Prospected Randomized Study of Two Y Devices in Continuous Ambulatory Peritoneal Dialysis (CAPD)

1989 ◽  
Vol 9 (3) ◽  
pp. 165-168 ◽  
Author(s):  
Giusto Viglino ◽  
Adolfo Colombo ◽  
Antonio Scalamogna ◽  
Pier L. Cavalli ◽  
Luisella Guerra ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dwell Time ◽  
Randomized Study ◽  
Test Group ◽  
Control Group ◽  
Safety And Efficacy

To evaluate acceptability, safety, and efficacy of a y set with two short branches (TAs) filled with electrolytic chloroxidizer solution during the dwell time, 60 patients were randomly allocated to be treated with the traditional y set (TCs) or with the T AS. Twenty-three were new patients whereas the remaining 37 were patients already on continuous ambulatory peritoneal dialysis (CAPD) with the TCs. The follow-up was 416.5 months in the control group and 387.4 months in the test group. During the study period there were 6 peritonitis episodes in each group with an incidence of 1 episode every 69.4 patient-months in the control group and 1 episode every 64.6 patient-months in the test group. Twenty-four patients (80%) in the control group and 27 (90%) in the test group were free from peritonitis. The probability to remain free from peritonitis was respectively 87% and 83% in the test group and in control group after 12 months, 70% and 78% after 21 months. seventy -nine percent of the patients who used both systems preferred the T AS for better handling, lower encumbrance, and major safety. One patient preferred the TCs, three patients did not find any differences between the two devices.

In Vitro and in Vivo Efficacy of a New Connector Device for Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 148-151 ◽  
Author(s):  
Giusto Viglino ◽  
Adolfo Colombo ◽  
Paolo Cantu ◽  
Corrado Camerini ◽  
Luigi Catizone ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Controlled Trial ◽  
Test Group ◽  
Control Group ◽  
In Vivo Efficacy ◽  
Short Branch

The purpose of this study was to evaluate the In vltro and in vivo efficacy of a new connection system for continuous ambulatory peritoneal dialysis (CAPO), called the T-set. With this system the patient wears a 27–cm extension line filled with Amuchina during the dwell time; the bag is made of a fill container linked to a drainage tube with a Y-shaped set. For bag exchange, only one connection is needed and this is subsequently flushed with the entire drainage volume. The in vitro efficacy of the system was tested with 20 sets filled with 10 mL of Amuchina and inoculated in the distallumen with 2.1x103 colony-forming units (cfu) of S. aureus. After an Incubation of 4–6 hours at 35–37°C, three dialysate samples per set were collected, respectively, at the beginning of drainage and filling. Al1120 samples were negative, whereas two control sets, filled with a phosphate-buffered saline, had positive drainage samples, and at least one positive Infusion sample, Indicating the efficacy of Amuchina in sterilizing the system under conditions simulating touch contamination. To evaluate the in vivo efficacy, safety, and acceptability of the T-system, a prospective randomized controlled trial was performed In seven centers: a control group (CG) of 56 patients (follow-up: 952.3 months, mean±SO: 17.0±7.8) was treated with a long branch (21 patients) or short branch (35 patients) Y-set and a test group (TG) of 66 patients (follow-up: 898.1 months, mean±SO: 13.6±7.8) with the T-set. The two groups were comparable for patient and dialysis characteristics. The incidence of peritonitis was 1143.3 months in the CG and 1129.0 months In the TG (p=NS). The percentage of patients without peritonitis was 67.8% In the CG and 68.2% In the TG (p=NS); the probability of remaining free from peritonitis was, respectively, 76% and 75% In the CG and in the TG at 1 year, and 66% and 60% at 2 years (p=NS). In the CG 26 patients and In the TG 21 patients were already on CAPO before the trial; among these 21 patients, 10 of 10 with the long Y-set and 4 of 11 with the short Y-set who transferred to the T-set preferred the latter for better handling (52.4%) or for less encumbrance (14.3%).

