Uremia and Host Resistance to Peritonitis in C.A.P.D-an Experimental Evaluation

1984 ◽  
Vol 4 (4) ◽  
pp. 202-205 ◽  
Author(s):  
Isabel A. Clarke ◽  
Douglas J. Ormrod ◽  
Thomas E. Miller
Keyword(s):  
Peritoneal Dialysis ◽  
Host Resistance ◽  
The Other ◽  
Risk Of Infection ◽  
Dialysis Fluid ◽  
Important Complication ◽  
Major Disadvantage ◽  
Direct Inoculation ◽  
Peritoneal Infection ◽  
Per Se

Peritonitis is an important complication of CAPD. Because uremia is believed to impair immunity, we sought to determine whether uremia per se predisposes patients on CAPD to peritoneal infection. Using an animal model of CAPD, we have evaluated the effect of severe uremia on host resistance to peritonitis. Intraperitoneal catheters were implanted in severely uremic and sham-operated non-uremic rats, which were then dialysed four times a day for two days. Alternatively, they were infused with dialysis fluid twice daily for eight days without drainage of the dialysate. Peritonitis was induced by direct inoculation of Escherichia coli; the bacteria in the peritoneal cavity and spleen were counted 24 hours after this challenge. Uremia did not impair resistance to experimentally induced peritonitis in either the dialysed or infused host. Continuous ambulatory peritoneal dialysis (CAPD) is becoming increasingly popular as a method for longteffil treatment of chronic renal failure. The major disadvantage is the risk of infection and peritonitis remains the single most important complication and reason for transfer of patients to another mode of therapy. Uremia is believed to impair immunity and predispose patients to infection (1, 2). Hence the question arises: Are patients on CAPD predisposed to peritoneal infection by the uremia itself? We developed a model of chronic uremia in rats, which made possible studies uncomplicated by many variabies associated with the clinical management of uremic patients. This paper examines the contribution of uremia to the susceptibility of the dialysed host to peritonitis. In the rats, we found it difficult to maintain dialysis for longer than two days because of rapid blockage of catheters by fibrin and connective tissue. As a consequence, we employed two models: one carried out peritoneal dialysis for two days, and the other involved infusions of dialysate without drainage for a longer period. Uremic and sham-operated animals, either dialysed or infused without drainage, were compared with noffilal controls with respect to their ability to withstand an intraperitoneal challenge with viable Escherichia cali.

scholarly journals Plasma erythropoietin level and heart failure in patients undergoing peritoneal dialysis: a cross-sectional study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kohsuke Terada ◽  
Yuichiro Sumi ◽  
Sae Aratani ◽  
Akio Hirama ◽  
Tetsuya Kashiwagi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Peritoneal Dialysis ◽  
Univariate Analysis ◽  
Transferrin Saturation ◽  
Left Ventricular ◽  
The Other ◽  
Renal Anemia ◽  
Cardiothoracic Ratio ◽  
Important Complication ◽  
Nyha Classification

Abstract Background Renal anemia is the important complication in patients undergoing peritoneal dialysis (PD), and heart failure (HF) is the important complication in patients on dialysis. Decreasing endogenous erythropoietin (EPO) in patients with chronic kidney disease is a major cause of renal anemia. On the other hand, high levels of EPO have been associated with the prognosis of patients with chronic HF. The association between plasma EPO and HF in patients on PD remains unclear. This study was designed to test our hypothesis that the plasma EPO level in patients on PD was associated with the markers of HF. Methods We investigated 39 patients undergoing PD at our hospital. We measured plasma EPO before erythropoiesis-stimulating agent (ESA) administration at the regular outpatient visits and then at 2 weeks after the final dose of ESA was administered and investigated the clinical factors. We estimated the correlations between the plasma EPO and the other parameters, and constructed univariate and multivariate logistic regression models for the risk for HF to estimate the effectiveness of plasma EPO and other factors on HF treatment in patients undergoing PD. Results The plasma EPO concentration was positively correlated with the ESA dose and negatively correlated with serum ferrum, transferrin saturation, and body mass index and showed no correlation with other factors, such as the New York Heart Association (NYHA) classification and ferritin level. In univariate analysis, the factors significantly associated with HF risk were N-terminal pro-brain natriuretic peptide (NT-pro BNP), cardiothoracic ratio (CTR), serum creatinine (Cr), serum beta 2 microglobulin, dialysate dose, left ventricular mass index, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and weekly Kt/V. We performed a multivariate analysis with NT-pro BNP, Cr, and CTR, and all three factors were significant in the analysis. Conclusion The plasma EPO level in patients undergoing PD was positively correlated with the monthly ESA dose and was not significant as a marker of HF, as judged with the NYHA classification. Therefore, the plasma EPO level may not be a useful marker for HF in patients undergoing PD.

