoneal dialysis patients after colonoscopy is a rare complication. We present a peritoneal dialysis patient who developed peritonitis shortly after colonoscopy together with a discussion on diagnosis, management and the current literature.

  14. Risk factors for the first episode of peritonitis in Southern Chinese continuous ambulatory peritoneal dialysis patients.

    Directory of Open Access Journals (Sweden)

    Xiaoguang Fan

    Full Text Available The first episode of peritonitis affects survival of the peritoneal membrane as a medium for dialysis as well as survival of patients. The aim of this study is to investigate risk factors associated with the first episode of peritonitis in Southern Chinese continuous ambulatory peritoneal dialysis (CAPD patients.This is a single-center, retrospective, cohort study. All incident CAPD patients from 1 January 2006 to 31 December 2010 were recruited, and followed up until their first episode of peritonitis or 31 December, 2012. Baseline demographic, socioeconomic, clinical and laboratory data were collected. Cox proportional model was used to determine the factors associated with the first episode of peritonitis.In a cumulative 30756.5 patient-months follow-up (the median vintage 26.1 months of 1117 CAPD patients, 309(27.7% patients presented the first episodes of peritonitis. The cumulative peritonitis-free survival was 86.2%, 78.1%, 71.4% and 57.8% at 1, 2, 3 and 5 year, respectively. The multivariate analysis showed that factors associated with risk for the first episode of peritonitis were elderly patients (>65 years [hazard ratio (HR = 1.427, 95% confidence interval (CI = 1.051 to 1.938, P = 0.023], male(HR = 1.315, 95% CI = 1.028 to 1.684, P = 0.030, lower education level (HR = 1.446, 95% CI: 1.127 to 1.855, P = 0.004 and albumin <38g/L (HR = 1.425, 95% CI: 1.112 to 1.825, P = 0.005.Older age, male, lower educational level and hypoalbuminemia at the commencement of PD were the risk factors associated with the first episode of peritonitis in Southern Chinese CAPD patients.

  15. The potential role of HMGB1 release in peritoneal dialysis-related peritonitis.

    Directory of Open Access Journals (Sweden)

    Shirong Cao

    Full Text Available High mobility group box 1 (HMGB1, a DNA-binding nuclear protein, has been implicated as an endogenous danger signal in the pathogenesis of infection diseases. However, the potential role and source of HMGB1 in the peritoneal dialysis (PD effluence of patients with peritonitis are unknown. First, to evaluate HMDB1 levels in peritoneal dialysis effluence (PDE, a total of 61 PD patients were enrolled in this study, including 42 patients with peritonitis and 19 without peritonitis. Demographic characteristics, symptoms, physical examination findings and laboratory parameters were recorded. HMGB1 levels in PDE were determined by Western blot and ELISA. The concentrations of TNF-α and IL-6 in PDE were quantified by ELISA. By animal model, inhibition of HMGB1 with glycyrrhizin was performed to determine the effects of HMGB1 in LPS-induced mice peritonitis. In vitro, a human peritoneal mesothelial cell line (HMrSV5 was stimulated with lipopolysaccharide (LPS, HMGB1 extracellular content in the culture media and intracellular distribution in various cellular fractions were analyzed by Western blot or immunofluorescence. The results showed that the levels of HMGB1 in PDE were higher in patients with peritonitis than those in controls, and gradually declined during the period of effective antibiotic treatments. Furthermore, the levels of HMGB1 in PDE were positively correlated with white blood cells (WBCs count, TNF-α and IL-6 levels. However, pretreatment with glycyrrhizin attenuated LPS-induced acute peritoneal inflammation and dysfunction in mice. In cultured HMrSV5 cells, LPS actively induced HMGB1 nuclear-cytoplasmic translocation and release in a time and dose-dependent fashion. Moreover, cytosolic HMGB1 was located in lysosomes and secreted via a lysosome-mediated secretory pathway following LPS stimulation. Our study demonstrates that elevated HMGB1 levels in PDE during PD-related peritonitis, at least partially, from peritoneal mesothelial cells

  16. Automated Accounting. Payroll. Instructor Module.

    Science.gov (United States)

    Moses, Duane R.

    This teacher's guide was developed to assist business instructors using Dac Easy Accounting Payroll Version 3.0 edition software in their accounting programs. The module contains assignment sheets and job sheets designed to enable students to master competencies identified in the area of automated accounting--payroll. Basic accounting skills are…

  17. PERITONEAL MALIGNANT MESOTHELIOMA : A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Dhamotharan

    2015-08-01

    Full Text Available INTRODUCTION : Peritoneal mesothelioma is a rare tumor, presenting difficulties in diagnosis and treatment. Peritoneum is the second most common area of the mesothelioma after pleura, and even synchronous pleural and peritoneal mesotheliomas are observed in 30 – 45% of all cases. The diagnosis may be difficult due to lack of specific symptoms and clinical findings. In addition, a delay in the diagnosis is not rare especially in the absence of previous asbestos exposure. Here we report a case of malignant peritoneal mesothelioma. The diagnostic and therapeutic approaches for these rare neoplasms are discussed. CASE PRESENTATION : Prolonged a bdominal pain and abdominal distension were the primary presentation symptoms and findings. A mass noted after imaging studies in the right lower quadrant of abdomen. Diagnostic lap a roscopy and sampling done from the mesenteric node. Final diagnosis were p ossible with histological and immunohistochemical documentation of tumor characteristics, which were consistent with dictating a mesothelial origin. No history of asbestos exposure was reported. CONCLUSION : Peritoneal mesotheliomas are rare clinical entiti es. However, patients with prolonged abdominal pain and abdominal masses should be considered to have atypical pathologies such as peritoneal mesotheliomas

  18. [Peritoneal malignant mesothelioma: review and recent data].

    Science.gov (United States)

    Mery, Éliane; Hommell-Fontaine, Juliette; Capovilla, Mathieu; Chevallier, Anne; Bibeau, Frédéric; Croce, Sabrina; Dartigues, Peggy; Kaci, Rachid; Lang-Averous, Gerlinde; Laverriere, Marie-Hélène; Leroux-Broussier, Agnès; Poizat, Flora; Robin, Nina; Valmary-Degano, Séverine; Verriele-Beurrier, Véronique; Villeneuve, Laurent; Isaac, Sylvie

    2014-02-01

    Peritoneal malignant mesothelioma is a rare tumor, less common than its pleural counterpart. It develops from the mesothelial cells overlying peritoneum and preferentially occurs in male, with an average age ranging from 47 to 60.5 years. Asbestos whose impact is less strong than in pleural mesothelioma, SV 40 virus, chronic peritonitis could be implicated as factors favoring the development of peritoneal mesothelioma. Clinical symptoms are not specific, and the imagery remains little or not contributive. The 2004 WHO classification recognizes 3 different types, which differ in terms of presentation and prognosis: diffuse epithelioid mesothelioma (the most common), sarcomatoid mesothelioma and biphasic mesothelioma. Many variants are described within these groups. Immunohistochemistry is mandatory to affirm or disprove peritoneal malignant mesothelioma diagnosis, based on a panel of antibodies divided in positive markers and negative markers. Indeed an accurate diagnosis is necessary to define a therapeutic strategy more and more frequently based on the combination of radical surgery and hyperthermic intra peritoneal chemotherapy. Such an approach significantly improves the prognosis of these aggressive diseases.

  19. Acute chylous peritonitis due to acute pancreatitis.

    Science.gov (United States)

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

    2012-04-28

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

  20. Pyruvate anions neutralize peritoneal dialysate cytotoxicity.

    Science.gov (United States)

    Mahiout, A; Brunkhorst, R

    1995-01-01

    A new peritoneal dialysate containing pyruvate anions was developed in order to avoid cytotoxic effect of conventional lactate-based dialysate. The dialysate has a final pH of 5.4 to 5.6 and is composed of 1.36-3.86% glucose-monohydrate; 132 mmol/l sodium; 1.75 mmol/l calcium; 0.75 mmol/l magnesium; 102 mmol/l chloride and 35 mmol/l pyruvate. For cytotoxicity testing peritoneal macrophages, and mesothelial cells (MC) were exposed to conventional lactate dialysate, and pyruvate dialysate. We investigated the O2- generation and cytokine synthesis after endotoxin stimulation in peritoneal macrophages and the proliferation of mesothelial cells of cultured human MC. After exposure to lactate dialysate O2- generation and cytokine synthesis in peritoneal macrophages and proliferation of mesothelial cells were inhibited when compared to solution containing pyruvate and the control solution. After preincubation with 3.86% glucose containing solutions, all negative effects became even more pronounced in the lactate group whereas after pre-exposure to pyruvate containing solution the toxic effects were absent. These results suggest that the acute toxic effects of commercially available peritoneal dialysates can be avoided by the use of sodium pyruvate instead of sodium lactate.

  1. Acute chylous peritonitis due to acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  2. Network based automation for SMEs

    DEFF Research Database (Denmark)

    Shahabeddini Parizi, Mohammad; Radziwon, Agnieszka

    2017-01-01

    The implementation of appropriate automation concepts which increase productivity in Small and Medium Sized Enterprises (SMEs) requires a lot of effort, due to their limited resources. Therefore, it is strongly recommended for small firms to open up for the external sources of knowledge, which...... automation solutions. The empirical data collection involved application of a combination of comparative case study method with action research elements. This article provides an outlook over the challenges in implementing technological improvements and the way how it could be resolved in collaboration...... with other members of the same regional ecosystem. The findings highlight two main automation related areas where manufacturing SMEs could leverage on external sources on knowledge – these are assistance in defining automation problem as well as appropriate solution and provider selection. Consequently...

  3. Encapsulating peritoneal sclerosis: experience of a tertiary referral center.

    LENUS (Irish Health Repository)

    Phelan, P J

    2010-05-01

    Encapsulating peritoneal sclerosis (EPS) is arguably the most serious complication of chronic peritoneal dialysis (PD) therapy with extremely high mortality rates. We aimed to establish the rates of EPS and factors associated with its development in a single center.

  4. Stages of Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer

    Science.gov (United States)

    ... peritoneal cancer include pain or swelling in the abdomen. Ovarian, fallopian tube, or peritoneal cancer may not ... swelling, or a feeling of pressure in the abdomen or pelvis. Vaginal bleeding that is heavy or ...

  5. Unsuccessful application of taurolidine in the treatment of fungal peritonitis in peritoneal dialysis.

    Science.gov (United States)

    Gallieni, M; Chiarelli, G; Olivi, L; Cozzolino, M; Cusi, D

    2011-01-01

    Fungal peritonitis (FP) is a serious complication for peritoneal dialysis (PD) patients, determining hospitalization, technique failure, catheter loss and death. In the 2005 update, treatment recommendations for FP from the International Society of Peritoneal Dialysis (ISPD) advocate catheter removal immediately after fungi are identified by microscopy or culture. The availability of more effective medical treatments could therefore be of great importance. The aim of this report is to describe a case of a 43-year-old, diabetic, HIV positive PD patient with fluconazole resistant Candida peritonitis, who was treated with an i.p. taurolidine solution. Taurolidine is a non-antibiotic antimicrobial, with broad bactericidal and fungicidal properties. It has been used during surgery for lavage of the peritoneum in cases of peritonitis. Its mechanism of action is related to direct toxic action on micro-organisms, through a chemical reaction between active taurolidine derivatives and structures on the cell wall. Treatment failed because the patient had severe burning pain during i.p. administration of the drug, limiting its dose. PD catheter removal allowed complete recovery. It remains undetermined if, with different doses and methodology, taurolidine could be more effective in treating bacterial and/or fungal peritonitis. Currently, catheter removal remains the most effective therapy of fungal peritonitis.

  6. Transition of Control: automation giving back control to the driver

    NARCIS (Netherlands)

    Willemsen, D.M.C.; Stuiver, A.; Hogema, J.

    2014-01-01

    The automotive domain is currently moving towards automated driver assistance applications, like automatic evasive maneuvers to avoid accidents, and even beyond assistance towards automated driving. However, in the near future these systems will only be active under certain conditions, thus still re

  7. Transition of Control : Automation Giving Back Control to the Driver

    NARCIS (Netherlands)

    Ahram, T; Karwowski, W; Marek, T; Willemsen, D; Stuiver, A; Hogema, J

    2014-01-01

    The automotive domain is currently moving towards automated driver assistance applications, like automatic evasive maneuvers to avoid accidents, and even beyond assistance towards automated driving. However, in the near future these systems will only be active under certain conditions, thus still re

  8. CT findings of lymphoma with peritoneal, omental and mesenteric involvement: Peritoneal lymphomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Karaosmanoglu, Devrim [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey); Karcaaltincaba, Musturay [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)], E-mail: musturayk@yahoo.com; Oguz, Berna; Akata, Deniz; Ozmen, Mustafa; Akhan, Okan [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)

    2009-08-15

    Purpose: We aimed to describe computed tomography (CT) findings in patients with peritoneal, omental and mesenteric lymphoma involvement. Materials and methods: We searched our archive retrospectively to find out patients with peritoneal, omental and mesenteric lymphoma involvement. We found 16 patients with non-hodgkin lymphoma meeting these criteria. CT studies of these patients were reevaluated for the presence of peritoneal involvement, ascites, omental mass, organomegaly, retroperitoneal lymphadenopathy, bowel wall thickening and other associated findings. Results: There were 14 males and 2 females with peritoneal and/or mesenteric and omental lymphoma involvement. Mean age was 39 (range 4-76). Subgroups of non-hodgkin lymphoma were diffuse large B-cell lymphoma (n = 11), small cell lymphocytic lymphoma (n = 2), small cleaved cell lymphoma (n = 1), T-cell lymphoma (n = 1) and Burkitt's lymphoma (n = 1). Peritoneal involvement was seen in 15 patients (93.8%) in the form of linear (n = 12) and nodular (n = 3) thickening. Ascites was seen in 12 (75%) patients. Omental and mesenteric masses were present in 10 (66.6%) and 10 (66.6%) patients, respectively. Bowel wall thickening, retroperitoneal lymphadenopathy and hepatosplenomegaly were also common and observed in 10, 10 and 11 patients, respectively. Solid organ involvement in the form of liver and splenic lesions was seen in 9 (56%) patients. Conclusion: Peritoneal involvement can be seen in many subtypes of lymphoma and most frequently in diffuse large B-cell lymphoma. Peritoneal lymphomatosis can mimic peritoneal carcinomatosis and should be included in the differential diagnosis list in patients with ascites, hepatosplenic lesions and unidentified cause of peritoneal thickening on CT in a male patient.

  9. Advanced Nursing Experience Is Beneficial for Lowering the Peritonitis Rate in Patients on Peritoneal Dialysis

    Science.gov (United States)

    Yang, Zhikai; Xu, Rong; Zhuo, Min; Dong, Jie

    2012-01-01

    ♦ Objectives: We explored the relationship between the experience level of nurses and the peritonitis risk in peritoneal dialysis (PD) patients. ♦ Methods: Our observational cohort study followed 305 incident PD patients until a first episode of peritonitis, death, or censoring. Patients were divided into 3 groups according to the work experience in general medicine of their nurses—that is, least experience (<10 years), moderate experience (10 to <15 years), and advanced experience (≥15 years). Demographic characteristics, baseline biochemistry, and residual renal function were also recorded. Multivariate Cox regression was used to analyze the association of risks for all-cause and gram-positive peritonitis with patient training provided by nurses at different experience levels. ♦ Results: Of the 305 patients, 91 were trained at the initiation of PD by nurses with advanced experience, 100 by nurses with moderate experience, and 114 by nurses with the least experience. Demographic and clinical variables did not vary significantly between the groups. During 13 582 patient–months of follow-up, 129 first episodes of peritonitis were observed, with 48 episodes being attributed to gram-positive organisms. Kaplan–Meier analysis showed that training by nurses with advanced experience predicted the longest period free of first-episode gram-positive peritonitis. After adjustment for some recognized confounders, the advanced experience group was still associated with the lowest risk for first-episode gram-positive peritonitis. The level of nursing experience was not significantly correlated with all-cause peritonitis risk. ♦ Conclusions: The experience in general medicine of nurses might help to lower the risk of gram-positive peritonitis among PD patients. These data are the first to indicate that nursing experience in areas other than PD practice can be vital in the training of PD patients. PMID:21719682

  10. Clinical effects of icodextrin in peritoneal dialysis.

    Science.gov (United States)

    Cnossen, Trijntje T; Konings, Constantijn J; van der Sande, Frank M; Leunissen, Karel M; Kooman, Jeroen P

    2008-10-01

    Objective. This study reviews the relevant publications on the clinical effects of icodextrin in peritoneal dialysis (PD). Design. The study provides a systematic review of the literature (MEDLINE search with icodextrin as the keyword). Results. Icodextrin induces sustained transcapillary ultrafiltration during long dwell periods. It also stimulates increased removal of sodium by the peritoneal membrane, reduction of extracellular water (ECW) and total body water (TBW). Effects of icodextrin on blood pressure control and residual renal function are discrepant. Icodextrin induces a reduction in the formation of advanced glycation end-products, while the longitudinal changes in the peritoneal membrane transport are less prominent. Conclusions. Use of icodextrin in PD improves the sodium and fluid balance. Icodextrin is potentially more biocompatible, when compared with the conventional glucose solutions. The side effects are rare.

  11. Benign multicystic peritoneal mesothelioma: a case report

    Directory of Open Access Journals (Sweden)

    Papapaulou Leonidas

    2010-11-01

    Full Text Available Abstract Introduction We report the case of a patient with a benign multicystic peritoneal mesothelioma and describe its appearance on computed tomography scans and ultrasonography, in correlation with gross clinical and pathological findings. Case presentation A 72-year-old Caucasian woman presented to our emergency department with acute abdomen signs and symptoms. A clinical examination revealed a painful palpable mass in her left abdomen. Abdominal ultrasonography and computed tomography demonstrated the presence of a large cystic mass in her left upper abdomen, adjacent to her left hemidiaphragm. The lower border of the mass extended to the upper margin of her pelvis. A complete resection of the lesion was performed. Pathological analysis showed a benign multicystic peritoneal mesothelioma. Conclusions Benign multicystic peritoneal mesothelioma is a rare lesion with a non-specific appearance on imaging. Its diagnosis always requires pathological analysis.

  12. Bile peritonitis due to intra-hepatic bile duct rupture

    OpenAIRE

    Lochan, R.; Joypaul, BV

    2005-01-01

    Generalized biliary peritonitis is a serious intra-abdominal emergency. Most of them occur due to duodenal ulcer perforation and rapidly evolve into bacterial peritonitis due to contamination by gut organisms and food. In this situation, recognition of the pathology and its treatment is straightforward and is usually associated with a good outcome. There are a few unusual causes of biliary peritonitis, of which rupture of the biliary tree is one. We describe a rare case of biliary peritonitis...

  13. Immunological Blood Parameters in Infected and Noninfected Biliary Peritonitis

    OpenAIRE

    Bilookiy, O. V.; Rohovyy, Yu. Ye.; Bilookiy, V. V.

    2015-01-01

    This work deals with the study of immunological blood parameters in infected and noninfected biliary peritonitis. Materials and methods. 55 patients with infected and noninfected biliary peritonitis were examined. There were 21 men and 34 women at the age of 28-74 years. 14 patients suffered from noninfected biliary peritonitis, 41 patients suffered from infected biliary peritonitis. The control group included 12 practically healthy persons. Results. The development of noninfected biliary per...

  14. ASPECTOS FARMACOLÓGICOS DE LA DIÁLISIS PERITONEAL

    Directory of Open Access Journals (Sweden)

    Musso CG

    2014-03-01

    Full Text Available Peritoneal dialysis is a renal replacement therapy, conducted through the peritoneal membrane, which facilitates the exchange of substances between two compartments: blood and peritoneal cavity. There are drug characteristics (smallness, lipid solubility, etc. that favor its spread, some of the peritoneum (thin thickness, etc. and others of the dialysate (osmolarity, etc.

  15. Effects of inflammation and infection on peritoneal transport

    NARCIS (Netherlands)

    van Esch, S.

    2014-01-01

    Peritoneal dialysis (PD) allows solute and water transport. Adequate PD depends on a good function of the peritoneal membrane. Peritoneal morphological and functional alterations mostly develop with time on PD. Glucose based dialysis solutions, inflammation and infections are conceivable enemies for

  16. Diagnosis of spontaneous bacterial peritonitis: Role of tween 80 and triton X in ascitic fluid cultures

    Directory of Open Access Journals (Sweden)

    Iyer R

    2009-01-01

    Full Text Available A patient with alcoholic cirrhosis of the liver, portal hypertension with hepatic encephalopathy and spontaneous bacterial peritonitis (SBP was admitted in an obtunded condition. Attempts at delineating the aetiology of the SBP using conventional cultures as well as automated systems were not successful. The use of non-anionic surfactant agents such as Tween 80-incorporated blood agar and Triton X treatment of the specimens facilitated the growth of Klebsiella pneumoniae from the ascitic fluid, which otherwise would have been concluded to represent culture-negative neutrocytic ascites. Thus, the use of the aforementioned agents could be explored in elucidating the aetiology of body cavity infections when conventional methods fail.

  17. [Postcoital test evaluated in peritoneal fluid].

    Science.gov (United States)

    Radwan, J; Bielak, A; Niwald, W; Pawlicki, J; Banaszczyk, R; Makuła, D

    1995-04-01

    The role of the peritoneal fluid in the physiology of reproduction, as well as in the transportation and survival of gametes, is little recognized. Taking this into consideration, the authors have examined the occurrence of spermatozoa in the peritoneal fluid, collected from patients during diagnostic laparoscopies, following intrauterine insemination with husband's sperm, in, so-called, Templeton's Test. In the group of patients with cervical factor six (6) mobile spermatozoa (85%) were observed, in the group with male factor -- three (3) (42%) and in the group with idiopathic infertility -- 1 (25%). A high utility of this test has been indicated, especially in infertility caused by the male factor and in endometriosis.

  18. Automation and information technology solutions for buildings and homes

    OpenAIRE

    Cuacos Encarnación, David

    2008-01-01

    This investigation is part of Master’s of Science degree in Industrial Engineering at the Universidad Carlos III of Madrid. The work has been carried out at Automation Technology Laboratory, of Helsinki University of Technology (TKK). This research is part of Assistive Automation project, which develops devices and systems assist independent living of elderly and disabled persons. The home automation system prototype is expected to increase the safety, comfort and independence of these people...

  19. Peritonitis bacteriana espontánea y bacteriemia por Aeromonas hydrophila Spontaneous bacterial peritonitis and bacteraemia due to Aeromonas hydrophila

    Directory of Open Access Journals (Sweden)

    J. J. García-Irure

    2003-12-01

    Full Text Available La peritonitis bacteriana es una complicación frecuente en los pacientes cirróticos. De los gérmenes etiológicos, Aeromonas es muy poco frecuente. Presentamos un caso clínico de un paciente cirrótico con peritonitis y bacteriemia por Aeromonas hydrophila. Este microorganismo es un bacilo gramnegativo de la familia Vibrionaceae. En el ser humano produce gastroenteritis con mucha frecuencia. De forma excepcional puede dar origen a infecciones extraintestinales, sobre todo en pacientes inmunodeprimidos. La peritonitis por Aeromonas se ha descrito en asociación a peritonitis bacteriana espontánea en pacientes cirróticos, en pacientes en diálisis peritoneal y en casos de peritonitis secundaria a perforación intestinal.Bacterial peritonitis is a frequent complication in cirrhotic patients. Amongst the aetiological germs, Aeromonas is very infrequent. We present the clinical case of a cirrhotic patient with peritonitis and bacteraemia due to Aeromonas hydrophila. This micro-organism is a Gram-negative bacillus of the Vibrionaceae family. It very frequently produces gastroenteritis in the human being. Exceptionally it can give rise to extraintestinal infections, especially in immunodepressed patients. Peritonitis due to Aeromonas has been described in association with spontaneous bacterial peritonitis in cirrhotic patients, in patients on peritoneal dialysis and in cases of peritonitis secondary to intestinal perforation.

  20. EFEITOS DA CASTRAÇÃO SOBRE CARACTERÍSTICAS FÍSICO-QUÍMICAS E CELULARES DO LÍQUIDO PERITONEAL DE EQUINOS

    Directory of Open Access Journals (Sweden)

    Paula Alessandra Di Filippo

    2016-07-01

    Full Text Available As one of the most frequently performed surgical techniques and the constant association with complications, ten animals were submitted to castration and physical, chemical and cytological peritoneal fluid characteristics were evaluated. The peritoneal fluid samples were obtained before surgery and after castration. It was evaluated the color and turbidity, total concentration and count of differential leukocyte, lactate, protein and phosphorus, as well as the activity of CK, AST, LDH and FA. After castration, the peritoneal fluid has become reddish and cloudy, there was an increase in protein, lactate and phosphorus as well the activity of CK, AST, AP and LDH. The changes were not associated with the development of postoperative complications and were due to inflammatory response triggered by surgical trauma. The analysis of peritoneal fluid can assist in post castration monitoring to the aiming the early and efficiently resolution of possible complications.

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Specific opsonic activity for staphylococci in peritoneal dialysis effluent during continuous ambulatory peritoneal dialysis

    DEFF Research Database (Denmark)

    Nielsen, H; Espersen, F; Kharazmi, A

    1992-01-01

    In a prospective study of intraperitoneal opsonins in 30 patients undergoing continuous ambulatory peritoneal dialysis (CAPD), the IgG concentration, the fibronectin concentration, the specific antistaphylococcal antibody level, and the opsonic activity against Staphylococcus epidermidis were...... measured in peritoneal dialysis effluent from the initiation of CAPD and monthly for 6 months. Significant correlation was found between the four assays, but the interindividual and intraindividual variations were considerable. No statistically significant correlation was observed between susceptibility...... of the patients to CAPD-related infectious peritonitis and any of the above-mentioned parameters of humoral defense. We conclude that at the present time it is not feasible to use these assays for the establishment of prognosis with regard to peritonitis in CAPD....

  3. Comparison between peritoneal tuberculosis and primary peritoneal carcinoma: a 16-year, single-center experience

    Institute of Scientific and Technical Information of China (English)

    WANG Dan; ZHANG Jun-ji; HUANG Hui-fang; SHEN Keng; CUI Quan-cai; XIANG Yang

    2012-01-01

    Background Peritoneal tuberculosis and primary peritoneal carcinoma can both present as an abdominal mass and ascites with elevated serum CA125.The purpose of our study was to evaluate the clinical features of peritoneal tuberculosis,compare them with features of primary peritoneal carcinoma,and establish definitive diagnostic procedures.Methods We conducted a retrospective study in patients with peritoneal tuberculosis from January 1995 to October 2010 at Peking Union Medical College Hospital.During this time,the data of 38 patients with primary peritoneal carcinoma were reviewed.Results The median age was 34 years (range,19-80 years).The most common symptoms were abdominal distension (16/30,53.3%) and an abdominal mass (12/30,40.0%).The serum CA125 level was elevated in 25 patients (83.3%).The median level of cancer antigen CA125 was 392.5 U/ml (range,0.64-850.0 U/ml).Abdominal ultrasound revealed a pelvic mass in 25 patients and ascites in 20 patients.Diagnostic laparoscopy was performed in 15 patients (50.0%) and exploratory laparotomy was performed in 12 patients (40.0%),and 3 patients (10.0%) who underwent laparoscopy converted to laparotomy because of severe adhesions.The intraoperative findings were adhesions,multiple white tubercles,and ascites.Frozen tissue sections were obtained in 17 patients,and 14 of whom showed chronic granulomatous reactions.Final pathological examinations confirmed the diagnosis.Conclusions Peritoneal tuberculosis should be considered as a differential diagnosis,especially for young women with an abdominal mass,ascites,and elevated serum CA125 levels.Laparoscopy is a useful diagnostic method for peritoneal tuberculosis,and intraoperative frozen sections are recommended when the diagnosis is in doubt.

  4. PI3K / Akt signaling regulates epithelialmesenchymal transition of peritoneal mesothelial cells in peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    彭翔

    2014-01-01

    Objective To investigate the role of PI3K/Akt signaling in the regulation of epithelial-mesenchymal transition(EMT)of peritoneal mesothelial cells(PMCs)in peritoneal dialysis in vitro and in vivo.Methods The level of phosphorylated serine/threonine kinase Akt and the expression of EMT associated gene and protein,including ZO-1,Vimentin and FN,were measured in mice EMT model.In vitro study,phosphorylation level and

  5. Recurrent bacterial peritonitis caused by Neisseria cinerea in a chronic ambulatory peritoneal dialysis (CAPD) patient.

    Science.gov (United States)

    George, M J; DeBin, J A; Preston, K E; Chiu, C; Haqqie, S S

    1996-10-01

    We present an unusual case of recurrent (chronic ambulatory peritoneal dialysis) CAPD-associated peritonitis caused by Neisseria cinerea. Using DNA restriction fragment length polymorphism (RFLP) analysis, we determined that the recurrent infection was caused by reinfection with a different N. cinerea strain rather than relapse with the index strain and that the probable origin of the reinfecting organism was the patient's upper respiratory tract.

  6. Leukotriene release from peripheral and peritoneal leukocytes following exposure to peritoneal dialysis solutions.

    Science.gov (United States)

    Jörres, A; Jörres, D; Topley, N; Gahl, G M; Mahiout, A

    1991-01-01

    During continuous ambulatory peritoneal dialysis (CAPD), peritoneal host defence mechanisms are repeatedly exposed to dialysis solutions (with unphysiological composition) which may compromise peritoneal immune cell functions. In this context, the current study focused on the capacity of peripheral and peritoneal PMN to release leukotrienes following exposure to conventional CAPD dialysates. PMN were obtained from peripheral blood of healthy volunteers and from the peritoneal effluent of CAPD patients with acute peritonitis. Following isolation, cells were incubated in fresh CAPD dialysates or control buffer, and calcium ionophore A23187-stimulated leukotriene synthesis was measured. Additional experiments included RP-HPLC analysis and radioactivity monitoring of lipoxygenase products in PMN labelled with 14C-arachidonic acid. Leukotriene B4 and leukotrienes C4/D4/E4 were determined by radioimmunoassay. Ionophore-triggered leukotriene release from cells exposed to control buffer was pronounced in inflammatory peritoneal PMN (70.4 +/- 31.3 ng/5 x 10(6) cells LTB4 and 13.4 +/- 19.8 ng/5 x 10(6) cells LTC4/D4/E4, mean +/- SD, n = 14) when compared to healthy peripheral PMN (26.6 +/- 16.9 ng/ml LTB4 and 6.3 +/- 6.6 ng/ml LTC4/D4/E4, n = 12). Incubation in fresh solutions for peritoneal dialysis severely depressed leukotriene release from both cell populations. These results indicate a severe inhibition of cellular responsiveness as a consequence of dialysate exposure which could contribute to the impairment of host defence early in the CAPD cycle.