Nutritional Status of Capd Patients at Three Years

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 195-204 ◽  
Author(s):  
Leocadia Palop ◽  
Nicanor Vega ◽  
Teresa Rodriguez ◽  
Ana Fernandez ◽  
Jose C. Rodriguez ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Steady State ◽  
Nutritional Status ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Nutritional Assessment ◽  
Residual Renal Function ◽  
Control Group ◽  
Protein Calorie Malnutrition

A nutritional assessment was carried out in 63 patients starting treatment from April 1990 up to December 1993. Anthropometric measurements were performed showing a prevalence of protein-calorie malnutrition (PCM) of 21 % in a total of 142 clinical surveys carried out in the above-mentioned sample. A steady state of albumin levels in plasma was verified during a three-year follow-up period at a lower level than that of the control group. The patients’ lymphocytic profile throughout the study was characterized by lymphopenia and decreased B and T 8 lymphocytes. During the first two years of continuous ambulatory peritoneal dialysis (CAPD), a high percentage of patients met the “adequacy” dialysis criteria as residual renal function plays an important role as regards treatment.

scholarly journals Rotary Instrument in Non-Surgical Treatment of Chronic Periodontal Disease: Clinic Randomized Study

2018 ◽  
Vol 12 (1) ◽  
pp. 952-959
Author(s):  
Carmine Verrusio ◽  
Mirko Medaglia ◽  
Roberto Lo Giudice ◽  
Francesco Puleio ◽  
David Rizzo ◽  
...  
Keyword(s):  
Randomized Study ◽  
Test Group ◽  
Root Surface ◽  
Periodontal Therapy ◽  
Control Group ◽  
Chronic Periodontal Disease ◽  
Rotary Instruments ◽  
And Control ◽  
Rotary Instrument

Objective: The aim of this study is to compare the efficacy of rotary instruments vs hand scalers in non-surgical periodontal therapy, studying the variation of periodontal health indexes. Materials and Methods: Forty patients (age between 30 and 70 years) with advanced chronic periodontitis, that were recruited for the study, were divided into two groups; control group and test group. Control patients were treated with hand scalers while test group patients were treated with rotary instruments. Periodontal indexes were evaluated at baseline and after 3 months. Results: Nonsignificant differences were found at 12 weeks follow up for all the parameters between test and control groups. Conclusions: Within their limits, the results indicate that different instruments can be effective in removing calculus and endotoxins. This requisite is mandatory for a proper periodontal healing. The reasons for clinicians to use diamond-coated instruments are related to a faster procedure, and the clinical evidence of a smooth root surface. The clinicians’ ability remains one of the most important variables that could affect periodontal therapy.

scholarly journals Twin- versus single-bag disconnect systems: infection rates and cost of continuous ambulatory peritoneal dialysis.

1996 ◽  
Vol 7 (11) ◽  
pp. 2392-2398 ◽  
Author(s):  
D C Harris ◽  
E J Yuill ◽  
K Byth ◽  
J R Chapman ◽  
C Hunt
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Randomized Study ◽  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection ◽  
Total Cost ◽  
Purchase Cost ◽  
Fluid Transfer

Although twin-bag disconnect fluid-transfer systems for continuous ambulatory peritoneal dialysis (CAPD) have a lower rate of catheter-related infection than single-bag systems, their greater monetary purchase cost has prevented universal adoption. Therefore, a single-center randomized study was performed in 63 adult patients to compare the efficiency and total cost of Freeline Solo (FS, twin-bag) and Basic Y (BY, single-bag) systems. Patients were new to CAPD (N = 39), or had a new CAPD catheter, or had had no episodes of peritonitis or exit-site infection in the previous 12 months (N = 24). Total follow-up was 631 patient months (pt.mon), and 53 patients were still on the trial at its termination. Patients rated FS as easier to use than BY (P < 0.001). Peritonitis occurred on 23 occasions in 12 out of 30 patients using BY, and on seven occasions in five of 33 patients using FS. Time to first infection was less with BY than FS (hazard ratio, 2.4; 95% confidence interval (CI), 1.0 to 5.3; P < 0.04). Cumulative incidence of peritonitis was 1 per 14.0 pt.mon with BY and 1 per 46.5 pt.mon with FS (odds ratio, 3.6; 95% CI 1.5 to 8.5; P = 0.004). Length of hospitalization for peritonitis or exit-site infection was 98 days in six patients with BY, versus 17 days in two patients with FS. With BY, four catheters were removed because of infection, but none with FS (P < 0.05). With BY, the total cost of infection was $AUD127,079 ($5033 per pt.yr) versus $19,250 ($704 per pt.yr) with FS, which offset the higher purchase cost of FS. The total cost of CAPD was $AUD956 per pt.yr less with FS than BY. In conclusion, the higher purchase cost of the FS twin-bag system is more than offset by savings from its lower incidence of peritonitis.

