Sparring på evaluering af Destination Trivsel

DEFF Research Database (Denmark)

Schulz, Anette

, konklusion – hvor udsagn fra elever i henholdsvis indskolingen, mellemtrinnet og udskolingen indledningsvist behandles separat og deskriptivt. Efterfølgende er data analyseret med afsæt i en kryds-case-analyse, hvor der på baggrund af den deskriptive analyse koblet til de respektive målgrupper er udledt en...

Røveri af bil - forbrydelsen der ikke findes

DEFF Research Database (Denmark)

Lentz, Lene Wacher

2018-01-01

Artiklen behandler den særegne strafferetlige problematik, at røveri af bil ikke straffes som sådan, men alene som ulovlig tvang og brugstyveri. Dette skyldes en formodning om, at tyven kun vil bruge bilen, ikke tilegne sig bilen. Konsekvensen bliver en langt lavere straf for "røveri af bil", end...

Om retsafgift i sager om prøvelse af myndighedsudøvelse

DEFF Research Database (Denmark)

Waage, Frederik

2013-01-01

Artiklen behandler de særligt lempelige regler for beregning af retsafgifter i sager om prøvelse af myndighedsudøvelse, jf. retsafgiftslovens § 1, stk. 4, 2. pkt. og § 2, stk. 3, 2. pkt., med henblik på en nærmere afklaring af, hvornår en retssag vedrører myndighedsudøvelse i retsafgiftslovens fo...

Håndtering af illikviditet i APV modellen

DEFF Research Database (Denmark)

Brandt, Mads; Dalgaard, Rune; Plenborg, Thomas

2014-01-01

Denne artikel behandler illikviditetspræmien i forbindelse med værdiansættelser. Mere præcist udledes den korrektion af illikviditetspræmien, der skal foretages, for at sikre konsistens i værdiansættelsen med henholdsvis Discounted Cash Flow (DCF) og Adjusted Present Value (APV) modellen. Artiklen...

Tilbagebetaling af sociale ydelser

DEFF Research Database (Denmark)

Hielmcrone, Nina Elisabeth von

konstateres, at der foreligger fejl og forsømmelser hos både modtager og myndighed. Dermed stilles der også spørgsmålstegn ved de såkaldt "objektive" tilbagebetalingsbestemmelser som f.x. i boligstøttelovens § 47 stk. 1 og 2.       Bogen behandler desuden de mange og vanskelige fortolkningsproblemer, der...... knytter sig til anvendelsen af tilbagebetalingsbestemmelserne i de sociale love....

Review af Business Process Reengineering litteraturen fra 1990-98

DEFF Research Database (Denmark)

Wit, Camilla Kølsen de

1998-01-01

Formålet med papiret er dels at biddrage med et overblik over centrale kilder om BPR, og dels at kommentere udviklingen i litteraturens behandling af hhv. BPR begrebet og BPR projektet. Reviewet er bygget op om en kronologisk tabel, der opsummerer kildernes hovedsynspunkter....

Forekomst af afvigende isbjørne i Østgrønland

DEFF Research Database (Denmark)

Dietz, R.; Sonne, Christian; Born, E. W.

I de seneste år har der været øget fokus på de mulige miljømæssige virkninger af de såkaldte persistente organisk forurenende stoffer i Arktis som f.eks DDT og PCB. Denne rapport behandler indsamlede oplysninger fra de østgrønlandske isbjørnejægere om forekomsten af isbjørne, her især forekomsten...

Tuberkulose forårsaget af Mycobacterium africanum

DEFF Research Database (Denmark)

Bek, Dorte; Kjeldsen, Marianne Kirstine; Hansen, Nikolaj Friis

2010-01-01

Tuberkulose (TB) forårsages af patogene arter fra Mycobacterium tuberculosis komplekset (MTBC) og har en incidens på cirka 7/100.000 i Danmark. På mistanke om TB hos en akut indlagt 40 årig afrikansk mand initieredes anti-TB behandling. Efter 13 timers indlæggelse afgik patienten ved døden. Fra...

Tilfredshedsundersøgelse af Palliativt Team Fyn

DEFF Research Database (Denmark)

Paulsen, Maja Skov

2007-01-01

Behandling af døende patienter i eget hjem kan være en vanskelig og udfor­ drende opgave. Målet med behand­ lingen skifter fra kurativt til lindrende, hvilket udfordrer selvopfattelsen som be­ handler, og samtidig vil palliativ behand­ ling ofte rumme komplicerede medicinsk faglige problemstillin...... problemstillinger samt eksisten­ tielle spørgsmål. Gennem de senere år er der etableret specialiserede palliative teams med udgående funktioner som støtte til de primære behandlere af dø­ ende mennesker....

Udvikling af medicinsk behandling mod bipolar lidelse

DEFF Research Database (Denmark)

Ellegaard, Pernille Kempel

2015-01-01

Selvom Esbjerg ligger i vandkants Danmark, er det den Psykiatriske Forskningsenhed i denne by, der er primus motor for et stort forsøg blandt mennesker, der lider af bipolar lidelse. Forsøget hedder ”NACOS”, og er et medicinsk forsøg til mennesker, der befinder sig i den depressive fase.......Selvom Esbjerg ligger i vandkants Danmark, er det den Psykiatriske Forskningsenhed i denne by, der er primus motor for et stort forsøg blandt mennesker, der lider af bipolar lidelse. Forsøget hedder ”NACOS”, og er et medicinsk forsøg til mennesker, der befinder sig i den depressive fase....

Evaluering af 'Tankerne på plads og hverdagen tilbage' - et kursusforløb for modermærkekræftramte

DEFF Research Database (Denmark)

Haslam, Trine Lolk

af modermærkekræft til at genvinde trygheden og kontrollen i deres liv, ved at gøre dem bedre i stand til at forstå, acceptere og håndtere deres sygdom og behandling, samt at reducere de modermærkekræftramtes brug af sundhedsvæsenet til det nødvendige. Således ønskes det at påvirke adfærd på kort og...... behandlingen samt give en tilbagemelding på operationsforløbet. På kurset underviser desuden en psykolog, der behandler de psykologiske aspekter ved det at få en livstruende sygdom, hvilket ligeledes er af stor betydning for kursisterne. Desk study underbygger dette ved at pointere, at patientskole med...... formidling af viden via forskellige metoder, giver positiv effekt. Analysen i forbindelse med programteori 2 underbygger at kurset er tilrettelagt og gennemført som gruppebaseret undervisning, hvilket jf. desk study bidrager til øget egenomsorg. Den procesorienterede dialogiske tilrettelæggelse og...

Dilemmaer i musikterapeutisk behandling af en traumatiseret flygtning med musikerbaggrund

Directory of Open Access Journals (Sweden)

Bolette Daniels Beck

2016-12-01

Full Text Available Denne artikel præsenterer et single case-studie af et receptivt musikterapiforløb med en 55-årig syrisk flygtning, som har været udsat for fængsling og tortur på grund af sine aktiviteter som protestsanger og musiker. Der beskrives problemstillinger og dilemmaer relateret til at anvende musik, der både kan trigge traumer, men også vække indre ressourcer. Kortlægning af patientens forskellige personlighedsdele og musikkens evne til integration af dem vil blive belyst gennem teorien om strukturel dissociation.

U.2010 B.1; Fagforeningers kontrol af virksomheders løn- og arbejdsvilkår

DEFF Research Database (Denmark)

Lind, Martin Gräs

2010-01-01

Artiklen behandler spørgsmålet, om og i hvilket omfang fagforeninger har ret til at kontrollere især overenskomstforpligtede arbejdsgivere. Det stigende antal udenlandske arbejdstagere på det danske arbejdsmarked har medført øget fokus på og behov for kontrolførelse af overenskomstens bestemmelse......, bl.a. for at sikre mod illegal beskæftigelse, omgåelse af overenskomsterne og social dumping....

Atrial fibrillation in the Danish population

DEFF Research Database (Denmark)

Hansen, Morten Lock

2010-01-01

. Evidensgrundlaget for at oral antikoagulations behandling (AK – behandling) nedsætter risikoen for tromboemboli er særdeles veldokumenteret. Derfor bør der i en korrekt behandling af patienter med atrieflimren, indgå en vurdering af, om der er indikation for AK – behandling. Flere studier har påvist en langsom og...... vaklende implementeringen af AK - behandlingen i daglig klinisk praksis. Mange atrieflimren patienter med indikation får ikke AK – behandling og mange uden indikation får det! Brug af AK - behandlingen kompliceres også af, at mange patienter med atreiflimren har indikation for trombocythæmmende behandling......, eksempelvis ved iskæmisk hjertesygdom. Hvor stor en blødningsrisiko man påfører patienten ved at kombinere clopidogrel, acetylsalicylsyre eller begge behandlinger med AK - behandling, er usikkert. I denne afhandling fokuseres på faktorer relateret til AK – behandling og de kliniske konsekvenser associeret til...

Behandling af patienter med Guillan Barré syndrom

DEFF Research Database (Denmark)

Oliel, Vibeke S.

2011-01-01

Resumè Guillain Barrés syndrom er en autoimmum sygdom karakteriseret ved motorisk, sensorisk og autonom dysfunktion. I Danmark rammes omkring 80 personer i alle aldre årligt af sygdommen. Akut inflammatorisk polyradikoloneuropati rammer de perifere nervers nerveskeder og medfører progredierende...

A.R.T. – Aggression Replacement Training

DEFF Research Database (Denmark)

Harbo, Lotte Junker; Domben, Eskil

2015-01-01

Artiklen indeholder en kort introduktion, eksemplificeret ved case, af det manualbaserede program til behandling af udadreagerende unge Aggression Replacement Training.......Artiklen indeholder en kort introduktion, eksemplificeret ved case, af det manualbaserede program til behandling af udadreagerende unge Aggression Replacement Training....

Metodik til studiet af strategiske ledelsesprocesser i organisationer

Directory of Open Access Journals (Sweden)

Jørgen Gulddahl Rasmussen

2010-10-01

Full Text Available Denne artikel handler om at skabe viden om en hverdagspraksis, der sjældent er sat ord på. Den behandler de ledelsesprocesser, der i virksomheder producerer strategi og omsætter sådanne strategier i produktive handlinger. Det er processer, der i små og mellemstore virksomheder er præget af intuition og af meget uformelle samspil mellem virksomhedsledere og medarbejdere. Metodikken er en videreudvikling af de metoder til produktion af kvalitative data, som FIRM-gruppen har eksperimenteret med gennem nogle år. Artiklen kan ses som en afrapportering af et flerårigt metodeudviklingsarbejde. Da erfaringer fra sådanne virksomheder viser, at strategiske processer i høj grad udvikler sig gennem uformel kommunikation, og at lederes intuition spiller en meget stor rolle, arbejder metodikken med en struktureret udviklingsdialog mellem et mindre antal virksomhedsledere med strategiske opgaver og forskere. Denne udviklingsdialog har til formål at følge og forstå de processer, der skaber ledernes egne praksisrelaterede ”teorier” for strategisk handling. Efter en præsentation af temaet gennemgås metodikkens praktiske fremgangsmåde med undersøgelser i en række virksomheder, opbygning af cases i samarbejde med ledere fra disse virksomheder, diskussion af disse og foreløbige konklusioner hen mod de næste trin i metodikken. Artiklen er skrevet samtidigt med arbejdet på et igangværende forskningsprojekt og vil derfor både være en præsentation og en udvikling af muligheder og vanskeligheder i metodikken.

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....

Intensiv musik- og psykomotorisk gruppeterapi m. flygtninge

DEFF Research Database (Denmark)

Telcs, Cathrine

2014-01-01

Evaluering af gruppemusikterapi i kombination med psykomotorisk behandling med 3 traumatiserede flygtninge ved hjælp af spørgeskemaer ( WHOQOL) og interviews.......Evaluering af gruppemusikterapi i kombination med psykomotorisk behandling med 3 traumatiserede flygtninge ved hjælp af spørgeskemaer ( WHOQOL) og interviews....

Forskningsbaseret viden kan bruges i praksis

DEFF Research Database (Denmark)

Braad, Mette; Bahnsen, Iben Bøgh; Axelsen, Hanne Clement

2013-01-01

Evidensbaseret praksis blev trænet i et samarbejde mellem sygeplejestuderende, kliniske vejledere og undervisere på sygeplejerskeuddannelsen i Aalborg. Resultatet af samarbejdet kommer nu præmature børn i CPAP-behandling til gode i form af systematisk soignering, aflastning og gel-behandling omkr......Evidensbaseret praksis blev trænet i et samarbejde mellem sygeplejestuderende, kliniske vejledere og undervisere på sygeplejerskeuddannelsen i Aalborg. Resultatet af samarbejdet kommer nu præmature børn i CPAP-behandling til gode i form af systematisk soignering, aflastning og gel...

Implementation of life cycle assessment models in solid waste management

DEFF Research Database (Denmark)

Damgaard, Anders

Teknologier til behandling af affald bliver løbende forbedret, og antallet af forskellige måder at behandle affaldet på er stigende. Det er derfor nødvendigt at finde en metode til at vurdere, hvad der er den mest optimale kombination af teknologier til affaldsbehandling. En af de metoder, der er...

Resource recovery from waste incineration residues

DEFF Research Database (Denmark)

Allegrini, Elisa

Affaldsforbrænding er i mange lande en vigtig teknologi til behandling og energiudnyttelse af affald. Udover energi resulterer forbrænding også i produktion af asker. Størstedelen af askerne udgøres af slagge, som efter behandling har gode tekniske egenskaber og kan anvendes til bygge- og anlægsf...

De nye myter

DEFF Research Database (Denmark)

Krogsdal, Iben Egekvist

Selvudvikling og selvrealisering i en psykologiseret tidsalder. Bogen er en omskrivning af min ph.d.-afhandling og behandler psykologiseringen af det moderne samfund ud fra terapiformen NLP.......Selvudvikling og selvrealisering i en psykologiseret tidsalder. Bogen er en omskrivning af min ph.d.-afhandling og behandler psykologiseringen af det moderne samfund ud fra terapiformen NLP....

Sport og medierettigheder

DEFF Research Database (Denmark)

Jakobsen, Søren Sandfeld

2014-01-01

Kapitlet behandler en række medie-, immaterial- og konkurrenceretlige aspekter ved overdragelse af tv-rettigheder til store sportsbegivenheder.......Kapitlet behandler en række medie-, immaterial- og konkurrenceretlige aspekter ved overdragelse af tv-rettigheder til store sportsbegivenheder....

Tilsynsdiamanten i spændingsfeltet mellem soft law og hard law

DEFF Research Database (Denmark)

Rasmussen, Niels Skovmand

2013-01-01

Artiklen behandler de retskildemæssige spørgsmål, som Tilsynsdiamanten udstedt af Finanstilsynet giver anledning til. Dette sker på baggrund af forskellige teorier omkring soft law og hard law.......Artiklen behandler de retskildemæssige spørgsmål, som Tilsynsdiamanten udstedt af Finanstilsynet giver anledning til. Dette sker på baggrund af forskellige teorier omkring soft law og hard law....

Antithrombotic drugs and interactions in ischemic heart disease

DEFF Research Database (Denmark)

Charlot, Mette Gitz

2011-01-01

Antithrombotisk behandling er en hjørnesten i moderne kardiologi og indgående viden om de præcise virkninger og bivirkninger af lægemidlerne er vigtig for at sikre hjertepatienter den optimale behandling. Denne ph.d. afhandling belyser vigtige problemstillinger omkring anvendelsen af antithrombot...

Moms og fast ejendom

DEFF Research Database (Denmark)

Edlund, Hans Henrik

1999-01-01

I artiklen gives et overblik over, hvorledes fast ejendom behandles momsmæssigt. Derfor findes en kort skitsering af reglerne for moms på byggearbejder, afgrænsningen mellem momspligtig og momsfri udlejning, muligheden for frivillig registrering af udlejning samt opgørelse af reguleringsforpligte......I artiklen gives et overblik over, hvorledes fast ejendom behandles momsmæssigt. Derfor findes en kort skitsering af reglerne for moms på byggearbejder, afgrænsningen mellem momspligtig og momsfri udlejning, muligheden for frivillig registrering af udlejning samt opgørelse af...

The effects of real-time telemedicine video consultations between nurses and patients with severe Chronic Obstructive Pulmonary Disease (COPD)

DEFF Research Database (Denmark)

Sorknæs, Anne Dichmann

Formålet med ph.d. studiet var at undersøge effekten af telekonsultationer som supplement til konventionel behandling sammenlignet med konventionel behandling hos udskrevne patienter med KOL med fokus på genindlæggelser, dødelighed, sundhedsøkonomi, sygeplejerskers og patienters oplevelse af tele...

Trækonstruktioner

DEFF Research Database (Denmark)

Larsen, H.J.; Riberholt, H.

Denne anvisning behandler materialer til trækonstruktioner og beregning af sædvanlige elementer og konstruktioner i henhold til Trænormen fra 2003 med tillæg. Forbindelser behandles i SBI-anvisning 194: Trækonstruktioner. Forbindelser. Anvisningen er tænkt anvendt af projekterende og som lærebog på...

Professionel kompetence og uddannelse

DEFF Research Database (Denmark)

Hedegaard, Karen Marie

Specialet behandler forholdet mellem professionel kompetence og uddannelse gennem en undersøgelse og diskussion af teorier og forskning om professionsbegrebet i sociologien historisk og aktuelt, bl.a. Talcott Parsons, MaxWeber og Thomas Mathiesen, og diskuterer forskellige forståelser af professi......Specialet behandler forholdet mellem professionel kompetence og uddannelse gennem en undersøgelse og diskussion af teorier og forskning om professionsbegrebet i sociologien historisk og aktuelt, bl.a. Talcott Parsons, MaxWeber og Thomas Mathiesen, og diskuterer forskellige forståelser af...

Tilgængelige boliger - indretning

DEFF Research Database (Denmark)

Sigbrand, Lone; Jensen, Philip Henrik

Anvisningen behandler indretning af boliger, så de er tilgængelige for personer med funktionsnedsættelser.Denne anvisning behandler indretning af boliger, så de er tilgængelige for personer med funktionsnedsættelser. Ved at følge anvisningen sikrer man sig, at man lever op til kravene om tilgænge...

Case report - curved femoral osteotomy for management of medial patellar luxation

DEFF Research Database (Denmark)

Allpass, Maja; Miles, James Edward

2015-01-01

Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation.......Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation....

Effect of intensive multifactorial treatment compared with routine care on aortic stiffness and central blood pressure among individuals with screen-detected type 2 diabetes

DEFF Research Database (Denmark)

Johansen, Nanna Borup; Charles, Morten; Vistisen, Dorte

2012-01-01

Baggrund: Interventionsstudier med kardiovaskulære endepunkter kræver meget store studie populationer og/eller en lang opfølgningstid. Intermediære endepunkter som ligger i den kausale gangsti mod klinisk relevante endpunkter er derfor brugbare redskaber til at vurdere effekten af behandling i...... studie som mangler tilstrækkelig kardiovaskulære tilfælde. Aorta stivhed er et anerkendt intermediært endemål i kliniske studier. I ADDITION Danmark studiet fik en del af deltagerne ved 6 års opfølgningsundersøgelsen undersøgt aortisk stivhed, målt ved karotid-femoral pulsbølge hastighed. Vi undersøgte...... herigennem effekten af intensiv multifaktoriel behandling sammenlignet med rutine behandling i almen praksis. Resultater: Patienterne in intensiv gruppen havde en 0,51 m/s (95%CI: -0,96; -0,05; p-værdi:0.03) sammenlignet med rutine behandlingsgruppen. Ekstrapolering af disse resultater på basis af en meta...

The Holocaust and Collective Memory in Scandinavia

DEFF Research Database (Denmark)

Lammers, Karl Christian

2011-01-01

Artiklen behandler Holocaust's plads i den kollektibve erindring i Skandinavien, og den viser hvorledes den "gode historie": redningen af de danske jøder i oktober 1943 i lang tid bestemte omgangen med Holocaust.......Artiklen behandler Holocaust's plads i den kollektibve erindring i Skandinavien, og den viser hvorledes den "gode historie": redningen af de danske jøder i oktober 1943 i lang tid bestemte omgangen med Holocaust....

Duer ikke! Væk!: En undersøgelse af individets fremtoning og adfærd på Tinder.

OpenAIRE

Vognsen, Karen Marie Veje; Hansen, Nick Krarup; Sloth, Andreas; Oftebro-Svendsen, Kristoffer; Bannebjerg, Laura Emilie

2016-01-01

Denne projektrapport behandler emnerne 'Individets adfærd og relations-dannelse' på det sociale medie 'Tinder'. Med afsæt i en række udvalgte teoretikere, har vi undersøgt, hvorvidt tinder giver brugerne anledning til en overfladisk adfærd. Derudover har vi set nærmere på Tinders system og opbygning, og undersøgt hvordan disse påvirker brugerne, når de møder hinanden for første gang. Projektet anvender både primær og sekundær data, samlet gennem litteratur, kvalitative og kvantitative metoder...

Impact of early detection and treatment of diabetes on the 6-year prevalence of cardiac autonomic neuropathy in people with screen-detected diabetes

DEFF Research Database (Denmark)

Charles, Morten; Fleischer, J; Witte, Daniel Rinse

2013-01-01

Baggrund: Der er begrænset viden om hvordan tidlig multifaktoriel behandling forbedrer konsekvenser af diabetes. Kardiel autonom neuropati (KAN) hos personer med diabetes indikerer omfattende skade på det autonome nervesystem og er relateret til mortalitet og livskvalitet. I dette studie fra...... ADDITION Danmark undersøgte vi effekten af tidlig opsporing og efterfølgende intensive behandling af type 2 diabetes i almen praksis på hyppigheden af kardiel autonom neuropati 6 år efter diagnose. Resultater: Prævalensen af tidlig KAN var 15,1% i rutine behandlingsgruppen (RG) og 15.5% i intensive...... kardiovaskulære risikofaktorer er således ikke nok til at forebygge at mange diabetes patienter udvikler KAN....

Fluconazol og amning

DEFF Research Database (Denmark)

Pedersen, Andreas James Thestrup; Hessellund, Anne; Bergmann, Troels Korshøj

2016-01-01

Når lokalbehandling til candidainfektion ikke er nok, er næste valg systemisk behandling. Men hvad, hvis kvinden ammer? Kan systemisk behandling med tablet fluconazol anvendes? Svaret er ja – men langvarig behandling (> 2 uger) bør undgås. Fluconazol vil udskilles i brystmælk, men mængden af...... fluconazol, som barnet derved indtager, er lav....

Behandling af demenssygdomme--hvem skal behandles?

DEFF Research Database (Denmark)

Hasselbalch, Steen; Kampmann, Jens Peter

2009-01-01

Recommendations for treatment with specific antidementia drugs in Denmark are given on the basis of recent evidence. Such evidence supports treatment of mild to moderate Alzheimer's Disease (AD) with acetylcholinesterase inhibitors (AchEI), and moderate to severe AD with memantine. Combination...... therapy with these drugs can be considered in moderate AD. Dementia with Lewy bodies and Parkinson's disease with dementia should be treated with rivastigmine. There is not sufficient evidence to recommend treatment with AchEI or memantine in pure vascular dementia or frontotemporal dementia...

Hovedlinjer i erhvervsstrafferetten, 6. udg

DEFF Research Database (Denmark)

Greve, Vagn; Langsted, Lars Bo

Bogen omhandler de generelle betingelser for strafansvar og beskrivelse af en række af de forbrydelser, der typisk begås i forbindelse med erhvervsudøvelse. Hertil kommer en gennemgang af retssystemets behandling af straffesager om erhvervskriminalitet....

Uddannelsesnutid: Velfærdsteknologi og kompetenceudvikling

DEFF Research Database (Denmark)

Petersen, Anne Kristine

2015-01-01

Kapitlet samler præsentationer af de forskellige typer af læringsmiljøer, der er udviklet i projektet, og analyser på tværs af undervisningsaktiviteterne, herunder identifikation af forskellige kompetence -og teknologiforståelser som en udfoldning af projektets behandling af begrebet ‘technological...... literacy’....

Can pay for performance improve the quality of primary care?

DEFF Research Database (Denmark)

Roland, Martin; Olesen, Frede

2016-01-01

I mange lande synes sundhedsvæsenet ikke at kunne tilbyde tilstrækkelig behandling af en lang række sygdomme. Højt kvalificerede læger er en afgørende faktor, men dygtige læger er ikke nok til at sikre god behandling. Derfor ses der nu mange steder efter nye incitamenter, som kan bidrage til at h...... til nye former for behandling og pleje. Vi har brug for mere forskning på dette område, hvis vi på et oplyst grundlag skal beslutte, om og evt. hvordan vi bedst indfører elementer af ”pay for perfomance” for at forbedre de services, der udbydes i sundhedsvæsenet....

Hvordan diagnosticerer man astma hos børn?

DEFF Research Database (Denmark)

Hermann, Christian

1997-01-01

Astma og astmatisk bronkit har ens symptomatologi og behandling og kan med vore dages effektive og bivirkningssvage medicin selv i de lettere grader behandles. Symptomerne kender vi i praksis fra op mod 1/3 af småbørnene, kunsten består i at stille behandlingsindikationen. Der opridses overvejende...... udfra kliniske kriterier enkle retningslinier, der nyder konsensus blandt danske almenmedicinere og pædiatere til hjælp i den daglige håndtering af sådanne symptomer i almen praksis. Til slut understreges, at opsporing af astma og astmatisk bronkitis naturligt hører hjemme i almen praksis, og...

Behandling af brandskader

DEFF Research Database (Denmark)

Lang, Christian Lyngsaa; Partoft, Søren; Astrup, Jakob

2015-01-01

This paper aims to clarify the newly revised guidelines regarding burn injuries as to assist medical personnel dealing with burns. The Department of Burns at Rigshospitalet is the main burn centre in Denmark, and thus creates the National Guidelines of burns treatment. The new guidelines have...

Behandling af hypertermi

DEFF Research Database (Denmark)

Mørch, Sofie Søndergaard; Andersen, Johnny Dohn Holmgren; Bestle, Morten Heiberg

2017-01-01

syndrome, a few endocrine emergencies as well as numerous intoxications. Rapid diagnosis and prompt cooling are pivotal, since the condition triggers a cascade of metabolic events which may progress to irreversible injury or death. Ice-water immersion and evaporative cooling are the methods of choice....

Identifying Patients at Risk and Patients in Need

DEFF Research Database (Denmark)

Schmidt, Thomas

2015-01-01

korttidssengeafsnit. Det viser sig at sygeplejerskernes anvendelse af patientmonitoreringsudstyret afhænger af tidspunkt på døgnet, og i hvilken sammenhæng systemet bruges. Behandling af patienter er udfordret af hvordan information indhentes og deles imellem klinikerne. Hyppigheden hvormed patienter monitoreres...

Digitalisering af sygeplejepraksis

DEFF Research Database (Denmark)

Konnerup, Ulla

2018-01-01

Det er ikke nyt at anvende teknologi indenfor sygepleje, men hvor den tidligere have det formål at behandle og pleje patienter, implementeres digitale teknologier i dag i hastigt stigende grad til administration, standardisering, dokumentation, monitorering og ikke mindst effektivisering. Tidlige...

Alvorlige candidainfektioner

DEFF Research Database (Denmark)

Reibel, Jesper; Pedersen, Anne Marie Lynge; Kragelund, Camilla

2016-01-01

rofund candidiasis og candidæmi er de alvorligste former for candidainfektion, og behandling af disse sker i hospitalsregi. Incidensen af candidæmi er væsentligt højere i Danmark end i de øvrige nordiske lande. Beregning af forekomsten af svampeinfektioner i Danmark har vist, at omkring 900...... candidiasis. Tandlægen kan varetage behandling af ukomplicerede tilfælde af oral candidiasis, dvs. i de tilfælde hvor årsagen er umid- delbar, fx bredspektret antibiotikabehandling, insufficient mund- og/eller protesehygiejne, nedsat spytsekretion og rygning. Behandlingen er imidlertid mere kompliceret, når...... underliggende sygdom er årsag til recidiverende og ofte behandlingsrefraktær oral candidiasis. Her kan multidisciplinært samarbejde være nødvendigt. For at opnå et optimalt behandlingsrespons er det vigtigt at identificere faktorer, der har betydning for terapivalg og behandlingsvarighed. Det drejer sig om...

Gentaget selvmordsforebyggende behandling

DEFF Research Database (Denmark)

Lind, Bertel

2014-01-01

ramme er casestudie (Yin 2009; George 2005; Flyvbjerg 1991). Casestudiet består af en række patientforløb, hvor hver patient har haft mere end ét registreret behandlingsforløb i databasen (n = 377). Kvantitativ undersøgelse blev udført ved hjælp af Microsoft SPSS 21 på de 377 patienter på baggrund af...

Sygepleje mellem pakker og personer

DEFF Research Database (Denmark)

Sandholm Larsen, Niels

2010-01-01

og af problemer med at rekruttere og fastholde sundhedsfaglig arbejdskraft. Som følge af demografiske ændringer antages særligt behandling og rehabilitering af kronisk syge ældre at udgøre et voksende indsatsområde. Sygeplejerskernes faglige organisation har været aktiv i etablering af kommunale...

From Stigma to Assertion

DEFF Research Database (Denmark)

Denne antologi indeholder otte bidrag af antropologer, historikere og religionsforskere til belysning af fortidens "urørlige kaster" og nutidens "dalits" i Indien. Specielt virkningerne af den indiske stats reservationspolitik over for disse grupper behandles. Denne politik har på én gang forbedr...

Sprog som musikalsk notation

DEFF Research Database (Denmark)

Bergstrøm-Nielsen, Carl

Artiklen behandler sprogbrug som supplement til noderne fra barokken og frem; Fluxus og Scratch Orchestra; den engelske Verbal Anthology; Stockhausens brug af verbal notation før tekst-samlingerne; detaljerede analyser af de to samlinger. Der konkluderes bla. om forskellige grader af fastlæggelse...

Peritoneal dialysis-related peritonitis: challenges and solutions

Science.gov (United States)

Salzer, William L

2018-01-01

Peritoneal dialysis is an effective treatment modality for patients with end-stage renal disease. The relative use of peritoneal dialysis versus hemodialysis varies widely by country. Data from a 2004 survey reports the percentage of patients with end-stage renal disease treated with peritoneal dialysis to be 5%–10% in economically developed regions like the US and Western Europe to as much as 75% in Mexico. This disparity is probably related to the availability and access to hemodialysis, or in some cases patient preference for peritoneal over hemodialysis. Peritoneal dialysis-related peritonitis remains the major complication and primary challenge to the long-term success of peritoneal dialysis. Fifty years ago, with the advent of the Tenckhoff catheter, patients averaged six episodes of peritonitis per year on peritoneal dialysis. In 2016, the International Society for Peritoneal Dialysis proposed a benchmark of 0.5 episodes of peritonitis per year or one episode every 2 years. Despite the marked reduction in peritonitis over time, peritonitis for the individual patient is problematic. The mortality for an episode of peritonitis is 5% and is a cofactor for mortality in another 16% of affected patients. Prevention of peritonitis and prompt and appropriate management of peritonitis is essential for the long-term success of peritoneal dialysis in all patients. In this review, challenges and solutions are addressed regarding the pathogenesis, clinical features, diagnosis, treatment, and prevention of peritoneal dialysis-related peritonitis from the viewpoint of an infectious disease physician.

Characterizing bovine host responses to mastitis pathogens by targeted proteomics

DEFF Research Database (Denmark)

Bislev, Stine Lønnerup

Mastitis, som er betændelse i yverkirtlen forårsaget af indtrængende patogener, udgør en betydelig udfordring for dyresundhed- og velfærd i malkekvægsbesætninger. Identifikation af følsomme diagnostiske mastitismarkører vil kunne hjælpe med at stille en tidligere diagnose og gavne effekten af...... behandling. Patogenspecifikke biomarkører, der kan måles direkte i mælk, er lovende for at diagnosticere mastitis i de tidligste stadier af sygdommen. Dermed kan den korrekte antibiotika behandling påbegyndes, så snart en infektion i yveret opdages. Den massive tilstedeværelse af de dominerende...... hinanden. For at opfylde dette formål blev der udviklet en SRM metode rettet mod proteiner, som formodes at spille en stor rolle i mastitis. Under udviklingen af SRM metoden blev der først udvalgt 20 biomarkørkandidater, der relaterer til inflammation og mastitis. Derefter skulle der udvælges peptider, som...

Translation as Transformation

DEFF Research Database (Denmark)

Klitgård, Ebbe

2008-01-01

Artiklen behandler de to tidligste oversættelser af Chaucer i Danmark, professor T.C. Bruuns oversættelse af Popes version af Chaucers The Wife of Bath's Prologue fra 1823, og skolebestyrer Louise Westergaards hæfte med oversættelse og referater af Chaucer fra 1853. Jeg viser hvordan en klassisk ...

Eosinophilic peritonitis: An unusual manifestation of tuberculous peritonitis in peritoneal dialysis patient

Directory of Open Access Journals (Sweden)

Hsin-Hui Wang

2011-07-01

Full Text Available Eosinophilic peritonitis is an uncommon clinical entity with diagnostic considerations separate from those of tuberculous peritonitis. We report a patient on continuous ambulatory peritoneal dialysis (CAPD with eosinophilic peritonitis resulting from tuberculous peritonitis. Acid-fast stain and mycobacterial culture of peritoneal dialysis effluent were both negative result. In the peritoneal dialysis effluent and blood samples, Mycobacterium tuberculosis was detected by polymerase chain reaction analyses. The initiation of antituberculous therapy resulted in resolution of the eosionphilia in the dialysis effluent. After 14 days of antituberculous therapy, the polymerase chain reaction analyses of tuberculosis were negative for both the blood and peritoneal dialysis effluents. Evaluation of tuberculosis infection is necessary if the CAPD-related peritonitis presents with an unusual and unexplained clinical course. Polymerase chain reaction can play an important role in the diagnosis of tuberculous peritonitis in patients undergoing CAPD.

Bereavement care in general practice

DEFF Research Database (Denmark)

Guldin, Mai-Britt; Vedsted, Peter; Jensen, Anders Bonde

2013-01-01

I dette studie testes effekten af en klinisk intervention over for håndtering af sorg i almen praksis. Interventionen handlede om, at tidlig identifikation af komplicerede sorgreaktioner via praktiserende læge kan være med til at sikre behandling til behandlingskrævende sorgreaktioner, der volder...

Forord

DEFF Research Database (Denmark)

Friedrichsen, Annegret

2006-01-01

skizofreni, gruppeterapi og psykoterapisupervision. Bogen rummer bl.a. indlæg om tab og sorg, terapeutisk brug af fejl, den neuropsykoanalytiske basis for sprogudvikling samt organisatoriske forhold vedrørende behandling af børn og psykoanalytisk terapi i Danmark. Flere af indlæggene er rigt kasuistisk illu...

Foreløbige retsmidler

DEFF Research Database (Denmark)

Werlauff, Erik

2008-01-01

Artiklen behandler foreløbige retsmidler ved EF-domstolen, fx mod Danmarks fortsatte byggeri af Storebæltsbroen i strid med fællesskabsretlige udbudsregler eller mod ikrafttrædelsen af en forbundslov om tyske motorvejsafgifter i strid med kravet om ligebehandling af inden- og udenlandske vognmænd...

Folkeretlige problemstillinger i forbindelse med konflikten mellem Ukraine og Rusland

DEFF Research Database (Denmark)

Buhl, Kenneth Øhlenschlæger

Konflikten mellem Ukraine og Rusland udgør en trussel mod den internationale retsorden og dermed også hele den europæiske orden. Med henblik på at give et grundlag for at forstå omfanget af dette aspekt af konflikten behandles her lovligheden af nogle af de handlinger, som har været konfliktens...

Selvstyre, køn og kvalitet i arbejdslivet

DEFF Research Database (Denmark)

Bilfeldt, Annette; Hofmeister, Elsebeth; Nielsen, Kurt Aagaard

viden som for styrkelse af medarbejderbestræbelser på etablering af kvalitet i arbejdslivet. Der redegøres i rapporten for udviklingen af projektets centrale temaer: konflikthåndtering og varetagelse af livssammenhængsrelaterede behov i et kønsperspektiv. Samarbejdets dilemmaer og vilkår behandles i...

Almen og praksisnær kompetenceudvikling for voksne

DEFF Research Database (Denmark)

Hviid, Marianne Kemeny; Keller, Hanne Dauer; Rasmussen, Annette

Rapporten sammenfatter og diskuterer erfaringer og resultater fra forskningsdelen i projektet KOM-UD (Kompetenceudvikling i udkantsområder). Rapportens kapiteler behandler forskellige aspekter af arbejdet med praksisnær (og oftest virksomhedsrettet) almen voksenundervisning med brug af resultater...

