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Peritonitis Guideline

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https://www.readbyqxmd.com/read/29773326/tremelimumab-combined-with-durvalumab-in-patients-with-mesothelioma-nibit-meso-1-an-open-label-non-randomised-phase-2-study
#1
Luana Calabrò, Aldo Morra, Diana Giannarelli, Giovanni Amato, Armida D'Incecco, Alessia Covre, Arthur Lewis, Marlon C Rebelatto, Riccardo Danielli, Maresa Altomonte, Anna Maria Di Giacomo, Michele Maio
BACKGROUND: Tremelimumab, an anti-CTLA4 monoclonal antibody, initially showed good activity when used alone in patients with mesothelioma, but did not improve the overall survival of patients who failed on first-line or second-line chemotherapy compared with placebo in the DETERMINE study. We aimed to investigate the efficacy and safety of first-line or second-line tremelimumab combined with durvalumab, an anti-PD-L1 monoclonal antibody, in patients with malignant mesothelioma. METHODS: In this open-label, non-randomised, phase 2 trial, patients with unresectable pleural or peritoneal mesothelioma received intravenous tremelimumab (1 mg/kg bodyweight) and durvalumab (20 mg/kg bodyweight) every 4 weeks for four doses, followed by maintenance intravenous durvalumab at the same dose and schedule for nine doses...
May 14, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29753403/clinical-studies-of-interventions-to-mitigate-cardiovascular-risk-in-peritoneal-dialysis-patients
#2
REVIEW
Dev Jegatheesan, Yeoungjee Cho, David W Johnson
Cardiovascular disease (CVD) is highly prevalent in the peritoneal dialysis (PD) population, affecting up to 60% of cohorts. CVD is the primary cause of death in up to 40% of PD patients in Australia, New Zealand, and the United States. Cardiovascular mortality rates are reported to be approximately 14 per 100 patient-years, which are 10- to 20-fold greater than those of age- and sex-matched controls. The excess risk of CVD is related to a combination of traditional risk factors (such as hypertension, dyslipidemia, obesity, smoking, sedentary lifestyle, and insulin resistance), nontraditional (kidney disease-related) risk factors (such as anemia, chronic volume overload, inflammation, malnutrition, hyperuricemia, and mineral and bone disorder), and PD-specific risk factors (such as dialysis solutions, glycation end products, hypokalemia, residual kidney function, and ultrafiltration failure)...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29746497/peritoneal-dialysis-related-peritonitis-caused-by-pseudomonas-species-insight-from-a-post-millennial-case-series
#3
Wanhong Lu, Bonnie Ching-Ha Kwan, Kai Ming Chow, Wing-Fai Pang, Chi Bon Leung, Philip Kam-To Li, Cheuk Chun Szeto
BACKGROUND: 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. METHODS: We reviewed the clinical course and treatment response of 153 consecutive episodes of PD peritonitis caused by Pseudomonas species from 2001 to 2015. RESULTS: Pseudomonas peritonitis accounted for 8.3% of all peritonitis episodes...
2018: PloS One
https://www.readbyqxmd.com/read/29740065/comparison-of-first-line-and-second-line-terlipressin-versus-sole-norepinephrine-in-fulminant-ovine-septic-shock
#4
Tim G Kampmeier, Philip H Arnemann, Michael Hessler, Laura M Seidel, Karsten Becker, Andrea Morelli, Sebastian W Rehberg, Christian Ertmer
The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V1 -selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study explored and compared the effects of first-line vs. second-line infusion of TP or sole norepinephrine regarding organ function, fluid and norepinephrine requirements and survival in fulminant ovine septic shock. Peritoneal sepsis was induced in 23 ewes after laparotomy and faecal withdrawal from the caecum...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29725741/-metabolic-management-and-nutrition-in-critically-ill-patients-with-renal-dysfunction-recommendations-from-the-renal-section-of-the-dgiin-%C3%A3-giain-and-divi
#5
W Druml, M Joannidis, S John, A Jörres, M Schmitz, J Kielstein, D Kindgen-Milles, M Oppert, V Schwenger, C Willam, A Zarbock
BACKGROUND: Intensive care patients with renal failure or insufficiency comprise a heterogeneous group of subjects with widely differing metabolic patterns and nutritional requirements. They include subjects with various stages of acute kidney injury (AKI), acute-on-chronic renal failure (A-CKD), without/with renal replacement therapy (RRT), chronic kidney disease (CKD), and subjects on regular hemodialysis or peritoneal dialysis therapy (HD/PD). GOALS: Development of recommendations by the renal section of DGIIN (Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichische Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin) for the metabolic management and the planning, indication, implementation, and monitoring of nutrition therapy in this heterogeneous group of patients...
