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

Peritoneal dialysis is associated with several metabolic and nutritional abnormalities, some of which are related to the use of glucose-based solutions. Furthermore, the catabolic effects of uremia per se, protein and amino acid losses into the dialysate, peritonitis and poor appetite contribute to amino acid abnormalities, negative nitrogen balance and a high prevalence of malnutrition in peritoneal dialysis patients. To overcome these problems the use of amino acid instead of glucose as an osmotic agent has been proposed. Short-term studies have shown that amino acid-based solutions in peritoneal dialysis may supplement in excess the daily losses of amino acids during dialysis with glucose-based solutions. The amino acid solutions produce similar ultrafiltration and solute transport as the standard glucose solutions although the period of effective ultrafiltration is rather short. However, it should be noted that some studies have reported that the transport of small and large solutes may increase in patients using amino acid solutions. During the early 1980s several investigators have developed and tested different amino acid solutions for peritoneal dialysis. The initial clinical experience from Toronto with amino acid solutions containing large amounts of non-essential amino acids and inadequate amount of buffer were in general discouraging. The patients, who were not always malnourished and tended to have a low energy intake, developed increased BUN levels, acidosis, no improvement in nutritional status or amino acid abnormalities and, in some cases, anorexia. In 1985 a new 1% amino acid solution, containing an increased buffer amount and amino acids (mainly essential) in proportions which take the amino acid abnormalities in uremic patients into account, became available. The use of this solution resulted in some improvement in amino acid pattern and nutritional parameters, but acidosis and increased BUN levels remained problems. The experiences from these and previous studies showed that: (1) the improvement of the composition of amino acid solutions was beneficial; (2) a further increase of the buffer amount was needed; (3) patients included should have signs of protein malnutrition combined with low dietary protein intake to benefit from intraperitoneal amino acid supply, and (4) energy intake should be sufficient to prevent amino acids to end up as energy source. For this purpose a new improved 1.1% amino acid solution has been developed containing a further increase of some essential amino acids and an increased amount of lactate (40 mmol/l). This solution has been tested in malnourished patients eating 0.8 g protein/kg/day and 25-30 kcal/kg/day.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Supplemented dialysis: amino acid-based solutions in peritoneal dialysis. 835 59

Medical records of 29 dogs with cholelithiasis were reviewed. Aged female small-breed dogs were overrepresented. Mean age was 9.5 years, and mean weight was 12 kg. Vomiting, anorexia, weakness, polyuria/polydipsia, weight loss, icterus, fever, and signs of abdominal pain were the most common clinical signs. Leukocytosis, neutrophilia with left shift, monocytosis, high activity of serum hepatic enzymes, hypoalbuminemia, and high concentrations of serum total bilirubin were common. Radiopaque choleliths were evident on abdominal radiography of 13 of 27 dogs. Microbial culturing of bile isolated organisms in 15 of 20 dogs. Gram-negative bacteria were most common. Surgery was performed in 22 dogs. Four dogs were treated medically, and 3 dogs were euthanatized without treatment. Surgical treatment consisted of cholecystectomy in 11 dogs, choledochotomy in 5 dogs, cholecystotomy in 4 dogs, and cholecystojejunostomy in 1 dog. Sphincter of Oddiotomy was performed in 1 dog. Five dogs had concurrent generalized peritonitis attributable to bile. Multiple choleliths were detected in most of the dogs. Choleliths were located in the gallbladder in 20 dogs and in the bile ducts in 14 dogs. The most common abnormalities of the gallbladder, identified histologically, were chronic cholecystitis, mucosal hyperplasia, and pericholecystic inflammation. The most common abnormalities of the liver were cholestasis, hepatocellular degeneration, and periportal fibrosis. Survival rate of dogs that underwent cholecystectomy tended to be higher (86%) than that of dogs treated via cholecystotomy (50%) or cholecystectomy in combination with choledochotomy (33%). Dogs that underwent medical treatment, abdominal exploratory, cholecystojenunostomy, choledochotomy, and sphincter of Oddiotomy died or were euthanatized because of redevelopment of clinical signs associated with cholelithiasis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cholelithiasis in dogs: 29 cases (1980-1990). 847 31