Træ og Stål i Havvand

DEFF Research Database (Denmark)

Jensen, Jens Kristian Jehrbo

Dette kompendium behandler træ- og stålkonstruktioners holdbarhed i marint miljø. Materialerne bliver udsat for kraftige påvirkninget· i form af bølgeslag, strø ninger, slid, nedbrydning og korrosion. Relevante mekanismer og beskyttelsessysleaer behandles . J~ftet tænkes anvendt ved undervisninge...... , spec ielt på anlægssektorens 6. semester, men andre interesserede er velkomne til at benytte det. Renskrivningen er foretaget af Tove Jensen, og Ingrid Christensen og Poul Skørbæk Sørensen har udført tegnearbejdet. Tak for veludført arbejde! Jens Kr . Jehcbo Jensen...

Dødelig venlafaxinforgiftning

DEFF Research Database (Denmark)

Pedersen, Julie Steen; Munck, Lars Kristian

2014-01-01

Venlafaxin er en serotonin- og noradrenalingenoptagelseshæmmer, der er godkendt til behandling af depressioner og angsttilstande. Symptomer ved forgiftning er serotonergt syndrom, generaliserede krampeanfald, rabdomyolyse samt akut lever-, hjerte- og nyresvigt. Der findes ingen antidot. Med afsæt i...

Radical Orthodoxy and Post-Structuralism: An Unholy Allaince

DEFF Research Database (Denmark)

Albinus, Lars

2009-01-01

Artiklen behandler det ambivalente forhold mellem Radical Orthodxy og fransk post strukturalisme. Gennem en fremstilling af specielt Foucault-receptionen argumenterer artiklen for, at alliancen med en moderne fornuftskritik bryder af på halvvejen for at forsvare en doxologisk traditionsforståelse...

Boligmarkedet under inflation

DEFF Research Database (Denmark)

Lunde, J.

Rapportens enkelte kapitler behandler prisdannelsen på boligmarkedet, huslejereguleringen, prisudviklingen på bolig-delmarkederne, fremkomsten af kapital- og debitorgevinster ved besiddelse og belåning af boligejendomme, samt de samfundsøkonomiske årsager til denne prisudvikling og disse gevinstd...

Dansk selskabsret 3

DEFF Research Database (Denmark)

Friis Hansen, Søren; Krenchel, Jens Valdemar

virksomheder, fra partnerskaber i liberale erhverv til store entreprenørfællesskaber og samarbejder mellem store virksomheder samt joint ventures. Bind 3 af Dansk selskabsret – Interessentskaber – behandler: •Interessentskabets stiftelse •Forholdet mellem interessenterne •Misligholdelse af...

Plast og Brand

DEFF Research Database (Denmark)

Jensen, Jens Kristian Jehrbo

Dette skrift behandler emnet: plast og brand set i relation til anvendelserne i byggeriet. Den udstrakte brug af plastmaterialer gør det nødvendigt at være opmærksom på forhold vedrørende termisk nedbrydning af brand. En analyse af plastmaterialer kan foretages ved hjælp af ret simple prøver , og...

The Mutual Relationship Between Peritonitis and Peritoneal Transport.

Science.gov (United States)

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

2016-01-01

♦ Preservation of the peritoneum is required for long-term peritoneal dialysis (PD). We investigated the effect of multiple peritonitis episodes on peritoneal transport. ♦ Prospectively collected data from 479 incident PD patients treated between 1990 and 2010 were analyzed, using strict inclusion criteria: follow-up of at least 3 years with the availability of a Standard Peritoneal Permeability Analysis (SPA) in the first year after start of PD and within the third year of PD, without peritonitis preceding the first SPA. For the purpose of the study, we only included patients who remained peritonitis-free (n = 28) or who experienced 3 or more peritonitis episodes (n = 16). ♦ At baseline the groups were similar with regard to small solute and fluid transport. However, the frequent peritonitis group had lower peritoneal protein clearances compared to the no peritonitis group, resulting in lower dialysate concentrations of proteins: albumin 196.5 mg/L vs 372.5 mg/L, IgG 36.4 mg/L vs 65.0 mg/L, and α-2-macroglobulin (A2M) 1.9 mg/L vs 3.6 mg/L, p peritonitis group. Frequent peritonitis did not affect free water transport. ♦ Slow initial peritoneal transport rates of serum proteins result in lower dialysate concentrations, and likely a lower opsonic activity, which is a risk factor for peritonitis. Patients with frequent peritonitis show an increase in small solute transport and a concomitant decrease of ultrafiltration. In long-term peritonitis-free PD patients, small solute transport decreased, while ultrafiltration increased. This suggests that frequent peritonitis leads to an increase of the vascular peritoneal surface area without all the structural membrane alterations that may develop after long-term PD. Copyright © 2016 International Society for Peritoneal Dialysis.

Internationale joint ventures - udvalgte selskabsretlige problemstillinger

DEFF Research Database (Denmark)

Sørensen, Karsten Engsig

2001-01-01

Artiklen behandler en række problemstillinger som er særlige for joint ventures stiftet i selskaber af aktie-, anpartsselskabstypen. Bl.a. behandles en række problemer omkring joint venture aftalens forhold til selskabets vedtægter samt en række problemstillinger knyttet til det forhold at der er...... etableret fælles kontrol over joint venture selskabet....

Behandling af infantile spasmer

DEFF Research Database (Denmark)

Kjærsgård, Lars; Rasmussen, Niels

2006-01-01

Infantile spasms (IS) are characterised by neurodevelopmental regression, a unique type of seizures and a hypsarrhythmic EEG pattern. Studies recommend the medical treatment of IS as a positive short-term outcome with respect to the spasms and in the resolution of the hypsarrhythmia. However...

Korrekt behandling af forfrysninger

DEFF Research Database (Denmark)

El-Charnoubi, Waseem Ghulam; Bonde, Christian; Alsbjørn, Bjarne F

2011-01-01

Frostbite is rare in Denmark and is often associated with psychiatric conditions or drug- and alcohol abuse. It is seen regularly in countries with an arctic climate and tradition for outdoor activities such as skiing and climbing. The past winter in Denmark was long and cold, so we may see this ...... this phenomenon more frequently in the future. We report two cases from the winter 2009/2010 and summarize the pathophysiology and briefly present the treatment strategy....

Behandling af Dupuytrens kontraktur

DEFF Research Database (Denmark)

Raundrup Kornø, Maj; Søe, Niels Henrik; Dahlin, Lars B

2015-01-01

Dupuytren’s disease treatment Dupuytren’s disease is a hereditary fibroproliferative disease commonly affecting the palmar fascia of the hand, which results in progressive and irreversibly fixed flexion contractures of the hand. It may occur in the sole of the foot or in the penis. Gen...

Behandling af rolandisk epilepsi

DEFF Research Database (Denmark)

Miranda, Maria Jose; Ahmad, Banoo Bakir

2017-01-01

Recent literature indicates, that rolandic epilepsy/epilepsy of childhood with centrotemporal spikes may not be as benign as previously assumed. This study investigates the existing evidence, which describes the treatment effects on seizure frequency as well as improvement of cognition in childre...

Behandling af lokaliseret prostatacancer

DEFF Research Database (Denmark)

Jakobsen, Henrik; Iversen, Peter; Mikines, Kári J

2007-01-01

vesicles performed as an open procedure or laparoscopically, external beam radiation therapy, or implantation of radioactive seeds into the prostate (brachytherapy). In older patients with good prognostic factors, active surveillance should be considered. The various therapeutic modalities are reviewed...

Behandling af lokaliseret prostatacancer

DEFF Research Database (Denmark)

Jakobsen, Henrik; Iversen, Peter; Mikines, Kári J

2007-01-01

vesicles performed as an open procedure or laparoscopically, external beam radiation therapy, or implantation of radioactive seeds into the prostate (brachytherapy). In older patients with good prognostic factors, active surveillance should be considered. The various therapeutic modalities are reviewed....

Betydning af centraliseret behandling

DEFF Research Database (Denmark)

Højgaard, Liselotte

2006-01-01

hospital organizations. Centralization with a focus on efficiency and low cost, as well as decentralization combined with the loss of university hospital functions, will further challenge the conditions of clinical research already seen worldwide and also experienced in Denmark....

Rehabilitation in Parkinson’s Disease

DEFF Research Database (Denmark)

Rose, Martin Høyer

Parkinsons sygdom (PD) er en progredierende neurodegenerativ sygdom med gradvis udvikling af motoriske og non-motoriske symptomer. Dopaminerg behandling udgør en effektiv symptomatisk behandlingsform, men indebærer risiko for langtidsbivirkninger i form af svært behandlelige fluktuationer i...

[Peritonitis in pediatric patients receiving peritoneal dialysis].

Science.gov (United States)

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

2015-12-01

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

IMPLANT FOR TREATMENT OF SKELETAL DEFORMITIES

DEFF Research Database (Denmark)

2011-01-01

Den foreliggende opfindelse vedrører en implantat til behandling af skeletale misdannelser bestående af en hul stang med mindst ét åbent ende, en osmotisk membran, der dækker mindst en del af den indvendige vægge nævnte stang, et stempel og et rum afgrænset af nævnte stempel og nævnte osmotiske m...

Fra Oklahoma! til Beauty and the Beast

DEFF Research Database (Denmark)

Nielsen, Steen Kaargaard

2010-01-01

Artiklens formål er at bidrage til en belysning af Original Broadway Cast-albummets historiske udvikling til og som distinkt fonografisk undergenre i den amerikanske produktion af musical-album. På baggrund af en kort introduktion til amerikansk musical-musik som fonografisk fænomen med definition...... konventionaliseringen af det kommercielle OBC-album behandles primært i en økonomisk, industrikulturel og teknologisk kontekstualisering....

Stofmisbrugsbehandling blandt grønlændere i Danmark

DEFF Research Database (Denmark)

Baviskar, Siddhartha

2016-01-01

undersøgelsen af en forløbsanalyse af en udvalgt gruppe på 221 grønlændere over en 5-årig periode, 2007-2011. Denne gruppe ankom for første gang til Danmark i 2007 og opholdt sig i landet i alle årene til og med 2011. Dermed opnår vi viden om både graden af sårbarhed blandt grønlænderne på stofmisbrugsområdet...... målt i forhold til de øvrige danskere, og hvordan grønlændernes sårbarhed ændrer sig over tid i Danmark. Oplysninger vedrørende stofmisbrugsbehandling stammer fra Register over stofmisbrugere i behandling (SIB), som er et register over borgere, der gennem deres kommune er visiteret til behandling...

Alternative Veier

DEFF Research Database (Denmark)

Kruse, Tove Elisabeth; Salamonsen, Anita

reflektioner omkring patienters brug af og erfaringer med alternativ behandling. Patientorganisationer, organisatoner for alternative behandlere og organisationer for læger og medicinstuderende har læst bogens patienthistorier og deres perspektiver lægges frem. Til slut i bogen diskuteres betydningen af de...

Letbeton 1

DEFF Research Database (Denmark)

Meyer, E.V.; Nerenst, P.

Denne SBI-anvisning giver en orienterende gennemgang af alle de forhold ved letbeton, som det er gavnligt for de fleste af byggeriets folk at have viden om. Den behandler fortrinsvis letbetoner fremstillet ved skumdannelse og ved luftudviklilng. Selve fremstillingsprocessen er kort beskrevet, sål...

Oplevelsesøkonomi

DEFF Research Database (Denmark)

Madsen, Jan Halberg

Bogen behandler dominerende teorier og værktøjer i alle led af værdikæden og belyser oplevelsesøkonomiens potentialer og mangfoldighed med eksempler og cases fra forskellige brancher. Teorierne behandles ud fra en praksisnær tilgang med cases og eksempler som fx Læsø Salt, Astrid Lindgren Verden,......, Hard Rock Cafe, Smukfest, Hverringe Gods og Eksperimentarium....

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

Science.gov (United States)

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

2015-01-01

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

The Association between Peritoneal Dialysis Modality and Peritonitis

Science.gov (United States)

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

2014-01-01

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

Regression of the inflammatory microenvironment of the peritoneal cavity in women with endometriosis by GnRHa treatment.

Science.gov (United States)

Nirgianakis, K; Bersinger, N A; McKinnon, B; Kostov, P; Imboden, S; Mueller, M D

2013-10-01

To investigate the effect of gonadotropin-releasing hormone analogues (GnRHa) on the peritoneal fluid microenvironment in women with endometriosis. Peritoneal fluid was collected from 85 women with severe endometriosis (rAFS stage III and IV) during laparoscopic surgery during the proliferative phase. Prior to surgery clinical data were collected. The concentrations of specific markers for endometriosis in the peritoneal fluid were determined using an ELISA and a comparison between peritoneal fluid markers in women using GnRHa and no hormonal treatment was performed using a non-parametric Mann-Whitney U test. The study included peritoneal fluid from 39 patients who had been administered GnRHa (Zoladex(®)) in the three months prior to surgery and 46 from women with no hormonal treatment in this period. Concentrations of IL-8, PAPP-A, glycodelin-A and midkine were significantly reduced in the GnRHa treatment group compared to women receiving no hormonal treatment. RANTES, MCP-1, ENA-78, TNF-α, OPG, IP-10 and defensin showed no significant change between the two groups. GnRHa mediate a significant regression in the inflammatory nature of the peritoneal microenvironment in women with endometriosis. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Taxis als Konzept der systemisch funktionalen Linguistik (SFL)

DEFF Research Database (Denmark)

Holsting, Alexandra Emilie Møller

På baggrund af den systemisk funktionelle lingvistiks behandling af "hypotaktiske ekspansionssætninger" (det der traditionelt betegnes og betragtes som adverbialsætninger) foreslås en alternativ inddeling der kan tage højde for de grammatiske forskelle som ikke kan forklares med udgangspunkt i de...

Industry and the environment-practical applications of environmental management approaches in business proceedings of the 3rd conference of the Nordic Business Environmental Management Network, March 28-30, 1996, Aarhus, Denmark

DEFF Research Database (Denmark)

Ulhøi, John Parm; Madsen, Henning

1996-01-01

Bogen indeholder refereed papers fra en international miljøledelseskonference ved Scandinavian Center Århus, arrangeret af forfatterne. Konferencen havde delegerede fra ialt 17 lande. Bogen, der indledes med en indledning skrevet af redaktørerne, er inddelt i en række hovedafsnit, der behandler e...

Towards applied integrationism

DEFF Research Database (Denmark)

Nielsen, Charlotte Marie Bisgaard

2011-01-01

Forsøg med Aspergerklasser fortsættes i Danmark. Artiklen giver bud på hvorfor Aspegere og lærere i konventionelle sammenhænge oplever kommunikationsproblemer i et integrationelt perspektiv og skitserer rammerne for en dybere behandling af emnet med inddragelser af perspektiver som Asperger...

Homing Interactions

DEFF Research Database (Denmark)

Borup Lynggaard, Aviaja

2012-01-01

. Denne bygger på en forståelse af mobilitet i relation til design, der er behandler de etnografiske data og hjemlighedskarakteristikaene. Ligeledes er der et bidrag i mangfoldigheden af ”Connecting interaction” eksperimenterne, samt i at studere velhavende med høj rejseaktivitet som inspiration...

Biodiversitet i dyrket skov

DEFF Research Database (Denmark)

Petersen, Flemming Rune

. Rapportens anden del er en gennemgang af fire væsentlige indgreb, der påføres skovøkosystemerne ved dyrkningspraksis. Rapportens tredje del behandler særlige driftstyper, der fremmer et stort naturindhold i danske skove, med udgangspunkt i Naturskovsstrategiens beskrivelse af "gamle driftsformer"....

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.

Naturlig ventilation i enfamiliehuse

DEFF Research Database (Denmark)

Bergsøe, N.C.

Meddelelsen beskriver resultaterne af en række beregninger foretaget ved anvendelse af et computerprogram. Beregningerne har til formål at belyse forskellige parametres indvirkning på funktionen af et naturligt ventilationssystem. Blandt andet belyses systemets afhængighed af aftrækskanalernes di...... dimension, udeluftventilarealet og placeringen af aftrækskanalernes udmunding i tagfladen. Derudover gengives i kortfattet form de væsentligste konklusioner af udvalgte publikationer, som behandler særlige forhold vedrørende naturlig ventilation i praksis....

Når specialer gør en forskel

DEFF Research Database (Denmark)

Dirckinck-Holmfeld, Lone; Iversen, Torben; Konnerup, Ulla

2008-01-01

I denne antologi fremlægger og diskuterer en række forskere deres konkrete erfaring med og overvejelser over didaktisk design og brugen af digitale medier i forskellige undervisnings- og læringskontekster fra grundskole til universitetsniveau. Bogens tre dele behandler: Børns og unges brug af dig...

Depression og placebo

DEFF Research Database (Denmark)

Christensen, Kaj Sparle

2016-01-01

Metaanalyser har længe dokumenteret, at effekten af behandling med antidepressive lægemidler er begrænset sammenlignet med effekten af placebobehandling. Antidepressive lægemidler er kun sikkert virksomme hos svært deprimerede personer. Psykoterapi og antidepressive lægemidler er lige effektive h...

International økonomi. 3.udgave

DEFF Research Database (Denmark)

Madsen, Erik Strøjer; Nielsen, Jørgen Ulff-Møller; Pedersen, Kurt

Tredie udgave af International Økonomi er udvidet en del i forhold til den forrige. De vigtigste udvidelser er den 'nye udenrigshandelsteori', som er udskilt i et selvstændigt kapitel, og koordination af den økonomiske politik mellem landene, der i bogens afsluttende kapitel behandles teoretisk s...

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

International Nuclear Information System (INIS)

Coche, Emmanuel; Lonneux, Max; Goffin, Eric

2005-01-01

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.)

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 ...

Det dynamiske drama

DEFF Research Database (Denmark)

Schneider, Magnus Tessing

2006-01-01

Artiklen behandler forskydningerne i Jan Kotts tre læsninger af A Midsummer Night's Dream fra hhv. 1964 ('Titania and the Ass's Head'), 1981 ('The Bottom Translation') og 1993 ('Bottom and the Boys'). Da de er skrevet på baggrund af forskellige historiske situationer, repræsenterer de tre essays ...

Sjældne medfødte sygdomme og deres orale manifestationer

DEFF Research Database (Denmark)

Lauridsen, Eva; Gjørup, Hans

2018-01-01

Behandlingen af patienter med medfødte sjældne sygdomme kan have orale, dentale eller kraniofaciale associerede afvigelser og være meget kompleks. Her beskrives kliniske og radiologiske karakteristika og principper for behandling af patienter med ektodermal dysplasi, cleidocranial dysplasi, osteo......, osteogenesis imperfecta og hereditær rakitis...

The new circus performance ABSINTH in Las Vegas

DEFF Research Database (Denmark)

Eigtved, Michael

Paperet behandler fem mulige postitioner hvorfra en konkret nycirkusforestilling, (Absinth, der spillede i oktober 2017 i et telt på pladsen for Cesars Palace, Las Vegas, USA) kan analyseres med henblik på at undersøge brugen af provokationer, komik og fornærmelser af publikum som kunstnerisk str...

Elevers læring gennem undersøgelse og faglig læsning

DEFF Research Database (Denmark)

Negendahl, Kim; Daugbjerg, Peer

2014-01-01

Med afsæt i Prof. Jens Rasmussens (2013) argumenter for undervisningsdifferentiering vha. præstationsstandarder behandles differentiering af naturfagsundervisnings målsætning for alle skolens elever. Fokus vil være på læreres arbejde med undervisningsplaner og opstillede mål i forhold til undervi...

Pendlingens sociale geografi - mod en ny type pendlingsforståelse

DEFF Research Database (Denmark)

Olesen, Anne Vingaard; Kjems, Erik; Reinau, Kristian Hegner

holdninger til pendling, hvilken korreleres til det billede, der tegnes geografisk. Data behandles i softwarepakken STATA 13 samt i QGIS. Resultater Spørgeskemadata fra 2,235 respondenter blev indsamlet af Gallup i efteråret 2015. Ud af disse opgav 1,508 respondenter adresser på henholdsvis hjem og...

De hjemsøgende og de hjemsøgte

DEFF Research Database (Denmark)

Baake-Hansen, Martin

Afhandlingen behandler spørgsmålet om vores forhold til hjemstavnen, om følelsen af nostalgi, om oplevelsen af eksil, og om den ambivalente forestilling om hjemkomst - med udgangspunkt i tre vigtige, tysksprogede forfatterskaber fra det 20. århundrede, der deler et både intenst og sammensat forho...

Revisors kompetence - efteruddannelse

DEFF Research Database (Denmark)

Kiertzner, Lars

2010-01-01

Nærværende artikel behandler efteruddannelseskravene for revisorer. Først præsenteres kravene for godkendte revisorer i afsnit 1 om de kompetencekrav, der stilles for at opnå godkendelse, og i afsnit 2 om efteruddannelseskravene, som de med virkning fra 1.1. 2009 er udmøntet i revisorloven (RL), ...... revisor har en af specialistuddannelserne - CIA m.v. - er der derimod sådanne krav, der dog ikke behandles her. Udgivelsesdato: April 2010...

I en højere sags tjeneste

DEFF Research Database (Denmark)

Langsted, Lars Bo; Jakobsen, Søren Sandfeld

2014-01-01

Artiklen behandler ud fra en retsdogmatisk metode nogle af de grundlæggende problemstillinger, regler, principper og hensynsafvejninger, der gælder, når staten eller private virksomheder vil gennemføre overvågning af borgerne og dermed gøre indgreb i retten til privatlivets fred. Særlig fokus er ...

Børs- og kapitalmarkedsret

DEFF Research Database (Denmark)

Schaumburg-Müller, Peer; Werlauff, Erik

Værket giver et samlet billede af danske og EU-retlige forskrifter om regulerede værdipapirmarkeder. Det beskrives i dybden, hvordan det danske værdipapirmarked fungerer, og hvilke regelsæt der skal iagttages af et selskab, der bliver børsnoteret eller allerede er børsnoteret. Desuden behandles h...

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

Science.gov (United States)

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

2015-01-01

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

Critical Components in Microfluidic Systems for Drug Delivery

DEFF Research Database (Denmark)

Bitsch, Lennart

2006-01-01

Formålet med denne afhandling har været at evaluere mulighederne for at anvende mikrofluide systemer til medicinsk behandling. Vi har især fokuseret på sikkerhed i reciprokerende pumper, med henblik på en kontinuer insulin behandling, og har identificeret mikroventiler som værende kritiske......-mikroventil. Sammenlignet med systemer der benytter passive ventiler opnår vi et markant højere sikkerhedsniveau med en drejeventil. Teknologien bygger på konstruktion med bløde inkompressible gummimaterialer, og hårde overflader. Grundlæggende studier af dynamisk friktion mellem gummi og en hård overflade viser...... dreje-mikroventiler med gode pakninsgsegenskaber. De overvejende fordele ved nedskalering af mekaniske systemer er mere kompakte, lavenergi-apparater. Vi har vist muligheden for at lave dreje-mikroventiler med lavt energiforbrug og gode pakningsegenskaber ved konstruktion og test af en demonstrator med...

Microbiology of Peritonitis in Peritoneal Dialysis Patients with Multiple Episodes

Science.gov (United States)

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

2012-01-01

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

The Mutual Relationship Between Peritonitis and Peritoneal Transport

NARCIS (Netherlands)

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

2016-01-01

♦ Preservation of the peritoneum is required for long-term peritoneal dialysis (PD). We investigated the effect of multiple peritonitis episodes on peritoneal transport. ♦ Prospectively collected data from 479 incident PD patients treated between 1990 and 2010 were analyzed, using strict inclusion

Klasseledelse, inklusion og differentiering

DEFF Research Database (Denmark)

Jørgensen, Christina; Mottelson, Martha

2014-01-01

Kapitlet behandler forholdet mellem de tre begreber klasseledelse, inklusion og differentiering og ser på, hvordan de folder sig ud i folkeskolens praksis. Der tages afsæt i en definition af klasseledelse som alle de redskaber, læreren tager i anvendelse med henblik på at få timen til tage form p...

Peritoneal dialysis peritonitis by anaerobic pathogens: a retrospective case series

OpenAIRE

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

2013-01-01

Background Bacterial infections account for most peritoneal dialysis (PD)-associated peritonitis episodes. However, anaerobic PD peritonitis is extremely rare and intuitively associated with intra-abdominal lesions. In this study, we examined the clinical characteristics of PD patients who developed anaerobic peritonitis. Methods We retrospectively identified all anaerobic PD peritonitis episodes from a prospectively collected PD registry at a single center between 1990 and 2010. Only patient...

Behandling af epilepsi ved stimulation af nervus vagus

DEFF Research Database (Denmark)

Hansen, Christian Pilebaek; Sidenius, Per Christian; Gyllenborg, Jesper

2010-01-01

epilepsy surgery is not feasible, vagus nerve stimulation (VNS) should be offered. VNS seems to have an effect in all epilepsy syndromes and seizure types. VNS is generally well-tolerated, and may even improve mood and quality of life. Many more epilepsy patients in Denmark should be offered VNS....

Behandling af epilepsi ved stimulation af nervus vagus

DEFF Research Database (Denmark)

Hansen, Christian Pilebaek; Sidenius, Per Christian; Gyllenborg, Jesper

2010-01-01

Epilepsy is a common neurological disorder, and between one fourth and one third of the patients do not obtain seizure freedom after treatment with antiepileptic drugs. If the epileptic seizures in such patients have severe consequences, the patients should be assessed for epilepsy surgery. In ca...

Behandling af epilepsi ved stimulation af nervus vagus

DEFF Research Database (Denmark)

Hansen, Christian Pilebaek; Sidenius, Per Christian; Gyllenborg, Jesper

2010-01-01

Epilepsy is a common neurological disorder, and between one fourth and one third of the patients do not obtain seizure freedom after treatment with antiepileptic drugs. If the epileptic seizures in such patients have severe consequences, the patients should be assessed for epilepsy surgery. In case...

Peritoneal Dialysis-Related Peritonitis: Atypical and Resistant Organisms

NARCIS (Netherlands)

Cho, Yeoungjee; Struijk, Dirk Gijsbert

2017-01-01

Peritoneal dialysis (PD)-related peritonitis remains to be one of the most frequent and serious complications of PD. In this study, existing literature has been reviewed on PD peritonitis caused by atypical organisms and antibiotic resistant organisms and their impact on patient outcomes. Although

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

Science.gov (United States)

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

2014-01-01

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

Benfotiamine protects against peritoneal and kidney damage in peritoneal dialysis.

Science.gov (United States)

Kihm, Lars P; Müller-Krebs, Sandra; Klein, Julia; Ehrlich, Gregory; Mertes, Laura; Gross, Marie-Luise; Adaikalakoteswari, Antonysunil; Thornalley, Paul J; Hammes, Hans-Peter; Nawroth, Peter P; Zeier, Martin; Schwenger, Vedat

2011-05-01

Residual renal function and the integrity of the peritoneal membrane contribute to morbidity and mortality among patients treated with peritoneal dialysis. Glucose and its degradation products likely contribute to the deterioration of the remnant kidney and damage to the peritoneum. Benfotiamine decreases glucose-induced tissue damage, suggesting the potential for benefit in peritoneal dialysis. Here, in a model of peritoneal dialysis in uremic rats, treatment with benfotiamine decreased peritoneal fibrosis, markers of inflammation, and neovascularization, resulting in improved characteristics of peritoneal transport. Furthermore, rats treated with benfotiamine exhibited lower expression of advanced glycation endproducts and their receptor in the peritoneum and the kidney, reduced glomerular and tubulointerstitial damage, and less albuminuria. Increased activity of transketolase in tissue and blood contributed to the protective effects of benfotiamine. In primary human peritoneal mesothelial cells, the addition of benfotiamine led to enhanced transketolase activity and decreased expression of advanced glycation endproducts and their receptor. Taken together, these data suggest that benfotiamine protects the peritoneal membrane and remnant kidney in a rat model of peritoneal dialysis and uremia. Copyright © 2011 by the American Society of Nephrology

Peritoneal Dialysis

Science.gov (United States)

... include: Infections. An infection of the abdominal lining (peritonitis) is a common complication of peritoneal dialysis. An ... day. You might have a lower risk of peritonitis because you connect and disconnect to the dialysis ...

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

Science.gov (United States)

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

2014-01-01

♦ Background: Peritonitis rate has been reported to be associated with technique failure and overall mortality in previous literatures. However, information on the impact of the timing of the first peritonitis episode on continuous ambulatory peritoneal dialysis (CAPD) patients is sparse. The aim of this research is to study the influence of time to first peritonitis on clinical outcomes, including technique failure, patient mortality and dropout from peritoneal dialysis (PD). ♦ Methods: A retrospective observational cohort study was conducted over 10 years at a single PD unit in Taiwan. A total of 124 patients on CAPD with at least one peritonitis episode comprised the study subjects, which were dichotomized by the median of time to first peritonitis into either early peritonitis patients or late peritonitis patients. Cox proportional hazard model was used to analyze the correlation of the timing of first peritonitis with clinical outcomes. ♦ Results: Early peritonitis patients were older, more diabetic and had lower serum levels of creatinine than the late peritonitis patients. Early peritonitis patients were associated with worse technique survival, patient survival and stay on PD than late peritonitis patients, as indicated by Kaplan-Meier analysis (log-rank test, p = 0.04, p peritonitis was still a significant predictor for technique failure (hazard ratio (HR), 0.54; 95% confidence interval (CI), 0.30 - 0.98), patient mortality (HR, 0.34; 95% CI, 0.13 - 0.92) and dropout from PD (HR, 0.50; 95% CI, 0.30 - 0.82). In continuous analyses, a 1-month increase in the time to the first peritonitis episode was associated with a 2% decreased risk of technique failure (HR, 0.98; 95% CI, 0.97 - 0.99), a 3% decreased risk of patient mortality (HR, 0.97; 95% CI, 0.95 - 0.99), and a 2% decreased risk of dropout from PD (HR, 98%; 95% CI, 0.97 - 0.99). Peritonitis rate was inversely correlated with time to first peritonitis according to the Spearman analysis (r = -0

Recent Peritonitis Associates with Mortality among Patients Treated with Peritoneal Dialysis

Science.gov (United States)

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

2012-01-01

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

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

Science.gov (United States)

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

2015-01-01

Peritoneal dialysis (PD) is frequently complicated by high rates of peritonitis, which result in hospitalization, technique failure, transfer to hemodialysis, and increased mortality. Early diagnosis, and identification of contributing factors are essential components to increasing effectiveness of care. In previous reports, neutrophil gelatinase-associated lipocalin (NGAL), a lipocalin which is a key player in innate immunity and rapidly detectable in peritoneal dialysis effluent (PDE), has been demonstrated to be a useful tool in the early diagnosis of peritonitis. This study investigates predictive value of PDE NGAL concentration as a prognostic indicator for PD-related peritonitis. A case-control study with 182 PD patients was conducted. Plasma and PDE were analyzed for the following biomarkers: C-reactive protein (CRP), blood procalcitonin (PCT), leucocytes and NGAL in PDE. The cases consisted of patients with suspected peritonitis, while controls were the patients who came to our ambulatory clinic for routine visits without any sign of peritonitis. The episodes of peritonitis were defined in agreement with International Society for Peritoneal Dialysis guidelines. Continuous variables were presented as the median values and interquartile range (IQR). Mann-Whitney U test was used to compare continuous variables. Univariate and multivariate logistic regression were used to evaluate the association of biomarkers with peritonitis. Receiver operating characteristic (ROC) curve analysis was used to calculate area under curve (AUC) for biomarkers. Finally we evaluated sensitivity, and specificity for each biomarker. All statistical analyses were performed with SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). During the 19-month study, of the 182 patients, 80 had a clinical diagnosis of peritonitis. C-reactive protein levels (p peritonitis. In univariate analysis, CRP (odds ratio [OR] 1,339; p = 0.001), PCT (OR 2,473; p peritonitis. In multivariate regression analysis

Denmark. Alcohol, Drugs and Tobacco Programme

DEFF Research Database (Denmark)

Barfod, S.; Saunders, J.; Wutzke, S.

1998-01-01

Artiklen omtaler de danske resultater af en spørgeskemaundersøgelse blandt praktiserende læger i 16 lande. Af de 304 besvarelser angiver 91%, at de højst behandler 2 patienter om måneden for alkoholproblemer. Læger med erfaring i alkoholbehandling, og læger, der arbejder mest, spørger oftere dere...

Kosmopolitiske indikationer

DEFF Research Database (Denmark)

Rold, Mette

2010-01-01

opretholdt i en fortsat dynamisk og normativ diskussion af pædagogisk teori. Afhandlingen går i dybden med fænomenologerne Løgstrup og Lévinas, anskuet i lyset af Immanuel Kants og Martin Heideggers grundlæggende ideer. Løgstrup og Lévinas behandler filosofisk spørgsmålet om den menneskelige subjektivitet...

Molecular Dynamics Simulations of Escherichia coli Ammonia Channel AmtB

DEFF Research Database (Denmark)

Nygaard, Thomas Pedersen

2007-01-01

p°a s°akaldte styrede MD simuleringer, hvor NH3 og NH+4 blev trukket igennem kanalen. Selve mekanismen, som involverer ovenfor nævnte A162 og D160, blev dernæst testet vha. af en special type MD simulering, hvor dele af systemet behandles kvantemekanisk. Den foresl°aede mekanisme kunne dog hverken...

WTO og skatteret

DEFF Research Database (Denmark)

Sørensen, Karsten Engsig

2005-01-01

Artiklen analyserer hvordan WTO-retten, særligt GATT-, GATS- og subsidieaftalen, kan påvirke indholdet af national skatteret. Udover en drøftelse af princippet om national behandling og mest begunstigelsesprincippet drøftes hvordan subsidieaftalen kan påvirke de nationale principper om global con...... contra territorial beskatning og reglerne om transfer pricing....

Diagnostik og behandling af fenylketonuri

DEFF Research Database (Denmark)

Bayat, Allan; Møller, Lisbeth Birk; Lund, Allan Meldgaard

2015-01-01

Primary phenylalanine hydroxylase deficiency, also known as phenylketonuria, results in accumulation of phenylalanine in the blood. Early identification and treatment prevents the majority of clinical sequelae to the disease, but psychological and neurodevelopmental problems can occur in some...

Behandling af gener efter whiplash

DEFF Research Database (Denmark)

Rittig-Rasmussen, Bjarne; Kongsted, Alice; Carstensen, Tina

2010-01-01

Treatment of whiplash-associated disorders starts with a thorough clinical examination, which may be repeated after 1-3 weeks. For optimal results it is essential that the patient receives clear information about the condition and that any pain is treated effectively with analgesics. Risk factors...

Onkologisk behandling af meningeal carcinomatose

DEFF Research Database (Denmark)

Sulim, S.; Høyer, Morten

2005-01-01

Meningeal carcinomatosis (MC) occurs in 5-8% of cancer patients. In the       majority of cases, MC appears in patients with advanced disease. The       increase in incidence is probably caused by improved survival due to       improvements in systemic therapy and an increased awareness of MC among...

Behandling af den hypoterme patient

DEFF Research Database (Denmark)

Kjærgaard, Benedict; Rudolph, Søren Finnemann; Lucas, Alexander

2008-01-01

Treatment of the hypothermic patient depends more on the clinical condition than on the core temperature. Unconscious patients need thorough investigation, and they can often be rewarmed with warm water in the pleural cavities. Cardiac arrest requires cardio pulmonary rescue until rewarming can b...

Kirurgisk behandling af cancer pancreatis

DEFF Research Database (Denmark)

Bergenfeldt, Magnus; Hansen, Carsten Palnaes; Mortensen, Michael Bau

2010-01-01

Surgery remains the only hope for cure in pancreatic cancer. The most common procedures are reviewed. Postoperative morbidity and mortality below 30% and 5%, respectively, are the standard. The benefit of extended lymph node dissection and portal-mesenteric vein resection is dubious. Selected pat...

Behandling af hydatidose med albendazol

DEFF Research Database (Denmark)

Magnussen, P; Gelletlie, R; Bygbjerg, Ib Christian

1989-01-01

of the patients had varying degrees of liver involvement which were reversible. Neutropenia did not occur. Various parameters for assessing the therapeutic effect are mentioned. Albendazol appears to be effective in the treatment of non-operable hydatid disease and to prevent recurrence after surgery....

Udredning og behandling af papilsekretion

DEFF Research Database (Denmark)

Saltvig, Iselin; Perdawood, Frea Ramzi; Matzen, Steen Henrik

2017-01-01

Nipple secretion is a common condition; it can occur in men and women, and be uni- or bilateral. It is related to hormonal changes, physical stimulation, intracerebral processes and certain drugs, and it is divided into three types: galactorrhoea, clear/bloody or viscous. Only the clear/bloody type...

Diagnose og behandling af binyrebarkkarcinom

DEFF Research Database (Denmark)

Abildgaard, Julie; Pappot, Helle; Petersen, Peter Meidahl

2013-01-01

Adrenocortical carcinomas (ACC) are rare tumours responsible for only 0.02% of the total number of malignant diseases. However the ACC are aggressive with a mean fiveyears survival of 20-50% and are often associated with increased production of adrenocortical hormones. The effect of the treatment...... is controversial and often based on small retrospective series or expert opinions. Centralization, international attention and collaboration in the treatment of ACC are mandatory. Randomized clinical trials are needed to determine the best treatment strategy in order to increase survival in patients with ACC....

