Possible Heparin-Inouceo Subcutaneous Necrosis in a CAPO Patient

1987 ◽  
Vol 7 (3) ◽  
pp. 187-189 ◽  
Author(s):  
Peter J. Somerville ◽  
Elizabeth O'Brien ◽  
Michael Kaye
Keyword(s):  
At Risk ◽  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Broad Spectrum ◽  
Anterior Abdominal Wall ◽  
Broad Spectrum Antibiotics

A patient developed subcutaneous necrosis of the tissue of the anterior abdominal wall while carrying out continuous ambulatory peritoneal dialysis (CAPD). This necrosis was preceded by a leak of heparin-containing dialysate into the area. We believe this represents an example of the entity -heparin-induced subcutaneous necrosis. After reviewing the appropriate literature, we have concluded that intraperitoneal heparin should be used with caution in CAPD patients, who are at risk for leakage and heparin necrosis, i.e. those who are diabetic, elderly, obese, and receiving broad spectrum antibiotics.

scholarly journals Fungal peritonitis in patients undergoing continuous ambulatory peritoneal dialysis in Qatar

2011 ◽  
Vol 5 (09) ◽  
pp. 646-651 ◽  
Author(s):  
Fahmi Yousef Khan ◽  
Mohammed Elsayed ◽  
Deshmukh Anand ◽  
Mohammed Abu Khattab ◽  
Doiphode Sanjay
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Broad Spectrum ◽  
Candida Species ◽  
Antibiotic Use ◽  
Fungal Species ◽  
Fungal Peritonitis ◽  
Bacterial Peritonitis ◽  
Broad Spectrum Antibiotics ◽  
Appropriate Therapy

Introduction: This study was conducted at Hamad General Hospital to determine the incidence of fungal peritonitis and to describe its clinical and microbiological findings in patients undergoing continuous ambulatory peritoneal dialysis in Qatar. Methodology: The medical records of these patients between 1 January 2005 and 31 December 2008 were retrospectively reviewed and the collected data were analysed. Results: During the study period, 141 episodes of peritonitis were observed among 294 patients. In 14 of these episodes (9.9%), fungal peritonitis was reported in 14 patients with a rate of 0.05 episodes per patient year, while the bacterial peritonitis rate was 0.63 per patient year. Thirteen (93%) patients had one or more previous episodes of bacterial peritonitis that was treated with multiple broad-spectrum antibiotics, 11 (85%) had received broad-spectrum antibiotics within the preceding month, 12 (92%) within three months, and 8 (62%) within six months. Candida species were the only fungal species isolated from the dialysate with predominance of non-albicans Candida species (especially Candida parapsilosis). Therapeutic approach was immediate catheter removal, followed by systemic antifungal therapy and temporary haemodialysis. Nine patients (64.3%) were continued on haemodialysis, whereas five patients (35.7%) died. Conclusions: Prior antibiotic use was an important risk factor predisposing patients to the development of fungal peritonitis. Early detection of fungal peritonitis would lead to early institution of appropriate therapy and prevention of complications.

Change in the Transport of Uric Acid under the Influence of Pyrazinoic Acid: In Vitro Studies with Human and Rabbit Peritoneum

1989 ◽  
Vol 9 (4) ◽  
pp. 303-306 ◽  
Author(s):  
Krystyna Czyźewska ◽  
Alicja Grzegorzewska ◽  
Jan Knapowski
Keyword(s):  
Uric Acid ◽  
Peritoneal Dialysis ◽  
Comparative Analysis ◽  
Abdominal Wall ◽  
Experimental Model ◽  
Anterior Abdominal Wall ◽  
Bidirectional Transport ◽  
Abdominal Operations ◽  
Pyrazinoic Acid

