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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
#1
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
https://www.readbyqxmd.com/read/28183858/comparison-of-topical-chlorhexidine-and-mupirocin-for-the-prevention-of-exit-site-infection-in-incident-peritoneal-dialysis-patients
#2
Htay Htay, David W Johnson, Sin Yan Wu, Elizabeth L Oei, Marjorie Wai Yin Foo, Jason C Choo
♦ Objective: Prevention of exit-site infection (ESI) is of paramount importance to peritoneal dialysis (PD) patients. The aim of this study was to evaluate the effectiveness of chlorhexidine in the prevention of ESI in incident PD patients compared with mupirocin. ♦ Methods: This retrospective, pre-test/post-test observational study included all incident PD patients at Singapore General Hospital from 2012 to 2015. Patients received daily topical exit-site application of either mupirocin (2012 - 2013) or chlorhexidine (2014 - 2015) in addition to routine exit-site cleaning with 10% povidone-iodine...
February 9, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28178895/repetitive-urine-and-blood-sampling-in-neonatal-and-weaned-piglets-for-pharmacokinetic-and-pharmacodynamic-modelling-in-drug-discovery-a-pilot-study
#3
Elke Gasthuys, Stijn Schauvliege, Thomas van Bergen, Joske Millecam, Ilaria Cerasoli, Ann Martens, Frank Gasthuys, Tim Vandecasteele, Pieter Cornillie, Wim Van den Broeck, Filip Boyen, Siska Croubels, Mathias Devreese
Piglets are considered to be suitable animal models for predicting the pharmacokinetics and pharmacodynamics (PK/PD) of test drugs for potential use in the paediatric population. Such PK/PD studies require multiple blood and urine samplings. The goal of the present study was to determine a suitable blood collection strategy applicable in the youngest age categories of six days, four weeks and eight weeks of age, as well as a urine collection technique for male piglets in the same age categories. Blood was collected either by a surgically-placed jugular vein catheter (six days old [ n = 4] and four weeks old [ n = 2] piglets) or by direct venepuncture of the jugular vein (four weeks old [ n = 2] and eight weeks old [ n = 4] piglets)...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28153190/acute-pd-evidence-guidelines-and-controversies-%C3%A2
#4
REVIEW
Daniela Ponce, Andre Balbi, Brett Cullis
Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#5
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
February 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28122398/comparison-between-types-of-dressing-following-catheter-insertion-and-early-exit-site-infection-in-peritoneal-dialysis
#6
Ana Elizabeth Figueiredo, Carolina de Mattos, Cristine Saraiva, Marcia Olandoski, Pasqual Barretti, Roberto Pecoits Filho, Thyago Proença de Moraes
AIM: To investigate whether the type of dressing used (occlusive vs semi-occlusive) impacts on exit-site infection (ESI). BACKGROUND: Exit-site infections are a major predisposing factor for peritoneal dialysis (PD)-related peritonitis, the main cause of technique failure and an important cause of mortality. Care taken in exit-site dressing is considered an important procedure for the prevention of trauma and contamination of this area. Nevertheless, to our knowledge, no study has yet analyzed the impact of different dressing types on early ESI (up to 2 months after catheter insertion)...
January 25, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28114140/peritoneal-dialysis-treatment-modality-option-in-acute-kidney-injury
#7
Daniela Ponce, Mariele Gobo-Oliveira, Andre Luís Balbi
BACKGROUND: Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. SUMMARY: The interest in PD to manage AKI patients has been increased and PD is now frequently used in developing countries because of its lower cost and minimal infrastructural requirements...
