Clinical Experience with Icodextrin in Continuous Ambulatory Peritoneal Dialysis Patients

1994 ◽  
Vol 14 (2_suppl) ◽  
pp. 51-54 ◽  
Author(s):  
Andrew Stein ◽  
Elizabeth Peers ◽  
Jane Hattersley ◽  
Kevin Harris ◽  
John Feehally ◽  
...  
Keyword(s):  
United Kingdom ◽  
Clinical Experience ◽  
Laboratory Data ◽  
Liver Function Tests ◽  
Sodium Concentration ◽  
Compassionate Use ◽  
Dialysis Patients ◽  
The United Kingdom ◽  
Bone Biochemistry ◽  
Retrospective Multicenter Study

Objectives To review the clinical experience in the United Kingdom with icodextrin (Ic). Design A retrospective multicenter study. Patients (1) the MICAS 1 patients who received Ic and elected to continue using it (called MICAS 2 patients), and (2) patients started on Ic on a named-patient basis (called compassionate use patients). Nearly all this latter group had ultrafiltration (UF) failure and were approaching hemodialysis (HC). Interventions The institution of one Ic bag, as the overnight exchange, usually in addition to three glucose bags. Results (1) MICAS 2: Of the 67 patients who received Ic and completed MICAS 1, 48 (72%) patients from eight units in the United Kingdom wished to continue Ic. Forty two percent of MICAS 2 patients were well on Ic after approximately 30 months of study (including the 6 months on MICAS 1). The main reasons for withdrawal were transplantation (21 %), death (17%), or transfer to HC for reasons other than UF failure (10%). There were no significant changes in laboratory data, including hematology, simple biochemistry, bone biochemistry, liver function tests, serum osmolality, and maltose levels. The adverse events reported were incidental to Ic. (2) Compassionate use: 30/63 (48%) patients remain well on Ic after 10 months of study. Eight patients (12%) went on to experience UF failure (again) after 13 months on Ic, requiring transfer to HC. The other main outcomes were death (11 %), transplantation (11 %), or transfer to HC for reasons unrelated to Ic (16%), usually intractable peritonitis. The serum sodium concentration decreased from 136.6±3.8 to 134.4±4.2 mmol/L (p < 0.05). There were no other significant changes in hematology or biochemistry measurements. Conclusion In MICAS 2 Ic probably maintained its effects, since there were no withdrawals due to UF failure. The compassionate use program has shown that a single Ic exchange is useful in UF failure, being able to prevent or delay transfer to hemodialysis. In both studies the safety and efficacy of Ic has been demonstrated in a large group of patients. A total of 192 patient-years of experience (including MICAS 1) has been accumulated to date. Properly controlled studies are needed to determine whether Ic, in its present form, should remain a “special needs” product (for UF failure) or whether it could replace glucose as the treatment of choice for CAPC patients.

scholarly journals Characterisation and source identification of biofluorescent aerosol emissions over winter and summer periods in the United Kingdom

2019 ◽  
Vol 19 (3) ◽  
pp. 1665-1684 ◽  
Author(s):  
Elizabeth Forde ◽  
Martin Gallagher ◽  
Virginia Foot ◽  
Roland Sarda-Esteve ◽  
Ian Crawford ◽  
...  
Keyword(s):  
United Kingdom ◽  
Relative Humidity ◽  
Aerosol Particles ◽  
Fungal Spores ◽  
Laboratory Data ◽  
Fungal Spore ◽  
Complete Analysis ◽  
Published Data ◽  
The United Kingdom ◽  
Fluorescent Particles

Abstract. Primary biological aerosol particles (PBAPs) are an abundant subset of atmospheric aerosol particles which comprise viruses, bacteria, fungal spores, pollen, and fragments such as plant and animal debris. The abundance and diversity of these particles remain poorly constrained, causing significant uncertainties for modelling scenarios and for understanding the potential implications of these particles in different environments. PBAP concentrations were studied at four different sites in the United Kingdom (Weybourne, Davidstow, Capel Dewi, and Chilbolton) using an ultraviolet light-induced fluorescence (UV-LIF) instrument, the Wideband Integrated Bioaerosol Spectrometer (WIBS), versions 3 and 4. Using hierarchical agglomerative cluster (HAC) analysis, particles were statistically discriminated. Fluorescent particles and clusters were then analysed by comparing to laboratory data of known particle types, assessing their diurnal variation and examining their relationship to the meteorological variables temperature, relative humidity, wind speed, and wind direction. Using local land cover types, sources of the suspected fluorescent particles and clusters were then identified. Most sites exhibited a wet discharged fungal spore dominance, with the exception of one site, Davidstow, which had higher concentrations of bacteria, suggested to result from the presence of a local dairy factory and farm. Differences were identified as to the sources of wet discharged fungal spores, with particles originating from arable and horticultural land at Chilbolton, and improved grassland areas at Weybourne. Total fluorescent particles at Capel Dewi were inferred to comprise two sources, with bacteria originating from the broadleaf and coniferous woodland and wet discharged fungal spores from nearby improved grassland areas, similar to Weybourne. The use of the HAC method and a higher fluorescence threshold (9 standard deviations instead of 3) produced clusters which were considered to be biological following the complete analysis. More published data and information on the reaction of different speciated biological particle types to fluctuations in meteorological conditions, such as relative humidity and temperature, would aid particle type characterisation in studies such as this.

