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https://www.readbyqxmd.com/read/29655573/-the-reality-on-peritoneal-dialysis-in-france-40years-after
#1
Jacques Rottembourg, Guy Rostoker
The share of peritoneal dialysis (PD) in the spectrum of chronic dialysis has decreased in France over the last ten years. Despite various facilities offered by the health authorities, PD remains confidential in many private units and some public hospitals. The enthusiasm present at the beginning of this technology, forty years ago, is declining, despite a real improvement in new developments, a real increase in patient survival, today at least similar to that on hemodialysis. Then, the aim of this review is first to give a summary of the principles and practice of patient and staff education and to describe the role of the medical contribution in decision-making...
April 11, 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29648838/binding-of-small-molecule-drugs-to-porcine-vitreous-humor
#2
Anna-Kaisa Rimpelä, Saku Reunanen, Marja Hagström, Heidi Kidron, Arto Urtti
Pharmacokinetics in the posterior eye segment has therapeutic implications due to the importance of retinal diseases in ophthalmology. In principle, drug binding to the components of the vitreous, such as proteins, collagen or glycosaminoglycans, could prolong ocular drug retention and modify levels of pharmacologically active free drug in the posterior eye segment. Since drug binding in the vitreous has been investigated only sparsely, we studied vitreal drug binding of 35 clinical small molecular drugs. Isolated homogenized porcine vitreous and the drugs were placed in a two-compartmental dialysis system that was used to separate the bound and unbound drug...
April 12, 2018: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29470707/modeling-simulation-and-employing-dilution-dialysis-microfluidic-chip-ddmc-for-heightening-proteins-refolding-efficiency
#3
F Kashanian, M M Masoudi, A Shamloo, M Habibi-Rezaei, A A Moosavi-Movahedi
Miniaturized systems based on the principles of microfluidics are widely used in various fields, such as biochemical and biomedical applications. Systematic design processes are demanded the proper use of these microfluidic devices based on mathematical simulations. Aggregated proteins (e.g., inclusion bodies) in solution with chaotropic agents (such as urea) at high concentration in combination with reducing agents are denatured. Refolding methods to achieve the native proteins from inclusion bodies of recombinant protein relying on denaturant dilution or dialysis approaches for suppressing protein aggregation is very important in the industrial field...
February 22, 2018: Bioprocess and Biosystems Engineering
https://www.readbyqxmd.com/read/29437872/mathematical-and-experimental-validation-of-flux-dialysis-method-an-improved-approach-to-measure-unbound-fraction-for-compounds-with-high-protein-binding-and-other-challenging-properties
#4
J Cory Kalvass, Colin Phipps, Gary J Jenkins, Patricia Stuart, Xiaomei Zhang, Lance Heinle, Marjoleen J M A Nijsen, Volker Fischer
A flux dialysis method to measure unbound fraction ( f u ) of compounds with high protein binding and other challenging properties was tested and validated. This method is based on the principle that the initial flux rate of a compound through a size-excluding dialysis membrane is proportional to the product of the compound initial concentration, f u , and unbound dialysis membrane permeability ( P mem ). Therefore, f u can be determined from the initial concentration and flux rate, assuming membrane P mem is known...
April 2018: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/29433878/the-effect-of-resident-involvement-on-bariatric-surgical-outcomes-an-acs-nsqip-analysis
#5
Ivy N Haskins, Jihad Kudsi, Kathleen Hayes, Richard L Amdur, Paul P Lin, Khashayar Vaziri
BACKGROUND: Surgical residency training programs in the United States are modeled on the principle of graduated responsibility. Residents are given greater responsibility and autonomy in the operating room and during perioperative care as they gain surgical skills and progress through their training. The impact of this method of surgical training on patient outcomes remains unknown. The purpose of this study is to compare early patient morbidity and mortality after bariatric surgery in cases with and without resident participation using the American College of Surgeons National Surgical Quality Improvement Program database...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29417389/vocational-activity-and-health-insurance-type-among-patients-with-end-stage-renal-disease-association-with-outcomes
#6
Jiacong Luo, Andrew Lee, Dena E Cohen, Carey Colson, Steven M Brunelli
It is widely thought that patients with end-stage renal disease who remain vocationally active and/or commercially insured following dialysis initiation have better clinical outcomes and higher quality of life than those who do not. However, scientifically robust data are lacking. Here, we examined whether vocational status (active, N = 1848; inactive, N = 10,001) and, separately, insurance status (commercial, N = 4858; Medicare/self-pay, N = 13,329; Medicaid, N = 3528) were associated with clinical outcomes and Kidney Disease Quality of Life (KDQOL) scores among a cohort of patients who initiated dialysis at a large US dialysis organization during 2015-2016...