January 24, 2017: Blood Purification
https://www.readbyqxmd.com/read/28096441/improved-outcome-of-enteric-peritonitis-in-peritoneal-dialysis-patients-aged-50-years-and-older-with-temporary-discontinuation-of-peritoneal-dialysis-and-intravenous-meropenem
#8
Alferso C Abrahams, Wim Rüger, Pieter M Ter Wee, Frans J van Ittersum, Walther H Boer
♦ 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)...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28096438/infection-prophylaxis-in-peritoneal-dialysis-patients-results-from-an-australia-new-zealand-survey
#9
Denise J Campbell, David W Mudge, Martin P Gallagher, Wai H Lim, Ranganathan Dwarakanathan, Walaa Saweirs, Jonathan C Craig
♦ Background: Clinical practice guidelines aim to reduce the rates of peritoneal dialysis (PD)-related infections, a common complication of PD in end-stage kidney disease patients. We describe the clinical practices used by Australian and New Zealand nephrologists to prevent PD-related infections in PD patients. ♦ Methods: A survey of PD practices in relation to the use of antibiotic and antifungal prophylaxis in PD patients was conducted of practicing nephrologists identified via the Australia and New Zealand Society of Nephrology (ANZSN) membership in 2013...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28086826/offering-patients-therapy-options-in-unplanned-start-options-implementation-of-an-educational-program-is-feasible-and-effective
#10
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter Rutherford
BACKGROUND: Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. METHODS: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28066919/innovations-in-treatment-delivery-risk-of-peritonitis-and-patient-retention-on-peritoneal-dialysis
#11
Beth Piraino
Early innovations in the delivery of peritoneal dialysis (PD) markedly improved its acceptability and lowered peritonitis rates. The standard osmotic agent was, and continues to be dextrose, an agent that is not ideal as it is readily absorbed. The development of icodextrin-containing dialysis fluid has allowed a long dwell time to provide more effective ultrafiltration. The development of a smaller, more easily used automated cycler, led to an increase in the proportion of patients on the cycler as opposed to CAPD...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28046874/su-f-p-46-comparative-study-between-two-normalization-prescriptions-for-accelerated-partial-breast-irradiation-a-dosimetric-study
#12
P Agarwal, D Sharma, A Gandhi, A Binjola, V Subramani, S Chander
PURPOSE: To compare the Accelerated Partial Breast Irradiation (APBI) plan with the normalized basal dose points and 5mm box prescription. METHODS: Five patients of APBI were planned twice in Oncentra Master planning TPS (Version 4.3) using TG-43 algorithm. The number of catheters for all the patients was 10 to 16 and implant plane 2 to 3. For planning all catheters were reconstructed. Source loading was done as per HR-CTV contoured. The HR-CTV volume range was from 75cc to 182cc...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046469/th-ab-bra-04-dosimetric-evaluation-of-mr-guided-hdr-brachytherapy-planning-for-cervical-cancer
#13
Y Kamio, M Barkati, D Beliveau-Nadeau
PURPOSE: To perform a retrospective study on 16 patients that had both CT and T2-weighted MR scans done at first fraction using the Utrecht CT/MR applicator (Elekta Brachytherapy) in order to evaluate uncertainties associated with an MR-only planning workflow. METHODS: MR-workflow uncertainties were classified in three categories: reconstruction, registration and contouring. A systematic comparison of the CT and MR contouring, manual reconstruction and optimization process was performed to evaluate the impact of these uncertainties on the recommended GEC ESTRO DVH parameters: D90% and V100% for HR-CTV as well as D2cc for bladder, rectum, sigmoid colon and small bowel...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28033679/peritoneal-dialysis-registry-with-2013-survey-report
#14
Ikuto Masakane, Takeshi Hasegawa, Satoshi Ogata, Naoki Kimata, Shigeru Nakai, Norio Hanafusa, Takayuki Hamano, Kenji Wakai, Atsushi Wada, Kosaku Nitta
Since 2009, the peritoneal dialysis (PD) registry has been carried out as part of the annual nationwide survey conducted by the Statistical Survey Committee of the Japanese Society for Dialysis Therapy with the cooperation of the Japanese Society for Peritoneal Dialysis. In this study, the current status of PD patients is reported on the basis of the results of the survey conducted at the end of 2013. The subjects were PD patients who lived in Japan and participated in the 2013 survey. Descriptive analysis was performed for various items including the current status of the combined use of PD and another dialysis method such as hemodialysis (HD) or hemodiafiltration (HDF), the method of exchanging dialysate, the use of an automated peritoneal dialysis (APD) machine, and the incidences of peritonitis and catheter exit-site infection...
