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

The method of indirect electrochemical oxidation was used in treatment of 34 patients with acute purulent peritonitis. Twenty patients treated by the traditional method were taken as a group of comparison. The method consists in the elevation of sensitivity of the polyresistant microflora to antibiotics after the introduction into the abdominal cavity of a warmed to 37 degrees C 0.06--0.08% solution of sodium hypochlorite (100-400 ml), buffered with sodium bicarbonate 0.4 g NaHO3 per 100 ml. A combined application of buffered sodium hypochlorite with antibiotics to patients with local, diffuse and general peritonitis resulted in shorter average terms of treatment correspondingly to (9 +/- 0.9), (13 +/- 1.3), (16 +/- 1.9) days against (17.2 +/- 2.4), (25.0 +/- 3.3), (34.7 +/- 4.1) days after traditional methods of treatment. Only 2 patients died of 13 patients with general peritonitis (15.38%). Thus, modelling the processes of oxidative detoxication and phagocytosis with using a transmitter of acute oxygen--an electrolysis solution of sodium hypochlorite is a practically safe and technically simple method of the active action on the inflammatory process in the abdominal cavity, so it may be widely used in treatment of peritonitis.
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PMID:[Sodium hypochlorite in the treatment of suppurative peritonitis]. 809 71

Loss of net ultrafiltration capacity is an important complication in long-term continuous ambulatory peritoneal dialysis (CAPD). It has been reported in animal studies that the drained volumes after a dwell period were larger when amphotericin B had been given intraperitoneally. In this study the effect of intraperitoneally administered amphotericin B on fluid kinetics was evaluated in 3 CAPD patients. The first patient lost 2.5 kg body weight during the first 4 days of treatment, whereas the net ultrafiltration in the second patient was higher in the treatment period compared with the nontreatment period (750 +/- 38 mL/day vs 438 +/- 34 mL/day (mean +/- SEM), p < 0.0001). In the last patient it can be demonstrated that the increase in the net ultrafiltration was caused by an increase in the transcapillary ultrafiltration (570 vs 454 mL/4 hours), but that lymphatic absorption was not different (251 vs 265 mL/4 hours). The higher transcapillary ultrafiltration capacity is probably caused by an increase in the hydraulic permeability. It is likely that this phenomenon is governed by the interaction of amphotericin B with membrane-bound cholesterol leading to the formation of transcellular pores. However, the administration of amphotericin B caused a chemical peritonitis, probably due to its solvent, sodium desoxycholate. Therefore, before amphotericin B can be used for the treatment of CAPD patients with ultrafiltration failure, further investigations are necessary to obtain a solvent for amphotericin B that is nontoxic and causes no chemical peritonitis.
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PMID:The effect of amphotericin B on fluid kinetics and solute transport in CAPD patients. 810 4

On the basis of its efficacy against ovarian carcinoma and its safe peritoneal administration, cisplatin administered by the intraperitoneal route was studied in a phase II multicentric trial. 34 patients with good performance status and residual disease less than 1 cm were treated with a 90 mg/m2 dose (60 mg/m2 at first cycle), administered in the abdominal cavity every 3 weeks for at least four cycles. In case of haematological or renal toxicity, intravenous sodium thiosulphate was perfused simultaneously with intraperitoneal cisplatin with protective intent. 25 patients were evaluable for response: 3 patients had pathological complete response and 1 patient had a microscopic disease (16% response rate in evaluable patients). Systemic toxicity was mild, and sodium thiosulphate clearly protected against leucopenia (6 patients) and renal toxicity (8 patients). Local side-effects were evaluable in 34 patients with 2 cases of infectious peritonitis, 1 of wound infection and 2 of haemorrhage. Of the 147 evaluable chemotherapy cycles, nine resulted in partial and one in total inflow obstruction, for which 4 patients needed surgical procedures for catheter-related complications, and 1 patient died of acute abdominal complications after such a procedure. We conclude that 90 mg/m2 intraperitoneal cisplatin has activity in pretreated patients with minimal residual disease, and that thiosulphate protects against haematological and renal toxicities. Only a randomised study can demonstrate a true benefit, which will have to be balanced with the toxicity of intraperitoneal drug administration.
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PMID:Phase II trial for intraperitoneal cisplatin plus intravenous sodium thiosulphate in advanced ovarian carcinoma patients with minimal residual disease after cisplatin-based chemotherapy--a phase II study of the EORTC Gynaecological Cancer Cooperative Group. 814 63