scholarly journals Early Clinical Experience with Bleomycin in the United Kingdom in Series of 105 Patients

BMJ ◽  
1972 ◽  
Vol 4 (5841) ◽  
pp. 635-638 ◽  
Author(s):  
K. E. Halnan ◽  
N. M. Bleehen ◽  
T. B. Brewin ◽  
T. J. Deeley ◽  
D. F. N. Harrison ◽  
...  
Keyword(s):  
United Kingdom ◽  
Clinical Experience ◽  
Early Clinical Experience ◽  
The United Kingdom ◽  
In Series

Effect of Bone Mineral Guideline Target Achievement on Mortality in Incident Dialysis Patients: An Analysis of the United Kingdom Renal Registry

2011 ◽  
Vol 57 (3) ◽  
pp. 415-421 ◽  
Author(s):  
Navdeep Tangri ◽  
Martin Wagner ◽  
John L. Griffith ◽  
Dana C. Miskulin ◽  
Alexandra Hodsman ◽  
...  
Keyword(s):  
United Kingdom ◽  
Bone Mineral ◽  
Dialysis Patients ◽  
The United Kingdom

Hepatopathy-thrombocytopenia syndrome--a complication of dactinomycin therapy for Wilms' tumor: a report from the United Kingdom Childrens Cancer Study Group.

1991 ◽  
Vol 9 (2) ◽  
pp. 268-273 ◽  
Author(s):  
J Raine ◽  
A Bowman ◽  
K Wallendszus ◽  
J Pritchard
Keyword(s):  
United Kingdom ◽  
Combination Chemotherapy ◽  
Wilms Tumor ◽  
Liver Function Tests ◽  
Study Group ◽  
Severe Thrombocytopenia ◽  
Cancer Study ◽  
The United Kingdom ◽  
Cancer Study Group

We have observed hepatopathy, associated with thrombocytopenia, in children receiving chemotherapy for Wilms' tumor. We have studied this hepatopathy-thrombocytopenia syndrome (HTS) in patients enrolled in the United Kingdom Childrens' Cancer Study Group (UKCCSG) Wilms' tumor trials (UKW1 and UKW2). At the time of this study, 501 patients had completed therapy. Treatment flow sheets were examined for evidence of hepatopathy (hepatomegaly with abnormal liver function tests) and severe thrombocytopenia (platelet count less than 25 x 10(9)/L). No child who developed the syndrome had received irradiation. HTS was seen in five of 355 (1.4%) of patients treated with combination chemotherapy but in none of the 146 patients treated with vincristine alone. In each instance, the onset was less than 10 weeks after diagnosis. In two children, hepatopathy was severe with jaundice, ascites, transaminases greater than 1,000 IU/L, and prolongation of prothrombin time. On average, HTS lasted 12 days, and resolved with supportive treatment. After recovery, the children tolerated chemotherapy, mostly at reduced dosage, without recurrence. There was no evident long-term morbidity. Dactinomycin is the probable cause of this syndrome. We conclude that the HTS is a rare but important complication of dactinomycin-containing combination chemotherapy for Wilms' tumor. Children developing "isolated" thrombocytopenia following dactinomycin are "at risk" of developing the full-blown syndrome and should have their treatment modified accordingly.

scholarly journals Predicting Mortality in Incident Dialysis Patients: An Analysis of the United Kingdom Renal Registry

2011 ◽  
Vol 57 (6) ◽  
pp. 894-902 ◽  
Author(s):  
Martin Wagner ◽  
David Ansell ◽  
David M. Kent ◽  
John L. Griffith ◽  
David Naimark ◽  
...  
Keyword(s):  
United Kingdom ◽  
Dialysis Patients ◽  
The United Kingdom
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