May 3, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29721399/emergency-management-of-spontaneous-bacterial-peritonitis-a-clinical-review
#6
REVIEW
Tracy MacIntosh
Spontaneous bacterial peritonitis (SBP) has a high mortality rate; early antimicrobial therapy is essential for improving patient outcomes. Given that cirrhotic patients are often coagulopathic, the perceived risk of bleeding may prevent providers from performing a paracentesis and ruling out this potentially deadly disease. We examine the pathophysiology and risk factors for SBP, and current guidelines for its diagnosis and treatment. We then review the time-sensitive nature of performing a paracentesis, and the current controversies and contraindications for performing this procedure in patients at risk for SBP...
March 1, 2018: Curēus
https://www.readbyqxmd.com/read/29706252/gadolinium-based-contrast-agents-in-kidney-disease-comprehensive-review-and-clinical-practice-guideline-issued-by-the-canadian-association-of-radiologists
#7
REVIEW
Nicola Schieda, Jason I Blaichman, Andreu F Costa, Rafael Glikstein, Casey Hurrell, Matthew James, Pejman Jabehdar Maralani, Wael Shabana, An Tang, Anne Tsampalieros, Christian van der Pol, Swapnil Hiremath
Use of gadolinium-based contrast agents (GBCAs) in renal impairment is controversial, with physician and patient apprehension in acute kidney injury (AKI), chronic kidney disease (CKD), and dialysis because of concerns regarding nephrogenic systemic fibrosis (NSF). The position that GBCAs are absolutely contraindicated in AKI, CKD stage 4 or 5 (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m2 ) and dialysis-dependent patients is outdated, and may limit access to clinically necessary contrast-enhanced MRI examinations...
May 2018: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/29682387/surgical-management-of-encapsulating-peritoneal-sclerosis-a-case-report-in-kidney-transplant-patient
#8
R Shahbazov, M Talanian, J L Alejo, F Azari, A Agarwal, K L Brayman
Introduction: Encapsulating peritoneal sclerosis (EPS) is a clinical syndrome of progressive fibrotic change in response to prolonged, repetitive, and typically severe insult to the peritoneal mesothelium, often occurring in the setting of peritoneal dialysis (PD). Clear guidelines for successful management remain elusive. We describe the successful surgical management of EPS in a 28-year-old male s/p deceased donor kidney transplant for end-stage renal disease (ESRD) secondary to focal segmental glomerulosclerosis (FSGS)...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29664179/developing-and-pilot-testing-a-shared-decision-making-intervention-for-dialysis-choice
#9
Jeanette Finderup, Jens K D Jensen, Kirsten Lomborg
BACKGROUND: Evidence is inconclusive on how best to guide the patient in decision-making around haemodialysis and peritoneal dialysis choice. International guidelines recommend involvement of the patient in the decision to choose the dialysis modality most suitable for the individual patient. Nevertheless, studies have shown lack of involvement of the patient in decision-making. OBJECTIVES: To develop and pilot test an intervention for shared decision-making targeting the choice of dialysis modality...
April 17, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/29658839/comparison-of-emergency-cholecystectomy-with-delayed-cholecystectomy-after-percutaneous-transhepatic-gallbladder-drainage-in-patients-with-moderate-acute-cholecystitis
#10
Chang-Wei Ke, Shuo-Dong Wu
INTRODUCTION: Patients with moderate (grade II) acute cholecystitis patients, as defined by the 2013 Tokyo Guidelines, were retrospectively compared with respect to emergency cholecystectomy (EC) and delayed cholecystectomy (DC) after percutaneous transhepatic gallbladder drainage (PTGBD) to determine the better treatment strategy. METHODS: Forty-nine of 103 patients with PTGBD and 47 of 54 patients with EC were assessed for eligibility from January 2013 to January 2017...