Natural (n = 157) and experimental (n = 5) infections with the nematode Eustrongylides ignotus are described for ciconiforms collected in Florida (USA). Larvae perforated the ventriculus in 3 to 5 hr and caused hemorrhage and bacterial peritonitis that sometimes progressed to a fibrous peritonitis with extensive adhesions. Severity of the disease was related inversely to the age of the bird and directly to the number of parasites involved. Some infections in adult birds were resolved. As a consequence of eustrongylidosis, anorexia and behavioral abnormalities resulted in emaciation and may have predisposed birds to traumatic death. Host-parasite adaptations apparently were not adequate for nestling ciconiforms as death of nestlings usually occurred before infections become patent (longer than 14 days, less than 23 days). Patent infections were found in both color morphs of the great blue heron (Ardea herodius), and in great egrets (Casmerodius albus) and snowy egrets (Egretta thula). We propose that birds of the family Ardeidae are the primary definitive hosts.
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PMID:Pathogenesis of Eustrongylides ignotus (Nematoda: Dioctophymatoidea) in Ciconiiformes. 848 74

A novel carrier solution, icodextrin 20 (7.5%) has allowed exploration of prolonged intraperitoneal (IP) infusion of the cytotoxic drug, 5-fluorouracil. Eighteen patients with intraperitoneal carcinomatosis were entered into a feasibility and pharmacokinetic study of prolonged regional (IP) chemotherapy.. Specialist nurses trained the patients to self-administer their own treatment via a permanent i.p. catheter. A twin bag delivery system was used to perform one exchange daily. It proved possible to deliver continuous (5 days per week) i.p. 5-fluorouracil at doses of 200 mg/m2 and 300 mg/m2 for up to 12 weeks. The toxicities seen were infective peritonitis, nausea and vomiting, lethargy and anorexia. This was a nurse-led study and the home-based therapy holds promise for patients with malignant peritoneal disease.
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PMID:Intraperitoneal chemotherapy: a prolonged infusion of 5-fluorouracil using a novel carrier solution. 871 77

Malnutrition, which is common in maintenance dialysis patients, is strongly associated with increased morbidity and mortality. An important contributing factor is anorexia, leading to reduced intake in relation to the recommended allowances, which for protein is higher than in healthy subjects. Uremic toxicity in underdialyzed patients may cause anorexia as a result of retention of toxic compounds in the middle molecular weight range, which are normally excreted in the urine. Various comorbidity factors and psychosocial and economic factors may also be associated with low nutritional intake. The hemodialysis procedure may reduce nutritional intake because of cardiovascular instability with nausea and vomiting and post-dialysis fatigue. Abdominal discomfort, absorption of glucose and amino acids, and peritonitis may reduce appetite in peritoneal dialysis patients. Underdialysis, if present, should be corrected and various catabolic factors such as acidosis, infections, and other comorbidity factors should be treated, dietary counseling should be given, and psychosocial and economic support should be provided when needed. Patients who remain malnourished despite such measures may be given parenteral or enteral nutritional supplementation. Peritoneal dialysis solutions with amino acids have been used successfully in CAPD patients who suffer from protein malnutrition. Recombinant human growth hormone and IGF-1 are new treatment alternatives that need further evaluation.
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PMID:Anorexia in dialysis patients. 873 65

