scholarly journals Peritoneal Resting with Heparinized Lavage Reverses Peritoneal Type I Membrane Failure. A Comparative Study of the Resting Effects on Normal Membranes

2014 ◽  
Vol 34 (7) ◽  
pp. 698-705 ◽  
Author(s):  
Erika De Sousa ◽  
Gloria Del Peso ◽  
Laura Alvarez ◽  
Silvia Ros ◽  
Ana Mateus ◽  
...  

BackgroundUltrafiltration failure (UFF) is a serious complication of long-term peritoneal dialysis (PD). Peritoneal rest (PR) has been demonstrated as a valid treatment to reverse the functional changes that occur in UFF. The effects of PR on a normally functioning human peritoneum are unknown but are expected to be neutral. Our hypothesis was that PR positively modifies peritoneal function in patients with UFF, in contrast to the absence of effects when PR is applied under normal conditions.Patients and MethodsWe studied 84 PR periods, comparing 35 patients with UFF and 49 controls (resting for abdominal surgery with temporary discontinuation of PD). We analyzed peritoneal transport pre-PR and post-PR by calculating the mass transfer coefficients of creatinine (Cr-MTAC), the dialysate/plasma creatinine ratio (D/P Cr) and the ultrafiltration (UF).ResultsBaseline data was similar for the 2 groups, although the UFF group had a longer median time in PD (39 [18 – 60] vs 10 [5 – 23] months; p = 0.00001). Peritoneal rest induced a decrease in D/P Cr, Cr-MTAC and an increase in UF capacity in the UFF group ( p = 0.0001, p = 0.004 and p = 0.001, respectively), without causing changes in the control group. Peritoneal rest in patients with more than 6 months of UFF was not able to reduce peritoneal solute transport or improve UF capacity. Response to PR did not differ among UFF patients with or without a previous history of peritonitis. Peritoneal rest enabled patients with UFF to continue on PD for a median time of 23 months (range, 13 – 46 months).ConclusionsPeritoneal rest induces functional changes in patients with UFF but not in those with no functional abnormalities. This demonstrates that PR works only when abnormal but reversible functional conditions are present. However, the effect is highly dependent on how early PR is applied.

Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.


2016 ◽  
Vol 23 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Mateja Kaja Jezovnik ◽  
Jawed Fareed ◽  
Pavel Poredos

Introduction: Although the role of inflammation in DVT has been investigated in different studies, there is no definite answer as to whether increased systemic inflammation is the cause or the consequence of DVT. Aim: To follow inflammatory parameters in a cohort of patients with idiopathic DVT. Methods: Out of 49 patients with an acute idiopathic DVT, which were investigated four months after an acute episode (DEVTA 1), 43 patients were included in the follow-up study investigating inflammatory markers and hemostatic markers of endothelial damage five years after an acute DVT (DEVTA 2). A control group consisted of 43 sex and age matched healthy subjects (CONTROLS). Results: The levels of inflammatory markers were significantly higher in DEVTA 2 in comparison to CONTROLS: tumor necrosis factor alpha 2.0 pg/mL (1.1-2.3) vs 1.3 pg/mL (0.8-1.9), p < .001, high sensitivity C-reactive protein 3.2 mg/L (1.5-5.2) vs 1.7 mg/L (0.9-3.0), p = .008, interleukin-6 (IL-6) 2.7 pg/mL (2.0-3.5) vs 2.1 pg/mL (1.5-2.6), p = .025, IL-8 5.0 pg/mL (3.6-7.3) vs 2.4 pg/mL (1.8-2.8), p < .001. IL-10 was significantly decreased (0.9 pg/mL (0.7-1.8) vs 1.8 (1.5-2.2), p < .001. Most of the proinflammatory markers remained elevated in the DEVTA 2 in comparison to DEVTA 1. Markers of endothelial damage were higher in DEVTA 2 in comparison to CONTROLS and higher than in DEVTA 1. Conclusion: Patients with idiopathic DVT have long-term increased inflammatory markers and markers of endothelial damage. These findings favor the hypothesis that inflammation is a cause and not merely a consequence of acute DVT.


2000 ◽  
Vol 20 (6) ◽  
pp. 631-636 ◽  
Author(s):  
Rafael Selgas ◽  
M.-Auxiliadora Bajo ◽  
M.-José Castro ◽  
Gloria Del Peso ◽  
Abelardo Aguilera ◽  
...  