Bidirectional transport of uric acid (UA) through human and rabbit peritoneum, and its change under the influence of pyrazinoic acid (PA) was investigated in vitro. Fragments of parietal peritoneum were taken from the region of anterior abdominal wall from rabbits (the animal series) and from patients undergoing abdominal operations (the human series). Under control conditions, higher values of the UA transport were found in the rabbit peritoneum in comparison with the human peritoneum, but in both series it was maintained at a constant level throughout the experiment lasting 120 min. In rabbit as well as in human peritoneum it was found that PA depressed about 50% of the UA transport from the interstitial to the mesothelial side, leaving the opposite direction intact. The results obtained in vitro are in agreement with previous observations in a patient undergoing peritoneal dialysis that showed decreased peritoneal UA excretion evoked by pyrazinamide. The comparative analysis proves the rabbit peritoneum to be a good experimental model for further investigations of peritoneal urate transport in man.

scholarly journals Fournier′s gangrene of the penis

2005 ◽  
Vol 38 (02) ◽  
pp. 154-156
Author(s):  
Francis Leo Tauro ◽  
M Roshan ◽  
B S Sathish Rao ◽  
J Ravikrishnan ◽  
Leo T Menezes
Keyword(s):  
Abdominal Wall ◽  
Broad Spectrum ◽  
Normal Skin ◽  
Skin Grafting ◽  
Early Therapy ◽  
Broad Spectrum Antibiotics ◽  
Localized Disease

ABSTRACTFournier′s gangrene is a rare, fulminant, though generally localized disease of the scrotum and penis with occasional extension up the abdominal wall. The usual organism is an anaerobic streptococcus synergistic with some second organism. Our case was unusual in that only the penis was involved without involving the scrotum or abdominal wall. Early therapy is the key, including hospitalization, debridement of entire shaft of the penis distal to the devasted area without excising the normal skin, parenteral broad-spectrum antibiotics & skin grafting. Only few cases of Fournier′s gangrene of the penis have been reported.

An Analysis of Peritonitis Rates with Bagless Continuous Ambulatory Peritoneal Dialysis (CAPD)

1990 ◽  
Vol 10 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Jack Rubin ◽  
Gay Case
Keyword(s):  
At Risk ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Connection System

This study was performed to evaluate if the increased number of connections needed to perform bagless continuous ambulatory peritoneal dialysis (CAPD) with the Delmed system was associated with an increased incidence of peritonitis. All patients, from April 1986 through October 1988, using the Delmed bag less connection system, the Delmed bag system, and the Abbott spike system were included. Fifty patients (42.7 years at risk) received bagless CAPD (53 episodes of peritonitis; 1.24 episodes/patient year of dialysis); 56 patients (46.8 years at risk) utilized the Delmed bag technique (76 episodes of peritonitis; 1.63 episodes/patient year); and 45 patients (66.7 years at risk) utilized the Abbott system (155 episodes of peritonitis; 2.36 episodes/patient year of dialysis). The time to the first peritonitis episode was not significantly different between groups. Fifteen patients were switched from the Abbott system (2.3 episodes/patient years) to the Delmed bagless system (0.9 episodes/patient year, peritonitis; p < 0.05) and 9 patients were switched from the Abbott spike system (2.3 episodes/patient years) to the Delmed bag system (1.4 episodes/patient years; p < 0.01). It is concluded that the Delmed bagless system is not associated with an increased incidence of peritonitis and that the Delmed system is at least as good as the spike connection devices.

Technical Aspects in Studying Peritoneal Morphology in Animal Models of Peritoneal Dialysis

2009 ◽  
Vol 29 (2_suppl) ◽  
pp. 40-44 ◽  
Author(s):  
Soner Duman ◽  
Sait Şen
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Histological Examination ◽  
Anterior Abdominal Wall ◽  
Anterior Wall ◽  
Abdominal Muscle ◽  
Tissue Samples ◽  
Peritoneal Tissue ◽  
Significant Difference ◽  
Peritonitis Model

