Factors associated with overhydration in peritoneal dialysis patients

Aim. Overhydration is a prevalent problem in peritoneal dialysis (PD) patients. The aim of the study was to evaluate the effect of several factors on the development of overhydration in PD patients. Material and Methods. The study was performed on 74 PD patients, who were divided into two groups according to bioimpedance analysis hydration status (OHBIA): Group A OHBIA < 1.1 L (n = 40) and Group B OHBIA ≥ 1.1 L (n = 34). The assessments of the adequacy of the dialysis dosage were based on the Kt/V ratio as well as weekly creatinine clearance. To evaluate the permeability of the peritoneal membrane a standard peritoneal equilibration test was used.Results. A statistically significant difference between the groups was found in: the average age of patients (53 ± 18 vs. 62 ± 14 years; p < 0.03), the prevalence of diabetes (27.5% vs. 55.9%; p < 0.02) and residual diuresis (1.7 ± 0.8 vs 1.2 ± 0.9 L; p < 0.05). There was no statistically significant difference in gender distribution, although attention is paid to the greater participation of male in overhydrated group. The study found no statistically significant differences between PD vintage, type of PD, assessment of adequacy of PD and other parameters describing the PD method. Logistic regression model selected diabetes (p < 0.03) as a significant risk factor for the occurrence of hypervolemia.Conclusions. Diabetes and older age are potential predisposing factors for the development of overhydration in PD patients. Overhydrated PD patients may have relatively high parameters regarding adequacy of dialysis therapy. Probably the most important protective factor in PD patients is residual diuresis

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Can early surgery improve the outcome of patients with meconium peritonitis? A single-center experience over 16 years

BMC Pediatrics ◽

10.1186/s12887-019-1844-5 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Yi Jiang ◽

Weihua Pan ◽

Wenjie Wu ◽

Weipeng Wang ◽

Suna Sun ◽

...

Keyword(s):

Birth Weight ◽

Survival Rate ◽

Gastrointestinal Disease ◽

Early Stage ◽

Significant Risk ◽

Early Operation ◽

Meconium Peritonitis ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background In the last century, meconium peritonitis(MP)was once a highly fatal gastrointestinal. disease With the development of fetal radiological technology, abnormal signs, such as pseudocysts, can. be detected during the fetal period so that more patients can be diagnosed prenatally and receive surgery. in the early stage of life. The survival rate of MP has increased up to 80% in recent years. According to. a review of the treatment and outcomes of patients diagnosed with MP, we evaluated the influence of. early operation on survival rate and discussed the risk factors of prognosis. Methods We collected 79 cases of patients diagnosed with MP who were treated in our department. from October 2001 to December 2017. They were divided into 2 groups. Patients in group A were born. in our hospital. Patients in group B were born in a local hospital with suspicion of MP and then transferred. to our department. Results The birth weight (BW) and gestational age (GA) of patients were higher in group A than in. group B. There was no significant difference in the proportion of premature and low birth weight (LBW). patients between the two groups (p = 0.422, p = 0.970). Their age at the time of surgery was younger in. group A than in group B (1.4 ± 2.0 vs. 6.9 ± 14.9, p < 0.001). The overall survival rate of group A was higher. than that of group B (95.0% vs. 79.5%, p = 0.038). The prognosis of premature patients was worse than. that of full-term infants for both groups (p = 0.012). Conclusions Prematurity is a significant risk factor related to death for MP patients. The survival rate. of MP patients can be improved by early operation during the neonatal period.

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MO696INCREMENTAL PERITONEAL DIALYSIS: BENEFICIAL EFFECTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab101.0018 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Adriana Fernandes ◽

João Carvão ◽

Rita Veríssimo ◽

Patrícia Branco ◽

Patricia Matias ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Hospital Admissions ◽