  7. Biocompatible Peritoneal Dialysis Fluids: Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Yeoungjee Cho

    2012-01-01

    Full Text Available 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.

  8. Ultrasonographic findings of sclerosing encapsulating peritonitis

    Energy Technology Data Exchange (ETDEWEB)

    Han, Jong Kyu; Lee, Hae Kyung; Moon, Chul; Hong, Hyun Sook; Kwon, Kwi Hyang; Choi, Deuk Lin [Soonchunhyangi University College of Medicine, Seoul (Korea, Republic of)

    2001-03-15

    To evaluate the ultrasonographic findings of the patients with sclerosing encapsulating peritonitis (SEP). Thirteen patients with surgically confirmed sclerosing encapsulating peritonitis were involved in this study. Because of intestinal obstruction, all patients had received operations. Among 13 patients, 12 cases had continuous ambulatory peritoneal dialysis (CAPD) for 2 months-12 years and 4 months from (mean; 6 years and 10 months), owing to chronic renal failure and one patient had an operation due to variceal bleeding caused by liver cirrhosis. On ultrasonographic examination, all patients showed loculated ascites which were large (n=7) or small (n=6) in amount with multiple separations. The small bowel loops were tethered posteriorly perisaltic movement and covered with the thick membrane. The ultrasonographic of findings of sclerosing encapsulating peritonitis were posteriorly tethered small bowels covered with a thick membrane and loculated ascites with multiple septa. Ultrasonographic examination can detect the thin membrane covering the small bowel loops in the early phase of the disease, therefore ultrasonography would be a helpful modality to diagnose SEP early.

  9. Peritoneal tuberculosis due to Mycobacterium caprae

    Directory of Open Access Journals (Sweden)

    T. Nebreda

    2016-01-01

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

  10. Secondary peritonitis caused by Streptomyces viridis

    NARCIS (Netherlands)

    P. Datta (Priya); S. Arora (Shilpa); A. Jain (Ashok); J. Chander (Jagdish); W.W.J. van de Sande (Wendy)

    2012-01-01

    textabstractStreptomyces organisms are soil inhabitants rarely causing nonmycetomic infections. We describe a case of secondary peritonitis caused by Streptomyces viridis in a chronic alcoholic patient who presented with fever, abdominal distension, and pain in the abdomen. The most likely source of

  11. Peritoneal changes due to laparoscopic surgery.

    NARCIS (Netherlands)

    Brokelman, W.J.; Lensvelt, M.M.A.; Borel Rinkes, I.H.; Klinkenbijl, J.H.G.; Reijnen, M.M.P.J.

    2011-01-01

    BACKGROUND: Laparoscopic surgery has been incorporated into common surgical practice. The peritoneum is an organ with various biologic functions that may be affected in different ways by laparoscopic and open techniques. Clinically, these alterations may be important in issues such as peritoneal met

  12. Complications after placement of peritoneal catheter

    Directory of Open Access Journals (Sweden)

    Đurđević-Mirković Tatjana

    2011-01-01

    Full Text Available Introduction. Peritoneal dialysis is one of the modalities used for treatment of end-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis and renal transplantation. Owing to the rich vascularization of the peritoneum, it is used in the processes of osmosis and diffusion, enabling the removal of uremic material from the body. The procedure includes introduction of peritoneal fluid via the peritoneal catheter. Complications. The catheter is placed through the anterior abdominal wall with its tip positioned in the small pelvis. There are several techniques for catheter placement considered minimally invasive, which, however, may be associated with various complications. These complications can be divided into mechanical (catheter dysfunction, cuff protrusion, hernia, dialysate leaks, visceral perforation and infectious (early peritonitis, exit site or tunnel infection, surgical wounds. In most cases, such complications are rare and can be successfully managed using conservative therapy; however, in some situations severe complications can endanger the life of the patient. On-time recognition of complications, particularly in patients at risk, is of paramount importance for an effective treatment. The development of complications can increase the morbidity and the chance of treatment failure, and therefore transfer to haemodialysis. Conclusion. The preoperative evaluation and determination of the risk factors as well as the early recognition and adequate management of complications are essential in their prevention.

  13. Automating Finance

    Science.gov (United States)

    Moore, John

    2007-01-01

    In past years, higher education's financial management side has been riddled with manual processes and aging mainframe applications. This article discusses schools which had taken advantage of an array of technologies that automate billing, payment processing, and refund processing in the case of overpayment. The investments are well worth it:…

  14. Peritoneal lavage cytology and carcinoembryonic antigen determination in predicting peritoneal metastasis and prognosis of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Ji-Kun Li; Miao Zheng; Chuan-Wen Miao; Jian-Hai Zhang; Guang-Han Ding; Wen-Shen Wu

    2005-01-01

    AIM: To evaluate the role of peritoneal lavage cytology (PLC) and carcinoembryonic antigen (CEA) determination of peritoneal washes (pCEA) in predicting the peritoneal metastasis and prognosis after curative resection of gastric cancer.METHODS: PLC and radioimmunoassay of CEA were performed in peritoneal washes from 64 patients with gastric cancer and 8 patients with benign diseases.RESULTS: The positive rate of pCEA (40.6%) was significantly higher than that of PLC (23.4%) (P<0.05).The positive rates of PLC and pCEA correlated with the depth of tumor invasion and lymph node metastasis (P<0.05). pCEA was found to have a higher sensitivity and a lower false-positive rate in predicting peritoneal metastasis after curative resection of gastric cancer as compared to PLC. The 1-, 3-, and 5-year survival rates of patients with positive cytologic findings or positive pCEA results were significantly lower than those of patients with negative cytologic findings or negative pCEA results (P<0.05). Multivariate analysis indicated that pCEA was an independent prognostic factor for the survival of patients with gastric cancer.CONCLUSION: Intraoperative pCEA is a more sensitive and reliable predictor of peritoneal metastasis as well as prognosis in patients with gastric cancer as compared to PLC method.

  15. Dialysate bacterial endotoxin as a prognostic indicator of peritoneal dialysis related peritonitis.

    Science.gov (United States)

    Szeto, Cheuk-Chun; Lai, Ka-Bik; Chow, Kai-Ming; Kwan, Bonnie Ching-Ha; Law, Man-Ching; Pang, Wing-Fai; Ma, Terry King-Wing; Leung, Chi-Bon; Li, Philip Kam-Tao

    2016-12-01

    Peritonitis is the major complication of peritoneal dialysis (PD). The aim of our present study is to explore the prognostic value of endotoxin level in PD effluent for the prediction of treatment failure in PD-related peritonitis. We studied 325 peritonitis episodes in 223 patients. PD effluent (PDE) was collected every 5 days for endotoxin level and leukocyte count. Patients were followed for relapsing or recurrent peritonitis. We found 20 episodes (6.2%) had primary treatment failure; 41 (12.6%) developed relapsing, 19 (5.8%) had recurrent, and 22 (6.8%) had repeat episodes. Endotoxin was detectable in the PDE of 19 episodes (24.4%) caused by Gram negative organisms, 4 episodes (6.8%) of mixed bacterial growth, and none of the culture negative episodes or those by Gram positive organisms. For episodes caused by Gram negative bacteria, a detectable endotoxin level in PDE on day 5 had a sensitivity and specificity of 66.7% and 83.3%, respectively, for predicting primary treatment failure. In contrast, PDE leukocyte count > 1000 per mm3 on day 5 had a sensitivity and specificity of 88.9% and 89.1%, respectively; the addition of PDE endotoxin assay did not improve the sensitivity or specificity. We conclude that detectable endotoxin in PDE 5 days after antibiotic therapy might predict primary treatment failure in peritonitis episodes caused by Gram negative organisms. However, the sensitivity and specificity of PDE endotoxin assay was inferior to PDE leukocyte count.

  16. Octreotide May Prevent Ultrafiltration Failure in Experimental Peritonitis Model

    Directory of Open Access Journals (Sweden)

    Ender HÜR

    2011-01-01

    Full Text Available OBJECTIVE: Ultrafiltration (UF failure is a frequent complication of peritoneal dialysis peritonitis. Octreotide (OCT has antiproliferative effects on many cells. The present study aimed to investigate the effect of OCT (administered locally or systemically on peritoneal alterations induced by bacterial peritonitis. MATERIAL and METHODS: Forty-two non-uremic female rats, weighing 160-180 g, were divided into four groups receiving no treatment (Control, n=12, peritonitis group (received 1.5 ml suspension of E. coli (107 CFU/ml (E.coli, n=12, and two treatment groups that received E.coli + 50 mcg/kg OCT (local OCT, n=10 intraperitoneally (IP and (systemic OCT, n=8 subcutaneously. After six hours, a one-hour PET was performed with 20 ml 3.86% PD solution; the D1/D0 glucose, UF volume, dialysate cell count, dialysate protein, TGF-β1, VEGF and IL-1β levels were determined. RESULTS: Exposure to E. coli causes bacterial peritonitis with increase in peritoneal permeability leading to rapid dissipation of the glucose gradient and UF failure. IP administration of OCT led to attenuation of UF failure by inhibiting local TGF-β1 production. Both local and systemic administration of OCT decreased dialysate cell count and maintained UF. CONCLUSION: Local or systemic OCT administration may help to preserve peritoneal viability and UF capacity by inhibiting cell infiltration to the peritoneal cavity and decreasing dialysate cell count during peritonitis. In the long-term, it can decrease peritoneal fibrosis.

  17. INTRAOPERATIVE PHOTODYNAMIC THERAPY FOR METASTATIC PERITONEAL TUMORS

    Directory of Open Access Journals (Sweden)

    E. A. Suleimanov

    2016-01-01

    Full Text Available This review is devoted to the cytoreductive treatment of malignant tumors of the abdominal organs. The actuality of the issue is determined both by increase of the incidence of abdominal cancer in Russia and in majority of developed countries and by high rate diagnosis on late stages of disease. The methods of treatment of peritoneal carcinomatosis, based on possible effects on the secondary peritoneal tumors after surgical cytoreduction to reduce the risk of local recurrence and disease progression are described. These methods of additional intraoperative specific antitumor action include intraoperative radiation therapy, hyperthermic intraperitoneal chemotherapy, intraoperative photodynamic therapy characterized by differences in difficulty of performance, mechanisms of effect on tumor and healthy tissues, efficiency. Benefits, opportunities and possibilities of application of intraoperative photodynamic therapy (IOPDT for secondary peritoneal tumors are described in details, the results of a number of domestic and foreign clinical studies are shown, the successful application of intraoperative photodynamic therapy in clinical oncology, which allows reducing the risk of secondary tumor lesions of the peritoneum significantly, is demonstrated. Photodynamic therapy – a method with high efficiency and almost no side effects and complications, based on the ability of photosensitizer to accumulate selectively and retain in the high proliferative tissues. The advantages of this type of treatment of patients with peritoneal carcinomatosis are a selective effect on the peritoneal carcinomatosis and on visually detected tumor tissue, high efficiency in patients with malignant tumors of the abdominal cavity and pelvis combined with surgical cytoreduction, minimal effect on normal organs and tissues of the patient, well tolerated procedure.

  18. Molecular diagnosis of mucopolysaccharidosis Type II (Hunter syndrome) by automated sequencing and computer-assisted interpretation: Toward mutation mapping of the Iduronate-2-sulfatase gene

    Energy Technology Data Exchange (ETDEWEB)

    Jonsson, J.J.; Aronovich, E.L.; Braun, S.E.; Whitley, C.B. [Univ. of Minnesota Medical School, Minneapolis, MN (United States)

    1995-03-01

    Virtually all mutations causing Hunter syndrome (mucopolysaccharidosis type II) are expected to be new mutations. Therefore, as a means of molecular diagnosis, we developed a rapid method to sequence the entire iduronate-2-sulfatase (IDS) coding region. PCR amplicons representing the IDS cDNA were sequenced with an automatic instrument, and output was analyzed by computer-assisted interpretation of tracings, using Staden programs on a Sun computer. Mutations were found in 10 of 11 patients studied. Unique missense mutations were identified in five patients: H229Y (685{r_arrow}T, severe phenotype); P358R (1073C{r_arrow}G, severe); R468W (1402C{r_arrow}T, mild); P469H (1406C{r_arrow}A, mild); and Y523C (1568A{r_arrow}G, mild). Nonsense mutations were identified in two patients: R172X (514C{r_arrow}T, severe) and Q389X (1165C{r_arrow}T, severe). Two other patients with severe disease had insertions of 1 and 14 bp, in exons 3 and 6, respectively. In another patient with severe disease, the predominant (<95%) IDS message resulted from aberrant splicing, which skipped exon 3. In this last case, consensus sequences for splice sites in exon 3 were intact, but a 395C{r_arrow}G mutation was identified 24 bp upstream from the 3` splice of exon 3. This mutation created a cryptic 5` splice site with a better consensus sequence for 5` splice sites than the natural 5` splice site of intron 3. A minor population of the IDS message was processed by using this cryptic splice site; however, no correctly spliced message was detected in leukocytes from this patient. The mutational topology of the IDS gene is presented. 46 refs., 6 figs., 2 tabs.

  19. Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications

    Directory of Open Access Journals (Sweden)

    Fernanda O. de Carvalho

    2014-04-01

    Full Text Available Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus. Objective: To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a “non reliable” peritoneum. Method: From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy. Results: After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far. Conclusion: Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.

  20. Morphological changes of the peritoneum in peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    方炜; 钱家麒; 余志远; 陈诗书

    2004-01-01

    Background Long-term peritoneal dialysis (PD) requires that the peritoneal membrane remain effective for dialysis. Research directed toward human peritoneal morphology and structure is limited. The present study was performed to investigate morphological changes of the human peritoneal membrane during PD and to elucidate the possible mechanisms of its functional deterioration. Methods A total of 32 peritoneal biopsies were performed in normal subjects (n=10), uremic nondialysis patients (n=12) at the time of catheter insertion, and PD patients (n=10) at the time of catheter removal or reinsertion or at the time of renal transplantation. Peritoneal morphology was examined by light microscopy, scanning electron microscopy, and transmission electron microscopy. Results The peritoneal membrane in normal subjects consisted of a monolayer of mesothelial cells on a basement membrane and a layer of connective tissue containing cells, blood vessels, and lymphatic vessels. Mesothelial cells were polygonal, often elongated, and had numerous microvilli on their luminal surface. There were lots of oval or roundish pinocytotic vesicles in the cytoplasm of the mesothelial cells. The peritoneal morphology of uremic nondialysis patients was similar to that of normal subjects. However, significant abnormalities of the peritoneal membrane were observed in PD patients, and the changes were found to be progressive. Microvilli were the first site of damage which involved microvilli shortening, a gradual reduction in their number, and, eventually, the total disappearance of microvilli. Mesothelial cells then detached from the basement membrane, disappearing completely in some cases. In the end, the peritoneal membrane consisted only of submesothelial connective tissue without any cells.Conclusions PD can modify peritoneal morphology and structure. The morphological change is progressive and may be one of the important causes of peritoneal failure. Peritoneal biopsies can provide lots of

  1. Peritonitis associated with exit site and tunnel infections.

    Science.gov (United States)

    Gupta, B; Bernardini, J; Piraino, B

    1996-09-01

    We reviewed all episodes of peritonitis associated with exit site and/or tunnel infection (n = 87; rate, 0.1/yr; 13% of all peritonitis episodes) occurring from 1979 to 1995. The exit site or tunnel infection was diagnosed at the time or shortly after the patient presented with peritonitis in 66% of the episodes. In the other one third the exit site or tunnel infection was diagnosed a median of 40 days prior to the development of peritonitis. Staphylococcus aureus accounted for 52% of episodes. Pseudomonas aeruginosa was the next most common organism. In 63 (72%) of the episodes the catheter was removed to resolve the infection at a median of 8 days (range, 0 to 226 days) from the onset of peritonitis. Catheter removal after 5 days predominately for refractory peritonitis (n = 23; median time to removal, 8 days) or relapsing peritonitis (n = 11; median time to catheter removal, 103 days). Patients with relapsing peritonitis suffered two to four episodes prior to removal of the catheter. Patients with peritonitis associated with tunnel infection were more likely to lose their catheter than patients with peritonitis associated with exit site infection (86% v 58%), while Staphylococcus epidermidis infections were less likely to result in catheter loss compared with all other organisms (15% v 82%). After a protocol to reduce S aureus catheter infections was implemented in 1990, the rate of catheter-related peritonitis decreased from 0.14/yr to 0.05/yr due to a decrease in S aureus episodes. We conclude that peritonitis episodes associated with a tunnel infection infrequently resolve without catheter removal. Delayed catheter removal in such circumstances often results in refractory or relapsing peritonitis. Therefore, catheter removal should be done promptly. Antibiotic prophylaxis for S aureus can reduce catheter-related peritonitis.

  2. Heating automation

    OpenAIRE

    Tomažič, Tomaž

    2013-01-01

    This degree paper presents usage and operation of peripheral devices with microcontroller for heating automation. The main goal is to make a quality system control for heating three house floors and with that, increase efficiency of heating devices and lower heating expenses. Heat pump, furnace, boiler pump, two floor-heating pumps and two radiator pumps need to be controlled by this system. For work, we have chosen a development kit stm32f4 - discovery with five temperature sensors, LCD disp...

  3. Automation Security

    OpenAIRE

    Mirzoev, Dr. Timur

    2014-01-01

    Web-based Automated Process Control systems are a new type of applications that use the Internet to control industrial processes with the access to the real-time data. Supervisory control and data acquisition (SCADA) networks contain computers and applications that perform key functions in providing essential services and commodities (e.g., electricity, natural gas, gasoline, water, waste treatment, transportation) to all Americans. As such, they are part of the nation s critical infrastructu...

  4. Marketing automation

    OpenAIRE

    Raluca Dania TODOR

    2017-01-01

    The automation of the marketing process seems to be nowadays, the only solution to face the major changes brought by the fast evolution of technology and the continuous increase in supply and demand. In order to achieve the desired marketing results, businessis have to employ digital marketing and communication services. These services are efficient and measurable thanks to the marketing technology used to track, score and implement each campaign. Due to the...

  5. Mesenteric ossification in CT indicates sclerosing peritonitis in chronic bacterial infection and pancreatitis; Mesenteriale Verknoecherungen als computertomographische Zeichen einer sklerosierenden Peritonitis bei chronischer Bauchfellentzuendung und Pankreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, J.; Kirchner, E.M. [Abt. fuer Diagnostische und Interventionelle Radiologie, Klinikum Niederberg Velbert (Germany); Kickuth, R. [Klinik fuer Radiologie und Nuklearmedizin, Katholisches Marienhospital Herne, Universitaetsklinik der Ruhr Univ. Bochum (Germany); Stein, A. [Klinik fuer Strahlentherapie und Onkologie, Universitaetsklinikum Frankfurt/Main (Germany)

    2004-07-01

    Sclerosing peritonitis already has been described as a serious complication of the continuous ambulatory peritoneal dialysis. But different other affections of the pertioneum such as chronic bacterial peritonitis and pancreatitis may result in sclerosing peritonitis, too. The symptom is characterised by thickened small bowel walls and periotoneal membranes as well as peritoneal calcifications which can be shown in computed tomography. We demonstrate two cases of peritoneal ossifications due to peritonitis and pancreatitis. (orig.) [German] Die sklerosierende Peritonitis wurde wiederholt als ernste Komplikation der Bauchfelldialyse beschrieben. Aber auch verschiedene andere Reizzustaende wie chronische bakterielle Peritonitis und Pankreatitis koennen eine sklerosierende Peritonitis nach sich ziehen. Hierbei zeigen sich neben einer Verdickung des Peritoneums und der Waende des Duenndarms auch computertomographisch nachweisbare Kalkeinlagerungen. Wir stellen zwei Patienten mit chronischer Peritonitis nach Sigmaperforation und Pankreatitis mit Verknoecherungen des Peritoneums vor. (orig.)

  6. [Biliary peritonitis: retrospective analysis of the disease].

    Science.gov (United States)

    Sirakov, M; Chupetlovski, S; Panov, Ts; Iliev, I

    2001-01-01

    The authors have done a biliary retrospective analysis of 10 deceased patients with a diagnosis of biliary peritonitis (BP). It is reported that the patients who died of BP are 9.5% of all who died of diffuse purulent peritonitis. All deceased patients were advanced and well advanced in years with prolonged complaints--in over 50% of them over 5 years. The complications set in 50% of the cases are recorded in the postoperative period. The perforation of the gallbladder and the biliopancreatitis are in the second place. Intrabiliary fistulas with 4 patients and 1 with a vesicocolon fistula; tumor of the pancreas with 4 patients; empyema of the gallbladder--3; diabetes with 3 of the patients and others are recorded as accompanying troubles which complicate the operation and the outcome of it. The time between the beginning of the complication and the operation with all the deceased patients is over 72 hours.

  7. Comparison of peritoneal equilibration test with {sup 99m}Tc-DTPA excretion in the assessment of peritoneal permeability

    Energy Technology Data Exchange (ETDEWEB)

    Das, B.K.; Senthilnathan, M.S.; Pradhan, P.K.; Nagabhushan, S. [Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, 226014, Lucknow (India); Jeloka, T.K.; Sharma, R.K. [Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow (India)

    2004-05-01

    Assessment of peritoneal permeability is necessary for successful management of end-stage renal disease (ESRD) patients by continuous ambulatory peritoneal dialysis (CAPD). The objective of this study was to develop an alternative method of assessing the peritoneal permeability and to compare this method with the conventional method, the peritoneal equilibrium test, first described by Twardowski in 1987. Twenty patients undergoing regular CAPD were included in this study. Before starting the peritoneal dialysis, 370 MBq (10 mCi) technetium-99m diethylene triamine penta-acetic acid ({sup 99m}Tc-DTPA) was injected intravenously. A standard dose of the same quantity was kept and used later for calculations. At the end of 4 h, a dialysate fluid sample (1 ml) was collected and the total dialysis effluent fluid volume was measured. Excretion of {sup 99m}Tc-DTPA into the dialysate fluid as a percentage of the injected dose was calculated. Simultaneously, standard peritoneal equilibrium test values were recorded for comparison. Peritoneal excretion of {sup 99m}Tc-DTPA ranged from 8% to 25% of the injected dose, depending on the peritoneal membrane permeability. When the results were compared with the conventional method, a good correlation (r=0.79) was found. This innovative radionuclide technique is a simple and convenient method to assess the peritoneal membrane permeability and can be used as an alternative to the peritoneal equilibrium test, which is very cumbersome and associated with many limitations. (orig.)

  8. 33 Years of Peritoneal Dialysis-Associated Peritonitis: A Single-Center Study in Japan.

    Science.gov (United States)

    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.

  9. Leiomiomatose peritoneal disseminada: relato de caso

    OpenAIRE

    2008-01-01

    Neste trabalho relata-se o caso de uma paciente de 46 anos de idade com queixa de aumento de volume periumbilical e dor leve antes da menstruação. O quadro evoluiu com aumento gradativo da dor. Foram realizados ultra-som, tomografia computadorizada e ressonância magnética. Após laparotomia exploradora, foi retirado material para biópsia que confirmou o diagnóstico de leiomiomatose peritoneal disseminada.

  10. Encapsulating peritonitis: computed tomography and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kadow, Juliana Santos; Fingerhut, Carla Jeronimo Peres; Fernandes, Vinicius de Barros; Coradazzi, Klaus Rizk Stuhr; Silva, Lucas Marciel Soares; Penachim, Thiago Jose, E-mail: vinicius.barros.fernandes@gmail.com [Pontificia Universidade Catolica de Campinas (PUC-Campinas), Campinas, SP (Brazil). Hospital e Maternidade Celso Pierro

    2014-07-15

    Sclerosing encapsulating peritonitis is a rare and frequently severe entity characterized by total or partial involvement of small bowel loops by a membrane of fibrous tissue. The disease presents with nonspecific clinical features of intestinal obstruction, requiring precise imaging diagnosis to guide the treatment. The present report emphasizes the importance of computed tomography in the diagnosis of this condition and its confirmation by surgical correlation. (author)

  11. Spontaneous bacterial peritonitis: Few additional points

    Institute of Scientific and Technical Information of China (English)

    Pankaj Jain

    2009-01-01

    Spontaneous bacterial peritonitis (SBP) is a treatable complication of decompensated cirrhosis. Coagulopathy with evidence of hyperfibrinolysis or clinically evident disseminated intravascular coagulation precludes paracentesis. Alcoholic hepatitis with fever, leucocytosis and abdominal pain should be evaluated for SBP. Oral ofloxacin is as effective as parenteral cefotaxime in treatment of SBP except for inpatients with vomiting,encephalopathy, or renal failure. Albumin is superior to hydroxyethyl starch in treatment of SBP.

  12. Home automation in the workplace.

    Science.gov (United States)

    McCormack, J E; Tello, S F

    1994-01-01

    Environmental control units and home automation devices contribute to the independence and potential of individuals with disabilities, both at work and at home. Devices currently exist that can assist people with physical, cognitive, and sensory disabilities to control lighting, appliances, temperature, security, and telephone communications. This article highlights several possible applications for these technologies and discusses emerging technologies that will increase the benefits these devices offer people with disabilities.

  13. Bile peritonitis due to intra-hepatic bile duct rupture

    Institute of Scientific and Technical Information of China (English)

    R Lochan; BV Joypaul

    2005-01-01

    Generalized biliary peritonitis is a serious intra-abdominal emergency. Most of them occur due to duodenal ulcer perforation and rapidly evolve into bacterial peritonitis due to contamination by gut organisms and food. In this situation, recognition of the pathology and its treatment is straightforward and is usually associated with a good outcome. There are a few unusual causes of biliary peritonitis, of which rupture of the biliary tree is one.We describe a rare case of biliary peritonitis due to rupture of an intra-hepatic biliary radical. Unusual causes of peritonitis do interrupt our daily routine emergency surgical experience. Rapid recognition of the presence of peritonitis, adequate resuscitation, recognition of operative findings, establishment of biliary anatomy, and performance of a meticulous surgical procedure resulted in a good outcome.

  14. Consequences of peritonism in an emergency department setting

    DEFF Research Database (Denmark)

    Bjørsum-Meyer, Thomas; Schmidt, Thomas A.

    2013-01-01

    Background: In patients who were referred to the emergency department (ED) with abdominal pain, it is crucial to determine the presence of peritonism to allow for appropriate handling and subsequent referral to stationary departments. We aimed to assess the incidence of perceived peritonism...... on the patients with abdominal pain. Following a physical examination, the patients with abdominal pain were divided into those who had clinical signs of peritonism and those who did not. Results: Among the 1,270 patients admitted to the ED, 10% had abdominal pain. In addition, 41% of these patients were found...... to have signs indicative of peritonism, and 90% were admitted to the Department of Surgery (DS). Also, 24% of those patients with signs of peritonism and admission to the DS underwent surgical intervention in terms of laparotomy/laparoscopy. Five of the patients without peritonism underwent surgery...

  15. US and CT findings in the diagnosis of tuberculous peritonitis

    Energy Technology Data Exchange (ETDEWEB)

    Demirkazik, F.B. [Dept. of Radiology, School of Medicine, Hacettepe Univ., Ankara (Turkey); Akhan, O. [Dept. of Radiology, School of Medicine, Hacettepe Univ., Ankara (Turkey); Oezmen, M.N. [Dept. of Radiology, School of Medicine, Hacettepe Univ., Ankara (Turkey); Akata, D. [Dept. of Radiology, School of Medicine, Hacettepe Univ., Ankara (Turkey)

    1996-07-01

    Purpose: To evaluate the ultrasonographic and CT findings of tuberculous peritonitis. Material and Methods: Ultrasonographic and CT findings of 11 patients with the ascitic type of tuberculous peritonitis were reviewed. Results: All patients had ascites, and ultrasonography (US) demonstrated fine complete and incomplete mobile septations in 10 patients. In 5 of them, the ascites had a lattice-like appearance. Diffuse regular peritoneal thickening was detected in all patients by CT and in 10 patients by US. CT demonstrated infiltration of the greater omentum in 9 patients, whereas US showed omental thickening in only 5 patients. Conclusion: Peritoneal and omental thickening detected by CT and ascites with fine, mobile septations shown by US strongly suggest the ascitic type of tuberculous peritonitis. The 2 imaging modalities should be used together for accurate diagnosis of tuberculous peritonitis. (orig.).

  16. Peritoneal dialysis in acute renal failure in canines: A review

    Directory of Open Access Journals (Sweden)

    R. H. Bhatt

    Full Text Available Peritoneal dialysis is a technique whereby infusion of dialysis solution into the peritoneal cavity is followed by a variable dwell time and subsequent drainage. During peritoneal dialysis, solutes and fluids are exchanged between the capillary blood and the intraperitoneal fluid through a biologic membrane, the peritoneum. Inadequate renal function leads to disturbance in the removal of the extra fluid and waste products. It removes the waste product and extra fluid from the body in renal failure in small animal practice. Peritoneal dialysis is more accessible, more affordable and easier to administer to the small animal patient. The most common indication for peritoneal dialysis in dogs is acute renal failure (ARF. Peritoneal dialysis is an important therapeutic tool for mitigating clinical signs of uremia and giving the kidneys time to recover in cats with acute kidney injury when conventional therapy is no longer effective. [Vet. World 2011; 4(11.000: 517-521

  17. Technique of Peritoneal Catheter Placement under Fluroscopic Guidance

    Directory of Open Access Journals (Sweden)

    Ahmed Kamel Abdel-Aal

    2011-01-01

    Full Text Available Peritoneal catheters are mainly used for peritoneal dialysis in patients with end-stage renal disease. Other uses of this catheter include intraperitoneal chemotherapy and gene therapy for ovarian cancer and draining of uncontrolled refractory ascites in patients with liver cirrhosis. Traditionally, surgeons place most of these peritoneal catheters either by laparoscopy or open laparotomy. We detail our percutaneous approach to placing peritoneal catheters using fluoroscopic guidance. We emphasize the use of additional ultrasound guidance, including gray scale and color Doppler ultrasound, to determine the safest puncture site and to guide the initial needle puncture in order to avoid bowel perforation and injury to epigastric artery. We present our experience in placing peritoneal catheters using this technique in 95 patients with various indications. Fluoroscopic guided percutaneous placement of peritoneal catheters is a safe, minimally invasive, and effective alternative to open surgical or laparoscopic placement.

