Update: Infektiöse Komplikationen der Peritonealdialyse

2018 ◽  
Vol 22 (09) ◽  
pp. 411-414
Author(s):  
Daniel Kitterer

ZusammenfassungInfektiöse Komplikationen stellen weiterhin eine wichtige Komplikation der Peritonealdialyse (PD) dar. Durch technische Entwicklungen der letzten Jahrzehnte sind heutzutage Peritonitisraten möglich, die unter 0,5 Ereignissen pro Jahr (kleiner als 1 Ereignis pro 24 Monate) liegen. Die Vermeidung von Exit-site-Infektionen und die perioperative Single-Shot-Antibiotikagabe stellen weitere Möglichkeiten dar, um Peritonitiden bei PD-Patienten zu vermeiden. Bei der Antibiotikaauswahl müssen lokale Resistenzen sowie koagulasenegative Staphylokokken mit Methicillin-/Oxacillinresistenz beachtet werden. Gramnegative Keime mit Resistenzen gegen Cephalosporine stellen weiterhin erfreulicherweise eine Ausnahme dar. Sollten solche Keime zu einer Peritonitis führen, kommen Carbapeneme intraperitoneal als Alternative in Frage.

2011 ◽  
Vol 3 (1) ◽  
pp. 67
Author(s):  
Akihiko Nogami ◽  

Verapamil-sensitive fascicular ventricular tachycardia (VT) is the most common form of idiopathic left VT. According to the QRS morphology and the successful ablation site, left fascicular VT can be classified into three subgroups: left posterior fascicular VT, whose QRS morphology shows right bundle branch block (RBBB) configuration and superior axis (common form); left anterior fascicular VT, whose QRS morphology shows RBBB configuration and right-axis deviation (uncommon form), and upper septal fascicular VT, whose QRS morphology shows narrow QRS configuration and normal or right-axis deviation (rare form). Posterior and anterior fascicular VT can be successfully ablated at the posterior or anterior mid-septum with a diastolic Purkinje potential during VT or at the VT exit site with a fused pre-systolic Purkinje potential. Upper septal fascicular VT can also be ablated at the site with diastolic Purkinje potential at the upper septum. Recognition of the heterogeneity of this VT and its unique characteristics should facilitate appropriate diagnosis and therapy.


2013 ◽  
Vol 24 (1) ◽  
pp. 44
Author(s):  
Rapur Ram ◽  
Gudithi. Swarnalatha ◽  
C. Shyamsunar Rao ◽  
G. Diwakar Naidu ◽  
Kaligotla Venkata Dakshinamurty

2004 ◽  
pp. 373-380 ◽  
Author(s):  
Timothy D. Solberg ◽  
Steven J. Goetsch ◽  
Michael T. Selch ◽  
William Melega ◽  
Goran Lacan ◽  
...  

Object. The purpose of this work was to investigate the targeting and dosimetric characteristics of a linear accelerator (LINAC) system dedicated for stereotactic radiosurgery compared with those of a commercial gamma knife (GK) unit. Methods. A phantom was rigidly affixed within a Leksell stereotactic frame and axial computerized tomography scans were obtained using an appropriate stereotactic localization device. Treatment plans were performed, film was inserted into a recessed area, and the phantom was positioned and treated according to each treatment plan. In the case of the LINAC system, four 140° arcs, spanning ± 60° of couch rotation, were used. In the case of the GK unit, all 201 sources were left unplugged. Radiation was delivered using 3- and 8-mm LINAC collimators and 4- and 8-mm collimators of the GK unit. Targeting ability was investigated independently on the dedicated LINAC by using a primate model. Measured 50% spot widths for multisource, single-shot radiation exceeded nominal values in all cases by 38 to 70% for the GK unit and 11 to 33% for the LINAC system. Measured offsets were indicative of submillimeter targeting precision on both devices. In primate studies, the appearance of an magnetic resonance imaging—enhancing lesion coincided with the intended target. Conclusions. Radiosurgery performed using the 3-mm collimator of the dedicated LINAC exhibited characteristics that compared favorably with those of a dedicated GK unit. Overall targeting accuracy in the submillimeter range can be achieved, and dose distributions with sharp falloff can be expected for both devices.


2019 ◽  
Author(s):  
Nina Wressnigg ◽  
Romana Hochreiter ◽  
Oliver Zoihsl ◽  
Andrea Fritzer ◽  
Nicole Bézay ◽  
...  

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