Rekommandation for behandling af paracetamolforgiftning

DEFF Research Database (Denmark)

Clemmesen, J O; Ott, P; Dalhoff, K P

1996-01-01

Based on recent reports concerning the efficacy of N-acetylcysteine (NAC) in paracetamol (acetaminophen) poisoning, guidelines for treatment and control of these patients are reviewed by a study group under the Danish Association for the Study of the Liver. It is recommended that NAC-treatment...... is initiated immediately after referral and continued for 36 hours in all cases. Further NAC-treatment should not be discontinued before a decrease in INR has been observed....

Farmakologisk behandling af psykotiske tilstande

DEFF Research Database (Denmark)

Fink-Jensen, A.; Larsen, J.T.; Nielsen, B.

2008-01-01

Antipsychotic medication has been used for more than fifty years and has brought a dramatic improvement in the treatment of psychotic diseases by removing or reducing the psychotic symptoms and thereby also allowing other treatment approaches to be used. However, an urgent need remains for new me...

stausartikel: behandling af subcutane abscesser

DEFF Research Database (Denmark)

Hardgrib, Nina; Petersen, Klaus Kjær

2017-01-01

Simple subcutaneous abscesses are common, and we have examined the literature concerning the ideal treatment of subcutaneous abscesses. We recommend radical debridement with removal of all pus, the abscess wall and any necrosis. If primary suture is chosen, preoperative antibiotics should be admi...

Behandling af astma hos gravide

DEFF Research Database (Denmark)

Akram, Iram; Ulrik, Charlotte Suppli; Johnsen, Claus Rikard

2016-01-01

Asthma is one of the most frequent chronic diseases which complicate pregnancy. Well-controlled asthma during pregnancy reduces the risk of for exacerbations and, consequently, the risk of adverse pregnancy outcome. Pharmacological therapy for pregnant women with asthma is a challenge, not least ...

Behandling af insulinom med alkoholsklerosering

DEFF Research Database (Denmark)

Schnack, Christina; Christensen, Carina Ørts; Beck-Nielsen, Henning

2012-01-01

The efficacy and safety of endoscopic ultrasound (EUS)-guided alcohol ablation of an insulinoma in a patient not candidate for surgery is being evaluated. A 89 year-old male patient with insulinoma and serious cardiac disease was treated with EUS-guided alcohol ablation. The only complication...... was a slight degree of pancreatitis. Two months after the ablation values of plasma glucose and serum pro-insulin were normalized. EUS-guided alcohol ablation is a safe and efficient alternative to surgical resection of insulinomas in poor surgical candidates....

Udredning og behandling af hoste

DEFF Research Database (Denmark)

Çolak, Yunus; Laursen, Lars Christian

2013-01-01

Cough is frequently a reason for seeing a doctor. Cough has a wide range of causes and the diagnosis can be difficult to make. Cough is often benign and self-limiting but can also be the first sign of malignancy. Especially chronic cough reduces the patients' quality of life. The purpose of this ...

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

Science.gov (United States)

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

1997-08-01

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

Risk Factors for Early-Onset Peritonitis in Southern Chinese Peritoneal Dialysis Patients.

Science.gov (United States)

Wu, Haishan; Huang, Rong; Yi, Chunyan; Wu, Juan; Guo, Qunying; Zhou, Qian; Yu, Xueqing; Yang, Xiao

♦ BACKGROUND: Early peritonitis was confirmed to be associated with a higher risk of early technique failure. However, literature concerning peritonitis within the first 3 months of peritoneal dialysis (PD) initiation is scarce. The present study was to investigate risk factors associated with early-onset peritonitis in PD patients. ♦ METHODS: In this retrospective observational cohort study, all incident PD patients from January 1, 2006, to December 31, 2013, were recruited and followed up until December 31, 2014. According to time-to-first episode of peritonitis, patients were divided into early-onset (≤ 3 months) peritonitis and late-onset (> 3 months) peritonitis. Baseline demographic, clinical, and laboratory data, as well as episodes of peritonitis, were collected. Risk factors associated with early-onset peritonitis were evaluated using logistic regression model. ♦ RESULTS: Of 1,690 patients on PD, 503 (29.8%) developed at least 1 episode of peritonitis and 118 (7.0%) patients presented the first episodes of peritonitis within the first 3 months. A multivariate logistic analysis showed that higher body mass index (BMI) (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.01 - 1.15, p = 0.034), hypoalbuminemia (OR 1.75, 95% CI 1.11 - 2.78, p = 0.017), and catheter exit-site infection (OR 4.14, 95% CI 2.45 - 7.00, p peritonitis. Compared to those with late-onset, patients with early-onset peritonitis had a higher overall peritonitis rate (0.76 vs 0.38 per patient-year, p 0.05). ♦ CONCLUSIONS: Higher BMI, hypoalbuminemia, and catheter exit-site infection were the risk factors associated with early-onset peritonitis in PD patients. Copyright © 2016 International Society for Peritoneal Dialysis.

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

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.

Acute Peritonitis Caused by Staphylococcus capitis in a Peritoneal Dialysis Patient.

Science.gov (United States)

Basic-Jukic, Nikolina

Acute peritonitis remains the most common complication of peritoneal dialysis (PD), with coagulase-negative staphylococci (CoNS) reported to account for more than 25% of peritonitis episodes (1). Staphylococcus capitis is a gram-positive, catalase-positive CoNS that was originally identified as a commensal on the skin of the human scalp (2). Advancement of microbiological technologies for bacterial identification enables diagnosis of previously unknown causes of acute peritonitis. This is the first reported case of acute peritonitis in a PD patient caused by S. capitis. Copyright © 2017 International Society for Peritoneal Dialysis.

Pneumococcal peritonitis in peritoneal dialysis - three case reports and literature review

OpenAIRE

Pereira, Tiago Assis; Vizinho, Ricardo; Branco, Patricia; Gaspar, Augusta; Barata, José Diogo

2015-01-01

Peritonitis and catheter-related infections are a frequent complication in peritoneal dialysis, usually driven by commensal microorganisms. They carry a significant morbidity and mortality burden and have known consequences on viability of peritoneal dialysis and patient survival. This article describes three clinical cases, in which three different peritoneal dialysis patients presented pneumococcal peritonitis, two of which were related with obvious previous or concomitant respiratory sympt...

The longitudinal effects of peritonitis on peritoneal membrane function
.

Science.gov (United States)

Sia, Christopher S B; Paul, Eldho; Tregaskis, Peter; Walker, Rowan G; Wilson, Scott G

2017-12-01

The longitudinal effects of peritoneal dialysis (PD) peritonitis on small solute clearance and ultrafiltration are controversial. We identified 27 patients with PD peritonitis over a 4-year period at a tertiary hospital. Adequacy tests at an "early" (1 - 3 months), "intermediate" (6 ± 2 months), and a "late" (12 ± 2 months) time period after the episode were compared with a pre-peritonitis baseline. The effect of time on serum albumin, weekly creatinine clearance, Kt/V, and net fluid volume removal was assessed. At 12 months, 16/27 (59.3%) patients were no longer on PD. Ten were transferred to hemodialysis, predominantly due to peritonitis (60%). Five patients died, and 1 received a renal allograft. Total daily fluid volume removal significantly decreased over time with an aggregated mean reduction of 523 mL/day between the baseline and 12-month test (1,624 ± 139 mL vs. 1,101 ± 160 mL; p = 0.02). This was due to an equivalent loss of both ultrafiltration and residual urine output, although the separate decline in these individual parameters was not statistically significant. There was no significant change in Kt/V, creatinine clearance, or serum albumin indicating preserved solute transport in those patients with sustained technique survival post peritonitis. Peritonitis is a common cause for transfer to hemodialysis. Fluid volume removal is the most significantly affected parameter at 12 months post peritonitis, driven by the combination of both ultrafiltration reduction and loss of residual diuresis. Clinicians should be aware that peritonitis identifies patients at high risk for technique failure. These findings should prompt clinicians to closely surveil volume status and consider backup dialytic strategies as early as 12 months post peritonitis.
.

Citrobacter Peritoneal Dialysis Peritonitis: Rare Occurrence with Poor Outcomes

Science.gov (United States)

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

2013-01-01

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

Peritoneal dialysis peritonitis by anaerobic pathogens: a retrospective case series

Science.gov (United States)

2013-01-01

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

Anvendelse af MIP ved kildekarakterisering og vurdering af nedbrydning af chlorerede opløsningsmidler

DEFF Research Database (Denmark)

Broholm, Mette Martina; Janniche, Gry Sander; Damgaard, Ida

2014-01-01

Membrane Interface Probing (MIP) er et 'direct push' screeningsværktøj, som kan anvendes ved karakterisering af forurenede grunde. Karakterisering af kildeområder med chlorerede opløsningsmidler (som DNAPL) udgør et vigtigt led i udviklingen af den konceptuelle forståelse, som er essentiel...... for risikovurdering og valg af afværgestrategi. Integreret karakterisering med en række metoder for direkte såvel som indirekte dokumentation af DNAPL i moræneler, herunder MIP, er beskrevet i Kerrn-Jespersen et al. (2013). Det samlede DNAPL-karakteriseringsprojekt er beskrevet i detaljer i Janniche et al. (2013). En...... vurdering af anvendte detektorer for MIP er foretaget af Olsson (2013). Ved karakterisering af forurening med bl.a. chlorerede opløsningsmidler er der behov for en vurdering af forureningssammensætning og nedbrydning. Tilsvarende vurdering er nødvendig, når udviklingen af stimuleret reduktiv dechlorering...

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

NARCIS (Netherlands)

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

2015-01-01

Little or no evidence is available on the impact of the first peritonitis episode on peritoneal transport characteristics. The objective of this study was to investigate the importance of the very first peritonitis episode and distinguish its effect from the natural course by comparison of

Evaluering av medisinsk behandling: Hva vet vi, og hvordan bør kunnskapen håndteres?

Directory of Open Access Journals (Sweden)

Jan Magnus Bjordal

2009-09-01

Full Text Available Kunnskap om effekten av medisinsk behandling fremskaffes i kliniske studier. Godt planlagte og gjennomførte randomiserte, placebokontrollerte studier tillegges størst vekt når data skal vurderes. De datamengdene vi besitter når det gjelder forskjellige behandlinger kan oppsummeres i oversikter eller terapianbefalinger som ofte blir normative for klinisk praksis. Dette stiller store krav til evalueringsprosedyrene. I denne oversiktsartikkelen diskuteres i innledningen noen eksempler på at kunnskapsgrunnlaget er blitt feiltolket. Deretter omtales kvalitetskriterier som legges til grunn i vurderingen av data, og den metodologiske basis for meta-analyser. Usikkerhetsmomenter og potensielle fallgruver ved bruk av meta-analyser omtales. Meta-analysens fortrinn eksemplifiseres ved bruk av data om behandling av korsryggsmerter, hvor det nylig er utarbeidet kliniske retningslinjer som etter vår oppfatning er beheftet med feil eller mangler. Meta-analysen har vesentlige fortrinn fremfor mindre formaliserte metoder for oppsummering av kunnskap om terapi ved sykdom

Peritonitis

Science.gov (United States)

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

Peritoneal carcinomatosis

International Nuclear Information System (INIS)

Raptopoulos, V.; Gourtsoyiannis, N.

2001-01-01

The peritoneum is a mesothelial lining of the abdominal cavity (parietal) and intraperitoneal viscera (visceral). The cavity contains a small amount of fluid, which circulates from cephalad to caudal to cephalad, influenced by negative pressure under the diaphragm during exhalation, gravity, and bowel peristalsis. Peritoneal reflections and mesenteries divide the cavity into various compartments (supramesocolic, inframesocolic, and pelvis). These reflections support the peritoneal organs and provide vascular and nervous connections while within the cavity they influence pathway of intraperitoneal fluid circulation. Capillary force over convex surfaces influence stasis of fluid and promotes peritoneal seeding; thus, there are numerous areas in which peritoneal masses are seen more commonly. These areas include the undersurface of the diaphragm (negative pressure and capillary force), the omentum (bathed in fluid), the right lower quadrant (oblique course from left superior to right inferior of the small bowel mesentery), the left lower quadrant (transverse course of the sigmoid), and the pelvis (gravity). Peritoneal carcinomatosis may be either primary (mesothelioma) or metastatic. The mode of spread is by direct invasion, lymphatic permeation, peritoneal seeding or hematogenous. The imaging patterns include fibronodular stranding, nodules, plaques, and masses. Mesenteric thickening may produce pleated or stellate patterns. Spiral CT is the most useful modality in diagnosis and follow-up of peritoneal tumors. (orig.)

Micrococcus species-related peritonitis in patients receiving peritoneal dialysis.

Science.gov (United States)

Kao, Chih-Chin; Chiang, Chih-Kang; Huang, Jenq-Wen

2014-01-01

Peritonitis is a major complication of peritoneal dialysis (PD) and remains the most common cause of PD failure. Micrococci are catalase-positive, coagulase-negative, and gram-positive cocci that are spherical, often found in tetrad, and belong to the family Micrococcaceae. Micrococcus species are commonly found in the environment, and it is now recognized that Micrococcus species can be opportunistic pathogens in immunocompromised patients. The only consistent predisposing factor for Micrococcus infection is an immunocompromised state. We report three cases of Micrococcus PD peritonitis. Improper practice of PD may have been the causative factor. Although Micrococcus species are low-virulence pathogens, infection could result in refractory peritonitis and subsequent PD failure. Intraperitoneal administration of vancomycin for at least 2 weeks is recommended for Micrococcus peritonitis.

Bibelens poetiske sprog

DEFF Research Database (Denmark)

Nielsen, Kirsten

2009-01-01

billeder (mand, kvinde, de fire elementer) for at leve op til en nutidig fortolkning af billedforbuddet: Du må ikke gøre dig noget fast, afgrænset billede af Gud. Afslutningsvis behandles træet som eksempel på et bibelsk billede samt genbrugen deraf i Svein Ellingsens salme "Vi rækker vore hænder frem"....

Improving Ion Computed Tomography

DEFF Research Database (Denmark)

Hansen, David Christoffer

2014-01-01

Strålebehandling med brug af ioner, kendt som partikelterapi, giveren mere præcis og skånsom behandling end traditionel stråleterapi med hårde røntgenstråler. Dette skyldes, at partiklerne bremses ned og stopper inden i patienten. Dermed bliver området på den anden side af tumoren ikke, eller kun...

Myths in peritoneal dialysis.

Science.gov (United States)

Lee, Martin B; Bargman, Joanne M

2016-11-01

To clarify misconceptions about the feasibility and risks of peritoneal dialysis that unnecessarily limit peritoneal dialysis uptake or continuation in patients for whom peritoneal dialysis is the preferred dialysis modality. The inappropriate choice of haemodialysis as a result of these misconceptions contributes to low peritoneal dialysis penetrance, increases transfer from peritoneal dialysis to haemodialysis, increases expenditure on haemodialysis and compromises quality of life for these patients. Peritoneal dialysis is an excellent renal replacement modality that is simple, cost-effective and provides comparable clinical outcomes to conventional in-centre haemodialysis. Unfortunately, many patients are deemed unsuitable to start or continue peritoneal dialysis because of false or inaccurate beliefs about peritoneal dialysis. Here, we examine some of these 'myths' and critically review the evidence for and against each of them. We review the feasibility and risk of peritoneal dialysis in patients with prior surgery, ostomies, obesity and mesh hernia repairs. We examine the fear of mediastinitis with peritoneal dialysis after coronary artery bypass graft surgery and the belief that the use of hypertonic glucose dialysate causes peritoneal membrane failure. By clarifying common myths about peritoneal dialysis, we hope to reduce overly cautious practices surrounding this therapy.

Benfotiamine Protects against Peritoneal and Kidney Damage in Peritoneal Dialysis

OpenAIRE

Kihm, Lars P.; Müller-Krebs, Sandra; Klein, Julia; Ehrlich, Gregory; Mertes, Laura; Gross, Marie-Luise; Adaikalakoteswari, Antonysunil; Thornalley, Paul J.; Hammes, Hans-Peter; Nawroth, Peter P.; Zeier, Martin; Schwenger, Vedat

2011-01-01

Residual renal function and the integrity of the peritoneal membrane contribute to morbidity and mortality among patients treated with peritoneal dialysis. Glucose and its degradation products likely contribute to the deterioration of the remnant kidney and damage to the peritoneum. Benfotiamine decreases glucose-induced tissue damage, suggesting the potential for benefit in peritoneal dialysis. Here, in a model of peritoneal dialysis in uremic rats, treatment with benfotiamine decreased peri...

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

Peritonitis is a serious problem in children receiving peritoneal dialysis. Campylobacter jejuni is an unusual cause of peritonitis. A 10-year-old boy who had end stage renal failure due to atypical hemolytic uremic syndrome was admitted to our hospital with abdominal pain and fever. Peritoneal dialysis fluid was cloudy and microscopic examination showed abundant leukocytes. Intraperitoneal cefepime treatment was started. Campylobacter jejuni was isolated from peritoneal dialysis fluid culture and oral clarithromycin was added to the treatment. At the end of therapy, peritoneal fluid culture was negative. To our knowledge, C. jejuni peritonitis was not reported in children previously. Although C. jejuni peritonitis is rarely encountered in children, it should be considered as an etiologic factor for peritonitis. Sociedad Argentina de Pediatría.

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.

CT features of peritonitis associated with continuous ambulatory peritoneal dialysis

International Nuclear Information System (INIS)

Yun, Ji Young; Byun, Jae Young; Lee, Sang Hoon; Kwon, Tae Ahn; Kim, Yeon Kil; Kim, Young Ok; Song, Kyung Sup

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

Treatment of Enterococcal Peritonitis in Peritoneal Dialysis Patients by Oral Amoxicillin or Intra-Peritoneal Vancomcyin: a Retrospective Study

Directory of Open Access Journals (Sweden)

Cheuk Chun Szeto

2017-10-01

Full Text Available Background/Aims: Enterococcal peritonitis in peritoneal dialysis (PD patients is associated with a high complication rate. The optimal treatment regimen of PD-related enterococcal peritonitis is controversial. The latest international guideline recommends intra-peritoneal (IP vancomycin. Although ampicillin is often effective for systemic enterococcal infections, they have little in vitro activity when added to common PD solutions. Since oral amoxicillin achieves therapeutic drug level in the peritoneal cavity, we explore the efficacy of oral amoxicillin for enterococcal peritonitis. Methods: We studied 105 episodes of enterococcal peritonitis over 20 years in our unit; 43 (41.0% were treated with oral amoxicillin, and 62 (59.0% with IP vancomycin. Their clinical outcome was reviewed. Result: The overall primary response rate to oral amoxicillin and IP vancomycin was 76.4% and 85.5%, respectively (p = 0.3. The complete cure rate of oral amoxicillin and IP vancomycin was 55.8% and 54.8%, respectively (p = 0.8. When the 5 episodes of ampicillin-resistant Enterococcus episodes were excluded, the primary response rate and complete cure rate of oral amoxicillin were 86.8% and 63.2%, respectively. Conclusion: Oral amoxicillin has an excellent primary response rate and complete cure rate for PD-related peritonitis episodes caused by Enterococcus species, indicating that oral amoxicillin is a valid and convenient therapeutic option for enterococcal peritonitis episodes.

Livline til virkeligheden

Directory of Open Access Journals (Sweden)

Sanne Storm

2003-03-01

Full Text Available Denne artikel er en oversættelse af mit foredrag på verdenskongressen i musikterapi i Oxford 2002. Den er baseret på mit speciale »Livline til virkeligheden - første skridt i enpsykoterapeutisk behandling« (Storm 2002. Artiklen tager udgangspunkt i en case med en alvorligt psykisk syg kvinde, der er indlagt for første gang på psykiatrisk sygehus til Obs. pro forskizofreni, og som i indlæggelsesperioden desuden har udviklet et stort ordmobiliseringsbesvær. Den musikterapeutiske behandling beskrives. Gennem analyser af tre udvalgte musikeksemplerdokumenteres den terapeutiske udvikling i musikterapi fra et ubevidst og præ-verbalt stadie til et bevidst og verbalt stadie, - en såkaldt psykisk re-organisering. Første og tredie musikeksempelanalyseres udfra morfologiske principper, og her inddrages dele af Daniel Sterns udviklingsteori som teoretisk platform til forståelse af patientens psykologiske problemstilling. Andet musikeksempelanalyseres med fokus på patientens stemme og på nodetransskriptionen af sangen, sådan som sangen synges. Til analyse af stemmen anvender jeg et stemmeassessmentskema jeg selv har udviklet og senere videreudviklet i samarbejde med Stephan Skov (Storm & Skov 2000. I en efterbehandling af tredie analyse, der omfatter en analyse af en klinisk improvisation, udledes en ny hypotese om, hvordan den kliniske improvisation gennemgår forskellige faser frem mod en re-organisering, og hvilken rolle og funktion musikken og musikterapeuten har.

Peritoneal Cell-free DNA: an innovative method for determining acute cell damage in peritoneal membrane and for monitoring the recovery process after peritonitis.

Science.gov (United States)

Virzì, Grazia Maria; Milan Manani, Sabrina; Brocca, Alessandra; Cantaluppi, Vincenzo; de Cal, Massimo; Pastori, Silvia; Tantillo, Ilaria; Zambon, Roberto; Crepaldi, Carlo; Ronco, Claudio

2016-02-01

Cell-free DNA (cfDNA) is present in the peritoneal effluent of stable peritoneal dialysis (PD) patients, but there are no data on cfDNA in PD patients with peritonitis. We investigated the variation of peritoneal cfDNA levels subsequent to peritonitis in PD patients. We enrolled 53 PD patients: 30 without any history of systemic inflammation or peritonitis in the last 3 months (group A) and 23 with acute peritonitis (group B). CfDNA was quantified in the peritoneal effluent. Peritoneal samples on days 1, 3, 10, 30 and until day 120 from the start of peritonitis were collected for white blood cells (WBC) count and cfDNA evaluation in group B. Quantitative analysis of cfDNA showed significantly higher levels in group B on day 1, 3, 10 and 30 compared with group A (p peritoneal cfDNA levels tended to progressively decline during follow-up of peritonitis. From this decreasing curve, we estimated that 49 days are necessary to reach the value of 51 genome equivalents (GE)/ml (75th percentile in controls) and 63 days to reach 31 GE/ml (median). Our results demonstrate that cfDNA increases in peritoneal effluent of PD patients with peritonitis and tends to progressively decline in step with peritonitis resolution and membrane repair process. Peritoneal cfDNA quantification could be an innovative method to determine acute damage and an inverse index of the repair process.

Risk of Peritoneal Dialysis-Related Peritonitis in a Multi-Racial Asian Population.

Science.gov (United States)

Ong, Loke Meng; Ch'ng, Chin Chin; Wee, Hong Chin; Supramaniam, Premaa; Zainal, Hadzlinda; Goh, Bak Leong; Bavanandan, Sunita; Mushahar, Lily; Hooi, Lai Seong; Ahmad, Ghazali

♦ BACKGROUND: Peritonitis is one of the most common complications of peritoneal dialysis (PD). Understanding the risk factors of peritonitis in a multi-racial Asian population may help to improve outcomes on PD. ♦ METHODS: We conducted a prospective observational study to identify risk factors for PD-related peritonitis over a 1-year period in 15 adult PD centers. All peritonitis episodes were independently adjudicated. ♦ RESULTS: A total of 1,603 participants with a mean age of 51.6 years comprising 52.7% females, 62.6% ethnic Malays, 27.0% Chinese, and 8.1% Indians were recruited. The overall peritonitis rate was 1 episode per 44.0 patient-months with 354 episodes recorded in 282 (17.6%) patients over 15,588 patient-months. Significant risk factors of peritonitis were severe obesity (incidence-rate ratio [IRR] 3.32, 95% confidence interval [CI]: 1.30, 8.45), hypoalbuminemia (IRR 1.61, 95% CI: 1.06, 2.46), Staphylococcus aureus nasal carriage (IRR 2.26, 95% CI: 1.46, 3.50), and use of Fresenius system (Fresenius Medical Care North America, Waltham, MA, USA) (IRR 2.49, 95% CI: 1.27, 4.89). The risk of peritonitis was lower in those on automated PD compared with standard PD (IRR 0.43, 95% CI: 0.25, 0.74), and in centers with a patient-staff ratio of 15 to 29.9 (IRR 0.67, 95% CI: 0.49, 0.90) and ≥ 30 (IRR 0.52, 95% CI: 0.34, 0.80). Prevalent patients and exit-site care with topical antibiotics were also protective against peritonitis. Peritonitis rates varied between racial groups. The IRRs of overall peritonitis and gram-positive peritonitis in Chinese versus other racial groups were 0.65 (95% CI: 0.46, 0.90) and 0.47 (95% CI: 0.24, 0.91), respectively. ♦ CONCLUSIONS: Multiple patient, center, and PD-system factors influence the risk of peritonitis. In the Asian population, there are racial differences in the risk of peritonitis. Copyright © 2017 International Society for Peritoneal Dialysis.

Acinetobacter Peritoneal Dialysis Peritonitis: A Changing Landscape over Time

Science.gov (United States)

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

2014-01-01

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

Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time.

Directory of Open Access Journals (Sweden)

Chia-Ter Chao

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

Weekend Compared with Weekday Presentations of Peritoneal Dialysis-Associated Peritonitis

Science.gov (United States)

Johnson, David W.; Clayton, Philip; Cho, Yeoungjee; Badve, Sunil V.; Hawley, Carmel M.; McDonald, Stephen; Boudville, Neil; Wiggins, Kathryn J.; Bannister, Kym; Brown, Fiona

2012-01-01

♦ Objective: Management of peritoneal dialysis (PD)-associated peritonitis requires timely intervention by experienced staff, which may not be uniformly available throughout the week. The aim of the present study was to examine the effects of weekend compared with weekday presentation on peritonitis outcomes. ♦ Methods: The study, which used data from the Australia and New Zealand Dialysis and Transplant Registry, included all Australian patients receiving PD between 1 October 2003 and 31 December 2008. The independent predictors of weekend presentation and subsequent peritonitis outcomes were assessed by multivariate logistic regression. ♦ Results: Peritonitis presentation rates were significantly lower on Saturdays [0.46 episodes per year; 95% confidence interval (CI): 0.42 to 0.49 episodes per year] and on Sundays (0.43 episodes per year; 95% CI: 0.40 to 0.47 episodes per year) than all other weekdays; they peaked on Mondays (0.76 episodes per year; 95% CI: 0.72 to 0.81 episodes per year). Weekend presentation with a first episode of peritonitis was independently associated with lower body mass index and residence less than 100 km away from the nearest PD unit. Patients presenting with peritonitis on the weekend were significantly more likely to be hospitalized [adjusted odds ratio (OR): 2.32; 95% CI: 1.85 to 2.90], although microbial profiles and empiric antimicrobial treatments were comparable between the weekend and weekday groups. Antimicrobial cure rates were also comparable (79% vs 79%, p = 0.9), with the exception of cure rates for culture-negative peritonitis, which were lower on the weekend (80% vs 88%, p = 0.047). Antifungal prophylaxis was less likely to be co-prescribed for first peritonitis episodes presenting on weekdays (OR: 0.68; 95% CI: 0.05 to 0.89). ♦ Conclusions: Patients on PD are less likely to present with peritonitis on the weekend. Nevertheless, the microbiology, treatment, and outcomes of weekend and weekday PD peritonitis

The big six, regnskabsbrugerne og FASBs nye regler om derivater

DEFF Research Database (Denmark)

Thinggaard, Frank

1997-01-01

Artiklen har flere formål. Dels at præsentere FASBs første forslag til den regnskabsmæssige behandling af samtlige derivater. Dels at analysere og sammenligne de enkelte big six revisions-firmaers holdning til forslagets vigtigste emner samt at sammenligne dette med kommentarerne fra en repræsent......Artiklen har flere formål. Dels at præsentere FASBs første forslag til den regnskabsmæssige behandling af samtlige derivater. Dels at analysere og sammenligne de enkelte big six revisions-firmaers holdning til forslagets vigtigste emner samt at sammenligne dette med kommentarerne fra en...... repræsentant for brugerne. Artiklen viser, at revisionsfirmaerne generelt er meget enige i deres bedømmelse af reglerne. De fleste er ikke modstandere af at værdiansætte derivater til fair value. Kritikken går på behandlingen af gevinsterne og tabene, hvor de er bange for den volatilitet, der kan komme i...... virksomhedernes resultater. Især for gevinster og tab på derivater, der sikrer fremtidige cash-flows. Artiklen forklarer nærmere, hvad modstanden består i, hvilket giver en dybere forståelse for, hvordan reglerne virker. Artiklen viser, at brugerne ikke er nær så kritiske som the big six....

Prophylactic Antibiotics for Endoscopy-Associated Peritonitis in Peritoneal Dialysis Patients

Science.gov (United States)

Wu, Hsin-Hsu; Li, I-Jung; Weng, Cheng-Hao; Lee, Cheng-Chia; Chen, Yung-Chang; Chang, Ming-Yang; Fang, Ji-Tseng; Hung, Cheng-Chieh; Yang, Chih-Wei; Tian, Ya-Chung

2013-01-01

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]; pperitonitis rate compared to that without antibiotic use (0% [0/16] vs. 25% [7/28]; pPeritonitis 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]; pperitonitis was noted if antibiotics were used prior to examination with invasive procedures (0% [0/10] vs. 53.8% [7/13] without antibiotic use; pperitonitis (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 as biopsy, polypectomy, IUD implantation/removal, and dilatation and curettage (D&C), pose a high risk for peritonitis. Prophylactic antibiotics for peritonitis prevention may be required in colonoscopic procedures and gynecologic procedures

32 years' experience of peritoneal dialysis-related peritonitis in a university hospital

NARCIS (Netherlands)

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

2014-01-01

Peritonitis in peritoneal dialysis (PD) patients can lead to technique failure and contributes to infection-related mortality. Peritonitis prevention and optimization of treatment are therefore important in the care for PD patients. In the present study, we analyzed the incidence of peritonitis,

Websiteanalyse

DEFF Research Database (Denmark)

Thorlacius, Lisbeth

2014-01-01

Studier i design og analyse af æstetiske aspekter i planlægning og brug af websites har kun i et begrænset omfang været under reflektorisk behandling. Det er baggrunden for dette kapitel, som indleder med en gennemgang af æstetikkens rolle i webdesign for derefter at se på genrer og stilarter i...... webdesign. Efterfølgende opstilles en model til analyse af visuel kommunikation på websites. Modellens teoretiske grundlag vil blive introduceret, og dens praktiske anvendelse vil blive demonstreret ved en sammenlignende analyse af Københavns Kommunes og multikunstner Henrik Vibskovs hjemmesider og Facebook-sider....

Peritoneal Fluid Analysis

Science.gov (United States)

... Get Tested? To help diagnose the cause of peritonitis, an inflammation of the membrane lining the abdomen, ... fever and your healthcare practitioner suspects you have peritonitis or ascites Sample Required? A peritoneal fluid sample ...

Peritoneal mesothelioma

International Nuclear Information System (INIS)

Ros, P.R.; Yuschok, T.J.; Buck, J.L.; Shekitka, K.M.; Kaude, J.V.; Armed Forces Inst. of Pathology, Washington, DC

1991-01-01

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.)

Skal alkoholmisbrug overhovedet behandles i almen praksis

DEFF Research Database (Denmark)

Barfod, Sverre Malm

1995-01-01

Som en del af en international undersøgelse gennemførtes telefon-interviews ud fra et semi-struktureret spørgeskema af 12 tilfældigt udvalgte praktiserende læger samt personlige interviews af seks nøglepersoner i sundhedsvæsenet. Alle de udspurgte praktiserende læger var interesserede i at udføre...

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

Science.gov (United States)

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

2017-07-01

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

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

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

Science.gov (United States)

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

2016-01-01

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

The dialysis catheter and infectious peritonitis in intermittent peritoneal dialysis

DEFF Research Database (Denmark)

Kolmos, Hans Jørn; Hemmeløff Andersen, Karl Erik; Hansen, Lise

1984-01-01

118 episodes of infectious peritonitis registered among 156 patients treated with intermittent peritoneal dialysis over a 5-yr period were analysed with special reference to potential routes of infection associated with the dialysis catheter. Peritonitis was randomly distributed among the patients......, and the change of keeping free of peritonitis declined exponentially with time. The main factor determining the individual number of episodes was the total space of time, in which a patient had been wearing a dialysis catheter, whereas the number of catheter disconnections played no significant role. A relative...... preponderance of cases due to Enterobacteriaceae was noted within the first week after catheter implantation. In contrast with this, peritonitis with skin microorganisms was not associated with the implantation of catheters....

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...

Shared care in prostate cancer

DEFF Research Database (Denmark)

Lund, Anette Svarre; Lund, Lars; Jønler, Morten

2016-01-01

Cirka 20 % af de patienter, der går til kontrol i urologiske ambulatorier efter afsluttet behandling for prostatakræft, ønsker at bliver fulgt hos egen læge. Men følger patienterne så planen? Og er kvaliteten af opfølgningen i orden − eller falder de mellem de berømte to stole? Dette studie følge...

Serious Mental Illness and Risk for Hospitalizations and Rehospitalizations for Ambulatory Care-sensitive Conditions in Denmark:

DEFF Research Database (Denmark)

Davydow, Dimitry; Ribe, Anette Riisgaard; Pedersen, Henrik Søndergaard

2015-01-01

Antallet af akutte indlæggelser for kroniske sygdomme har i de senere år været stigende i den vestlige verden. De mange indlæggelser har medført øgede udgifter i sundhedsvæsenet, selvom nogle af disse indlæggelser potentielt kunne være undgået med forebyggelse og behandling i det nære sundhedsvæs...

Kommende standarder for revisors ydelser - "Efter clarity"

DEFF Research Database (Denmark)

Kiertzner, Lars

2011-01-01

Atiklen præsenterer på et overordnet niveau kommende standarder med videre fra IAASB. Formålet er at give et samlet overblik over, hvad der kan forventes i de kommende år. Den første og største del af artiklen behandler allerede igangsatte projekter, der befinder sig et sted i tilblivelsesprocess...... ISA 700 om revisionspåtegningen ISA 720 om andre oplysninger i regnskaber og ISRE 2400 om review. Andre projekter om vejledninger (IAPS), andre erklæringsopgaver og beslægtede opgaver behandles kun perifert....

Ionic conductivity of peritoneal dialysate: a new, easy and fast method of assessing peritoneal membrane function in patients undergoing peritoneal dialysis.

Science.gov (United States)

La Milia, Vincenzo; Pontoriero, Giuseppe; Virga, Giovambattista; Locatelli, Francesco

2015-10-01

Peritoneal membrane function can be assessed using the peritoneal equilibration test (PET) and similar tests, but these are almost always complicated to use, require a considerable amount of working time and their results cannot always be easily interpreted. Ionic conductivity is a measure of the ability of an electrolyte solution to conduct electricity. We tested the hypothesis that the ionic conductivity of peritoneal dialysate can be used to evaluate peritoneal membrane function in peritoneal dialysis patients. We measured the ionic conductivity and classic biochemical parameters of peritoneal dialysate in 69 patients during a modified PET and compared their ability to evaluate peritoneal membrane function and to diagnose ultrafiltration failure (UFF). Ionic conductivity was correlated well with classical parameters of peritoneal transport as glucose reabsorption of glucose (D/D0: r(2) = 0.62, P conductivity area under the receiver-operating characteristic curve was 0.91 (95% confidence interval: 0.81-0.96) with sensitivity of 1.00 and specificity of 0.84 at a cut-off value of 12.75 mS/cm. These findings indicate that the ionic conductivity of peritoneal dialysate can be used as a new screening tool to evaluate peritoneal membrane function. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

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 ... The peritoneal fluid culture may be negative, even if you have ... diagnosis of peritonitis is based on other factors, in addition ...

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.

CT findings of peritoneal tuberculosis and peritoneal carcinomatosis: relationship between peritoneal change and omental infiltration

International Nuclear Information System (INIS)

Jeong, Seong Ki; Jung, Hae Jong; Kang, Sung Hag; Shin, Sung Ran; Lee, Kil Jun; Lee, Min Jin; Lee, Sang Chun

1997-01-01

To compare the CT findings of peritoneal tuberculosis (PT) and peritoneal carcinomatosis (PC) based on the morphologic features of the peritoneum and assess the relationship between the degree of peritoneal thickness and the severity of omental infiltration in PT and PC. We retrospectively reviewed the CT findings of 15 patients with PT and 14 with PC. We checked morphologic changes of the peritoneum as seen on CT, for the following points: 1) the presence of peritoneal change: 2) the pattern of any change-diffuse thickening, plaque or nodularity, combined thickening (diffuse and plaque, or nodularity) 3) the degree of thickness on the whole peritoneum - mild (grossly definite, but not more than 3mm), moderate (more than 3mm); 4) the presence of irregularity on the peritoneal surface. We also evaluated the significance of the relationship between peritoneal thickness and omental infiltration in both disease entities. The degree of omental infiltration was described as follows : grade 1 (no change or focal smudge pattern); grade 2 (diffuse smudge), grade 3 (omental cake regardless extent). Peritoneal change was seen in 12 of 15 PT patients and in 7 of 14 PC patients. In all 12 PT patients, the pattern of change was diffuse thickening, and among the seven PC patients, there was diffuse thickening in one, plaque or nodular thickening in four, and combined thickening in two. In PT patients, the degree of thickness on the whole peritoneum was mild in six and moderate in six, and in PC patients it was mild in two and moderate in one. An irregular peritoneum surface was seen in one patient with PT and in two with PC. The degree of omental infiltration in PT was grade 1 in four patients, grade 2 in six and grade 3 in five. In PC, it was grade 1 in six patients, grade 2 in two and grade 3 in six. Smooth diffuse thickening of the peritoneum was seen in 11 of 15 PT cases and in one of 14 PC (P 0.5). In PT and PC different CT findings based on peritoneal morphologic changes

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.