  18. Bile peritonitis due to intra-hepatic bile duct rupture.

    Science.gov (United States)

    Lochan, R; Joypaul, B V

    2005-11-14

    Generalized biliary peritonitis is a serious intra-abdominal emergency. Most of them occur due to duodenal ulcer perforation and rapidly evolve into bacterial peritonitis due to contamination by gut organisms and food. In this situation, recognition of the pathology and its treatment is straightforward and is usually associated with a good outcome. There are a few unusual causes of biliary peritonitis, of which rupture of the biliary tree is one. We describe a rare case of biliary peritonitis due to rupture of an intra-hepatic biliary radical. Unusual causes of peritonitis do interrupt our daily routine emergency surgical experience. Rapid recognition of the presence of peritonitis, adequate resuscitation, recognition of operative findings, establishment of biliary anatomy, and performance of a meticulous surgical procedure resulted in a good outcome.

  19. Infectious peritonitis profile in peritoneal dialysis at Ibn Sina University Hospital: a 6-year data report

    Directory of Open Access Journals (Sweden)

    Bekaoui S

    2014-08-01

    Full Text Available Samira Bekaoui, Intissar Haddiya, Maria Slimani Houti, Fatima Zahra Berkchi, Fatima Ezaitouni, Naima Ouzeddoun, Rabia Bayahia, Loubna Benamar Department of Nephrology, Dialysis, and Renal Transplantation, Ibn Sina University Hospital, Rabat, Morocco Background: Infectious peritonitis (IP is the most common complication in peritoneal dialysis (PD. The purpose of this study is to assess the prevalence of IP and to determine its clinical, biological, and evolutive characteristics. Patients and methods: We conducted a five year, five months retrospective study from July 2006 to December 2011. All patients on peritoneal dialysis that have been followed on PD for a minimum of 3 months and who presented IP during follow-up were included. Data were analyzed using SPSS 17.0. Results: The 76 episodes of IP were identified in 36 patients. The peritonitis rate (months × patients/peritonitis, as calculated by the Registre de Dialyse Péritonéale de Langue Française (RDPLF Registry [French peritoneal dialysis registry] in December 2011, was 18.59. Time to occurrence of peritonitis from the start of peritoneal exchange was 15.44±10 months. The mean age of our patients was 49.1±16.8 years [10–80]: the youngest patient's age was 10, while the oldest was 80 years old (male to female: sex ratio M/F=1,66. Also, 22% of our patients were diabetic. The mean follow-up in PD was 22.6±14 months. Abdominal pain was present in 79% of the cases. Fever and vomiting were noted in 42% and 38% of cases, respectively. The C-reactive protein rate was elevated in 77% of cases, and leukocytosis was found in 27% of cases. Bacteriological proof was present in 73.68% of cases. Gram-positive cocci were involved in 56.6% of microbiologically proven IP cases. Gram-negative bacilli were represented in 37.7%. The outcome was favorable in 89.4%. The PD catheter was removed in 2.63% of the cases. In addition, 7.89% of our patients were transferred to hemodialysis. Discussion: The

  20. PREDICTION OF OUTCOME USING THE MANNHEIM PERITONITIS INDEX IN CASES OF PERITONITIS

    Directory of Open Access Journals (Sweden)

    Sanjeev

    2015-08-01

    Full Text Available BACKGROUND: Peritonitis still presents an extremely common & dreaded problem in emergency surgery. Despite aggressive surgical techniques, the prognosis of peritonitis and intra - abdominal sepsis is very poor, especially when multiple organ failure develops. Therefore early objective & reliable classification of the severity of peritonitis and intra - abdominal sepsis is needed not only to predict prognosis & to select patients for these aggressive surgical techniques but also to evaluate & compare the results of different treatment regimens. So, in this prospective st udy of 60 cases of peritonitis, the reliability of the Mannheim peritonitis index is assessed & its predictive power evaluated. MATERIALS & METHOD S : This prospective study was carried out in the department of surgery, GMCH, Udaipur from June 2014 to June 2 015 after taking the permission from institutional ethics committee. Patients from both sexes of various age groups having peritonitis of varied aetiology & who had undergone laparotomy were taken. A detailed history, thorough clinical examination & necess ary investigations were performed in e ach case according to planned p r o forma. After resuscitation laparotomy was done & operative findings were noted carefully and a proper note on the progress of each patient was maintained and any complications encounter ed were noted. So, early classification of patients presenting with peritonitis by means of objective scoring system was done to select patients for aggressive surgery & overall morbidity & mortality were analyzed. RESULTS: Total 60 patients of peritonitis were examined and common causes were peptic (61.6%, typhoid (21.6% and appendicular (8.3 %. Most common age group was found to be 21 to 50 years and male to female ratio was 4:1. Peritonitis was more common in patients involved in hard work and chronic Be di smokers (61.6%. About 46% of patients who presented for treatment within 48 hours of onset of illness

  1. An unusual case of neonatal peritoneal calcifications associated with hydrometrocolpos

    Energy Technology Data Exchange (ETDEWEB)

    Hu, M.X.; Methratta, S. [College of Medicine and Dentistry of New Jersey - New Jersey Medical School, Newark (United States). Dept. of Radiology

    2001-10-01

    Neonatal peritoneal calcifications usually suggest a diagnosis of meconium peritonitis, but in this case, a premature baby girl, peritoneal calcifications were caused by hydrometrocolpos secondary to imperforate hymen, a rare association. The patient presented with respiratory distress and ascites and demonstrated abdominal calcifications on plain film. Other radiographic work-up revealed hydrometrocolpos without evidence of gastrointestinal tract obstruction. The patient was diagnosed and treated for imperforate hymen; she was recovered fully. (orig.)

  2. Acute hydrothorax complicating peritoneal dialysis: a case report

    OpenAIRE

    2010-01-01

    Abstract Introduction Acute hydrothorax is an uncommon but a well-recognized complication of peritoneal dialysis. No single test is definitive for diagnosis. Although it is not a life-threatening condition, hydrothorax often requires abandonment of peritoneal dialysis. Delay in diagnosis can lead to worsening of the clinical status. Case Presentation A 33-year-old Caucasian woman with lupus, who was successfully treated with temporary peritoneal dialysis 17 years previously, presented with ac...

  3. [Peritonitis in the course of peritoneal dialisis caused by Haemophilus influenzae with BLNAR phenotype].

    Science.gov (United States)

    Miklaszewska, Monika; Klepacka, Joanna; Drozdz, Dorota; Zachwieja, Katarzyna; Pietrzyk, Jacek A; Kadłubowski, Marcin; Hryniewicz, Waleria

    2009-04-01

    Most common bacterial species causing peritonitis in the course of peritoneal dialysis (PDP) are coagulase-negative staphylococci, Staphylococcus aureus and streptococci. Haemophilus influenzae is rarely associated with PDP. Hereby we present the first known case of APD-associated peritonitis caused by non-type able H. influenzae (NTHi) presenting the beta-lactamase negative, ampicillin-resistant (BLNAR) phenotype. An 18 year old boy who had been treated with the APD for 12 months due to SLE was admitted in good general condition with diagnosis of PDP. Standard diagnostic and therapeutical procedures were initiated. Dialysis fluid was turbid with cytosis of 435 WBC/ml. From dialysis fluid pure culture of Gram-negative coccobacillus was isolated. The isolate was identified as a BLNAR phenotype. The same bacterium was isolated from nasal swab. Blood cultures were negative. After evaluation of antimicrobial susceptibility the treatment was changed for the oral ciprofloxacin. The treatment was successful. Control tests 2 days later revealed cytosis of 15 WBC/mm3 and control cultures of peritoneal fluid were negative. After two weeks of treatment the patient was discharged in a good condition. Haemophilus influenzae is a bacterium frequently colonizing the nasopharyngeal cavity. A PCR-based method allowed to classify isolates as NTHi. Infection was probably of the respiratory origin as the isolates (from peritoneal fluid and nasal swab) were undistinguishable. There are only few reports describing this species as an ethiologic agent of peritonitis. This case prove that Haemophilus species should be taken into account as a possible aethiologic agent of PDP, especially in patients on immunosupression with carrier state of H. influenzae in the upper respiratory tract. This kind of microorganism requires specific conditions during its growing in vitro. Identification of its sensitivity to antibiotics is essential in order to detect strains of BLNAR phenotype, as it is a

  4. Iron inhibits respiratory burst of peritoneal phagocytes in vitro

    DEFF Research Database (Denmark)

    Gotfryd, Kamil; Jurek, Aleksandra; Kubit, Piotr

    2011-01-01

    Objective. This study examines the effects of iron ions Fe(3+) on the respiratory burst of phagocytes isolated from peritoneal effluents of continuous ambulatory peritoneal dialysis (CAPD) patients, as an in vitro model of iron overload in end-stage renal disease (ESRD). Material and Methods....... Respiratory burst of peritoneal phagocytes was measured by chemiluminescence method. Results. At the highest used concentration of iron ions Fe(3+) (100 µM), free radicals production by peritoneal phagocytes was reduced by 90% compared to control. Conclusions. Iron overload may increase the risk of infectious...

  5. Clinical outcomes and mortality in elderly peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Tamer Sakacı

    2015-05-01

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

  6. First case of CAPD-related peritonitis caused by Morganella morganii.

    Science.gov (United States)

    Atalay, H; Güney, I; Solak, Y; Almaz, E

    2010-01-01

    Morganella morganii, a gram-negative bacillus, is a rare cause of peritonitis. In this article we report a 55-year-old female patient with peritonitis due to Morganella morganii who was receiving continuous ambulatory peritoneal dialysis (CAPD).

  7. ERP processes automation in corporate environments

    Directory of Open Access Journals (Sweden)

    Antonoaie Victor

    2017-01-01

    Full Text Available The automation processes are used in organizations to speed up analyses processes and reduce manual labour. Robotic Automation of IT processes implemented in a modern corporate workspace provides an excellent tool for assisting professionals in making decisions, saving resources and serving as a know-how repository. This study presents the newest trends in process automation, its benefits such as security, ease of use, reduction of overall process duration, and provide examples of SAPERP projects where this technology was implemented and meaningful impact was obtained.

  8. ROBOTIC ASSISTANCE IN SPINE SURGERY

    Directory of Open Access Journals (Sweden)

    N. A. Konovalov

    2010-01-01

    Full Text Available Robotic assistance recently gains increasing popularity in spinal surgery. Robotic assistance provides higher effectiveness and safety especially in complex anatomy environment. 16 patients with degenerative disc disease were operated with robotic assistance device («SpineAssist»; MAZOR Surgical Technologies, Caesarea, Israel. The robot was used for automated intraoperative positioning of the instruments according to preoperatively planned trajectories. Robotic assistance enabled optimal screw placement even in complex anatomical cases (thin pedicles and rotational deformity. No implant-related complications were recorded.

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

    OpenAIRE

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

    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 nephropath...

  10. First report on the isolation of Aureimonas altamirensis from a patient with peritonitis

    Directory of Open Access Journals (Sweden)

    Percy Schröttner

    2014-12-01

    Full Text Available The isolation of Aureimonas altamirensis (a rare opportunistic pathogen with a yet unresolved pathogenicity from the ascites fluid of a patient with bacterial peritonitis is reported. The strain was first identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS and the result was confirmed using 16S rDNA sequencing. An antimicrobial susceptibility profile was determined according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST guidelines published in 2013, revealing sensitivity to all antibiotics tested. The patient was treated effectively with levofloxacin.

  11. Survey of the Attitude of Physicians towards Establishing and Maintaining a Peritoneal Dialysis Program

    Directory of Open Access Journals (Sweden)

    Souqiyyeh Muhammad

    2006-01-01

    Full Text Available In an attempt to evaluate the attitude of physicians towards establishing and maintaining a peritoneal dialysis (PD program in the Kingdom of Saudi Arabia (KSA, we sent a questionnaire to 160 physicians; the heads of the 148 active dialysis centers in the KSA and 12 other consultants working in these centers. This covered decision makers in 109 centers (73.6% in the Ministry of Health (MOH, 18 (12.2% in Governmental-non-MOH centers, and 21 (14.2 % in private hospitals that, together, care for a population of more than 7300 patients on chronic hemodialysis (HD and 559 on PD. The study was performed between September and December 2005. A total of 145 of the 160 physicians (90.6% from 141 dialysis centers (95.2% answered the questionnaire. There were 81 respondents (56.3% who believed that follow-up of the PD patients should be available in all the dialysis centers, 80 (55.2% would like to have a PD clinic at their centers, and only 20 (13.8% had PD clinics in their centers. However, 93 (66.4% respondents did not request from the administration of their hospitals to open a PD clinic and 62 (44.6% admitted to having no expertise in managing the patients on PD, while 53 (38.1% claimed that they did not have enough space in their dialysis centers to start a PD program. Regarding training and expertise, 57 (40.7%, 58 (43.3%, 48 (35.6% and 72 (52.9% physicians had training in continuous ambulatory PD (CAPD, intermittent peritoneal dialysis (IPD, automated peritoneal dialysis (APD or continuous cyclic peritoneal dialysis (CCPD, and acute PD, respectively. The comparisons between the health sectors in the KSA showed that MOH had significantly less active PD programs, and this reflected tremendously on the knowledge of the staff. Our survey indicates that the current practices concerning the PD programs in the KSA are modest, and that a new strategy is required to spread this modality of therapy horizontally in all the dialysis centers, and vertically by

  12. Survey of the attitude of physicians towards establishing and maintaining a peritoneal dialysis program.

    Science.gov (United States)

    Souqiyyeh, Muhammad Ziad; Shaheen, Faissal A M

    2006-09-01

    In an attempt to evaluate the attitude of physicians towards establishing and maintaining a peritoneal dialysis (PD) program in the Kingdom of Saudi Arabia (KSA), we sent a questionnaire to 160 physicians; the heads of the 148 active dialysis centers in the KSA and 12 other consultants working in these centers. This covered decision makers in 109 centers (73.6%) in the Ministry of Health (MOH), 18 (12.2%) in Governmental-non-MOH centers, and 21 (14.2%) in private hospitals that, together, care for a population of more than 7300 patients on chronic hemodialysis (HD) and 559 on PD. The study was performed between September and December 2005. A total of 145 of the 160 physicians (90.6%) from 141 dialysis centers (95.2%) answered the questionnaire. There were 81 respondents (56.3%) who believed that follow-up of the PD patients should be available in all the dialysis centers, 80 (55.2%) would like to have a PD clinic at their centers, and only 20 (13.8%) had PD clinics in their centers. However, 93 (66.4%) respondents did not request from the administration of their hospitals to open a PD clinic and 62 (44.6%) admitted to having no expertise in managing the patients on PD, while 53 (38.1%) claimed that they did not have enough space in their dialysis centers to start a PD program. Regarding training and expertise, 57 (40.7%), 58 (43.3%), 48 (35.6%) and 72 (52.9%) physicians had training in continuous ambulatory PD (CAPD), intermittent peritoneal dialysis (IPD), automated peritoneal dialysis (APD) or continuous cyclic peritoneal dialysis (CCPD), and acute PD, respectively. The comparisons between the health sectors in the KSA showed that MOH had significantly less active PD programs, and this reflected tremendously on the knowledge of the staff. Our survey indicates that the current practices concerning the PD programs in the KSA are modest, and that a new strategy is required to spread this modality of therapy horizontally in all the dialysis centers, and vertically by

  13. Automated Budget System

    Data.gov (United States)

    Department of Transportation — The Automated Budget System (ABS) automates management and planning of the Mike Monroney Aeronautical Center (MMAC) budget by providing enhanced capability to plan,...

  14. Acquiring User Models to Test Automated Assistants

    Science.gov (United States)

    2013-01-01

    vectors, but operates in a markedly different style from the user. Once we have extracted our traces and feature vectors from them, we will want to know ...prior work focuses on performing well on a specific task, such as flying well (Šuc, Bratko, and Sam- mut 2004), (Bain and Sammut 1995), instead of

  15. Peritonitis following percutaneous gastrostomy tube insertions in children

    Energy Technology Data Exchange (ETDEWEB)

    Dookhoo, Leema [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); University of Toronto, Faculty of Medicine, Toronto, ON (Canada); Mahant, Sanjay [The Hospital for Sick Children, Department of Pediatrics, Toronto, ON (Canada); Parra, Dimitri A.; John, Philip R.; Amaral, Joao G.; Connolly, Bairbre L. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2016-09-15

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  16. Automation 2017

    CERN Document Server

    Zieliński, Cezary; Kaliczyńska, Małgorzata

    2017-01-01

    This book consists of papers presented at Automation 2017, an international conference held in Warsaw from March 15 to 17, 2017. It discusses research findings associated with the concepts behind INDUSTRY 4.0, with a focus on offering a better understanding of and promoting participation in the Fourth Industrial Revolution. Each chapter presents a detailed analysis of a specific technical problem, in most cases followed by a numerical analysis, simulation and description of the results of implementing the solution in a real-world context. The theoretical results, practical solutions and guidelines presented are valuable for both researchers working in the area of engineering sciences and practitioners looking for solutions to industrial problems. .

  17. Marketing automation

    Directory of Open Access Journals (Sweden)

    TODOR Raluca Dania

    2017-01-01

    Full Text Available The automation of the marketing process seems to be nowadays, the only solution to face the major changes brought by the fast evolution of technology and the continuous increase in supply and demand. In order to achieve the desired marketing results, businessis have to employ digital marketing and communication services. These services are efficient and measurable thanks to the marketing technology used to track, score and implement each campaign. Due to the technical progress, the marketing fragmentation, demand for customized products and services on one side and the need to achieve constructive dialogue with the customers, immediate and flexible response and the necessity to measure the investments and the results on the other side, the classical marketing approached had changed continue to improve substantially.

  18. Aspects of osseous, peritoneal and renal handling of bisphosphonate during peritoneal dialysis: a methodological study

    DEFF Research Database (Denmark)

    Joffe, P; Henriksen, Jens Henrik Sahl

    1996-01-01

    to continuous ambulatory peritoneal dialysis (CAPD). The aims were: to assess the kinetics of 99m-technetium MBP (99mTc-MBP) in CAPD, and to evaluate the correctness of the assumption that the peritoneal and renal clearances of 99mTc-MBP equal the total plasma clearance of 51-chromium ethylenediamine tetra......-acetic acid (51Cr-EDTA). Eight patients on CAPD were studied cross-sectionally. The mean plasma clearances of 99mTc-MBP and 51Cr-EDTA in the steady state (4h) were 38.2 and 12.2 ml min-1 (p peritoneal clearances (0-4 h) were 5.2 and 7.2 ml min-1 (p ....5 and 2.8 ml min-1 (not significant), respectively. The bone bisphosphonate clearance (BBC) at steady state was 26.0 ml min-1, a value which was significantly higher than that at infinity (16.5 ml min-1, p peritoneal and renal clearances of 99m...

  19. Bladder perforation in a peritoneal dialysis patient

    Directory of Open Access Journals (Sweden)

    M Ounissi

    2012-01-01

    Full Text Available The dysfunction of the catheter in peritoneal dialysis (PD is a frequent compli-cation. However, perforation of organs are rare, particularly that of the urinary bladder. This re-quires an early diagnosis and prompt treatment of patients. We report here the case of a 38-year-old woman having end-stage renal disease due to autosomal-dominant polycystic kidney disease treated by PD since November 2000. Three years later, she was treated for Staphylococcal peritonitis. Four months later, she presented with a severe urge to urinate at the time of the fluid exchanges. The biochemical analysis of the fluid from the bladder showed that it was dialysis fluid. Injection of contrast through the catheter demonstrated the presence of a fistula between the bladder and the peritoneal cavity. She underwent cystoscopic closure of the fistulous tract and the PD catheter was removed. Subsequently, the patient was treated by hemodialysis. One month later, a second catheter was implanted surgically after confirming the closure of the fistula. Ten days later, she presented with pain at the catheter site and along the tunnel, which was found to be swollen along its track. The injection of contrast produced swelling of the subcutaneous tunnel but without extravasation of the dye. PD was withdrawn and the patient was put back on hemodialysis. Bladder fistula is a rare complication in PD and diagnosis should be suspected when patient complains of an urge to pass urine during the exchanges, which can be confirmed by contrast study showing presence of dye in the bladder. PD may be possible after the closure of the fistula, but recurrence may occur.

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

    Science.gov (United States)

    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

  1. Peritoneal Tuberculosis in Pregnancy: A Rare Occurrence

    Directory of Open Access Journals (Sweden)

    Priti Anand

    2014-09-01

    Full Text Available Extrapulmonary tuberculosis is least common form of tuberculosis in pregnancy, early diagnosis of which will help to reduce maternal and neonatal morbidity and mortality. My patient is 25 years old primigravida admitted with Ascitis, Anorexia, low grade fever on and off. Diagnosed as peritoneal tuberculosis after abdominal fluid sent for AFB culture. Patient was given Antitubercular treatment. Ascitic fluid gradually declined and pregnancy moved on but patient landed up in preterm labour and delivered baby which the pediatrician was unable to save because of extreme prematurity.

  2. Peritoneal mesothelioma in a jaguar (Panthera onca).

    Science.gov (United States)

    Souza, Francisco de Assis Leite; de Carvalho, Ciro José Sousa; de Almeida, Hatawa M; Pires, Lidiany Viana; Silva, Lucilene dos Santos; Costa, Francisco Assis Lima; Silva, Silvana M Medeiros de Sousa

    2013-09-01

    A 21-yr-old female jaguar (Panthera onca) died in a zoo in Teresina, Piaui, Brazil, following a history of abdominal distension, ascites, anorexia, and dyspnea. At necropsy, a dark red, watery, blood-tinged serous fluid was present in the abdominal cavity. The peritoneum was thick with firm, yellow, villous projections. Histologically, the tumors were composed of a biphasic population of cells, which reacted to anti-cytokeratin and anti-vimentin antibodies, consistent with a biphasic benign mesothelioma of peritoneal origin. This is the first reported case of mesothelioma in a captive jaguar.

  3. Microbubble-enriched lavage fluid for treatment of experimental peritonitis

    NARCIS (Netherlands)

    Sharma, P. K.; Rakhorst, G.; Engels, E.; van der Mei, H. C.; Busscher, H. J.; Ploeg, R. J.

    2008-01-01

    Background: Relaparotomies and closed postoperative peritoneal lavage (CPPL) are performed to treat persistent peritonitis. This experimental animal study compared open abdominal lavage with CPPL, and evaluated the potential of microbubble-enriched lavage fluids to improve the efficiency of CPPL and

  4. Peritoneal tuberkulose hos patient med formodet dissemineret ovariecancer

    DEFF Research Database (Denmark)

    Madsen, Lone Wulff; Neumann, Gudrun; Pedersen, Court

    2012-01-01

    imaging) supported this suspicion. Peritoneal biopsy from laparoscopy showed granulomas with central necrosis. Microscopy, culture and polymerase chain reaction from biopsy samples were negative for Mycobacterium tuberculosis. Follow-up with a CT scan after six months of full tuberculosis treatment showed...... normal conditions. Peritoneal tuberculosis is a diagnostic challenge, but should be considered in case of immigrants from high-risk areas....

  5. Perforation af rectum med faekal peritonitis efter staplet haemorideoperation

    DEFF Research Database (Denmark)

    Beuke, Anna-Christina; Pedersen, Mark Ellebaek; Qvist, Niels

    2008-01-01

    Rectal perforation and faecal peritonitis after stapled operation for grade IV haemorrhoids is described. The complication is rare, but surgeons performing the procedure must be familiar with potential risk factors.......Rectal perforation and faecal peritonitis after stapled operation for grade IV haemorrhoids is described. The complication is rare, but surgeons performing the procedure must be familiar with potential risk factors....

  6. Disseminated peritoneal leiomyomatosis with malignant change, in a male

    DEFF Research Database (Denmark)

    Lausen, I; Jensen, O J; Andersen, E

    1990-01-01

    Disseminated peritoneal leiomyomatosis (DPL) is a rare disorder, characterized by the occurrence of multiple leiomyomas scattered throughout the peritoneal cavity. Until this report DPL had been observed only in women and there is only one previous case with malignant change. A case of DPL...

  7. Laparoscopy can be used to diagnose peritoneal tuberculosis

    DEFF Research Database (Denmark)

    Ferløv Schwensen, Jakob; Bulut, Mustafa; Nordholm-Carstensen, Andreas

    2014-01-01

    and widespread pale nodules were found throughout the peritoneum. Consequently, the patient was diagnosed with peritoneal tuberculosis. This case demonstrates that atypical manifestations of tuberculosis exist in Denmark and that laparoscopy with biopsy can be performed to obtain the diagnosis when suspecting...... peritoneal tuberculosis....

  8. [Ecology and mechanisms of bacterial resistance to antibiotics in peritonitis].

    Science.gov (United States)

    Edern, Anita; Fines-Guyon, Marguerite; Castrale, Cindy; Ficheux, Maxence; Ryckelynck, Jean-Philippe; Lobbedez, Thierry

    2012-11-01

    Peritonitis remains a common complication of peritoneal dialysis. The aim of our study is to describe the mechanisms of antibiotic resistance in bacteria isolated during peritonitis in peritoneal dialysis, to determine whether antibiotic therapy proposed by the International Society for Peritoneal Dialysis (ISPD) is adapted to the mechanisms of resistance. All causative microorganisms of peritonitis, isolated in 106 dialysis patients and reported 170 episodes of peritonitis, during the study period (01/01/2005 to 31/12/2010) were reviewed. According to the usual classification, twelve groups of microorganism were created. An interpretive reading of antibiograms was performed in each group to identify resistance phenotypes. The species most frequently isolated are coagulase-negative staphylococci (n=73) of which 46 had PBP2a (penicillin-binding protein). Many Enterobacteriaceae were also isolated (n=45), they are susceptible to third generation cephalosporins with the exception of Enterobacteriaceae producing an extended spectrum β-lactamase (ESBL) or a cephalosporinase. Except for staphylococci, probabilistic antibiotic therapy recommended by the ISPD to treat peritonitis is effective. Indeed, many staphylococci producing a PBP2a, a first-generation cephalosporin cannot be administered in all cases. It is therefore necessary to identify patients with a strain of staphylococcus producing a PBP2a, it must be treated by vancomycin.

  9. Comparative Proteomic Analysis of Peritoneal Dialysate from Chronic Glomerulonephritis Patients

    Directory of Open Access Journals (Sweden)

    Hsin-Yi Wu

    2013-01-01

    Full Text Available Peritoneal dialysis (PD frequently contributes to peritoneal damage which cannot be easily identified without invasive techniques, implying the urgent need for biomarkers and revealing mechanisms. Chronic glomerulonephritis (CGN is one of the leading causes of receiving dialysis treatment. Here, we attempted to analyze the peritoneal dialysate collected from CGN patients when they receive continuous ambulatory peritoneal dialysis (CAPD treatment for the first time and after a year to reveal the protein changes that resulted from PD. Proteins were displayed by two-dimensional gel electrophoresis (2DE. Altered gel spots were digested followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS analysis for protein identification. Eight proteins were found to have differential expression levels between two groups. Their differential expressions were validated by Western blots in other sets of peritoneal dialysates. Proteins identified with higher levels in the first-time dialysate suggested their dominant appearance in CGN patients, while those that showed higher levels in peritoneal dialysate collected after one year may result from initial peritoneal inflammation or changes in the permeability of the peritoneum to middle-sized proteins. All the identified proteins may provide a perceptiveness of peritoneal changes caused by PD and may function as potential biomarkers or drug targets.

  10. Posttransplant encapsulating peritoneal sclerosis : A worrying new trend?

    NARCIS (Netherlands)

    Fieren, Marien W. J. A.; Betjes, Michiel G. H.; Korte, Mario R.; Boer, Walther H.

    2007-01-01

    Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication in patients on peritoneal dialysis (PD). We describe a cluster of 13 EPS cases occurring in 2 university hospitals in The Netherlands. Most of these cases were diagnosed after recent kidney transplantation, when the patients

  11. A peritoneal dialysis patient with osmotic demyelination syndrome

    Directory of Open Access Journals (Sweden)

    Hing Ming Cheng

    2016-04-01

    Full Text Available A peritoneal dialysis patient with cirrhosis presented with drowsiness, vomiting, and mild hyponatremia. Despite no active correction of hyponatremia, she developed convulsion and quadriplegia. Magnetic resonance imaging of the brain showed changes of osmotic demyelination syndrome. This case illustrates that osmotic demyelination syndrome may occur in peritoneal dialysis without rapid correction of hyponatremia.

  12. Automation of (64)Cu production at Turku PET Centre.

    Science.gov (United States)

    Elomaa, Viki-Veikko; Jurttila, Jori; Rajander, Johan; Solin, Olof

    2014-07-01

    At Turku PET Centre automation for handling solid targets for the production of (64)Cu has been built. The system consists of a module for moving the target from the irradiation position into a lead transport shield and a robotic-arm assisted setup for moving the target within radiochemistry laboratory. The main motivation for designing automation arises from radiation hygiene.

  13. Automated software engineering planning with SASEA

    Energy Technology Data Exchange (ETDEWEB)

    Lawlis, P.K. [C.J. Kemp Systems, Inc., Fairborn, OH (United States); Hoffman, C.L. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States). Idaho National Engineering and Environmental Lab.

    1998-07-01

    Planning for effective software engineering is not easy, and software project managers would usually welcome assistance in this area. Very effective assistance could be provided by automated tools that are decision aids. However, a comprehensive suite of such tools does not yet exist. One area that has been addressed is the selection of a programming language. This paper discusses in detail a decision tool that has been developed for language selection. It also addresses the areas in which other such tools are required.

  14. A totally laparoscopic peritoneal free flap for reconstruction of hand

    Institute of Scientific and Technical Information of China (English)

    En-Qi Guo; Qing-Ping Xie

    2016-01-01

    Management of defects on the hand and foot with exposed tendons remains a major challenge for plastic surgeons.Here,we present a case of hand reconstruction with a totally laparoscopic peritoneal flap.The anterior rectus sheath was preserved in situ.The peritoneal free flap supplied by peritoneal branches of the deep inferior epigastric artery was retrieved by laparoscopy to cover the soft tissue defect of the hand.The defect of the dorsal hand was 17 cm × 12 cm.The peritoneal flap measuring 22 cm × 15 cm survived completely without any complications.A following split-thickness skin graft offered the successful wound closure.Motor and sensory function improved gradually within the first year follow-up.The totally laparoscopic peritoneal free flap is a good choice for reconstruction of the soft tissue defects accompanied by exposed tendons on the hand and foot.

  15. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Erol, Bekir; Ciftci, Tuerkmen T. [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey)

    2011-11-15

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  16. [Medical and economic evaluation of new peritoneal dialysis solutions].

