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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mathematical modeling and clinical trials have increased the use of intraperitoneal (IP) therapy in cancer care. A direct result of this increase in IP therapy research is an increasing use of access devices. One of the most commonly selected access devices is the Tenckoff catheter. The prevention and management of complications of IP therapy via the Tenckhoff catheter are nursing's responsibility. Complications include peritonitis, catheter occlusion, exit site infections, leakage of fluid from around the catheter, and chemical peritonitis. Nurses' expertise in this area as clinicians and patient educators contributes to the success of IP therapy.
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PMID:Intraperitoneal therapy via the Tenckhoff catheter. Prevention and management of complications. 224 10

Intraperitoneal administration of ara-C produces a peritoneal/plasma concentration ratio of 330-1,000: In principle, optimal tumor-cell kill should be obtained when high ara-C concentrations ar maintained in the environment of the tumor for very long periods of time. A phase 1 study was undertaken to determine the maximum tolerated dose of ara-C that could be given as a continuous i.p. infusion for 3 weeks. A total of 14 patients with refractory malignancies were given 28 courses in the outpatient setting. Ara-C infusions were given using a portable programmable pump (Pancreatec Provider Model 2000). No significant side effects were observed in patients receiving 30 mg/m2 per day (five courses) or 40 mg/m2 per day x 21 days (seven courses). However, at a dose of 60 mg/m2 per day, although 10/16 courses were tolerated for at least 1 week, only 3/16 attempted courses could be continued for the full 3 weeks. The dose-limiting toxicity was chemical peritonitis, which occurred during 7/16 courses at this dose level and required termination of therapy in 4 courses. Myelosuppression was also observed at this dose. There was a large variation in the ara-C and ara-U peritoneal concentrations both within and between patients. The mean peritoneal ara-C concentration increased nonlinearly with ara-C dose whereas the mean ara-U concentration decreased. This study establishes the feasibility and safety of giving a cell-cycle-specific drug intraperitoneally over an extremely prolonged period. For subsequent studies a dose of 40 mg/m2 per day for 21 days is recommended.
Cancer Chemother Pharmacol 1990
PMID:Extremely prolonged continuous intraperitoneal infusion of cytosine arabinoside. 231 Nov 75

Evaluating an elderly patient with an acute abdomen is a challenging clinical problem. THe diagnosis is more difficult to secure in this age group, because it is difficult to obtain an accurate history, and physical findings are more subtle. The major factors that increase mortality include associated medical diseases, emergent operations, and delay in recognition and treatment of the problem. Patients with widespread malignancy and generalized peritonitis fare poorly, but operative mortality in the geriatric group has improved significantly because of more prompt diagnosis, aggressive resuscitation, precise monitoring, and expedient but definitive procedures. As the proportion of elderly patients in the population continues to rise, it becomes increasingly important to evaluate and manage this problem expediently.
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PMID:The acute abdomen in the geriatric patient. 232 16

Seventy-two patients with pyogenic liver abscess treated from Jan. 1986 through June 1988 were reviewed retrospectively. The average age was 55 years with a male to female ratio of 1.4:1. Most patients presented with the typical fever, chills and RUQ pain, but unusual signs and symptoms were also common. The right lobe was more commonly involved than left lobe. Biliary tract stone was the most frequent etiology (44.4%) and association with DM was common (37.5%). An elevated alkaline phosphatase and leukocytosis were useful clues to a liver abscess, but diagnosis depended on imaging of an abscess cavity either by echo or CT scan. The average time from onset of Symptoms to diagnosis was 9.3 days and a delay in diagnosis by the doctors was common. The most common complication was septicemia and factors with poor prognosis were old age (greater than or equal to 60 yrs), septicemia, cancer, peritonitis, and serum bilirubin greater than or equal to 5 mg/dl. The overall mortality was 29% with no difference between the group with surgical drains (28.5%) and the group with percutaneous transhepatic aspiration or drains (29.4%).
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PMID:[Pyogenic liver abscess--report of 72 cases]. 237 3