The Natural Time Course of Membrane Alterations During Peritoneal Dialysis Is Partly Altered by Peritonitis.

Science.gov (United States)

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

2016-01-01

♦ The quality of the peritoneal membrane can deteriorate over time. Exposure to glucose-based dialysis solutions is the most likely culprit. Because peritonitis is a common complication of peritoneal dialysis (PD), distinguishing between the effect of glucose exposure and a possible additive effect of peritonitis is difficult. The aim of the present study was to compare the time-course of peritoneal transport characteristics in patients without a single episode of peritonitis-representing the natural course-and in patients who experienced 1 or more episodes of peritonitis during long-term follow-up. ♦ This prospective, single-center cohort study enrolled incident adult PD patients who started PD during 1990-2010. A standard peritoneal permeability analysis was performed in the first year of PD treatment and was repeated every year. The results in patients without a single episode of peritonitis ("no-peritonitis group") were compared with the results obtained in patients who experienced 1 or more peritonitis episodes ("peritonitis group") during a follow-up of 4 years. ♦ The 124 patients analyzed included 54 in the no-peritonitis group and 70 in the peritonitis group. The time-course of small-solute transport was different in the groups, with the peritonitis group showing an earlier and more pronounced increase in the mass transfer area coefficient for creatinine (p = 0.07) and in glucose absorption (p = 0.048). In the no-peritonitis group, the net ultrafiltration rate (NUFR) and the transcapillary ultrafiltration rate (TCUFR) both showed a steep increase from the 1st to the 2nd year of PD that was absent in the peritonitis group. Both groups showed a decrease in the NUFR after year 3. A decrease in the TCUFR occurred only in the peritonitis group. That decrease was already present after the year 1 in patients with severe peritonitis. The time-course of free water transport showed a continuous increase in the patients without peritonitis, but a decrease in the

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

Lyden af musik - er lyden af idealisme

DEFF Research Database (Denmark)

Eigtved, Michael

2015-01-01

Programartiklen til Det Ny Teaters opsætning af Rodgers & Hammersteins The Sound of Music, undersøger musicalgenrens - og især de konkrete ophavsmænds- affinitet til fremstillingen af såvel idealistiske som ideologiske universer.......Programartiklen til Det Ny Teaters opsætning af Rodgers & Hammersteins The Sound of Music, undersøger musicalgenrens - og især de konkrete ophavsmænds- affinitet til fremstillingen af såvel idealistiske som ideologiske universer....

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

Science.gov (United States)

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

2014-01-01

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

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)

[Clinical analysis for patients with continuous ambulatory peritoneal dialysis associated peritonitis].

Science.gov (United States)

Liu, Jian; Huang, Xun; Liu, Yao; Xu, Hui; Gong, Rui'e; Li, Chunhui

2016-12-28

To analyze the clinical characteristics of continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis in the tertiary hospitals and to discuss the preventive and therapeutic strategy.
 Methods: The clinical characteristics, pathogens, resistance and outcomes of 126 CAPD associated peritonitis in 104 patients from Jan, 2013 to June, 2016, were retrospectively analyzed.
 Results: Among the patients, the incidence rates of abdominal pain, fever, diarrhea and emesis were 104 (82.54%), 56 (44.44%), 49 (38.89%), and 31 (23.60%), respectively. Among them, 88 patients suffered peritonitis once, other 16 patients suffered multiple peritonitis or recurrent peritonitis for 38 times. Among the 38 times, the numbers for recurrent, repeated or catheter-associated peritonitis were 2, 2, or 3, respectively. Peritoneal fluids from 103 cases were cultured, and 64 cases were positive in bacteria, with a rate of 62.14%. A total of 70 strains of bacteria were separated, including 42 strains of gram-positive bacteria, 21 strains of gram-negative bacteria, and 7 strains of fungus. The most common gram-positive pathogens were Staphylococcus epidermidis, Enterococcus faecalis and Staphylococcus haemolyticus, while Escherichia coli, Klebsiella pneumoniae and Klebsiella pneumoniae were the most common gram-negative bacteria. Candida albicans was the major fungal pathogens. Gram-positive cocci showed resistance to gentamycin, levofloxacin, moxifloxacin, vancomycin and linezolid, with a rate at 20.00%, 36.11%, 5%, 0%, and 0%, respectively. The gram-negative bacilli were resistent to cefoperazone/sulbactam, gentamycin, cephazolin, and ceftazidime, with a rate at 6.25%, 10.53%, 64.29%, and 15.38%, respectively. There were no imipenem, amikacin, piperacillin/tazobactam-resistant strains were found.
 Conclusion: The most common pathogen causing CAPD associated peritonitis is gram-positive bacteria. It is crucial to take the anti-infection therapy for CAPD associated peritonitis

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.

Peritonitis in peritoneal dialysis patients after renal transplantation

NARCIS (Netherlands)

Bakir, N.; Surachno, S.; Sluiter, W. J.; Struijk, D. G.

1998-01-01

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. We

Peritoneal Dialysis-Related Peritonitis Due to Melioidosis: A Potentially Devastating Condition.

Science.gov (United States)

Kanjanabuch, Talerngsak; Lumlertgul, Nuttha; Pearson, Lachlan J; Chatsuwan, Tanittha; Pongpirul, Krit; Leelahavanichkul, Asada; Thongbor, Nisa; Nuntawong, Gunticha; Praderm, Laksamon; Wechagama, Pantiwa; Narenpitak, Surapong; Wechpradit, Apinya; Punya, Worauma; Halue, Guttiga; Naka, Phetpailin; Jeenapongsa, Somboon; Eiam-Ong, Somchai

2017-01-01

♦ BACKGROUND: Melioidosis, an infectious disease caused by Burkholderia pseudomallei , is endemic in Southeast Asia and Northern Australia. Although a wide range of clinical manifestations from this organism are known, peritonitis associated with peritoneal dialysis (PD) has rarely been reported. ♦ PATIENTS AND METHODS: Peritoneal dialysis patients from all regions in Thailand were eligible for the study if they had peritonitis and either peritoneal fluid or effluent culture positive for B. pseudomallei . Patient data obtained included baseline characteristics, laboratory investigations, treatments, and clinical outcomes. When possible, PD fluid and removed Tenckhoff (TK) catheters were submitted for analyses of minimal inhibitory concentration (MIC) and microbial biofilm, respectively. ♦ RESULTS: Twenty-six patients were identified who were positive for peritoneal B. pseudomallei infection. The recorded mean age was 50 ± 15 (24 - 75) years, and the majority (58%) were female. Most of the cases were farmers living in Northeastern and Northern Thailand. Almost half of the cases had diabetes. Infections were reported commonly during the monsoon season and winter. The clinical presentations of peritonitis were similar to the manifestations from other microorganisms. Nine patients (41%) died (7 from sepsis), 6 fully recovered, and 7 switched to permanent hemodialysis. The mortality was potentially associated with sepsis ( p = 0.007), infection during the monsoon season ( p = 0.017), high initial dialysate neutrophils ( p = 0.045), and high hematocrit ( p = 0.045). Although no antibiotic resistance to ceftazidime and carbapenems was detected, approximately 50% of patients died with this treatment. Microbial biofilms were identified on the luminal surface of 4 out of 5 TK catheters, but the removal of the catheter did not alter the outcomes. ♦ CONCLUSION: Peritoneal dialysis-related peritonitis due to melioidosis is uncommon but highly fatal. Increased awareness

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

Science.gov (United States)

Yung, Susan; Chan, Tak Mao

2012-01-01

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

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...

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.

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. PMID:26989432

Pigeons and peritonitis?

Science.gov (United States)

Greaves, I; Kane, K; Richards, N T; Elliott, T S; Adu, D; Michael, J

1992-01-01

We report an outbreak of fungal peritonitis due to Candida parapsilosis in 12 patients undergoing chronic ambulatory peritoneal dialysis (CAPD). All 12 patients were treated by removal of the CAPD catheter together with systemic antifungal therapy. There were no peritonitis-related deaths. Four patients were successfully returned to CAPD at a later date. Microbiological investigation during the outbreak demonstrated colonization of various areas of the CAPD Unit and medical ward with the organism. C. parapsilosis was also isolated from pigeon guano obtained from window-sills. The number of cases of peritonitis due to this organism decreased markedly after bird-proof netting was installed. We believe that this is the first report of an outbreak of CAPD peritonitis due to faecal carriage of C. parapsilosis by pigeons.

Reflections on Contemporary Construction Practice

DEFF Research Database (Denmark)

Beim, Anne

2011-01-01

Indledningskapitlet til bogen, Tectonic Visions in Architecture, som behandler det for arkitketuren centrale tektonikbegreb. Gennem analyse af et antal moderne bygningsværker berøres arkitekturens teknologiske aspekter og produktonsformer og ikke mindst industrielle processer og miljøtilpasset...

Prognostic Factors for Peritonitis Outcome

NARCIS (Netherlands)

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

2012-01-01

Despite advances in treatment and prevention, peritonitis remains a major problem in peritoneal dialysis (PD) patients with often technique failure as a consequence. The last decades the focus of PD peritonitis has changed from lowering peritonitis incidence to improvement of peritonitis outcome.

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

Science.gov (United States)

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

2014-01-01

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

Meta-analysis of interleukin-6 concentration in peritoneal fluid of women with endometriosis

International Nuclear Information System (INIS)

Zuo Liandong; Zheng Hui; Li Hongyi

2003-01-01

To investigate whether the Interleukin-6 (IL-6) concentration in peritoneal fluid of patients with endometriosis (EM) is higher than that of healthy, synthetic quantitative analysis was used to study international literatures on IL-6 in peritoneal fluid of women with EM by means of Meta-analysis. The results showed that IL-6 levels of ELISA in the women with EM were -0.472-3.974 times of standard deviation higher than those in the healthy control group. Regardless of measurement methods, -0.73-3.45 times of standard deviation was higher. Both results could not generally think that the IL-6 in peritoneal fluid of EM patient was higher than that of normal persons. However, when EM was diagnosed at the time of laparoscopy or surgery and staged according to AFS, I-II stage were attributed to EM1, III-IV stage were EM2. It was found by Meta-analysis that the elevated IL-6 levels had a mutual relation with the severity of EM: The levels of EM1 were -4.807-5.608 times of standard deviation higher than those of then healthy, with no significant difference (P>0.05), whereas those of EM2 were 0.54-5.34 times or 1.13-5.46 times of standard deviation higher than those of EM1 or healthy, respectively, both with significant difference. The higher the IL-6 levels of the patients had in peritoneal fluid, the more serious EM were. The dysregulation of IL-6 responses might play a role in the pathophysiology of EM

Early Peritonitis in a Large Peritoneal Dialysis Provider System in Colombia.

Science.gov (United States)

Vargas, Edgar; Blake, Peter G; Sanabria, Mauricio; Bunch, Alfonso; López, Patricia; Vesga, Jasmín; Buitrago, Alberto; Astudillo, Kindar; Devia, Martha; Sánchez, Ricardo

♦ BACKGROUND: Peritonitis is the most important complication of peritoneal dialysis (PD), and early peritonitis rate is predictive of the subsequent course on PD. Our aim was to calculate the early peritonitis rate and to identify characteristics and predisposing factors in a large nationwide PD provider network in Colombia. ♦ METHODS: This was a historical observational cohort study of all adult patients starting PD between January 1, 2012, and December 31, 2013, in 49 renal facilities in the Renal Therapy Services in Colombia. We studied the peritonitis rate in the first 90 days of treatment, its causative micro-organisms, its predictors and its variation with time on PD and between individual facilities. ♦ RESULTS: A total of 3,525 patients initiated PD, with 176 episodes of peritonitis during 752 patient-years of follow-up for a rate of 0.23 episodes per patient year equivalent to 1 every 52 months. In 41 of 49 units, the rate was better than 1 per 33 months, and in 45, it was better than 1 per 24 months. Peritonitis rates did not differ with age, ethnicity, socioeconomic status, or PD modality. We identified high incidence risk periods at 2 to 5 weeks after initiation of PD and again at 10 to 12 weeks. ♦ CONCLUSION: An excellent peritonitis rate was achieved across a large nationwide network. This occurred in the context of high nationwide PD utilization and despite high rates of socioeconomic deprivation. We propose that a key factor in achieving this was a standardized approach to management of patients. Copyright © 2017 International Society for Peritoneal Dialysis.

Virksomhedens personalearbejde

DEFF Research Database (Denmark)

Virksomhedens personalearbejde er et tema som dækker over forskellige tilgange til ledelse og administration af de menneskelige ressourcer i organisationen. Både den personaleadministrative tilgang og Human Ressource Management (HRM) - tilgangen præsenteres i bogen. Et af hovedsynspunkterne i bogen...... er, at der ikke findes generelle principper for ledelse og administration af de menneskelige ressourcer i den enkelte organisation. Bogens ide er at samle udvalgte centrale emner med relevans for virksomhedens personalearbejde i praksis. Følgende emner behandles: Virksomhedens personalearbejde i...

[Fungal peritonitis due to Rhodotorula mucilaginosa in a patient with automated peritoneal dialysis: Literature review].

Science.gov (United States)

Verdugo, Fernando J; Briones, Eduardo; Porte, Lorena; Amaro, José; Fica, Alberto

2016-04-01

Fungal peritonitis is a major complication of peritoneal dialysis associated with high mortality. Most survivors have a high rate of abandonment of peritoneal dialysis. We report a case of fungal peritonitis due to an unusual agent. An 83 year-old woman, with a history of type 2 diabetes mellitus and multiple episodes of bacterial peritonitis associated to technical flaws in the implementation of automated peritoneal dialysis, was admitted due to abdominal pain and cloudy peritoneal fluid. Rhodotorula mucilaginosa was identified in the peritoneal fluid by MALDI-TOF. She was treated with catheter removal and oral posaconazole for 14 days showing clinical resolution and non-recurrence.

En genlæsning af John Rawls i lyset af hans diskussion af forholdet til fremtidige generationer

DEFF Research Database (Denmark)

Lübcke, Poul

2009-01-01

På grundlag af en konsekventialistisk rekonstruktion af Rawls' politiske position gøres der rede for Rawls eksplicitte og implicitte vurdering af vores ansvar over for fremtidige generationer......På grundlag af en konsekventialistisk rekonstruktion af Rawls' politiske position gøres der rede for Rawls eksplicitte og implicitte vurdering af vores ansvar over for fremtidige generationer...

Kompetencer i dansk

DEFF Research Database (Denmark)

Bundsgaard, Jeppe; Christiansen, Eva Terese; Flamant, Sanne Harder

udvikler nogle af de væsentligste kompetencer i det senmoderne samfund. Kompetencetilgangen stiller en logik og en metode til rådighed for valg af undervisningsindhold og -metoder og danner desuden grundlag for refleksion i og over undervisningen. Kompetencer i dansk behandler bl.a. emner som litteratur......, kommunikation, sociale netværk, læringsspil, gruppearbejde, evaluering og interkulturelle kompetencer. Til bogen er knyttet hjemmesiden www.kompetenceridansk.dk....

Peritoneal mesothelioma.

OpenAIRE

Anderson, J. H.; Stewart, C. J.; Hansell, D. T.; Anderson, J. R.

1990-01-01

We report two patients who presented with small bowel obstruction secondary to peritoneal mesothelioma. The difficulties in establishing this diagnosis at an early stage are illustrated. Recent advances in the management of peritoneal mesothelioma are reviewed.

Rusmidler og mundhulen

DEFF Research Database (Denmark)

Pedersen, Anne Marie Lynge

2016-01-01

millioner af dødsfald, især alkoholmisbrug. Cannabis er det mest almindeligt anvendte illegale stof i hele verden, men der produceres til stadighed nye stoffer på verdensmarkedet. Litteraturen om virkningerne af illegale stoffer på den orale sundhed er relativ sparsom på grund af vanskeligheder med...... bruksisme. Desuden er det velkendt, at overdreven indtagelse af alkohol øger risikoen for oral cancer betydeligt. Det er vigtigt, at tandlæger har et indgående kendskab til de kliniske manifestationer ved misbrug og de medicinske risici, der kan være ved behandling af patienter med misbrug, men også...

Kompetencestrategi

DEFF Research Database (Denmark)

Drejer, Anders; Riis, Jens Ove

fortæller, hvordan man kan arbejde med virksomheders kompetencer i dialog med produkt-markedsområdet. For at give en mere detaljeret forståelse af, hvad kompetencer består af, beskriver forfatterne fire indholdselementer til en bred definition af kompetenceer som et samspil mellem mennesker, teknologi......, organisation og kultur. Bogen placerer kompetencer i deres rette, strategiske sammenhæng og giver svar på centrale spørgsmål om, hvordan man arbejder med virksomhedens kompetenceer i praksis. Bogen giver en ramme for en bred behandling af virksomheders kompetence og anviser modeller og metoder til...

Indeklima - Materialer - Byggeri

DEFF Research Database (Denmark)

Jensen, Jens Kristian Jehrbo

I dette hæfte behandles emnerne INDEKLIMA MATERIALER BYGGERI med henblik på at opnå en forståelse af de begreber, der har betydning for menneskets velvære. Nogle af de vigtigste indeklimabegreber gennemgås og materialers fordele og ulemper belyses. Emner som afgasning, materialevalg, depoteffekt...... efter behov. Hæftet erstatter det tidligere hæfte: "Noget om indeklima - især om materialer" fra 1988. Renskrivningen er foretaget af Mette Bjerring, og tegninger og fotos er færdiggjort af Ingrid Christensen. Begge bedes modtage min hjerteligste tak. Juli 1992. Jens Kr. Jehrbo Jensen...

Energirenovering af parcelhuse

DEFF Research Database (Denmark)

Aggerholm, Søren

af de tre huse består i efterisolering af lofter op til 300 mm, udskiftning af almindelige termoruder til energiruder, og installation af solvarmeanlæg til produktion af varmt brugsvand. I de tre huse er der ved energirenoveringen opnået en reduktion af energiforbruget på 16-22 procent. Rapporten...

Effect of assistance on peritonitis risk in diabetic patients treated by peritoneal dialysis: report from the French Language Peritoneal Dialysis Registry.

Science.gov (United States)

Benabed, Anais; Bechade, Clemence; Ficheux, Maxence; Verger, Christian; Lobbedez, Thierry

2016-04-01

Diabetic patients treated by peritoneal dialysis (PD) have been reported to be at an increased risk of peritonitis. This has been attributed to impairment in host defense, visual impairment, disability and muscle wasting, which could compromise ability to safely perform catheter connections. This study aimed to evaluate whether assisted PD is associated with a lower risk of peritonitis in diabetic patients. This was a retrospective study based on data from the French Language Peritoneal Dialysis Registry. We included diabetic patients starting PD between 1 January 2002 and 31 December 2012. The end of the observation period was 31 December 2013. Using complementary regression analysis (Fine and Gray, Hurdle models), we assessed the relationship between peritonitis occurrence, peritonitis number over time and the type of assisted PD. Of the 3598 diabetic patients, there were 2040 patients on nurse-assisted PD. These patients were older, more comorbid and more frequently on continuous ambulatory peritoneal dialysis (CAPD). In the multivariate analysis, nurse assistance was associated with a reduced risk of peritonitis in the Fine and Gray [subdistribution hazard ratio: 0.78 (95% confidence interval, CI, 0.68-0.89)] and in the first component of the Hurdle models [rate ratio: 0.82 (95% CI 0.71-0.93)], but not a lower incidence of peritonitis after an initial episode [rate ratio: 0.82 (95% CI 0.95-1.38)]. Transplant failure, glomerulonephritis and CAPD were associated with an increased risk. In France, nurse-assisted PD is associated with a lower risk of peritonitis in diabetic patients treated by PD but not a lower incidence of peritonitis. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

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

Science.gov (United States)

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

2016-01-01

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

Kortlægning af evalueringer og undersøgelser af vejledning knyttet til vejledning af unge i UU-regi

DEFF Research Database (Denmark)

Skovhus, Randi Boelskifte; thomsen, rie

2013-01-01

Kortlægning af evalueringer og undersøgelser af vejledning knyttet til vejledning af unge i UU-regi 2004-2013. Et arbejdspapir......Kortlægning af evalueringer og undersøgelser af vejledning knyttet til vejledning af unge i UU-regi 2004-2013. Et arbejdspapir...

Fremtidssikring af kloaknet

DEFF Research Database (Denmark)

Hansen, Ernst Jan de Place

2008-01-01

Beskrivelse af hvordan man ved udbygning af eksisterende kloaknet og ved nytænkning af planlægning af nye bydele kan sikre sig langsigtet mod konsekvenserne af klimaændinger og kraftigere nedbør...

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....

Kontraktetablering i supervision

DEFF Research Database (Denmark)

Mortensen, Karen Vibeke; Jacobsen, Claus Haugaard

2007-01-01

Kapitlet behandler kontraktetablering i supervision, et element, der ofte er blevet negligeret eller endog helt forbigået ved indledningen af supervisionsforløb. Sikre aftaler om emner som tid, sted, procedurer for fremlæggelse, fortrolighed, ansvarsfordeling og evaluering skaber imidlertid trygh...

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. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

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

Socio-Economic Status and Peritonitis in Australian Non-Indigenous Peritoneal Dialysis Patients

Science.gov (United States)

Tang, Wen; Grace, Blair; McDonald, Stephen P.; Hawley, Carmel M.; Badve, Sunil V.; Boudville, Neil C.; Brown, Fiona G.; Clayton, Philip A.; Johnson, David W.

2015-01-01

♦ Background: The aim of the present study was to investigate the relationship between socio-economic status (SES) and peritoneal dialysis (PD)-related peritonitis. ♦ Methods: Associations between area SES and peritonitis risk and outcomes were examined in all non-indigenous patients who received PD in Australia between 1 October 2003 and 31 December 2010 (peritonitis outcomes). SES was assessed by deciles of postcode-based Australian Socio-Economic Indexes for Areas (SEIFA), including Index of Relative Socio-economic Disadvantage (IRSD), Index of Relative Socio-economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO). ♦ Results: 7,417 patients were included in the present study. Mixed-effects Poisson regression demonstrated that incident rate ratios for peritonitis were generally lower in the higher SEIFA-based deciles compared with the reference (decile 1), although the reductions were only statistically significant in some deciles (IRSAD deciles 2 and 4 – 9; IRSD deciles 4 – 6; IER deciles 4 and 6; IEO deciles 3 and 6). Mixed-effects logistic regression showed that lower probabilities of hospitalization were predicted by relatively higher SES, and lower probabilities of peritonitis-associated death were predicted by less SES disadvantage status and greater access to economic resources. No association was observed between SES and the risks of peritonitis cure, catheter removal and permanent hemodialysis (HD) transfer. ♦ Conclusions: In Australia, where there is universal free healthcare, higher SES was associated with lower risks of peritonitis-associated hospitalization and death, and a lower risk of peritonitis in some categories. PMID:24497587

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

International Nuclear Information System (INIS)

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

1991-01-01

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

Peritonitis with Listeria monocytogenes in a patient on automated peritoneal dialysis

DEFF Research Database (Denmark)

Poulsen, Hanna Bjarkhamar; Á Steig, Torkil; Björkman, Jonas T

2018-01-01

We present a case where Listeria monocytogenesserotype 1/2a was determined to be the causative agent of peritonitis in a patient on automated peritoneal dialysis. The patient, a 53-year-old Caucasian woman from the Faroe Islands was admitted to the National Hospital reporting of constant abdominal...... pain and a fever. Peritoneal cultures were positive for growth of L. monocytogenes. The patient was successfully treated with oral amoxicillin for 2 weeks and intraperitoneal vancomycin for 3 weeks. To date, the patient has not been readmitted due to peritonitis. The Faroese salmon was the suspected...

Paecilomyces variotii peritonitis in a patient on continuous ambulatory peritoneal dialysis.

Science.gov (United States)

Uzunoglu, E; Sahin, A M

2017-06-01

Paecilomyces variotii (P. variotii) is an extremely rare cause of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. When diagnosed, it usually portends poor prognosis. Patient's survival depends on early laboratory diagnosis and proper treatment. We herein report a P. variotii peritonitis in a patient on CAPD which is a quite rare clinical entity. Laboratory diagnosis was confirmed via both morphological analysis and DNA sequencing. Antifungal susceptibility tests were performed and interpreted according to the Clinical Laboratory Standards Institute M38-A2 guidelines. After laboratory diagnosis, the patient was treated succesfully with liposomal amphotericin B and itraconazole combination and the peritoneal catheter was removed. This case is worthy of reporting since P. variotii is an uncommon cause of peritonitis and leads to dilemmas in both laboratory diagnosis and treatment strategies. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

An adherent nerve root – Classification and exercise therapy in a patient diagnosed with lumbar disc prolapse

DEFF Research Database (Denmark)

Melbye, Martin

2010-01-01

Patienter med diskusprolaps får oftest besked på, at det ikke skal gøre ondt for at gøre godt, i forbindelse med behandling og genoptræning. Der findes dog en ganske lille gruppe patienter som udvikler en restriktiv tilstand, hvor der dannes adhærencer ved nerveroden, i forbindelse med opheling a...... prolapsen. Tilstanden remodelleres med smertefulde hjemmeøvelser som gradvist progredieres over nogle måneder. En ny case-rapport i Manual Therapy dokumenterer fysioterapidiagnostik, klinisk ræsonnering og behandling af en patient med denne lidelse. Udgivelsesdato: 2010...

Applied peritoneal anatomy

International Nuclear Information System (INIS)

Patel, R.R.; Planche, K.

2013-01-01

The peritoneal cavity is a complex anatomical structure with multiple attachments and connections. These are better understood with reference to the embryological development of this region. Armed with this knowledge, the diagnosis and assessment of a wide range of common intra-abdominal diseases becomes straightforward. This article will review and simplify the terminology, complex embryological development, and anatomy of the peritoneum, peritoneal attachments, and the reflections forming the peritoneal boundaries. Normal anatomy will be described using schematic diagrams with corresponding computed tomography (CT) and magnetic resonance imaging (MRI) images, including CT peritoneograms. The relevance of intra- and extra-peritoneal anatomy to common pathological processes will be demonstrated

Alternaria alternata peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis

Directory of Open Access Journals (Sweden)

Yosra Guedri

2017-01-01

Full Text Available Fungal peritonitis is a serious complication of peritoneal dialysis (PD leading to loss of ultrafiltration and discontinuation of PD treatment. The most frequently isolated fungi are Candida albicans and, filamentous fungi such Alternaria alternata species are found only rarely. We report the case of a 75-year-old woman who developed peritonitis due to this black fungus.

Outcomes of Peritonitis in Children on Peritoneal Dialysis: A 25-Year Experience at Severance Hospital

Science.gov (United States)

Lee, Kyong Ok; Park, Se Jin; Kim, Ji Hong; Lee, Jae Seung; Kim, Pyung Kil

2013-01-01

Purpose Relatively little is known on the microbiology, risk factors and outcomes of peritoneal dialysis (PD)-associated peritonitis in Korean children. We performed this study in order to evaluate the incidence, treatment and clinical outcomes of peritonitis in pediatric PD patients at Severance Hospital. Materials and Methods We analyzed data from 57 PD patients younger than 18 years during the period between June 1, 1986 and December 31, 2011. The collected data included gender, age at commencement of PD, age at peritonitis, incidence of peritonitis, underlying causes of end stage renal disease, microbiology of peritonitis episodes, antibiotics sensitivity, modality and outcomes of PD. Results We found 56 episodes of peritonitis in 23 of the 57 PD patients (0.43 episodes/patient-year). Gram-positive bacteria were the most commonly isolated organisms (40 episodes, 71.4%). Peritonitis developed in 17 patients during the first 6 months following initiation of PD (73.9%). Peritonitis episodes rarely resulted in relapse or the need for permanent hemodialysis and no patient deaths were directly attributable to peritonitis. Antibiotic regimens included cefazolin+tobramycin from the years of 1986 to 2000 and cefazolin+ceftazidime from the years of 2001 to 2011. While antibiotic therapy was successful in 48 episodes (85.7%), the treatment was ineffective in 8 episodes (14.3%). The rate of continuous ambulatory PD (CAPD) peritonitis was statistically higher than that of automated PD (APD) (p=0.025). Conclusion Peritonitis was an important complication of PD therapy and we observed a higher incidence of PD peritonitis in patients with CAPD when compared to APD. PMID:23709435

Improved Outcome of Enteric Peritonitis in Peritoneal Dialysis Patients Aged 50 Years and Older with Temporary Discontinuation of Peritoneal Dialysis and Intravenous Meropenem.

Science.gov (United States)

Abrahams, Alferso C; Rüger, Wim; Ter Wee, Pieter M; van Ittersum, Frans J; Boer, Walther H

2017-01-01

♦ BACKGROUND: Peritonitis is a major cause of morbidity, mortality, and technique failure in peritoneal dialysis (PD) patients, especially when caused by enteric microorganisms (EM). We have implemented a treatment protocol specifically aimed at improving the outcome in EM peritonitis. The adapted protocol was applied in all PD patients 50 years and older presenting with peritonitis who were considered to be at risk of EM peritonitis and involves 3 interventions: 1) temporary discontinuation of PD without removing the catheter (peritoneal rest), 2) intravenous meropenem, and 3) meropenem intracatheter as lock (Mero-PerRest protocol). ♦ METHODS: In this observational study, we compared the outcome of 203 peritonitis episodes in 71 patients treated with the Mero-PerRest protocol, with 217 episodes in 104 patients treated with a more traditional intraperitoneal gentamicin-rifampicin-based regimen. ♦ RESULTS: In EM peritonitis episodes, the Mero-PerRest protocol resulted in a higher primary cure rate (90.0% vs 65.3%, adjusted odds ratio [OR] 4.54 [95% confidence interval (CI) 1.46 - 14.15]) and better technique survival (90.0% vs 69.4%, adjusted OR 3.41 [95% CI 1.07 - 10.87]). This effect was most distinct in patients with polymicrobial EM peritonitis (cure rate 87.5% vs 34.8%, p = 0.0003). Interestingly, primary cure rate (95.6% vs 84.7%, adjusted OR 3.92 [95% CI 1.37 - 11.19]) and technique survival (95.6% vs 85.6%, adjusted OR 3.60 [95% CI 1.25 - 10.32]) were also excellent in non-EM peritonitis episodes. Patient survival did not differ significantly. ♦ CONCLUSION: The poor outcome of peritonitis caused by EM in PD patients aged 50 years and older could be improved by applying a treatment protocol involving temporary discontinuation of PD without catheter removal and intravenous and intracatheter meropenem. Copyright © 2017 International Society for Peritoneal Dialysis.

Diagnostik og behandling af neuromyelitis optica

DEFF Research Database (Denmark)

Nielsen, Helle Hvilsted; Ravnborg, Mads; Illes, Zsolt

2014-01-01

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease characterized by antibodies against aquaporin-4 in up to 80% of the cases and even less in the NMO spectrum disorders, which may be difficult to distinguish from early multiple sclerosis. While immunosuppressive therapy should...

Traditionel og alternativ behandling af sklerosepatienter

DEFF Research Database (Denmark)

Stenager, E N; Stenager, Egon; Knudsen, L

1989-01-01

The medicine consumption and the employment of alternative treatment were investigated in a material of 117 patients with disseminated sclerosis (DS) considered to be a representative sample of the patients with DS in the County of Funen. This investigation revealed that the preparations most com...... in social classes 4 and 5 and in women. In addition, is was found that there was no difference in social class, sex and age among the patients who employ alternative methods of treatment. The patients themselves have not experienced any effect from alternative treatment....

Diagnostik og behandling af hidrosadenitis suppurativa

DEFF Research Database (Denmark)

Ring, Hans Christian; Saunte, Ditte Marie; Riis, Peter Theut

2017-01-01

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels and scarring involving the intertriginous regions. Although patients with HS present a distinct symptomatology with a subsequent impairment of quality of life, an overall diagnostic time...... of seven years has been reported. A better and broader understanding of this disease may potentially reduce the diagnostic delay. This review provides an updated overview of diagnosis, monitoring tools as well as early treatment interventions....

Ny behandling af kronisk hepatitis B

DEFF Research Database (Denmark)

Andersen, Ellen Sloth; Weis, Nina M

2008-01-01

Worldwide, 350 million people are infected with chronic hepatitis B. Over the last few years, it has been possible to treat chronic hepatitis B. Treatment very often consists of nucleos(t)ide analogs and in a few cases of pegylated alpha-interferon. In 2007, a new nucleoside analog, Telbivudine...

Målrettet behandling af lymfoproliferativ sygdom

DEFF Research Database (Denmark)

Niemann, Carsten Utoft; Geisler, Christian Hartmann

2014-01-01

The development of targeted treatment of chronic lymphocytic leukaemia (CLL) is changing the prognostic outlook for CLL patients. The B-cell antigen receptor pathway is identified as pivotal for CLL pathogenesis and CLL cell proliferation. Inhibition of this pathway by ibrutinib (Bruton's tyrosin...

Neurointensiv behandling af svaere traumatiske hjerneskader

DEFF Research Database (Denmark)

Welling, Karen-Lise Kobberø; Eskesen, Vagn; Romner, Bertil

2010-01-01

We present a Danish algorithm for the neurointensive care of patients with severe traumatic brain injury. The primary goal is to avoid cerebral ischaemia and hypoxia and secondarily brain injury. Patient evaluation by a neurosurgeon is mandatory, and decision-making concerning extended cerebral...

Elektrokemoterapi til behandling af kutane metastaser

DEFF Research Database (Denmark)

Falk, Hanne; Matthiessen, Louise Wichmann; Dahlstrøm, Karin

2015-01-01

Cutaneous metastases occur in up to 9% of all patients with cancer and may cause discomfort and stigmatization. Electrochemotherapy is a local treatment using electric pulses to permeabilize cell membranes, enabling chemotherapy, such as bleomycin, to enter the cells and increase the cytotoxic...... effect by at least 300-fold. Electrochemotherapy is an efficient, once only treatment for cutaneous metastases with an objective response of 62-99%. Electrochemotherapy can reduce discomfort such as ulceration, oozing, bleeding and pain. Adverse events depend on the size of treatment area, but are very...

Behandling af Tourettes syndrom med aripiprazol

DEFF Research Database (Denmark)

Stenstrøm, Anne Dorte; Sindø, Ingrid

2008-01-01

Tourette's syndrome (TS) is a motoric disorder characterised by multiple motor and vocal tics. The treatment for patients with moderate to severe TS includes antipsychotic medication. A case report is described in which a 20 year-old male had taken antipsychotic medication since the age of five......, due to TS. The initial treatment consisted of pimozide and risperidone, both of which had an unsatisfactorily efficacy on tics and side effects in the form of weight gain and sedation. The patient is now treated with aripiprazole and there is a marked reduction of tics and no side effects...

Impotens forarsaget af behandling med methotrexat

DEFF Research Database (Denmark)

Penninga, Ida Elisabeth Irene; Larsen, H.K.; Andersen, S.E.

2008-01-01

impotence nine months after initiation of treatment. Two weeks after discontinuation of MTX the impotence subsided, but when MTX treatment was reintroduced, the impotence returned after two months. Only a few other cases of impotence associated with MTX have been described previously Udgivelsesdato: 2008/1/28...

Ipilimumab til behandling af metastaserende melanom

DEFF Research Database (Denmark)

Ghasemi, Habib; Schmidt, Henrik; Stolle, Lars Bjørn

2015-01-01

Until recently metastatic melanoma was a disease with limited treatment options and a poor prognosis. However, new promising products have been developed. Ipilimumab, a full human anti-cytotoxic T-lymphocyte antigen-4 antibody, has shown improved survival in several clinical trials and is now a p...

Kirurgisk behandling af urininkontinens hos kvinder

DEFF Research Database (Denmark)

Ammendrup, A.C.; Sørensen, Helle Christina; Sander, Pia

2010-01-01

: In total, 94 operating gynaecologists and urologists were identified, 63 responded (71%) of whom 49 (78%) performed UI surgery. UI surgeons were gynaecologists 43 (88%) of these 24 (49%) were urogynecologists (working more than 50% with urogynecology) and five (10%) urologists. Tension-free Vaginal Tape......INTRODUCTION: During the last decade, minimal invasive procedures have been introduced for treatment of urinary incontinence (UI) in women leading to shorter hospitalisation and fewer complications. The aim of this study was to outline clinical practice and attitudes among Danish UI surgeons....... MATERIAL AND METHODS: Surgeons performing UI procedures were identified and mailed a questionnaire in 2007 concerning 2006. Questions included specialisation, number of procedures, type of surgery, complications and attitude towards learning surgery and maintaining a sufficient level of routine. RESULTS...

