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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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)
https://www.readbyqxmd.com/read/27916081/-clinical-comparison-of-modified-laparoscopic-and-conventional-placement-of-peritoneal-dialysis-catheters
#14
Q D Tu, Q He, X G Shen, X X Jiang, Y M Liu, Q Q Shen, H J Zhang, W F Chen, L X Yao
Objective: To explore the clinical efficacy of the modified laparoscopic placement of peritoneal dialysis catheters by nephrologists. Methods: A total of 188 patients diagnosed as end-stage renal disease (ESRD) were enrolled, who received catheter and continuous ambulatory peritoneal dialysis (CAPD) therapy from January 2011 to May 2016 in Zhejiang Provincial People's Hospital. They were divided into group A (with modified laparoscopic placement of peritoneal dialysis catheters, n=59) and group B (with conventional placement of peritoneal dialysis catheter, n=129)...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#15
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27903857/a-hyperpigmented-reticular-rash-in-a-patient-on-peritoneal-dialysis
#16
Andrew M South, Milene K Crispin, Ann L Marqueling, Scott M Sutherland
Chronically ill patients often develop uncommon exam findings. A 16-year-old female with end-stage renal disease secondary to immune complex-mediated glomerulonephritis on peritoneal dialysis (PD) developed a pruritic, hyperpigmented reticular rash on her abdomen, sparing the PD catheter insertion site. The rash appeared approximately 6 weeks after initiating PD. She used a heating pad nightly during PD for dialysis drain pain. Testing for systemic and autoimmune disease was negative. She was referred to dermatology, where the diagnosis of erythema ab igne (EAI), a well-described but less well-known hyperpigmented reticular cutaneous eruption caused by chronic exposure to low levels of infrared heat, was confirmed...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27903856/laparoscopic-left-hemicolectomy-for-colon-cancer-in-peritoneal-dialysis-patients-a-valid-and-safe-surgical-technique-to-ensure-peritoneal-dialysis-survival
#17
Sara Auricchio, Giulio Mari, Andrea Galassi, Beatrice Dozio, Marco Pozzi, Dario Maggioni, Renzo Scanziani
A laparoscopic approach represents an effective alternative to open surgery in patients undergoing peritoneal dialysis (PD). In these patients, conventional thinking provides for removal of the peritoneal catheter during left colon resections because of higher risk of patient contamination and peritonitis. The present paper describes 3 cases of laparoscopic left hemicolectomy for colon cancer performed in PD patients without complications and without peritoneal catheter removal, leading to subsequent early PD resumption...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27903855/fitz-hugh-curtis-syndrome-consequent-to-a-wound-infection-following-removal-of-a-peritoneal-dialysis-catheter
#18
Tal Zilberman-Daniels, Keren Cohen-Hagai, Yael Einbinder, Alexandra Osadchy, Sydney Benchetrit, Ze'ev Korzets
Fitz-Hugh-Curtis syndrome (FHCS) is a condition characterized by inflammation of the liver capsule (perihepatitis) and adjacent peritoneal surfaces. We report a case of FHCS developing in a peritoneal dialysis (PD) patient in whom catheter removal due to recurrent peritonitis was complicated by post-operative wound infection. To the best of our knowledge, this is the first case description of FHCS in the context of PD.
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27903854/geographical-variation-in-peritoneal-dialysis-catheter-insertion-and-initiation-within-the-united-states
#19
Achint Patel, Harshil Shah, Shanti Patel, Girish N Nadkarni, Jaime Uribarri
Peritoneal dialysis (PD) is an effective but underutilized renal replacement therapy modality. There are limited data regarding geographical variation in PD catheter insertion and utilization of PD as a first renal replacement therapy in the United States. We explored the variation in catheter insertion and initiation of PD utilizing 2 large, nationally representative databases. The incidence of catheter insertion differed significantly by geographical region, being highest in the South (7.30/100 end-stage renal disease [ESRD] patients; 95% confidence [CI] interval 6...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27903851/management-of-peritoneal-dialysis-catheters-that-erode-into-bowel-two-pediatric-case-reports-and-a-review-of-the-literature
#20
Troy A Markel, Karen W West
Erosion of peritoneal dialysis (PD) catheters into the intestine is a rare complication of PD. Herein, we convey the first reports of 2 pediatric patients undergoing PD who were found to have the catheter eroding into their intestines. They were treated minimally with catheter removal and antibiotics. Definitive repair of the intestinal injury was not performed. These are the first pediatric patients reported with PD catheter erosion. Perforating injuries may be self-limiting, and therefore a more minimal approach may be considered in certain patient populations who do not express overt signs of peritonitis or illness...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
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