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https://www.readbyqxmd.com/read/28408712/peritoneal-dialysis-catheter-surgery-using-transversus-abdominis-plane-block
#1
Dean Markić, Božidar Vujičić, Mladen Ivanovski, Kristian Krpina, Antun Gršković, Dražen Rahelić, Nino Rubinić, Željko Župan, Hrvoje Lasić, Mauro Materljan, Sanjin Rački
♦Background: Peritoneal dialysis (PD) catheter surgery can be performed using regional anesthesia. We present our PD catheter placement and extraction experience using ultrasound-guided transversus abdominis plane (TAP) block. ♦ Methods: In the present study, we analyzed 74 patients from our center with end-stage renal disease (ESRD) who underwent PD catheter placement (60 patients) and removal (14 patients) using a TAP block between June 2011 and December 2015. ♦ Results: The TAP block was successful for 55/60 (91...
April 13, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28408711/a-randomized-controlled-trial-to-determine-the-appropriate-time-to-initiate-peritoneal-dialysis-after-insertion-of-catheter-timely-pd-study
#2
Dwarakanathan Ranganathan, George John, Edward Yeoh, Nicola Williams, Barry O'Loughlin, Thin Han, Lakshman Jeyaseelan, Ramanathan Kavitha, Helen Healy
♦Background: The optimal time for the commencement of peritoneal dialysis (PD) after PD catheter insertion is unclear. If dialysis is started too soon after insertion, dialysate leaks and infection could occur. However, by starting PD earlier, morbidity and costs can be reduced through lesser hemodialysis requirements. This is the first randomized controlled trial to determine the safest and shortest interval to commence PD after catheter insertion. ♦ Methods: All consecutive patients undergoing PD catheter insertion at the Royal Brisbane and Women's Hospital and Rockhampton Hospital from 1 March 2008 to 31 May 2013 who met the inclusion and exclusion criteria were invited to participate in the trial...
April 13, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28407419/antibiotic-treatment-of-biofilm-infections
#3
REVIEW
Oana Ciofu, Estrella Rojo-Molinero, María D Macià, Antonio Oliver
Bacterial biofilms are associated with a wide range of infections, from those related to exogenous devices, such as catheters or prosthetic joints, to chronic tissue infections such as those occurring in the lungs of cystic fibrosis patients. Biofilms are recalcitrant to antibiotic treatment due to multiple tolerance mechanisms (phenotypic resistance). This causes persistence of biofilm infections in spite of antibiotic exposure which predisposes to antibiotic resistance development (genetic resistance). Understanding the interplay between phenotypic and genetic resistance mechanisms acting on biofilms, as well as appreciating the diversity of environmental conditions of biofilm infections which influence the effect of antibiotics are required in order to optimize the antibiotic treatment of biofilm infections...
April 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28393968/-encapsulating-peritoneal-sclerosis
#4
Rubén Torres, Paula Ebner, María Eugenia Sanhueza, Miriam Alvo, Erico Segovia, Paula Segura
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is a complication of peritoneal dialysis (PD) with a low prevalence but high mortality. It is characterized by peritoneal inflammation and fibrosis with subsequent development of intestinal encapsulation. It is associated with a long lapse on PD, frequent episodes of peritonitis, high glucose solution use, and high peritoneal transport status. AIM: To report the clinical features of patients on PD, who developed EPS...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28390069/antimicrobial-agents-for-preventing-peritonitis-in-peritoneal-dialysis-patients
#5
REVIEW
Denise Campbell, David W Mudge, Jonathan C Craig, David W Johnson, Allison Tong, Giovanni Fm Strippoli
BACKGROUND: Peritoneal dialysis (PD) is an important therapy for patients with end-stage kidney disease and is used in more than 200,000 such patients globally. However, its value is often limited by the development of infections such as peritonitis and exit-site and tunnel infections. Multiple strategies have been developed to reduce the risk of peritonitis including antibiotics, topical disinfectants to the exit site and antifungal agents. However, the effectiveness of these strategies has been variable and are based on a small number of randomised controlled trials (RCTs)...