Biofarmaka til behandling af reumatoid artritis

DEFF Research Database (Denmark)

Baslund, Bo; Bendtzen, Klaus

2008-01-01

The current status on the use of biopharmaceuticals in the treatment of rheumatoid arthritis is reviewed. Blocking of TNF-alpha, co-stimulation of CD28+ T-cells and depletion of CD20+ B-cells are all effective ways to diminish inflammation and joint damage. However, not all patients react to thes...

Abatacept til behandling af reumatoid artritis

DEFF Research Database (Denmark)

Nielsen, Henrik; Hansen, Annette

2009-01-01

Abatacept (CTLA4Ig) is a human fusion protein which consists of a cytotoxic lymphocytic-associated type 4 antigen which is bound to the Fc part of the IgG1. Abatacept binds to CD80/CD86 on antigen-presenting cells thus blocking the co-stimulatory signal to the naïve T cells and interfering with a...

Flumazenil til behandling af hepatisk encefalopati

DEFF Research Database (Denmark)

Elkjaer, J M; Jensen, T U; Emborg, J

2000-01-01

Hepatic encephalopathy (HE) is the neuropsychiatric syndrome that occurs as a complication to liver failure in patients with acute or chronic liver disease. Mental status in this syndrome can range from subtle deficits to coma, with respiratory insufficiency and aspiration to the lungs...

Biologisk behandling af psoriasis og psoriasisartritis

DEFF Research Database (Denmark)

Kragballe, Knud; Deleuran, Bent

2008-01-01

Psoriasis is an immune-mediated inflammatory skin disease which may be associated with psoriatic arthritis. Biological therapy is indicated in patients who do not respond to, or are intolerant to, or have contraindication against traditional therapy. TNFalpha antagonists are used for both skin...

Moderne behandling af type B-aortadissektion

DEFF Research Database (Denmark)

Klitfod, L.; Baekgaard, N.; Just, S.

2008-01-01

Rapid classification is essential in the management of aortic dissections, as Type A dissections require surgery, while the optimal treatment of Type B dissections is controversial. Medical treatment with antihypertensive medication and analgesics has so far been the main treatment of uncomplicated...... Type B dissections, while surgery has been reserved for complications and persistent pain in spite of medical treatment. Endovascular techniques are less invasive than open repair and show promising early results Udgivelsesdato: 2008/9/8...

Kirurgisk behandling af levermetastaser og levercancer

DEFF Research Database (Denmark)

Wojdemann, M.; Burcharth, F.; Rokkjaer, M.

2008-01-01

Hepatic resection is the golden standard in treatment of tumours from primary liver cancer and colorectal liver metastases, but is appropriate for a variety of other benign and malignant tumours in the liver. The selection of patients and criteria are discussed. Curative liver surgery...

Udredning og behandling af morbus Osler

DEFF Research Database (Denmark)

Kjeldsen, Anette Drøhse; Andersen, Poul Erik; Tørring, Pernille Mathiesen

2011-01-01

Morbus Osler or hereditary haemorrhagic telangiectasia (HHT) is a genetic disorder resulting in development of arteriovenous malformations in the mucosa and in visceral organs. The most common symptom is epistaxis. The disease may, however, cause a variety of other serious manifestations such as ......Morbus Osler or hereditary haemorrhagic telangiectasia (HHT) is a genetic disorder resulting in development of arteriovenous malformations in the mucosa and in visceral organs. The most common symptom is epistaxis. The disease may, however, cause a variety of other serious manifestations...

Farmakologisk behandling af astma under graviditet

DEFF Research Database (Denmark)

Akram, Iram; Ulrik, Charlotte Suppli; Johnsen, Claus Rikard

2016-01-01

Asthma is one of the most frequent chronic diseases which complicate pregnancy. Well-controlled asthma during pregnancy reduces the risk of for exacerbations and, consequently, the risk of adverse pregnancy outcome. Pharmacological therapy for pregnant women with asthma is a challenge, not least ...

Behandling af peritonsillær absces

DEFF Research Database (Denmark)

Anthonsen, Kristian; Trolle, Waldemar

2012-01-01

Peritonsillar abscess (PTA) is associated with high morbidity and can cause serious and life-threatening complications. In Denmark, the most commonly isolated bacteria are Fusobacterium necrophorum and Streptococcus pyogenes gr. A. The incidence of PTA in Denmark is 41/100,000/year, the highest...

Kirurgisk behandling af urininkontinens hos kvinder

DEFF Research Database (Denmark)

Ammendrup, Astrid Cecilie; Sørensen, Helle Christina; Sander, Pia

2010-01-01

(TVT) was the preferred sling in 2006. A total of 20 (47%) UI surgeons used only TVT, seven (17%) only transobturator slings (TOS) and 15 (36%) both TVT and TOS. Only 11 (24%) performed > 25 TVT per year and 11 (27%) performed > 25 TOS per year. In all, UI surgeons had experience with ten different...

Ny behandling af kronisk hepatitis B

DEFF Research Database (Denmark)

Andersen, Ellen Sloth; Weis, Nina M; Weis, Nina M

2008-01-01

Worldwide, 350 million people are infected with chronic hepatitis B. Over the last few years, it has been possible to treat chronic hepatitis B. Treatment very often consists of nucleos(t)ide analogs and in a few cases of pegylated alpha-interferon. In 2007, a new nucleoside analog, Telbivudine......, was approved to treat chronic hepatitis B. In phase II and ongoing phase III studies, Telbivudine has proven more effective than the nucleoside analog, Lamivudine, which was very often used up until recently. Udgivelsesdato: 2008-Nov-24...

Medicinsk efterbehandling af brystkraeft. Endokrin behandling

DEFF Research Database (Denmark)

Mouridsen, Henning T; Andersen, Jørn

2007-01-01

For women with steroid receptor-positive breast cancers, endocrine therapy has proven to be a major component of adjuvant therapy reducing the risk of recurrence and death. The selective estrogen-receptor modulator (SERM) tamoxifen has been well established as safe and effective in the adjuvant...... care of both pre- and postmenopausal women. For premenopausal women, ovarian suppression is an important option to be considered. Additionally, aromatase inhibitors have recently demonstrated further benefits in postmenopausal women. The ideal sequencing of treatment with tamoxifen and/or an aromatase...

Operativ behandling af thoracic outlet syndrome

DEFF Research Database (Denmark)

Birkeland, Peter; Stiasny, Jerzy

2012-01-01

of the brachial plexus. At surgery, we found and severed a fibrous band that compressed the inferior trunk. Postoperatively, the pain subsided and fine hand movements improved. One patient had no cervical rib, however, in the two other cases we found rudimentary cervical ribs. Magnetic resonance imaging......We present three cases with longstanding true neurogenic thoracic outlet syndrome. All patients had aching pain in the shoulder, arm and ulnar border of the hand. On examination, we found atrophy of the hand muscles. Electromyography revealed signs of compromised function of the inferior trunk...

Inspiration til fremtidens naturfaglige uddannelser

DEFF Research Database (Denmark)

Denne antologi udgør bind 2 af rapporten fra arbejdsgruppen for Fremtidens Naturfaglige Uddannelser. Antologien indeholder ti artikler og præsenterer vigtige elementer af det analysegrundlag som ligger bag arbejdsgruppens oplæg til strategi. Det enkelte essay i antologien behandler centrale...... problemstillinger inden for et eller flere naturfag eller en uddannelse/et uddannelsesniveau. Rapportens 1. bind - den selvstændige publikation Fremtidens naturfaglige uddannelser. Naturfag for alle - vision og oplæg til strategi indeholder arbejdsgruppens anbefalinger og bud på strategi for udvikling af...

Microbiological aspects of peritonitis in patients on continuous ambulatory peritoneal dialysis

Directory of Open Access Journals (Sweden)

S Vikrant

2013-01-01

Full Text Available The objective of the study was to identify the microbiological spectrum and drug-sensitivity pattern of peritonitis in patients on continuous ambulatory peritoneal dialysis. This was a prospective study done over a period of a year-and-a-half at a tertiary-care hospital in a hilly state of India. The effluent dialysate bags from 36 consecutive patients with peritonitis were studied. One hunderd ml dialysate fluid was processed under aseptic conditions by lysis centrifugation method. Microscopy and culture was done from the deposits for bacteriological, fungal, and mycobacterial isolates. They were identified by colony morphology and their biochemical reactions. Drug susceptibility testing was done by Kirby-Bauer disc diffusion method. In 36 dialysates, 33 (91.6% dialysates were culture-positive and in 3 (8.4%, the culture was negative. A total of 36 microorganisms were isolated in 33 cultures. Among the 36 microorganisms, 19 (52.8% isolates were gram-positive, 10 (27.8% were gram-negative, 5 (13.9% were fungi, and 2 (5.6% were mycobacterial isolates. All gram-positive organisms were sensitive to ampicillin, amoxi-clavulanic acid, cefazolin, clindamycin, and vancomycin. Neither a methicillin-resistant Staphylococci aureus nor a vancomycin-resistant Enterococcus was isolated in gram-positive isolates. Gram-negative organisms were sensitive to ciprofloxacin, ceftriaxone, ceftazidime, cefepime, gentamicin, piperacillin-tazobactam and imipenem. One of the gram-negative isolate was an extended spectrum beta-lactamase producer. Gram-positive peritonitis was more frequent than gram-negative peritonitis in our continuous ambulatory peritoneal dialysis patients. Mycobacterial causes were responsible for peritonitis in patients with culture-negative peritonitis which was not responding to the conventional antimicrobial therapy.

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

International Nuclear Information System (INIS)

Karaosmanoglu, Devrim; Karcaaltincaba, Musturay; Oguz, Berna; Akata, Deniz; Ozmen, Mustafa; Akhan, Okan

2009-01-01

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.

How nice to be good at it

DEFF Research Database (Denmark)

Gregersen, Frans

2010-01-01

De emner og forfattere der behandles er: tekst og undertekst i dagligsprog og fiktionsprosa: Ian McEwan, fortællerstilarter: Walter Scott og citatpraksis: dagligsproget. Artiklens pointe er at påvise sammenhængen mellem dagligsproget og kunstprosaens videre forarbejdning af effekter herfra....

Patients' Obligation, Embodiment, Motives, and Self in Hypertension - a Qualitative Study from General Practice (PhD thesis)

DEFF Research Database (Denmark)

Sångren, Henrik

Resume: Afhandlingen besk‘ftiger sig med hvordan patienter oplever at blive diagnosticeret med forh›jet blodtryk (hypertension). Unders›gelsen unders›ger hvilke motiver der bev‘ger patienter til at acceptere medicinsk behandling af deres forh›jede blodtryk, og hvorledes de oplever livet med hyper...

Medarbejdernes retsstilling ved grænseoverskridende overtagelse og fusion

DEFF Research Database (Denmark)

Hansen, Lone L.

Bogen, der er en publiceret ph.d.-afhandling, analyserer en række komplekse spørgsmål om medarbejdernes retsstilling, når den virksomhed, de arbejder i, overtages af en udenlandsk virksomhed gennem majoritetsovertagelse, virksomhedsoverdragelse, fusion eller spaltning. Afhandlingen behandler over...

Europæiske menneskerettigheder

DEFF Research Database (Denmark)

Werlauff, Erik

Bogen behandler de europæiske menneskerettigheder, således som de udspringer af Den Europæiske Menneskeretskonvention, EMRK. Menneskerettighedernes historiske og sociale baggrund forklares, og EMRK-retsgrundlaget sammenholdes med den danske Grundlov og med EU-retten, herunder med den omstændighed...

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

Science.gov (United States)

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

2016-01-01

Spontaneous peritonitis, especially spontaneous fungal peritonitis (SFP), is an important and potentially fatal complication in patients with endstage liver disaese. We evaluated potential risk factors, microbiological findings, and outcome of patients with SFP compared to spontaneous bacterial peritonitis (SBP) in critically ill patients. Retrospective analyses of critically ill patients with suspected spontaneous peritonitis. Out of 205 patients, 20 (10%) had SFP, 28 (14%) had SBP, 48 (24%) had peritonitis without microbiological findings (SP) and 109 (52%) had no-peritonitis (NP). APACHE II and SOFA score were significantly higher in patients with SFP (26; 22-28; pperitonitis could be significantly more often found in patients with SFP (65%; pperitonitis was significantly more often in patients with SFP (85%; pperitonitis.

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

Science.gov (United States)

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

2015-12-01

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

The Association Between Glucose Exposure and the Risk of Peritonitis in Peritoneal Dialysis Patients.

Science.gov (United States)

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

♦ Little or no clinical evidence is available on the association between glucose exposure and peritoneal host defense in peritoneal dialysis (PD) patients. The objective of the present study was to quantify the exposure to glucose during the first year on PD and investigate the association with subsequent peritonitis. ♦ We analyzed prospectively collected demographic and peritonitis data from incident adult PD patients between 1990 and 2010. For the present study, we conducted a review of both in- and outpatient medical records of all patients to obtain their day-to-day dialysis schemes during the first year on PD. From these data, the average exposure to glucose was quantified. The exposure was stratified into low- and high-glucose groups based on the median, analyzed per standard deviation and in quartiles. Cox proportional hazard models were used to calculate crude and adjusted hazard ratios (HRs) and 95% confidence intervals for the association between glucose exposure and peritonitis. Adjustments were made for age, sex, primary kidney disease, diabetes mellitus, Davies comorbidity score and the treatment period. ♦ In total, 230 patients were included in the study of whom 151 (66%) experienced a first peritonitis episode. The median follow-up time was 2.6 years (interquartile range [IQR]: 1.9 - 3.8) in the low-glucose group and 3.1 (IQR: 2.1 - 4.2) in the high-glucose group. After adjustment for confounding factors, no association between high glucose exposure and the risk of peritonitis was found (HR: 0.81; 0.55 - 1.17). No association was present when glucose exposure was analyzed per standard deviation (SD) (HR: 0.98; 0.79 - 1.21) or patient quartiles were applied. No association was identified between glucose exposure and severe peritonitis, Staphylococcus aureus peritonitis, or a peritonitis episode that lasted more than 14 days. ♦ Exposure to glucose is not associated with an increased risk of peritonitis. The equilibrium between glycemic harm to

Degenrative Fibroid and Sclerosing Peritonitis

Directory of Open Access Journals (Sweden)

Michael Critchley

2012-01-01

Full Text Available Sclerosing peritonitis is a rare condition characterised by ascites, peritoneal and bowel wall thickening. Causes reported in the literature include luteal ovarian the comas, peritoneal dialysis, peritoneal chemotherapy and liver cirrhosis. We report an interesting case of a woman presenting with diarrhoea, abdominal distension, ascites and pleural effusion. She was subsequently diagnosed with Sclerosing Peritonitis caused by a degenerating fibroid which was successfully treated by Total Abdominal Hysterectomy and Bilateral Salpingoophrectomy.

Fast ejendom III

DEFF Research Database (Denmark)

Munk-Hansen, Carsten

Bogen er det tredje bind af tre planlagte bind om fast ejendom: I Overdragelsen, II Bolighandlen og III Ejerbeføjelsen. Fremstillingens giver et grundigt overblik over centrale områder af en omfattende regulering af fast ejendom, med angivelse af litteratur, hvor læseren kan søge yderligere...... oplysning. En ejer af fast ejendom er på særdeles mange områder begrænset i sin råden sammenlignet med ejeren af et formuegode i almindelighed. Fremstillingen tager udgangspunkt i ejerens perspektiv (fremfor samfundets eller myndighedernes). Både den privatretlige og offentligretlige regulering behandles......, eksempelvis ejendomsdannelsen, servitutter, naboretten, hævd, zoneinddelingen, den fysiske planlægning, beskyttelse af natur, beskyttelse af kultur, forurening fra fast ejendom, erstatning for forurening, jordforurening, ekspropriation, byggeri og adgang til fast ejendom....

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.

Fermentering af korn øger fordøjeligheden af næringsstoffer

DEFF Research Database (Denmark)

Pedersen, Anni Øyan; Jørgensen, Henry Johs. Høgh; Knudsen, Knud Erik Bach

2010-01-01

Et fordøjelighedsforsøg har vist, at energiværdien af byg og hvede steg ved fermentering. Effekten var størst ved fermentering af byg, hvor fordøjeligheden af organisk stof for enden af tyndtarmen steg statistisk sikkert med 9 %. Ved fermentering af hvede steg fordøjeligheden af organisk stof...... af vand og dels CO2-produktion og dermed tørstoftab. Anbefaling om beregning af energiværdi i fermenteret korn vil blive foretaget ud fra resultaterne af et produktionsforsøg med slagtesvin, som er under publicering. Fosforudnyttelse i fermenteret korn undersøges yderligere i et produktionsforsøg med...

Surrealistiske collager

DEFF Research Database (Denmark)

Paldam, Camilla Skovbjerg

Surrealismen er en af de avantgardebevægelser, der trods sine snart 100 år bliver ved med at drage og fascinere. Denne bog giver en indføring i de væsentligste sider af 1920’ernes og 30’ernes surrealisme gennem et fokus på surrealistisk collage i både litteratur og billedkunst. Med inddragelse af....... Dette eksemplificeres gennem nedslag i temaer som byen, barndommen, kvinden, monstret og mannequindukken, som surrealisterne var dybt optagede af. Endvidere behandler bogen surrealisternes udbredte interesse for det mytiske og mystiske, hvor collage bliver et vigtigt led i forsøget på at finde og skabe...

The Language Faculty – Mind or Brain?

Directory of Open Access Journals (Sweden)

Torben Thrane

2009-05-01

Full Text Available Artiklens sigte er at underkaste Chomskys nyskabende nominale sammensætning – "the mind/brain" – en nøjere undersøgelse. Hovedargumentet er at den skaber en glidebane, således at det der burde være en funktionel diskussion – hvad er det hjernen gør når den behandler sprog? – i stedet bliver en systemdiskussion – hvad er den interne struktur af den menneskelige sprogevne? Argumentet søges ført igennem under streng iagttagelse af de kognitive videnskabers opfattelse af information og repræsentation, specielt som forstået af den amerikanske filosof Frederick I. Dretske.

Facilitated Work Based Learning - analyseret i et pragmatisk perspektiv

DEFF Research Database (Denmark)

Thomassen, Anja Overgaard

Ph.d.-afhandlingen behandler, med afsæt i John Deweys (1859-1952) pragmatisme, Facilitated Work Based Learning (FWBL) der er en tilgang til efter/videreuddannelse. På baggrund af konkrete uddannelsesforløb gennemført ud fra FWBL analyseres de udfordringer der opstår omkring gennemførelse af...... mødes for at samarbejde. Afhandlingen bidrager med et nyt begreb kaldet "den tredje kontekst" der tydeliggør, hvordan uddannelse, der gennemføres i en virksomhed, kan forstås. Ligeledes udvikles der, med afsæt i Deweys pragmatisme, en model der tydeliggør, hvorledes kompetenceudvikling kan understøttes...

Musik og billeddannelse (GIM med PTSD-ramte flygtninge: Introduktion til tre single case-studier

Directory of Open Access Journals (Sweden)

Bolette Daniels Beck

2016-12-01

Full Text Available Mange flygtninge kommer fra kulturer med helt andre forestillinger og begreber om årsager til og forventninger om behandling af psykisk lidelse end man almindeligvis anvender i psykiatrien. F.eks. er psykisk lidelse i mange mellemøstlige kulturer forbundet med skam, og udtrykkes måske derfor snarere i form af fysisk smerte. For at et behandlingsforløb skal lykkes, er der behov for kulturel sensitivitet hos behandleren, når der skal samarbejdes med tolken, skabes et møde på tværs af kulturer samt etableres en fælles forståelse af behandlingens formål og proces.

Spiseforstyrrelser

DEFF Research Database (Denmark)

Dynesen, Anja Weirsøe; Gehrt, Charlotte Astrid; Vammen, Katrine Schjødt

2017-01-01

Spiseforstyrrelser er blandt de mest alvorlige sygdomme blandt unge kvinder. Tidlig igangsættelse af behandling er afgørende for prognosen. Dette vanskeliggøres imidlertid af, at personer med en spiseforstyrrelse ofte ikke har erkendt eller skjuler deres sygdom. Da orale komplikationer som dental...... erosion og hævede spytkirtler ofte er eneste objektive tegn på en spiseforstyrrelse, kan tandlægen i nogle tilfælde være den første sundhedsprofessionelle, der får en mistanke om, at en patient lider af en spiseforstyrrelse. Italesættelse af mistanken om en spiseforstyrrelse er vanskelig, og patienten bør...

Evaluering for læring

Directory of Open Access Journals (Sweden)

Bent B. Andresen

2006-05-01

Full Text Available

Første gang publiceret i UNEV nr. 9: Evaluering og feedback i netstøttet uddannelse, sept. 2006, red. Simon Heilesen.
ISSN 1603-5518.

I fokus er løbende evalueringer af blended e-læring. Sammen med deres vejledere evaluerer deltagerne typisk deres arbejde med problemstillinger og med at nå mål og tilfredsstille forventninger. Spørgsmålet er, hvordan denne evalueringspraksis bedst kan tilrettelægges. Det er temaet i artiklen. Evalueringer foretages ofte på grundlag af eksamener og samtaler bordet rundt om et e-læringsforløbs samlede værdi. Sigtet er bagudrettet. Artiklen giver et bud på en praksis, som er fremadrettet og mere langsigtet. Især behandles evaluering for læring, som har til formål at skabe passende udfordringer for alle deltagere samt differentiere deres undervisning og vejledning – og dermed øge kvalitet af deres læring. Endvidere behandles spørgsmålet om, hvordan man løbende kan indsamle evalueringsdata og følge op på analyser heraf.

Tekster og sproghandlinger

DEFF Research Database (Denmark)

Borchmann, Simon

2010-01-01

Denne artikel er en sprogvidenskabelig introduktion til temaet tekst og sproghandling. Artiklen tjener dels som en beskrivelse af den historiske baggrund for temaet, dels som en argumentation for at det er relevant at behandle en bestemt problematik i relation til dette tema. Artiklen er delt i t...

Sundhedsfremmende pædagogik på specialinstitutioner

DEFF Research Database (Denmark)

From, Ditte-Marie

2015-01-01

Det specialiserede områdets sundhedsarbejde knytter sig ikke kun til behandling og tilpasning af handicap og vanskeligheder. Selv om sundhed i offentligheden i Danmark tænkes overvejende medicinsk og i forhold til risikofyldte livsstilsformer, så er der en bagvedliggende politisk og faglig virkel...

Familie Sygepleje til hjertesvigtspatienter i ambulant regi: Sygeplejerskernes erfaringer

DEFF Research Database (Denmark)

Voltelen, Barbara; Konradsen, Hanne; Østergaard, Birte

Baggrund: Patienter med hjertesvigt og deres familier oplever mange udfordringer forbundet med at leve sygdommen. Forskning har vist at familier ønsker at blive medinddraget i behandlingen af og omsorgen for deres kære. Sygeplejersker har en vigtig rolle i forbindelse med hjertesvigt behandling o...

Common Concern for retsudviklingen i Grønland

DEFF Research Database (Denmark)

Basse, Ellen Margrethe; Sommer, Tine

2013-01-01

Artiklen behandler indledningsvis de komplekse kompetenceforhold, der er tale om i Grønland, og den udfordring som inuitterne står over for som konsekvens af klimaændringer og råstof- og olieindvindingsinteresser. Deres internationale menneskerettigheder og de globale miljøretlige forpligtelser o...

Lyden-af-Leg

DEFF Research Database (Denmark)

Toft, Herdis

Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform.......Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform....

Sundhedseffekter af luftforurening-beregningspriser

DEFF Research Database (Denmark)

Andersen, M. S.; Frohn, L. M.; Jensen, S. S.

Denne rapport afrapporterer det fortsatte arbejde med udvikling af miljøøkonomiske beregningspriser. På grundlag af EcoSense 4.0 fra ExternE-projektet, er der foretaget nye beregninger af eksternaliteter ved luftforurening med sundhedseffekter. Samtidig giver rapporten en vurdering af luftspredni......Denne rapport afrapporterer det fortsatte arbejde med udvikling af miljøøkonomiske beregningspriser. På grundlag af EcoSense 4.0 fra ExternE-projektet, er der foretaget nye beregninger af eksternaliteter ved luftforurening med sundhedseffekter. Samtidig giver rapporten en vurdering af...

Anvendelse af alternative isoleringsmaterialer

DEFF Research Database (Denmark)

Hansen, Ernst Jan de Place

2003-01-01

Resume af By og Byg Anvisning 207 om anvendelse af alternative isoleringsmaterialer, udarbejdet af Statens Byggeforskningsinstitut under udviklingsprogrammet "Miljø- og arbejdsmiljøvenlig isolering"......Resume af By og Byg Anvisning 207 om anvendelse af alternative isoleringsmaterialer, udarbejdet af Statens Byggeforskningsinstitut under udviklingsprogrammet "Miljø- og arbejdsmiljøvenlig isolering"...

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.

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

International Nuclear Information System (INIS)

Kim, Tae Hoon

1996-01-01

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

Peritoneal mesothelioma

International Nuclear Information System (INIS)

Raptopoulos, V.

1985-01-01

The definitive diagnosis of peritoneal mesothelioma and its differentiation from metastatic peritoneal carcinomatosis may be difficult because of the clinical, macroscopic, and microscopic variability of the tumor. To this purpose, a combination of criteria, including the clinical picture, the gross pathologic findings, the exclusion of other primary neoplasms, and the microscopic findings, must be taken into consideration. Conventionally, these criteria may be established only after surgical exploration and extensive sampling. Experience with patients with peritoneal mesothelioma and metastatic peritoneal carcinomatosis, as well as a review of the recent imaging literature, shows excellent correlation between computed tomography or ultrasound and the operative or autopsy findings. These imaging modalities showed soft-tissue masses or nodules; thickened omentum (omental cake), peritoneum, mesentery, and bowel wall; pleural plaques; and usually disproportionally small, if any, ascites. The latter two observations may be useful in differentiating mesothelioma from carcinomatosis macroscopically. Furthermore, fine-needle aspiration biopsy, after performing wide sampling of the tumors in different locations under ultrasonic or computed tomographic guidance, produced diagnostic cytologic specimens. Thus, the need for exploratory surgery may be alleviated, and the diagnosis of peritoneal mesothelioma may be made prospectively and relatively noninvasively with the use of computed tomography or ultrasound and fine-needle aspiration biopsy. Since epidemiologic studies predict increasing incidence of this neoplasm, especially among asbestos workers, it is suggested that these techniques be seriously considered as screening methods for high-risk populations.67 references

CT findings of peritoneal mesothelioma

International Nuclear Information System (INIS)

Woo, Young Hoon; Oh, Yeon Hee; Kim, Hong; Kim, Jung Sik; Woo, Seong Ku; Kim, Ok Bae; Joo, Yang Goo

1990-01-01

The peritoneal mesothelioma is a rare neoplasm which arises from the peritoneal lining of the abdomen, tending to spread along the peritoneal cavity and to invade abdominal organs. Authors report the CT findings of 4 patients with histologically proven peritoneal mesothelioma seen at Dongsan Medical Center, School of Medicine, Keimyung University. None of them had a history of exposure to asbestos and no clear etiologic factor could be determined in any patient. CT showed peritoneal and mesenteric thickenings in all cases, omental thickenings in 3 cases, peritoneal nodules, mesenteric masses or omental masses in 2 cases each other, bowel wall involvement in 1 case, and disproportionally small ascites in 2 cases. Distant hematogenous metastases to the liver and retroperitoneal lymph nodes were seen in 1 case. Our experience with 4 peritoneal mesotheliomas as well as a review of the recent imaging literature shows excellent correlation between computed tomography and the operitoneoscopic findings

Hydration status measured by BCM: A potential modifiable risk factor for peritonitis in patients on peritoneal dialysis.

Science.gov (United States)

Santhakumaran, Territa; Samad, Nasreen; Fan, Stanley L

2016-05-01

Peritoneal dialysis peritonitis and fluid overhydration (OH) are frequent problems in peritoneal dialysis. The latter can cause gut wall oedema or be associated with malnutrition. Both may lead to increased peritonitis risk. We wished to determine if OH is an independent risk factor for peritonitis (caused by enteric organisms). Retrospectively study of patients with >2 bioimpedance assessments (Body Composition Monitor). We compared peritonitis rates of patients with above or below the median time-averaged hydration parameter (OH/extracellular water, OH/ECW). Multivariate analysis was performed to determine independent risk factors for peritonitis by enteric organism. We studied 580 patients. Peritonitis was experienced by 28% patients (followed up for an average of 17 months). The overall peritonitis rate was 1:34 patient months. Patients with low OH/ECW values had significantly lower rates of peritonitis from enteric organisms than overhydrated patients (incident rate ratio 1.53, 95% confidence interval 1.38-1.70, P peritonitis from enteric organisms when multivariate model included demographic parameters (odds ratio for a 1% increment of OH/ECW was 1.05; 95% confidence interval 1.01-1.10, P peritonitis. While this may partly be due to the high co-morbidity of patients (advanced age and diabetes), on multivariate analysis, only inclusion of nutritional parameters reduced this association. It remains to be determined if overhydration will prove to be a modifiable risk factor for peritonitis or whether malnutrition will prove to be more important. © 2015 Asian Pacific Society of Nephrology.

Beregning af nitratudvaskning

DEFF Research Database (Denmark)

Petersen, Jens; Petersen, Bjørn Molt; Blicher-Mathiesen, Gitte

2006-01-01

I forbindelse med kommunalreformen ønskes en ensartet forvaltning af reglerne for vurdering af virkninger på miljøet (VVM) ved ansøgninger om udvidelse af husdyrbrug, herunder beregning af nitratudvaskningen. Rapporten foreslår et beregningskoncept, der bygger på den ansøgende bedrifts samlede kv...

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

Tuberculous peritonitis: CT appearance

International Nuclear Information System (INIS)

Hanson, R.D.; Hunter, T.B.

1985-01-01

Rare, sporadic cases of tuberculous peritonitis do occur in the United States and other advanced countries. Because there are few descriptions of the CT appearance of the peritoneal forms of tuberculous (TB), this report illustrates a case of tuberculous peritonitis with prominent CT findings and discusses the differentiation of this entity from other, more common diseases

Identifikation af referencevandløb til implementering af vandrammedirektivet i Danmark

DEFF Research Database (Denmark)

Kristensen, Esben Astrup; Baattrup-Pedersen, Annette; Skriver, Jens

Definition og beskrivelse af referencetilstanden er centralt for implementering af vandrammedirektivet, da bedømmelse af den økologiske tilstand sker som afvigelsen fra den upåvirkede referencetilstand. I denne rapport præsenteres analyser af danske, udenlandske og historiske data med det formål...

[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.

Restaurering af Skjern Å

DEFF Research Database (Denmark)

Jessen, K.; Boysen Larsen, B.; Bundgaard, P.

Denne rapport indeholder resultaterne af den natur- og miljøovervågning, der blev iværksat som en del af naturgenopretningen af Skjern Å 1999-2002. Ved projektet ophørte den kunstige afvanding af den vestlige del af Skjern Å dalen. Størstedelen af de dyrkede arealer ændredes til ekstensive græsni...

Relevansen af Aristoteles' etik for konceptionen af eksistentiel terapi

DEFF Research Database (Denmark)

Dræby, Anders

Siden sin undfangelse i begyndelsen af det 20. århundrede har den eksistentielle terapi repræsenteret et filosofisk funderet alternativ til de former for terapeutisk praksis, der er funderet i den funktionalistiske medicinske metafysik. Anvendelse af elementer fra Aristoteles' etik muliggør en...... fremhævelse af den eksistentielle terapi som en praktisk eksistensfænomenologisk livskunst, hvis anliggende er en frembringelse af det enkelte menneskes muligheder fra det skjulte og ind i det uskjulte, så mennesket viser sig som det er ved sig selv...

Non-infectious complications of continuous ambulatory peritoneal dialysis: evaluation with peritoneal computed tomography

International Nuclear Information System (INIS)

Camsari, T.; Celik, A.; Ozaksoy, D.; Salman, S.; Cavdar, C.; Sifil, A.

1998-01-01

The purpose of the study was to evaluate the non-infectious complications of continuous ambulatory peritoneal dialysis (CAPD) using peritoneal computed tomography (PCT). Twenty symptomatic patients were included in the study. Initially 2000 ml of dialysate fluid was infused into the peritoneal cavity and standard peritoneal computed cavity and standard peritoneal computed tomography (SPCT) serial scans with 10 mm thickness were performed from the mid-thoracic region to the genital organs. Afterwards, 100 ml of non-ionic contrast material containing 300 mg/ml iodine was injected through the catheter and was distributed homogeneously in the intra-abdominal dialysate fluid by changing the positions of the patients; after waiting for 2-4 h, the CT scan was repeated as peritoneal contrast computed tomography (PCCT). In patients (n = 20) both SPCT and PCCT revealed 90 % (n = 18) pathological findings. But PCCT showed 60 % (n = 12) additional pathological findings. We believe that PCT is beneficial for evaluation of non-infectious complications of CAPD. But PCCT is superior to SPCT in evaluating non-infectious complications encountered in patients on CAPD treatment. (author)

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

School Classes for Talented Pupils

DEFF Research Database (Denmark)

Rasmussen, Annette; Rasmussen, Palle

Det hævdes ofte, at der er behov for særlige indsatser for at stimulere de mest talentfulde elever i skolen. I artiklen behandles dette spørgsmål i sociologisk perspektiv, på baggrund af følgeforskning i forbindelse med en "talentklasse" i Nordjylland....

Incongruent pronomianl case in the Swedish dialect of Västra Nyland (Finland)

DEFF Research Database (Denmark)

Jørgensen, Henrik

2012-01-01

Artiklen behandler nogle data om afvigende brug af pronominal kasus den svenske dialekt i Västra Nyland (Finland). Disse kasusformer afviger radikalt fra svensk i øvrigt, men ligner mønstre der genkendes fra dansk og delvis norsk; endvidere har talt engelsk og fransk mange lignende former....

Fichte

DEFF Research Database (Denmark)

Nielsen, Carsten Fogh

2016-01-01

af en udefrakommende andethed. Disse tre temaer behandles med udgangspunkt i tre tekster, som Fichte skrev og publicerede umiddelbart før og under sin ansættelse som professor ved universitetet i Jena i perioden 1794- 1799: "Über den Begriff der Wissenschaftslehre oder der sogenannten Philosophie...

Psykiatrisk og klinisk psykologisk assessment

DEFF Research Database (Denmark)

Poulsen, Stig Bernt; Simonsen, Erik

2017-01-01

i centrum og med en bred videnskabelig tilgang. Alle psykiske lidelser i WHO´s diagnoseliste ICD-10 bliver gennemgået med fokus på årsagsforhold, forekomst, diagnostik og behandling, og der refereres desuden til diagnoserne i den nyeste udgave af den amerikanske diagnoseliste (DSM-5). Fremstillingen...

Danskernes racisme

DEFF Research Database (Denmark)

Necef, Mehmet Ümit

2010-01-01

Jens Peter Frølund Thomsen, politolog fra Århus Universitet, har i bogen Konflikten om de nye danskere (2006) undersøgt danskernes holdninger til her-boende etniske minoriteter, herunder racismens omfang og dens former. Ar-tiklen diskuterer Thomsens definition på racisme og hans behandling af sin...

Om distributionen af hvidhed

DEFF Research Database (Denmark)

Frello, Birgitta

2007-01-01

Med udgangspunkt i John Fords Western, Forfølgeren fra 1956, præsenteres en analyse af repræsentationer af race og overskridelse af raceskel, særligt i relation til konstitueringen af subjektpositioner, hvorfra spørgsmål om hvidhed og ikke-hvidhed kan afgøres.......Med udgangspunkt i John Fords Western, Forfølgeren fra 1956, præsenteres en analyse af repræsentationer af race og overskridelse af raceskel, særligt i relation til konstitueringen af subjektpositioner, hvorfra spørgsmål om hvidhed og ikke-hvidhed kan afgøres....

Benefit of an operating vehicle preventing peritonitis in peritoneal dialysis patients: a retrospective, case-controlled study.