December 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28007763/early-and-late-patient-outcomes-in-urgent-start-peritoneal-dialysis
#15
Emily J See, Yeoungjee Cho, Carmel M Hawley, Lauren R Jaffrey, David W Johnson
♦ Background: Significant interest in the practice of urgent-start peritoneal dialysis (PD) is mounting internationally, with several observational studies supporting the safety, efficacy, and feasibility of this approach. However, little is known about the early complication rates and long-term technique and peritonitis-free survival for patients who start PD urgently (i.e. within 2 weeks of catheter insertion), compared to those with a conventional start. ♦ Methods: This single-center, matched case-control study evaluated patients commencing PD between 2010 and 2015...
December 22, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27987228/pharmacokinetics-and-pharmacodynamics-of-intrathecally-administered-xen2174-a-synthetic-conopeptide-with-norepinephrine-reuptake-inhibitor-and-analgesic-properties
#16
Pieter Okkerse, Justin L Hay, Elske Sitsen, Albert Dahan, Erica Klaassen, William Houghton, Geert Jan Groeneveld
AIM: Xen2174 is a synthetic 13-amino acid peptide that binds specifically to the norepinephrine transporter, which results in inhibition of norepinephrine uptake. It is being developed as a possible treatment for moderate to severe pain and is delivered intrathecally. The current study was performed to assess the pharmacodynamics (PD) and the cerebrospinal fluid (CSF) pharmacokinetics (PK) of Xen2174 in healthy subjects. METHODS: This was a randomized, blinded, placebo-controlled study in healthy subjects...
November 2, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27974935/the-time-for-surgery-of-peritonitis-associated-with-peritoneal-dialysis
#17
Mihalache O, Bugă C, Doran H, Catrina E, Bobircă F, Andreescu A, Mustățea P, Pătrașcu T
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...
July 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27951553/nephrologist-initiated-peritoneal-dialysis-catheter-insertion-programme-a-new-paradigm-shift
#18
Bak-Leong Goh
BACKGROUND: The success rate of peritoneal dialysis (PD) catheter insertion is known to vary among different operators and may be influenced by many factors such as patient and various situational factors. Traditionally, surgeons have inserted Tenckhoff catheters by mini-laparotomy or an open technique. However, with recent advances in endoscopic instrumentation and video capabilities, peritoneoscope Tenckhoff catheter insertion has become a viable approach in interventional nephrologist-initiated PD access programmes...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27935534/representativeness-of-honeypot-trial-participants-to-australasian-pd-patients
#19
Lei Zhang, Sunil V Badve, Elaine M Pascoe, Elaine Beller, Alan Cass, Carolyn Clark, Janak de Zoysa, Nicole M Isbel, Xusheng Liu, Steven McTaggart, Alicia T Morrish, Geoffrey Playford, Anish Scaria, Paul Snelling, Liza A Vergara, Carmel M Hawley, David W Johnson
♦ Background: The HONEYPOT trial failed to establish the superiority of exit-site application of Medihoney compared with nasal mupirocin prophylaxis for the prevention of peritonitis in peritoneal dialysis (PD) patients. This study aimed to assess the representativeness of the patients in the HONEYPOT trial to the Australian and New Zealand PD population. ♦ Methods: This study compared baseline characteristics of the 371 PD patients in the HONEYPOT trial with those of 6,085 PD patients recorded on the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry...
December 1, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27930527/feasibility-of-radiofrequency-ablation-as-an-alternative-to-surgical-intervention-in-patients-with-huge-multiloculated-pyogenic-liver-abscesses-a-retrospective-cohort-study
#20
Shan Ke, Xue-Mei Ding, Jun Gao, Shao-Hong Wang, Jian Kong, Li Xu, Wen-Bing Sun
This retrospective cohort study investigated the feasibility of radiofrequency (RF) ablation as an alternative to surgical intervention in patients with huge multiloculated pyogenic liver abscesses (PLAs).From August 2010 to April 2016, 83 patients with PLA were admitted to Beijing Chao-Yang Hospital, China. Four of these patients had huge multiloculated PLAs and underwent RF ablation plus antibiotics. The inclusion criteria for RF ablation were as follows: multiloculated PLA confirmed by computed tomography (CT) or magnetic resonance imaging (MRI), widest diameter of the PLA ≥5 cm, failure to respond to or not suitable to treatment with percutaneous drainage (PD), and patient refusal of surgery...
December 2016: Medicine (Baltimore)
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