Angiotensin Receptor Blockers ◽

Cardiac Insufficiency ◽

Full Dose ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background and Aims Incremental peritoneal dialysis (Incr_Dial) is a renal replacement therapy strategy based on lower dose prescription rather than the standard “full dose” (Full_Dial). Individualized clearance goals were achieved combining residual renal function (RRF) and peritoneal clearance. Maintaining RRF is a crucial issue to peritoneal dialysis (PD) patients and the best PD strategy to preserve it is subject to debate. The aim of this study is to compare Incr_Dial and Full_Dial in terms of RRF preservation and other clinical outcomes. Method This was a single-center, retrospective descriptive study. We included a cohort of incident and prevalent adult PD patients in the PD Unit between January – December of 2020. Patients without a follow-up < six months and who started PD at another center were excluded. Patients were assigned according to their first PD protocol in two groups – Group A: Incr_Dial protocol (continuous ambulatory PD: less than four dwells daily, less than 2 L dwell volumes, less than seven days a week treatment, or some combination of these; automated PD: without a long dwell, less than 10 L daily delivered by cycler and day dwells, treatment for less than 7 days a week or some combination of these); Group B: Full_Dial protocol. Statistical analysis was performed using SPSS 20.0. Statistical significance level p <0.05. Results Among 84 PD patients, 68% underwent incremental PD (Group A) and 31% underwent conventional full-dose PD (Group B). The mean age was 55.9±15.4 years, 60.7% were male and 32.5% diabetic. There were no statistically significant differences between the two groups regarding: demographic characteristics, comorbidities (diabetes, hypertension, cardiac insufficiency or ischemic heart disease) and drugs (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and/or loop diuretics). The median Incr_Dial duration to achieve PD full dose was 10.2 months (IQ 5.1-17). At the beginning of PD, there was no statistically significant difference in diuresis between both groups (A: 1.79L vs B: 1.2L, p=0.07), however after 6 months of PD there was a superior urinary output in Group A (A: 1.67L vs B: 1.1L, p=0.037). Group A (Incr_Dial) was also associated with a superior renal clearance of creatinine at the beginning (A: 81 L/sem/1.73m2 vs B: 56.8L/sem/1.73m2, p=0.021) and after 12 months (A: 70.7L/sem/1.73m2 vs B: 26.3 L/sem/1.73m2, p<0.01); and superior Kt/V renal/week at the beginning (A: 1.48 vs B: 1.02, p=0.02) and after 12 months (A: 1.28 vs B: 0.49, p<0.001). There are no differences between mortality (A: 1.9% vs B: 12%, p=0.094), peritonitis-free time (A: 158 days vs B: 236 days, p=0.133) and the numbers of peritonitis per year (A: 0.32 vs B: 0.5, p=0.940). However, the rate of hospital admissions per year was lower in Group A (A: 0.22 vs B: 0.70, p=0.001). Conclusion Incremental PD is a safe strategy of renal replacement therapy to start PD. In our PD population, it showed similar patient survival rates and a significantly less hospital admissions. Incremental PD was also beneficial for preserving RRF when compared to full-dose PD.

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A Strict Low Protein Diet during the Predialysis Period Suppresses Peritoneal Permeability at Induction of Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686080902900317 ◽

2009 ◽

Vol 29 (3) ◽

pp. 319-324 ◽

Cited By ~ 5

Author(s):

Takeshi Hasegawa ◽

Ashio Yoshimura ◽

Makoto Hirose ◽

Daisuke Komukai ◽

Hironori Tayama ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Protein Diet ◽

Low Protein Diet ◽

Peritoneal Equilibration Test ◽

Laboratory Findings ◽

Low Protein ◽

Group A ◽

Peritoneal Permeability ◽

Group B ◽

Median Amount

Background The factors that predict baseline peritoneal permeability remain largely unknown. We noticed that patients that adhered to a strict low protein diet (LPD) during the predialysis period seldom showed high peritoneal permeability on the peritoneal equilibration test (PET) at the introduction of peritoneal dialysis (PD). Therefore, we investigated whether a strict LPD during the predialysis period affects peritoneal permeability. Method We retrospectively analyzed 37 patients that started PD in a single Japanese center. Patients were divided into group A and group B by the median amount of daily protein intake (PI) during the predialysis period using urine collected over 24 hours. Results There were no differences between groups A and B in age, gender, proportion of diabetic nephropathy, blood pressure, body mass index, or body surface area. There were also no differences between the groups in laboratory findings, including hematocrit, serum albumin, and serum creatinine. The PETs showed a significantly lower dialysate-to-plasma ratio of creatinine at 4 hours (Cr D/P) for group A than for group B ( p = 0.02). Furthermore, a significant positive correlation between Cr D/P and PI was observed ( r = 0.53, p < 0.01). Conclusion It is suggested that a strict LPD during the predialysis period may suppress peritoneal permeability at induction of PD.

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Assessment of Omentin- 1 AS AN Adipokine in obese male and females with and without fatty liver disease

QJM ◽

10.1093/qjmed/hcab100.034 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohammed Ali Marei Makhlouf ◽

Gina Gamal ◽

Ahmad Magdy ◽

Amal Muatafa Ali Mustafa Eid

Keyword(s):