April 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28386935/exit-site-care-in-the-netherlands-the-use-of-guidelines-in-practice
#6
Bettie P Hoekstra, Anneke de Vries-Hoogsteen, Bieneke Winkels, Helma Zevenbergen-Osinga, Ingrid Thijssen-Broers, Trian Bellemakers
BACKGROUND: The aim of this paper is to describe the quality of exit site care by evaluating the use of the Dutch exit site guideline over a period of 15 years. METHOD: The special interest group (SIG) for peritoneal dialysis (PD) analysed results of three surveys concerning general exit site care among members of the Dutch Association for nurses and carers (V&VN), the dialysis and nephrology section. RESULTS: In 2002 (when no guidelines were available) the survey showed huge diversity in practice, with no definition of the post-operative period after catheter placement and no uniform monitoring of the exit site...
April 6, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28365266/effect-of-coronary-anatomy-and-hydrostatic-pressure-on-intracoronary-indices-of-stenosis%C3%A2-severity
#7
Tobias Härle, Mareike Luz, Sven Meyer, Kay Kronberg, Britta Nickau, Javier Escaned, Justin Davies, Albrecht Elsässer
OBJECTIVES: The authors sought to analyze height differences within the coronary artery tree in patients in a supine position and to quantify the impact of hydrostatic pressure on intracoronary pressure measurements in vitro. BACKGROUND: Although pressure equalization of the pressure sensor and the systemic pressure at the catheter tip is mandatory in intracoronary pressure measurements, subsequent measurements may be influenced by hydrostatic pressure related to the coronary anatomy in the supine position...
March 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28360373/successful-treatment-of-pd-peritonitis-due-to-morganella-morganii-resistant-to-third-generation-cephalosporins-a-case-report
#8
Vaibhav Keskar, Mohan Biyani, Syed Obaid Amin, Greg Knoll
Morganella morganii is a rare cause of peritonitis in patients on peritoneal dialysis (PD). Most of the reported cases have resorted to a switch to hemodialysis. We herein report a case of peritonitis due to M. morganii resistant to third-generation cephalosporins, which was treated successfully with intraperitoneal (IP) tobramycin followed by oral ciprofloxacin. Early microbiologic diagnosis is essential in the treatment of peritonitis from rare microorganisms such as Morganella morganii, and appropriate antibiotic therapy is the key to avoiding catheter loss and subsequent switch to hemodialysis...
March 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28360368/the-pull-technique-for-removal-of-peritoneal-dialysis-catheters-a-call-for-re-evaluation-of-practice-standards
#9
Marvin Grieff, Elizabeth Mamo, Gina Scroggins, Alexander Kurchin
♦ BACKGROUND: The most commonly used peritoneal dialysis (PD) catheters have silicon tubing with attached Dacron cuffs. The current standard of care for PD catheter removal is by complete surgical dissection, withdrawing both the tubing and the cuffs. The intention is to avoid infection of any residual part of the catheter. We retrospectively analyzed our results with the alternative 'pull' technique, by which the silicon tube is pulled out, leaving the Dacron cuffs within the abdominal wall. This technique never gained popularity due to concern that the retained cuffs would get infected...