Objective Peritoneal biopsies are considered useful for gaining a better understanding of the pathophysiology of the peritoneum during experimental peritoneal dialysis (PD). Different peritoneal tissue samples (i.e., abdominal wall, liver, diaphragm, intestine, and omentum) may be used, but there can be artifacts due to peritoneal tissue processing. Aim To investigate differences in peritoneal membranes from different parts of the peritoneum, and also 2 different fixatives, in experimental PD and a peritonitis model in rats. Methods Peritoneal tissues from the anterior abdominal wall, liver, omentum, and intestine were taken from each of 3 groups of animals: sham, experimental PD, and peritonitis model. Tissue samples were immediately fixed with 4% formaldehyde and routinely processed for histological examination. Two parietal peritoneal tissue samples according to longitudinal and horizontal sections of anterior wall inner abdominal muscle were also taken. All samples were immediately fixed with 4% formaldehyde and B5 fixative (B5), and then routinely processed for histological examination. Results In all groups, histopathological findings were more commonly seen in the abdominal wall samples. There were no changes observed in peritoneal membranes other than those of anterior abdominal wall samples from both sham and PD model rats. However, there was a significant difference between anterior and posterior facets of liver in the peritonitis model. Furthermore, the antimesenteric site of intestinal peritoneum was less affected than the mesenteric site. There were no significant histopathological differences between B5 and 4% formaldehyde fixation ( p > 0.05). Conclusion Our results suggest that peritoneum obtained from the anterior abdominal wall is the most affected area and therefore the most suitable site to investigate peritoneal changes in the experimental rat PD model. There were no significant differences between fixation with 4% formaldehyde and B5 solution. Abdominal wall samples should be of the same direction of inner abdominal muscle, that is, horizontal sectioning should be used for measurements of the submesothelial area.

scholarly journals Mycobacterium fortuitum abdominal wall abscesses following liposuction

2008 ◽  
Vol 41 (01) ◽  
pp. 58-61
Author(s):  
Hussam Al Soub ◽  
Eman Al-Maslamani ◽  
Mona Al-Maslamani
Keyword(s):  
Antibiotic Therapy ◽  
Abdominal Wall ◽  
Broad Spectrum ◽  
Mycobacterium Fortuitum ◽  
Surgical Drainage ◽  
Abdominal Abscesses ◽  
Broad Spectrum Antibiotics

ABSTRACTwe describe here a case of abdominal abscesses due to mycobacterium fortuitum following liposuction. the abscesses developed three months after the procedure and diagnosis was delayed for five months. the clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. this condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably result in the identification of more cases. combination antibiotic therapy with surgical drainage in more extensive diseases is essential for cure.

Neuropathy and Quality of Life in Diabetic Continuous Ambulatory Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 242-247 ◽  
Author(s):  
Theofanis Apostolou ◽  
Ram Gokal
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Peritoneal Dialysis ◽  
Autonomic Neuropathy ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Diabetic Patients ◽  
Number Of Patients ◽  
End Stage ◽  
The Impact

Oiabetes mellitus is the commonest cause of end-stage renal failure and is associated with considerable morbidity. Neuropathy is one of the most serious complications of diabetes, linked to the incidence of nephropathy and retinopathy. The prevalence of neuropathy increases with age and duration of diabetes. Peripheral sensorimotor neuropathy is the main manifestation of neurological dam -age in diabetes, while autonomic neuropathy, a devastating complication, is also present in a large number of patients with long-term diabetes. Clinical features of autonomic neuropathy are mainly cardiovascular disorders and abnormal visceral function. One of the most important sequelae of neuropathy is the development of the insensitive foot at risk of ulceration, deformation, Charcot neuroarthropathy, and amputation. Prevention, education, and identification of the at-risk patient are the key elements in managing these severe complications. Oialysis, and mainly peritoneal dialysis, still remains the main renal replacement therapy for end-stage renal disease (ESRO) diabetic patients. It is obvious from many studies that diabetes and its complications are major risk factors associated with poorer survival rates, increased morbidity, and decreased quality of life. Few, if any, data are available specifically evaluating quality of life in continuous ambulatory peritoneal dialysis (CAPO) diabetic patients. Fewer data are available estimating the impact of neuropathy on the quality of life of such patients. Specific studies must be carried out to further investigate quality-of-life issues and neuropathy in this vulnerable group of patients.

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