    Science.gov (United States)

    Ryckelynck, J-P; Lobbedez, T; Ficheux, M; Chatelet, V; Thuillier-Lecouf, A; Henri, P; Hurault de Ligny, B

    2009-06-01

    Conventional peritoneal dialysis solutions are mostly bioincompatible in relationship with a low pH, a high glucose and glucose degradation products (GDP) concentrations inducing anatomical and functional peritoneal membrane alterations. Use of icodextrin solution instead of glucose hypertonic solution preserves peritoneal membrane minimizing glucose exposure and its peritoneal absorption. Physiological fluids with a neutral pH and less GDP seem to have a positive effect on residual renal function which declines more slowly when they are early prescribed, before highly damaged and sclerotic kidneys. Preliminary data show that patients and technique survivals are better when physiological solutions are used either for diabetic and non diabetic patients. However, these new solutions do not improve peritonitis rates except for bicarbonate solutions but this fact must still be confirmed by other studies. In spite of a higher cost, physiological solutions must be proposed mainly for patients with a low comorbidity index and a high life expectancy.

  17. Meconium peritonitis following intestinal atresia: A case report

    Directory of Open Access Journals (Sweden)

    Riley K. Kitamura

    2016-06-01

    Full Text Available Meconium peritonitis is a sterile chemical peritonitis, which frequently occurs after intestinal perforation in utero. Overall mortality rates have drastically decreased with earlier prenatal diagnosis and improved perinatal care. However, perinatal surgical management of meconium peritonitis is largely dependent on individual surgeon experience. We present a case of meconium peritonitis with emergent cesarean section delivery after the patient developed massive meconium ascites, hydrops fetalis, and non-reassuring fetal monitoring. In the immediate post-natal period, the patient was intubated and a peritoneal drain was placed for respiratory and hemodynamic stabilization. He was then taken to the operating room the following day for laparotomy and bowel resection. His post-operative course was uneventful, and he was discharged home in good clinical condition.

  18. Periodontal treatment reduces chronic systemic inflammation in peritoneal dialysis patients.

    Science.gov (United States)

    Siribamrungwong, Monchai; Yothasamutr, Kasemsuk; Puangpanngam, Kutchaporn

    2014-06-01

    Chronic systemic inflammation, a non traditional risk factor of cardiovascular diseases, is associated with increasing mortality in chronic kidney disease, especially peritoneal dialysis patients. Periodontitis is a potential treatable source of systemic inflammation in peritoneal dialysis patients. Clinical periodontal status was evaluated in 32 stable chronic peritoneal dialysis patients by plaque index and periodontal disease index. Hematologic, blood chemical, nutritional, and dialysis-related data as well as highly sensitive C-reactive protein were analyzed before and after periodontal treatment. At baseline, high sensitive C-reactive protein positively correlated with the clinical periodontal status (plaque index; r = 0.57, P chronic systemic inflammation in peritoneal dialysis patients. Treatment of periodontal diseases can improve systemic inflammation, nutritional status and erythropoietin responsiveness in peritoneal dialysis patients.

  19. Candida peritonitis in dogs: report of 5 cases.

    Science.gov (United States)

    Bradford, Katy; Meinkoth, Jim; McKeirnen, Kelci; Love, Brenda

    2013-06-01

    Candida peritonitis is reported in people and is associated with significant morbidity and mortality compared with sterile or bacterial peritonitis. Recognized predisposing risk factors include peritoneal dialysis, hollow viscous organ perforation, abdominal surgery, inflamed intestinal mucosa, antimicrobial administration, and immunosuppression. In this report, we describe 5 cases of dogs with peritonitis complicated by Candida spp; 3 dogs with C albicans, one dog with C albicans and C glabrata, and one dog with C glabrata only. The 3 dogs with C albicans peritonitis presented with duodenal perforation due to NSAID therapy, intestinal resection and anastomosis following postspay-surgery dehiscence, and intestinal foreign body removal. The 2 dogs with C glabrata peritonitis had undergone cholecystectomy due to gall bladder rupture and dehiscence of intestinal biopsy removal sites following exploratory laparatomy. In all cases, initial diagnosis of fungal peritonitis was made via cytologic examination of peritoneal effusions, which revealed marked pyogranulomatous inflammation with numerous 3-8 μm oval, deeply basophilic yeast organisms with thin clear capsules noted within phagocytes and extracellularly. In addition, germ tube formation, hyphae, and pseudohyphae were rarely seen in some of the cases with pure C albicans. Identity of the organisms was determined by culture in all cases and confirmed by PCR in 3 cases. Candida spp. are commensals normally inhabiting the alimentary, the upper respiratory, and the lower urogenital tracts of mammals. They are opportunistic pathogens that can invade and colonize tissue when a patient is immune-compromised or there is disruption of the mucosal barrier. Candida peritonitis should be considered in patients with peritoneal contamination with gastrointestinal or biliary contents.

  20. Peritonitis and technique failure caused by Roseomonas mucosa in an adolescent infected with HIV on continuous cycling peritoneal dialysis.

    Science.gov (United States)

    Boyd, Mary Adetinuke; Laurens, Matthew B; Fiorella, Paul D; Mendley, Susan R

    2012-11-01

    We report the first case of peritonitis caused by Roseomonas mucosa which led to technique failure in an adolescent patient with HIV receiving peritoneal dialysis. Identification of the causative organism by 16S rRNA gene sequencing and phylogenetic analysis is described.

  1. Complicated Candida parapsilosis peritonitis on peritoneal dialysis in a neonate with renal failure because of bilateral adrenal abscesses.

    Science.gov (United States)

    Cheng, I; Chen, Yi-Lin; Lin, Cheng-Hui; Jow, Guey-Mei; Mu, Shu-Chi

    2011-10-01

    We present a full-term female infant with a difficult delivery course complicated with Escherichia coli sepsis and bilateral adrenal abscesses. She developed renal failure and received peritoneal dialysis. Peritonitis of Candida parapsilosis developed later. The infant was successfully treated with hemofiltration and a combination of antifungal agents.

  2. Changes in eicosanoid and tumour necrosis factor-α production by rat peritoneal macrophages during carrageenin-induced peritonitis

    NARCIS (Netherlands)

    W.M. Pruimboom (Wanda); A. Verdoold (A.); C.J.A.M. Tak (Corné); A.P.J. van Dijk (Arie); M. van Batenburg (M.); J.H.P. Wilson (Paul); F.J. Zijlstra (Freek)

    1994-01-01

    textabstractChanges and correlations in cytokine and eicosanoid production by blood monocytes, non-purified and purified peritoneal cells during a carrageenin-induced peritonitis were investigated for a period of ten days. The cells were isolated and stimulated in vitro. Cytokine and eicosanoid prod

  3. Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon

    Directory of Open Access Journals (Sweden)

    Legakis Nikolaos

    2006-02-01

    Full Text Available Abstract Background Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon is a rare cause of small bowel obstruction, especially in adult population. Diagnosis is usually incidental at laparotomy. We discuss one such rare case, outlining the fact that an intra-operative surprise diagnosis could have been facilitated by previous investigations. Case presentation A 56 year-old man presented in A&E department with small bowel ileus. He had a history of 6 similar episodes of small bowel obstruction in the past 4 years, which resolved with conservative treatment. Pre-operative work-up did not reveal any specific etiology. At laparotomy, a fibrous capsule was revealed, in which small bowel loops were encased, with the presence of interloop adhesions. A diagnosis of abdominal cocoon was established and extensive adhesiolysis was performed. The patient had an uneventful recovery and follow-up. Conclusion Idiopathic sclerosing encapsulating peritonitis, although rare, may be the cause of a common surgical emergency such as small bowel ileus, especially in cases with attacks of non-strangulating obstruction in the same individual. A high index of clinical suspicion may be generated by the recurrent character of small bowel ileus combined with relevant imaging findings and lack of other plausible etiologies. Clinicians must rigorously pursue a preoperative diagnosis, as it may prevent a "surprise" upon laparotomy and result in proper management.

  4. Peritoneal Dialysis Tailored to Pediatric Needs

    Directory of Open Access Journals (Sweden)

    C. P. Schmitt

    2011-01-01

    Full Text Available Consideration of specific pediatric aspects is essential to achieve adequate peritoneal dialysis (PD treatment in children. These are first of all the rapid growth, in particular during infancy and puberty, which must be accompanied by a positive calcium balance, and the age dependent changes in body composition. The high total body water content and the high ultrafiltration rates required in anuric infants for adequate nutrition predispose to overshooting convective sodium losses and severe hypotension. Tissue fragility and rapid increases in intraabdominal fat mass predispose to hernia and dialysate leaks. Peritoneal equilibration tests should repeatedly been performed to optimize individual dwell time. Intraperitoneal pressure measurements give an objective measure of intraperitoneal filling, which allow for an optimized dwell volume, that is, increased dialysis efficiency without increasing the risk of hernias, leaks, and retrofiltration. We present the concept of adapted PD, that is, the combination of short dwells with low fill volume to promote ultrafiltration and long dwells with a high fill volume to improve purification within one PD session. The use of PD solutions with low glucose degradation product content is recommended in children, but unfortunately still not feasible in many countries.

  5. Encapsulating peritonitis and familial Mediterranean fever

    Institute of Scientific and Technical Information of China (English)

    Resat Dabak; Oya Uygur-Bayrami(c)li; Didem K1l1(c) Ayd1n; Can Dolap(c)1oglu; Cengiz Gemici; Turgay Erginel; Cem Turan; Nimet Karaday1

    2005-01-01

    AIM: To investigate the relationship between encapsulating peritonitis and familial Mediterranean fever (FMF). METHODS: The patient had a history of type 2 diabetes and laparoscopic cholecystectomy was performed one year ago for cholelithiasis. Eleven months after the operation she developed massive ascites. Biochemical evaluation revealed hyperglycemia, mild Fe deficiency anemia, hypoalbuminemia and a CA-125 level of 2 700 IU. Ascitic evaluation showed characteristics of exudation with a cell count of 580/mm3. Abdominal CT showed omental thickening and massive ascites. At exploratory laparotomy there was generalized thickening of the peritoneum and a laparoscopic clip encapsulated by fibrous tissue was found adherent to the uterus. Biopsies were negative for malignancy and a prophilactic total abdominal hysterectomy and bilateral salpingooophorectomy were performed. RESULTS: The histopathological evaluation was compatible with chronic nonspecific findings and mild mesothelial proliferation and chronic inflammation at the uterine serosa and liver biopsy showed inactive cirrhosis. CONCLUSION: The patient was evaluated as sclerosing encapsulating peritonitis induced by the laparoscopic clip acting as a foreign body. Due to the fact that the patient had FMF the immune response was probably exaggerated.

  6. Feline Coronaviruses: Pathogenesis of Feline Infectious Peritonitis.

    Science.gov (United States)

    Tekes, G; Thiel, H-J

    2016-01-01

    Feline infectious peritonitis (FIP) belongs to the few animal virus diseases in which, in the course of a generally harmless persistent infection, a virus acquires a small number of mutations that fundamentally change its pathogenicity, invariably resulting in a fatal outcome. The causative agent of this deadly disease, feline infectious peritonitis virus (FIPV), arises from feline enteric coronavirus (FECV). The review summarizes our current knowledge of the genome and proteome of feline coronaviruses (FCoVs), focusing on the viral surface (spike) protein S and the five accessory proteins. We also review the current classification of FCoVs into distinct serotypes and biotypes, cellular receptors of FCoVs and their presumed role in viral virulence, and discuss other aspects of FIPV-induced pathogenesis. Our current knowledge of genetic differences between FECVs and FIPVs has been mainly based on comparative sequence analyses that revealed "discriminatory" mutations that are present in FIPVs but not in FECVs. Most of these mutations result in amino acid substitutions in the S protein and these may have a critical role in the switch from FECV to FIPV. In most cases, the precise roles of these mutations in the molecular pathogenesis of FIP have not been tested experimentally in the natural host, mainly due to the lack of suitable experimental tools including genetically engineered virus mutants. We discuss the recent progress in the development of FCoV reverse genetics systems suitable to generate recombinant field viruses containing appropriate mutations for in vivo studies.

  7. Telehealth: Acceptability, clinical interventions and quality of life in peritoneal dialysis

    Science.gov (United States)

    Dey, Vishal; Jones, Audrey; Spalding, Elaine M

    2016-01-01

    Introduction: Telehealth technologies are being widely adopted across the globe for management of long-term conditions. There are limited data on its use, effectiveness and patient experience in end-stage renal disease. The aim of this pilot project was to explore patient acceptability of technology and evaluate its effect on clinical interventions and quality of life in patients undergoing peritoneal dialysis. Methods: Peritoneal dialysis patients were provided with computer tablets (PODs). PODs contained a knowledge database with treatment- and symptom-based questionnaires that generated alerts for the clinical team. Alerts were reviewed daily and followed up by a telephone call or clinic visit. Interventions were at the discretion of clinicians. Data were recorded prospectively and quality of life and Quebec User Evaluation of Satisfaction with assistive Technology questionnaires evaluated at the start and end of the programme. Results: In all, 22 patients have participated over 15 months. The mean age was 61.6 years and PODs were utilised for an average of 341.9 days with 59.1% choosing to continue beyond the study period. We received a total of 1195 alerts with an average of 2.6 alerts per day. A total of 36 admissions were avoided and patients supported to self-manage on 154 occasions. Quebec User Evaluation of Satisfaction with assistive Technology scores remained high throughout the programme although no improvement in quality of life was seen. Discussion: Telehealth is useful to monitor patients with renal failure on peritoneal dialysis. It is acceptable across age groups and provides an additional resource for patients to self-manage. Satisfaction scores and retention rates suggest a high level of acceptability.

  8. Peritoneal dialysis for chronic kidney disease patients: A single-center experience in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Khalil ur-Rehman

    2011-01-01

    Full Text Available To evaluate the peritoneal dialysis (PD program in our hospital, we retrospectively studied all patients dialyzed with this modality over the last 5 years. A total of 56 patients having end-stage renal disease (ESRD, with mean age ± SD of 49 ± 20 years (range 16-92 years, were dialyzed with PD: 38 (68% patients with continuous ambulatory PD and 18 (32% patients with automated PD. Twenty-six (46% patients were females. The mean follow-up time of these patients was 17 ± 14 months. The underlying etiologies for ESRD in these patients were diabetes mellitus (48%, glomerulonephritis (9%, and hypertension (7%. Twenty-seven patients (48% were put on PD from the start, while 29 (52% patients were switched from hemodialysis (HD to PD. Nineteen (34% patients developed a total of 29 episodes of peritonitis. The incidence of peritonitis was 0.4 episode per patient-year. Exit-site infections occurred in 17 (30% patients. No tunnel infection was observed during the study period. Non-infectious catheter-related complications occurred in 12.5% of the patients; six (11% patients had hernia (umbilical or inguinal. At the end of the study, 23 (41% patients continued on PD, 17 (30% received a renal transplant, 7 (13% suffered technique failure and subsequently switched to HD, and 9 (16% patients died. To conclude, our study demonstrates that the rate of PD related complications is found to be quite low in our program, with an acceptable technique failure rate and mortality. Therefore, PD is a safe and an effective treatment modality in the integrated care approach to patients with ESRD.

  9. Detection of fungal DNA in peritoneal fluids by a PCR DNA low-density microarray system and quantitation of serum (1-3)-β-D-glucan in the diagnosis of peritoneal candidiasis.

    Science.gov (United States)

    Corrales, Isabel; Giménez, Estela; Aguilar, Gerardo; Delgado, Carlos; Puig, Jaime; Izquierdo, Ana; Belda, Javier; Navarro, David

    2015-02-01

    Microbiological documentation of peritoneal candidiasis (PC) is hampered by the low numbers of yeasts observable by direct microscopic examination and recoverable by culture methods. The performance of a polymerase chain reaction (PCR) DNA Low-Density Microarray System (CLART STIs B) was compared to that of BACTEC FX automated culture method for the detection of Candida spp. in 161 peritoneal fluids (PF) from patients with peritonitis. The clinical utility of (1-3)-β-d-glucan (BDG) antigenemia in the diagnosis of PC was evaluated in 42 of these patients. The overall agreement between the PCR assay and the culture method was good (κ = 0.790), and their sensitivities were 93.5% and 74.19%, respectively. Serum BDG levels in patients with Candida spp. in PFs (median, 200.3 pg/mL; Range, 22.0-523.4 pg/mL) was significantly higher (P = 0.002) than those found in patients without the yeast (median, 25.3 pg/mL; Range, 0-523.4 pg/mL). Our study demonstrates the potential clinical utility of molecular methods and the measurement of serum BDG levels for the diagnosis of PC.

  10. A companion agent for automated training systems

    NARCIS (Netherlands)

    Buiël, E.F.T.; Lubbers, J.

    2007-01-01

    TNO Defence, Security & Safety has a long history of applied research in the area of automated simulator-based training by means of Computer-Assisted Instruction (CAI). Traditionally, a CAI system does not enable a true dialogue between the learner and the virtual instructor. Most frequently, the sy

  11. Human and automation: a matter of cooperation.

    OpenAIRE

    Hoc, Jean-Michel

    2007-01-01

    International audience; Most of the time, machine design should be considered as human-machine system design in order to solve human-machine cooperation problems. The traditional levels of automation should be re-interpreted in terms of cooperation requirements. A framework is proposed in order to categorise car-driving assistance devices on the basis of human-machine cooperation.

  12. Automating Relational Database Design for Microcomputer Users.

    Science.gov (United States)

    Pu, Hao-Che

    1991-01-01

    Discusses issues involved in automating the relational database design process for microcomputer users and presents a prototype of a microcomputer-based system (RA, Relation Assistant) that is based on expert systems technology and helps avoid database maintenance problems. Relational database design is explained and the importance of easy input…

  13. [Peritoneal dialysis for acute renal failure: Rediscovery of an old modality of renal replacement therapy].

    Science.gov (United States)

    Issad, Belkacem; Rostoker, Guy; Bagnis, Corinne; Deray, Gilbert

    2016-07-01

    Acute renal failure (ARF) in adults in the intensive care unit (ICU) often evolves in a context of multiple organ failure, which explains the high mortality rate and increase treatment needs. Among, two modalities of renal replacement therapy, peritoneal dialysis (PD) was the first modality used for the treatment of ARF in the 1950s. Today, while PD is generalized for chronic renal failure treatment, its use in the ICU is limited, particularly, due to the advent of new hemodialysis techniques and the development of continuous replacement therapy. Recently, a renewed interest in the use of PD in patients with ARF has manifested in several emerging countries (Brazil, Vietnam). A systematic review in 2013 showed a similar mortality in ARF patients having PD (58%) and those treated by hemodialysis or hemodiafiltration/hemofiltration (56.1%). In the International society of peritoneal dialysis (ISPD)'s guideline (2013), PD may be used in adult ARF as the other blood extracorporeal epuration technics (recommendation with grade 1B). PD is the preferred method in cardiorenal syndromes, in frailty patients with hemodynamic instability and those lacking vascular access; finally PD is also an option in elderly and patients with bleeding tendency. In industrial countries, high volume automated PD with a flexible catheter (usually Tenckhoff) is advocated.

  14. The Best Choice of Treatment for Acute Colonic Diverticulitis with Purulent Peritonitis Is Uncertain

    DEFF Research Database (Denmark)

    Hupfeld, Line; Burcharth, Jakob; Pommergaard, Hans-Christian

    2014-01-01

    Severe stages of acute, colonic diverticulitis can progress into intestinal perforations with peritonitis. In such cases, urgent treatment is needed, and Hartmann's procedure is the standard treatment for cases with fecal peritonitis. Peritoneal lavage may be an alternative to resection for acute...... diverticulitis with purulent peritonitis, but ongoing randomized trials are awaited to clarify this....

  15. Positive peritoneal fluid fungal cultures in postoperative peritonitis after bariatric surgery.

    Science.gov (United States)

    Zappella, N; Desmard, M; Chochillon, C; Ribeiro-Parenti, L; Houze, S; Marmuse, J-P; Montravers, P

    2015-09-01

    Postoperative peritonitis (POP) is a common surgical complication after bariatric surgery (BS). We assessed the importance of positive fungal cultures in these cases of POP admitted to the intensive care unit. Clinical features and outcome were compared in 25 (41%) Candida-positive patients (6 (22%) fluconazole-resistant Candida glabrata) and 36 patients without Candida infection. Candida infections were more commonly isolated in late-onset peritonitis and were often associated with multidrug-resistant bacteria. Risk factors for intensive care unit mortality (19.6%) were diabetes and superobesity. Candida infections, including fluconazole-resistant strains, are common in POP after BS. These data encourage the empirical use of a broad-spectrum antifungal agent.

  16. Peritoneal vascular reserve characterization through nitroprusside-induced modification of peritoneal mass transfer coefficients.

    Science.gov (United States)

    Selgas, R; Carmona, A R; Martinez, M E; Perez-Fontan, M; Salinas, M; Conesa, J; Martinez Ara, J; Sicilia, L S

    1985-07-01

    The transport of solutes across the peritoneum may be increased by the topical administration of nitroprusside; the effects of the drug seem to be due to an increase in the number of perfused capillaries and/or in their permeability. We have compared the peritoneal mass transfer coefficients (MTC) for urea, creatinine and parathormone (PTH) under basal conditions and after administration of nitroprusside (4.5 mg/l dialysate) in 15 patients under CAPD therapy. The mean increments of the MTC were 48.8% for urea, 77.5% for creatinine and 323% for PTH. The relative MTC increments for the three molecules (taken in pairs) were: MTCPTH/urea' 2.53 times (mean), MTCPTH/creatinine' 1.7 times, and MTCcreatinine/urea' 0.73-times, with very variable ranges. The overall mean increment (OMI) for all three ratios ranged from -1.25 and +6 times. In six patients, some of the relative increments (and in three of them the OMI) were negative but the epidemiological features of these patients revealed no clear data. The OMI shows a direct correlation with the body surface area and an inverse correlation with the the duration of CAPD and ESRD and with the number of peritonitis episodes, albeit without statistical significance. We conclude that the peritoneal vascular reserve has individual characteristics, and that perhaps the OMI or some other similar index might serve to quantify and characterise it, if our findings are confirmed.

  17. [A test for sperm cell survival in peritoneal fluid].

    Science.gov (United States)

    Radwan, J; Niwald, W; Bielak, A; Pawlicki, J; Banaszczyk, R; Makuła, D

    1995-06-01

    The role of the peritoneal fluid in the physiology of reproduction, as well as in the transportation and survival of gametes, is little known. The authors have examined interactions between spermatozoa and the peritoneal fluid, collected during laparoscopy in the, so-called, survival test, from 42 infertile couples. The studied survival of spermatozoa in the peritoneal fluid was relatively high--19% after 48 hours--longer than in Menezo B2 fluid. Values of the test have been indicated, especially in cases of endometriosis-caused and idiopathic infertility.

  18. Spontaneous biliary peritonitis in acalculous cholecystitis: fact or misdiagnosis?

    Science.gov (United States)

    Sökmen, S; Coker, A; Unek, T

    2001-01-01

    It is often speculated that an inflamed gallbladder weeps bile to produce bile peritonitis. This may be so, but more likely the problem is a peritoneal effusion in a jaundiced patient which thus resembles bile. So-called "spontaneous or idiopathic biliary peritonitis" in acute acalculous cholecystitis without a proven cause is a further example of this very rare condition. Spontaneous perforations of the extrahepatic biliary ductal system associated with acalculous cholecystitis are uncommon albeit reported in adults. Most patients present with an acute abdomen and are operated upon urgently without diagnostic iter. A recent experience with such a case prompted a thorough review of 27 similar cases previously reported.

  19. [Appendiceal peritonitis in childhood, antibiotic treatment with cefoxitin].

    Science.gov (United States)

    Aristegui, J; de la Fuente, E; Pérez Legorburu, A; de Gárate, J

    1982-11-01

    Twenty one cases of appendiceal peritonitis in children are reviewed. An antibiotic (sodium cefoxitine) has been used during the post-operative course to decrease the risk of suppurative complications. Cultures obtained from peritoneal exudate yielded "E. coli" and "Bacteroides" sp. as the most commonly isolated bacteria. External drainage was placed as a rutine and the percentage of suppurative complications was 14%. No patient showed evidence of adverse reactions to the antibiotic and the mortality of the serie was zero. Obtained results allow to state that cefoxitine is effective in the management of appendiceal peritonitis in children.

  20. Automated Essay Scoring

    Directory of Open Access Journals (Sweden)

    Semire DIKLI

    2006-01-01

    Full Text Available Automated Essay Scoring Semire DIKLI Florida State University Tallahassee, FL, USA ABSTRACT The impacts of computers on writing have been widely studied for three decades. Even basic computers functions, i.e. word processing, have been of great assistance to writers in modifying their essays. The research on Automated Essay Scoring (AES has revealed that computers have the capacity to function as a more effective cognitive tool (Attali, 2004. AES is defined as the computer technology that evaluates and scores the written prose (Shermis & Barrera, 2002; Shermis & Burstein, 2003; Shermis, Raymat, & Barrera, 2003. Revision and feedback are essential aspects of the writing process. Students need to receive feedback in order to increase their writing quality. However, responding to student papers can be a burden for teachers. Particularly if they have large number of students and if they assign frequent writing assignments, providing individual feedback to student essays might be quite time consuming. AES systems can be very useful because they can provide the student with a score as well as feedback within seconds (Page, 2003. Four types of AES systems, which are widely used by testing companies, universities, and public schools: Project Essay Grader (PEG, Intelligent Essay Assessor (IEA, E-rater, and IntelliMetric. AES is a developing technology. Many AES systems are used to overcome time, cost, and generalizability issues in writing assessment. The accuracy and reliability of these systems have been proven to be high. The search for excellence in machine scoring of essays is continuing and numerous studies are being conducted to improve the effectiveness of the AES systems.

  1. EFFECT OF SILVER NANOPARTICLES IN EXPERIMENTAL PERITONITIS

    Directory of Open Access Journals (Sweden)

    D. V. Chegodar

    2015-01-01

    Full Text Available In our research we have investigated the effect of intraperitoneal introduction of silver nanoparticles solution (linear particle size of 10–20 nm into intact animals and in the simulation of experimental peritonitis. We have evaluated the indices of nonspecific proteinases and their inhibitors in blood serum and peritoneum lavage. The intraperitoneal introduction of silver nanoparticles solution to intact animals leads to the minimal reaction of proteinase-inhibitor systems components in blood serum and peritoneum lavage. When modeling inflammatory process in peritoneum cavity by intraperitoneal injection of 10% filtered fecal suspension of rats, application of silver nanoparticles solution is accompanied by decrease in extent of activation of proteinases and preservation of inhibitory potential, both at systemic and local level, which can indicate antiinflammatory effects of nanosilver.

  2. Experimental Trichinellosis in rats: Peritoneal macrophage activity

    Directory of Open Access Journals (Sweden)

    Gruden-Movsesijan Alisa

    2010-01-01

    Full Text Available The influence of Trichinella spiralis infection on macrophage activity in rats during the first 28 days of infection was examined by measuring the production of NO and IL-6, as well as the expression of mannose receptor on the surface of peritoneal macrophages. During the course of a dynamic shift in the 3 life-cycle stages of the parasite, intermittent variations in NO production were observed but ended with increased values that coincided with the highest values for IL-6 release in the final, muscle phase of infection. No change in mannose receptor expression was observed during the course of infection. These results confirm that the Trichinella spiralis infection provokes changes in macrophage activity that could influence not only the course of the parasitic disease but also the overall immune status of the host.

  3. Idiopathic sclerosing encapsulating peritonitis: Abdominal cocoon

    Institute of Scientific and Technical Information of China (English)

    Jenny N Tannoury; Bassam N Abboud

    2012-01-01

    Abdominal cocoon,the idiopathic form of sclerosing encapsulating peritonitis,is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane.Preoperative diagnosis re quires a high index of clinical suspicion.The early clinical features are nonspecific,are often not recognized and it is difficult to make a definite pre-operative diagnosis.Clinical suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging findings and lack of other plausible etiologies.The radiological diagnosis of abdominal cocoon may now be confidently made on computed tomography scan.Surgery is important in the management of this disease.Careful dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases.

  4. Chlamydia Peritonitis and Ascites Mimicking Ovarian Cancer

    Science.gov (United States)

    Macer, Matthew; Azodi, Masoud

    2016-01-01

    Background. Pelvic inflammatory disease (PID) rarely results in diffuse ascites. Severe adhesive disease secondary to PID may lead to the formation of inclusion cysts and even pelvic peritoneal nodularity due to postinflammatory scarring and cause an elevation of serum CA-125 levels. The constellation of these findings may mimic an ovarian neoplasm. Case. We report a case of a 22-year-old female who presented with multiple pelvic cysts and diffuse ascites due to Chlamydia trachomatis infection. The initial gynecologic exam did not reveal obvious evidence of PID; however, a positive Chlamydia trachomatis test, pathologic findings, and the exclusion of other etiologies facilitated the diagnosis. Conclusion. Chlamydia trachomatis and other infectious agents should be considered in the differential diagnosis of a young sexually active female with abdominal pain, ascites, and pelvic cystic masses. Thorough workup in such a population may reduce the number of more invasive procedures as well as unnecessary repeat surgical procedures. PMID:27747116

  5. Advances in diffuse malignant peritoneal mesothelioma

    Directory of Open Access Journals (Sweden)

    Tristan D. Yan

    2011-12-01

    Full Text Available 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. A 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 median survival of 40 to 90 months and 5-year survival of 30% to 60% after the combined treatment using cytoreductive surgery and perioperative intraperitoneal chemotherapy. This improvement in survival has prompted new searches 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.

  6. Manufacturing and automation

    Directory of Open Access Journals (Sweden)

    Ernesto Córdoba Nieto

    2010-04-01

    Full Text Available The article presents concepts and definitions from different sources concerning automation. The work approaches automation by virtue of the author’s experience in manufacturing production; why and how automation prolects are embarked upon is considered. Technological reflection regarding the progressive advances or stages of automation in the production area is stressed. Coriat and Freyssenet’s thoughts about and approaches to the problem of automation and its current state are taken and examined, especially that referring to the problem’s relationship with reconciling the level of automation with the flexibility and productivity demanded by competitive, worldwide manufacturing.

  7. The effects of angiotensin-converting enzyme inhibitors on peritoneal protein loss and solute transport in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Taner Basturk

    2012-08-01

    Full Text Available OBJECTIVE: The objective of this study was to examine the effects of angiotensin-converting enzyme inhibitors on peritoneal membrane transport, peritoneal protein loss, and proteinuria in peritoneal dialysis patients. METHODS: Fifty-four peritoneal dialysis patients were included in the study. The patients were divided into two groups. Group 1 (n = 34 was treated with angiotensin-converting enzyme inhibitors. Group 2 (n = 20 did not receive any antihypertensive drugs during the entire follow-up. Eleven patients were excluded from the study thereafter. Thus, a total of 30 patients in Group 1 and 13 patients in Group 2 completed the study. We observed the patients for six months. Group 1 patients received maximal doses of angiotensin-converting enzyme inhibitors for six months. Parameters at the beginning of study and at the end of six months were evaluated. RESULTS: At the end of six months, total peritoneal protein loss in 24-hour dialysate effluent was significantly decreased in Group 1, whereas it was increased in Group 2. Compared to the baseline level, peritoneal albumin loss in 24-hour dialysate effluent and 4-hour D/P creatinine were significantly increased in Group 2 but were not significantly changed in Group 1. A covariance analysis between the groups revealed a significant difference only in the decreased amount of total protein loss in 24-hour dialysate. Proteinuria was decreased significantly in Group 1. CONCLUSION: This study suggests that angiotensin-converting enzyme inhibitors reduce peritoneal protein loss and small-solute transport and effectively protect peritoneal membrane transport in peritoneal dialysis patients.