Since March 1979 (the Italian-French-Spanish meeting in Turin), we have been using the double-bag system for peritoneal fluid exchange in patients on continuous ambulatory peritoneal dialysis (CAPD). This technique, subsequently followed by many others because of the advantages to the patients, still represents the best tool in bag-exchange procedure, because it satisfies the following characteristics: single luer-lock connection; flush-before-fill; simple, safe, and aseptic manipulation; short training period; no carrying bag; good patient acceptance; and low incidence of exogenous peritonitis. In 13 years with 237 patients selected for double-bag treatment, we have observed an incidence of 1 episode of peritonitis every 26.6 patient-months. Few clinical CAPD-related complications like hypotension and alterations of Ca-P metabolism were observed, probably as a result of more personalized peritoneal fluid with high Na+ (136 mEq/L) and Ca2+ (3.5 mEqL) concentrations. In the meantime, we have also had available plasticizer-free bags, which eliminated one of the main risk factors in peritoneal sclerosis. The utilization of the plasticizer-free double-bag system, currently adopted by numerous other centers, still remains the best option from a clinical and psychological viewpoint of the patients on CAPD.
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PMID:Why the double-bag system still remains the best technique for peritoneal fluid exchange in continuous ambulatory peritoneal dialysis. 839 54

Microangiopathy has been observed in the peritoneum of diabetic patients, and an increase in vascular permeability to small and large molecules has been described in the skeletal muscle of diabetic patients. Therefore, we examined the peritoneal equilibration test (PET) data from 19 diabetic and 19 nondiabetic stable peritoneal dialysis (PD) patients. These two groups of patients were matched in terms of age, gender, duration of PD and hypertension, incidence of peritonitis, levels of blood pressure, degree of uremia, levels of serum lipids, hematocrit, weekly KT/V, and body surface area. Compared to the nondiabetics, the diabetics had higher dialysate-to-serum ratios or mass transfer coefficients of urea or creatinine. These differences were not related to their differences in serum sodium or glucose. Regression analysis showed that the duration of hypertension was a negative determinant of peritoneal transport of urea and creatinine in diabetic patients. Our results suggest that the diabetic patients had a higher peritoneal diffusive transport of small solutes, which was offset by their duration of hypertension.
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PMID:Increased peritoneal solute transport in diabetic peritoneal dialysis patients. 853 40

The aim of this study was to examine the possibility of increasing sodium and water removal with peritoneal dialysis. Ten patients aged 67.3 +/- 6.2 years, on continuous ambulatory peritoneal dialysis (CAPD) for 28.1 +/- 13.9 months, with no episodes of peritonitis for at least 2 months and clinically normohydrated, gave their informed consent to undergo two consecutive peritoneal equilibration tests (PETs) with dialysis solution at a sodium concentration of 126 mEq/L (low sodium) and 132 mEq/L (normal sodium), both with 2.5% glucose. Net ultrafiltration and sodium mass transfer were 319.4 +/- 178.5 and 443.2 +/- 234.4 mL (p = 0.0346) and 27.7 +/- 24.5 and 28.2 +/- 27.1 mEq (p = NS), respectively. There were no variations in natremia or the transport indices of the studied solutes or in the arterial pressure or heart rate. All patients showed drowsiness or torpor during the low sodium PET and one had cramps. The 126 mEq/L sodium dialysis solution showed no advantages compared to the more common solution, 132 mEq/L. However, further study is necessary to check the potentiality of solutions with different sodium and glucose compositions for both acute and chronic use.
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PMID:Low sodium concentration solution in normohydrated CAPD patients. 853 44

We administered potassium iodide and propylthiouracil per rectum, in conjunction with intravenous dexamethasone and propranolol, for emergent treatment of a patient in thyroid storm with small bowel obstruction. Shortly after initiation of this treatment, the patient successfully underwent two emergent surgical procedures for resection of an intestinal volvulus with advanced peritonitis. Serum levels of iodide and propylthiouracil showed substantial absorption of these drugs via the rectal route. Measurement of 24-h urinary-free iodide indicated that the bioavailability of potassium iodide delivered by retention enema was at least 40%. Parenteral iodide preparations have been unavailable in the past, and continue to be difficult to obtain emergently. Rectal administration of inorganic iodide is an effective, readily available and less expensive alternative to parenteral sodium iodide for patients in thyroid storm with upper gastrointestinal tract dysfunction.
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PMID:Rectal administration of iodide and propylthiouracil in the treatment of thyroid storm. 856 81