Fatty Liver ◽

Protective Factor ◽

University Hospital ◽

Significant Difference ◽

Hospital Patients ◽

Group A ◽

Group 2 ◽

Group B ◽

Obese Male ◽

Control Study

Abstract Background Omentin-1 (intelectin-1) “a new adipokine described in 2003,” acts centrally to modulate the insulin resistance, body weight, and inflammation. However, its role in the liver pathogenesis and in the metabolic consequences of the liver disorders is not fully elucidated. Aim and objectives the aim of the study was to assess the relation of serum omentin1 with fatty liver in obese and non-obese Subjects and methods This was a comparative case control study was conducted at Ain Shams university hospital. Patients were divided in to two group: Group1: 40 patient 20 patient with fatty liver 10 of them obese and 10 non-obese compared with 20 not have fatty live 10obese and 10 non-obese, group 2. The duration of the study ranges from 6-12 months. Results There was statistically significant difference between the four studied subgroups as regard Omentin1 and Apelin. There was statistically significant difference between group A and group B in obese as regard Omentin1 and Apelin. Conclusion Omentin-1 might be considered as a protective factor in the evaluation of occurrence of NAFLD, especially in central obese patients. Thus, the measurement of these novel adipokines may contribute to the evaluation of NAFLD occurrence.

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Features and outcomes of secondary sepsis and urinary tract infections in COVID-19 patients treated with stem cell nebulization

10.1101/2020.12.05.20244483 ◽

2020 ◽

Author(s):

Gina M. Torres Zambrano ◽

Rene Antonio Rivero ◽

Carlos A. Villegas Valverde ◽

Yendry Ventura Carmenate

Keyword(s):

Stem Cells ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Protective Factor ◽

Antimicrobial Agents ◽

Rational Approach ◽

Significant Difference ◽

Group A ◽

Group B ◽

Tract Infections

AbstractBackgroundCOVID-19 is the defining global crisis of our time. Secondary complication such as urinary tract infections and sepsis, worsen the already established problem, creating a new challenge.ObjectiveTo characterize the features and outcomes in COVID-19 patients with sepsis and urinary tract infection.MethodsAn observational and analytical study was conducted within the framework of the SENTAD COVID clinical trial at the Abu Dhabi Stem Cells Center, were the patients received a nebulization therapy with the use of autologous stem cells (group A). Those patients were compared with a not stem cells treated control arm (group B), and both received the UAE COVID 19 standard management. An analysis of the culture samples, antimicrobial agents and the efficacy of the therapy on patient’s outcomes was done.ResultsA significant difference between the groups was found in the UTI incidence (p=*0.0206). Patients in group A showed a lower tendency to sepsis in comparison with group B (7% vs 21%), HR=0.35, (95% Confidence Interval: 0.13 – 0.91), p=0.0175. It was calculated a NNT=7.3. Candida albicans was the most frequently agent causing sepsis and UTI. The massive use of broad-spectrum antimicrobials was striking.ConclusionsWe found a protective factor of stem cells against secondary infection in COVID 19 cases, in terms of sepsis and UTI. The suggested immunomodulatory effect of stem cells offers a therapeutic strategy to manage the disease and avoid several complications. Antimicrobial agents can lead to increased opportunistic infections, so a rational approach to these treatments must be considered.

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Risk factors for delayed and non-union following transfibular ankle arthrodesis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20210526 ◽

2021 ◽

Vol 7 (2) ◽

pp. 199

Author(s):

Hyeon Soo Kim ◽

Sung Jin Shin ◽

Jin Woo Kim

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Ankle Joint ◽

Significant Risk ◽

Significant Risk Factor ◽

Ankle Arthrodesis ◽

Delayed Union ◽

Non Union ◽

Group A ◽

Group B

Background: This study was to identify risk factors associated with delayed union and non-union in patients who underwent transfibular ankle arthrodesis.Methods: This study included 43 patients who underwent ankle arthrodesis using transfibular approach between January 2012 and September 2018 and were followed up for more than 12 months. The patients were divided into two groups according to delayed union or non-union. Group A included patients who had delayed union or non-union and Group B included patients without these complications. Variables that could contribute to non-union including etiologies, age, chronic renal failure, hypertension, diabetes, smoking, pre-operative talus bone quality, pre-operative angulation of the talus and fixation methods were evaluated.Results: The mean time to bone union was 12.7±7.25 weeks. Group A included 12 patients with 5 cases of non-union and 7 cases of delayed union and group B included 31 patients. Infection of the ankle joint (OR, 1.73; p=0.041) was risk factor for non-union and delayed union on the basis of multivariate analysis.Conclusions: We concluded that infection of the ankle joint is the most significant risk factor for delayed union and nonunion in our study. Careful attention should be paid preoperatively, intraoperatively and postoperatively to patients who have this risk factor to obtain a satisfactory surgical outcome.