During a 5-year period, 32 patients with colorectal carcinoma underwent a Hartmann procedure. Twenty operations were performed as emergencies for obstruction or peritonitis, and 12 for the elective treatment of colorectal malignancies. Of 22 surviving patients with potentially curable resections, 17 had restoration of colorectal continuity without complication. Five patients refused this option. Of the nine palliative procedures, seven patients developed a pelvic recurrence, one developed metastatic disease, and the remaining patient died after surgery. The median hospital stay was 17 days (range 8-48 days). There were two postoperative deaths (6%), both from pulmonary emboli. Thrombotic events occurred in three further patients, and wound sepsis in four. Other complications inherent to this procedure were individual cases of pelvic sepsis, anastomotic stricture, and a failed initial attempt at 'reversal'. These findings confirm that this operation is safe and effective in dealing with rectal and distal sigmoid colon malignancies with potential for local recurrence, and in those presenting as an emergency with obstruction or peritonitis, particularly when the operator is a surgical trainee.
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PMID:Hartmann's procedure for carcinoma of rectum and distal sigmoid colon: 5-year audit. 203 11

We had demonstrated that the NK cell mediated cytotoxicity of murine spleen cells could be augmented by in vivo priming and subsequent in vitro challenge with a streptococcal preparation OK432, and the cell surface phenotype of induced killer cells was Thy-1+, asialo GM1+, suggesting that the activated cells were of NK lineage (OK-NK cell). We had also clarified that IL-2 played a major role in inducing the OK-NK cells via the production of IFN-gamma. In this study, we examined the effect of adoptive transfer of OK-NK cells on syngeneic tumors in mice. Mice were implanted with SP2 myeloma cells intraperitoneally (i.p.), or C26 colon adenocarcinoma cells subcutaneously to make the models of peritonitis carcinomatosa or solid tumor, and the OK-NK cells were transferred i.p. or intratumorally, adoptively. By the adoptive transfer of OK-NK cells, 92% of mice bearing SP2-tumor had be cured. The tumor growth of C26-solid tumor was inhibited, and the survival rate of mice bearing C26-tumor was significantly increased. The intratumoral remnants of 125I-labelled OK-NK cells were 61, 27 and 8% at 4, 12 and 36h after intratumoral transfer, respectively. By multiple transfer of OK-NK cells, the antitumor effect was more effectively augmented than that of a single transfer. Results in this study suggested that OK-NK cells could be useful for the therapy of cancer patients.
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PMID:Successful adoptive immunotherapy with OK432-inducible activated natural killer cells in tumor-bearing mice. 240 Jun 28

The growth rate of 49 cases with recurrent gastric cancer was investigated with two tumor markers (AFP & CEA). The average doubling time of liver metastases (24.7 +/- 11.9 days) in 18 cases was significantly shorter from that of lymph node metastases (41.1 +/- 22.4 days) in 13 cases and of peritonitis carcinomatosa (42.2 +/- 19.6 days) in 18 cases. Latent period of recurrent cancer calculated by these doubling times was ranged from 1.0 to 3.5 years (mean 1.7 years) in liver metastases, from 1.0 to 5.0 years (mean 2.7 years) in lymph nodes metastases and from 1.5 to 6.0 years (mean 2.7 years) in peritonitis carcinomatosa. Only in liver metastases, positive correlation between the doubling time (X) and the duration of survival (Y) was observed by expressing the formula Y = 0.45 X-0.58 (R = 0.661, p less than 0.05). It is noteworthy that there is a significant correlation in spite of large differences in background subjects (systemic condition, size of metastatic lesion, etc.) and the growth rate of tumor is considered to play a very important role for determining the degree of biological malignancy of individual cancer patients in relation to survival.
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PMID:[Chronology of recurrent gastric cancer]. 242 66

Twelve cases of pseudomyxoma peritonei in Kurume University Hospital and its affiliated hospitals were clinicopathologically analysed. The patients were 42 to 81 years old, and the averaged age was 65.1 years. One case was before menopause. As to past history, one had undergone simple hysterectomy for myoma uteri previously, another patient (No. 8) was diagnosed as having mucinous adenocarcinoma of the appendix and two others (cases No. 2 and 7) had had treatment for pleurisy and peritonitis. Histologically, 3 cases were diagnosed as benign, 4 were borderline malignancy, and 5 were frankly malignant. Six cases were cytologically examined. Four of 6 were recognized as malignant cases. It was thought the diagnosis should be done by both cytological and radiological examination. It was suggested by the past history and histological infiltration of inflammatory cells in cases No. 2 and 7 that the histogenesis of pseudomyxoma peritonei was related to the inflammation with mucinous tumors. The relationship between histological findings and prognosis was unclear. Three cases were treated by surgery only, 6 cases by surgery and chemotherapy, and the other 3 cases by surgery, chemotherapy and washing intraperitoneally with dextran. The five year survival rate for cases treated by surgery and chemotherapy was 40.0%, including 2 patients still living more than 10 years later. All three cases treated by washing intraperitoneally with dextran survived, but for less than 5 years. The result of treatment by washing with dextran was thought to be an effective therapy for pseudomyxoma peritonei.
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PMID:[Clinicopathological study of pseudomyxoma peritonei]. 248 Mar 94