March 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28352029/the-mystery-of-the-nonfunctioning-catheter-an-unusual-complication-of-peritoneal-dialysis-outflow-failure
#10
Pramod K Guru, Beth Piraino
Noninfectious complications of peritoneal dialysis (PD) remain an important impediment to successful implementation of PD. Rare noninfectious complications of the PD catheter are sparsely reported. We report an unusual complication of outflow failure due to a peritoneal catheter that separated into two distinct intra-abdominal segments, due to an unusual method of placement in which two catheters were connected to make a long intra-abdominal portion to permit a high exit site on the abdominal wall. The application of this unusual rather a unique technique led to separation of the two catheter portions and the outflow failure shortly after the patient started continuous ambulatory PD...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28339843/availability-and-cost-of-extracorporeal-treatments-for-poisonings-and-other-emergency-indications-a-worldwide-survey
#11
Josée Bouchard, Valery Lavergne, Darren M Roberts, Monique Cormier, Genevieve Morissette, Marc Ghannoum
Background: Extracorporeal treatments (ECTRs) are used for different conditions, including replacement of organ function and poisoning. Current recommendations for ECTRs in various poisonings suggest that intermittent haemodialysis (IHD) is the most efficient technique. However, the practicality of these recommendations is poorly defined in view of limited information on availability and cost worldwide. Methods: A survey invitation to an Internet-based questionnaire was emailed between January 2014 and March 2015 to members of international societies to determine the availability, time to initiation and cost of ECTRs (including filters, dialysate, catheter, anticoagulant and nursing/physician salary)...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339647/detection-of-human-immunodeficiency-virus-1-ribonucleic-acid-in-the-peritoneal-effluent-of-renal-failure-patients-on-highly-active-antiretroviral-therapy
#12
Kwazi C Z Ndlovu, Wilbert Sibanda, Alain Assounga
Background.: We evaluated the shedding of human immunodeficiency virus (HIV)-1 particles into continuous ambulatory peritoneal dialysis (CAPD) effluents of HIV-positive patients with end-stage renal disease (ESRD). Methods.: A total of 58 HIV-positive patients with ESRD on highly active antiretroviral therapy (HAART) who had Tenckhoff catheters inserted between September 2012 and February 2015 were prospectively reviewed and followed for 18 months. Peritoneal dialysis (PD) effluent samples from functioning CAPD catheters and plasma samples were obtained at three points during regular clinic visits on days 45 ± 37, 200 ± 19 and 377 ± 13 after catheter insertion...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28297057/dialysis-access-issues-related-to-conversion-from-peritoneal-dialysis-to-hemodialysis-and-vice-versa
#13
Maurizio Gallieni, Antonino Giordano, Anna Ricchiuto, Davide Gobatti, Maurizio Cariati
ABSTRACTHemodialysis (HD) and peritoneal dialysis (PD) represent two complementary modalities of renal replacement therapy (RRT) for end-stage renal disease patients. Conversion between the two modalities is frequent and more likely to happen from PD to HD. Every year, 10% of PD patients convert to HD, suggesting the need for recommendations on how to proceed with the creation of a vascular access in these patients. Criteria for selecting patients who would likely fail PD, and therefore take advantage of a backup access, are undefined...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28284758/urgent-start-peritoneal-dialysis-complications-prevalence-and%C3%A2-risk-factors
#14
Damin Xu, Tianjiao Liu, Jie Dong
BACKGROUND: Mechanical complications are of particular concern in urgent-start peritoneal dialysis (PD) because of the shorter break-in period. However, risk factors have been reported inconsistently and data in urgent-start PD populations are limited. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: All patients treated with urgent-start PD, defined as PD therapy initiated within 1 week after catheter insertion, January 2003 to May 2013...
