Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The measurement of the adequacy of dialysis in continuous ambulatory peritoneal dialysis (CAPD) is controversial. The use of weekly total creatinine clearance (TCC) has been recommended, but not validated. We analyzed data from our recent urea kinetics in a CAPD study to investigate TCC and its relationship to patient outcomes. TCC was measured over 24 hours by adding residual renal and peritoneal creatinine clearance, correcting for 1.73 m2 surface area and converting to a weekly value. Seventy-six patients had 218 measurements, on starting CAPD and then at 6-month intervals, with mean follow-up of 20 months (range 1-57 months). The mean TCC was 73.62 +/- 32.11 L/week. Due mainly to the loss of residual renal function, the TCC decreased with time (r = -0.40, p < 0.0001), from 88.65 L/week initially to 66.11 at one year, 59.84 at two years, and 50.47 at three years. Dialysate-to-plasma creatinine concentration ratios (D/P Cr) increased with time (r = 0.28, p < 0.0001) from 0.62 initially to 0.66 at one year and 0.73 at two years. The TCC correlated significantly with serum levels of creatinine (r = -0.46, p < 0.0001), urea (r = -0.21, p < 0.001), potassium (r = 0.14, p < 0.05), phosphate (r = 0.25, p < 0.001), and hemoglobin (r = 0.16, p < 0.01), but not with serum albumin or with clinical outcomes including technique failure, hospital days, transfusions, peritonitis rate, nerve conduction velocity, or subjective indices of well-being, except for a weak correlation with the fatigue index (r = 0.19, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is total creatinine clearance a good predictor of clinical outcomes in continuous ambulatory peritoneal dialysis? 142 Apr 89

We examined the predictive value of urea kinetics for patient outcomes in CAPD by measuring dialysis index (DI; a means of quantifying CAPD dose using urea kinetics), KT/V and normalized protein catabolic rate (PCRN) on 222 occasions in 76 new patients at the time of starting CAPD and at subsequent six month intervals. We investigated how these indices altered with time and in relation to each other, and how they correlated with a wide range of subsequent patient outcomes. DI, KT/V and PCRN all tended to decrease with time on CAPD (P less than 0.0004, less than 0.0001 and 0.0005, respectively). DI and KT/V were highly correlated with each other (r = 0.89, P less than 0.0001) and both correlated with PCRN (r = 0.57, P less than 0.0001 and r = 0.60, P less than 0.0001, respectively). DI and KT/V both correlated inversely with subsequent values for serum creatinine (P less than 0.0001), urea (P less than 0.0002), potassium (P less than 0.02) and phosphate (P less than 0.002), and directly with bicarbonate (P less than 0.0001). PCRN correlated inversely with serum creatinine (P less than 0.0002) and directly with urea (P less than 0.0001) and with the number of blood transfusions received (P less than 0.03). None of these indices correlated with levels of hemoglobin, PTH, alkaline phosphatase or albumin, or with nerve conduction velocity or any other subsequent clinical outcomes including death, technique failure, hospital days, peritonitis rate and subjective indices of fatigue, pruritus and insomnia. We conclude that the urea kinetic model is predictive of some biochemical outcomes but not of clinical outcomes in CAPD patients.
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PMID:Lack of correlation between urea kinetic indices and clinical outcomes in CAPD patients. 205 26

An examination of 49 patients with local and diffuse purulent peritonitis at different stages of surgical treatment has shown that the pyodestructive process in the abdominal cavity develops against the background of thrombocytosis, thrombocyte destruction, their decreased energy resources and tendency to retarded and irreversible aggregation. To correct the disturbed aggregation properties of thrombocytes the HBO and intraaortal infusions of antiaggregants and vasoactive drugs may be used.
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PMID:[The functional properties of thrombocytes in patients with suppurative peritonitis]. 338 7