Enteral feeding is often required in patients with cancer of the head and neck. Percutaneous endoscopic gastrostomies (PEGs) and jejunostomies (PEJs) can facilitate enteral feeding in patients who require this treatment. The endoscopic technique allows for the placement of feeding gastrostomies and jejunostomies without a surgical procedure and eliminates the need for nasal tubes for long-term enteral feeding. Forty-two patients with head and neck tumors were referred for placement of PEGs because of severe dysphagia induced by tumors, surgery, radiation, or chemotherapy. The procedure was performed in the gastroenterology suite. Patients were sedated with intravenous meperidine and diazepam, and local anesthetic with lidocaine was applied to the area of incision. Average procedure time was approximately 20 minutes. The procedure was successful in 39 patients in whom tubes were placed ranging in diameter from 15F to 22F. PEGs were placed in 36 patients with intact stomachs and PEJs in three patients with previous gastrectomies. The remaining three procedures were unsuccessful because of technical reasons. There were three localized skin infections, and all responded to antibiotic therapy. Neither peritonitis nor any other immediate complication occurred. In 16 nonhospitalized patients, the procedure was performed on an outpatient basis. After a mean followup of 4.5 +/- 6 months of enteral feeding in the home, there was only one case of aspiration and subsequent pneumonia, and this case responded to antibiotics. No other long-term complications were noted. Thus feeding gastrostomies and jejunostomies can be placed safely and easily in patients with cancers of the head and neck by endoscopic methods without abdominal surgery. These tubes can be used for enteral feeding and eliminate the need for nasogastric tubes. They are better tolerated, are of a wider diameter, and have a reduced risk for migration, clogging, and aspiration-related complications.
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PMID:Percutaneous endoscopic gastrostomy and jejunostomy for long-term feeding in patients with cancer of the head and neck. 251 33

To focus attention on the problem of infant mortality in Lebanon, data were compiled on infant mortality from 1978 to 1986 at the American University of Beirut Medical Center. Causes of death are analyzed for 602 males and 398 females. 54.9% deaths occurred at 1 month of age and 77.4% died within the 1st year. Autopsies were performed on .7%. 37.7% of all neonatal deaths were due to neonatal diseases such as hyaline membrane disease, asphyxia neonatorum, immaturity, necrotizing enterocolitis, hemorrhage, hemolysis, meconium aspiration, and kernicterus. Better prenatal care would reduce this group, or the administration of corticosteroids to the mother 24-48 hours prior to delivery, as well as rapid resuscitation at birth and prevention of the 5 curses: hypoxemia, hypoglycemia, hypothermia, hypotension, and acidosis. Although unavailable in Lebanon, administration of surfactants through an endotracheal tube would also help. Infections constitute 25.1% of deaths; many are preventable through adequate public health measures and strict personal hygiene, i.e., diseases such as sepsis, pneumonia, meningitis, gastroenteritis, hepatitis, encephalitis, and 1-2 cases of the following: diphtheria, measles, peritonitis, tetanus, tuberculosis, cytomegalis inclusion, herpes, parathyphoid, pertussis, poliomyelitis, and shigellosis. Congenital diseases were 21.6%. In utero diagnosis could prevent some diseases and in utero treatment is possible for hydrocephalus and hydronephrosis. Screening programs postnatally could lead to treatment. 5.9% were malignancies such as leukemia, lymphoma, brain tumors, histocytosis, Wilm's tumor, Ewing sarcoma, and Hodgkin's disease. Early diagnosis is critical if mortality is to be reduced in this group, but medical advances are still needed. 2.9% are miscellaneous diseases such as poisoning, rheumatic diseases, marasmus, Reye's syndrome, nephrosis, rickets, and epilepsy. Most of these diseases are preventable, except for rheumatic inflammation of the heart. Recommended necessary steps to reduce infant mortality are: prenatal care, diagnosis and screening, intrauterine surgery; resuscitation and intensive care centers with modern equipment and trained personnel; national vaccination and screening programs; adequate public health measures and hygiene; parental education; and well-equipped hospitals to serve all regardless of income level.
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PMID:Pediatric mortality: an avoidable tragedy. 251 28


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