Science.gov (United States)

Fang, Pan; Lu, Jia; Liu, Ying-Hong; Deng, Hong-Mei; Zhang, Lei; Zhang, Hong-Qing

2018-06-01

Peritonitis, which is one of the leading complications of peritoneal dialysis (PD) worldwide, severely affected morbidity and mortality of the PD patients. Although many efforts have been made to prevent PD-related peritonitis, it seems impossible to prevent it completely. Many causes have been reported to lead to peritonitis, and contamination during bag exchange is one of the important risk factors for peritonitis. Here, we introduce an operating vehicle, which we invented to provide a sterile and safe space for bag exchange. A single-center, retrospective, case-control study was undertaken to determine whether this operating vehicle has a protective role in preventing peritonitis. In total, 462 continuous ambulatory peritoneal dialysis patients were included in this study from October 2014 to March 2017. According to their personal will, these patients chose to use operating vehicle or traditional method during their bag exchange. The demographic, clinical and laboratory data of these patients in the two groups were collected, analyzed and compared. Of 462 patients with home dialysis, operating vehicle group consisted of 61 patients, and control group consisted of 401 patients. In the control group, over 677 patient-years, peritonitis occurred in 69 of 401 patients (17.2%), while in the operating vehicle group, over 60 patient-years, only 4 of 61 patients (6.6%) had episodes of peritonitis. The number of patients suffered from peritonitis was significantly decreased in the operating vehicle group (P = 0.034). Besides, there were a total of 99 episodes of peritonitis, and the rate was 1 episode every 7.2 patient-years in control group and 1 episode every 12 patient-years in the operating vehicle group. There was significant difference between the two groups (0.013). Positive dialysate cultures were obtained in majority of the peritonitis episodes (60.6%). Operating vehicle might help to reduce PD-related peritonitis by preventing contamination during bag

Serum 25-Hydroxyvitamin D Level Could Predict the Risk for Peritoneal Dialysis-Associated Peritonitis.

Science.gov (United States)

Pi, Hai-Chen; Ren, Ye-Ping; Wang, Qin; Xu, Rong; Dong, Jie

2015-12-01

♦ As an immune system regulator, vitamin D is commonly deficient among patients on peritoneal dialysis (PD), which may contribute to their impaired immune function and increased risk for PD-related peritonitis. In this study, we aimed to investigate whether vitamin D deficiency could predict the risk of peritonitis in a prospective cohort of patients on PD. ♦ We collected 346 prevalent and incident PD patients from 2 hospitals. Baseline demographic data and clinical characteristics were recorded. Serum 25-hydroxyvitamin D (25[OH]D) was measured at baseline and prior to peritonitis. The mean doses of oral active vitamin D used during the study period were also recorded. The outcome was the occurrence of peritonitis. ♦ The mean age of patients and duration of PD were 58.95 ± 13.67 years and 28.45 (15.04 - 53.37) months, respectively. Baseline 25(OH)D level was 16.15 (12.13 - 21.16) nmol/L, which was closely associated with diabetic status, longer PD duration, malnutrition, and inflammation. Baseline serum 25(OH)D predicted the occurrence of peritonitis independently of active vitamin D supplementation with a hazard ratio (HR) of 0.94 (95% confidence interval [CI] 0.90 - 0.98) after adjusting for recognized confounders (age, gender, dialysis duration, diabetes, albumin, residual renal function, and history of peritonitis). Compared to the low tertile, middle and high 25(OH)D level tertiles were associated with a decreased risk for peritonitis with HRs of 0.54 (95% CI 0.31 - 0.94) and 0.39 (95% CI 0.20 - 0.75), respectively. ♦ Vitamin D deficiency evaluated by serum 25(OH)D rather than active vitamin D supplementation is closely associated with a higher risk of peritonitis. Copyright © 2015 International Society for Peritoneal Dialysis.

[Spontaneous bacterial peritonitis].

Science.gov (United States)

Velkey, Bálint; Vitális, Eszter; Vitális, Zsuzsanna

2017-01-01

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

Energirenovering af Traneparken

DEFF Research Database (Denmark)

Rose, Jørgen; Thomsen, Kirsten Engelund; Mørck, Ove

Nærværende rapport udgør en del af afrapporteringen af PSO ELFORSK projektet Vejledning for energirenovering af boligblokke til lavenergiklasse 2015 og 2020. Arbejdet har været finansieret af PSO midler via ELFORSK, projekt: 347-023. Formålet med projektet er at udvikle en vejledning for dybtgående...

The association between soluble intercellular adhesion molecule-1 levels in drained dialysate and peritoneal injury in peritoneal dialysis.

Science.gov (United States)

Igarashi, Yusuke; Morishita, Yoshiyuki; Yoshizawa, Hiromichi; Imai, Reika; Imai, Toshimi; Hirahara, Ichiro; Akimoto, Tetsu; Ookawara, Susumu; Ishibashi, Kenichi; Muto, Shigeaki; Nagata, Daisuke

2017-11-01

Chronic inflammation of the peritoneum causes peritoneal injury in patients on peritoneal dialysis. Intercellular adhesion molecule-1 and its circulating form, soluble intercellular adhesion molecule-1, play pivotal roles in inflammation. However, their role in peritoneal injury is unclear. We measured changes in intercellular adhesion molecule-1 expression in the peritoneum of a peritoneal injury model in rats. The associations between soluble intercellular adhesion molecule-1 levels in drained dialysate and the solute transport rate (D/P-Cr and D/D0-glucose) determined by the peritoneal equilibration test, and matrix metalloproteinase-2 levels in drained dialysate were investigated in 94 peritoneal drained dialysate samples. Intercellular adhesion molecule-1 expression was increased in the peritoneum of rats with peritoneal injury. Soluble intercellular adhesion molecule-1 levels in drained dialysate were significantly positively correlated with D/P-Cr (r = .51, p molecule-1expression is increased in the peritoneum of a peritoneal injury model in the rat, and soluble intercellular adhesion molecule-1 levels in drained dialysate are associated with peritoneal injury in patients on peritoneal dialysis. These results suggest that soluble intercellular adhesion molecule-1 could be a novel biomarker of peritoneal injury in patients on peritoneal dialysis.

Uptake of chemicals and metabolism kinetics related to toxic effects and consideration of phytoremediation as a remediation option

DEFF Research Database (Denmark)

Ucisik, Ahmed Süheyl

Denne ph.d.-afhandling præsenterer resultaterne af en detailleret undersøgelse af ”Optag af kemiske stoffer og nedbrydningskinetik i relation til toksiske effekter samt overvejelser vedrørende phytoremediering som en oprensningsteknologi” og indeholder fire artikler, som beskriver og diskuterer det...... fysisk-kemiske egenskaber. Anvendelsen af planter til behandling af forurenet jord, sediment og van d kaldes phytoremediering. For at implementere phytoremediering som en teknologi til oprensning af kemiske stoffer kræves (1) det kemiske stof må ikke være stærk toksisk overfor planten (2) stoffet må ikke......-transpirationstest. Phytoremediering af phenol, 4-chlorphenol og cyanid med piletræer kan anses for en effektiv remedieringsmulighed på grund af dens høje fjernelseseffektivitet og ubetydelige akkumulering inde i palntevævet. Phytoremediering af 2,4-dichlorphenol synes ikke mulig på grund af den lave fjernelseseffektivitet....

Fortællingen

DEFF Research Database (Denmark)

Hejlsted, Annemette

Fortællingen - teori og analyse introducerer til teorier om fortællingen og præsenterer et sæt af analytiske tilgange til fortællinger af enhver art. Bogen lægger vægt på læsersynsvinklen og retter opmærksomheden mod de vilkår for menings- og betydningsdannelse, der kendetegner fortællingen. Begr....... Begreber om plot, fortællingens verden, karakterer, fortæller, modus og genre behandles, og deres anvendelse demonstreres på dansk og nordisk litteratur - med inddragelse af eksempler fra film og tv-reklamer....

Behandlingsmuligheder ved xerostomi og hyposalivation

DEFF Research Database (Denmark)

Jensen, Siri Beier; Dynesen, Anja Weirsøe; Pedersen, Anne Marie Lynge

2011-01-01

Behandlingsmuligheder ved nedsat spytsekretion og xerostomi For at kunne iværksætte adækvat lindring og behandling af nedsat spytsekretion og xerostomi bør det tilstræbes, at den tilgrundliggende årsag i videst muligt omfang er forsøgt diagnosticeret. I en del tilfælde er det dog ikke muligt at u...... infektioner, særlig oral candidose. Hvis det drejer sig om lægemiddelinduceret xerostomi og nedsat spytsekretion, kan en effektiv, lindrende behandlingsstrategi være af stor betydning for at sikre overholdelse af lægemiddelindtagelsen....

Study Labs Kortlægningsrapport UCSJ

DEFF Research Database (Denmark)

Jørnø, Rasmus Leth Vergmann; Hestbech, Astrid Margrethe; Gynther, Karsten

2015-01-01

Rapporten er en delleverance i det regionale forprojekt S​tudy Labs,​der udføres som et samarbejde mellem Holbæk, Odsherred og Kalundborg kommune og University College Sjælland (UCSJ). Samarbejdet er delvist medfinansieret af Region Sjælland. Rapporten behandler projektets etableringsfase...... for at nå de kommunale målsætninger. De potentielle målgrupper er blevet kortlagt. Samtidig er undersøgelser i brugergrupperne blevet gjort håndgribelige i form af Personaer. Kommunerne har, faciliteret af Educationlab, gennemført designworkshops og er fremkommet med designs for Study Labs, der som...

Stata - En praktisk introduktion

DEFF Research Database (Denmark)

Sønderskov, Kim Mannemar

Denne guide introducerer læseren til statistikprogrammet Stata og gennemgår, hvordan Stata anvendes til vicenskabelig analyse af kvantitave data. Gennem en række eksempler og øvelser guides læseren igennem datahåndtering, basale uni- og bivariate analyser samt lineær regression. Derudover behandles...... emner som fx illustration af resultaterne fra interaktionsmodeller. Bogen er skrevet til studerende, der ikke tidligere har arbejdet med statistiksoftware, og er således velegnet i metode- og statistikundervisningen på BA-niveau. Den er også velegnet til erfarne brugere af andre programmer og til Stata...

Periostin-Binding DNA Aptamer Treatment Ameliorates Peritoneal Dialysis-Induced Peritoneal Fibrosis

Directory of Open Access Journals (Sweden)

Bo Young Nam

2017-06-01

Full Text Available Peritoneal fibrosis is a major complication in peritoneal dialysis (PD patients, which leads to dialysis discontinuation. Periostin, increased by transforming growth factor β1 (TGF-β1 stimulation, induces the expression of extracellular matrix (ECM genes. Aberrant periostin expression has been demonstrated to be associated with PD-related peritoneal fibrosis. Therefore, the effect of periostin inhibition by an aptamer-based inhibitor on peritoneal fibrosis was evaluated. In vitro, TGF-β1 treatment upregulated periostin, fibronectin, α-smooth muscle actin (α-SMA, and Snail expression and reduced E-cadherin expression in human peritoneal mesothelial cells (HPMCs. Periostin small interfering RNA (siRNA treatment ameliorated the TGF-β1-induced periostin, fibronectin, α-SMA, and Snail expression and restored E-cadherin expression in HPMCs. Similarly, the periostin-binding DNA aptamer (PA also attenuated fibronectin, α-SMA, and Snail upregulation and E-cadherin downregulation in TGF-β1-stimulated HPMCs. In mice treated with PD solution for 4 weeks, the expression of periostin, fibronectin, α-SMA, and Snail was significantly increased in the peritoneum, whereas E-cadherin expression was significantly decreased. The thickness of the submesothelial layer and the intensity of Masson’s trichrome staining in the PD group were significantly increased compared to the untreated group. These changes were significantly abrogated by the intraperitoneal administration of PA. These findings suggest that PA can be a potential therapeutic strategy for peritoneal fibrosis in PD patients.

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

CT findings of peritoneal carcinomatosis

International Nuclear Information System (INIS)

Kim, Eun Sook; Park, Mi Sook; Cho, On Koo; Koh, Byung Hee; Kim, Soon Yong

1989-01-01

CT findings in 137 patients with peritoneal cacinomatosis were reviewed to determine the CT signs of peritoneal malignancy. CT of the 20 liver cirrhosis and 17 tuberculous peritonitis were also reviewed to define the differential point between benign and malignant peritoneal change. The results were as follows. 1. The most common primary malignancy encountered in peritoneal carcinomatosis was stomach Ca.(50.4%), followed by pancreas Ca, hepatoma, colon Ca. and ovarian Ca. 2. Ascites was the most common CT feature of peritoneal malignancy, present in 99 cases (72.3%). The amount of ascites was voluminous, grade III in 70% of cases and showed high density ascites with average 23 Hounsfield units. 3. Greater omentum involvement was noted in 88 patients, peritoneum in 71 patients and mesentery in 65% patients. There was no correlation of the primary malignancy type with the incidence or pattern of the above mentioned site. 4. Bowel wall thickenings were observed in 51 patients, among which transverse colon was most frequently involved. 5. Mean attenuation value of ascites in liver cirrhosis was 10.7 HU, which was much lower than that of peritoneal carcinomatosis. 6. Even though intraperitoneal findings in Tbc. Peritonitis showed tendency of relatively small amount of ascites with more predominant mesenteric change, but, the findings of high density ascites, change of peritoneum and omentum etc. were very similar to those of peritoneal carcinomatosis. Therefore, based on only intraperitoneal change, differential diagnosis between them was difficult. 7. False negatives in CT diagnosis of peritoneal carcinomatosis occurred in 7 cases. There were tiny nodular changes in intraperitoneal cavity without ascites on operative findings

PERITONEAL CARCINOMATOSIS

Directory of Open Access Journals (Sweden)

I. V. Stepanov

2014-01-01

Full Text Available The literature review examines the main pathological and morphogenetic aspects of the development of peritoneal carcinomatosis and its molecular and biological features. In addition, the basic principles of peritoneal carcinomatosis classification have been presented and groups of tumors, which may be complicated by dissemination to the peritoneum, have been designated. Particular attention is paid to the problems of diagnosis and treatment.

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

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

Microbiological Trends and Antimicrobial Resistance in Peritoneal Dialysis-Related Peritonitis, 2005 to 2014.

Science.gov (United States)

Zelenitsky, Sheryl A; Howarth, Jacy; Lagacé-Wiens, Philippe; Sathianathan, Christie; Ariano, Robert; Davis, Christine; Verrelli, Mauro

2017-01-01

♦ BACKGROUND: Information related to the microbiology of peritonitis is critical to the optimal management of patients receiving peritoneal dialysis (PD). The goal was to characterize the microbiological etiology and antimicrobial susceptibilities of PD-related peritonitis (PDRP) from 2005 to 2014, inclusive. ♦ METHODS: The distribution of organisms in culture-positive PDRP was described for new episodes and relapse infections, and further detailed for monomicrobial and polymicrobial peritonitis. Annual and overall rates of PDRP were also characterized. Antimicrobial susceptibility rates were calculated for the most common and significant organisms. ♦ RESULTS: We identified 539 episodes of PDRP including 501 new and 38 relapse infections. New episodes of peritonitis were associated with a single organism in 85% of cases, and 44% of those involved staphylococci. Polymicrobial PDRP was more likely to involve gram-negative organisms, observed in 58% versus 24% of monomicrobial infections. Antimicrobial resistance was relatively stable from 2005 to 2014. Methicillin resistance was present in 57% of Staphylococcus epidermidis and 20% of other coagulase-negative staphylococci. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for only 11% of S. aureus peritonitis compared with 2% in our previous study of PDRP from 1991 to 1998. Ciprofloxacin resistance in Escherichia coli increased from 3% in our previous study to 24% in 2005 - 2014. ♦ CONCLUSIONS: This study characterizes important differences in the distribution of organisms in new episodes of PDRP and relapse infections, as well as monomicrobial versus polymicrobial peritonitis. It also shows relatively stable rates of antimicrobial resistance from 2005 to 2014, but some increases compared with our previous study. Copyright © 2017 International Society for Peritoneal Dialysis.

Om Hegels opfattelse af Gorgias, set på baggrund af tidligere filosofihistorikeres fremstilling

DEFF Research Database (Denmark)

Huggler, Jørgen

2010-01-01

En undersøgelse af Hegels tolkning af sofisten Gorgias giver anledning til at se på receptionen af sofisterne hos notable filosofihistorikere i det 18. århundrede. En sådan undersøgelse viser, at Hegel har en original og velvillig tolkning af sofisterne koncentreret omkring begrebet Bildung og det...... at give grunde for noget. Hegels udlægning af Gorgias bygger på hans tolkning af eleaterne, især af Zenon. Når Hegel har en særlig tolkning af eleaterne, skyldes det hans egne mangeårige filosofiske bestræbelser, og en identificering af en særlig, immanent objektiv dialektik hos Zenon, som han finder......, at Gorgias fører videre. Hegels filosofiske forståelse er tilstrækkelig udviklet til at kunne knytte positive kommentarer til alle dele af diskussionen i Gorgias' ræsonnement Om det ikkeværende, eller Om naturen. Det lykkes dog bedst i forhold til de to første af Gorgias' tre underteser. I hegelsk perspektiv...

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.

Ensretning af historieundervisningen

DEFF Research Database (Denmark)

Rønhede, Søren

2008-01-01

"Det er ikke kun i Putins Rusland, at statsmagten vil dirigere historieundervisningen." (Politiken havde fokuseret på "ensretning af historieundervisningen" i Rusland) "Kanonen fra 2006 er undfanget af Udvalget til Styrkelse af Historie i Folkeskolen. Dette udvalg havde regeringen nedsat; men bid...... bidrager kanonen til faglig styrkelse?" spørges der. Det vises, at flere kanonpunkter ikke er fagligt funderede, men af mytologisk art....

IT-baseret fagleksikografi: Nye perspektiver

DEFF Research Database (Denmark)

Laursen, Anne Lise; Duvå, Grete

2003-01-01

IT-baseret fagleksikografi: nye perspektiver For leksikografer vil der altid være områder, der ikke kan behandles tilfredsstillende inden for den traditionelle ordbogs snævre rammer. Elektroniske versioner af forskellige håndbøger, herunder ordbøger, åbner imidlertid for helt nye muligheder, idet...

Akupunktur til patienten med kvalme og opkastning i forbindelse med kemoterapi - er der evidens for dette?

DEFF Research Database (Denmark)

Pedersen, Birgith; Sørensen, Lene Bundgaard; Stricker, Lisbeth

2008-01-01

  Patienter, der får kemoterapi med højemetogene stoffer lider stadig af kvalme og opkastning trods understøttende behandling med moderne antieemtika som 5HT3-antagonister eksempelvis ondansetron. Akupunkturstimulation anvendes for flere lidelser i sundhedsvæsenet og det undersøges om der er evid...

Der flammer en ild

DEFF Research Database (Denmark)

Nielsen, Kirsten

2009-01-01

Artiklen er et foredrag holdt ved Det Teologiske Fakultets tværfaglige symposium, poesiTEOri, 9. november 2007, under fokusområdets tema 2: Bibel og litteratur. Indledningsvis behandles kort salmer som ritual. Derpå følger en drøftelse af salmer som tekst, herunder forfatterrollen. Som eksempler ...

Fissurforsegling, SEAL og infiltrationer

DEFF Research Database (Denmark)

Dige, Irene

Fissurforsegling har været en almindelig del af tandplejens behandlingsspektrum i cariesforebyggelse og -behandling siden 1970’erne. I takt med et fald i cariesforekomsten i den danske befolkning i denne periode, er der sket en ændring i indikationerne for fissurforsegling fra at være et overveje...

OCD og orofaciale dyskinesier forårsaget af sjælden basalganglielidelse

DEFF Research Database (Denmark)

Elmgreen, Søren Bruno; Danielsen, Erik Hvid

2014-01-01

Bevægeforstyrrelser hos psykiatriske patienter skyldes sædvanligvis ekstrapyramidale bivirkninger til antipsykotisk medicin. Her beskrives en sjælden årsag til orofaciale dyskinesier, tungedystoni og koreiforme bevægelser hos en 31-årig mand i behandling for obsessiv-kompulsiv lidelse (OCD)....

CT manifestation of peritoneal metastasis

International Nuclear Information System (INIS)

Cha, Soon Joo; Kang, Eun Young; Suh, Won Hyuck

1989-01-01

Peritoneal metastasis is frequent mode of dissemination of intraabdominal malignancies. Radiologic diagnosis of peritoneal metastasis has relied on indirect evidence on a barium UGI series and small bowel examination. With the advent of CT scanning, CT is capable of direct imaging of peritoneum. The sensitivity of CT in detecting peritoneal metastasis and CT manifestation of peritoneal metastatic lesions had reported occasionally, but rarely in Korea. So, authors illustrated the CT manifestation of peritoneal metastatic lesions in 32 cases of macroscopically proven cases in laparoscopy or laparotomy in Korea University Hae Wha Hospital during recent 4 years. The results are as follows. 1. Of total 32 cases, 18 cases were male and 14 cases were female. Age incidence was the most common in 6th decade. 2. The most common type of malignancy that cause peritoneal metastasis was the stomach cancer and next common type of malignancies were pancreas cancer in men and ovarian cancer in women. 3. Of total 32 cases of peritoneal metastasis which was confirmed by laparoscopy or laparotomy macroscopically, 23 cases (72%) were detected peritoneal thickening and/or omental pathology by CT, and the remaining 9 cases (28%) were not detected by CT. 4. Ascites was present in 19 cases (59%). 5. Parietal peritoneal thickening was present in 16 cases (50%) by CT and sheetlike pattern was the most common findings. The patterns of peritoneal thickening was relatively nonspecific and was not correlated with primary tumor type. 6. Tumor involvement of greater omentum by CT was present in 19 cases (59%). There were 7 cases of smudged appearance pattern, 6 cases of nodular pattern, 6 cases of omental cake pattern and no cystic mass pattern. The patterns of omental pathology was relatively nonspecific and was nor correlated with primary tumor type

Leukocyte esterase reagent strip as a bedside tool to detect peritonitis in patients undergoing acute peritoneal dialysis

Directory of Open Access Journals (Sweden)

Vinay Rathore

2017-01-01

Full Text Available Peritonitis is a common and life-threatening complication of acute peritoneal dialysis (PD. Diagnosis requires the presence of clinical signs of peritonitis which are nonspecific and laboratory investigations [total leukocyte count (TLC, Gram-stain, and culture of PD effluent fluid] which are time-consuming and not available at the bedside. In this study, we evaluated the use of leukocyte esterase reagent strip (LERS as a bedside test to diagnose peritonitis in patients undergoing acute PD. Patients who underwent acute PD were monitored for signs and symptoms of peritonitis. PD effluent fluid analysis included TLC, absolute neutrophil count, Gram-stain, and culture for the diagnosis of peritonitis. LERS (Multistix 10SG was simultaneously dipped in PD effluent fluid and read at two minutes. Reading of + was considered as indicative of peritonitis. Twenty-one out of 166 (12.6% patients undergoing acute PD developed peritonitis. LERS detected peritonitis in 20 patients. The sensitivity, specificity, positive predictive value, and negative predictive value (NPV of LERS were 95.2%, 95.2%, 74.1%, and 99.3%, respectively. LERS has very high sensitivity and NPV and can be used as a rapid bedside tool to exclude peritonitis in patients undergoing acute PD.

New perspectives on CT in peritoneal carcinomatosis and other peritoneal malignancies

International Nuclear Information System (INIS)

Walkey, M.M.; Friedman, A.C.; Radecki, P.D.; Sohotra, P.

1987-01-01

Seventy-three abdominopelvic CT studies in 60 patients with peritoneal tumor spread were reviewed. Ascites was the most common CT finding (74%), with loculation occurring in half. A new finding, loculation of fluid out of the cul-de-sac, is described. Parietal peritoneal thickening and enhancement was visible as a thin enhancing line along the peritoneal surface in 62% of studies. This represents the CT correlate of miliary seeding that has progressed to the point of confluence. Tumor involvement of the omentum was manifest as marbled fat, enhancing nodules, or an omental cake. Mucin-producing implants and their progression to pseydomyxoma peritonei were observed. In 26 patients without a known malignancy, a specific diagnosis was possible in 13 (50%) with identification of a primary tumor. Of 13 patients with no visible primary, six (46%) had ovarian peritoneal carcinomatosis with normal-sized ovaries or minimal adnexal pathology

Optimering af byggeprocessen via bedre/forøget brug af digitale modeller

DEFF Research Database (Denmark)

Carlsen, Mads; Grøn, Dorte Marie Frilund; Alon, Nevo

2013-01-01

Projektet klarlægger nødvendigheden for, og muligheder i, en struktureret og konsekvent planlægning ved anvendelsen af BIM i relation til projektering, udførelse og drift af byggeri. Der er udarbejdet et planlægningsværktøj, der muliggør en sådan planlægning. Samtidig kortlægges de nødvendige data......, der kan udtrækkes af en BIM model ved gennemførelsen af en LCA simulering. Projektet afsluttes med en præsentation af en udviklet demonstratorapplikation til gennemførelse af LCA simuleringer koblet med BIM modellen....

Obligatory referral among other factors associated with peritonitis in peritoneal dialysis patients.

Science.gov (United States)

Oygar, D D; Yalin, A S; Altiparmak, M R; Ataman, R; Serdengecti, K

2011-01-01

Peritonitis is one of the major comorbidities of peritoneal dialysis (PD) patients. The aim of this study was to concentrate on potential risk factors, including more recently studied ones among the classical ones for peritonitis, in PD patients. We analysed 109 patients (F/M = 42/67) followed up at least for 3 months in a single centre, a tertiary referral hospital for 360.1 patient years. In the study which is designed as a retrospective cohort study, demographic characteristics, conditions for choosing PD, type of PD treatment, some chemical tests and peritonitis episodes were recorded from the files of the patients. The rate of peritonitis was found to be 0.22 episode/patient year and 22 (20.18%) of the patients had more than one episode. Twenty seven (24.8%) of the patients were allocated to PD due to obligatory reasons. According to multiple regression analysis, the associated factors were found to be PD allocation type (obligatory versus voluntary) (p = 0.04; RR = 2.6), serum albumin level (p = 0.05; RR = 1.2), and anti-hepatitis C Virus Antibody positivity (p = 0.03; RR = 1.6). Frequency of female patients were significantly higher in the group who had multiple episodes (p = 0.01). Obligatory referral which can be an indication of loss of motivation for peritoneal dialysis procedures, is thought to be a strong risk factor for peritonitis in PD patients and should be further studied. Patients with multiple episodes had a higher frequency of obligatory referral as expected and additionally, they were higher in number of females when compared to the ones with single episode.

A contemporary approach to the prevention of peritoneal dialysis-related peritonitis in children: the role of improvement science.

Science.gov (United States)

Redpath Mahon, Allison; Neu, Alicia M

2017-08-01

Peritonitis is a leading cause of hospitalizations, morbidity, and modality change in pediatric chronic peritoneal dialysis (CPD) patients. Despite guidelines published by the International Society for Peritoneal Dialysis aimed at reducing the risk of peritonitis, registry data have revealed significant variability in peritonitis rates among centers caring for children on CPD, which suggests variability in practice. Improvement science methods have been used to reduce a variety of healthcare-associated infections and are also being applied successfully to decrease rates of peritonitis in children. A successful quality improvement program with the goal of decreasing peritonitis will not only include primary drivers directly linked to the outcome of peritonitis, but will also direct attention to secondary drivers that are important for the achievement of primary drivers, such as health literacy and patient and family engagement strategies. In this review, we describe a comprehensive improvement science model for the reduction of peritonitis in pediatric patients on CPD.

The Role of Monitoring Gentamicin Levels in Patients with Gram-Negative Peritoneal Dialysis-Associated Peritonitis

Science.gov (United States)

Tang, Wen; Cho, Yeoungjee; Hawley, Carmel M.; Badve, Sunil V.; Johnson, David W.

2014-01-01

♦ Background: There is limited available evidence regarding the role of monitoring serum gentamicin concentrations in peritoneal dialysis (PD) patients receiving this antimicrobial agent in gram-negative PD-associated peritonitis. ♦ Methods: Using data collected in all patients receiving PD at a single center who experienced a gram-negative peritonitis episode between 1 January 2005 and 31 December 2011, we investigated the relationship between measured serum gentamicin levels on day 2 following initial empiric antibiotic therapy and subsequent clinical outcomes of confirmed gram-negative peritonitis. ♦ Results: Serum gentamicin levels were performed on day 2 in 51 (77%) of 66 first gram-negative peritonitis episodes. Average serum gentamicin levels on day 2 were 1.83 ± 0.84 mg/L with levels exceeding 2 mg/L in 22 (43%) cases. The overall cure rate was 64%. No cases of ototoxicity were observed. Day-2 gentamicin levels were not significantly different between patients who did and did not have a complication or cure. Using multivariable logistic regression analysis, failure to cure peritonitis was not associated with either day-2 gentamicin level (adjusted odds ratio (OR) 0.96, 95% confidence interval (CI) 0.25 - 3.73) or continuation of gentamicin therapy beyond day 2 (OR 0.28, 0.02 - 3.56). The only exception was polymicrobial peritonitis, where day-2 gentamicin levels were significantly higher in episodes that were cured (2.06 ± 0.41 vs 1.29 ± 0.71, p = 0.01). In 17 (26%) patients receiving extended gentamicin therapy, day-5 gentamicin levels were not significantly related to peritonitis cure. ♦ Conclusion: Day-2 gentamicin levels did not predict gentamicin-related harm or efficacy during short-course gentamicin therapy for gram-negative PD-related peritonitis, except in cases of polymicrobial peritonitis, where higher levels were associated with cure. PMID:24385334

Mycobacterium fortuitum and Polymicrobial Peritoneal Dialysis-Related Peritonitis: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Anwar Hamade

2014-01-01

Full Text Available Mycobacterium fortuitum is a ubiquitous, rapidly growing nontuberculous mycobacterium (NTM. It is the most commonly reported NTM in peritoneal dialysis (PD associated peritonitis. We report a case of a 52-year-old man on PD, who developed refractory polymicrobial peritonitis necessitating PD catheter removal and shift to hemodialysis. Thereafter, M. fortuitum was identified in the PD catheter culture and in successive cultures of initial peritoneal effluent and patient was treated with amikacin and ciprofloxacin for six months with a good and sustained clinical response. Months after completion of the course of antibiotics, the patient successfully returned to PD. To our knowledge, this is the first reported case of M. fortuitum peritonitis in the field of polymicrobial PD peritonitis. It demonstrates the diagnostic yield of pursuing further investigations in cases of refractory PD peritonitis. In a systematic review of the literature, only 20 reports of M. fortuitum PD peritonitis were identified. Similar to our case, a delay in microbiological diagnosis was frequently noted and the Tenckhoff catheter was commonly removed. However, the type and duration of antibiotic therapy varied widely making the optimal treatment unclear.

The Natural Time Course of Membrane Alterations During Peritoneal Dialysis Is Partly Altered by Peritonitis

NARCIS (Netherlands)

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

2016-01-01

♦ The quality of the peritoneal membrane can deteriorate over time. Exposure to glucose-based dialysis solutions is the most likely culprit. Because peritonitis is a common complication of peritoneal dialysis (PD), distinguishing between the effect of glucose exposure and a possible additive effect

Risk Factors for the First Episode of Peritonitis in Southern Chinese Continuous Ambulatory Peritoneal Dialysis Patients

Science.gov (United States)

Fan, Xiaoguang; Huang, Rong; Wang, Juan; Ye, Hongjian; Guo, Qunying; Yi, Chunyan; Lin, Jianxiong; Zhou, Qian; Shao, Fengmin; Yu, Xueqing; Yang, Xiao

2014-01-01

Background 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. Methods 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. Results 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 peritonitis in Southern Chinese CAPD patients. PMID:25222609

Calcification of peritoneal carcinomatosis from gastric carcinoma

International Nuclear Information System (INIS)

Matsuoka, Y.; Itai, Y.; Ohtomo, K.; Nishikawa, J.; Sasaki, Y.

1991-01-01

Peritoneal calcification is noted in peritoneal dissemination from serious cystoadenocarcinoma of the ovary, pseudomyxoma peritonei and meconium peritonitis. This article discusses a case of peritoneal disseminated calcification from gastric carcinoma. To the author's knowledge, this is the first report in English literature of gastric cancer showing peritoneal calcification. (author). 10 refs.; 1 fig

Styring af kommunal digitalisering

DEFF Research Database (Denmark)

Jæger, Birgit

2017-01-01

Digitalisering af både interne arbejdsprocesser og kommunikation med borgere og virksomheder har længe været en vigtig faktor i moderniseringen af den offentlige sektor. Derfor er der stort fokus på styring af digitaliseringen. Denne artikel undersøger, dels hvordan digitaliseringen i den kommunale...... sektor styres, og dels hvilke styringsparadigmer der kan identificeres. Med udgangspunkt i en konkret kommune analyseres styringen af digitalisering gennem et hierarki af offentlige digitaliseringsstrategier. Gennem udvikling af en helt ny form for organisering, en såkaldt Digitaliseringsforening...

Civil Procedure in Denmark

DEFF Research Database (Denmark)

Werlauff, Erik; Petersen, Lars Lindencrone

Værket gennemgår regler og praksis for civilprocessen ved danske domstole, ligesom også voldgift i Danmark behandles. Der skrives ud fra begge forfatteres betydelige teoretiske viden og praktiske erfaring på området. I vidt omfang inddrages og analyseres retspraksis i form af afgørelser fra dansk...

Danish general practitioners' self-reported competences in end-of-life care

DEFF Research Database (Denmark)

Winthereik, Anna; Neergaard, Mette; Vedsted, Peter

2016-01-01

Praktiserende læger har en central rolle i palliativ behandling, og deres deltagelse er værdsat af patienter og pårørende. I dette spørgeskemastudie undersøger forfatterne, hvordan praktiserende læger i region Midtjylland vurderede deres fortrolighed og egne evner inden for palliation. Derudover ...

Senhjerneskade i et forståelsesperspektiv

DEFF Research Database (Denmark)

Nielsen, Charlotte Marie Bisgaard

2015-01-01

sker der, når personer med senhjerneskade i praksis møder sundhedsprofessionelles normer, krav og ønsker om at behandle eller udbedre skaden? Det engelske låneord for ‘selvhjulpet’; ’how-abled’ (Raudaskoski, 2013) versus ‘handicappet’/hhv. ’disabled’ beskriver bedst artiklens forudsatte forståelse af...

'Forestillet læringsvej' i IT-baserede pædagogiske udviklingsprojekter

DEFF Research Database (Denmark)

Misfeldt, Morten

2010-01-01

I denne artikel indføres begrebet 'forestillet læringsvej', og det bruges til at beskrive forskellige tilgange til forholdet imellem udviklingsprojekters mål om at ændre praksis og de resultater, der kan komme ud af at undersøge denne praksisændring. Artiklen behandler det forhold, at interventio...

Hvordan forstås og praktiseres anerkendelsesbegrebet i Aggression Replacement Training?

DEFF Research Database (Denmark)

Harbo, Lotte Junker

2013-01-01

Artiklen undersøger den forståelse af anerkendelse som er på spil i behandlingsmetoden Aggression Replacement Training - A.R.T. Begrebet anerkendelse optræder hyppigt i både manual og uddannelse i og omkring manualen og artiklen behandler den begrebsforvirring der kan iaggtages omkring begrebet når...

Peritonitis as the First Presentation of Disseminated Listeriosis in a Patient on Peritoneal Dialysis-a Case Report.

Science.gov (United States)

Beckerleg, Weiwei; Keskar, Vaibhav; Karpinski, Jolanta

2017-01-01

Infections with Listeria monocytogenes are uncommon but serious, with mortality rate approaching 30% in cases of systemic involvement despite first-line therapy. They are usually caused by ingestion of contaminated foods, but spontaneous infections have also been described. Listeria monocytogenes is a rare cause of peritonitis, and most of the published cases are in patients with cirrhosis and ascites. There are a few reported cases of Listeria peritonitis associated with peritoneal dialysis (PD), primarily isolated peritonitis.If detected early, Listeria peritonitis can be successfully treated with ampicillin, alone or in combination with gentamicin. Vancomycin has been listed as a second-line agent. However, it has been associated with treatment failure.In this case report, we present a patient who developed disseminated listeriosis, with peritonitis as the first manifestation of disseminated infection. This case illustrates the importance of having a high index of suspicion for L. monocytogenes if patients deteriorate despite empiric therapy for PD-associated peritonitis and serves as a further example demonstrating the inadequate coverage of vancomycin for L. monocytogenes . Copyright © 2017 International Society for Peritoneal Dialysis.

Effect of fluid supplementation and modality on peritoneal permeability characteristics in a rat peritoneal dialysis model

NARCIS (Netherlands)

Zweers, M. M.; Splint, L. J.; Krediet, R. T.; Struijk, D. G.

2001-01-01

OBJECTIVE: Hemoconcentration may influence peritoneal permeability parameters in anesthetized animals without fluid supplementation. Therefore, the aim of this study was to investigate the effects of fluid supplementation on peritoneal permeability in an acute peritoneal dialysis model in

Livscyklusvurdering af basiskemikalier

DEFF Research Database (Denmark)

Olsen, Stig Irving

1998-01-01

Dette resumé af metoder og væsentlige erfaringer fra erhvervsforskerprojektet Livscyklusvurdering af basiskemikalier er skrevet i erkendelse af, at hovedrapporten er for omfattende til en hurtig introduktion i problemstillingerne. Formålet med denne rapport er derfor at give et kort overblik over...

Globalisering af uddannelse

DEFF Research Database (Denmark)

Jensen, Henning Høgh

2005-01-01

Det globale marked for uddannelse er i voldsom vækst og er ved at blive et af Danmarks vigtigste vareområder. Hvorledes kan KVL agere i globaliseringen af uddannelse for at sikre en høj kvalitet af egne kandidater med gode jobmuligheder?...