Ten patients aged 5-14 years and 1 adolescent were treated by CAPD during 12 patient years. Overall survival and rehabilitation were good despite relatively high serum concentrations of urea (19 mmol/l) and creatinine (735 mumol/l). Dietary restrictions were only occasionally necessary, 6 patients required phosphate binders. No radiological bone changes developed in 4 patients with initially normal x-rays, but lesions progressed in 3 with pre-existing osteodystrophy despite administration of 1.25 (OH) 2D3 and Al-hydroxide. Statural growth was unsatisfactory: Height decreased in the 7 patients observed over 1 year from -2.4 to -2.7 SDS. Peritoneal diffusion curves varied considerably between patients, yet remained unchanged at repeat examination. Parents fatigue developed in 6 families and was partly responsible for peritonitis. The incidence of peritonitis fell from 1 episode in 3.3 months to 1 in 8 months. Intensive family support by regular telephone contact and home visits appeared as the most important measure in prevention of parents fatigue and hence of peritonitis. We consider CAPD as a valuable alternative method to haemodialysis.
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PMID:[5 years of continuous ambulatory peritoneal dialysis in the child]. 395 93

We analyzed retrospectively the clinical data of 9 patients with miliary tuberculosis who had been treated in Kyoto City Hospital during the past 12 years. Majority of our patients were female (7 of 9) and were of elder age-groups (mean age: 68.5 years, range: 56-85 years). The most common symptoms at the first visit were fever, fatigue and loss of appetite, but respiratory symptoms were rather rare and moderate. Some cases showed normal chest radiograms at the onset, but during the course of the disease miliary shadows were noticed in all cases. Tuberculin test and smear examination of sputum were not diagnostic. In 4 cases, fiberoptic bronchoscopy had been performed together with bronchoalveolar lavage (BAL), bronchial washing and transbronchial lung biopsy (TBLB). Smear examination BAL-fluid or bronchial washing for acid-fast bacilli was positive in all 4 cases tested. In 7 cases, serum level of tumor markers (CEA, TPA, SLX, NSE, SCC, CA19-9, CA125, DU-PAN 2 and Elastase I) had been measured under the suspicion of malignant diseases. CEA had elevated in 6 cases, NSE in 2 cases, SLX, TPA, CA19-9, CA125 and DU-PAN 2 in 1 case each, and, as a whole, at least one tumor marker had elevated in 6 of 7 cases tested. Though the degree of such elevation of tumor markers had not been so remarkable except for CA125 in a patient who had been complicated with tuberculous peritonitis, but from these results malignancy had not been' able to rule out.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical studies on nine cases with miliary tuberculosis: serum level of tumor markers and bronchoscopy in differential diagnosis]. 783 21

From October 1990 to October 1992 the first 23 laparoscopically operated patients were recorded. 11 patients retrospectively including a supplementary questioning to missing data, 12 patients prospectively with a follow-up 6-8 weeks later. They were compared with 35 from April 1991 to April 1992 conventionally operated and prospectively observed patients. Laparoscopy was performed on patients with subacute clinical signs. The median age was comparable. Acute appendicitis was histologically confirmed in 18% of the laparoscopically and in 80% of the conventionally operated patients. Operating time was in mean 110 minutes for laparoscopic and 65 minutes for open appendectomy. The postoperative complications for laparoscopy included 4 Douglas abscesses (2 x open and 2 x pararectal revisions), one peritonitis due to a defect Roeder-loop and an haematoma of the abdominal wall. One case of wound infection (3%), one pericoecal abscess which needed an ileoascendostomy and a postoperative fatigue syndrome were recorded for open appendectomy. The postoperative return to normal diet was faster for laparoscopy. Return to normal bowel habits, the need of analgesia and the nominal analogue scales concerning pain, quality of sleep, well-being and appetite showed no obvious differences between the two operation methods. The postoperative stay was on average 6.7 days for laparoscopy and 5.6 days for the open operation. The results show the severe complications which may happen when introducing this new operation method. The laparoscopic appendectomy should only be performed electively in subacute appendicitis or when diagnostic exploration shows an inflamed appendix. Careful rinsing of the operation site and perioperative antibiotic treatment are mandatory. We made good experiences when using a stapler for the removal of the appendix.
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PMID:[Does laparoscopic appendectomy have advantages? Laparoscopic appendectomy in comparison with conventional appendectomy--an observational study during introduction of laparoscopy]. 814 46