The parameters of potassium homeostasis (potassium concentration in the plasma, red cells, and urine and potassium to sodium ratio in the urine) and of carbohydrate-energy metabolism (CEM) assessed from the activities of the key enzymes of glycolysis and pentose phosphate route of glucose oxidation were determined in 52 patients on day 2 postoperation. Relationships between potassium metabolism and CEM status were revealed in children with diffuse peritonitis. Disorders in potassium homeostasis were associated with CEM changes. In children with a favorable course of the disease the adaptation changes in the metabolic system, characterized by increased intensity of glucose oxidation and intactness of cellular energy homeostasis, permit the maintenance of potassium homeostasis at optimal potassemia of low therapeutic value. In case of a lethal outcome failure of therapeutic measures aimed at correction of potassium homeostasis is coupled with CEM disorders manifesting by reduced glucose oxidation after the pentose phosphate route, reduced concentration of adenyl nucleotides, disordered membrane permeability, and accumulation of organic acids.
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PMID:[The interrelationship of changes in carbohydrate-energy metabolism and potassium homeostasis in children with diffuse suppurative peritonitis]. 871 16

The natriuretic effect of atrial natriuretic peptide (ANP) is blunted in certain clinical disorders such as congestive heart failure and liver cirrhosis, despite the elevated plasma ANP levels. These sodium-retaining states are characterized by increased activity of the renal sympathetic nerves. Recent studies have shown higher levels of circulating and urinary catecholamines in cancer patients. We hypothesized that the increased adrenergic activity may be responsible for ascites formation in patients with peritonitis carcinomatosa (PC). The objective of this study was to determine the renal responses to endogenous ANP in patients with PC. Patients, hospitalized at our institute for PC, were examined using renal clearance studies for 2 h. Non-cancer patients were also examined as control subjects. Statistical analysis was performed using Wilcoxon's rank sum test. The results showed that absolute and fractional sodium excretions were markedly lower in patients with PC (54 +/- 16 microEq/min, means +/- SE, p < 0.0005; 0.55 +/- 0.15%, p < 0.005) than in control patients (166 +/- 14 microEql/min; 1.14 +/- 0.09%, respectively). Plasma ANP concentration was increased in patients with PC (34.7 +/- 8.4 pg/ml, p < 0.001) in comparison with control patients (13.3 +/- 2.0 pg/ml). Plasma and urinary levels of norepinephrine were significantly higher in cancer patients (0.36 +/- 0.10 ng/ml, p < 0.05; 125 +/- 20 ng/dl GF, p < 0.05) than in the controls (0.17 +/- 0.02 ng/ml; 73 +/- 13 ng/dl GF). These results suggest that increased renal sympathetic nerve activity may contribute to the attenuation of the natriuretic effect of ANP in patients with PC.
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PMID:Resistance to natriuresis in patients with peritonitis carcinomatosa. 874 Jan 93

We examined the effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) and cefmetazole sodium on survival, neutrophil count, and neutrophil function in rats with peritonitis produced by cecal ligation and puncture. Rats with peritonitis received either rhG-CSF (50 or 100 micrograms/kg) with or without cefmetazole (50 mg/kg) for 3 days, cefmetazole alone, or no treatment and were evaluated as controls. The mortality rate of all treated rats was significantly lower than that of the untreated rats. The survival rate was 57.1% for the rats given both rhG-CSF and cefmetazole, but there was no significant improvement of survival as compared with cefmetazole therapy alone. Treatment with rhG-CSF at 100 micrograms/kg caused the circulating neutrophil count to increase significantly. The phagocytic activity for latex beads and neutrophil H2O2 production showed a greater enhancement by phorbol myristate acetate (PMA) in the untreated rats, thus indicating that neutrophils from treated rats were more activated. These findings show that rhG-CSF can improve survival and neutrophil function in rats with peritonitis, while combined therapy with cefmetazole was also found to be beneficial.
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PMID:Activation of neutrophil function by recombinant human granulocyte colony-stimulating factor improves the survival of rats with peritonitis. 888 40


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