Objective To define risk factors for ultrafiltration failure (UFF) during early stages of peritoneal dialysis (PD). Design Retrospective analysis of a group of patients whose peritoneal function was prospectively followed. Setting A tertiary-care public university hospital. Patients Nineteen of 90 long-term PD patients required a peritoneal resting period to recover UF capacity: 8 had this requirement before the third year on PD (early, EUFF group) and 11 had a late requirement (LUFF group). The remaining 71 patients, those with stable peritoneal function over time, constituted the control group. Main Outcome Measures Peritoneal UF capacity under standard conditions (monthly) and small solute peritoneal transport (yearly). Results None of the conditions appearing at the start of PD or during the observation period could be definitely identified as the cause of UFF. There were no differences in characteristics between the EUFF group and the other two groups, except for the higher prevalence of diabetes in the EUFF group. Residual renal function (RRF) declined in all three groups during the first 2 years, with rapid loss during the third year in the EUFF group. This rapid loss in RRF was coincident with UFF. Peritoneal solute and water transport at baseline was similar in the three groups. After 2 years on PD, individuals in the EUFF group showed a significantly lower UF and higher creatinine mass transfer coefficient values than those in the LUFF group. Diabetic patients in the control group showed remarkable stability in UF capacity over time. During the second year on PD, requirement for increases in dialysate glucose concentration was 3.4 ± 0.5% in the LUFF group, but as high as 25.5 ± 24.2% in the EUFF group. The accumulated days of active peritonitis (APID, days with cloudy effluent) were similar for the three groups after 1, 2, and 3 years on PD. Interestingly, diabetic patients in the control group showed an APID index significantly lower than the overall EUFF group. Diabetics in the control group also had significantly lower APID versus nondiabetics in the control group ( p = 0.016). Conclusions Our findings suggest that certain patients develop early UFF type I. Diabetic state and a higher glucose requirement to obtain adequate UF suggest that glucose on both sides of the peritoneal membrane could be responsible. The mechanisms for this higher requirement remain to be elucidated. The identification of a larger cohort of these early UFF patients should lead to a better exploration of the primary pathogenic mechanisms.


1977 ◽  
Vol 130 (4) ◽  
pp. 377-385 ◽  
Author(s):  
David W. Pierce

SummaryThe difficulties in measuring suicidal intent in cases of self-injury are discussed, and a scale is described to measure this intent. This scale has been used in 500 cases of self-injury. It is practical and reliable. Results show that the scores derived from it are closely related to the similar Beck Scale; they are also related to age, sex, social isolation, method of self-injury, previous history of self-injury or of psychiatric treatment, physical health at the time of self-injury and alcohol abuse. These results are discussed with particular reference to suicide prediction and the future validation of the scale by long-term follow-up.


2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Ceyda Sarıal ◽  
Abdulhamıt Tayfur ◽  
Beyza Kap ◽  
Dılara Donder ◽  
Ozum Melıs Ertuzun ◽  
...  

Objectives: To investigate the impact of having previous history of inversion ankle sprain on balance tests in adolescent volleyball players. Methods: Fourty-five adolescent volleyball players with mean age of 15.26±1.03 participated in our study. Twenty-nine were uninjured (control group) and sixteen had previously experienced inversion injuries on right ankle. 9 players had the injury more than than one year ago and 7 players had it before six to twelf months. Balancing abilities were evaluated by Star Excursion Balance Test (SEBT) and Single Limb Hurdle Test (SLHT). The fact that players with history of injury had the ankle sprain at right foot led us to perform the measurements in the control group also for the right foot. We compared the results of injured and uninjured players on both tests. Results: Uninjured players' reaching distance on right foot was found out to be significantly more than in players with ankle sprain at medial and posteromedial directions of SEBT(p<.05), whereas there were no differences detected for the other directions (p>.05). For comparing athletes' performances with SLHT, finishing time was found significantly better in uninjured players (p<.05). Conclusion: Adolescent volleyball players with history of injury show lower performance on balance tests compared to uninjured players. This demonstrates that they should be given a training including balance and stabilization programs.


2016 ◽  
Vol 62 (5) ◽  
pp. 67-68
Author(s):  
Lubov V. Matchekhina ◽  
Ekaterina A. Shestakova ◽  
Zhanna E. Belaya ◽  
Marina V. Shestakova

Introduction. The relevance of carbohydrate metabolism studying in patients with Cushing disease can be explained by frequent occurrence of glucose metabolism disturbances on the one hand, and difficulties in glucose-lowering therapy in these patients on the other. The effectiveness of hyperglycaemia treatment may be reduced due to difficulties in remission / cure of the underlying disease, as well as to the use of specific drug-therapy, leading to the hyperglycaemia. There is a growing interest in research aimed at studying the role of incretin system in the pathogenesis of secondary hyperglycemia associated with neuroendocrine diseases recently.Methods. A total of 20 patients with Cushing disease were included, (19 female and 1 male), the mean age was 37.5 years (18-69). All of the patients were diagnosed with Cushing disease for the first time (using urinary free cortisol levels and MRI-data); none of them had a history of previous drug therapy, radiotherapy or pituitary surgery. The mean HbA1c level was 5,8% (5,3-6,2). All patients underwent OGTT, during which glucose, glucagon, GLP1, GLP2, GIP, ghrelin were measured at 0, 30 and 120 min respectively. The control group included 21 patients without previous history of carbohydrate metabolism disturbances. After OGTT 57% were presented without any carbohydrate metabolism disturbances, 28,57% presented with prediabetes and 14,43% were diagnosed with diabetes.Results. After glucose levels analyzing 40% of patients were diagnosed with early carbohydrate metabolism disturbances ,15% were diagnosed with diabetes. After glucose intake a slight inrease in glucagon levels with a peak by 30’ (p=0,001) compared to gradually decreasing levels in controls was observed . The levels of GIP during OGTT were not significantly different compared to control group. GLP-1 and GLP-2 levels were significantly higher compared to controls (p=0,017 and p<0,001 respectively) with peak levels at 30’. Ghrelin levels were also significantly higher compared to controls (p=0,013)Conclusion. Incretins levels can be possible markers of specific carbohydrate metabolism disturbances in patients with Cushing disease and presumably will help to differentiate steroid diabetes from T2DM. Further investigations needed to prove these speculations.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10012-10012
Author(s):  
M. Takeuchi ◽  
T. Saeki ◽  
M. Sano ◽  
H. Sonoo ◽  
H. Honjo ◽  
...  