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

We explored the relationship between the experience level of nurses and the peritonitis risk in peritoneal dialysis (PD) patients. 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 (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. 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. 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.

Comparison of peritoneal equilibration test with 99mTc-DTPA excretion in the assessment of peritoneal permeability

International Nuclear Information System (INIS)

Das, B.K.; Senthilnathan, M.S.; Pradhan, P.K.; Nagabhushan, S.; Jeloka, T.K.; Sharma, R.K.

2004-01-01

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 ( 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 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 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.)

Peritoneal dialysis-related peritonitis caused by Pseudomonas species: Insight from a post-millennial case series.

Science.gov (United States)

Lu, Wanhong; Kwan, Bonnie Ching-Ha; Chow, Kai Ming; Pang, Wing-Fai; Leung, Chi Bon; Li, Philip Kam-To; Szeto, Cheuk Chun

2018-01-01

Pseudomonas peritonitis is a serious complication of peritoneal dialysis (PD). However, the clinical course of Pseudomonas peritonitis following the adoption of international guidelines remains unclear. We reviewed the clinical course and treatment response of 153 consecutive episodes of PD peritonitis caused by Pseudomonas species from 2001 to 2015. Pseudomonas peritonitis accounted for 8.3% of all peritonitis episodes. The bacteria isolated were resistant to ceftazidime in 32 cases (20.9%), and to gentamycin in 18 cases (11.8%). In 20 episodes (13.1%), there was a concomitant exit site infection (ESI); in another 24 episodes (15.7%), there was a history of Pseudomonas ESI in the past. The overall primary response rate was 53.6%, and complete cure rate 42.4%. There was no significant difference in the complete cure rate between patients who treated with regimens of 3 and 2 antibiotics. Amongst 76 episodes (46.4%) that failed to respond to antibiotics by day 4, 37 had immediate catheter removal; the other 24 received salvage antibiotics, but only 6 achieved complete cure. Antibiotic resistance is common amongst Pseudomonas species causing peritonitis. Adoption of the treatment guideline leads to a reasonable complete cure rate of Pseudomonas peritonitis. Treatment with three antibiotics is not superior than the conventional two antibiotics regimen. When there is no clinical response after 4 days of antibiotic treatment, early catheter removal should be preferred over an attempt of salvage antibiotic therapy.

Undervisning af tosprogede elever

DEFF Research Database (Denmark)

Horst, Christian

2003-01-01

Artiklen fremdrager hovedresultaterne fra Virginia P. Collier's og Wayne P. Thomas's længdeundersøgelser af tosprogede elever i USA, som formentlig er de mest omfattende undersøgelser af undervisningen af tosprogede elever overhovedet. Resultaterne diskuteres i relation til udviklingen af en...

Niklas Luhmann

DEFF Research Database (Denmark)

Harste, Gorm; Harste, Hannah

2018-01-01

Kapitlet introducerer til Niklas Luhmanns sociologi om selvreferentielle kommunikationssystem og anvender den til fortolkningen af sundhedssystemet. Hvorledes kommunikaerer sundhedssystemet om sundhed og sygdom? Hvorledes skal de to "koder" for behandling forstås, og hvilke positioner sætter de...... patienter og borgere i? Kapitlet analyserer, hvordan sundhedssystemet adskiller sig fra andre af samfundets funktionssystemer som retssystemet, det politiske system, massemedierne, undervisningssystemet, forskningssystemet osv. Afslutningsvist markerer kapitlet, hvorledes Luhmanns systemteoretiske...... perspektiv kan sammenlignes med Michel Foucaults, Pierre Bourdieus og Jürgen Habermas' perspektiver på sundhed....

EU's tiltræden til EMRK - et sisyfosarbejde?

DEFF Research Database (Denmark)

Bang Fuglsang Madsen Sørensen, Henning

2015-01-01

EU-Domstolen afviste med opinion 2/13 den 18. december 2014 at lade EU tiltræde EMRK på grundlag af et udkast til en tiltrædelsesaftale. I artiklen behandles baggrunden for og det konkrete indhold i EU-Domstolens afvisning, hvorefter det undersøges, i hvilket omfang EMD fremover kan forventes...... at respektere EU-rettens forrang og dermed undlade at holde medlemsstaterne ansvarlige for påståede krænkelser som følge af medlemsstaternes forpligtelser efter EU-retten....

Computed tomography manifestations of peritoneal diseases

International Nuclear Information System (INIS)

Gordon, K.; Lee, W.K.; Hennessy, O.

2005-01-01

The peritoneal cavity is a potential space that is divided by the peritoneal reflections into various complex subspaces. It can be involved in many disease processes including developmental, inflammatory, neoplastic and traumatic conditions. Computed tomography is highly sensitive and consistent in detecting peritoneal pathology. This pictorial essay aims to emphasize and illustrate the CT features of the spectrum of peritoneal diseases. Copyright (2005) Blackwell Science Pty Ltd

6 belysninger af vejledning

DEFF Research Database (Denmark)

Toft, Helle Mary; Jessing, Carla Tønder; Nymann, Anette

Artiklerne belyser vejledning af unge og vejledning af voksne. I relation til unge drejer det sig om: 1. vejledning af unge med vanskeligheder i forhold til uddannelse - her unge med særlige vejledningsbehov, og mentorordninger for unge, og 2. vejledning af unge i ungdomsuddannelser og i erhvervs...

Brug af alternativ isolering i forbindelse med renovering af ældre etageejendomme

DEFF Research Database (Denmark)

Hansen, Ernst Jan de Place

2003-01-01

Resume af rapport om praktiske erfaringer med brug af alternative isoleringsmaterialer i en renoveringsopgave, udarbejdet af Byfornyelse København m.fl. under Energistyrelsens udviklingsprogram "Miljø- og arbejdsmiljøvenlig isolering"...

Unusual dialysate leakage complicating peritoneal dialysis

International Nuclear Information System (INIS)

Chiu, Jainn-Shiun; Yu, Fu-Chiu; Chen, Chiou-An; Wang, Yuh-Feng

2006-01-01

A 16-year-old female who had end-stage renal disease on 2-month continuous ambulatory peritoneal dialysis (CAPD) presented with perineal pain 4 days before admission. The physical examination revealed bilateral labial edema. Peritoneal scintigraphy was requested after infusing 2 L peritoneal dialysate with direct administration of 370 MBq (10mCi) technetium-99m diethylenetriamine pentra-acetic acid into peritoneal cavity via Tenckhoff catheter. Radioactive uptake from right inguinal to labial region was clearly demonstrated, and this indicated the site of peritoneal leakage. After surgical intervention unilaterally, she continued CAPD without any recurrence (au)

A case of bacterial peritonitis caused by Roseomonas mucosa in a patient undergoing continuous ambulatory peritoneal dialysis.

Science.gov (United States)

Matsukuma, Yuta; Sugawara, Koji; Shimano, Shota; Yamada, Shunsuke; Tsuruya, Kazuhiko; Kitazono, Takanari; Higashi, Harumichi

2014-11-01

Bacterial peritonitis remains a life-threatening complication of peritoneal dialysis (PD). Roseomonas is a bacterial genus of pink-pigmented, oxidized, gram-negative coccobacilli that was first named in 1993. Importantly, Roseomonas mucosa exhibits antibiotic resistance, with significant resistance to cephalosporin, which is often selected as an empirical antibiotic regimen for peritonitis in PD patients. We herein report the case of a PD patient with bacterial peritonitis caused by Roseomonas mucosa that was fortunately identified using 16S rRNA gene sequencing and successfully treated with ciprofloxacin. Given that Roseomonas demonstrates resistance to a variety of antibiotics. The administration of empiric antibiotic therapy based on the recommendation of the International Society of Peritoneal Dialysis guidelines occasionally fails, leading to the aggravation of bacterial peritonitis. Hence, nephrologists should consider Roseomonas as one of the potential causative organisms of peritonitis, especially when gram-negative bacilli are resistant to cephalosporin and cannot be identified using standard laboratory methods.

Pharmacological inhibition of heparin-binding EGF-like growth factor promotes peritoneal angiogenesis in a peritoneal dialysis rat model.

Science.gov (United States)

Li, Zhenyuan; Yan, Hao; Yuan, Jiangzi; Cao, Liou; Lin, Aiwu; Dai, Huili; Ni, Zhaohui; Qian, Jiaqi; Fang, Wei

2018-04-01

Molecular mechanisms of peritoneal dialysis (PD) ultrafiltration failure, peritoneal neo-angiogenesis, and fibrosis remain to be determined. We aimed to determine the role of heparin-binding EGF-like growth factor (HB-EGF) inhibition on angiogenesis of peritoneal membrane in a PD rat model. 32 male Wistar rats were assigned into (1) control group; (2) uremic non-PD group: subtotal nephrectomy-induced uremic rats without PD; (3) uremic rats subjected to PD: uremic rats that were dialyzed with Dianeal ® for 4 weeks; (4) CRM 197 group: dialyzed uremic rats were supplemented with CRM197, a specific HB-EGF inhibitor. Peritoneal transport function was examined by peritoneal equilibration test. Expression of HB-EGF and EGFR in peritoneal samples were examined by real-time PCR, immunohistochemical staining, and western blot. Progressive angiogenesis and fibrosis were observed in uremic PD rats, and there were associated with decreased net ultrafiltration (nUF), increased permeability of peritoneal membrane, and reduced expression of HB-EGF and EGFR protein and mRNA in uremic PD rats compared to uremic non-PD or control groups (both p CRM197 significantly induced peritoneal membrane permeability, decreased nUF, increased higher vessel density, and reduced pericyte count compared to that of uremic PD rats. The levels of HB-EGF and EGFR expression negatively correlated with vessel density in peritoneal membrane (both p < 0.001). PD therapy was associated with peritoneal angiogenesis, functional deterioration, and downregulation of HB-EGF/EGFR. Pharmacological inhibition of HB-EGF promoted PD-induced peritoneal angiogenesis and fibrosis and ultrafiltration decline, suggesting that HB-EGF downregulation contributes to peritoneal functional deterioration in the uremic PD rat model.

Peritoneal dialysis and peritonitis rate: Kuwait, four years' experience.

Science.gov (United States)

Alyousef, Anas M; Abdou, Salah M; Mansour, Yasser S; Radi, Ahmad D

2016-01-01

Peritoneal dialysis (PD) program was established in Farwaniya Hospital Kidney Center, Kuwait, in February 2011. Patient recruitment for this modality of treatment was growing steadily. One of the major complications of PD is peritonitis. There is a belief that PD therapy is inferior and carries more complications than hemodialysis, we aimed to show that PD is a good and a non-inferior option for dialysis therapy with comparable outcome in both patient and technique survival. This was a retrospective analysis of all patients who were on PD from February 2011 to December 2014. Peritonitis rate, exit site infection rate, and all-cause mortality rate were all assessed for this period. Peritonitis rate during the 1 st year, 2011, was 0.92 incidents/year. This number had progressively declined in the following years; in 2012, it was 0.65 incidents/year; in 2013, it was 0.58 incidents/year; and in 2014, it was 0.38 incidents/year. This improvement in the rate of peritonitis incidence could be explained by better education of patients and meticulous supervision of the nursing staff. Farwaniya Hospital Kidney Center had an all-cause mortality rate of 9.3% among patients on renal replacement therapy in 2011. In 2012, all-cause mortality rate increased to 17.1%. The following year, 2013, it decreased to 14.3%, and in 2014, all-cause mortality rate dropped further to 7.6%. All-cause mortality rate among PD patients was zero in 2011. In 2012, the all-cause mortality rate in PD was 11.54%, and in 2013, it decreased to 10.52%. Then, again in 2014, the all-cause mortality rate among PD patients was zero. This improvement in all-cause mortality rate could be explained by the better medical care offered to the end-stage renal disease patients, in particular PD patients, in Farwaniya Hospital Kidney Center.

Fungal peritonitis by Thermoascus crustaceus in a peritoneal dialysis patient from Chile.

Science.gov (United States)

Alvarez, Eduardo; Castillo, Alvaro; Iturrieta, Isabel

Fungal peritonitis is a relatively uncommon infection in peritoneal dialysis patients. However, it can be associated with significant morbimortality. In recent reports, Candida species and other filamentous fungi have been reported as being aetiological agents. Thermoascus species are ubiquitous, thermophilic fungi, with an anamorph in the Paecilomyces genus. Here we present the first report of fungal peritonitis by Thermoascus crustaceus from Chile. We present the case of an 83-year-old female patient, with a history of cholecystectomy, hernia repair, severe arterial hypertension, hip and knee osteoarthritis and several episodes of peritoneal dialysis with a cloudy exudate. Bacterial cultures were negative. In addition, a history of two months with intermittent fever peaks mainly in the evening was reported. Blood culture bottles inoculated with peritoneal fluid revealed the presence of fungal growth. Morphological and molecular studies allowed us to identify the aetiological agent as Thermoascus crustaceus. An antifungal susceptibility test was performed using the M38-A2 method, developed by the Clinical and Laboratory Standards Institute (CLSI). The MIC values to amphotericin B, itraconazole, voriconazole and echinochandins were 0.5, 0.25, 0.25 and 0.125μg/ml, respectively. Antifungal treatment with amphotericin B was prescribed, with good patient progress. Fungal peritonitis is a very rare entity. Moreover, the spectrum of fungal pathogens continues to expand, a reason for which morphological and molecular studies are necessary for a rapid diagnosis. Copyright © 2017 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.

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. © 2016 Asian Pacific Society of Nephrology.

Clinical Characteristics and Outcomes of “Silent” and “Non-Silent” Peritonitis in Patients on Peritoneal Dialysis

Science.gov (United States)

Dong, Jie; Luo, Suping; Xu, Rong; Chen, Yuan; Xu, Ying

2013-01-01

♦ Objectives: We compared the clinical characteristics and outcomes of “silent” peritonitis (meaning episodes without fever and abdominal pain) and “non-silent” peritonitis in patients on peritoneal dialysis (PD). ♦ Methods: Our cohort study collected data about all peritonitis episodes occurring between January 2008 and April 2010. Disease severity score, demographics, and biochemistry and nutrition data were recorded at baseline. Effluent cell counts were examined at regular intervals, and the organisms cultured were examined. Treatment failure was defined as peritonitis-associated death or transfer to hemodialysis. ♦ Results: Of 248 episodes of peritonitis occurring in 161 PD patients, 20.9% led to treatment failure. Of the 248 episodes, 51 (20.6%) were not accompanied by fever and abdominal pain. Patients with these silent peritonitis episodes tended to be older (p = 0.003). The baseline values for body mass index, triglycerides, and daily energy intake were significantly lower before silent peritonitis episodes than before non-silent episodes (p = 0.01, 0.003, and 0.001 respectively). Although silent peritonitis episodes were more often culture-negative and less often caused by gram-negative organisms, and although they presented with low effluent white cell counts on days 1 and 3, the risk for treatment failure in those episodes was not lower (adjusted odds ratio: 1.33; 95% confidence interval: 0.75 to 2.36; p = 0.33). ♦ Conclusions: Silent peritonitis is not a rare phenomenon, especially in older patients on PD. Although these episodes were more often culture-negative, silent presentation was not associated with a better outcome. PMID:22855888

Delta 2.0

DEFF Research Database (Denmark)

Skott, Jeppe; Skott, Charlotte Krog; Jess, Kristine

DELTA 2.0 er en ny og helt opdateret udgave af Delta, der i ti år været brugt i matematiklærernes grund-, efter- og videreuddannelse. DELTA 2.0 er seriens almene fagdidaktik. Der er også fagdidaktiske overvejelser i de øvrige bøger i serien, men de er knyttet til specifikt matematisk indhold. DELTA...... 2.0 behandler mere generelle matematikdidaktiske problemstillinger såsom læringsteoretiske overvejelser i forbindelse med matematik, centrale aspekter af det at undervise i matematik og digitale teknologier som værktøj til at støtte elevers faglige læring af matematik....

Benchmarking for controllere: metoder, teknikker og muligheder

DEFF Research Database (Denmark)

Bukh, Per Nikolaj; Sandalgaard, Niels Erik; Dietrichson, Lars Grubbe

2008-01-01

Benchmarking indgår på mange måder i både private og offentlige virksomheders ledelsespraksis. I økonomistyring anvendes benchmark-baserede indikatorer (eller nøgletal), eksempelvis ved fastlæggelse af mål i resultatkontrakter eller for at angive det ønskede niveau for visse nøgletal i et Balanced...... Scorecard eller tilsvarende målstyringsmodeller. Artiklen redegør for begrebet benchmarking ved at præsentere og diskutere forskellige facetter af det, samt redegør for fire forskellige anvendelser af benchmarking for at vise begrebets bredde og væsentligheden af at klarlægge formålet med et...... benchmarkingprojekt. Dernæst bliver forskellen på resultatbenchmarking og procesbenchmarking behandlet, hvorefter brugen af intern hhv. ekstern benchmarking, samt brugen af benchmarking i budgetlægning og budgetopfølgning, behandles....

Ultrasound-guided biopsy of the thickened peritoneal reflections: efficacy and diagnostic role in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis

International Nuclear Information System (INIS)

Kim, Young Hwan; Ryeom, Hun Kyu; Chung, Tae Gyun; Park, Hyo Yong; Kim, Yong Joo; Kang, Duck Sik

2000-01-01

To evaluate the accuracy and safety of ultrasound-guided biopsy of the thickened peritoneal reflections and to determine the efficacy and diagnostic role of this procedure in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis. Twenty-seven patients with only mildly thickened (25 mm or less) peritoneal reflections without apparent mass formations, and in whom imaging findings were not diagnostic, underwent ultrasound-guided biopsy. Five-MHz linear or convex linear array transducers were used for ultrasound guidance, and an automated gun with 18-gauge (n=3D23) or 20-gauge (n=3D4) needles for tissue sampling. biopsies were performed on the thickened parietal peritoneum (n=3D9), greater omentum (n=3D11), and small bowel mesentery (n=3D7), and the results were compared with the final diagnosis determined by radiologic/clinical follow-up (n=3D17) or laparoscopic biopsy (n=3D10). Complications and changes in hemoglobin and hematocrit levels after the procedure were evaluated. Specimens adequate for pathologic examination were obtained in all 27 patients. The histopathologic results were metastatic carcinomatosis (n=3D15), peritoneal tuberculosis (n=3D8), and chronic granulomatous inflammation (n=3D4). Specific pathologic diagnosis was obtained in all patients except the four with chronic granulomatous inflammation. Differentiation between benignancy and malignancy was possible in all patients and the histopathologic specific accuracy rate was 100%. No clinically significant complications were observed. In 24 patients with ascites at the site of the biopsy, transient bleeding was observed immediately after the procedure, but this stopped spontaneously within a few minutes. Post-procedural hemoglobin and hematocrit levels were only minimally lower (mean values of 0.9 g/dL and 3.0%, respectively) than pre-procedurally. Ultrasound-guided biopsy of thickened peritoneal reflections is a safe and effective diagnostic procedure and is useful in

Ultrasound-guided biopsy of the thickened peritoneal reflections: efficacy and diagnostic role in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis

Energy Technology Data Exchange (ETDEWEB)

Kim, Young Hwan; Ryeom, Hun Kyu; Chung, Tae Gyun; Park, Hyo Yong; Kim, Yong Joo; Kang, Duck Sik [Kyungpook National University Hospital, Taegu (Korea, Republic of)

2000-08-01

To evaluate the accuracy and safety of ultrasound-guided biopsy of the thickened peritoneal reflections and to determine the efficacy and diagnostic role of this procedure in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis. Twenty-seven patients with only mildly thickened (25 mm or less) peritoneal reflections without apparent mass formations, and in whom imaging findings were not diagnostic, underwent ultrasound-guided biopsy. Five-MHz linear or convex linear array transducers were used for ultrasound guidance, and an automated gun with 18-gauge (n=3D23) or 20-gauge (n=3D4) needles for tissue sampling. biopsies were performed on the thickened parietal peritoneum (n=3D9), greater omentum (n=3D11), and small bowel mesentery (n=3D7), and the results were compared with the final diagnosis determined by radiologic/clinical follow-up (n=3D17) or laparoscopic biopsy (n=3D10). Complications and changes in hemoglobin and hematocrit levels after the procedure were evaluated. Specimens adequate for pathologic examination were obtained in all 27 patients. The histopathologic results were metastatic carcinomatosis (n=3D15), peritoneal tuberculosis (n=3D8), and chronic granulomatous inflammation (n=3D4). Specific pathologic diagnosis was obtained in all patients except the four with chronic granulomatous inflammation. Differentiation between benignancy and malignancy was possible in all patients and the histopathologic specific accuracy rate was 100%. No clinically significant complications were observed. In 24 patients with ascites at the site of the biopsy, transient bleeding was observed immediately after the procedure, but this stopped spontaneously within a few minutes. Post-procedural hemoglobin and hematocrit levels were only minimally lower (mean values of 0.9 g/dL and 3.0%, respectively) than pre-procedurally. Ultrasound-guided biopsy of thickened peritoneal reflections is a safe and effective diagnostic procedure and is useful in

Opsigtsvækkende nyt om derivater fra USA

DEFF Research Database (Denmark)

Thinggaard, Frank

1997-01-01

Der er opsigsvækkende nyt fra USA om den regnskabsmæssige behandling af derivater som terminskontrakter, futures, optioner, swaps m.v. Glem alt om historiske anskaffelsespriser. For derivater er der kun ét mål, som kan bruges: markedsværdier (fair-values). Glem alt om snakken om 'off-balance-sheet...

Præstationsledelse i en krisetid

DEFF Research Database (Denmark)

Elmholdt, Claus Westergård; Hoffmann Birk, Rasmus; Børgesen, Kenneth

front og fra front til top? Hvad sker der når medarbejderne motiveres gennem hård performance management, målstyring og incitamenter? Hvordan kan man bedrive intelligent performance management, som ikke dræber medarbejdernes kreativitet og indre motivation? Det er nogle af de spørgsmål som behandles i...

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

Science.gov (United States)

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

2016-06-01

The Standardizing Care to improve Outcomes in Pediatric End stage renal disease (SCOPE) Collaborative aims to reduce peritonitis rates in pediatric chronic peritoneal dialysis patients by increasing implementation of standardized care practices. To assess this, monthly care bundle compliance and annualized monthly peritonitis rates were evaluated from 24 SCOPE centers that were participating at collaborative launch and that provided peritonitis rates for the 13 months prior to launch. Changes in bundle compliance were assessed using either a logistic regression model or a generalized linear mixed model. Changes in average annualized peritonitis rates over time were illustrated using the latter model. In the first 36 months of the collaborative, 644 patients with 7977 follow-up encounters were included. The likelihood of compliance with follow-up care practices increased significantly (odds ratio 1.15, 95% confidence interval 1.10, 1.19). Mean monthly peritonitis rates significantly decreased from 0.63 episodes per patient year (95% confidence interval 0.43, 0.92) prelaunch to 0.42 (95% confidence interval 0.31, 0.57) at 36 months postlaunch. A sensitivity analysis confirmed that as mean follow-up compliance increased, peritonitis rates decreased, reaching statistical significance at 80% at which point the prelaunch rate was 42% higher than the rate in the months following achievement of 80% compliance. In its first 3 years, the SCOPE Collaborative has increased the implementation of standardized follow-up care and demonstrated a significant reduction in average monthly peritonitis rates. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Hjemtagning af dialysebehandling til grønlandske patienter med kronisk nyresvigt

DEFF Research Database (Denmark)

Kronborg, Christian; Kjær, Trine; Bech, Mickael

en periode på 10 år forventes at medføre ekstraomkostninger på ca. 13,9 millioner kroner sammenlignet med at lade patienterne behandle som nu på Rigshospitalet i København. Det vil altså sige en gennemsnitlig ekstraomkostning på ca. 4 millioner kroner om året. Estimatet er dog påvirkeligt at flere...

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....

Spirometry utilization among Danish adults initiating medication targeting obstructive lung disease

DEFF Research Database (Denmark)

Koefoed, Mette

2013-01-01

litteraturen, at mange af disse patienter får medicinsk behandling for deres symptomer uden yderligere undersøgelser, selvom symptomer og klinisk undersøgelse ikke med tilstrækkelig sikkerhed kan prædiktere, hvem der har astma og eller KOL. Spirometri er anbefalet som Gold Standard for at bekræfte eller...... den diagnostiske proces og at blive udsat for unødig medicinsk behandling. Litteraturen tyder på, at mange medicinbrugere ikke bliver undersøgt med spirometri og muligvis ikke har obstruktive lungelidelser. Dette kvalitetsproblem bør afdækkes, og associationer med manglende spirometri i denne gruppe...... bør klarlægges, så interventioner kan målrettes. Formål: Blandt nye brugere af obstruktiv lungemedicin var formålet at: • Afdække i hvor høj grad spirometri var udført indenfor det første år, efter at medicineringen var påbegyndt • Afdække om patientkarakteristika såsom socioøkonomisk og demografisk...

Energirenovering af Sems Have

DEFF Research Database (Denmark)

Jensen, Søren Østergaard; Rose, Jørgen; Mørck, Ove

Nærværende rapport udgør en del af afrapporteringen af PSO ELFORSK projektet Vejledning for energirenovering af boligblokke til lavenergiklasse 2015 og 2020. Arbejdet har været finansieret af PSO midler via ELFORSK, projekt: 347-023. Formålet med projektet er at udvikle en vejledning for dybtgående...

Choledocholitiasis. Endoskopisk behandling af 416 konsekutive patienter

DEFF Research Database (Denmark)

Pedersen, F M; Brandt, C J; Schaffalitzky de Muckadell, O B

1998-01-01

patients who underwent ERC for common bile duct stones between January 1990 and January 1995. The overall success rate of achieving a common bile duct free of stones was 89.0%, and in 94.7% of the patients endoscopic treatment was definitive. The overall complication rate was 9.6% and the 30-day mortality...

Kirurgisk behandling af midt og lav rectumcancer

DEFF Research Database (Denmark)

Bjørn, Maya Xania; Perdawood, Sharaf Karim

2017-01-01

Total mesorectal excision (TME) is standard treatment of mid- and low rectal cancer and has evolved with minimally invasive surgery. Laparoscopic TME has proven to be technically challenging, and recent randomized controlled studies fail to prove it oncologically superior to open TME. Robotic......-assisted TME may overcome the technical difficulties and shows comparable oncological results, yet it is associated with significant additional costs. Transanal TME is a promising method which seems to overcome the technical and financial issues of the other techniques, without compromising the short...

Ikkekirurgisk behandling af lumbal nerverodspåvirkning

DEFF Research Database (Denmark)

Andersen, Mikkel Østerheden; Andresen, Andreas K; Lorenzen, Marianne Dyrby

2017-01-01

evidence is found regarding non-surgical treatment of patients with lumbar radiculopathy. Physiotherapy, in the form of group sessions, seems to have the best level of evidence. However, evidence is still very limited and of poor quality. No evidence has been found with regards to acupuncture...

MINDFULNESS BEHANDLING AF DANSKE VETERANER - ET PILOTSTUDIE

DEFF Research Database (Denmark)

Fjorback, Lone

2015-01-01

I foråret 2014 mødtes en gruppe på 12 danske veteraner en gang om ugen i 9 uger for at deltage i programmet Mindfulness Baseret Stress Reduktion (MBSR). Deltagerne havde meldt sig frivilligt, og gruppen var blandet mht. alder, køn, antal udsendelser og diagnoser. Det, de havde til fælles, var...

Behandling af pilonidalcyster med neodynium-yttriumaluminiumgranat-laser

DEFF Research Database (Denmark)

Lindholt, Christine S; Lindholt, Jes S; Lindholt, Jan

2008-01-01

A 23 year-old woman with a nonsupporative pilonidal cyst was successfully treated causally with Nd-YAG laser, and without any recidivate after 9 months follow-up. The mechanism is presumed to be that YAG-laser has a wave-length of 1064 nm. Consequently, the wave penetration through the skin is de...... is deeper than most other lasers before the energy is absorbed in melanin and oxyhaemoglobin, so the contents of the cyst can be reached and destroyed. The treatment could be a very attractive alternative to open surgery. Udgivelsesdato: 2008-Jun-23...

Behandling af pilonidalcyster med neodynium-yttriumaluminiumgranat-laser

DEFF Research Database (Denmark)

Lindholt, Christine S; Lindholt, Jes Sanddal; Lindholt, Jan

2008-01-01

A 23 year-old woman with a nonsupporative pilonidal cyst was successfully treated causally with Nd-YAG laser, and without any recidivate after 9 months follow-up. The mechanism is presumed to be that YAG-laser has a wave-length of 1064 nm. Consequently, the wave penetration through the skin is de...... is deeper than most other lasers before the energy is absorbed in melanin and oxyhaemoglobin, so the contents of the cyst can be reached and destroyed. The treatment could be a very attractive alternative to open surgery....

Biologisk behandling af sjaeldne inflammatoriske reumatiske sygdomme

DEFF Research Database (Denmark)

Baslund, Bo

2008-01-01

The current status of the use of biological medicine in the treatment of adult onset morbus still, Wegeners granulomatosis and systemic lupus erythematosus (SLE) is reviewed. The need for controlled trials is emphasized. Anti-CD20 treatment for SLE patients with kidney involvement and patients...... with Wegeners granulomatosis seems promising. Anti-TNF and IL1 receptor antagonist can control disease activity in most patients with adult morbus still....

Behandling af diabetes mellitus med biologiske laegemidler

DEFF Research Database (Denmark)

Larsen, Claus Morten; Mandrup-Poulsen, Thomas

2008-01-01

Biologic therapeutics are currently not approved for the treatment of patients with type 1 and type 2 diabetes. However, promising results from recent randomized controlled studies suggest that biologic therapeutics have therapeutic potential. This article summarizes the causal steps of the patho......Biologic therapeutics are currently not approved for the treatment of patients with type 1 and type 2 diabetes. However, promising results from recent randomized controlled studies suggest that biologic therapeutics have therapeutic potential. This article summarizes the causal steps...... of the pathogenesis of type 1 and type 2 diabetes which are targeted by biologic therapeutics and reviews the treatment results. Udgivelsesdato: 2008-Jun-9...

Nyrepåvirkning ved behandling af hjertesvigt

DEFF Research Database (Denmark)

Rasmussen, Zhiying Zhang; Barfod, Toke; Klit, Jakob

2009-01-01

The case of a 66-year-old male with heart failure and cardiorenal syndrome is presented. The patient had normal renal function before intensive treatment with diuretics and ACE inhibitor. Shortly after the ACE inhibitor was stopped and diuretics were either stopped or reduced in dosage, his renal...

Behandling af ideopatisk hypereosinofilt syndrom med imatinib

DEFF Research Database (Denmark)

Sørensen, Anne Louise; Larsen, Herdis

2008-01-01

We here report a case of idiopathic hypereosinophilic syndrome with prompt response to treatment with imatinib. The patient presented with chest pain, myalgias, fatigue and weakness. Blood tests and bone marrow examination revealed striking eosinophilia. Clonal or reactive disorders were excluded...

Klinik, diagnostik og behandling af Lyme-borreliose

DEFF Research Database (Denmark)

Ocias, Lukas Frans; Jensen, Bo Bødker; Knudtzen, Fredrikke Christie

2017-01-01

Lyme borreliosis is an infection caused by the Borrelia burgdorferi sensu lato complex and transmitted by Ixodes ricinus ticks in Denmark. It can manifest itself in several different forms of which erythema migrans is the most common and is diagnosed by clinical assessment of the characteristic...

Behandling af svaer hypovolaemi med hypertont saltvand

DEFF Research Database (Denmark)

Rask, H; Nielsen, S L; Crawford, M E

1996-01-01

of hypovolaemia HS instantaneously expands plasma volume and improves central haemodynamics through increased filling pressures and direct myocardial stimulation. HS, as compared to isotonic fluids, causes precapillary vasodilation, reduction of cell oedema and decreased haematocrit and hence improves regional...... and capillary perfusion. Furthermore HS-infusion has been shown to attenuate reperfusion injury and restore cell function in cells damaged during hypovolaemic shock. Animal experiments as well as clinical studies on the use of HS are reviewed. A short description of the pathophysiology of acute hypovolaemic...

Prevalence of CMMSE defined cognitive impairment among peritoneal dialysis patients and its impact on peritonitis.

Science.gov (United States)

Shea, Yat Fung; Lam, Man-Fai; Lee, Mi Suen Connie; Mok, Ming Yee Maggie; Lui, Sing-Leung; Yip, Terence P S; Lo, Wai Kei; Chu, Leung Wing; Chan, Tak-Mao

2016-02-01

Peritoneal dialysis (PD) exchange procedure is complex. Patients with cognitive impairment (CI) may require assistance. We studied the prevalence of CI among PD patients, its impact on PD-related peritonitis and the outcome of assisted PD. Cantonese version of Mini-Mental State examination (CMMSE) was performed in 151 patients newly started on PD. Data on patient characteristics including demographics, co-morbidities, blood parameters, medications, and number of PD-related peritonitis in the first 6 months were collected. 151 subjects were recruited. The age of studied patients was 60 ± 15.0 years, and 45% were female. The prevalence of CI was 13.9% using education-adjusted cut-off of CMMSE. Patients older than 65-year-old, female, and lower education level were independent risk factors for CI (OR 9.27 p = 0.001, OR 14.84 p = 0.005, and OR 6.10 p = 0.009, respectively). Age greater than 65-year old is an independent risk factor for PD-related peritonitis but CI was not. Patients requiring assisted PD were of older age (p peritonitis (p = 0.07). CI is common among local PD patients. Overall, CI could not be identified as an independent risk factor for PD peritonitis. There is a higher prevalence of CI among assisted PD patients but helpers may not completely eliminate the risk of PD-related peritonitis.

CT manifestations of peritoneal carcinomatosis.

Science.gov (United States)

Walkey, M M; Friedman, A C; Sohotra, P; Radecki, P D

1988-05-01

Seventy-three abdominopelvic contrast-enhanced CT scans obtained in 60 patients with peritoneal tumor spread were reviewed retrospectively to determine the CT signs of peritoneal malignancy. Ascites was present in 54 studies (74%) and was the most common CT finding. Loculation of the fluid occurred in 25 (46%) of these. In nine (17%) of the 54, a new finding, absence of cul-de-sac fluid in the presence of generalized ascites, was noted. Parietal peritoneal thickening with contrast enhancement of the peritoneum, making the peritoneum visible as a thin line along the abdominal wall, was present in 45 (62%) of studies. This is believed to represent confluent peritoneal metastases. Small-bowel involvement was present in half of the cases (wall thickening and irregularity with or without obstruction). Tumor involvement of the omentum was visible as soft-tissue permeation of fat, enhancing nodules, and/or an omental cake. Of the 26 patients without a previously known malignancy, identification of the primary tumor in addition to peritoneal carcinomatosis was possible in 13 (50%). Appreciation of the spectrum of CT findings in peritoneal carcinomatosis is essential for accurate evaluation of scans in patients with abdominopelvic malignancies.

Corynebacterium species: an uncommon agent of peritoneal dialysis-related peritonitis and a challenging treatment

OpenAIRE

Ferreira, Joel; Teixeira e Costa, Fernando; Ramos, Aura

2015-01-01

Introduction: Corynebacterium is a component of normal skin flora and it is responsible for an increasing incidence of nosocomial infections in the last decades. Peritonitis and exit-site infections caused by this microorganism are uncommon but have a significant clinical impact due to their high relapsing rate. The ideal therapeutic approach in these situations is not yet clearly defined. Methods: Retrospective analysis of Corynebacterium spp peritonitis in a peritoneal dialysis unit between...

Midler til lindring af mundtørhed og stimulation af spytsekretion

DEFF Research Database (Denmark)

Dynesen, Anja Weirsøe; Pedersen, Anne Marie Lynge; Jensen, Allan Bardow

2013-01-01

effekt. I relation til risikoen for at udvikle caries, der er forhøjet hos den mundtørre patient, er det dog væsentligt at anbefale produkter uden sukker. Ligesom produktets indhold af syre og dermed det erosive potentiale er af betydning i forhold til udviklingen af dentale erosioner. Systemisk...

Af Upraktiske Grunde

DEFF Research Database (Denmark)

Vaaben, Nana Katrine

2001-01-01

som både Claude Levi-Strauss lægger op til i sine klassiske studier af "den vilde tanke", og som Jean Baudrillard siden har lagt op til i sine analyser af samlere som en slags ekstreme forbrugere, der er i færd med at komplettere deres identitet gennem besiddelser af genstande. Imidlertid tillægger...

Ledelse af projektmyldret

DEFF Research Database (Denmark)

større arbejdsgrupper, og det kan være selvorganiserede store udviklingsprogrammer. Et projekt kører sjældent alene, og derfor er der ikke kun tale om projektledelse, men i lige så høj grad om ledelse af projekter. Ledelse af virksomhedens mylder af projekter er ikke let, og forfatterne gennemgår derfor...