  8. Level of 8-OHdG in drained dialysate appears to be a marker of peritoneal damage in peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Morishita Y

    2011-12-01

    Full Text Available Yoshiyuki Morishita, Minami Watanabe, Ichiro Hirahara, Tetsu Akimoto, Shigeaki Muto, Eiji KusanoDivision of Nephrology, Department of Medicine, Jichi Medical University, Tochigi, JapanPurpose: Peritoneal dialysis (PD is a successful renal replacement therapy; however, long-term PD leads to structural and functional peritoneal damage. Therefore, the monitoring and estimation of peritoneal function are important in PD patients. Oxidative stress has been implicated as one possible mechanism of peritoneal membrane damage. The aim of this study was to evaluate the association between an oxidative stress marker, 8-hydroxydeoxyguanosine (8-OHdG, and peritoneal damage in PD patients.Methods: The authors evaluated 8-OHdG in drained dialysate by enzyme immunoassay to investigate the association between 8-OHdG and solute transport rate estimated by peritoneal equilibration test and matrix metalloproteinase-2 (MMP-2 level in 45 samples from 28 PD patients.Results: The 8-OHdG level was significantly correlated with dialysate:plasma creatine ratio (r = 0.463, P < 0.05 and significantly inversely correlated with D/D0 glucose (where D is the glucose level of peritoneal effluents obtained 4 hours after the injection and D0 is the glucose level obtained immediately after the injection (r = -0.474, P < 0.05. The 8-OHdG level was also significantly correlated with MMP-2 level (r = 0.551, P < 0.05, but it was not correlated with the age of subjects, the duration of PD, or blood pressure.Conclusion: The level of 8-OHdG in drained dialysate may be a useful novel marker of peritoneal damage in PD.Keywords: oxidative stress, solute transport rate, MMP-2, peritoneal equilibration test

  9. Tuberculous peritonitis in the first trimester of pregnancy

    Science.gov (United States)

    Jung, Sukyung; Yun, Nae Ri; Kim, Jeong Ok; Lee, Jeong Hoon; Kim, Ho Yeon; Song, Eunseop; Lee, Byoung Ick; Hwang, Sung Ook

    2017-01-01

    Tuberculous peritonitis in pregnancy is a rare form of extrapulmonary tuberculosis that is not easily diagnosed. The clinical presentations of tuberculous peritonitis are usually non-specific and mimic those of other diseases, such as ovarian malignancy or chronic liver disease, and this non-specificity can cause diagnostic delays and complications. The authors report the case of a 31-year-old primigravida woman who presented with uncontrolled fever, dyspnea, elevated liver enzymes, and mild abdominal distension at 13+2 weeks of gestation. At 14+2 weeks, a therapeutic abortion was conducted and tuberculous peritonitis was confirmed by laparoscopic excisional biopsy of peritoneal nodules and histopathologic examination. The patient recovered on antituberculosis therapy and abdomen and chest follow up radiographic findings have confirmed improvement. PMID:28344965

  10. Increasing fill volume reduces cardiac performance in peritoneal dialysis

    DEFF Research Database (Denmark)

    Ivarsen, Per; Povlsen, Johan V; Jensen, Jens Dam

    2007-01-01

    BACKGROUND: It is generally accepted that peritoneal dialysis (PD) affects systemic haemodynamics less than haemodialysis, but little is known about changes in haemodynamics during PD. It is unknown if increasing PD volume causes changes in cardiovascular haemodynamics possibly increasing...

  11. Complications of planned relaparotomy in patients with severe general peritonitis

    NARCIS (Netherlands)

    van Goor, Harry; Hulsebos, RG; Bleichrodt, RP

    1997-01-01

    Objective: To analyse the complications of planned relaparotomy for severe general peritonitis and to define when to discontinue relaparotomies. Design: Retrospective study. Setting: University hospital, The Netherlands. Subjects: 24 consecutive patients who underwent planned relaparotomy for widesp

  12. Peritonitis in myeloifbrosis:a cautionar y tale

    Institute of Scientific and Technical Information of China (English)

    Narasimhaiah Srinivasaiah; Mohammad K Zia; Vummiti Muralikrishnan

    2010-01-01

    BACKGROUND: Primary myeloifbrosis (PMF) is a myelopro-liferative disorder characterized by bone marrow ifbrosis. Extra-medullary hematopoiesis sometimes occurs even in the peritoneal cavity, apart from organs such as the liver, spleen, and lymph nodes. This may sometimes be complicated by spontaneous infection and complications. We report a rather unusual case of PMF, who presented as an emergency with spontaneous peritonitis to general surgery department and had a fulminant clinical course. METHOD: A clinical case note review was done and a literature search was undertaken. RESULTS: A rather unusual case of PMF, who presented as an emergency with spontaneous peritonitis to general surgery department. The patient underwent a laparotomy and had a fulminant clinical course. CONCLUSIONS: Peritonitis in myeloifbrosis may have a number of causes. Clinicians need to be aware of them and provide conservative management prior to surgical treatment.

  13. Peritoneal and genital coccidioidomycosis in an otherwise healthy Danish female

    DEFF Research Database (Denmark)

    Bæk, Ole; Astvad, Karen; Serizawa, Reza

    2017-01-01

    pain. Computed tomography scan and ultrasound examination of the pelvis raised suspicion of salpingitis. A laparoscopy exposed a necrotic salpinx and several small white elements that resembled peritoneal carcinomatosis. Histological workup however determined that she suffered from disseminated...

  14. Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention

    Science.gov (United States)

    ... and primary peritoneal cancer: Oral contraceptives Taking oral contraceptives (“the pill”) lowers the risk of ovarian cancer. The longer oral contraceptives are used, the lower the risk may be. ...

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

    Science.gov (United States)

    ... and primary peritoneal cancer: Oral contraceptives Taking oral contraceptives (“the pill”) lowers the risk of ovarian cancer. The longer oral contraceptives are used, the lower the risk may be. ...

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

    Directory of Open Access Journals (Sweden)

    Timothy Bowen

    2015-01-01

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

  17. Peritonite por bário Barium peritonitis

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior

    1999-10-01

    Full Text Available We report a case of a 49 years-old man who underwent a barium meal examination for an epigastric pain. A perforated gastric ulcer with barium extravasation into peritoneal cavity was seen on X-rays. During an emergency laparotomy, a perforated pyloric ulcer was noted, along with barium contamination in the peritoneal cavity. The ulcer was closed with an omental patch and an extensive peritoneal lavage with saline was performed. During the postoperative period, the patient developed signs of peritonitis and underwent a new laparotomy was at the 9th day showing a subfrenic abscess with a large barium contamination. The patient presented septic shock and multiple organ failure. dying on the 21th day.

  18. Laparoscopic Lavage for Perforated Diverticulitis With Purulent Peritonitis

    DEFF Research Database (Denmark)

    Thornell, Anders; Angenete, Eva; Bisgaard, Thue

    2016-01-01

    BACKGROUND: Perforated diverticulitis with purulent peritonitis has traditionally been treated with open colon resection and stoma formation with risk for reoperations, morbidity, and mortality. Laparoscopic lavage alone has been suggested as definitive treatment. OBJECTIVE: To compare laparoscopic...

  19. Inhibiting effect of short hairpin RNA on expression of transforming growth factor-β1 in human peritoneal mesothelial cells induced by peritoneal dialysis solution

    Institute of Scientific and Technical Information of China (English)

    LIU Fu-you; LING Guang-hui; LIU Hong; PENG You-ming; LIU Ying-hong; DUAN Shao-bin

    2005-01-01

    @@ The peritoneum response to peritoneal dialysis can lead to fibrosis. The transforming growth factor-β1 (TGF-β1) plays an important role in regulating tissue repair and remodeling after injury. Excessive synthesis and deposition of matrix proteins by peritoneal mesothelial cells can lead to structural and functional changes in the peritoneal membrane, jeopardizing the long-term efficacy of peritoneal dialysis (PD).

  20. An automated swimming respirometer

    DEFF Research Database (Denmark)

    STEFFENSEN, JF; JOHANSEN, K; BUSHNELL, PG

    1984-01-01

    An automated respirometer is described that can be used for computerized respirometry of trout and sharks.......An automated respirometer is described that can be used for computerized respirometry of trout and sharks....

  1. Configuration Management Automation (CMA) -

    Data.gov (United States)

    Department of Transportation — Configuration Management Automation (CMA) will provide an automated, integrated enterprise solution to support CM of FAA NAS and Non-NAS assets and investments. CMA...

  2. Autonomy and Automation

    Science.gov (United States)

    Shively, Jay

    2017-01-01

    A significant level of debate and confusion has surrounded the meaning of the terms autonomy and automation. Automation is a multi-dimensional concept, and we propose that Remotely Piloted Aircraft Systems (RPAS) automation should be described with reference to the specific system and task that has been automated, the context in which the automation functions, and other relevant dimensions. In this paper, we present definitions of automation, pilot in the loop, pilot on the loop and pilot out of the loop. We further propose that in future, the International Civil Aviation Organization (ICAO) RPAS Panel avoids the use of the terms autonomy and autonomous when referring to automated systems on board RPA. Work Group 7 proposes to develop, in consultation with other workgroups, a taxonomy of Levels of Automation for RPAS.

  3. Transperitoneal transport of sodium during hypertonic peritoneal dialysis

    DEFF Research Database (Denmark)

    Graff, J; Fugleberg, S; Brahm, J

    1996-01-01

    The mechanisms of transperitoneal sodium transport during hypertonic peritoneal dialysis were evaluated by kinetic modelling. A total of six nested mathematical models were designed to elucidate the presence or absence of diffusive, non-lymphatic convective and lymphatic convective solute transport....... Experimental results were obtained from 26 non-diabetic patients undergoing peritoneal dialysis. The model validation procedure demonstrated that only diffusive and non-lymphatic convective transport mechanisms were identifiable in the transperitoneal transport of sodium. Non-lymphatic convective sodium...

  4. Treatment of ascites and spontaneous bacterial peritonitis - Part I

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Grønbæk, Henning; Aagaard, Niels Kristian

    2012-01-01

    National guidelines for treatment of ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and hyponatremia have been approved by the Danish Society of Gastroenterology and Hepatology. Ascites develops in approximately 60% of patients with cirrhosis during a 10 year period and is freq......National guidelines for treatment of ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and hyponatremia have been approved by the Danish Society of Gastroenterology and Hepatology. Ascites develops in approximately 60% of patients with cirrhosis during a 10 year period...

  5. Behandling af peritoneal karcinose med laparoskopisk intraperitoneal kemoterapi under tryk

    DEFF Research Database (Denmark)

    Graversen, Martin; Pfeiffer, Per; Mortensen, Michael Bau

    2016-01-01

    Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new treatment option in patients with peritoneal carcinomatosis (PC). PIPAC has proven efficacious in the treatment of PC from ovarian, colon and gastric cancer. PIPAC has a favourable profile regarding safety for patients and occupati......Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new treatment option in patients with peritoneal carcinomatosis (PC). PIPAC has proven efficacious in the treatment of PC from ovarian, colon and gastric cancer. PIPAC has a favourable profile regarding safety for patients...

  6. Efficacy of peritoneal dialysis in severe thiazide-induced hyponatraemia

    OpenAIRE

    1981-01-01

    A patient with severe thiazide-induced hyponatraemia (plasma sodium 99 mmol/l) is described, who had signs suggestive of cerebral oedema. Co-existent problems of cardiac and respiratory insufficiency were thought to make treatment with hypertonic saline hazardous. A 40-hr peritoneal dialysis successfully reversed both hyponatraemia and the associated cerebral signs, plasma sodium increasing at a rate of 0·83 mmol/hr. Peritoneal dialysis appears to be a safe and efficacious method of treating ...

  7. Biliary peritonitis following percutaneous nephrolithotomy: Minimally invasive management

    OpenAIRE

    Yadav, Siddharth; Singh, Animesh; Singh, Prabhjot

    2015-01-01

    Percutaneous nephrolithotomy (PCNL) is a standard procedure for large renal calculi but has potential for complications. Rarely, biliary tract injury can occur during PCNL that can lead to biliary peritonitis with sepsis. Such cases are usually managed by emergent cholecystectomy. We present a case of biliary peritonitis resulting from gall bladder injury during PCNL, managed minimally invasively with an abdominal drain and endoscopic retrograde cholangiography with common bile duct stenting.

  8. Biliary peritonitis following percutaneous nephrolithotomy: Minimally invasive management.

    Science.gov (United States)

    Yadav, Siddharth; Singh, Animesh; Singh, Prabhjot

    2015-01-01

    Percutaneous nephrolithotomy (PCNL) is a standard procedure for large renal calculi but has potential for complications. Rarely, biliary tract injury can occur during PCNL that can lead to biliary peritonitis with sepsis. Such cases are usually managed by emergent cholecystectomy. We present a case of biliary peritonitis resulting from gall bladder injury during PCNL, managed minimally invasively with an abdominal drain and endoscopic retrograde cholangiography with common bile duct stenting.

  9. The management of anemia in pediatric peritoneal dialysis patients

    OpenAIRE

    Schröder, Cornelis H.; ,

    2003-01-01

    Anemia is common in chronic renal failure. Guidelines for the diagnosis and treatment of anemia in adult patients are available. With respect to the diagnosis and treatment in children on peritoneal dialysis, the European Pediatric Peritoneal Dialysis Working Group (EPPWG) has produced guidelines. After a thorough diagnostic work-up, treatment should aim for a target hemoglobin concentration of at least 11 g/l. This can be accomplished by the administration of erythropoietin and iron preparat...

  10. Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience

    Directory of Open Access Journals (Sweden)

    Ur-Rahman Shafiq

    2008-11-01

    Full Text Available Abstract Background Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome. Methods A prospective study includes three hundred consecutive patients of perforation peritonitis studied in terms of clinical presentations, Causes, site of perforation, surgical treatment, post operative complications and mortality, at (DUHS&CHK Pakistan, from 1st September 2005 – 1st March 2008, over a period of two and half years. All patients were resuscitated underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. Results The most common cause of perforation peritonitis noticed in our series was acid peptic disease 45%, perforated duodenal ulcer (43.6% and gastric ulcer 1.3%. followed by small bowel tuberculosis (21% and typhoid (17%. large bowel perforation due to tuberculosis 5%, malignancy 2.6% and volvulus 0.3%. Perforation due to acute appendicitis (5%. Highest number of perforations has seen in the duodenum 43.6%, ileum37.6%, and colon 8%, appendix 5%, jejunum 3.3%, and stomach 2.3%. Overall mortality was (10.6%. Conclusion The spectrum of perforation peritonitis in Pakistan continuously differs from western country. Highest number of perforations noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. Most common cause of perforation peritonitis is perforated duodenal ulcer, followed by small bowel tuberculosis and typhoid perforation. Majority of the large bowel perforations are also tubercular

  11. Apoptosis and T cell depletion during feline infectious peritonitis

    OpenAIRE

    Horzinek, M.C.; Haagmans, B. L.; Egberink, H F

    1996-01-01

    Cats that have succumbed to feline infectious peritonitis, an immune- mediated disease caused by variants of feline coronaviruses, show apoptosis and T-cell depletion in their lymphoid organs. The ascitic fluid that develops in the course of the condition causes apoptosis in vitro but only in activated T cells. Since feline infectious peritonitis virus does not infect T cells, and viral proteins did not inhibit T-cell proliferation, we postulate that soluble mediators released during the infe...

  12. (1→3)-β-D-glucan and galactomannan testing for the diagnosis of fungal peritonitis in peritoneal dialysis patients, a pilot study.

    Science.gov (United States)

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

    2015-05-01

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

  13. PERITONEAL DIALYSIS AFTER REPAIR OF CONGENITAL HEART DISEASE IN CHILDREN

    Institute of Scientific and Technical Information of China (English)

    罗新锦; 许建屏; 沈向东; 陈霞

    2003-01-01

    Objective. To investigate the effect of peritoneal dialysis on fluid balance and outcome in childrenwho receive cardiac operation.Methods. From July to Dec. 2000, 12(2.08%) patients of 576 consecutive children who underwentheart operation required peritoneal dialysis because of acute renal failure. The mean age of these 12 pa-tients was (2.9±2.0) years (range, 5 months~7 years) and the mean body weight was (12±3) kg (range,7.4~18.5 kg ).Results. The interval between the operation and the initiation of peritoneal dialysis was (21.2±11.4)hours (4.4~42 hours). The duration of peritoneal dialysis was (6.3±4.8) days (0.47~15 days). Mortality inthese 12 patients was 25%. Fluid removed by peritoneal dialysis was(34.7±17.8) ml@kg1@day-1@ Asymop-tomatic hypokalemia, thrombocytopenia and hyperglycemia were frequent complications, which were easilymanaged. Hemodynamics and pulmonary function improved during the study period.Conclusion. The early initiation of peritoneal dialysis is an effective and safe method totreat acute renal failure after cardiac operation in children.

  14. Workflow automation architecture standard

    Energy Technology Data Exchange (ETDEWEB)

    Moshofsky, R.P.; Rohen, W.T. [Boeing Computer Services Co., Richland, WA (United States)

    1994-11-14

    This document presents an architectural standard for application of workflow automation technology. The standard includes a functional architecture, process for developing an automated workflow system for a work group, functional and collateral specifications for workflow automation, and results of a proof of concept prototype.

  15. Ileum and colon perforation following peritoneal dialysis-related peritonitis and high-dose calcium polystyrene sulfonate.

    Science.gov (United States)

    Kao, Chih-Chin; Tsai, Yi-Chiun; Chiang, Wen-Chih; Mao, Tsui-Lien; Kao, Tze-Wah

    2015-10-01

    A rare but severe complication, intestinal necrosis, has been reported after sodium polystyrene sulfonate (SPS; Kayexalate) and sorbitol intake. Some case reports described bowel perforation following calcium polystyrene sulfonate (CPS; Kalimate) administration. We report a case of ileum and colon perforation following peritoneal dialysis-related peritonitis and high-dose Kalimate in a 59-year-old female patient. The patient had a history of hypertension, diabetes mellitus, and end-stage renal disease (ESRD). During hospitalization for peritoneal dialysis-related peritonitis, she developed hyperkalemia, and Kalimate was administered orally. However, severe abdominal distension and pain occurred just one day after Kalimate intake. An urgent surgery disclosed several perforations in the ileum and sigmoid colon. Pathology of the resected gut showed transmural necrosis and perforation with basophilic angulated crystals. The patient finally expired during hospitalization due to refractory septic shock.

  16. Automations influence on nuclear power plants: a look at three accidents and how automation played a role.

    Science.gov (United States)

    Schmitt, Kara

    2012-01-01

    Nuclear power is one of the ways that we can design an efficient sustainable future. Automation is the primary system used to assist operators in the task of monitoring and controlling nuclear power plants (NPP). Automation performs tasks such as assessing the status of the plant's operations as well as making real time life critical situational specific decisions. While the advantages and disadvantages of automation are well studied in variety of domains, accidents remind us that there is still vulnerability to unknown variables. This paper will look at the effects of automation within three NPP accidents and incidents and will consider why automation failed in preventing these accidents from occurring. It will also review the accidents at the Three Mile Island, Chernobyl, and Fukushima Daiichi NPP's in order to determine where better use of automation could have resulted in a more desirable outcome.

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

    Institute of Scientific and Technical Information of China (English)

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

    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 failure,but not for mortality in

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

    Directory of Open Access Journals (Sweden)

    Ji-Chao Guan

    2015-01-01

    Full Text Available 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

  19. Automated Car Park Management System

    Science.gov (United States)

    Fabros, J. P.; Tabañag, D.; Espra, A.; Gerasta, O. J.

    2015-06-01

    This study aims to develop a prototype for an Automated Car Park Management System that will increase the quality of service of parking lots through the integration of a smart system that assists motorist in finding vacant parking lot. The research was based on implementing an operating system and a monitoring system for parking system without the use of manpower. This will include Parking Guidance and Information System concept which will efficiently assist motorists and ensures the safety of the vehicles and the valuables inside the vehicle. For monitoring, Optical Character Recognition was employed to monitor and put into list all the cars entering the parking area. All parking events in this system are visible via MATLAB GUI which contain time-in, time-out, time consumed information and also the lot number where the car parks. To put into reality, this system has a payment method, and it comes via a coin slot operation to control the exit gate. The Automated Car Park Management System was successfully built by utilizing microcontrollers specifically one PIC18f4550 and two PIC16F84s and one PIC16F628A.

  20. Automation in Clinical Microbiology

    Science.gov (United States)

    Ledeboer, Nathan A.

    2013-01-01

    Historically, the trend toward automation in clinical pathology laboratories has largely bypassed the clinical microbiology laboratory. In this article, we review the historical impediments to automation in the microbiology laboratory and offer insight into the reasons why we believe that we are on the cusp of a dramatic change that will sweep a wave of automation into clinical microbiology laboratories. We review the currently available specimen-processing instruments as well as the total laboratory automation solutions. Lastly, we outline the types of studies that will need to be performed to fully assess the benefits of automation in microbiology laboratories. PMID:23515547

  1. SPECTRUM OF SECONDARY PERITONITIS IN NORTH COASTAL ANDHRA PRADESH, INDIA

    Directory of Open Access Journals (Sweden)

    Janardhana Rao Konkena

    2016-08-01

    Full Text Available BACKGROUND Secondary peritonitis due to perforation of Gastrointestinal Tract (GIT is one of the most common surgical emergencies worldwide. The spectrum of aetiology of secondary peritonitis in tropical countries differs from western countries. This study was conducted in King George Hospital, Visakhapatnam, in the state of Andhra Pradesh, India. The purpose of this study is to highlight the salient causes of secondary peritonitis and its outcome. METHODS A retrospective analysis of 603 patients of secondary peritonitis was done from January 2013 to December 2015 at King George Hospital, Visakhapatnam, Andhra Pradesh, India. All cases which were found to have peritonitis as a result of perforation of any part of GIT at the time of surgery were included in the study. All cases with either primary peritonitis or that due to anastomotic dehiscence were excluded. RESULTS A total of 603 patients were studied. Among them, 493 (81.7% were males and 110 (18.3% were females. Most common cause of secondary peritonitis in our study was acid peptic disease(52.40% followed by appendicular pathology(11.2%, gastrointestinal perforation due to injury of abdomen (9.62%, small bowel perforation due to typhoid aetiology (7.63%, gangrenous bowel (6.30%, ruptured liver abscess (2.98%, biliary peritonitis (1.99% and some miscellaneous rare causes. Overall, mortality in this study was found to be 8.95%. CONCLUSION The spectrum of secondary peritonitis in North Coastal Andhra Pradesh differs from other areas in India and western countries. Highest incidence of secondary peritonitis is due to perforation noted in gastroduodenal region, which is in contrast to western hemisphere where the predominant cause is lower gastrointestinal tract. Considering the relatively higher rate of gastroduodenal perforation quoted in this study, it is vital that awareness about the role of Helicobacter pylori ought to be considered. Special focus must also be made to increase awareness

  2. Assisted Living Facilities, ElderCareFacilities-Elder care facilities in the State of Utah, Published in 2005, 1:24000 (1in=2000ft) scale, State of Utah Automated Geographic Reference Center.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Other information as of 2005. It is described as...

  3. Satisfaction with care in peritoneal dialysis patients.

    Science.gov (United States)

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

    2006-10-01

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

  4. Tackling feline infectious peritonitis via reverse genetics.

    Science.gov (United States)

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

    2014-01-01

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

  5. Treatment of cats with feline infectious peritonitis.

    Science.gov (United States)

    Hartmann, Katrin; Ritz, Susanne

    2008-05-15

    Feline infectious peritonitis (FIP) infection resulting in clinical signs is invariably fatal despite clinical intervention. As FIP is an immune-mediated disease, treatment is mainly aimed at controlling the immune response triggered by the infection with the feline coronavirus (FCoV). Immune suppressive drugs such as prednisone or cyclophosphamide may slow disease progression but do not produce a cure. In nearly every published case report of attempted therapy for clinical FIP, glucocorticoids have been used; there are, however, no controlled studies that evaluate the effect of glucocorticoids as a therapy for FIP. Some veterinarians prescribe immune modulators to treat cats with FIP with no documented controlled evidence of efficacy. It has been suggested that these agents may benefit infected animals by restoring compromised immune function, thereby allowing the patient to control viral burden and recover from clinical signs. However, a non-specific stimulation of the immune system may be contraindicated as clinical signs develop and progress as a result of an immune-mediated response to the mutated FCoV.

  6. Feline infectious peritonitis: still an enigma?

    Science.gov (United States)

    Kipar, A; Meli, M L

    2014-03-01

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

  7. Genotyping coronaviruses associated with feline infectious peritonitis.

    Science.gov (United States)

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

    2015-06-01

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

  8. Preditores de peritonite em pacientes em um programa de diálise peritoneal Predictor factors of peritoneal dialysis-related peritonitis

    Directory of Open Access Journals (Sweden)

    João Victor Duarte Lobo

    2010-06-01

    Full Text Available INTRODUÇÃO: Peritonite é a principal complicação relacionada com a diálise peritoneal (DP. OBJETIVO: Avaliar possíveis preditores para o seu desenvolvimento em pacientes em programa crônico na modalidade. MÉTODO: Realizou-se estudo de coorte retrospectivo em 330 pacientes (média de idade 53 ± 19 anos em programa de DP na Clínica de Nefrologia de Sergipe (Clinese, em Aracaju/ SE, Brasil, entre 1.º de janeiro de 2003 e 31 de dezembro de 2007. Variáveis sociodemográficas e clínicas foram avaliadas comparativamente entre pacientes que apresentaram (141% - 42,7% ou não (189% - 57,3% peritonite. Na análise estatística, utilizaramse teste t de Student, qui-quadrado e modelo de regressão com múltiplas variáveis. RESULTADOS : Ocorreu um episódio de peritoniteacada28,4pacientes/mês(0,42episódio/ paciente/ano. O Staphylococcus aureus foi o agente etiológico mais frequente (27,8%. Não se utilizava antibioticoterapia profilática e 136 pacientes (41,2% haviam apresentado previamente infecção de sítio de saída do cateter peritoneal (ISSCP. Identificou-se maior risco de peritonite nos pacientes com albuminemia INTRODUCTION: Peritonitis remains a major complication of peritoneal dialysis (PD. OBJECTIVE: Evaluate peritonitis incidence, etiology and outcome in cronic PD patients. METHODS: A retrospective cohort study was carried out on 330 patients (mean age of 53 ± 19 years who had been treated by PD in a dialysis center in Aracaju/SE, Brazil between January 1st, 2003 and December 31th, 2007. Data of patients with and without peritonitis were compared using Student's ttest, chi-squared statistic and multiple logistic regression. RESULTS: There were 213 peritonitis among 141 patients (1.51 episode/patient resulting in a rate of 28.44 patient/episode/ month (0.42 patient/episode/year. Staphylococcus aureus was the most frequent micro-organism isolated (27.8%, followed by Escherichia coli (13.4% and 32.5% were culture

  9. Surgical Assisting

    Science.gov (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  10. Automated DNA Sequencing System

    Energy Technology Data Exchange (ETDEWEB)

    Armstrong, G.A.; Ekkebus, C.P.; Hauser, L.J.; Kress, R.L.; Mural, R.J.

    1999-04-25

    Oak Ridge National Laboratory (ORNL) is developing a core DNA sequencing facility to support biological research endeavors at ORNL and to conduct basic sequencing automation research. This facility is novel because its development is based on existing standard biology laboratory equipment; thus, the development process is of interest to the many small laboratories trying to use automation to control costs and increase throughput. Before automation, biology Laboratory personnel purified DNA, completed cycle sequencing, and prepared 96-well sample plates with commercially available hardware designed specifically for each step in the process. Following purification and thermal cycling, an automated sequencing machine was used for the sequencing. A technician handled all movement of the 96-well sample plates between machines. To automate the process, ORNL is adding a CRS Robotics A- 465 arm, ABI 377 sequencing machine, automated centrifuge, automated refrigerator, and possibly an automated SpeedVac. The entire system will be integrated with one central controller that will direct each machine and the robot. The goal of this system is to completely automate the sequencing procedure from bacterial cell samples through ready-to-be-sequenced DNA and ultimately to completed sequence. The system will be flexible and will accommodate different chemistries than existing automated sequencing lines. The system will be expanded in the future to include colony picking and/or actual sequencing. This discrete event, DNA sequencing system will demonstrate that smaller sequencing labs can achieve cost-effective the laboratory grow.

  11. CD90+ mesothelial-like cells in peritoneal fluid promote peritoneal metastasis by forming a tumor permissive microenvironment.

    Directory of Open Access Journals (Sweden)

    Joji Kitayama

    Full Text Available The peritoneal cavity is a common target of metastatic gastrointestinal and ovarian cancer cells, but the mechanisms leading to peritoneal metastasis have not been fully elucidated. In this study, we examined the roles of cells in peritoneal fluids on the development of peritoneal metastasis. We found that a minor subset of human intraperitoneal cells with CD90(+/CD45(- phenotype vigorously grew in culture with mesothelial-like appearance. The mesothelial-like cells (MLC displayed the characteristics of mesenchymal stem cell, such as differentiating into adipocytes, osteocytes, and chondrocytes, and suppressing T cell proliferation. These cells highly expressed type I collagen, vimentin, α-smooth muscle actin and fibroblast activated protein-α by the stimulation with TGF-β, which is characteristic of activated myofibroblasts. Intraperitoneal co-injection of MLCs with the human gastric cancer cell line, MKN45, significantly enhanced the rate of metastatic formation in the peritoneum of nude mice. Histological examination revealed that many MLCs were engrafted in metastatic nodules and were mainly located at the fibrous area. Dasatinib, a potent tyrosine kinase inhibitor, strongly inhibited the proliferation of MLCs but not MKN45 in vitro. Nevertheless, oral administration of Dasatinib significantly inhibited the development of peritoneal metastasis of MKN45, and resulted in reduced fibrillar formation of metastatic nodules. These results suggest floating MLCs in the peritoneal fluids support the development of peritoneal metastasis possibly through the production of the permissive microenvironment, and thus the functional blockade of MLCs is a reasonable strategy to treat recurrent abdominal malignancies.