10012 Background: Some prospective studies in US and UK (represented by Women’s Health Initiative and Million Women Study) show that HRT use may increase the risk of breast cancer. However, it is unclear whether or not this perspective is applicable to Japanese women, due to several factors such as the difference in incidence of breast cancer, difference in HRT prevalence, which are to be concerned in this study. To investigate the relationship between HRT use and breast cancer, a case-control study was conducted in Japan. Methods: We sent self-administered questionnaire to 4,500 cases who have a previous history of confirmed histological breast cancer and 4,500 controls who were selected according to the inclusion criteria. All the subjects were between age 45 and 69 at the time of enrollment. Among these subjects, 3,434 in case group and 2,427 in control group sent back their questionnaire (total 5,861). The datacenter was run in Kitasato Univ. and the statistical analysis was performed using SAS (version 9.1). Control was selected by considering the screening record for GI disease and respiratory disorders, with no previous history of breast cancer, gynecological and hormonal disease at the time of screening. We asked about past history of exposure to the factors supposed to be breast cancer-causing; previous or current use of HRT, age at diagnosis, academic background, BMI, lifestyle habits, age of menarche, birth history, history of breast feeding, family history, use of contraceptive agents and menopausal status. Results: As the main analysis result, 164 (5.0%) out of 3,316 cases and 253 (7.4%) out of 2355 controls had used HRT (Odds ratio 0.432 [95% CI 0.352–0.530]. Conclusions: The result of this study shows that HRT users were less likely to develop breast cancer than never users. However, in this study, there was a difference in the observation period for the past use of HRT between cases and controls. Considering the transition of HRT prevalence in Japan, there may be a possibility that this difference can be a cause of a serious bias for the main analysis result. Further sensitivity analyses are needed to evaluate the robustness of the findings and this point is under consideration. No significant financial relationships to disclose.


2016 ◽  
Vol 33 (S1) ◽  
pp. S337-S337
Author(s):  
M. Pantovic Stefanovic ◽  
B. Dunjic-Kostic ◽  
M. Lackovic ◽  
A. Damjanovic ◽  
A. Jovanovic ◽  
...  

IntroductionImmune alterations are believed to be an important part in etiopathogenesis of affective disorders. However, it is not clear if the altered immune mediators are related to distinct disorders or particular psychopathology.AimsThe aim of our study was to explore the differences in C-reactive protein levels (CRP) between euthymic BD patients and healthy controls, as well as to explore the relationship between CRP and lifetime presented psychopathology within BD.MethodsThe study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.ResultsThe CRP levels were significantly higher in BD patients when compared to healthy controls. After covarying for confounders, we observed that CRP levels, in euthymic BD patients, were related to number of previous suicide attempts, but not other indicators of lifetime psychopathology.ConclusionsBD patients per se, and particularly those with more suicide attempts, are more likely to present with proinflammatory state, even when in remission. Previous history of suicide attempts could bear specifically vulnerable endophenotype within BD. Systemic, longitudinal monitoring of the course of illness, and potential inflammatory mediators that underlie its systemic nature is warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2018 ◽  
Vol 39 (09) ◽  
pp. 682-687
Author(s):  
Paul van Donkelaar ◽  
Jill Dierijck ◽  
Alexander Wright ◽  
Jonathan Smirl

AbstractOcular near point of convergence (NPC) has been shown to be sensitive to the effects of concussion and subconcussive impacts. To determine if NPC is also sensitive to a previous history of concussion, male contact-sport athletes either with (n=26) or without (n=16) a history of at least one previous concussion had their NPC assessed. The results showed that participants with a history of concussion displayed NPC values (9.4±1.6 cm) indistinguishable from those with no history of concussion (8.4±2.1 cm, t-test, p=0.09). This was the case regardless of whether 1, 2, or 3 or more concussions had occurred and despite the fact participants with concussion (mean time since last concussion: 1136 days) suffered from an increased number and severity of symptoms as assessed with the SCAT 3 (3.6±2.2 vs. 2.13±1.89 symptoms, 6.1±4.1 vs. 3.19±2.99 severity, t-test, p<0.05). Taken together, these results imply that NPC may not be a suitable tool to assess the potential long-term effects of one or more concussions over a longer time frame. Future research using larger sample sizes is warranted to evaluate the potential dose-response relationship between number of prior concussions and NPC.


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