Evaluering af ordning med psykologbehandling af personer med let til moderat depression

DEFF Research Database (Denmark)

Fjeldsted, Rita; Christensen, Kaj Sparle

Herværende rapport evaluerer den pr. 1.4.2008 indførte ordning med mulighed for henvisning til psykologbehandling med 60 % tilskud for patienter med let til moderat depression. Evalueringen har betjent sig af flere gensidigt supplerende metoder: spørgeskemaundersøgelser overfor patienter, psykolo......Herværende rapport evaluerer den pr. 1.4.2008 indførte ordning med mulighed for henvisning til psykologbehandling med 60 % tilskud for patienter med let til moderat depression. Evalueringen har betjent sig af flere gensidigt supplerende metoder: spørgeskemaundersøgelser overfor patienter...... tidligere evaluering af forsøgsordning af psykologbehandling af depression i perioden 2005-06. 18.419 personer i alderen 18-37 år blev henvist til psykolog i den undersøgte ordning i perioden 1.2.2009 – 31.1.2010, svarende til en henvisningshyppighed på 1,6 % af baggrundsbefolkningen i samme aldersgruppe....... Ordningen giver mulighed for én rehenvisning, og 9 % blev rehenvist i perioden. Spørgeskemaresultater viser, at kun 33 % af de henviste falder ind under henvisningskriteriet ” let til moderat depression” på tidspunktet for opstart af psykologbehandling, 39 % har ingen tegn på depression, og 28 % har svær...

Behandling af placenta percreta kræver involvering af flere specialer

DEFF Research Database (Denmark)

Clausen, Caroline; Lönn, Lars; Albrechtsen, Charlotte Krebs

2011-01-01

Placenta percreta is a rare life-threatening obstetrical condition, often resulting in severe haemorrhage and hysterectomy. The incidence seems to be increasing, probably secondary to the increase in caesarean section rates. We present a protocol for an elective multidisciplinary approach with pr...

Comparison of peritonitis rates and patient survival in automated and continuous ambulatory peritoneal dialysis: a 10-year single center experience.

Science.gov (United States)

El-Reshaid, Wael; Al-Disawy, Hanan; Nassef, Hossameldeen; Alhelaly, Usama

2016-09-01

Peritonitis is a common complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD). In this retrospective study, peritonitis rates and patient survival of 180 patients on CAPD and 128 patients on APD were compared in the period from January 2005 to December 2014 at Al-Nafisi Center in Kuwait. All patients had prophylactic topical mupirocin at catheter exit site. Patients on CAPD had twin bag system with Y transfer set. The peritonitis rates were 1 in 29 months in CAPD and 1 in 38 months in APD (p peritonitis free patients over 10-year period in CAPD and APD were 49 and 60%, respectively (p peritonitis was 10.25 ± 3.1 months in CAPD compared to 16.1 ± 4 months in APD (p peritonitis was 13.1 ± 1 and 14 ± 1.4 months respectively (p = 0.3) whereas in peritonitis free patients it was 15 ± 1.4 months in CAPD and 23 ± 3.1 months in APD (p = 0.025). APD had lower incidence rate of peritonitis than CAPD. Patient survival was better in APD than CAPD in peritonitis free patients but was similar in patients who had peritonitis.

Evaluering af metoder til risikovurdering af kombinationseffekter og etablering af PBTK/TD modeller for pesticider - et ph.d.-projekt

DEFF Research Database (Denmark)

Reffstrup, Trine Klein

2012-01-01

I dette ph.d.-projekt ved DTU Fødevareinstituttet er den nuværende viden om metoder til risikovurdering af kombinationseffekter af kemiske stoffer med fokus på pesticider gennemgået. Endvidere undersøgtes, hvordan man kan implementere matematiske computermodeller som et værktøj i vurderingen af...

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

Science.gov (United States)

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

2015-03-01

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

Escherichia coli Peritonitis in Peritoneal Dialysis: The Prevalence, Antibiotic Resistance and Clinical Outcomes in a South China Dialysis Center

Science.gov (United States)

Feng, Xiaoran; Yang, Xiao; Yi, Chunyan; Guo, Qunying; Mao, Haiping; Jiang, Zongpei; Li, Zhibin; Chen, Dongmei; Cui, Yingpeng; Yu, Xueqing

2014-01-01

♦ Introduction: Escherichia coli (E. coli) peritonitis is a frequent, serious complication of peritoneal dialysis (PD). The extended-spectrum β-lactamase (ESBL)-producing E. coli peritonitis is associated with poorer prognosis and its incidence has been on continuous increase during the last decades. However, the clinical course and outcomes of E. coli peritonitis remain largely unclear. ♦ Methods: All of the E. coli peritonitis episodes that occurred in our dialysis unit from 2006 to 2011 were reviewed. The polymicrobial episodes were excluded. ♦ Results: In total, ninety episodes of monomicrobial E. coli peritonitis occurred in 68 individuals, corresponding to a rate of 0.027 episodes per patient-year. E. coli was the leading cause (59.2%) of monomicrobial gram-negative peritonitis. ESBL-producing strains accounted for 35.5% of E. coli peritonitis. The complete cure rate and treatment failure rate of E. coli peritonitis were 77.8% and 10.0% respectively. Patients with preceding peritonitis had a higher risk of ESBL production as compared to those without peritonitis history [odds ratio (OR): 5.286; 95% confidence interval (CI): 2.018 - 13.843; p = 0.001]. The risk of treatment failure was significantly increased when the patient had a baseline score of Charlson Comorbidity Index (CCI) above 3 (OR: 6.155; 95% CI: 1.198 - 31.612; p = 0.03), or had diabetes mellitus (OR: 8.457; 95% CI: 1.838 - 38.91; p = 0.006), or hypoalbuminemia (≤ 30g/l) on admission (OR: 13.714; 95% CI: 1.602 - 117.428; p = 0.01). Prolonging the treatment course from 2 to 3 weeks or more reduced the risk of relapse and repeat significantly (p peritonitis remains a common complication of PD. The clinical outcomes of E. coli peritonitis are relatively favorable despite the high ESBL rate. A history of peritonitis is associated with increased risk for ESBL development. The severity of baseline comorbidities, the presence of diabetes mellitus and hypoalbuminemia at admission are associated

Snit af målinger: VK afhængig af DF og NA

DEFF Research Database (Denmark)

Thomsen, Søren Risbjerg

2007-01-01

ANALYSE: Ekstra Risbjerg-snit af meningsmålinger grundet fortsat valgrummel - VK-regeringen vil blive afhængig af både DF og NA. Udgivelsesdato: 21. august 2007......ANALYSE: Ekstra Risbjerg-snit af meningsmålinger grundet fortsat valgrummel - VK-regeringen vil blive afhængig af både DF og NA. Udgivelsesdato: 21. august 2007...

Late effects of cancer treatment

DEFF Research Database (Denmark)

Hansen, Asger Aarup

2017-01-01

De sidste 20 års forbedringer inden for kræftbehandling har medført, at flere overlever diagnosen. I dag er der op mod 260.000 kræftoverlevere i Danmark. Som konsekvens af den hårde behandling oplever mange tidligere patienter eftervirkninger og senfølger er opstået som betegnelse for de eftervir...

Becifringsklaver 6

DEFF Research Database (Denmark)

Olsen, Jens Stig

Bogen er sjette og sidste bind i en serie, som grundigt behandler det fænomen at spille klaver efter becifring. Bøgerne er lærebøger, som primært er beregnet for studerende på læreruddannelsens musiklinie, universitet, konservatorie og andre musikuddannelser. Bøgerne kan dog også anvendes af børn...

Libanon i regionen

DEFF Research Database (Denmark)

Schmidt, Søren

2011-01-01

Artiklen behandler Libanons regionale relationer, herunder forholdet til Syrien og Iran. Syrien har gjort krav på Libanon, grebet ind i borgerkrigten, rømmet landet, bevaret agenter og en vis opbakning, er mistænkt i Hariri-sagen, og er senest dybt påvirket af det arabiske forår. Ikke en nem, men...

Journalistik om et bebudet historisk øjeblik

DEFF Research Database (Denmark)

Jørndrup, Hanne

2012-01-01

samtidens interesse som ’historiske’, hvordan behandler journalistikken disse begivenheder, og hvad kan påberåbelsen af historien bruges til? Barack Obamas indsættelse som USA’s 44. præsident i januar 2009 blev om noget udråbt til et historisk øjeblik. Nærværende artikel analyser den journalistiske praksis...

Mesteren

DEFF Research Database (Denmark)

Pedersen, Peter Ole

2013-01-01

Anmeldelsen behandler nøglescener og tematikker i Paul Thomas Andersons 'The Master' (USA 2012). I de forkerte hænder kunne filmen, der handler om opblomstringen af en Scientology-lignende nyreligiøs kult i 50ernes Amerika, være endt i en trygt fordømmende fortælling. Men i Paul Thomas Andersons...

Kunstens Psykologi og Sansningens Primat

DEFF Research Database (Denmark)

Levin, Kasper

2012-01-01

. Spørgsmålet er imidlertid om ikke kunstpsykologien udelukker sig selv fra væsentlige indsigter ved på denne måde at behandle kunstværker som traditionelt empiriske eller repræsentationelle genstande. Med udgangspunkt i en analyse af Sigmund Freuds tilgang til kunst vil jeg pege på filosoffen Gilles Deleuze...

SOS

DEFF Research Database (Denmark)

2015-01-01

Dette støttepapir kan ikke stå alene. Teksten er alene tænkt som en hjælp til gruppearbejdet eller den enkelte midt i skriveprocessen og kan ikke anvendes, hvis man ikke er godt hjemme i grundbøgernes behandling af de samme emner. Det anbefales at følge undervisernes instrukser, anvisninger i gru...

Manual on best practices

DEFF Research Database (Denmark)

Oxlund, Bjarke

Der er mange måder at imødegå den globale hiv/aids epidemi på, men ikke alle tilgange virker lige godt. 'Best practices' er blevet lanceret af UNAIDS og andre som et værktøj til at sikre, at kun de mest effektive og virkningsfulde interventioner bliver promoveret i hiv/aids forebyggelse, behandling...

Optimering af model for spredning af luftforurening

DEFF Research Database (Denmark)

Pedersen, Jens Christian

2008-01-01

De nuværende luftforureningsmodeller har problemer med at bevare massen af diverse kemiske stoffer og med at der ind i mellem optræder negative værdier. Derfor arbejder specialestuderende Ayoe Buus Hansen på om at forbedre den model DMU bruger til at beskrive transport og spredning af luftforuren...... luftforurening på alle skalaer på den nordlige halvkugle ved at sammenligne tre alternative beregningsmodeller. ...

Aktiv kontra passiv forvaltning

DEFF Research Database (Denmark)

Bechmann, Ken L.; Pedersen, Lasse Heje

2017-01-01

Fordele og ulemper ved aktiv og passiv forvaltning har fået fornyet opmærksomhed blandt andet i forbindelse med den forestående implementering af MiFID II. Som bidrag til denne diskussion indeholder dette nummer af Finans/Invest tre artikler, der behandler aktiv og passiv forvaltning fra...... forskellige vinkler. Denne leder forklarer, hvorfor valget mellem aktiv og passiv forvaltning er mere kompliceret, end hvad man kunne tro ved første øjekast, og konkluderer, at der vil være plads til - og behov for - begge typer forvaltning....

WNT Signaling Is Required for Peritoneal Membrane Angiogenesis.

Science.gov (United States)

Padwal, Manreet Kaur; Cheng, Genyang; Liu, Limin; Boivin, Felix J; Gangji, Azim; Brimble, Kenneth Scott; Bridgewater, Darren; Margetts, Peter J

2018-01-24

The WNT signaling pathway is involved in wound healing and fibrosis. We evaluated the WNT signaling pathway in peritoneal membrane injury. We assessed WNT1 protein expression in the peritoneal effluents of 54 stable peritoneal dialysis (PD) patients and WNT-related gene expression in ex vivo mesothelial cell cultures from 21 PD patients. In a transforming growth factor beta (TGFB) mediated animal model of peritoneal fibrosis, we evaluated regulation of the WNT pathway and the effect of WNT inhibition on peritoneal fibrosis and angiogenesis. WNT1 and WNT2 gene expression were positively correlated with peritoneal membrane solute transport in PD patients. In the mouse peritoneum, TGFΒ-induced peritoneal fibrosis was associated with increased expression of WNT2 and WNT4. Peritoneal b-catenin protein was significantly upregulated after infection with AdTGFB along with elements of the WNT signaling pathway. Treatment with a b-catenin inhibitor (ICG-001) in mice with AdTGFB-induced peritoneal fibrosis resulted in attenuation of peritoneal angiogenesis and reduced vascular endothelial growth factor. Similar results were also observed with the WNT antagonist Dickkopf related protein (DKK) 1. In addition to this, DKK-1 blocked epithelial to mesenchymal transition and increased levels of the cell adhesion protein E-cadherin. We provide evidence that WNT signaling is active in the setting of experimental peritoneal fibrosis and WNT1 correlates with patient peritoneal membrane solute transport in PD patients. Intervention in this pathway is a possible therapy for peritoneal membrane injury.

Epidemiology of peritonitis following maintenance peritoneal dialysis catheter placement during infancy: a report of the SCOPE collaborative.

Science.gov (United States)

Zaritsky, Joshua Jacob; Hanevold, Coral; Quigley, Raymond; Richardson, Troy; Wong, Cynthia; Ehrlich, Jennifer; Lawlor, John; Rodean, Jonathan; Neu, Alicia; Warady, Bradley A

2018-04-01

Maintenance peritoneal dialysis (PD) is the dialysis modality of choice for infants and young children. However, there are limited outcome data for those who undergo PD catheter insertion and initiate maintenance PD within the first year of life. Using data from the Children's Hospital Association's Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (ESRD) Collaborative (SCOPE), we examined peritonitis rates and patient survival in 156 infants from 29 North American pediatric dialysis centers who had a chronic PD catheter placed prior to their first birthday. In-hospital and overall annualized rates of peritonitis were 1.73 and 0.76 episodes per patient-year, respectively. Polycystic kidney disease was the most frequent renal diagnosis and pulmonary hypoplasia the most common co-morbidity in infants with peritonitis. Multivariable regression models demonstrated that nephrectomy at or prior to PD catheter placement and G-tube insertion after catheter placement were associated with a nearly sixfold and nearly threefold increased risk of peritonitis, respectively. Infants with peritonitis had longer initial hospital stays and lower overall survival (86.3 vs. 95.6%, respectively; P high and several risk factors associated with the development of peritonitis were identified. Given that peritonitis was associated with a longer duration of initial hospitalization and increased mortality, increased attention to the potentially modifiable risk factors for infection is needed.

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

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.

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

Science.gov (United States)

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

2016-08-01

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

The Effects of Biocompatible Compared with Standard Peritoneal Dialysis Solutions on Peritonitis Microbiology, Treatment, and Outcomes: the balANZ Trial

Science.gov (United States)

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

2012-01-01

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

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. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

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...

Peritoneal Albumin and Protein Losses Do Not Predict Outcome in Peritoneal Dialysis Patients

NARCIS (Netherlands)

Balafa, Olga; Halbesma, Nynke; Struijk, Dirk G.; Dekker, Friedo W.; Krediet, Raymond T.

2011-01-01

Background and objectives Peritoneal clearance of albumin unlike the transport of small molecules is defined by both vascular surface area and size-selective permeability. Few studies have supported a positive correlation between peritoneal albumin loss and mortality. The aim of this study was to

CONTENTS OF CHEMOKINES AND CYTOKINES IN PERITONEAL FLUID FROM THE PATIENTS WITH ENDOMETRIOSIS OF VARIOUS SEVERITY

Directory of Open Access Journals (Sweden)

D. I. Sokolov

2007-01-01

Full Text Available Abstract. Endometriosis is a disease accompanied by development of heterotopic endometrial foci at the peritoneum, proliferation of endothelial cells, and inflammatory reaction. Aiming to specify the dynamics of inflammatory process in endometriosis of different severity, as well as significance of chemokines and cytokines in angiogenesis and inflammation, we determined concentrations of RANTES, IL-8, IP-10, MIG, MCP-1 chemokines, as well as IL-4, IL-6 and IL-10 cytokines in peritoneal fluid from patients by endometriosis. Forty women at reproductive age with an endometriosis have been observed. Among them, endometriosis grade I-II was registered in 20 cases, whereas grade III-IV has been confirmed in 20 women. Twenty-two women without evidence of endometriosis referred to diagnostic laparoscopy for pregnancy planning, comprised a control group. Diagnosis of endometriosis was based upon endoscopic findings and results of histological research. Severity grade of endometriosis was estimated according to R-AFS classification. Sampling of peritoneal fluid was carried out when performing surgical laparoscopies. Concentrations of chemokines and cytokines were determined by flow cytometry techniques, using BD Cytometric Bead Array test kits and FACStrack flow cytometer. The amounts of RANTES in peritoneal fluid were higher in grade I-II endometriosis, in comparison with grade III-IV endometriosis and control samples. Concentrations of IP-10, IL-8, МСР-1, MIG, IL-6, and IL-4 were higher than in control group and correlated with severity of the disease. IL-10 was not detectable in peritoneal fluid of the patients with endometriosis. These results suggest a significant role of the mentioned cytokines and chemokines that may promote invasion of endometrial cells, growth of heterotopic endometrioid locuses, development of vascular bed and induction of inflammatory processes, in development and progression of endometriosis.

Peritoneal borderline cystoadenocarcinoma

Directory of Open Access Journals (Sweden)

Manoel João Batista Castello Girão

Full Text Available Carcinomas of peritoneal origin represent a seldom diagnosed entity of unknown etiology, with important implications in terms of prophylactic oophorectomy. Initially described in patients belonging to families at high risk for ovarian cancer, it possibly has a pathogeny similar to that of endosalpingiosis and of some cases of endometriosis. We report a case of peritoneal borderline mucinous carcinoma with an anatomopathological diagnosis of normal ovaries.

Analysis of early mesothelial cell responses to Staphylococcus epidermidis isolated from patients with peritoneal dialysis-associated peritonitis.

Science.gov (United States)

McGuire, Amanda L; Mulroney, Kieran T; Carson, Christine F; Ram, Ramesh; Morahan, Grant; Chakera, Aron

2017-01-01

The major complication of peritoneal dialysis (PD) is the development of peritonitis, an infection within the abdominal cavity, primarily caused by bacteria. PD peritonitis is associated with significant morbidity, mortality and health care costs. Staphylococcus epidermidis is the most frequently isolated cause of PD-associated peritonitis. Mesothelial cells are integral to the host response to peritonitis, and subsequent clinical outcomes, yet the effects of infection on mesothelial cells are not well characterised. We systematically investigated the early mesothelial cell response to clinical and reference isolates of S. epidermidis using primary mesothelial cells and the mesothelial cell line Met-5A. Using an unbiased whole genome microarray, followed by a targeted panel of genes known to be involved in the human antibacterial response, we identified 38 differentially regulated genes (adj. p-value peritonitis. This study provides new insights into early mesothelial cell responses to infection with S. epidermidis, and confirms the importance of validating findings in primary mesothelial cells.

[Peritoneal dialysis adequacy in pediatrics. From the peritoneal equilibration test to the aquaporins].

Science.gov (United States)

Bolte, Lillian; Cano, Francisco

2015-01-01

An evaluation of the characteristics of peritoneal solute and water transport is essential to assess the suitability of prescribing dialysis in patients suffering from chronic renal disease. There are currently a series of models to perform this evaluation. The peritoneal equilibration test (PET) evaluates the peritoneal transport capacity, classifying the patients into four transport categories: high, high-average, low-average, and low. The short PET enables the same evaluation to be made in only 2hours, and has been validated in paediatric patients. On the other hand, the MiniPET provides additional information by evaluating the free water transport capacity by the ultra-small pores, and the Accelerated Peritoneal Examination Time (APEX) evaluates the time when the glucose and urea equilibration curves cross, and has been proposed as the optimum dwell time to achieve adequate ultrafiltration. An analysis is presented on the current information on these diagnostic methods as regards free water transport via aquaporins, which could be an important tool in optimising solute and water transport in patients on chronic peritoneal dialysis, particularly as regards the cardiovascular prognosis. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Efficacy of Prophylactic Antibiotics at Peritoneal Catheter Insertion on Early Peritonitis: Data from the Catheter Section of the French Language Peritoneal Dialysis Registry.

Science.gov (United States)

Lanot, Antoine; Lobbedez, Thierry; Bechade, Clémence; Verger, Christian; Fabre, Emmanuel; Dratwa, Max; Vernier, Isabelle

2016-01-01

International guidelines recommend the use of a prophylactic antibiotic before the peritoneal dialysis (PD) catheter can be inserted. The main objective of this study was to assess whether this practice is associated with a lower risk of early peritonitis and to estimate the magnitude of the centre effect. A retrospective, multi-centric study was conducted, in which data from the French Language Peritoneal Dialysis Registry was analysed. Patients were separated into 2 groups based on whether or not prophylactic antibiotics were used prior to catheter placement. Out of the 2,014 patients who had a PD catheter placed between February 1, 2012 and December 31, 2014, 1,105 were given a prophylactic antibiotic. In a classical logit model, the use of prophylactic antibiotics was found to protect the individual against the risk of early peritonitis (OR 0.67, 95% CI 0.49-0.92). However, this association lost significance in a mixed logistic regression model with centre as a random effect: OR 0.73 (95% CI 0.48-1.09). Covariates associated with the risk of developing early peritonitis were age over 65: OR 0.73 (95% CI 0.39-0.85), body mass index over 35 kg/m2: OR 1.99 (95% CI 1.13-3.47), transfer to PD due to graft failure: OR 2.24 (95% CI 1.22-4.11), assisted PD: OR 1.96 (95% CI 1.31-2.93), and the use of the Moncrief technique: OR 3.07 (95% CI 1.85-5.11). There is a beneficial effect of prophylactic antibiotic used prior to peritoneal catheter placement, on the occurence of early peritonitis. However, the beneficial effect could be masked by a centre effect. © 2016 S. Karger AG, Basel.

State-of-the-art imaging of peritoneal carcinomatosis

International Nuclear Information System (INIS)

Pfannenberg, C.; Schwenzer, N.F.; Bruecher, B.L.

2012-01-01

Imaging studies are essential in the evaluation of patients with suspected or known peritoneal malignancy. Despite major advances in imaging technology in the last few years, the early and adequate detection of a peritoneal dissemination remains challenging because of the great variety in size, morphology and location of the peritoneal lesions. New therapeutic approaches in peritoneal-based neoplasms combining cytoreductive surgery and peritonectomy with hyperthermic intraoperative chemotherapy (HIPEC) suggest improved long-term survival, provided that a complete (macroscopic) cytoreduction is achieved. The preoperative radiological assessment of the extent and distribution of peritoneal involvement plays a vital role in the patient selection process. Despite its known limited accuracy in detecting small peritoneal lesions and the involvement of the small bowel/mesentery, contrast-enhanced MDCT remains the standard imaging modality in the assessment of peritoneal carcinomatosis. MRI, especially with diffusion-weighted images, and FDG-PET/CT are promising methods for the evaluation of peritoneal carcinomatosis with superior results in recent studies, but still have a limited role in selected cases because of high costs and limited availability. Generally, to obtain the most precise readings of peritoneal carcinomatosis, an optimized examination protocol and dedicated radiologists with a deep knowledge of peritoneal pathways and variable morphologies of peritoneal disease are required. (orig.)

Pharmacokinetics of Intraperitoneal Cefalothin and Cefazolin in Patients Being Treated for Peritoneal Dialysis-Associated Peritonitis.

Science.gov (United States)

Roberts, Darren M; Ranganathan, Dwarakanathan; Wallis, Steven C; Varghese, Julie M; Kark, Adrian; Lipman, Jeffrey; Roberts, Jason A

2016-01-01

♦ The standard treatment of peritoneal dialysis (PD)-associated peritonitis (PD-peritonitis) is intraperitoneal (IP) administration of antibiotics. Only limited data on the pharmacokinetics and appropriateness of contemporary dose recommendations of IP cefalothin and cefazolin exist. The aim of this study was to describe the pharmacokinetics of IP cefalothin and cefazolin in patients treated for PD-peritonitis. ♦ As per international guidelines, IP cefalothin or cefazolin 15 mg/kg once daily was dosed with gentamicin in a 6-hour dwell to patients with PD-peritonitis during routine care. Serial plasma and PD effluent samples were collected over the first 24 hours of therapy. Antibiotic concentrations were quantified using a validated chromatographic method with pharmacokinetic analysis performed using a non-compartmental approach. ♦ Nineteen patients were included (cefalothin n = 8, cefazolin n = 11). The median bioavailability for both antibiotics exceeded 92%, but other pharmacokinetic parameters varied markedly between antibiotics. Both antibiotics achieved high PD effluent concentrations throughout the antibiotic dwell. Cefazolin had a smaller volume of distribution compared with cefalothin (14 vs 40 L, p = 0.003). The median trough total plasma antibiotic concentration for cefazolin and cefalothin during the dwell differed (plasma 56 vs 13 mg/L, p Peritoneal Dialysis.

En verden af medier

DEFF Research Database (Denmark)

Tække, Jesper

2009-01-01

Bogen: 'En verden af medier – Medialiseringen af politik, sprog, religion og leg' anmeldes. Anmeldelsen kan læses på: http://ojs.statsbiblioteket.dk/index.php/mediekultur/article/view/1370/1499 Udgivelsesdato: 2009......Bogen: 'En verden af medier – Medialiseringen af politik, sprog, religion og leg' anmeldes. Anmeldelsen kan læses på: http://ojs.statsbiblioteket.dk/index.php/mediekultur/article/view/1370/1499 Udgivelsesdato: 2009...

Udforskning af journalistiske moralnormer

DEFF Research Database (Denmark)

Mogensen, Kirsten

2010-01-01

Kirsten Mogensen beskriver professionelle journalistiske normer. Med udgangspunkt i amerikansk tv's dækning af begivenhederne 11. september kombinerer Kirsten Mogensen kvalitative interviews og tekstanalyse for på den måde at beskrive professionelle journalistiske normer. Metoden er en kombinatio...... af halvstrukturerede, udforskende interviews med både kvantitative og kvalitative analyser af den faktiske dækning, og er primært udledt af Alf Ross' essay om normer og direktiver....

Peritoneal mesothelioma: CT and MRI findings

International Nuclear Information System (INIS)

Puvaneswary, M.; Chen, S.; Proietto, T.

2002-01-01

Two patients with histologically proven diagnosis of peritoneal mesothelioma are presented. Both patients had CT scans of the abdomen. The second patient was also examined with MRI. Although imaging findings are striking, they are non-specific and diagnosing peritoneal mesothelioma in the absence of pleural calcification or pleural plaque on chest radiograph or CT is difficult. However, it is possible to suggest the correct diagnosis in a patient with the presence of non-calcified omental and peritoneal infiltration or masses without liver secondaries or lymphadenopathy. Magnetic resonance imaging with its multi-planar capabilities is a highly sensitive non-invasive modality in the evaluation of malignant peritoneal mesothelioma and can demonstrate the exact site and clarify whether the mass is arising from the peritoneal surface or within a visceral organ. Copyright (2002) Blackwell Science Pty Ltd

Pilotprojekt - In situ test af stimuleret aerob nedbrydning til oprensning af pesticidpunktkilder

DEFF Research Database (Denmark)

Tsitonaki, Katerina; Roost, Sandra; Larsen, Lars

Denne rapport omhandler et pilotforsøg i felten, hvor det er undersøgt, hvorvidt aerob nedbrydning af phenoxysyre-pesticider kan stimuleres ved tilsætning af ilt suppleret med tilsætning af specifikke pesticidnedbrydende bakterier. Forsøget er udført på en forurenet lokalitet, Skelstofte, hvor der...

Peritoneal carcinomatosis - the role of FDG PET

International Nuclear Information System (INIS)

Turlakow, A.; Yeung, H.W.; Macapinlac, H.A.; Sanchez, A.F.; Larson, S.M.

2002-01-01

Full text: Peritoneal carcinomatosis can be difficult to diagnose, as CT is insensitive, with peritoneal biopsy and lavage often subject to problems of sampling error. The aim of our study was to evaluate the role of FDG PET in detecting peritoneal carcinomatosis in patients with biopsy-proven metastases from stomach, ovarian and adrenal cancer and mesothelioma. 92 FDG-PET scans of patients with stomach (49), ovarian (14) adrenal cancer (7) and mesothelioma (22) were reviewed. Studies were performed 45 minutes following IV injection of 10 mCi of 18 F-FDG. Of this group 15 patients had biopsy-proven findings of peritoneal disease while 14 had PET studies reported as suspicious for peritoneal metastasis. Of the 15 biopsy-positive patients, FDG PET was positive in 7, CT in 6 and either PET or CT in 10 (sensitivities 46.6,40.0 and 66.6% respectively). In a further 4 patients without biopsies, where other imaging studies confirmed peritoneal disease, PET was also positive. 2 distinct abnormal scintigraphic patterns of focal and uniform FDG uptake were identified corresponding to nodular and diffuse peritoneal disease at pathology. Our study demonstrates that FDG PET adds to conventional imaging in the staging of peritoneal carcinomatosis. It is also a useful diagnostic tool when peritoneal biopsy is either unavailable or inappropriate. We have identified 2 distinct scintigraphic patterns which appear to predict the presence of either nodular or diffuse peritoneal pathology.Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Peritonitis tuberculosa en pacientes infectados por el virus de la inmunodeficiencia humana Tuberculous peritonitis in HIV-infected patients

Directory of Open Access Journals (Sweden)

D. Cecchini

2010-09-01

Full Text Available Con el objetivo de describir aspectos clínicos y de laboratorio de la peritonitis por Mycobacterium tuberculosis en pacientes VIH (+, se realizó un análisis retrospectivo de historias clínicas de pacientes VIH+ con aislamiento de M. tuberculosis de líquido ascítico (LA atendidos en el período 1996-2005 en el Hospital Muñiz, Buenos Aires, Argentina. Se incluyeron 21 pacientes con una mediana de edad de 34 años; el 52% era de sexo masculino. La mediana del valor de linfocitos T CD4+ en sangre periférica fue de 85/mm³; la tasa de pacientes con tuberculosis previa alcanzó el 40%; mientras que la proporción de sujetos con cuadro clínico compatible con cirrosis, con enolismo y con serología reactiva al virus de la hepatitis C (VHC fue del 65%, 45% y 85%, respectivamente. Los síntomas más frecuentes fueron la distensión abdominal (71%, la fiebre (62% y el dolor abdominal (19%. Las características químicas (medianas del LA fueron las siguientes: recuento de leucocitos: 751/mm³ (predominio mononuclear: 79%; proteínas: 3,1 g/dl; LDH: 351 UI/l. Se obtuvo baciloscopía positiva en el LA del 14% de los enfermos y se comprobó infección por M. tuberculosis multirresistente (TBC-MR en el 20%. Se aisló M. tuberculosis de otras muestras en el 71% de los casos. Quince pacientes recibieron tratamiento antituberculoso; en el 30% el tratamiento empírico inicial no se adecuó a la sensibilidad de la cepa. La mortalidad global fue del 66,4%, lo que se considera un valor elevado. Esto sería atribuible a la alta frecuencia de TBC-MR, al grado de inmunosupresión y a la prevalencia de cirrosis secundaria a enolismo y de coinfección por el VHC.In order to describe the clinical and laboratory findings of Mycobacterium tuberculosis peritonitis M. tuberculosis in HIV+ patients, we conducted a retrospective analysis of the medical records of HIV+ patients with isolation of M. tuberculosis from ascitic fluid (AF, assisted at Hospital Muñiz, Buenos

Intelligent styring af dynamisk LED belysning

DEFF Research Database (Denmark)

Thorseth, Anders; Corell, Dennis Dan; Hansen, Søren Stentoft

Denne slutrapport giver en kort beskrivelse af arbejdet, der er udført af DTU Fotonik i projektet ”Intelligent styring af dynamisk LED belysning” støttet af EUDP. Arbejdet er udført i perioden 2011‐2012 i samarbejde med Lighten.......Denne slutrapport giver en kort beskrivelse af arbejdet, der er udført af DTU Fotonik i projektet ”Intelligent styring af dynamisk LED belysning” støttet af EUDP. Arbejdet er udført i perioden 2011‐2012 i samarbejde med Lighten....

The clinical role of imaging in peritoneal carcinomatosis

International Nuclear Information System (INIS)

Prassopoulos, P.

2015-01-01

Full text: Intraperitoneal seeding, the so-called peritoneal carcinomatosis (PC) is a common mechanism of spread in advanced intra-abdominal malignancies including ovarian (71%), gastric (17%) and colorectal (10%) cancers. When cancer cells from a growing primary neoplasm reach the peritoneal surface, they are carried out by the peritoneal fluid and disseminated throughout the peritoneal cavity.the location of implants development is governed mostly by peritoneal fluid circulation and by anatomic pathways formed by peritoneal reflections, namely ligaments, mesenteries and omenta. The most common sites where the peritoneal fluid may temporarily arrested facilitating implantation of cancer cells include cul-de-sac, distal small bowel mesentery, right paracolic gutter, posterior sub-hepatic space, greater omentum and subphrenic spaces. MDCT with thin collimation and i.v contrast material supplemented by multiplanar reconstructions is the primary imaging modality for the investigation of peritoneal carcinomatosis. Ascitis, contrast enhanced smooth, nodular, or plaque-like peritoneal thickening, peritoneal nodules, plaques or masses, rounded, ill-defined soft-tissue or cystic mesenteric masses, mesenteric fixation with increased attenuation values and thickening, irregular soft-tissue permeation of omental fat or confluent solid omental masses are the most frequent CT findings of peritoneal carcinomatosis. CT has a sensitivity and specificity between 85-95%, depending on the size, location and applied examination protocol. MR imaging using a post-gadolinium enhanced 3dFlASH sequence with fat saturation may alternatively

Evaluering af afdeling H

DEFF Research Database (Denmark)

Kjær Minke, Linda; Birkmose, Sofie Meldal

2016-01-01

Som led i Kriminalforsorgens flerårsaftale 2013-2016 blev det åbne statsfængsel Søbysøgård i januar 2015 udvidet med 42 lukkede pladser i den nybyggede afdeling H. Nærværende evaluering kortlægger de erfaringer personalet og indsatte har gjort sig i løbet af det første år. Etableringen af den...... lukkede fængselsafdeling H giver en unik mulighed for at følge henholdsvis hvilke faktorer, der bidrager til udvikling af fængselskultur, og hvordan de respektive faktorer influerer på udvikling af fængselskulturen. Evalueringens metoder består af kvalitative og kvantitative metoder såsom dokumentanalyse...

Overførsel af viden ved flytning af produktion

DEFF Research Database (Denmark)

Madsen, Erik Skov; Riis, Jens Ove; Wæhrens, Brian Vejrum

2010-01-01

Empiriske studier i tre industrielle virksomheder har afsløret, at selv virksomheder med mange års erfaring i at overføre produktion til andre lande hovedsagelig fokuserer på planlægning af den fysiske overflytning af produktionsudstyr og fokuserer på den eksplicitte viden, der er tilknyttet prod...

Peritoneal Dialysis in Children*

African Journals Online (AJOL)

1971-06-02

Jun 2, 1971 ... cellular fluid' into the peritoneal cavity allows both the removal of excess fluid ... occur. In adults the maximum peritoneal urea clearance is ob- tained with a dialysis ..... and Records. Pulse and respiration rates, temperature and blood .... diffusion of urea out of the brain cells, with consequent movement of ...

Test af Software

DEFF Research Database (Denmark)

Dette dokument udgør slutrapporten for netværkssamarbejdet ”Testnet”, som er udført i perioden 1.4.2006 til 31.12.2008. Netværket beskæftiger sig navnlig med emner inden for test af indlejret og teknisk software, men et antal eksempler på problemstillinger og løsninger forbundet med test af...... administrativ software indgår også. Rapporten er opdelt i følgende 3 dele: Overblik. Her giver vi et resumé af netværkets formål, aktiviteter og resultater. State of the art af software test ridses op. Vi omtaler, at CISS og netværket tager nye tiltag. Netværket. Formål, deltagere og behandlede emner på ti...

Implementering af MultifunC

DEFF Research Database (Denmark)

Henze-Pedersen, Sofie; Kohl, Katrine Syppli; Oldrup, Helene

(MultifunC), som allerede havde vist lovende resultater i Norge og Sverige. I 2011 og 2012 åbnede to danske MultifunC-institutioner derfor i henholdsvis København og Aarhus. Denne rapport undersøger, hvordan implementeringen af MultifunC-programmet er forløbet i Danmark. Undersøgelsen viser, at ingen af de...... to danske institutioner lykkedes med at implementere MultifunC tilfredsstillende i løbet af implementeringsperioden. Det har fx været vanskeligt at implementere det tætte tværfaglige samarbejde mellem medarbejdere med forskellige fagprofessionelle baggrunde, som behandlingsprogrammet indebærer. Det har...... desuden været særdeles vanskeligt for de danske MultifunC-institutioner at få etableret det eksterne samarbejde med de sociale myndigheder i kommunerne, politiet, skoler og praktiksteder samt fritidstilbud i nærområdet, som også er en væsentlig del af behandlingsprogrammet. Undersøgelsen af finansieret af...

Water and solute transport across the peritoneal membrane.

Science.gov (United States)

Morelle, Johann; Devuyst, Olivier