April 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29650928/-conversion-surgery-after-etoposide-cisplatin-ep-therapy-for-huge-pancreatic-neuroendocrine-carcinoma-a-case-report
#11
Akiko Nakazawa, Tetsuya Mitsui, Yoichi Miyata, Riki Ninomiya, Masahiko Komagome, Akira Maki, Fumiaki Ozawa, Yoshifumi Beck
Neuroendocrine carcinoma(NEC)is known as rapid tumor growth, high grade malignancy and poor prognosis. We report a case of huge pancreatic NEC successfully performed conversion surgery after EP therapy. A 70-year-old female, was presented to our hospital with appetite loss. CT scan revealed huge tumor, 15 cm in diameter, locating at the pancreas with possible involvement to liver, stomach, common hepatic artery, left gastric artery and gastroduodenal artery. Peritoneal dissemination and para-aortic lymph node metastasis were also suspected...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650921/-a-case-of-laparoscopic-whole-layer-cholecystectomy-for-elevated-lesion-suspected-biliary-cancer
#12
Yosuke Ishihara, Kei Naito, Koji Miyagawa, Satoshi Kataoka, Nobuaki Fuji
A case of attempted laparoscopic cholecystectomy for elevated lesion which was clearly early biliary cancer. Laparoscopic cholecystectomy has become popular as a minimally invasive surgical method, and is the primary choice for benign diseases. However for cases of suspected biliary cancer, open cholecystectomy, rather than laparoscopic, is recommended according to medical guidelines. The reason for this is that in cases of damage to the gallbladder, bile spillage to the abdominal cavity may occur, leading to port site recurrence and peritoneal recurrence...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29644071/clinical-management-of-patients-on-peritoneal-dialysis-in-italy-results-from-the-atena-study
#13
Carlo Crepaldi, Alessandro Possidoni, Flavia Caputo, Roberto Dell'Aquila, Emilio Giulio Galli, Anna Maria Costanzo, Giuliana Gualberti, Umberto di Luzio Paparatti, Roberto Russo
Background: In Italy, few studies have examined the clinical management of peritoneal dialysis (PD) patients, resulting in a lack of information and awareness. Methods: A total of 378 PD patients (64.7 ± 14.3 years, 58.9% males) were enrolled across 15 centres in a 12-month retrospective and 6-month prospective study. The primary objective was to evaluate the achievement of Kidney Disease Outcomes Quality Initiative and Kidney Disease Improving Global Outcomes guidelines on recommended target values for anaemia, high blood pressure and mineral metabolism...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29572704/prognostic-impact-of-r0-resection-and-targeted-therapy-for-colorectal-cancer-with-synchronous-peritoneal-metastasis
#14
Dai Shida, Takefumi Yoshida, Taro Tanabe, Shunsuke Tsukamoto, Hiroki Ochiai, Yukihide Kanemitsu
BACKGROUND: The National Comprehensive Cancer Network guidelines recommend R0 resection and targeted therapy, a combination of cytotoxic and molecular targeted agents, such as bevacizumab, cetuximab, and panitumumab, for colorectal cancer with synchronous peritoneal metastasis (M1c). While these therapeutic strategies are drawing attention, their efficacy has not been fully examined. METHODS: The study population comprised 248 consecutive M1c patients who were treated at the National Cancer Center Hospital from 1997 to 2013...
March 23, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29551300/-first-line-management-without-ivf-of-infertility-related-to-endometriosis-result-of-medical-therapy-results-of-ovarian-superovulation-results-of-intrauterine-insemination-cngof-has-endometriosis-guidelines
#15
J Boujenah, P Santulli, E Mathieu-d'Argent, C Decanter, C Chauffour, P Poncelet
INTRODUCTION: Using the structured methodology of French guidelines (HAS-CNGOF), the aim of this chapter was to formulate good practice points (GPP), in relation to optimal non-ART management of endometriosis related to infertility, based on the best available evidence in the literature. MATERIALS AND METHODS: This guideline was produced by a group of experts in the field including a thorough systematic search of the literature (from January 1980 to March 2017)...
