scholarly journals Repeat and Relapsing Peritonitis Microbiological Trends and Outcomes: A 21-Year Single-Center Experience

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marina Reis ◽  
Catarina Ribeiro ◽  
Ana Marta Gomes ◽  
Clara Santos ◽  
Daniela Lopes ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Catheter Removal ◽  
Control Group ◽  
Single Center ◽  
Cure Rate ◽  
Technique Survival ◽  
Tenckhoff Catheter ◽  
Single Center Experience ◽  
The Impact ◽  
Multiple Episodes

Peritonitis is a major peritoneal dialysis complication. Despite a high cure rate, relapsing and repeat peritonitis is associated with Tenckhoff catheter biofilm and multiple episodes of peritoneal damage. In relapsing peritonitis, prompt catheter removal is mandatory; otherwise, in repeat peritonitis, there is not a clear indication for catheter removal. It is questionable if the approach to removal should be different. There are few recent data on repeat and relapsing peritonitis microbiology and clinical outcomes since most studies are from the past decade. This study evaluates the microbiology, clinical outcomes, and impact of relapsing and repeat peritonitis on technique survival and the impact of catheter removal in development of further peritonitis episodes by the same microorganism. We developed a single-center retrospective study from 1998 to 2019 that compared repeat and relapsing peritonitis with a control group in terms of causative microorganisms, cure rate, catheter removal, and permanent and temporary transfer to hemodialysis. We also compared repeat and relapsing peritonitis clinical outcomes when Tenckhoff catheter was not removed. Comparing to the control group, the repeat/relapsing group had a higher cure rate (80.4% versus 74.5%, p = 0.01 ) and lower rate of hospitalization (10.9% versus 27.7%, p = 0.01 ). Technique survival was superior in the repeat/relapsing group (log rank = 4.5, p = 0.03 ). Gram-positive peritonitis was more common in the repeat/relapsing group especially Streptococci viridans (43.5% versus 21.3%, p = 0.01 ) and Gram-negatives in the control group (26.6% vs 9.0%, p = 0.02 ). When the Tenckhoff catheter was not removed after a repeat episode, 58.6% developed a new repeat/relapsing episode versus 60.0% in the relapsing group. Although repeat and relapsing peritonitis have a higher cure rate, it leads to further episodes of peritonitis and consequent morbidity. When Tenckhoff catheter was not removed, the probability of another peritonitis episode by the same microorganism is similar in repeat and relapsing peritonitis.

scholarly journals Impact of Tocilizumab on Clinical Outcomes in COVID-19-Associated Cytokine Release Syndrome: A Single-Center Experience

2021 ◽  
pp. 089719002110282
Author(s):  
Karan Raja ◽  
Nicole Daniel ◽  
Susan Morrison ◽  
Ruben Patel ◽  
Jessica Gerges ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Status ◽  
Rank Test ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Single Center ◽  
Post Dose ◽  
Single Center Experience ◽  
Signed Rank Test ◽  
The Impact

Background: Tocilizumab is an interleukin-6 receptor antagonist hypothesized to blunt the uncontrolled immune response, cytokine release syndrome, in severe COVID-19 and prevent attributable morbidity and mortality. Objective: The objective of this study was to assess the impact of tocilizumab on clinical outcomes in COVID-19-associated cytokine release syndrome. Methods: Single-center, retrospective cohort study assessing sixty-nine adult patients receiving tocilizumab for suspected COVID-19 cytokine release syndrome. The primary outcome was change in WHO clinical status scale on day seven post-dose analyzed using the Wilcoxon signed rank test. Secondary outcomes assessed impact of timing of administration on clinical outcome. Safety analyses included development of neutropenia, thrombocytopenia, transaminitis, and sepsis within 7 days post-dose. Statistical analyses were conducted using Microsoft Excel. Results: No aggregate clinical change was found between day 0 and day 7. Eleven patients improved, twenty-seven worsened, and thirty-one showed no change. Clinical outcomes were weakly correlated with time from symptom onset (rs = 0.21; p = 0.08) or hospital admission (rs = -0.08; p = 0.49) to dose. In-hospital mortality was 63%. Sepsis was diagnosed in 21 patients, five of which were post-dose. Transaminitis, neutropenia, and thrombocytopenia occurred in seven, one, and six patients, respectively. Conclusion: Tocilizumab did not appear to influence clinical outcomes in our study population, irrespective of timing of administration. Adverse events were not considered drug-related.

scholarly journals The Impact of Peritonitis on Clinical Outcomes of PD Patients: A Single Center Experience

2019 ◽  
Vol 28 (1) ◽  
pp. 54-61
Author(s):  
Zuhal Atan Ucar ◽  
◽  
Yener Koc ◽  
Taner Basturk ◽  
Feyza Bayraktar Caglayan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Single Center ◽  
Single Center Experience ◽  
The Impact

scholarly journals Risk Factors and Outcome of Contamination in Patients on Peritoneal Dialysis—A Single-Center Experience of 15 Years