scholarly journals Co-existence of Hypertension and Pre-existing Cardiovascular Disease, Hypertension, and Pre-existing Cardiovascular Disease and Mortality in Patients on Continuous Ambulatory Peritoneal Dialysis

2020 ◽  
Author(s):  
Xiaoyang Wang ◽  
Xiaojiang Zhan ◽  
Qian Zhou ◽  
Xiaoran Feng ◽  
FenFen Peng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cox Regression ◽  
Multinomial Logistic Regression ◽  
Chinese Patients ◽  
Control Group ◽  
Cvd Mortality

Abstract Background Little is known about the effect of co-existence of hypertension (HTN) and pre-existing cardiovascular disease (CVD), pre-existing CVD, and HTN on mortality in patients on continuous ambulatory peritoneal dialysis (CAPD).Methods We conducted a retrospective study of 3073 incident Chinese patients on CAPD from five dialysis centers between January 1, 2005 and December 31, 2018 in a real-world setting. The primary and secondary outcomes were all-cause and CVD mortality. The association between co-existence of HTN and pre-existing CVD, pre-existing CVD, and HTN and mortality was analyzed using Cox regression models.Results Over a median of 33.7 months of follow-up, 581 (18.6%) patients died, with 286 (9.3%) CVD mortality. Multinomial logistic regression showed that diabetes mellitus was associated with 6.22 (95% CI 4.46 to 8.68)-time risk of co-existence of HTN and pre-existing CVD After adjusting for the confounding factors, HTN plus CVD, pre-existing CVD, and HTN groups had a higher risk of all-cause mortality (HR 3.98, 95% CI 3.07 to 5.17; HR 2.18, 95% CI 1.27 to 3.74; and HR 1.83, 95% CI 1.47 to 2.28) and CVD mortality (HR 4.68, 95% CI 3.27 to 6.69; HR 2.11, 95% CI 0.96 to 4.63; and HR 1.87, 95% CI 1.37 to 2.54), respectively, compared to the control group. There was no significant interaction between HTN and pre-existing CVD on all-cause and CVD mortality (β = 0.010, P = 0.973; β = 0.058, P = 0.892) in the study population.Conclusions CAPD patients with co-existence of HTN and pre-existing CVD at the start of CAPD are at highest risk of all-cause and CVD mortality, followed by pre-existing CVD patients and HTN patients accordingly, with diabetes mellitus as a robustly predictor for co-existence of HTN and pre-existing CVD.

A Randomized Multicenter Clinical Trial to Evaluate the Effects of An Ultraviolet Germicidal System on Peritonitis Rate in Continuous Ambulatory Peritoneal Dialysis

1985 ◽  
Vol 5 (1) ◽  
pp. 19-24 ◽  
Author(s):  
◽  
K.D. Nolph
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Control Period ◽  
Test Group ◽  
Multicenter Trial ◽  
National Registry ◽  
Control Group ◽  
Base Line ◽  
Stage Renal Disease ◽  
End Stage

In continuous ambulatory peritoneal dialysis (CAPD), peritonitis frequently is assumed to result from spike contamination during bag exchanges. An ultraviolet germicidal chamber has been developed, which disinfects the spike and the solution-bag outlet before spike insertion. This report summarizes the results of a multicenter trial carried out to determine if this device reduces the incidence of peritonitis in patients on CAPD. Ten centers contributed 167 patients who were followed during a base-line historical control period for a minimum of four months. Thereafter, 93 patients were randomized to a control group, and 74 to the test group. After an interim period for retraining (both groups) and change over (test group), a trial period of nine months was undertaken. Peritonitis rates and actuarial analyses of time-to-peritonitis showed no significant differences between historical and trial periods in either group, or between groups during either period. In both groups, rates of peritonitis were consistently lower than rates reported in the National Registry. The results suggest that, in the patients participating in these studies, spike contamination may have been an infrequent cause of peritonitis. In the U.S.A. over 9000 patients with end-stage renal disease are maintained on continuous ambulatory peritoneal dialysis (CAPD) (I). A peritonitis rate of 1.6 episodes per patient year represents the national average in the latest report of the U.S.A. CAPD Registry (2). Most clinicians assume that spike contaminations during bag exchanges are responsible for some portion of these episodes. Popovich, Moncrief and colleagues have described preliminary experiences with an ultraviolet germicidal system shown to disinfect intraspike contaminations with solutions containing 200,000 organisms per ml (3–4). An integrated dose of ultraviolet light within the germicidal chamber kills microorganisms before spike insertion into a fresh bag of solution. An improved chamber has been made available for clinical trials by Travenol Laboratories Inc (Deerfield, Illinois) (5). This study summarizes the results of a multicenter trial designed to test the effects of this germicidal chamber on the frequency of peritonitis in a population of patients maintained on CAPD.