March 8, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28279412/image-guided-approach-to-peritoneal-dialysis-catheter-placement
#15
Igor Latich, Randy L Luciano, Ali Mian
Peritoneal dialysis (PD) is a vastly underused form of renal replacement therapy that offers great flexibility to the patient, breaks the cycle of tri-weekly visits to a hemodialysis center, and is associated with fewer interventions to maintain functional dialysis access. PD catheter placement allows for urgent initiation of dialysis and minimizes the unnecessary use of temporary vascular access catheters. Image-guided placement of a PD catheter by interventional radiologists that combines ultrasound and fluoroscopy is an elegant, cost saving, safe, less invasive, and at least as effective an option when compared with traditional surgical placement...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28241247/peritoneal-dialysis-vs-furosemide-for-prevention-of-fluid-overload-in-infants-after-cardiac-surgery-a-randomized-clinical-trial
#16
David M Kwiatkowski, Stuart L Goldstein, David S Cooper, David P Nelson, David L S Morales, Catherine D Krawczeski
Importance: Fluid overload after congenital heart surgery is frequent and a major cause of morbidity and mortality among infants. Many programs have adopted the use of peritoneal dialysis (PD) for fluid management; however, its benefits compared with those of traditional diuretic administration are unknown. Objective: To determine whether infants randomized to PD vs furosemide for the treatment of oliguria have a higher incidence of negative fluid balance on postoperative day 1, as well as avoidance of 10% fluid overload; shorter duration of mechanical ventilation, intensive care unit stay, and inotrope use; and fewer electrolyte abnormalities...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28240802/impact-of-pay-for-performance-on-access-at-first-dialysis-in-queensland
#17
Jennie Haarsager, Rathika Krishnasamy, Nicholas A Gray
AIM: Commencement of haemodialysis with an arteriovenous fistula (AVF) or arteriovenous graft (AVG) is associated with improved survival compared with commencement with a central venous catheter. In 2011-12, Queensland Health made incentive payments to renal units for early referred patients who commenced peritoneal dialysis (PD), or haemodialysis with an AVF/AVG. The aim of this study was to determine if pay-for-performance improved clinical care. METHODS: All patients who commenced dialysis in Australia between 2009 and 2014 and were registered with the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) were included...
February 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28237984/effect-of-a-quality-improvement-program-to-improve-guideline-adherence-and-attainment-of-clinical-standards-in-dialysis-care-report-of-outcomes-in-year-1
#18
Sajeda Youssouf, Azri Nache, Chandrakumaran Wijesekara, Rachel J Middleton, David Lewis, Aladdin E Shurrab, Edmond O'Riordan, Lesley P Lappin, Donal O'Donoghue, Philip A Kalra, Janet Hegarty
BACKGROUND: Best practice in dialysis is synthesised in clear international guidelines. However, a large gap remains between the international guidelines and the actual delivery of care. In this paper, we report outcomes for the first year of a multifaceted dialysis improvement programme in our network. METHODS: One year collaborative involving 3 haemodialysis units and a peritoneal dialysis (PD) programme involving 299 dialysis patients. Each unit addressed a different indicator (unit A - catheter-related bloodstream infection [CRBSI], unit B - pre-dialysis blood pressure [BP], unit C - dialysis dose, unit D - anaemia) with a shared aim to match the top 10% in the UK...
February 25, 2017: Nephron
https://www.readbyqxmd.com/read/28218354/dialysis-access-infections-and-hospitalisations-in-unplanned-dialysis-start-patients-results-from-the-options-study
#19
Anna Machowska, Mark D Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul R Qureshi, Bengt Lindholm, Peter Rutherford
INTRODUCTION: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients. METHODS: In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients...
February 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28198656/fungicidal-activity-and-pk-pd-of-caspofungin-as-tools-to-guide-antifungal-therapy-in-a-fluconazole-resistant-c-parapsilosis-candidemia
#20
Carlo Tascini, Emanuela Sozio, Antonello Di Paolo, Giancarlo Tintori, Alessandro Leonildi, Giacomo Bertolino, Franco Carmassi, Enrico Tagliaferri, Francesco Menichetti, Francesco Barchiesi
Candida parapsilosis may be responsible for bloodstream infections (BSI) and it is characterised by an increased incidence of fluconazole resistance. A 75-year old woman with severe comorbidities received the insertion of a peripherally inserted central venous catheter. Fluconazole did not prevent a C. parapsilosis BSI hence caspofungin was started after a nephrotoxic first-line treatment with amphotericin B. The ratio of peak plasma concentration over the minimum inhibitory concentration (Cmax/MIC) was adopted to maximise efficacy of caspofungin...
February 15, 2017: Journal of Chemotherapy
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