  12. Malignant Peritoneal Mesothelioma: Clinicopathological Characteristics of Two Cases

    Directory of Open Access Journals (Sweden)

    Mustafa Cem Algın

    2014-01-01

    Full Text Available Introduction. Peritoneal mesothelioma is a rare tumor, presenting difficulties in diagnosis and treatment. Peritoneum is the second most common area of the mesothelioma after pleura, and even synchronous pleural and peritoneal mesotheliomas are observed in 30–45% of all cases. The diagnosis may be difficult due to lack of specific symptoms and clinical findings. In addition, a delay in the diagnosis is not rare especially in the absence of previous asbestos exposure. Here we report two cases of malignant peritoneal mesotheliomas. The diagnostic and therapeutic approaches for these rare neoplasms are discussed. Case Presentation. The cases were two men (one aged 54 years old and the other 40 years old. Prolonged abdominal pain and swelling were the primary presentation symptoms and findings. The mesotheliomas were developed in the right upper quadrant of abdomen in both of the cases. Both cases were treated with surgical resection. Final diagnosis were possible with histological and immunohistochemical documentation of tumor characteristics, which were consistent with dictating a mesothelial origin. No history of asbestos exposure was reported. Conclusion. Peritoneal mesotheliomas are rare clinical entities. However, patients with prolonged abdominal pain and abdominal masses should be considered to have atypical pathologies such as peritoneal mesotheliomas.

  13. The features of peritoneal metastases from gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Gianni Mura; Beatrice Verdelli

    2016-01-01

    Peritoneal Carcinomatosis (PC) from metastasization of Gastric Cancer (GC), either present at ifrst diagnosis of GC or as recurrence, is considered a fatal disease with no hope of deifnitive cure. Although newer agents like S1 and docetaxel have shown some promise, the median overall survival with the current ifrst line chemotherapy is only 8 to 14 months, and is not greatly improved by adding targeted therapy. A multi-modal approach with cytoreductive surgery (CRS) associated with hyperthermic intraperitoneal chemotherapy (HIPEC) has been developed along the last two decades in order to tackle this problem. It’s an aggressive, combined treatment still under investigation. Studies coming from Europe and Far East reported long-term survival with 5-year survival rates up to nearly 25% in case of complete cytoreduction. Prophylactic/adjuvant setting is the most evidence-based indication for HIPEC in advanced-stage GC patients without PC, in order to prevent peritoneal recurrence and to improve overall survival. The rationale for immuno treatment in patients with gastric PC is strong. A randomized phase II study, combining complete CRS with intraperitoneal catumaxomab is on-going. The detection of free peritoneal cancer cells is the more realistic and practical way for the identiifcation of patients at risk of carcinomatosis after surgery. The routine use of techniques of molecular detection in peritoneal washing appears to be the more sensitive method. Such patients are potential candidate for multimodal and locoregional treatments in order to prevent the peritoneal recurrence.

  14. Independent prognostic value of peritoneal immunocytodiagnosis in endometrial carcinoma.

    Science.gov (United States)

    Benevolo, M; Mariani, L; Vocaturo, G; Vasselli, S; Natali, P G; Mottolese, M

    2000-02-01

    Among the clinical parameters that play a pivotal role in predicting the outcome of patients with endometrial carcinoma, intraperitoneal microscopic dissemination represents an important cause of recurrences. To date, peritoneal cytology has been incorporated into the current surgical staging system (International Federation of Gynecology and Obstetrics 88), although its predictive value remains a controversial issue. In this study the authors investigated the possibility of applying immunocytochemistry (ICC) to the diagnosis of peritoneal washing (PW) aimed at improving conventional cytology and verifying the prognostic value of peritoneal malignant cells. The authors analyzed 182 PWs sampled from endometrial cancer patients. The ICC analysis was performed using two monoclonal antibodies (MAbs)--AR-3 and B72.3--that in combination recognize more than 95% of endometrial carcinomas. The presence of peritoneal-free cancer cells was identified morphologically in 27 of 182 lavages (14.8%) and ICC in 50 of 182 (27.5%), with a significant improvement (p <0.0001). Five-year survival analysis, comparing results of ICC and cytodiagnosis, demonstrated a significant decrease of disease-free survival in patients with peritoneal microscopic disease. Furthermore, multivariate analysis showed that ICC diagnosis of PWs is an independent prognostic factor. Data indicate that the use of selected MAbs allows one to identify cytologically false-negative cases, providing results that are highly predictive of a worse clinical outcome.

  15. COMPUTER-ASSISTED ACCOUNTING

    Directory of Open Access Journals (Sweden)

    SORIN-CIPRIAN TEIUŞAN

    2009-01-01

    Full Text Available What is computer-assisted accounting? Where is the place and what is the role of the computer in the financial-accounting activity? What is the position and importance of the computer in the accountant’s activity? All these are questions that require scientific research in order to find the answers. The paper approaches the issue of the support granted to the accountant to organize and manage the accounting activity by the computer. Starting from the notions of accounting and computer, the concept of computer-assisted accounting is introduced, it has a general character and it refers to the accounting performed with the help of the computer or using the computer to automate the procedures performed by the person who is doing the accounting activity; this is a concept used to define the computer applications of the accounting activity. The arguments regarding the use of the computer to assist accounting targets the accounting informatization, the automating of the financial-accounting activities and the endowment with modern technology of the contemporary accounting.

  16. Iterative Decomposition of Water and Fat with Echo Asymmetric and Least—Squares Estimation (IDEAL) (Reeder et al. 2005) Automated Spine Survey Iterative Scan Technique (ASSIST) (Weiss et al. 2006)

    OpenAIRE

    Kenneth L. Weiss; Dongmei Sun; Rebecca S. Cornelius; Jane L. Weiss

    2008-01-01

    Background and Purpose: Multi-parametric MRI of the entire spine is technologist-dependent, time consuming, and often limited by inhomogeneous fat suppression. We tested a technique to provide rapid automated total spine MRI screening with improved tissue contrast through optimized fat-water separation.Methods: The entire spine was auto-imaged in two contiguous 35 cm field of view (FOV) sagittal stations, utilizing out-of-phase fast gradient echo (FGRE) and T1 and/or T2 weighted fast spin ech...

  17. Bot, Cyborg and Automated Turing Test

    Science.gov (United States)

    Yan, Jeff

    The Automated Turing test (ATT) is almost a standard security technique for addressing the threat of undesirable or malicious bot programs. In this paper, we motivate an interesting adversary model, cyborgs, which are either humans assisted by bots or bots assisted by humans. Since there is always a human behind these bots, or a human can always be available on demand, ATT fails to differentiate such cyborgs from humans. The notion of “telling humans and cyborgs apart” is novel, and it can be of practical relevance in network security. Although it is a challenging task, we have had some success in telling cyborgs and humans apart automatically.

  18. Effect of topical and systemic antibiotics on bacterial growth kinesis in generalized peritonitis in man.

    Science.gov (United States)

    Krukowski, Z H; Al-Sayer, H M; Reid, T M; Matheson, N A

    1987-04-01

    Quantitative bacteriology in peritoneal exudate was studied in 40 patients with generalized peritonitis of small intestinal, appendicular or colonic origin. Bacterial growth kinesis was measured in 28 of the patients. Systemic antibiotics given before operation resulted in a significant reduction in both the concentration and growth rate of viable bacteria in the peritoneal fluid. Lavage of the peritoneal cavity with saline resulted in a further reduction in growth rate in patients given pre-operative systemic antibiotics by an effect attributable to simple dilution. In contrast, peritoneal lavage with tetracycline (1 mg/ml) resulted in complete inhibition of bacterial growth in the residual peritoneal fluid. These observations support the policy of giving systemic antibiotics to patients with generalized peritonitis as soon as the diagnosis has been made and provide bacteriological evidence for the value of peroperative antibiotic peritoneal lavage.

  19. Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis

    DEFF Research Database (Denmark)

    Angenete, Eva; Thornell, Anders; Burcharth, Jakob

    2016-01-01

    OBJECTIVE: To evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial. BACKGROUND: Perforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection...

  20. [THE RISK FACTORS OF THE DIALYSIS PERITONITIS (THREE-YEARS PROSPECTIVE INVESTIGATION)].

    Science.gov (United States)

    Mishalov, V G; Zavodovskiy, E S; Markulan, L Yu; Goyda, S M

    2015-09-01

    The risk factors of the dialysis peritonitis occurrence were determined in patients with chronic renal disease, to whom a substitute renal therapy, using peritoneal dialysis, was conducted. The results of a three-year prospective investigation and treatment of 73 patients in Kyiv City Oleksandrivska Clinical Hospital on the base of the general surgery and nephrology departments in 2007 - 2010 yrs were studied. The dialysis peritonitis (first episode) have occurred in 42 (57.5%) patients. Cumulative rate of a dialysis peritonitis in accordance to a censored data (the dialysis peritonitis suspension or other causes) have constituted 67.7%. Due to the dialysis peritonitis occurrence the peritoneal dialysis was stopped in 14 (19.2%) patients. The obesity, raising of a serum albumin level, constipation, preliminary injection into the site of the catheter exit site we consider a risk factors for the dialysis peritonitis occurrence.

  1. FIBRINOLYTIC-ACTIVITY IN THE ABDOMINAL-CAVITY OF RATS WITH FECAL PERITONITIS

    NARCIS (Netherlands)

    van Goor, Harry; de Graaf, JS; Sluiter, WJ; van der Meer, J; Bom, VJJ; Bleichrodt, RP

    1994-01-01

    Generalized peritonitis causes a reduction in abdominal fibrinolytic activity, resulting in persistence of intraabdominal fibrin with subsequent adhesion and abscess formation. The activities of tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI) were measured in the periton

  2. Treatment Option Overview (Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer)

    Science.gov (United States)

    ... peritoneal cancer include pain or swelling in the abdomen. Ovarian, fallopian tube, or peritoneal cancer may not ... swelling, or a feeling of pressure in the abdomen or pelvis. Vaginal bleeding that is heavy or ...

  3. [Efficacy of continuous ambulatory peritoneal dialysis in treatment of children with end-stage renal insufficiency].

    Science.gov (United States)

    Sahapozova, E; Ruso, B; Kuzmanovska, D; Tasić, V; Ristoska-Bojkoviska, N

    1998-01-01

    Three children (2 girls and 1 boy) with end-stage renal failure were put in program of continuous ambulatory peritoneal dialysis in the period of 2.5 years (January 1995-September 1997). The age of the children at the treatment onset was 5-12 years. One of three children died due to cardiovascular failure after six-month treatment. Two out of three children had a total of 8 episodes of peritonitis in the period of 37 months during the treatment with peritoneal dialysis. The incidence of peritonitis occurrence in our patients was one episode in 4 patients/months. Most frequent cause for peritonitis occurrence was Staphylococcus aureus in 50% of isolated bacteria. Obtained results in peritoneal equilibration test revealed that the transport and ultrafiltration rate of peritoneal membrane decreased after recurrent peritonitis episodes.

  4. The Automated Palomar 60 Inch Telescope

    Science.gov (United States)

    Cenko, S. Bradley; Fox, Derek B.; Moon, Dae-Sik; Harrison, Fiona A.; Kulkarni, S. R.; Henning, John R.; Guzman, C. Dani; Bonati, Marco; Smith, Roger M.; Thicksten, Robert P.; Doyle, Michael W.; Petrie, Hal L.; Gal-Yam, Avishay; Soderberg, Alicia M.; Anagnostou, Nathaniel L.; Laity, Anastasia C.

    2006-10-01

    We have converted the Palomar 60 inch (1.52 m) telescope from a classic night-assistant-operated telescope to a fully robotic facility. The automated system, which has been operational since 2004 September, is designed for moderately fast (tdesign requirements, hardware and software upgrades, and lessons learned from roboticization. We present an overview of the current system performance as well as plans for future upgrades.

  5. Influence of peritoneal transfer status on fasting blood glucose in non-diabetic nephropathy patients on continuous ambulatory peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    YU Xu-fang; ZHOU Yun-fei; FENG Ling; ZHANG Dong-liang; LIU Wen-hu

    2009-01-01

    Background Extra glucose load in peritoneal dialysis is an important cause of newly-occurred diabetic mellitus, which initiates insulin treatment in some of the dialytic patients.The purpose of this study was to discuss the influence of the peritoneal transfer status on fasting blood glucose in non-diabetic nephropathy patients who are on continuous ambulatory peritoneal dialysis (CAPD).Methods One hundred and forty-five patients with total KT/V per week over 2.0 were recruited, including 60 males and 85 females. Fasting blood glucose (FBG), creatinine, blood urea nitrogen (BUN), blood albumin, blood lipid profile and blood C-reactive protein (CRP) were analyzed at the beginning of the peritoneal dialysis and after 12 months. A peritoneal equilibration test (PET) was carried out at the 3rd month of CAPD, and meantime residual renal function, peritoneal solute clearance rate, ultrafiltration volume and urine volume were also evaluated.Results Twenty-one cases were identified as a low transfer group (L), 32 cases as a low average transfer group (LA), 58 cases as a high average transfer group (HA) and 34 cases as a high transfer group (H). At the end of the 12th month, 83 cases had elevated FBG Through stepwise multiple regression analysis we found the FBG level in these patients was positively related to glucose load and CRP, and negatively related to glucose absorption in the peritoneum (D/D_0) and blood albumin (P<0.05). Kaplan-Meier analysis during a 48-month follow-up found the morbidity of hyperglycemia to be 17/34 cases (50.1%) in the high transfer group, 20/58 cases (34.5%) in the high average transfer group, 11/32 cases (34.3%) in the low average transfer group, and 1/21 cases (5.4%) in the low transfer group.Conclusions Patients with high peritoneal transfer capacity might have the highest morbidity from hyperglycemia among patients with these four different peritoneal transfer status. Glucose load, baseline CRP and FBG level before peritoneal dialysis, and

  6. Peritoneal dialysis-related peritonitis due to Staphylococcus aureus: a single-center experience over 15 years.

    Directory of Open Access Journals (Sweden)

    Pasqual Barretti

    Full Text Available Peritonitis caused by Staphylococcus aureus is a serious complication of peritoneal dialysis (PD, which is associated with poor outcome and high PD failure rates. We reviewed the records of 62 S. aureus peritonitis episodes that occurred between 1996 and 2010 in the dialysis unit of a single university hospital and evaluated the host and bacterial factors influencing peritonitis outcome. Peritonitis incidence was calculated for three subsequent 5-year periods and compared using a Poisson regression model. The production of biofilm, enzymes, and toxins was evaluated. Oxacillin resistance was evaluated based on minimum inhibitory concentration and presence of the mecA gene. Logistic regression was used for the analysis of demographic, clinical, and microbiological factors influencing peritonitis outcome. Resolution and death rates were compared with 117 contemporary coagulase-negative staphylococcus (CoNS episodes. The incidence of S. aureus peritonitis declined significantly over time from 0.13 in 1996-2000 to 0.04 episodes/patient/year in 2006-2010 (p = 0.03. The oxacillin resistance rate was 11.3%. Toxin and enzyme production was expressive, except for enterotoxin D. Biofilm production was positive in 88.7% of strains. The presence of the mecA gene was associated with a higher frequency of fever and abdominal pain. The logistic regression model showed that diabetes mellitus (p = 0.009 and β-hemolysin production (p = 0.006 were independent predictors of non-resolution of infection. The probability of resolution was higher among patients aged 41 to 60 years than among those >60 years (p = 0.02. A trend to higher death rate was observed for S. aureus episodes (9.7% compared to CoNS episodes (2.5%, (p = 0.08, whereas resolution rates were similar. Despite the decline in incidence, S. aureus peritonitis remains a serious complication of PD that is associated with a high death rate. The outcome of this infection is negatively

  7. TARDIS: An Automation Framework for JPL Mission Design and Navigation

    Science.gov (United States)

    Roundhill, Ian M.; Kelly, Richard M.

    2014-01-01

    Mission Design and Navigation at the Jet Propulsion Laboratory has implemented an automation framework tool to assist in orbit determination and maneuver design analysis. This paper describes the lessons learned from previous automation tools and how they have been implemented in this tool. In addition this tool has revealed challenges in software implementation, testing, and user education. This paper describes some of these challenges and invites others to share their experiences.

  8. Critical ventriculo-peritoneal shunt failure due to peritoneal tuberculosis: Case report and diagnostic suggestions for abdominal pseudocyst

    Directory of Open Access Journals (Sweden)

    Hajime Takase

    2014-01-01

    Full Text Available Background: Tuberculous peritonitis (TBP is a well-known complication of ventriculo-peritoneal (VP shunt treatment for hydrocephalus resulting from tuberculous meningitis (TBM. However, a case of hydrocephalus unrelated to TBM resulting from VP shunt malfunction due to TBP has not been reported. Case Description: A 21-year-old male presented with nausea, abdominal pain, and headache. VP and cysto-peritoneal (CP shunts had been inserted to treat hydrocephalus due to a suprasellar arachnoid cyst, replaced the VP and removed the CP in his childhood. Computed tomography demonstrated acute hydrocephalus and an abdominal pseudocyst surrounding the distal end of the peritoneal tube. Initial laboratory data showed elevated white blood cell count and C-reactive protein level, but no causative pathogen was identified. External drainage of cerebrospinal fluid (CSF and of the fluid in the peritoneal cyst was established, and empirical antibiotic therapy was initiated. Bacterial cultures eventually revealed Mycobacterium tuberculosis infection, and TBP was diagnosed. The patient responded well to antituberculosis (anti-TB agents and insertion of a ventriculo-pleural shunt. Conclusion: This case highlights the possibility of CSF shunt failure and concomitant neurological sequelae from TB infection even when the pathogen has not invaded the central nervous system, as in TBM. Moreover, TBP is rare in developed countries and therefore may be misdiagnosed because of nonspecific clinical features and low sensitivity of common TB screening methods.

  9. Dialysate White Blood Cell Change after Initial Antibiotic Treatment Represented the Patterns of Response in Peritoneal Dialysis-Related Peritonitis

    Directory of Open Access Journals (Sweden)

    Pichaya Tantiyavarong

    2016-01-01

    Full Text Available Background. Patients with peritoneal dialysis-related peritonitis usually have different responses to initial antibiotic treatment. This study aimed to explore the patterns of response by using the changes of dialysate white blood cell count on the first five days of the initial antibiotic treatment. Materials and Methods. A retrospective cohort study was conducted. All peritoneal dialysis-related peritonitis episodes from January 2014 to December 2015 were reviewed. We categorized the patterns of antibiotic response into 3 groups: early response, delayed response, and failure group. The changes of dialysate white blood cell count for each pattern were determined by multilevel regression analysis. Results. There were 644 episodes in 455 patients: 378 (58.7% of early response, 122 (18.9% of delayed response, and 144 (22.3% of failure episodes. The patterns of early, delayed, and failure groups were represented by the average rate reduction per day of dialysate WBC of 68.4%, 34.0%, and 14.2%, respectively (p value < 0.001 for all comparisons. Conclusion. Three patterns, which were categorized by types of responses, have variable rates of WBC declining. Clinicians should focus on the delayed response and failure patterns in order to make a decision whether to continue medical therapies or to aggressively remove the peritoneal catheter.

  10. Effects of automation of information-processing functions on teamwork.

    Science.gov (United States)

    Wright, Melanie C; Kaber, David B

    2005-01-01

    We investigated the effects of automation as applied to different stages of information processing on team performance in a complex decision-making task. Forty teams of 2 individuals performed a simulated Theater Defense Task. Four automation conditions were simulated with computer assistance applied to realistic combinations of information acquisition, information analysis, and decision selection functions across two levels of task difficulty. Multiple measures of team effectiveness and team coordination were used. Results indicated different forms of automation have different effects on teamwork. Compared with a baseline condition, an increase in automation of information acquisition led to an increase in the ratio of information transferred to information requested; an increase in automation of information analysis resulted in higher team coordination ratings; and automation of decision selection led to better team effectiveness under low levels of task difficulty but at the cost of higher workload. The results support the use of early and intermediate forms of automation related to acquisition and analysis of information in the design of team tasks. Decision-making automation may provide benefits in more limited contexts. Applications of this research include the design and evaluation of automation in team environments.

  11. Laboratory Automation and Middleware.

    Science.gov (United States)

    Riben, Michael

    2015-06-01

    The practice of surgical pathology is under constant pressure to deliver the highest quality of service, reduce errors, increase throughput, and decrease turnaround time while at the same time dealing with an aging workforce, increasing financial constraints, and economic uncertainty. Although not able to implement total laboratory automation, great progress continues to be made in workstation automation in all areas of the pathology laboratory. This report highlights the benefits and challenges of pathology automation, reviews middleware and its use to facilitate automation, and reviews the progress so far in the anatomic pathology laboratory.

  12. Serous ovarian, fallopian tube and primary peritoneal cancers

    DEFF Research Database (Denmark)

    Sørensen, Rie D; Schnack, Tine H; Karlsen, Mona A

    2015-01-01

    OBJECTIVE: The aim of this systematic review is to analyze data on risk factors, epidemiology, clinicopathology and molecular biology from studies comparing primary peritoneal cancer, fallopian tube cancer and ovarian cancer of serous histology, in order to achieve a greater understanding...... of whether or not these disorders should be considered as separate entities. METHODS: A systematic literature search was conducted in PubMed and MEDLINE. Case-control studies comparing primary serous peritoneal or fallopian tube carcinomas with primary serous ovarian carcinomas or a control group were...... included. RESULTS: Twenty-eight studies were found eligible. Primary peritoneal cancer patients were older, had higher parity, were more often obese and had poorer survival compared to ovarian cancer patients. Differences in protein expression patterns of Her2/neu, estrogen and progestin receptors...

  13. Pharmacokinetics of amikacin during hemodialysis and peritoneal dialysis

    DEFF Research Database (Denmark)

    Regeur, L; Colding, H; Jensen, H

    1977-01-01

    The pharmacokinetics of amikacin were examined in six bilaterally nephrectomized patients undergoing hemodialysis and in four patients with a minimal residual renal function undergoing peritoneal dialysis. The mean elimination half-life before the dialysis was 86.5 h in the anephric patients and 44...... renal function. During hemodialysis the half-life decreased to less than 10% (5.6 h) of the pretreatment value. The effectiveness of peritoneal dialysis was less as the half-life decreased to only about 30% (17.9 h) of the pretreatment value. During the dialyses a significant correlation between...... the half-life of amikacin and the decrease in blood urea and serum creatinine was demonstrated. The pharmacokinetic data were used to make dosage regimen recommendations for the treatment of patients undergoing intermittent hemodialysis or peritoneal dialysis....

  14. Basis for selecting optimum antibiotic regimens for secondary peritonitis.

    Science.gov (United States)

    Maseda, Emilio; Gimenez, Maria-Jose; Gilsanz, Fernando; Aguilar, Lorenzo

    2016-01-01

    Adequate management of severely ill patients with secondary peritonitis requires supportive therapy of organ dysfunction, source control of infection and antimicrobial therapy. Since secondary peritonitis is polymicrobial, appropriate empiric therapy requires combination therapy in order to achieve the needed coverage for both common and more unusual organisms. This article reviews etiological agents, resistance mechanisms and their prevalence, how and when to cover them and guidelines for treatment in the literature. Local surveillances are the basis for the selection of compounds in antibiotic regimens, which should be further adapted to the increasing number of patients with risk factors for resistance (clinical setting, comorbidities, previous antibiotic treatments, previous colonization, severity…). Inadequate antimicrobial regimens are strongly associated with unfavorable outcomes. Awareness of resistance epidemiology and of clinical consequences of inadequate therapy against resistant bacteria is crucial for clinicians treating secondary peritonitis, with delicate balance between optimization of empirical therapy (improving outcomes) and antimicrobial overuse (increasing resistance emergence).

  15. Acute acalculous cholecystitis complicated with peritonitis caused by Lactobacillus plantarum.

    Science.gov (United States)

    Tena, Daniel; Martínez, Nora Mariela; Losa, Cristina; Fernández, Cristina; Medina, María José; Sáez-Nieto, Juan Antonio

    2013-08-01

    Lactobacillus spp. rarely causes human disease. We report a case of a 57-year-old man with non-insulin-dependent diabetes and vascular disease admitted to our hospital with severe abdominal pain and fever. Signs of peritonitis were found upon examination. The patient underwent surgery, and a diagnosis of perforated cholecystitis with purulent peritonitis was made intra-operatively. A cholecystectomy was performed, and therapy with imipenem was initiated. Lactobacillus plantarum was isolated from bile and peritoneal fluid cultures 2 days later. The patient recovered well and was discharged on post-operative day 16 after 14 days of treatment with imipenem. To our knowledge, this is the second case reported of acute cholecystitis caused by Lactobacillus spp. This organism should be considered as a cause of biliary infections, especially in patients with underlying diseases. Correct identification is often difficult, but it is very important because these organisms are usually resistant to vancomycin and other antibiotics.

  16. Photodynamic Detection of Peritoneal Metastases Using 5-Aminolevulinic Acid (ALA

    Directory of Open Access Journals (Sweden)

    Yutaka Yonemura

    2017-03-01

    Full Text Available In the past, peritoneal metastasis (PM was considered as a terminal stage of cancer. From the early 1990s, however, a new comprehensive treatment consisting of cytoreductive surgery and perioperative chemotherapy has been established to improve long-term survival for selected patients with PM. Among prognostic indicators after the treatment, completeness of cytoreduction is the most independent predictors of survival. However, peritoneal recurrence is a main cause of recurrence, even after complete cytoreduction. As a cause of peritoneal recurrence, small PM may be overlooked at the time of cytoreductive surgery (CRS, therefore, development of a new method to detect small PM is desired. Recently, photodynamic diagnosis (PDD was developed for detection of PM. The objectives of this review were to evaluate whether PDD using 5-aminolevulinic acid (ALA could improve detection of small PM.

  17. Spontaneous Bacterial Peritonitis Caused by Infection with Listeria monocytogenes

    Directory of Open Access Journals (Sweden)

    Michael Vincent F. Tablang

    2008-11-01

    Full Text Available Spontaneous bacterial peritonitis is a severe and life-threatening complication in patients with ascites caused by advanced liver disease. The organisms most commonly involved are coliform bacteria and third-generation cephalosporins are the empiric antibiotics of choice. This is an uncommon case of spontaneous bacterial peritonitis caused by Listeria monocytogenes in a female patient with liver cirrhosis from autoimmune hepatitis. She did not improve with ceftriaxone and her course was complicated by hepatic encephalopathy, seizures and multi-organ failure. This case emphasizes that a high index of suspicion should be maintained for timely diagnosis and treatment. Listerial peritonitis should be suspected in patients with end-stage liver disease and inadequate response to conventional antibiotics within 48–72 h. Ampicillin/sulbactam should be initiated while awaiting results of ascitic fluid or blood culture.

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

    Science.gov (United States)

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

    2002-01-01

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

  19. Association between arterial stiffness and peritoneal small solute transport rate.

    Science.gov (United States)

    Zhe, Xing-wei; Tian, Xin-kui; Chen, Wei; Guo, Li-juan; Gu, Yue; Chen, Hui-min; Tang, Li-jun; Wang, Tao

    2008-05-01

    While cardiovascular disease accounts for 40-50% of the mortality in dialysis patients, and while a high peritoneal transport in continuous ambulatory peritoneal dialysis (CAPD) is an independent predictor of outcome, it is unclear if there are any links. Aortic stiffness has become established as a cardiovascular risk factor. We thus studied pulse wave velocity (PWV) in CAPD patients to explore the possible link between peritoneal small solute transport and aortic stiffness. CAPD patients (n = 76, 27 M/49 F) in our center were included in the present study. Aortic stiffness was assessed by brachial pulse pressure (PP) and carotid-femoral PWV. Patients' peritoneal small solute transport rate was assessed by D/P(cr) at 4 h. Extracellular water over total body water (E/T ratio) was assessed by means of bioimpedance analysis. C-reactive protein was also measured. Carotid-femoral PWV was positively associated with patients' age (r = 0.555; P < 0.01), time on peritoneal dialysis (r = 0.332; P < 0.01), diabetic status (r = 0.319; P < 0.01), D/P(cr) (r = 0.241; P < 0.05), PP (r = 0.475; P < 0.01), and E/T (r = 0.606; P < 0.01). In a multivariate regression analysis, carotid-femoral PWV was independently determined by E/T (P < 0.01), PP (P < 0.01), age (P < 0.01), and D/P(cr) (P < 0.05). D/P(cr), in addition to E/T, age, and PP, was an independent predictor of elevated carotid-femoral PWV in CAPD patients, suggesting that there might be a link between high aortic stiffness and increased peritoneal small solute transport rate.

  20. Changes of serum leptin levels and the influential factors in peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    晏焕青

    2014-01-01

    Objective To investigate the changes of serum leptin levels and the influential factors in maintenance peritoneal dialysis patients.Methods Seventy-six peritoneal dialysis patients were chosen at the time before,and 3months,6 months,12 months,18 months and 24months after they began the peritoneal dialysis therapy,to examine body mass index(BMI),

  1. Intraperitoneal pseudocyst formation: complication of fungal peritonitis in continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Sahpazova, E; Ruso, B; Kuzmanovska, D

    2007-10-01

    A 14-year-old girl, with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD) the last 4 years, after an episode of Candida albicans was switched to hemodialysis. One month later she came back because of a palpable-painful abdominal mass and abdominal distention. Computed tomography (CT) and ultrasound examination demonstrated a demarkated fluid collection in the lower abdomen and pelvis. The cyst was drained percutaneously and the culture disclosed candida albicans which was treated with fluconasole. Two months later, the girl was admitted again with the same symptoms. An investigative laparotomy was undergone and the cyst was drained again. Fluid cultures were negative. CT abdomen examination six months later was negative for cyst relapse. In conclusion, intraperitoneal pseudocyst is a serious complication of CAPD. Surgical intervention may be preferable to percutaneous drainage.