February 7, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29372947/the-perception-of-art-among-patients-and-staff-on-a-renal-dialysis-unit
#7
C Corrigan, L Peterson, C McVeigh, P J Lavin, G J Mellotte, C Wall, A Baker Kerrigan, L Barnes, D O'Neill, H Moss
This study investigated the purpose and effectiveness of giving outpatients an opportunity to engage in art activities while receiving dialysis treatment. A mixed method study was conducted. 21 semi-structured interviews were conducted with outpatients attending the dialysis unit and 13 surveys of clinicians were completed. The principle reasons to partake in the art activity programme included: to pass time, to relieve boredom, to be creative, to try something new, distraction from concerns, to stay positive and to achieve something new...
October 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29368417/continuing-education-online-monitoring-of-haemodialysis-dose
#8
REVIEW
Aarne Vartia
BACKGROUND: Kt/Vurea reflects the efficacy of haemodialysis scaled to patient size (urea distribution volume). The guidelines recommend monthly Kt/V measurements based on blood samples. Modern haemodialysis machines are equipped with accessories monitoring the dose online at every session without extra costs, blood samples and computers. OBJECTIVE: To describe the principles, devices, benefits and shortcomings of online monitoring of haemodialysis dose. DESIGN: A critical literature overview and discussion...
January 25, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/29333620/in-center-hemodialysis-education-challenges-and-innovations-in-training-of-fellows-in-nephrology
#9
Louise M Moist, Robert M Lindsay
The in-center dialysis unit and practice of dialysis, in the current multi-team approach, requires knowledge and skills in all the domains including medical expert, communicator, collaborator, scholar, health advocate, and leader. We are tasked as a community, to embrace and incentivize new innovations and technology to address these needs for our post graduate trainees. These innovations must address the basic principles of dialysis, quality improvement, technical and procedural skills as well as leadership and administration skills...
March 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29315798/end-stage-renal-disease-treatment-options-education-what-matters-most-to-patients-and-families
#10
Jennifer St Clair Russell, L Ebony Boulware
Treatment modality education can offer many important benefits to patients and their families. Evidence suggests such education can increase use of home dialysis, reduce catheter use, decrease 90-day mortality, and increase transplantation. While these benefits are encouraging, not all patients are offered options education and when they are, it may not be presented in a way that is immediately applicable to them and their lives. Furthermore, little is known regarding specific characteristics (e.g. format such as group or individual or in-person or online, duration, teaching methods, location, content) of educational programs that are most successful...
March 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29249390/left-ventricular-assist-devices-kidney-disease-and-dialysis
#11
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
February 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29210176/online-measurement-of-hemodialysis-adequacy-using-effective-ionic-dialysance-of-sodium-a-review-of-its-principles-applications-benefits-and-risks
#12
REVIEW
Shakil Aslam, Subodh J Saggi, Moro Salifu, Robert J Kossmann
Dialysis dose is an important determinant of clinical outcomes in patients with end stage renal disease on maintenance dialysis. In clinical practice dialysis dose is monitored at least monthly by urea clearance based on Urea Kinetic Modeling. Online clearance monitoring using effective ionic dialysance (EID) of sodium (Na+ ) is available on some hemodialysis machines. This paper reviews the background, methodology, additional applications, and potential risks associated with EID. Effective ionic dialysance provides a reliable, real-time, noninvasive, and inexpensive measurement of dialysis dose during an ongoing hemodialysis (HD) session to allow interventions and assess the impact of these changes on clearance...
December 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29198641/hemodialysis-self-management-intervention-randomized-trial-hed-smart-a-practical-low-intensity-intervention-to-improve-adherence-and-clinical-markers-in-patients-receiving-hemodialysis
#13
Konstadina Griva, Mooppil Nandakumar, Jo-An H Ng, Kevin F Y Lam, Hayley McBain, Stanton P Newman
BACKGROUND: Poor adherence to treatment is common in hemodialysis patients. However, effective interventions for adherence in this population are lacking. Small studies of behavioral interventions have yielded improvements, but clinical effectiveness and long-term effects are unclear. STUDY DESIGN: Multicenter parallel (1:1) design, blinded cluster-randomized controlled trial. SETTING & PARTICIPANTS: Patients undergoing maintenance hemodialysis enrolled in 14 dialysis centers...
March 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29163939/infection-prevention-and-control-measures-and-tools-for-the-prevention-of-entry-of-carbapenem-resistant-enterobacteriaceae-into-healthcare-settings-guidance-from-the-european-centre-for-disease-prevention-and-control
#14
A P Magiorakos, K Burns, J Rodríguez Baño, M Borg, G Daikos, U Dumpis, J C Lucet, M L Moro, E Tacconelli, G Skov Simonsen, E Szilágyi, A Voss, J T Weber
Background: Infections with carbapenem-resistant Enterobacteriaceae (CRE) are increasingly being reported from patients in healthcare settings. They are associated with high patient morbidity, attributable mortality and hospital costs. Patients who are "at-risk" may be carriers of these multidrug-resistant Enterobacteriaceae (MDR-E).The purpose of this guidance is to raise awareness and identify the "at-risk" patient when admitted to a healthcare setting and to outline effective infection prevention and control measures to halt the entry and spread of CRE...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29121886/the-strange-case-of-mr-h-starting-dialysis-at-90-years-of-age-clinical-choices-impact-on-ethical-decisions
#15
Giorgina Barbara Piccoli, Andreea Corina Sofronie, Jean-Philippe Coindre
BACKGROUND: Starting dialysis at an advanced age is a clinical challenge and an ethical dilemma. The advantages of starting dialysis at "extreme" ages are questionable as high dialysis-related morbidity induces a reflection on the cost- benefit ratio of this demanding and expensive treatment in a person that has a short life expectancy. Where clinical advantages are doubtful, ethical analysis can help us reach decisions and find adapted solutions. CASE PRESENTATION: Mr...