scholarly journals Improvement of the heart failure patient process for the prevention of new events through tele-education and continuous tele-optimization of the treatment by nursing staff

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Perez Serrano ◽  
CNP Carlos Nicolas Perez Garcia ◽  
DEV Daniel Enriquez Vazquez ◽  
MFE Marcos Ferrandez Escarabajal ◽  
JDD Jesus Diz Diaz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nyha Class ◽  
Randomized Study ◽  
Primary Objective ◽  
Control Group ◽  
Close Monitoring ◽  
Chronic Patients ◽  
Face To Face ◽  
Funding Sources

Abstract Funding Acknowledgements Type of funding sources: None. Introduction patients with heart failure (HF) are especially vulnerable to SAR-CoV-2 infection especially due to their worse prognosis for this disease. Purpose to demonstrate that patients with HF will present similar health outcomes if their education and pharmacological treatment is optimised remotely by a nurse rather than through conventional care. Methods  A single-centre, observational, prospective, non-randomized study was carried out in which two groups were compared. The experimental group had most of their care provided virtually by a nurse who could optimise their medication according to the clinical guides whilst the control group received conventional face-to-face care. During a follow-up period of 6 months, patients included in the study have an initial face-to-face consultation with a cardiologist and an evaluation of the patient where the treatment objectives are established. The rest of the follow-ups were done through videoconsultation with the nurse every 15 days for 6 months where the neurohormonal treatment was optimized and an educational program was carried out with different cardiovascular educational topics. Results   Thirty-seven patients have been included. Sex: 30 men (81.0%) and 7 women (19.0%) Mean age: 67.9 years (12.8). Range 42-87 years. Etiology: 61.2% ischemic and 38.8% non-ischemic mean LVEF at inclusion = 30.2%. A total of 17 patients have completed the study: a 13% average improvement of FEVI, a reduction of NT-proBNP of and improvement in functional heart failure class. The primary objective was to compare the proportion of neurohormonal drugs prescribed, as well as the mean of the maximum doses reached in each after 6 months of follow-up, as well as mean ejection fraction, NYHA class and mean NT-proBNP (Table 1) Conclusions Telemedicine offers us valuable tools that allow us to take care of chronic patients, reducing exposure to the virus as much as possible. Efficient use of virtual tools and human resources makes close monitoring possible. Specialized nursing is a key element in the education, pharmacological optimization and monitoring of these patients. Parámetros analíticos Valores iniciales Valores finales NT-proBNP ( pg/mL) 3469,7 (± 4057,3) 1446,4 (± 1305,2) Creatinina (mg/dL) 1,10 (± 0,24) 1,12 (± 0,39) TFG (mL/min/1,73m2 ) 65,4 (± 21,2) 62,7 (± 23, 6) Potasio (meq /L) 4,5 (± 0,5) 4,6 (± 0,4) Fevi 29,4 % (± 7,2) FEVI 42,7 % (± 9,6)

Results of Peritoneal Equilibration Test during Treatment with Polyglucose Dialysis Solution

2002 ◽  
Vol 22 (3) ◽  
pp. 357-364 ◽  
Author(s):  
Alicja E. Grzegorzewska ◽  
Danuta Antczak-Jȩdrzejczak ◽  
Magdalena Leander
Keyword(s):  
Peritoneal Dialysis ◽  
Dwell Time ◽  
Control Period ◽  
University Hospital ◽  
Control Group ◽  
Peritoneal Equilibration Test ◽  
Dialysis Unit ◽  
Dialysis Solution ◽  
Glucose Ratio ◽  
Peritoneal Permeability