March 15, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29545085/synchronous-metastatic-gastric-cancer-molecular-background-and-clinical-implications-with-special-attention-to-mismatch-repair-deficiency
#16
Karol Polom, Christine Böger, Elizabeth Smyth, Daniele Marrelli, Hans-Michael Behrens, Luigi Marano, Thomas Becker, Florian Lordick, Christoph Röcken, Franco Roviello
BACKGROUND: Current guidelines recommend that metastatic gastric cancer should not be treated with surgery unless this is required for symptom control. We hypothesized that patients with mismatch repair deficiency (MMRd) gastric cancer and metastatic disease detected at the timepoint of surgical resection would have superior survival compared to patients with MMRd cancers in the same setting. METHODS: Clinicopathological details and survival data were collected from prospective databases at two large European centers on patients who had undergone surgery and were diagnosed with synchronous stage IV gastric cancer (distant lymph nodes, positive peritoneal cytology, peritoneal, and distant metastases) at the timepoint of surgery...
March 2, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29544710/-deeply-infiltrating-endometriosis-and-infertility-cngof-has-endometriosis-guidelines
#17
E Mathieu d'Argent, J Cohen, C Chauffour, J L Pouly, J Boujenah, C Poncelet, C Decanter, P Santulli
Deeply infiltrating endometriosis is a severe form of the disease, defined by endometriotic tissue peritoneal infiltration. The disease may involve the rectovaginal septum, uterosacral ligaments, digestive tract or bladder. Deeply infiltrating endometriosis is responsible for disabling pain and infertility. The purpose of these recommendations is to answer the following question: in case of deeply infiltrating endometriosis associated infertility, what is the best therapeutic strategy? First-line surgery and then in vitro fertilization (IVF) in case of persistent infertility or first-line IVF, without surgery? After exhaustive literature analysis, we suggest the following recommendations: studies focusing on spontaneous fertility of infertile patients with deeply infiltrating endometriosis found spontaneous pregnancy rates about 10%...
March 12, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29544111/competition-of-charge-mediated-and-specific-binding-by-peptide-tagged-cationic-liposome-dna-nanoparticles-in-vitro-and-in-vivo
#18
Emily Wonder, Lorena Simón-Gracia, Pablo Scodeller, Ramsey N Majzoub, Venkata Ramana Kotamraju, Kai K Ewert, Tambet Teesalu, Cyrus R Safinya
Cationic liposome-nucleic acid (CL-NA) complexes, which form spontaneously, are a highly modular gene delivery system. These complexes can be sterically stabilized via PEGylation [PEG: poly (ethylene glycol)] into nanoparticles (NPs) and targeted to specific tissues and cell types via the conjugation of an affinity ligand. However, there are currently no guidelines on how to effectively navigate the large space of compositional parameters that modulate the specific and nonspecific binding interactions of peptide-targeted NPs with cells...
June 2018: Biomaterials
https://www.readbyqxmd.com/read/29530346/quality-of-life-and-cost-effectiveness-in-a-randomized-trial-of-patients-with-colorectal-cancer-and-peritoneal-metastases
#19
P H Cashin, H Mahteme, I Syk, J E Frödin, B Glimelius, W Graf
BACKGROUND: The aim was to compare health-related quality-of-life (HRQOL) and cost-effectiveness between cytoreductive surgery with intraperitoneal chemotherapy (CRS + IPC) and systemic chemotherapy for patients with colorectal peritoneal metastases. METHODS: Patients included in the Swedish Peritoneal Trial comparing CRS + IPC and systemic chemotherapy completed the EORTC QLQ-C30 and SF-36 questionnaires at baseline, 2, 4, 6, 12, 18, and 24 months. HRQOL at 24 months was the primary endpoint...
February 21, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29525273/appropriate-use-of-total-parenteral-nutrition-in-children-with-perforated-appendicitis
#20
Yasmine Yousef, Fouad Youssef, Michael Homsy, Trish Dinh, Hayden Stagg, Robin Petroze, Robert Baird, Jean-Martin Larberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
BACKGROUND: Total parenteral nutrition (TPN) is often used in children with perforated appendicitis, despite the absence of clear indications. We assessed the validity of specific clinical indications for initiation of TPN in this patient cohort. METHODS: Data were gathered prospectively on duration of nil per os (NPO) status and TPN use in a cohort of children treated under a perforated appendicitis protocol during a 19-month period. TPN was started in the immediate postoperative period in patients who had generalized peritonitis and severe intestinal dilatation at operation, or later per the discretion of the attending surgeon...
May 2018: Journal of Pediatric Surgery
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