November 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28929019/heterologous-expression-of-plasmodium-vivax-apical-membrane-antigen-1-pvama1-for-binding-peptide-selection
#16
Ching Hoong Chew, Yvonne Ai Lian Lim, Kek Heng Chua
BACKGROUND: Plasmodium is an obligate intracellular parasite. Apical membrane antigen 1 (AMA1) is the most prominent and well characterized malarial surface antigen that is essential for parasite-host cell invasion, i.e., for sporozoite to invade and replicate within hepatocytes in the liver stage and merozoite to penetrate and replicate within erythrocytes in the blood stage. AMA1 has long served as a potent antimalarial drug target and is a pivotal vaccine candidate. A good understanding of the structure and molecular function of this Plasmodium protein, particularly its involvement in host-cell adhesion and invasion, is of great interest and hence it offers an attractive target for the development of novel therapeutics...
2017: PeerJ
https://www.readbyqxmd.com/read/28924630/role-of-in-vitro-release-methods-in-liposomal-formulation-development-challenges-and-regulatory-perspective
#17
Deepak Solomon, Nilesh Gupta, Nihal S Mulla, Snehal Shukla, Yadir A Guerrero, Vivek Gupta
In the past few years, measurement of drug release from pharmaceutical dosage forms has been a focus of extensive research because the release profile obtained in vitro can give an indication of the drug's performance in vivo. Currently, there are no compendial in vitro release methods designed for liposomes owing to a range of experimental challenges, which has created a major hurdle for both development and regulatory acceptance of liposome-based drug products. In this paper, we review the current techniques that are most often used to assess in vitro drug release from liposomal products; these include the membrane diffusion techniques (dialysis, reverse dialysis, fractional dialysis, and microdialysis), the sample-and-separate approach, the in situ method, the continuous flow, and the modified United States Pharmacopeia methods (USP I and USP IV)...
November 2017: AAPS Journal
https://www.readbyqxmd.com/read/28877926/effectiveness-of-quality-improvement-strategies-for-the-management-of-ckd-a-meta-analysis
#18
Samuel A Silver, Chaim M Bell, Glenn M Chertow, Prakesh S Shah, Kaveh Shojania, Ron Wald, Ziv Harel
BACKGROUND AND OBJECTIVES: Quality improvement interventions have enhanced care for other chronic illnesses, but their effectiveness for patients with CKD is unknown. We sought to determine the effects of quality improvement strategies on clinical outcomes in adult patients with nondialysis-requiring CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a systematic review of randomized trials, searching Medline and the Cochrane Effective Practice and Organization of Care database from January of 2003 to April of 2015...
October 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28854342/short-term-effects-of-hemodiafiltration-versus-conventional-hemodialysis-on-erythrocyte-performance
#19
Hara T Georgatzakou, Vassilis L Tzounakas, Anastasios G Kriebardis, Athanassios D Velentzas, Apostolos C Kokkalis, Marianna H Antonelou, Issidora S Papassideri
Hemodiafiltration (HDF) is a renal replacement therapy that is based on the principles of diffusion and convection for the elimination of uremic toxins. A significant and increasing number of end-stage renal disease (ESRD) patients are treated with HDF, even in the absence of definite and conclusive survival and anemia treatment data. However, its effects on red blood cell (RBC) physiological features have not been examined in depth. In this study, ESRD patients under regular HDF or conventional hemodialysis (cHD) treatment were examined for RBC-related parameters, including anemia, hemolysis, cell shape, redox status, removal signaling, membrane protein composition, and microvesiculation, in repeated paired measurements accomplished before and right after each dialysis session...
March 2018: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28762638/principles-of-treating-enlarging-pseudoaneurysm-in-a-dialysis-arteriovenous-graft
#20
Daniel V Patel, Tushar J Vachharajani
The arteriovenous graft (AVG) is one of the major types of permanent vascular access used to provide hemodialysis. Complications encountered with AVG use include stenosis, infection, thrombosis, and pseudoaneurysm formation. Venous outflow stenosis along with frequent needle cannulation at the same site can lead to breakdown of the graft material, resulting in pseudoaneurysm formation. In the following case, we illustrate common management principles used to treat pseudoaneurysms. While stent-grafts have been utilized for pseudoaneurysm repair, stent-graft usage is not always optimal...
August 1, 2017: Hemodialysis International
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