The purpose of this study is to clarify stressors resulting from continuous ambulatory peritoneal dialysis (CAPD) in CAPD patients and to discuss adaptation to daily life. With reference to the dialysis stressor scale used by Baldree and Masaki et al., a scale for CAPD stressors, consisting of 42 items, was devised, and the stressors were investigated in 56 patients, with the following results: 1) The items rated as high CAPD stressors included the frequency of bag exchange, itch, fatigue, anxiety about the future, and restricted physical activities. Restriction of meal and fluid intake, which are highly-rated stressors in patients on hemodialysis (HD) were not highly-rated stressors in these 56 CAPD patients. Thus, there was a difference between HD and CAPD. 2) The degree of cognition of CAPD stressors increased according to an individual's situation. (1) The presence or absence of an occupation had the greatest effect on the cognition of CAPD stressors. (2) The degrees of cognition of anxiety about the future and work-related difficulties as stressors were high in patients under 60 years of age. (3) The degree of cognition of items related to work as stressors was high in male patients while that of items related to body image as stressors was high in female patients. (4) There was a qualitative difference in stressor congnition between patients with a history of CAPD of shorter than 3 months and those whose history was 3 months or longer. (5) The degree of congnition of infection was also low in patients who suffered from peritonitis. (6) The degree of congnition of symptoms causing physical discomfort was high in patients with diabetic nephropathy. (7) There were significant differences in several variables, in terms of the degree of congnition, among patients with regard to work difficulties and the absence of familial cooperation. On the basis of these results, guidance for patients and their families is necessary.
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PMID:[Analysis of continuous ambulatory peritoneal dialysis (CAPD) stressors in CAPD patients]. 818 6

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

We studied the effectiveness of CAPD in large patients (> 80 kg) (group B, n = 49) by comparing them to a group of patients whose body weight was 60-80 kg (group A, n = 193). Patients in group B were two years younger (55.4 versus 57.7 years, p < 0.01), were predominantly male (M: F ratio 33/16 vs 84/109) and had slightly higher residual creatinine clearance (8 ml/min vs 6 ml/min) at the beginning of treatment. The prevalence of diabetes and the prevalence of comorbid conditions in the two groups were similar. The incidence of peritonitis was similar between the two groups. Patients with a large weight spent significantly fewer days in hospital (20.6 +/- 25 vs 23.4 +/- 35.0 days/year); reasons for hospitalization were similar, except for weakness/fatigue that was more frequent (10%) in group B than in group A (2%). The initial weekly dialysate volume was similar in the two groups (57 +/- 51 in group B and 56 +/- 101 in group A) and increased in both groups at the end of the study to 60 +/- 141 in group B and 61 +/- 171/week in group A. The weight of 6 patients in group B and 5 in group A decreased below the range of that group. On the contrary the weight of 28 patients in group A increased to the range of group B. Based on the final weight there were 166 patients whose weight was 60-80 kg, and 71 patients whose weight was over 80 kg (80-109 kg). Patient survival was similar between the two groups. There was a significantly higher death rate among those patients whose weight decreased in both groups compared to those whose weight increased or remained stable. We conclude that CAPD is an effective treatment in the management of ESRD patients with weights over 80 kg. There is a high mortality among patients whose weight decreases irrespective of their initial weight.
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PMID:Is CAPD an effective treatment for ESRD patients with a weight over 80 kg? 920 70

A 39-year-old man had a 2-year history of fatigue, weight loss, drug-resistant ascites, and decreased intestinal motility. During adolescence he began to suffer frequent episodes of acute benign peritonitis that spontaneously subsided at age 35. The fact that his younger brother was taking colchicine for the same symptoms led us to diagnose familial Mediterranean fever (FMF). The medical workup revealed uniform thickening of the intestinal wall with no signs of amyloidosis. Exploratory laparotomy revealed diffuse peritoneal mesothelioma that proved to be unresponsive to chemotherapy. There was no history of asbestos exposure. It is probable that the chronic peritoneal inflammation was responsible for the development of this tumor, although in almost all cases of FMF this phenomenon causes only limited peritoneal fibrosis or, less commonly, encapsulating peritonitis. A computerized search of the literature indicates that this is the second report of peritoneal mesothelioma associated with FMF.
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PMID:Peritoneal mesothelioma in recurrent familial peritonitis. 925 60


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