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Extreme corneal flattening following collagen crosslinking for progressive keratoconus

European Journal of Ophthalmology ◽

10.1177/1120672120947664 ◽

2020 ◽

pp. 112067212094766

Author(s):

Prema Padmanabhan ◽

Michael W Belin ◽

Vasanthi Padmanaban ◽

Rachapalle Reddi Sudhir

Keyword(s):

Regression Analysis ◽

Significant Risk ◽

Significant Risk Factor ◽

Multivariate Regression Analysis ◽

Retrospective Case ◽

Collagen Crosslinking ◽

Cohort Group ◽

Group A ◽

Group B ◽

Corneal Flattening

Purpose: To study the clinical, tomographic and densitometric features of eyes that showed >5 D of corneal flattening following collagen crosslinking (CXL) for progressive keratoconus and to identify preoperative predictive factors for such a response. Methods: This was a retrospective case control study of 548 eyes with progressive keratoconus which had undergone epithelium-off CXL (Dresden protocol) with a follow-up of 1 to 10 years. Eyes that showed ⩾5 D corneal flattening in maximum keratometry (Kmax) following CXL (group A) were compared with one eye of the remaining patients in the same cohort (group B). Changes in refraction and visual acuity, Kmax and thinnest pachymetry were compared between both groups. Univariate and multivariate regression analysis identified preoperative risk factors for unusual corneal flattening. Results: Forty three eyes in group A were compared with 502 eyes in group B. At the time of maximum flattening, group A showed more flattening (−7.6 ± 3.2 D) and thinning (−53.7 ± 45.2 µ) than group B (−1.69 ± 2.9 D and −26.6 ± 36.7 µ, respectively). Multivariate analysis based on parameters suggested by a univariate regression analysis identified pre-op Kmax to be the most significant predictor of intense corneal flattening. A subgroup analysis of K-matched eyes revealed that the duration of time following CXL was a significant risk factor for extreme corneal flattening following CXL Conclusion: An intense corneal flattening >5 D in Kmax was documented in 7.85% of a cohort of keratoconus patients who underwent CXL. High preoperative Kmax and the duration of time following CXL were significant predictors of this response which was accompanied by significant corneal thinning.

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DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

The Egyptian Cardiothoracic Surgeon ◽

10.35810/ects.v1i4.89 ◽

2019 ◽

Vol 1 (4) ◽

pp. 133-139

Author(s):

Yasser Hamdy ◽

Mohammed Mahmoud Mostafa ◽

Ahmed Elminshawy

Keyword(s):

Right Ventricular ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Early Postoperative Period ◽

Tricuspid Valve Repair ◽

Ring Annuloplasty ◽

Significant Difference ◽

Group A ◽

Group B ◽

The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

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Effect of short-term use of oral contraceptive pills on intraocular pressure

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v35i3.871 ◽

2020 ◽

Vol 35 (3) ◽

Author(s):

Tayyaba Gul Malik ◽

Hina Nadeem ◽

Eiman Ayesha ◽

Rabail Alam

Keyword(s):

Oral Contraceptive ◽

Childbearing Age ◽

Short Term ◽

Oral Contraceptive Pills ◽

Contraceptive Pills ◽

Time Period ◽

Significant Difference ◽

Group A ◽

Group B ◽

Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age. Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21. Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

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Comparative Clinical study of Jatyadi Taila and Jatyadi Ghrita in the management of Dushta Vrana

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v3i3.12875 ◽

2018 ◽

Vol 3 (3) ◽

Author(s):

Rajendra Joshi ◽

N. B. Mashetti ◽

Rakesh Kumar Gujar

Keyword(s):

Clinical Study ◽

Burning Sensation ◽

Normal Process ◽

Surgical Practice ◽

Local Factors ◽

Significant Difference ◽

Comparative Clinical Study ◽

Group A ◽

Contaminated Wound ◽

Group B

Dushta Vrana is a common and frequently encountered problem faced in surgical practice. The presence of Dushta Vrana worsens the condition of the patient with different complications and may become fatal. Local factors on wound like slough, infection and foreign body, affect the normal process of healing. A healthy wound in a normal body heals earlier with a minimum scar as compared to a contaminated wound. Therefore in this study all the efforts are made to make a Dushta Vrana into a Shuddha Vrana. Once the Vrana becomes Shuddha, Ropana of the Vrana will start. The objective of the study was to evaluate the clinical efficacy of Jatyadi Taila and Jatyadi Ghrita in Dushta Vrana. Clinically diagnosed 60 Patients of Dushta Vrana were randomly divided into two groups, each consisting of 30 Patients. Group A were treated with the Jatyadi Taila and Group B was treated by Jatyadi Ghrita. The results observed was based on the relief obtained on the subjective and objective parameters taken for consideration for this study viz, size of ulcer, discharge, smell, pain, burning sensation, itching and granulation were found significant (P Lass Than 0.05). On the basis of assessment criteria and overall result of treatment, the patients of Jatyadi Taila group showed better results when compared to Jatyadi Ghrita group. Even though statistically there is no much significant difference between the two groups, but by seeing the effect on individual parameters (subjective and objective) and over all response, Jatyadi Taila seems to be effective when compared to Jatyadi Ghrita. It is having more Ropana qualities when compared to Shodhana.

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