Background Results of peritoneal equilibration test (PET) suggest prolonged effect of polyglucose dialysis solution (PG-DS) on peritoneal permeability. Objectives An evaluation of dialysate-to-plasma ratio (D/P) of urea, D/P creatinine, and D/D0 glucose (ratio of dialysate glucose at designated dwell time to dialysate glucose at 0 dwell time), and mass transfer area coefficients (KBD) of these solutes in PET before introduction, during administration, and after discontinuation of PG-DS in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Design Single-center prospective study with PG-DS; retrospective selection of the control group. Setting Peritoneal dialysis unit in a university hospital. Patients Fourteen patients (11 males; age 45.1 ± 8.5 years) treated with CAPD for 17.5 ± 9.9 months. 7.5% PG-DS was used for the overnight exchange. After discontinuation of the PG-DS, standard dialysis solutions, as previously used, were reintroduced. The control group was selected to match both CAPD duration and peritoneal permeability of the patients in the PG-DS group at the start of the study. Methods Standard PET was carried out at 1.6 ± 0.8 months before the introduction of PG-DS (study period I, n = 14), after 1.2 ± 0.6 months’ use of PG-DS (study period II, n = 14), after 4.4 ± 0.8 months’ use of PG-DS (study period III, n = 11), after 8.8 ± 2.2 months’ use of PG-DS (study period IV, n = 9), and at 2.0 ± 0.6 months after PG-DS discontinuation (study period V, n = 11). Patients in the control group underwent PET at similar time intervals (control periods I – V). Results In the PG-DS group, a tendency toward increased peritoneal permeability for urea and creatinine was shown during the consecutive study periods. D/D0 glucose was significantly higher only in the PET performed during use of PG-DS (periods II – IV) compared to results obtained in period I. In the control group, both D/P and KBD of both urea and creatinine remained unchanged, but KBD glucose was higher in the first 2 hours of the PET in control period V compared to respective values in control period III. Conclusion Changes in peritoneal permeability are observed in CAPD patients treated with PG-DS. These changes may be at least partially related to the administration of polyglucose.

Nutritional Status of Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD)

1983 ◽  
Vol 3 (3) ◽  
pp. 138-141 ◽  
Author(s):  
Brigitte Heide ◽  
Andreas Pierratos ◽  
Ramesh Khanna ◽  
Jean Pettit ◽  
Raymond Ogilvie ◽  
...  
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Protein Intake ◽  
Biochemical Parameters ◽  
Total Body Potassium ◽  
Total Body ◽  
Over Time

Nutritional follow-up of 20 CAPD patients for 18–24 months showed a decrease in total body nitrogen, increase in total body potassium and body weight, and a decrease in protein intake over time. There was no correlation between changes in TBN and the biochemical parameters measured. Serial dietetic assessments and measurements of total body nitrogen as well as adherence to an adequate protein intake will assist in the prevention of malnutrition in CAPD patients.

A randomized controlled clinical trial to evaluate safety and efficacy of a Unani formulation in the management of Kalaf (Melasma)

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ifra Abdul Qaiyyum ◽  
Mohammad Nawab ◽  
Munawwar Husain Kazmi
Keyword(s):  
Quality Of Life ◽  
Test Group ◽  
Control Group ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
End Point ◽  
Intergroup Comparison ◽  
And Control ◽  
Change In Mean

Abstract Objectives Kalaf (Melasma) is an acquired facial hypermelanism. It has direct impact on patient’s quality of life and leads to development of various personality disorders. Lack of effective treatment and recurrences have drawn the attention of researcher to find alternative treatment. This study aimed to evaluate safety and efficacy of a topical Unani formulation in the management of melasma. Methods We conducted a prospective randomized controlled clinical study on the participants diagnosed with melasma. The participants (n=72) randomized into test (n=36) and control (n=36) groups. Sixty participants (n=30 in each group) completed the duration of therapy. The participants of the test group were treated with a classical Unani formulation and control group with hydroquinone 4%. The primary end point was change in mean MASI score and secondary end point was improvement in quality of life after eight weeks of treatment. Results The Unani formulation reduced 40.5% mean MASI score (17.31 ± 9.58 to 10.28 ± 5.92) in comparison to 32% reduction in mean MASI score (20.58 ± 9.49 to 13.92 ± 7.38) in the control group after eight weeks of treatment. When comparing with baseline the difference in MASI score was found statistically significant in both groups (p<0.05). On intergroup comparison, the change in MASI score between both groups was not statistically significant (p>0.05). In addition, MQOL and DQLI also improved significantly in both groups. Conclusions This study concluded that the Unani formulation and the control drug were equally effective and safer in the management of melasma.

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