2012 ◽  
Vol 32 (6) ◽  
pp. 612-616 ◽  
Author(s):  
Desmond Y.H. Yap ◽  
Wai Ling Chu ◽  
Flora Ng ◽  
Terence Pok Siu Yip ◽  
Sing Leung Lui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Clinical Outcomes ◽  
Clinical Characteristics ◽  
Prophylactic Antibiotics ◽  
Catheter Removal ◽  
Single Center ◽  
Single Center Experience ◽  
Culture Negative

♦ ObjectiveContamination is an important risk factor for peritoneal dialysis (PD)–related peritonitis. The present study outlines the clinical characteristics and outcomes of PD patients experiencing touch contamination.♦ MethodsWe reviewed the case records of PD patients from 1995 to 2010. Patients who experienced contamination of their PD system were identified and stratified into “dry” and “wet” contamination groups. Risk factors, microbiology, and clinical outcomes were compared.♦ ResultsOf 548 episodes of touch contamination, 246 involved dry contamination, and 302, wet contamination. After contamination, 17 episodes of peritonitis (3.1%) developed; all episodes occurred in the wet contamination group ( p < 0.001). The incidence of peritonitis after wet contamination was 5.63%. Prophylactic antibiotics significantly reduced the risk of peritonitis (1 of 182 episodes, p < 0.001). Half the patients experiencing peritonitis had either culture-negative or staphylococcal episodes, and most of those episodes responded to intraperitoneal antibiotics. In 2 patients, peritonitis was attributable to Pseudomonas, and in 3, to Acinetobacter. In these latter patients, outcomes were less favorable, with catheter removal being required in 4 of the 5 episodes.♦ ConclusionsThe overall rate of peritonitis was low after contamination. Wet contamination was associated with a much higher risk of peritonitis. Prophylactic antibiotics after wet contamination were effective in preventing peritonitis.

The Impact of Marijuana Use on Liver Transplant Recipients: A 900 Patient Single Center Experience

2021 ◽  
Author(s):  
Jacob Guorgui ◽  
Takahiro Ito ◽  
Daniela Markovic ◽  
Antony Aziz ◽  
Stephanie Younan ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Marijuana Use ◽  
Transplant Recipients ◽  
Single Center ◽  
Single Center Experience ◽  
Liver Transplant Recipients ◽  
The Impact

scholarly journals Effects of post-interventional antiplatelet therapy on angiographic vasospasm, delayed cerebral ischemia, and clinical outcome after aneurysmal subarachnoid hemorrhage: a single-center experience

2021 ◽  
Author(s):  
Claudia Ditz ◽  
Björn Machner ◽  
Hannes Schacht ◽  
Alexander Neumann ◽  
Peter Schramm ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Functional Outcome ◽  
Antiplatelet Therapy ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Control Group ◽  
Lesion Volume ◽  
Single Center ◽  
Single Center Experience

AbstractPlatelet activation has been postulated to be involved in the pathogenesis of delayed cerebral ischemia (DCI) and cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to investigate potentially beneficial effects of antiplatelet therapy (APT) on angiographic CVS, DCI-related infarction and functional outcome in endovascularly treated aSAH patients. Retrospective single-center analysis of aSAH patients treated by endovascular aneurysm obliteration. Based on the post-interventional medical regime, patients were assigned to either an APT group or a control group not receiving APT. A subgroup analysis separately investigated those APT patients with aspirin monotherapy (MAPT) and those receiving dual treatment (aspirin plus clopidogrel, DAPT). Clinical and radiological characteristics were compared between groups. Possible predictors for angiographic CVS, DCI-related infarction, and an unfavorable functional outcome (modified Rankin scale ≥ 3) were analyzed. Of 160 patients, 85 (53%) had received APT (n = 29 MAPT, n = 56 DAPT). APT was independently associated with a lower incidence of an unfavorable functional outcome (OR 0.40 [0.19–0.87], P = 0.021) after 3 months. APT did not reduce the incidence of angiographic CVS or DCI-related infarction. The pattern of angiographic CVS or DCI-related infarction as well as the rate of intracranial hemorrhage did not differ between groups. However, the lesion volume of DCI-related infarctions was significantly reduced in the DAPT subgroup (P = 0.011). Post-interventional APT in endovascularly treated aSAH patients is associated with better functional outcome at 3 months. The beneficial effect of APT might be mediated by reduction of the size of DCI-related infarctions.

scholarly journals SP501STRAIGHT VERSUS SWAN-NECK PERITONEAL DIALYSIS CATHETERS: PATIENT, TECHNIQUE SURVIVAL AND OUTCOMES, A 20-YEAR SINGLE CENTER EXPERIENCE

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii544-iii545
Author(s):  
Dimitra Biblaki ◽  
Vassilis Filiopoulos ◽  
Lamprini Takouli ◽  
Christina Kaitantzoglou ◽  
Alexis Dounavis ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Single Center ◽  
Technique Survival ◽  
Single Center Experience
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