  2. Intraperitoneal pseudocyst formation: Complication of fungal peritonitis in continuous ambulatory peritoneal dialysis

    Science.gov (United States)

    Sahpazova, E; Ruso, B; Kuzmanovska, D

    2007-01-01

    A 14-year-old girl, with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD) the last 4 years, after an episode of Candida albicans was switched to hemodialysis. One month later she came back because of a palpable painful abdominal mass and abdominal distention. Computed tomography (CT) and ultrasound examination demonstrated a demarkated fluid collection in the lower abdomen and pelvis. The cyst was drained percutaneously and the culture disclosed candida albicans which was treated with fluconasole. Two months later, the girl was admitted again with the same symptoms. An investigative laparotomy was undergone and the cyst was drained again. Fluid cultures were negative. CT abdomen examination six months later was negative for cyst relapse. In conclusion, intraperitoneal pseudocyst is a serious complication of CAPD. Surgical intervention may be preferable to percutaneous drainage. PMID:19582199

  3. Primary bacterial peritonitis in otherwise healthy children: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Dann, Phoebe H.; Amodio, John B.; Rivera, Rafael; Fefferman, Nancy R. [New York University School of Medicine, Department of Radiology, New York (United States)

    2005-02-01

    We report the imaging findings of two recent cases of primary bacterial peritonitis in otherwise healthy children with a clinical presentation mimicking acute appendicitis. Primary bacterial peritonitis is rare in the absence of underlying systemic disease. Although it has been described in the pediatric literature, the imaging findings have not been described in the radiological literature to the best of our knowledge. With imaging playing an increasing role in the evaluation of appendicitis in children, it is important for the radiologist to be familiar with this inflammatory process. (orig.)

  4. Rapid white blood cell detection for peritonitis diagnosis

    Science.gov (United States)

    Wu, Tsung-Feng; Mei, Zhe; Chiu, Yu-Jui; Cho, Sung Hwan; Lo, Yu-Hwa

    2013-03-01

    A point-of-care and home-care lab-on-a-chip (LoC) system that integrates a microfluidic spiral device as a concentrator with an optical-coding device as a cell enumerator is demonstrated. The LoC system enumerates white blood cells from dialysis effluent of patients receiving peritoneal dialysis. The preliminary results show that the white blood cell counts from our system agree well with the results from commercial flow cytometers. The LoC system can potentially bring significant benefits to end stage renal disease (ESRD) patients that are on peritoneal dialysis (PD).

  5. Spontaneous Fungal Peritonitis in Ascites of Cardiac Origin

    Science.gov (United States)

    Gandhi, Seema; Attar, Bashar M.

    2017-01-01

    Spontaneous fungal peritonitis (SFP) is an infrequent but severe complication most commonly described in patients with liver cirrhosis. We present the first case of culture-proven SFP occurring in cardiogenic ascites. The diagnosis of SFP was clinically challenging as the initial ascites was consistent with the more common diagnosis of spontaneous bacterial peritonitis (SBP). The patient did not respond to antibacterial therapy, however, and the final diagnosis was only made with positive ascitic cultures that grew Candida glabrata. SFP should be considered in patients with either cardiac or cirrhotic ascites and have a delayed or lack of response to traditional SBP treatment.

  6. Proteomics in extracorporeal blood purification and peritoneal dialysis.

    Science.gov (United States)

    Thongboonkerd, Visith

    2010-01-03

    Extracorporeal blood purification and peritoneal dialysis are widely used in renal replacement therapy for patients with end-stage renal disease (ESRD) and acute kidney injury (AKI). Additionally, extracorporeal blood purification can be used also for treatment of non-renal disorders to remove endogenous or exogenous toxins from the blood circulation. Efforts have been made to characterize these toxins removed by diffusion (dialysis), convection (ultrafiltration), and/or adsorption (toxins are adsorbed onto the dialysis membrane and are thus removed) using different types of dialysis membrane. This review summarizes important findings obtained from recent proteomic studies applied to extracorporeal blood purification and peritoneal dialysis in settings of ESRD, AKI and hepatic failure.

  7. Acute peritonitis as the first presentation of valvular cardiomyopathy.

    LENUS (Irish Health Repository)

    Higgins, Nikki

    2012-02-01

    Valvular cardiomyopathy can present a diagnostic challenge in the absence of overt cardiac symptoms. This report describes the case of a 46-year-old woman who presented with acute peritonitis associated with vomiting and abdominal distension. Subsequent abdominal computed tomography and ultrasound revealed bibasal pleural effusions, ascites, and normal ovaries. An echocardiogram revealed that all cardiac chambers were dilated with a global decrease in contractility and severe mitral, tricuspid, and aortic regurgitation. A diagnosis of cardiomyopathy with acute heart failure, secondary to valvular heart disease, was secured. Acute peritonitis as the presenting feature of valvular cardiomyopathy is a rare clinical entity.

  8. Diagnosis and Management of Peritoneal Metastases from Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Evgenia Halkia

    2012-01-01

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

  9. Spontaneous rupture of intrahepatic biliary ducts with biliary peritonitis.

    Science.gov (United States)

    Aydin, Unal; Yazici, Pinar; Coker, Ahmet

    2007-01-01

    Spontaneous rupture of intrahepatic biliary ducts is a rare cause of acute abdomen due to biliary peritonitis. We report a 92-year-old woman with 48-h history of upper abdominal pain, nausea and vomiting and peritoneal signs. CT scan showed free fluid in the abdomen and mild dilatation of the common bile duct. Exploratory laparotomy showed bile in the abdominal cavity with leak-age from a ruptured bile duct radicle in segment 3, as confirmed on intraoperative cholangiography. She underwent cholecystectomy, choledochotomy with removal of gallstones, repair of the perforation with primary suture and placement of a T-tube. She had an uneventful recovery.

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

    Science.gov (United States)

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

    2000-01-01

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

  11. Survival of Enterococcus faecalis in Mouse Peritoneal Macrophages

    OpenAIRE

    Gentry-Weeks, Claudia R.; Karkhoff-Schweizer, RoxAnn; Pikis, Andreas; Estay, Monica; Keith, Jerry M.

    1999-01-01

    Enterococcus faecalis was tested for the ability to persist in mouse peritoneal macrophages in two separate studies. In the first study, the intracellular survival of serum-passaged E. faecalis 418 and two isogenic mutants [cytolytic strain FA2-2(pAM714) and non-cytolytic strain FA2-2(pAM771)] was compared with that of Escherichia coli DH5α by infecting BALB/c mice intraperitoneally and then monitoring the survival of the bacteria within lavaged peritoneal macrophages over a 72-h period. All ...

  12. The Intelligent CAI System for Chemistry Based on Automated Reasoning

    Institute of Scientific and Technical Information of China (English)

    王晓京; 张景中

    1999-01-01

    A new type of intelligent CAI system for chemistry is developed in this paper based on automated reasoning with chemistry knowledge.The system has shown its ability to solve chemistry problems,to assist students and teachers in studies and instruction with the automated reasoning functions.Its open mode of the knowledge base and its unique style of the interface between the system and human provide more opportunities for the users to acquire living knowledge through active participation.The automated reasoning based on basic chemistry knowledge also opened a new approach to the information storage and management of the ICAI system for sciences.

  13. Automating checks of plan check automation.

    Science.gov (United States)

    Halabi, Tarek; Lu, Hsiao-Ming

    2014-07-08

    While a few physicists have designed new plan check automation solutions for their clinics, fewer, if any, managed to adapt existing solutions. As complex and varied as the systems they check, these programs must gain the full confidence of those who would run them on countless patient plans. The present automation effort, planCheck, therefore focuses on versatility and ease of implementation and verification. To demonstrate this, we apply planCheck to proton gantry, stereotactic proton gantry, stereotactic proton fixed beam (STAR), and IMRT treatments.

  14. Automation in Warehouse Development

    NARCIS (Netherlands)

    Hamberg, R.; Verriet, J.

    2012-01-01

    The warehouses of the future will come in a variety of forms, but with a few common ingredients. Firstly, human operational handling of items in warehouses is increasingly being replaced by automated item handling. Extended warehouse automation counteracts the scarcity of human operators and support

  15. Automate functional testing

    Directory of Open Access Journals (Sweden)

    Ramesh Kalindri

    2014-06-01

    Full Text Available Currently, software engineers are increasingly turning to the option of automating functional tests, but not always have successful in this endeavor. Reasons range from low planning until over cost in the process. Some principles that can guide teams in automating these tests are described in this article.

  16. More Benefits of Automation.

    Science.gov (United States)

    Getz, Malcolm

    1988-01-01

    Describes a study that measured the benefits of an automated catalog and automated circulation system from the library user's point of view in terms of the value of time saved. Topics discussed include patterns of use, access time, availability of information, search behaviors, and the effectiveness of the measures used. (seven references)…

  17. Patent Processus Vaginalis in Patients Undergoing continuous Ambulatory Peritoneal Dialysis - Two Cases Confirmed by Radionuclide Peritoneal Scintiscan -

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Tae; Son, Sang Kyun; Lee, Kyu Bo; Whang, Kee Suk; Cho, Dong Kyu; Koh, Chul Woo [Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

    1989-07-15

    Continuous ambulatory peritoneal dialysis (CAPD) is a well established method of treating end stage renal failure, and is commonly used as an alternative to hemodialysis. Several complications have been observed. These include catheter malfunction, abdominal and inguinal hernia, and peritonitis. A relatively frequent complication is swelling of external genitalia, due to bowel fluid passing through a patent processus vaginalis. Special diagnostic procedures are necessary to determine the nature of the abnormality and to guide the surgical correction. We reported two cases of patent processus vaginalis in patient on CAPD proved by radionuclide peritonea scintiscan using {sup 99m}Tc-tin colloid.

  18. Aberrant gene methylation in the peritoneal fluid is a risk factor predicting peritoneal recurrence in gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Masatsugu; Hiraki; Yoshihiko; Kitajima; Seiji; Sato; Jun; Nakamura; Kazuyoshi; Hashiguchi; Hirokazu; Noshiro; Kohji; Miyazaki

    2010-01-01

    AIM:To investigate whether gene methylation in the peritoneal fluid (PF) predicts peritoneal recurrence in gastric cancer patients.METHODS: The gene methylation of CHFR (checkpoint with forkhead and ring finger domains), p16, RUNX3 (runt-related transcription factor 3), E-cadherin, hMLH1 (mutL homolog 1), ABCG2 (ATP-binding cassette, sub-family G, member 2) and BNIP3 (BCL2/adenovirus E1B 19 kDa interacting protein 3) were analyzed in 80 specimens of PF by quantitative methylation-specific polymerase chain r...

  19. Automated information retrieval using CLIPS

    Science.gov (United States)

    Raines, Rodney Doyle, III; Beug, James Lewis

    1991-01-01

    Expert systems have considerable potential to assist computer users in managing the large volume of information available to them. One possible use of an expert system is to model the information retrieval interests of a human user and then make recommendations to the user as to articles of interest. At Cal Poly, a prototype expert system written in the C Language Integrated Production System (CLIPS) serves as an Automated Information Retrieval System (AIRS). AIRS monitors a user's reading preferences, develops a profile of the user, and then evaluates items returned from the information base. When prompted by the user, AIRS returns a list of items of interest to the user. In order to minimize the impact on system resources, AIRS is designed to run in the background during periods of light system use.

  20. Advances in inspection automation

    Science.gov (United States)

    Weber, Walter H.; Mair, H. Douglas; Jansen, Dion; Lombardi, Luciano

    2013-01-01

    This new session at QNDE reflects the growing interest in inspection automation. Our paper describes a newly developed platform that makes the complex NDE automation possible without the need for software programmers. Inspection tasks that are tedious, error-prone or impossible for humans to perform can now be automated using a form of drag and drop visual scripting. Our work attempts to rectify the problem that NDE is not keeping pace with the rest of factory automation. Outside of NDE, robots routinely and autonomously machine parts, assemble components, weld structures and report progress to corporate databases. By contrast, components arriving in the NDT department typically require manual part handling, calibrations and analysis. The automation examples in this paper cover the development of robotic thickness gauging and the use of adaptive contour following on the NRU reactor inspection at Chalk River.

  1. Automation in immunohematology.

    Science.gov (United States)

    Bajpai, Meenu; Kaur, Ravneet; Gupta, Ekta

    2012-07-01

    There have been rapid technological advances in blood banking in South Asian region over the past decade with an increasing emphasis on quality and safety of blood products. The conventional test tube technique has given way to newer techniques such as column agglutination technique, solid phase red cell adherence assay, and erythrocyte-magnetized technique. These new technologies are adaptable to automation and major manufacturers in this field have come up with semi and fully automated equipments for immunohematology tests in the blood bank. Automation improves the objectivity and reproducibility of tests. It reduces human errors in patient identification and transcription errors. Documentation and traceability of tests, reagents and processes and archiving of results is another major advantage of automation. Shifting from manual methods to automation is a major undertaking for any transfusion service to provide quality patient care with lesser turnaround time for their ever increasing workload. This article discusses the various issues involved in the process.

  2. Automated model building

    CERN Document Server

    Caferra, Ricardo; Peltier, Nicholas

    2004-01-01

    This is the first book on automated model building, a discipline of automated deduction that is of growing importance Although models and their construction are important per se, automated model building has appeared as a natural enrichment of automated deduction, especially in the attempt to capture the human way of reasoning The book provides an historical overview of the field of automated deduction, and presents the foundations of different existing approaches to model construction, in particular those developed by the authors Finite and infinite model building techniques are presented The main emphasis is on calculi-based methods, and relevant practical results are provided The book is of interest to researchers and graduate students in computer science, computational logic and artificial intelligence It can also be used as a textbook in advanced undergraduate courses

  3. Automation in Warehouse Development

    CERN Document Server

    Verriet, Jacques

    2012-01-01

    The warehouses of the future will come in a variety of forms, but with a few common ingredients. Firstly, human operational handling of items in warehouses is increasingly being replaced by automated item handling. Extended warehouse automation counteracts the scarcity of human operators and supports the quality of picking processes. Secondly, the development of models to simulate and analyse warehouse designs and their components facilitates the challenging task of developing warehouses that take into account each customer’s individual requirements and logistic processes. Automation in Warehouse Development addresses both types of automation from the innovative perspective of applied science. In particular, it describes the outcomes of the Falcon project, a joint endeavour by a consortium of industrial and academic partners. The results include a model-based approach to automate warehouse control design, analysis models for warehouse design, concepts for robotic item handling and computer vision, and auton...

  4. Automation in Immunohematology

    Directory of Open Access Journals (Sweden)

    Meenu Bajpai

    2012-01-01

    Full Text Available There have been rapid technological advances in blood banking in South Asian region over the past decade with an increasing emphasis on quality and safety of blood products. The conventional test tube technique has given way to newer techniques such as column agglutination technique, solid phase red cell adherence assay, and erythrocyte-magnetized technique. These new technologies are adaptable to automation and major manufacturers in this field have come up with semi and fully automated equipments for immunohematology tests in the blood bank. Automation improves the objectivity and reproducibility of tests. It reduces human errors in patient identification and transcription errors. Documentation and traceability of tests, reagents and processes and archiving of results is another major advantage of automation. Shifting from manual methods to automation is a major undertaking for any transfusion service to provide quality patient care with lesser turnaround time for their ever increasing workload. This article discusses the various issues involved in the process.

  5. High Levels of Soluble C5b-9 Complex in Dialysis Fluid May Predict Poor Prognosis in Peritonitis in Peritoneal Dialysis Patients

    Science.gov (United States)

    Mizuno, Masashi; Suzuki, Yasuhiro; Higashide, Keiko; Sei, Yumi; Iguchi, Daiki; Sakata, Fumiko; Horie, Masanobu; Maruyama, Shoichi; Matsuo, Seiichi; Morgan, B. Paul; Ito, Yasuhiko

    2017-01-01

    Background We searched for indicators to predict the prognosis of infectious peritonitis by measuring levels of complement proteins and activation products in peritoneal dialysis (PD) fluid (PDF) of patients at early stages of peritonitis. We retrospectively analyzed the relationship between the levels of sC5b-9, C3 and C4 in PDF and the subsequent clinical prognosis. Methods We measured levels of sC5b-9, C3 and C4 in PDF on days 1, 2 and 5 post-onset of peritonitis in 104 episodes of infectious peritonitis in PD patients from 2008 and retrospectively compared levels with clinical outcomes. Further analysis for the presence of causative microorganisms or to demonstrate bacterial culture negative peritonitis was performed and correlated with change of levels of sC5b-9 in PDF. Results When PD patients with peritonitis were divided into groups that either failed to recover from peritonitis and were finally withdrawn from PD (group 1; n = 25) or recovered (group 2; n = 79), levels of sC5b-9, C3 and C4 in PDF were significantly higher in group 1 patients compared to those in group 2 on day5. Analysis of microorganisms showed significantly higher sC5b-9 levels in PDF of peritonitis cases caused by culture negative peritonitis in group 1 compared with group 2 when we analyzed for individual microorganisms. Of note, on day5, the sC5b-9 levels in PDF were similarly high in peritonitis caused by fungi or other organisms. Conclusion Our results suggested that levels of complement markers in PDF, especially sC5b-9, have potential as surrogate markers to predict prognosis of PD-related peritonitis. PMID:28046064

  6. Preventive effect of continuous quality improvement on the malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    赵班

    2013-01-01

    Objective To investigate the preventive effect of continuous quality improvement (CQI) on malnutrition,inflammation,peritoneal dialysis adequacy and cardiovascular events in elderly patients undergoing peritoneal dialysis.Methods A single-center prospective self-controlled study was performed.32 stable elderly patients to undergo continuous ambulatory peritoneal dialysis (CAPD) were included.The continuous quality improvement program was conducted by using the 4-step problem-solving

  7. Inhibidores de la MEK 1/2 para el tratamiento de la fibrosis peritoneal

    OpenAIRE

    Strippoli, Raffaele; Pozo Barriuso, Miguel Ángel del; López Cabrera, Manuel

    2008-01-01

    Inhibidores de la MEK 1/2 para el tratamiento de la fibrosis peritoneal. Fármacos útiles en la prevención y tratamiento de la fibrosis de la membrana peritoneal (opacificación peritoneal, síndrome del peritoneo bronceado, fibrosis mural y síndrome de peritonitis esclerosante) que se produce como consecuencia de una diálisis peritoneal a largo plazo, método de selección de estos fármacos, y método para la recolección de datos útiles en el diagnóstico de dicha enferme...

  8. EVALUAT I ON OF VARIOUS PROGNOSTIC FACTORS IN PERFORATIVE PERITONITIS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Sarada

    2015-09-01

    Full Text Available Peritonitis is one of the major problems confronting the surgeons in day to day practice. Despite many advances in understanding pathophysiology, mortality rate of diffuse suppurative peritonitis remains high. A prospective study, with prior institutional ethics committee approval, involving 100 patients of perforative peritonitis is done to assess the vari ous prognostic factors in management of generalized peritonitis. Role of age, gender, duration, type of perforation, associated systemic factors are studied in relation to morbidity and mortality in the outcome of management of peritonitis. Elderly age, il eal perforations, delay in presentation of more than 24 hours and associated shock on day one are found to have bad prognosis

  9. Estudo descritivo sobre a prática da diálise peritoneal em domicílio Descriptive study about the practice of home peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Sarah Silva Abrahão

    2010-03-01

    Full Text Available INTRODUÇÃO: A partir da vivência no atendimento de crianças/adolescentes portadores de doença renal crônica (DRC em tratamento dialítico no ambiente hospitalar pensou-se que aspectos seriam relevantes para a aplicação da diálise peritoneal domiciliar. O objetivo deste estudo foi descrever o nível de escolaridade e de informação do cuidador sobre a técnica de diálise peritoneal (DP, a renda familiar e condições gerais do local de realização da diálise e buscar associação com a realização inadequada da técnica. MÉTODO: Trata-se de um estudo descritivo do universo de 30 crianças e adolescentes com DRC assistidos pelo HC/UFMG no período de março de 2004 a maio de 2006. Os dados foram analisados utilizando-se o software SPSS versão 13.0. As seguintes variáveis foram testadas como possíveis fatores de risco para inadequação da técnica de diálise: escolaridade do cuidador, renda familiar, nível de informação do cuidador sobre a técnica de diálise, antissepsia das mãos, ausência de pia no quarto da diálise. RESULTADOS: A qualidade de aplicação da técnica de DP foi considerada inadequada em 18 (60% pacientes. Todos os valores de Odds Ratio estiveram dentro dos limites dos intervalos de confiança (95% e foram > 1, indicando a possibilidade de associação positiva entre a variável independente e a variável pesquisada, embora sem diferença estatística significativa. CONCLUSÕES: A análise estatística não mostrou associação entre as variáveis, entretanto acredita-se que elas exercem um papel positivo para o sucesso da aplicação da técnica dialítica.INTRODUCTION: As experienced with the assistance evaluation of children/adolescents with chronic kidney disease in dialysis treatment on hospital we thought about which aspects could be relevant to the peritoneal dialysis (PD application at home. The objective was to describe the level of schooling and information of the parents about the PD technique

  10. Kocuria species peritonitis: although rare, we have to care.

    Science.gov (United States)

    Dotis, John; Printza, Nikoleta; Stabouli, Stella; Papachristou, Fotios

    2015-01-01

    Kocuria species are found in the environment and on human skin. These micro-organisms are generally considered to be nonpathogenic saprophytes, rarely causing infection. However, the peritoneum has been reported to be a site of Kocuria infection. We reviewed all cases of peritonitis in peritoneal dialysis (PD) patients caused by Kocuria species that were reported in the worldwide literature. In total, 12 episodes of Kocuria species peritonitis have been reported in 9 PD patients. The median age of the patients was 62 years (range: 8 - 78 years). In the reported episodes, 4 different Kocuria species were isolated, with K. varians being the predominant species (41.7%). The most common initial symptom was abdominal pain (83.3%), followed by turbid effluent (75%) and fever (33.3%). Intraperitoneal first-generation cephalosporins and glycopeptides were the most-used antibiotics, with first-generation cephalosporins being more often preferred as first-line therapy. The median duration of treatment was 14 days, and in 2 episodes, the Tenckhoff catheter was removed. Although Kocuria peritonitis in PD patients is rare, it should be promptly treated because relapses can occur, especially with K. varians episodes.

  11. Unusual migration of ventriculo peritoneal distal catheter into vagina

    Directory of Open Access Journals (Sweden)

    Sghavamedin Tavallaee

    2015-04-01

    Full Text Available VP shunt is one of the most popular methods for ICP reduction and treatment of hydrocephalus. Various complications of this method are not uncommon such as shunt malfunction, infection and unusual migration of distal catheter. I present a case of migration of the peritoneal catheter out of the vagina.

  12. Monocyte chemotactic protein-1 gene polymorphism and spontaneous bacterial peritonitis

    Institute of Scientific and Technical Information of China (English)

    Levent; Filik

    2010-01-01

    I read with great interest the article by Gbele et al published in issue 44 of World J Gastroenterol 2009.The results of their study indicate that-2518 Monocyte chemotactic protein-1(MCP-1)genotype AA is a risk factor for spontaneous bacterial peritonitis in patients with alcoholic cirrhosis.However,there are some items that need to be discussed.

  13. CLINICAL STUDY AND MANAGEMENT OF PERITONITIS SECONDARY TO GASTROINTESTINAL PERFORATION

    Directory of Open Access Journals (Sweden)

    Karbhari

    2014-03-01

    Full Text Available Perforation peritonitis is the most common surgical emergency in India. Peritonitis due to upper gastrointestinal tract perforation constitutes majority of these cases. Despite advances in surgical techniques, antimicrobial therapy and intensive care support, management of peritonitis continues to be highly demanding, difficult and complex. . In contrast to western countries where lower gastro-intestinal tract perforations predominate, upper gastro intestinal tract perforations constitute the majority of cases in India1. Earlier Rawlinson in the year 1727 was the first to give a clear description of the signs and symptom of gastric ulcer and peritonitis.2 MATERIALS AND METHODS: All patients having GI perforation admitted in all surgical units of Basaweshwar Teaching and General Hospital, Gulbarga were considered for the study. A total of 50 cases were studied over a period of 18 months from Dec 2009 to May 2011.Data was entered in the proforma made for the study and analyzed RESULTS &CONCLUSION: Patient group more than 50yrs were the most commonly affected group and duodenal ulcer perforation (60% was the most common. Males (92% were affected more than females. Most common symptom was vomiting (68%. Guarding and rigidity were present in 90% patients. Laparotomy with closure of the perforation with omental patch is the commonest operative management for perforated peptic ulcer. The overall mortality was 4%

  14. Nutritional status over time in hemodialysis and peritoneal dialysis

    NARCIS (Netherlands)

    Jager, KJ; Merkus, MP; Huisman, RM; Boeschoten, EW; Dekker, FW; Korevaar, JC; Tijssen, JGP; Krediet, RT

    2001-01-01

    Malnutrition is a risk factor for mortality in the dialysis population. So far, prospective studies comparing the time course of nutritional status in new hemodialysis (HD) and peritoneal dialysis (PD) patients have not been published. The aims of this study were to compare the time course of nutrit

  15. Peritoneal inflammation – A microenvironment for Epithelial Ovarian Cancer (EOC

    Directory of Open Access Journals (Sweden)

    Liu Jinsong

    2004-06-01

    Full Text Available Abstract Epithelial ovarian cancer (EOC is a significant cause of cancer related morbidity and mortality in women. Preferential involvement of peritoneal structures contributes to the overall poor outcome in EOC patients. Advances in biotechnology, such as cDNA microarray, are a product of the Human Genome Project and are beginning to provide fresh opportunities to understand the biology of EOC. In particular, it is now possible to examine in depth, at the molecular level, the complex relationship between the tumor itself and its surrounding microenvironment. This review focuses on the anatomy, physiology, and current immunobiologic research of peritoneal structures, and addresses certain potentially useful animal models. Changes in both the inflammatory and non-inflammatory cell compartments, as well as alterations to the extracellular matrix, appear to be signal events that contribute to the remodeling effects of the peritoneal stroma and surface epithelial cells on tumor growth and spread. These alterations may involve a number of proteins, including cytokines, chemokines, growth factors, either membrane or non-membrane bound, and integrins. Interactions between these molecules and molecular structures within the extracellular matrix, such as collagens and the proteoglycans, may contribute to a peritoneal mesothelial surface and stromal environment that is conducive to tumor cell proliferation and invasion. These alterations need to be examined and defined as possible prosnosticators and as therapeutic or diagnostic targets.

  16. Continuous ambulatory peritoneal dialysis: Nurses′ experiences of teaching patients

    Directory of Open Access Journals (Sweden)

    Amnah Shubayra

    2015-01-01

    In conclusion, the findings of this study showed several factors that are considered as barriers for the nurses during teaching the CAPD patients and the need to improve the communication and teaching in the peritoneal dialysis units, including the importance of individualized teaching.

  17. A Rare Complication of Percutaneous Nephrolithotomy: Biliary Peritonitis

    Directory of Open Access Journals (Sweden)

    Sadi Turkan

    2014-04-01

    Full Text Available Percutaneous nephrolithotomy is a common method in stone therapy in the last 30 years. High success rates as well as high complication rates are also available. We present offer patient who developing gallbladder injury and peritonitis in percutaneous nephrolithotomy for the right renal pelvis, mid, and lower calyces stone.

  18. A Rare Complication of Percutaneous Nephrolithotomy: Biliary Peritonitis

    OpenAIRE

    Sadi Turkan

    2014-01-01

    Percutaneous nephrolithotomy is a common method in stone therapy in the last 30 years. High success rates as well as high complication rates are also available. We present offer patient who developing gallbladder injury and peritonitis in percutaneous nephrolithotomy for the right renal pelvis, mid, and lower calyces stone.

  19. Pathways of peritoneal tumour recurrence after abdominal surgical trauma

    NARCIS (Netherlands)

    M.E.E. van Rossen (Marie Elma)

    2000-01-01

    textabstractThe peritoneum is the largest and the most complex arranged serous membrane in the body that lines both the intra-abdominal wall and the viscera contained within the peritoneal cavity. It is capable of walling off infections and has several functions such as the ability to synthesise, se

  20. Standardised Models for Inducing Experimental Peritoneal Adhesions in Female Rats

    Directory of Open Access Journals (Sweden)

    Bernhard Kraemer

    2014-01-01

    Full Text Available Animal models for adhesion induction are heterogeneous and often poorly described. We compare and discuss different models to induce peritoneal adhesions in a randomized, experimental in vivo animal study with 72 female Wistar rats. Six different standardized techniques for peritoneal trauma were used: brushing of peritoneal sidewall and uterine horns (group 1, brushing of parietal peritoneum only (group 2, sharp excision of parietal peritoneum closed with interrupted sutures (group 3, ischemic buttons by grasping the parietal peritoneum and ligating the base with Vicryl suture (group 4, bipolar electrocoagulation of the peritoneum (group 5, and traumatisation by electrocoagulation followed by closure of the resulting peritoneal defect using Vicryl sutures (group 6. Upon second look, there were significant differences in the adhesion incidence between the groups (P<0.01. Analysis of the fraction of adhesions showed that groups 2 (0% and 5 (4% were significantly less than the other groups (P<0.01. Furthermore, group 6 (69% was significantly higher than group 1 (48% (P<0.05 and group 4 (47% (P<0.05. There was no difference between group 3 (60% and group 6 (P=0.2. From a clinical viewpoint, comparison of different electrocoagulation modes and pharmaceutical adhesion barriers is possible with standardised models.

  1. Strangulated Femoral Hernia Turned to Be Peritoneal Cyst

    Directory of Open Access Journals (Sweden)

    Dionysios Dellaportas

    2012-01-01

    Full Text Available Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein. Case Presentation. The patient was admitted to our hospital suffering from a palpable groin mass on the right, which became painful and caused great discomfort for the last hours. Physical examination revealed a tender and tense, irreducible groin mass. An inguinal operative approach was selected and the mass was found protruding through the femoral ring. After careful dissection it turned out to be a large unilocular cyst, containing serous fluid, probably originating from the peritoneum. McVay procedure was used to reapproximate the femoral ring. Histologic examination showed a peritoneal inclusion cyst. Discussion. Peritoneal inclusion cysts are usually asymptomatic but occasionally present with various, nonspecific symptoms according to their size. Our case highlights that high index of clinical suspicion and careful exploration during repair of a hernia is mandatory in order to reach the correct diagnosis about hernia’s contents.

  2. Peritoneal dialysis in an ageing population: a 10-year experience.

    LENUS (Irish Health Repository)

    Smyth, Andrew

    2012-02-01

    Chronic kidney disease (CKD) is becoming increasingly prevalent and there are increasing numbers of older patients with advanced CKD. Peritoneal dialysis (PD) is a potential treatment. This study aims to compare PD outcomes in age-defined populations in the largest PD centre in the Republic of Ireland over 10 years.

  3. Aquaporin-1: new developments and perspectives for peritoneal dialysis.

    Science.gov (United States)

    Devuyst, Olivier; Yool, Andrea J

    2010-01-01

    Peritoneal dialysis involves diffusive and convective transport and osmosis through the highly vascularized peritoneal membrane. Several lines of evidence have demonstrated that the water channel aquaporin-1 (AQP1) corresponds to the ultrasmall pore predicted by the model of peritoneal transport. Proof-of-principle studies have shown that upregulation of the expression of AQP1 in peritoneal capillaries results in increased water permeability and ultrafiltration, without affecting the osmotic gradient or small solute permeability. Conversely, studies in Aqp1 mice have shown that haplo-insufficiency for AQP1 results in significant attenuation of water transport. Recent studies have demonstrated that AQP1 is involved in the migration of different cell types, including endothelial cells. In parallel, chemical screening has identified lead compounds that could act as antagonists or agonists of AQPs, with description of putative binding sites and potential mechanisms of gating the water channel. By modulating water transport, these pharmacological agents could have clinically relevant effects in targeting specific tissues or disease states.