Between October 1991 and October 1993, 17 AIDS patients (14 intravenous drug users, 3 sexually acquired) were commenced on percutaneous endoscopic gastrostomy (PEG) feeding in St James's Hospital. Indications were progressive weight loss related to severe anorexia, persistent oesophageal candidiasis (5) and absence of gag reflex (1). Two patients requested PEG tube removal after one week because of crampy abdominal pain without peritonitis. Five patients died from AIDS related infections within 6 weeks of PEG insertion. Ten patients were followed up for > 2 months (mean 5.2 months, range 2.5-15.5 months). In these 10 patients, 1 patient developed a PEG site infection which responded to topical antibiotics. There were no other complications. There was a significant (P < 0.001) increase in energy and protein intake at 2 months. Variant degrees of weight gain occurred in all patients (mean 2.6 kg) (P < 0.01). Small but significant increases in other anthropometric variables occurred. Patients who died within 6 weeks of PEG insertion were older, and had a lower serum albumin than the group who survived > 2 months (P < 0.01). A self-administered questionnaire demonstrated that the majority of patients found PEG feeding acceptable and preferable to nasogastric (NG) feeding.
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PMID:An evaluation of percutaneous endoscopic gastrostomy feeding in AIDS. 873 34

A 22-year-old Nepali man presented with a 2-month history of fever, ill health, anorexia, loss of weight and diarrhoea. Apart from an ill-defined lower abdominal mass, physical examination was unremarkable. Investigations showed the picture of malabsorption syndrome with no evidence of structural gastro-intestinal tract involvement on barium meal, small bowel and large bowel enema, upper gastro-intestinal endoscopy, colonoscopy and mucous membrane biopsy. Laparoscopy showed typical features of tuberculous peritonitis. Liver biopsy showed tuberculous granulomatous hepatitis, and peritoneal biopsy showed caseating granulomata. The patient responded rapidly to antituberculosis chemotherapy.
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PMID:Malabsorption syndrome complicating tuberculous peritonitis. 944 Oct 65

Plasma leptin and ob gene mRNA levels were increased in mice following bacterial peritonitis, and blocking an endogenous tumor necrosis factor alpha (TNF-alpha) response blunted the increase. However, plasma leptin concentrations did not correlate with the associated anorexia. We conclude that leptin expression is under partial regulatory control of TNF-alpha in peritonitis, but the anorexia is not dependent on increased leptin production.
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PMID:Increased leptin expression in mice with bacterial peritonitis is partially regulated by tumor necrosis factor alpha. 952 18

Two cats with abdominal effusion and anorexia were diagnosed as feline infectious peritonitis (FIP). We tried to evaluate the effect of thromboxane (Tx) synthetase inhibitor, ozagrel hydrochloride, on the progression of symptoms and clinicopathologic data characteristic to FIP. After administration of Tx synthetase inhibitor, improvement of appetite and activity, decreases of peritoneal effusion, reduction of leukocyte number to normal level, and improvement of hyper gamma-globulinemia were found in 2 cats with FIP. These findings suggest that the vasculitis in FIP can be successfully treated with Tx synthetase inhibitor which inhibits platelet aggregation.
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PMID:Effect of thromboxane synthetase inhibitor on feline infectious peritonitis in cats. 963 7

A six-year-old, spayed female Shetland sheepdog was presented with acute onset of anorexia and vomiting. An inflammatory leukogram and elevated serum amylase, lipase, alkaline phosphatase, alanine transferase, and triglycerides supported a diagnosis of severe acute pancreatitis. An enlarged, hypoechoic pancreas was visualized on abdominal ultrasonography. The patient clinically responded to medical therapy consisting of nothing per os, total parenteral nutrition, and supportive care. She presented again three weeks later with anorexia and vomiting. A large, anechoic mass was seen in the left limb of the pancreas on ultrasonographic examination of the abdomen. Differentials for this mass included abscess, focal peritonitis, and pancreatic pseudocyst. Clinical signs resolved with supportive care. The mass failed to resolve. Sterile fluid (35 ml) was removed via ultrasonographic-guided centesis 42 days after initial presentation. Ultrasonographic appearance, biochemical analyses, and fluid examination with negative cultures suggested pancreatic pseudocyst. The pseudocyst gradually resolved over the next seven months postcentesis.
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PMID:Resolution of a pancreatic pseudocyst in a dog following percutaneous ultrasonographic-guided drainage. 982 89


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