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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 1979 to 1989, continuous ambulatory peritoneal dialysis (CAPD) was undertaken for terminal renal failure in 104 patients (56 women and 48 men; average age 54 +/- 15.3 years at the onset of dialysis), for a total observation period of 175 patients years. Survival rate for patients and methods and dialysis effectiveness were analysed retrospectively, the incidence of peritonitis prospectively, 40 patients were aged 60 years and over. Diabetic nephropathy was the most common cause of terminal renal failure (44%). Cumulative patient survival rate was 80% in the first year of treatment; 57% of patients were still alive after two years. The cause of death in 45 of the 54 patients who had died was unrelated to CAPD, cardiac disease and cerebrovascular accident being the most frequent causes (n = 26). During the first treatment year 47% of patients contracted bacterial peritonitis, 59% during the first two years. In 9% of patients CAPD had to be discontinued within the first two treatment years because of CAPD-related complications. There was no case of sclerosing peritonitis or of ultrafiltration loss forcing CAPD termination. These data indicate that there is no plausible explanation from a medical viewpoint for the highly restrictive use of CAPD in the Federal Republic of Germany.
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PMID:[Continuous ambulatory peritoneal dialysis. Patient and method survival rate, peritonitis incidence and dialysis efficacy over 10 years]. 201 38

We studied the effects of systemic sepsis on peripheral microcirculatory fluid exchange by examining changes in flow (Qlymph) and lymph-to-plasma [L/P] total protein and albumin ratios from lymph draining, the efferent duct of a prefemoral lymph node in sheep, before and during surgically-induced peritonitis. After baseline study, peritonitis was produced by cecal ligation, perforation, and devascularization. By 24 hours blood cultures revealed a polymicrobial bacteremia. The hemodynamic response to the septic insult during the 72-hour study period was characterized by an increase in heart rate and an initial fall in stroke volume index; yet, the mean blood pressure remained unchanged from baseline levels throughout the study protocol. The intrapulmonary shunt fraction increased (p less than 0.05) by 48 hours, as did both the Qlymph (2.6 +/- 1.9 ml/hr to 6.8 +/- 4.6 ml/hr; p less than 0.05) and the calculated lymph albumin clearance (1.6 +/- 1.2 ml/hr to 3.1 +/- 1.7 ml/hr; p less than 0.05). Although the calculated serum to interstitial colloid osmotic pressure gradient fell (F = 4.37; p less than 0.04), both the [L/P] total protein and albumin ratios were unchanged from baseline throughout 72 hours of study. Further, [L/P] total protein ratios were unrelated to Qlymph (r = -0.20); as Qlymph (experimental/baseline) increased with sepsis, [L/P] total protein ratio (experimental/baseline) did not fall (r = +0.62). We therefore conclude that systemic sepsis, as represented by this model of bacterial peritonitis, results in increased peripheral microcirculatory fluid flux that is primarily a consequence of an increase in permeability of the peripheral microvascular exchanging membrane.
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PMID:Peripheral lymph flow in sheep with bacterial peritonitis: evidence for increased peripheral microvascular permeability accompanying systemic sepsis. 389 Feb 43

New liver transplant programs have usually been associated with a significant learning curve. This learning curve, however, can be minimized or avoided if certain conditions are met. In this paper we describe the establishment of a new liver transplant program in Szczecin, Poland and present its early results. Four members of the team underwent training in clinical liver transplantation in major centers in Europe. Transplant protocols were then adopted, all the necessary facilities set up, and multidisciplinary team created. Between February 2002 and August 2003, 22 adult orthotopic liver transplantations (OLT) were performed in 21 patients (13 male; mean age 46.3 years; range 33-62), including I retransplant for early hepatic artery thrombosis. Eighteen (86%) patients are alive between 4 and 22 (median 11) months after OLT. Seventeen patients have normal liver function and 14 of them have resumed full life activity. Three patients died: one of bacterial peritonitis (day 6), one of chronic rejection with allograft failure (month 4) and one following massive stroke (month 10). Surgical complications occurred in 7 patients (33%). We believe that proper training of vital team members at established transplant centers with good results, availability of adequate equipment and all the facilities required with strict adherence to transplant protocols are all paramount for a successful start of a liver transplant program.
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PMID:Early results of a new liver transplant program in Szczecin, Poland. 1517 Oct 8

Since the introduction of human serum albumin as a plasma expander in the 1940s, considerable research has allowed a better understanding of its biochemical properties and potential clinical benefits. Albumin has a complex structure, which is responsible for a variety of biological functions. In disease, the albumin molecule is susceptible to modifications that may alter its biological activity. During the last decades, different methods to measure albumin function have been developed. Recent studies have shown that not only albumin concentration but also albumin function is reduced in liver failure. This observation led to the concept of effective albumin concentration, which represents the fact that plasma albumin concentration does not reflect its function. Indeed, in liver disease albumin function is several times less than its concentration. In patients with cirrhosis, albumin infusion reduces mortality in patients with spontaneous bacterial peritonitis and improves outcome following large volume paracentesis. In combination with vasoconstrictors, albumin is useful in the management of patients with hepatorenal syndrome. Its role is being investigated in a large number of indications, which rely on its volume and nonvolume expansion functions such as stroke, severe sepsis, Alzheimer's disease, malaria, burns, and ovarian hyperstimulation syndrome. This review explores the above concepts, reviews the available evidence for the use of albumin in liver diseases, defines therapeutic limitations, and explores the challenges that should be addressed in future research.
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PMID:Albumin: pathophysiologic basis of its role in the treatment of cirrhosis and its complications. 2342 99