  4. Apoptosis and T cell depletion during feline infectious peritonitis

    NARCIS (Netherlands)

    Horzinek, M.C.; Haagmans, B.L.; Egberink, H.F.

    1996-01-01

    Cats that have succumbed to feline infectious peritonitis, an immune- mediated disease caused by variants of feline coronaviruses, show apoptosis and T-cell depletion in their lymphoid organs. The ascitic fluid that develops in the course of the condition causes apoptosis in vitro but only in activa

  5. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  6. Use of biogenic nanomaterials to improve the peritoneal dialysis technique: A Translational Research Perspective

    CERN Document Server

    Kumar, Dinesh

    2015-01-01

    Intraperitoneal and catheter exit site infections are the most common complications associated with prolonged peritoneal dialysis (PD) therapy used for treating the patients with end stage renal failure (ESRF). Recurrent and persistent infections often cause inflammation of the peritoneum, a condition known as infectious peritonitis and to resolve the condition, patients require antibiotic treatment. However, if the treatment is delayed or if it fails due to antibiotic resistance, the peritonitis may lead to permanent malfunctioning of peritoneal membrane causing technique failure and transferring the patients to haemodialysis. Severe and prolonged peritonitis is not only the major cause of technique failure, it is also the leading cause of mortality and morbidity in PD patients. Therefore, there is an urgent need to improve the existing PD technique so that the frequency of PD associated infections could be reduced and infectious peritonitis episodes thereof during prolonged peritoneal dialysis. In this pers...

  7. Aliskiren prevents the toxic effects of peritoneal dialysis fluids during chronic dialysis in rats.

    Directory of Open Access Journals (Sweden)

    Juan Pérez-Martínez

    Full Text Available The benefits of long-term peritoneal dialysis (PD in patients with end-stage renal failure are short-lived due to structural and functional changes in the peritoneal membrane. In this report, we provide evidence for the in vitro and in vivo participation of the renin-angiotensin-aldosterone system (RAAS in the signaling pathway leading to peritoneal fibrosis during PD. Exposure to high-glucose PD fluids (PDFs increases damage and fibrosis markers in both isolated rat peritoneal mesothelial cells and in the peritoneum of rats after chronic dialysis. In both cases, the addition of the RAAS inhibitor aliskiren markedly improved damage and fibrosis markers, and prevented functional modifications in the peritoneal transport, as measured by the peritoneal equilibrium test. These data suggest that inhibition of the RAAS may be a novel way to improve the efficacy of PD by preventing inflammation and fibrosis following peritoneal exposure to high-glucose PDFs.

  8. Transport of ions across peritoneal membrane.

    Science.gov (United States)

    Islam, Nurul; Bulla, Nisar A; Islam, Shahina

    2004-12-15

    The electrical conductance of ions across the peritoneal membrane of young buffalo (approximately 18-24 months old) has been recorded. Aqueous solutions of NaF, NaNO3, NaCl, Na2SO4, KF, KNO3, KCl, K2SO4, MgCl2, CaCl2, CrCl3, MnCl2, FeCl3, CoCl2, and CuCl2 were used. The conductance values have been found to increase with increase in concentration as well as with temperature (15 to 35 degrees C) in these cases. The slope of plots of specific conductance, kappa, versus concentration exhibits a decrease in its values at relatively higher concentrations compared to those in extremely dilute solutions. Also, such slopes keep on increasing with increase in temperature. In addition, the conductance also attains a maximum limiting value at higher concentrations in the said cases. This may be attributed to a progressive accumulation of ionic species within the membrane. The kappa values of electrolytes follow the sequence for the anions: SO4(2-)>Cl->NO3->F- while that for the cations: K+>Na+>Ca2+>Mn2+>Co2+>Cu2+>Mg2+>Cr3+>Fe3+. In addition, the diffusion of ions depends upon the charge on the membrane and its porosity. The membrane porosity in relation to the size of the hydrated species diffusing through the membrane appears to determine the above sequence. As the diffusional paths in the membrane become more difficult in aqueous solutions, the mobility of large hydrated ions gets impeded by the membrane framework and the interaction with the fixed charge groups on the membrane matrix. Consequently, the membrane pores reduce the conductance of small ions, which are much hydrated. An increase in conductance with increase in temperature may be due to the state of hydration, which implies that the energy of activation for the ionic transport across the membrane follows the sequence of crystallographic radii of ions accordingly. The Eyring's equation, kappa=(RT/Nh)exp[-DeltaH*/RT]exp[DeltaS*/R], has been found suitable for explaining the temperature dependence of conductance in

  9. 7 CFR 277.18 - Establishment of an Automated Data Processing (ADP) and Information Retrieval System.

    Science.gov (United States)

    2010-01-01

    ... acquisition including hardware, software, telecommunications, system testing, and data security; (iv) The... need for human assistance or intervention. Automated Data Processing Equipment or hardware means: (1... unauthorized use; (C) Software and data security; (D) Telecommunications security; (E) Personnel security;...

  10. Revisiting mouse peritoneal macrophages: heterogeneity, development and function

    Directory of Open Access Journals (Sweden)

    Alexandra Dos Anjos Cassado

    2015-05-01

    Full Text Available Tissue macrophages play a crucial role in the maintenance of tissue homeostasis and also contribute to inflammatory and reparatory responses during pathogenic infection and tissue injury. The high heterogeneity of these macrophages is consistent with their adaptation to distinct tissue environments and specialization to develop niche-specific functions. Although peritoneal macrophages are one of best-studied macrophage populations, only recently it was demonstrated the co-existence of two subsets in mouse PerC, which exhibit distinct phenotypes, functions and origins. These macrophage subsets have been classified according to their morphology as LPMs (large peritoneal macrophages and SPMs (small peritoneal macrophages. LPMs, the most abundant subset under steady-state conditions, express high levels of F4/80 and low levels of class II molecules of the major histocompatibility complex (MHC. LPMs appear to be originated from embriogenic precursors, and their maintenance in PerC is regulated by expression of specific transcription factors and tissue-derived signals. Conversely, SPMs, a minor subset in unstimulated PerC, have a F4/80lowMHC-IIhigh phenotype and are generated from bone-marrow-derived myeloid precursors. In response to infectious or inflammatory stimuli, the cellular composition of PerC is dramatically altered, where LPMs disappear and SPMs become the prevalent population together with their precursor, the inflammatory monocyte. SPMs appear to be the major source of inflammatory mediators in PerC during infection whereas LPMs contribute for gut-associated lymphoid tissue (GALT-independent and retinoic acid-dependent IgA production by peritoneal B-1 cells. In the last years, considerable efforts have been made to broaden our understanding of LPM and SPM origin, transcriptional regulation and functional profile. This review addresses these issues, focusing on the impact of tissue-derived signals and external stimulation in the complex

  11. Assistive Technologies

    Science.gov (United States)

    Auat Cheein, Fernando A., Ed.

    2012-01-01

    This book offers the reader new achievements within the Assistive Technology field made by worldwide experts, covering aspects such as assistive technology focused on teaching and education, mobility, communication and social interactivity, among others. Each chapter included in this book covers one particular aspect of Assistive Technology that…

  12. Systematic review automation technologies

    Science.gov (United States)

    2014-01-01

    Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects. We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time. PMID:25005128

  13. The effect of peritoneal lavage on the postoperative course after colonic anastomosis and perforation in the rat.

    Science.gov (United States)

    Arnesjö, B; Breland, U; Petersson, B G

    1975-01-01

    Peritoneal lavage was given during four days to rats subjected either to transection and re-anastomosis or perforation of the descending part of the colon or caecum. Control rats were treated in the smae way but did not receive peritoneal lavage. The rats which were treated with a colonic anastomosis and peritoneal lavage had significantly less abdominal adhesions, peritonitis and peritoneal fluid observed at autopsy 11 or 60 days after surgery. No rats developed anastomosis insufficiency and all survived. Peritoneal lavage in rats subjected to colonic or caecal perforation increased the survival time and reduced the mortality rate, the frequency of adhesions and the signs of peritonitis. An increased frequency of peritoneal adhesions was observed after extensive mobilization of the colon during operation when no peritoneal lavage had been given. The peritoneal lavage catheter per se did not cause adhesions.

  14. Prognostic impact of peritonitis in hemodialysis patients: A national-wide longitudinal study in Taiwan

    Science.gov (United States)

    Lee, Cheng-Chia; Wu, Patricia W.; Chang, Chee-Jen; Tian, Ya-Chung; Yang, Chih-Wei

    2017-01-01

    Background Peritonitis has been independently associated with increased morbidity and mortality in peritoneal dialysis patients. However, there are few reports on peritonitis in hemodialysis patients. We aim at investigating both the risk profiles and prognostic impact of peritonitis in hemodialysis patients. Methods This nation-wide longitudinal study uses claims data obtained from the Taiwan National Health Insurance Research Database. A total of 80,733 incident hemodialysis patients of age ≥ 20 years without a history of peritonitis were identified between January 1, 1998 and December 31, 2009. Predictors of peritonitis events were estimated using Cox proportional hazard models. Time-dependent Cox proportional hazard models were used to estimate hazard ratio for mortality attributed to peritonitis exposure. Results Of 80,733 incident hemodialysis patients over a 13-year study period, peritonitis was diagnosed in 935 (1.16%), yielding an incidence rate of 2.91 per 1000 person-years. Female gender, liver cirrhosis and polycystic kidney disease were three of the most significant factors for peritonitis in both non-diabetic and diabetic hemodialysis patients. The cumulative survival rate of patients with peritonitis was 38.8% at 1 year and 10.1% at 5 years. A time-dependent Cox multivariate analysis showed that peritonitis had significantly increased hazard ratio for all cause mortality. Additionally, the risk of mortality remained significantly higher for non-diabetic hemodialysis patients that experienced peritonitis. Conclusions The risk of peritonitis in hemodialysis patients is higher in female gender, liver cirrhosis and polycystic kidney disease. Although peritonitis is a rare condition, it is associated with significantly poorer outcome in hemodialysis patients. PMID:28301536

  15. Chef infrastructure automation cookbook

    CERN Document Server

    Marschall, Matthias

    2013-01-01

    Chef Infrastructure Automation Cookbook contains practical recipes on everything you will need to automate your infrastructure using Chef. The book is packed with illustrated code examples to automate your server and cloud infrastructure.The book first shows you the simplest way to achieve a certain task. Then it explains every step in detail, so that you can build your knowledge about how things work. Eventually, the book shows you additional things to consider for each approach. That way, you can learn step-by-step and build profound knowledge on how to go about your configuration management

  16. Policy challenges of increasing automation in driving

    Directory of Open Access Journals (Sweden)

    Ata M. Khan

    2012-03-01

    Full Text Available The convergence of information and communication technologies (ICT with automotive technologies has already resulted in automation features in road vehicles and this trend is expected to continue in the future owing to consumer demand, dropping costs of components, and improved reliability. While the automation features that have taken place so far are mainly in the form of information and driver warning technologies (classified as level I pre-2010, future developments in the medium term (level II 2010–2025 are expected to exhibit connected cognitive vehicle features and encompass increasing degree of automation in the form of advanced driver assistance systems. Although autonomous vehicles have been developed for research purposes and are being tested in controlled driving missions, the autonomous driving case is only a long term (level III 2025+ scenario. This paper contributes knowledge on technological forecasts regarding automation, policy challenges for each level of technology development and application context, and the essential instrument of cost-effectiveness for policy analysis which enables policy decisions on the automation systems to be assessed in a consistent and balanced manner. The cost of a system per vehicle is viewed against its effectiveness in meeting policy objectives of improving safety, efficiency, mobility, convenience and reducing environmental effects. Example applications are provided that illustrate the contribution of the methodology in providing information for supporting policy decisions. Given the uncertainties in system costs as well as effectiveness, the tool for assessing policies for future generation features probabilistic and utility-theoretic analysis capability. The policy issues defined and the assessment framework enable the resolution of policy challenges while allowing worthy innovative automation in driving to enhance future road transportation.

  17. Ventricular assist device

    Science.gov (United States)

    VAD; RVAD; LVAD; BVAD; Right ventricular assist device; Left ventricular assist device; Biventricular assist device; Heart pump; Left ventricular assist system; LVAS; Implantable ventricular assist device

  18. Automation for System Safety Analysis

    Science.gov (United States)

    Malin, Jane T.; Fleming, Land; Throop, David; Thronesbery, Carroll; Flores, Joshua; Bennett, Ted; Wennberg, Paul

    2009-01-01

    This presentation describes work to integrate a set of tools to support early model-based analysis of failures and hazards due to system-software interactions. The tools perform and assist analysts in the following tasks: 1) extract model parts from text for architecture and safety/hazard models; 2) combine the parts with library information to develop the models for visualization and analysis; 3) perform graph analysis and simulation to identify and evaluate possible paths from hazard sources to vulnerable entities and functions, in nominal and anomalous system-software configurations and scenarios; and 4) identify resulting candidate scenarios for software integration testing. There has been significant technical progress in model extraction from Orion program text sources, architecture model derivation (components and connections) and documentation of extraction sources. Models have been derived from Internal Interface Requirements Documents (IIRDs) and FMEA documents. Linguistic text processing is used to extract model parts and relationships, and the Aerospace Ontology also aids automated model development from the extracted information. Visualizations of these models assist analysts in requirements overview and in checking consistency and completeness.

  19. Avaliação do fluido peritoneal de asininos Evaluation of peritoneal fluid from asinines

    Directory of Open Access Journals (Sweden)

    M.F.C. Louro

    2006-10-01

    Full Text Available The peritoneal fluid from six female health donkeys was evaluated. In each animal, it was carried out eight abdominocentesis with 40x12 needles, at 72-hour intervals. All animals presented clinical changes, and there was higher frequency of yellow-tinged fluid with turbidity aspect. Means, and respective standard deviations, for cytology and protein concentration were: erythrocytes, 24.7±11.7x10³/mm³; leukocytes, 15.8±6.79x10³/mm³; mesothelial cells, 3.85±1.30x10³/mm³; neutrophils, 10.9±4.51x10³/mm³; lymphocytes, 1.41±0.51x10³/mm³; macrophages, 0.98±0.55x10³/mm³; eosinophils, 2.48±1.36x10³/mm³, and total proteins, 1.97±0.31 g/dl.

  20. Automated Vehicles Symposium 2015

    CERN Document Server

    Beiker, Sven

    2016-01-01

    This edited book comprises papers about the impacts, benefits and challenges of connected and automated cars. It is the third volume of the LNMOB series dealing with Road Vehicle Automation. The book comprises contributions from researchers, industry practitioners and policy makers, covering perspectives from the U.S., Europe and Japan. It is based on the Automated Vehicles Symposium 2015 which was jointly organized by the Association of Unmanned Vehicle Systems International (AUVSI) and the Transportation Research Board (TRB) in Ann Arbor, Michigan, in July 2015. The topical spectrum includes, but is not limited to, public sector activities, human factors, ethical and business aspects, energy and technological perspectives, vehicle systems and transportation infrastructure. This book is an indispensable source of information for academic researchers, industrial engineers and policy makers interested in the topic of road vehicle automation.

  1. I-94 Automation FAQs

    Data.gov (United States)

    Department of Homeland Security — In order to increase efficiency, reduce operating costs and streamline the admissions process, U.S. Customs and Border Protection has automated Form I-94 at air and...

  2. Automated Vehicles Symposium 2014

    CERN Document Server

    Beiker, Sven; Road Vehicle Automation 2

    2015-01-01

    This paper collection is the second volume of the LNMOB series on Road Vehicle Automation. The book contains a comprehensive review of current technical, socio-economic, and legal perspectives written by experts coming from public authorities, companies and universities in the U.S., Europe and Japan. It originates from the Automated Vehicle Symposium 2014, which was jointly organized by the Association for Unmanned Vehicle Systems International (AUVSI) and the Transportation Research Board (TRB) in Burlingame, CA, in July 2014. The contributions discuss the challenges arising from the integration of highly automated and self-driving vehicles into the transportation system, with a focus on human factors and different deployment scenarios. This book is an indispensable source of information for academic researchers, industrial engineers, and policy makers interested in the topic of road vehicle automation.

  3. Hydrometeorological Automated Data System

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Hydrologic Development of the National Weather Service operates HADS, the Hydrometeorological Automated Data System. This data set contains the last 48...

  4. Automating the Media Center.

    Science.gov (United States)

    Holloway, Mary A.

    1988-01-01

    Discusses the need to develop more efficient information retrieval skills by the use of new technology. Lists four stages used in automating the media center. Describes North Carolina's pilot programs. Proposes benefits and looks at the media center's future. (MVL)

  5. Diagnosis of spontaneous bacterial peritonitis: An update on leucocyte esterase reagent strips

    Institute of Scientific and Technical Information of China (English)

    Anastasios Koulaouzidis

    2011-01-01

    Ascites remain the commonest complication of decom-pensated cirrhosis. Spontaneous bacterial peritonitis (SBP) is defined as the infection of ascitic fluid (AF) in the ab-sence of a contiguous source of infection and/or an intra-abdominal inflammatory focus. An AF polymorphonuclear (PMN) leucocyte count ≥ 250/mm3 -irrespective of the AF culture result- is universally accepted nowadays as the best surrogate marker for diagnosing SBP. Frequently the results of the manual or automated PMN count do not reach the hands of the responsible medical personnel in a timely manner. However, this is a crucial step in SBP man-agement. Since 2000, 26 studies (most of them published as full papers) have checked the validity of using leukocyte esterase reagent strips (LERS) in SBP diagnosis. LERS appear to have low sensitivity for SBP, some LERS types more than others. On the other hand, though, LERS have consistently given a high negative predictive value (> 95% in the majority of the studies) and this supports the use of LERS as a preliminary screening tool for SBP diagnosis. Finally, an AF-tailored dipstick has been developed. Within the proper setting, it is set to become the mainstream pro-cess for handling AF samples.

  6. Ascitic fluid analysis for diagnosis and monitoring of spontaneous bacterial peritonitis

    Institute of Scientific and Technical Information of China (English)

    Oliviero Riggio; Stefania Angeloni

    2009-01-01

    Polymorphonuclear (PMN) cell count in the ascitic fluid is essential for the diagnosis and management of spontaneous bacterial peritonitis (SBP). To date, PMN cell count is routinely performed by traditional manual counting. However, this method is time-consuming, costly, and not always timely available. Therefore, considerable efforts have been made in recent years to develop an alternative test for a more rapid diagnosis and monitoring of SBP. The use of urinary reagent strips was proposed to achieve an "instant" bedside diagnosis of SBP. A series of reports evaluated the urine strip test for SBP diagnosis and reported promising results. However, a recent large multicenter study revealed a surprising lack of diagnostic efficacy of the urine screening test for SBP diagnosis. Another method, more recently proposed as an alternative to the manual PMN count, is the measurement of lactoferrin in ascitic fluid, but the data available on the diagnostic value of this test are limited to a single study. However,both urinary reagent strips and ascitic lactoferrin tests are qualitative methods and need, therefore, to be further confirmed by standard cytology of the ascitic fluid.To date, the only quantitative method proposed as a valid alternative to manual PMN counting is automated blood cell counters, commonly used in all laboratories for blood cell counting. Data available in the literature on the diagnostic performance of this method are limited but very promising, and this tool seems to have the potential to replace the manual counting method.

  7. Disassembly automation automated systems with cognitive abilities

    CERN Document Server

    Vongbunyong, Supachai

    2015-01-01

    This book presents a number of aspects to be considered in the development of disassembly automation, including the mechanical system, vision system and intelligent planner. The implementation of cognitive robotics increases the flexibility and degree of autonomy of the disassembly system. Disassembly, as a step in the treatment of end-of-life products, can allow the recovery of embodied value left within disposed products, as well as the appropriate separation of potentially-hazardous components. In the end-of-life treatment industry, disassembly has largely been limited to manual labor, which is expensive in developed countries. Automation is one possible solution for economic feasibility. The target audience primarily comprises researchers and experts in the field, but the book may also be beneficial for graduate students.

  8. ACCOUNTING AUTOMATIONS RISKS

    OpenAIRE

    Муравський, В. В.; Хома, Н. Г.

    2015-01-01

    Accountant accepts active voice in organization of the automated account in the conditions of the informative systems introduction in enterprise activity. Effective accounting automation needs identification and warning of organizational risks. Authors researched, classified and generalized the risks of introduction of the informative accounting systems. The ways of liquidation of the organizational risks sources andminimization of their consequences are gives. The method of the effective con...

  9. Instant Sikuli test automation

    CERN Document Server

    Lau, Ben

    2013-01-01

    Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. A concise guide written in an easy-to follow style using the Starter guide approach.This book is aimed at automation and testing professionals who want to use Sikuli to automate GUI. Some Python programming experience is assumed.

  10. Automated security management

    CERN Document Server

    Al-Shaer, Ehab; Xie, Geoffrey

    2013-01-01

    In this contributed volume, leading international researchers explore configuration modeling and checking, vulnerability and risk assessment, configuration analysis, and diagnostics and discovery. The authors equip readers to understand automated security management systems and techniques that increase overall network assurability and usability. These constantly changing networks defend against cyber attacks by integrating hundreds of security devices such as firewalls, IPSec gateways, IDS/IPS, authentication servers, authorization/RBAC servers, and crypto systems. Automated Security Managemen

  11. Automation of Diagrammatic Reasoning

    OpenAIRE

    Jamnik, Mateja; Bundy, Alan; Green, Ian

    1997-01-01

    Theorems in automated theorem proving are usually proved by logical formal proofs. However, there is a subset of problems which humans can prove in a different way by the use of geometric operations on diagrams, so called diagrammatic proofs. Insight is more clearly perceived in these than in the corresponding algebraic proofs: they capture an intuitive notion of truthfulness that humans find easy to see and understand. We are identifying and automating this diagrammatic reasoning on mathemat...

  12. Automated Lattice Perturbation Theory

    Energy Technology Data Exchange (ETDEWEB)

    Monahan, Christopher

    2014-11-01

    I review recent developments in automated lattice perturbation theory. Starting with an overview of lattice perturbation theory, I focus on the three automation packages currently "on the market": HiPPy/HPsrc, Pastor and PhySyCAl. I highlight some recent applications of these methods, particularly in B physics. In the final section I briefly discuss the related, but distinct, approach of numerical stochastic perturbation theory.

  13. Marketing automation supporting sales

    OpenAIRE

    Sandell, Niko

    2016-01-01

    The past couple of decades has been a time of major changes in marketing. Digitalization has become a permanent part of marketing and at the same time enabled efficient collection of data. Personalization and customization of content are playing a crucial role in marketing when new customers are acquired. This has also created a need for automation to facilitate the distribution of targeted content. As a result of successful marketing automation more information of the customers is gathered ...

  14. Strategies for preserving residual renal function in peritoneal dialysis patients.

    Science.gov (United States)

    Nongnuch, Arkom; Assanatham, Montira; Panorchan, Kwanpeemai; Davenport, Andrew

    2015-04-01

    Although there have been many advancements in the treatment of patients with chronic kidney disease (CKD) over the last 50 years, in terms of reducing cardiovascular risk, mortality remains unacceptably high, particularly for those patients who progress to stage 5 CKD and initiate dialysis (CKD5d). As mortality risk increases exponentially with progressive CKD stage, the question arises as to whether preservation of residual renal function once dialysis has been initiated can reduce mortality risk. Observational studies to date have reported an association between even small amounts of residual renal function and improved patient survival and quality of life. Dialysis therapies predominantly provide clearance for small water-soluble solutes, volume and acid-base control, but cannot reproduce the metabolic functions of the kidney. As such, protein-bound solutes, advanced glycosylation end-products, middle molecules and other azotaemic toxins accumulate over time in the anuric CKD5d patient. Apart from avoiding potential nephrotoxic insults, observational and interventional trials have suggested that a number of interventions and treatments may potentially reduce the progression of earlier stages of CKD, including targeted blood pressure control, reducing proteinuria and dietary intervention using combinations of protein restriction with keto acid supplementation. However, many interventions which have been proven to be effective in the general population have not been equally effective in the CKD5d patient, and so the question arises as to whether these treatment options are equally applicable to CKD5d patients. As strategies to help preserve residual renal function in CKD5d patients are not well established, we have reviewed the evidence for preserving or losing residual renal function in peritoneal dialysis patients, as urine collections are routinely collected, whereas few centres regularly collect urine from haemodialysis patients, and haemodialysis dialysis

  15. Elements of EAF automation processes

    Science.gov (United States)

    Ioana, A.; Constantin, N.; Dragna, E. C.

    2017-01-01

    Our article presents elements of Electric Arc Furnace (EAF) automation. So, we present and analyze detailed two automation schemes: the scheme of electrical EAF automation system; the scheme of thermic EAF automation system. The application results of these scheme of automation consists in: the sensitive reduction of specific consummation of electrical energy of Electric Arc Furnace, increasing the productivity of Electric Arc Furnace, increase the quality of the developed steel, increasing the durability of the building elements of Electric Arc Furnace.

  16. INDUCTION OF CHRONIC KIDNEY FAILURE IN A LONG-TERM PERITONEAL EXPOSURE MODEL IN THE RAT: EFFECTS ON FUNCTIONAL AND STRUCTURAL PERITONEAL ALTERATIONS

    NARCIS (Netherlands)

    F. Vrtovsnik; A. Coester; D. Lopes-Barreto; D.R. de Waart; A. van der Wal; D.G. Struijk; R. Krediet; M. Zweers

    2010-01-01

    Background: A long-term peritoneal exposure model has been developed in Wistar rats. Chronic daily exposure to 3.86% glucose based, lactate buffered, conventional dialysis solutions is possible for up to 20 weeks and induces morphological abnormalities similar to those in long-term peritoneal dialys

  17. Identification and Characterization of a Rare Fungus, Quambalaria cyanescens, Isolated from the Peritoneal Fluid of a Patient after Nocturnal Intermittent Peritoneal Dialysis.

    Directory of Open Access Journals (Sweden)

    Chee Sian Kuan

    Full Text Available Peritonitis is the leading complication of peritoneal dialysis, which is primarily caused by bacteria rather than fungi. Peritonitis is responsible for approximately 18% of the infection-related mortality in peritoneal dialysis patients. In this paper, we report the isolation of a rare fungus, Quambalaria cyanescens, from the peritoneal fluid of a man after he switched from continuous ambulatory peritoneal dialysis to nocturnal intermittent peritoneal dialysis. Based on the morphological examination and multigene phylogeny, the clinical isolate was confirmed as Q. cyanescens. This pathogen exhibited low sensitivity to all tested echinocandins and 5-flucytosine. Interestingly, morphological characterization revealed that Q. cyanescens UM 1095 produced different pigments at low temperatures (25°C and 30°C on various culture media. It is important to monitor the emergence of this rare fungus as a potential human pathogen in the tropics. This study provides insight into Q. cyanescens UM 1095 phenotype profiles using a Biolog phenotypic microarray (PM. Of the 760 nutrient sources tested, Q. cyanescens UM 1095 utilized 42 compounds, and the fungus can adapt to a broad range of osmotic and acidic environments. To our knowledge, this is the first report of the isolation of Q. cyanescens from peritoneal fluid, revealing this rare fungus as a potential human pathogen that may be misidentified using conventional methods. The detailed morphological, molecular and phenotypic characterization of Q. cyanescens UM 1095 provides the basis for future studies on its biology, lifestyle, and potential pathogenicity.

  18. Identification and Characterization of a Rare Fungus, Quambalaria cyanescens, Isolated from the Peritoneal Fluid of a Patient after Nocturnal Intermittent Peritoneal Dialysis.

    Science.gov (United States)

    Kuan, Chee Sian; Yew, Su Mei; Toh, Yue Fen; Chan, Chai Ling; Lim, Soo Kun; Lee, Kok Wei; Na, Shiang Ling; Hoh, Chee-Choong; Yee, Wai-Yan; Ng, Kee Peng

    2015-01-01

    Peritonitis is the leading complication of peritoneal dialysis, which is primarily caused by bacteria rather than fungi. Peritonitis is responsible for approximately 18% of the infection-related mortality in peritoneal dialysis patients. In this paper, we report the isolation of a rare fungus, Quambalaria cyanescens, from the peritoneal fluid of a man after he switched from continuous ambulatory peritoneal dialysis to nocturnal intermittent peritoneal dialysis. Based on the morphological examination and multigene phylogeny, the clinical isolate was confirmed as Q. cyanescens. This pathogen exhibited low sensitivity to all tested echinocandins and 5-flucytosine. Interestingly, morphological characterization revealed that Q. cyanescens UM 1095 produced different pigments at low temperatures (25°C and 30°C) on various culture media. It is important to monitor the emergence of this rare fungus as a potential human pathogen in the tropics. This study provides insight into Q. cyanescens UM 1095 phenotype profiles using a Biolog phenotypic microarray (PM). Of the 760 nutrient sources tested, Q. cyanescens UM 1095 utilized 42 compounds, and the fungus can adapt to a broad range of osmotic and acidic environments. To our knowledge, this is the first report of the isolation of Q. cyanescens from peritoneal fluid, revealing this rare fungus as a potential human pathogen that may be misidentified using conventional methods. The detailed morphological, molecular and phenotypic characterization of Q. cyanescens UM 1095 provides the basis for future studies on its biology, lifestyle, and potential pathogenicity.

  19. Final Report on the Automated Computer Science Education System.

    Science.gov (United States)

    Danielson, R. L.; And Others

    At the University of Illinois at Urbana, a computer based curriculum called Automated Computer Science Education System (ACSES) has been developed to supplement instruction in introductory computer science courses or to assist individuals interested in acquiring a foundation in computer science through independent study. The system, which uses…

  20. Modelling and experimental study for automated congestion driving

    NARCIS (Netherlands)

    Urhahne, J.A.; Piastowski, P.; Voort, van der M.C.; Bebis, G; Boyle, R.; Parvin, B.; Koracin, D.; Pavlidis, I.; Feris, R.; McGraw, T.; Elendt, M.; Kopper, R.; Ragan, E.; Ye, Z.; Weber, G.

    2015-01-01

    Taking a collaborative approach in automated congestion driving with a Traffic Jam Assist system requires the driver to take over control in certain traffic situations. In order to warn the driver appropriately, warnings are issued (“pay attention” vs. “take action”) due to a control transition stra