The Problem of the Typology of Rationality in Muslim Culture

2019 ◽  
Vol 62 (6) ◽  
pp. 88-99
Author(s):  
Andrey A. Lukashev
Keyword(s):  
Modern Philosophy ◽  
Theoretical Basis ◽  
Theoretical Models ◽  
The Other ◽  
Common Denominator ◽  
Islamic Culture ◽  
The Common ◽  
Per Se ◽  
The One ◽  
Muslim Culture

The typology of rationality is one of major issues of modern philosophy. In an attempt to provide a typology to Oriental materials, a researcher faces additional problems. The diversity of the Orient as such poses a major challenge. When we say “Oriental,” we mean several cultures for which we cannot find a common denominator. The concept of “Orient” involves Arabic, Indian, Chinese, Turkish and other cultures, and the only thing they share is that they are “non-Western.” Moreover, even if we focus just on Islamic culture and look into rationality in this context, we have to deal with a conglomerate of various trends, which does not let us define, with full confidence, a common theoretical basis and treat them as a unity. Nevertheless, we have to go on trying to find common directions in thought development, so as to draw conclusions about types of rationality possible in Islamic culture. A basis for such a typology of rationality in the context of the Islamic world was recently suggested in A.V. Smirnov’s logic of sense theory. However, actual empiric material cannot always fit theoretical models, and the cases that do not fit the common scheme are interesting per se. On the one hand, examination of such cases gives an opportunity to specify certain provisions of the theory and, on the other hand, to define the limits of its applicability.

Insulin Resistance and Glucose Homeostasis in Peritoneal Dialysis

2009 ◽  
Vol 29 (2_suppl) ◽  
pp. 145-148 ◽  
Author(s):  
Paulo Cezar Fortes ◽  
Thyago Proença de Moraes ◽  
Jamille Godoy Mendes ◽  
Andrea E. Stinghen ◽  
Silvia Carreira Ribeiro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Peritoneal Dialysis ◽  
Metabolic Disorders ◽  
Patient Survival ◽  
Metabolic Abnormalities ◽  
Dialysis Fluid ◽  
Altered Glucose ◽  
Insulin Homeostasis ◽  
Therapeutic Measures

Cardiovascular disease (CVD) is the main cause of death in peritoneal dialysis (PD) patients, a situation that can be explained by a combination of traditional and nontraditional risk factors for CVD in these patients. Glucose and insulin homeostasis are altered in chronic kidney disease (CKD) patients even in the early stages of CKD, leading to insulin resistance by various pathways. Several factors have been implicated in the pathogenesis of insulin resistance, including anemia, dyslipidemia, uremia, malnutrition, excess of parathyroid hormone, vitamin D deficiency, metabolic acidosis, and increase in plasma free fatty acids and proinflammatory cytokines. Insulin resistance and dyslipidemia are observed and increase with the progression of CKD, playing an important role in the pathogenesis of hypertension and atherosclerosis. Particularly in PD patients, exposure to glucose from dialysis fluid accentuates the foregoing metabolic abnormalities. In conclusion, insulin resistance and altered glucose metabolism are frequently observed in CKD, and although dialysis partly corrects those disturbances, the use of glucose PD solutions intensifies a series of harmful metabolic consequences. New therapeutic measures aimed at reducing metabolic disorders are urgently needed and perhaps will improve PD patient survival.

The Effect of a Nitric Oxide Inhibitor (L-Name) on Peritoneal Transport during Dialysis in Rats

1998 ◽  
Vol 18 (2) ◽  
pp. 188-192 ◽  
Author(s):  
Andrzej Breborowicz ◽  
Katarzyna Wieczorowska Tobis ◽  
Katarzyna Korybalska ◽  
Alicja Polubinska ◽  
Maciej Radkowski ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Peritoneal Dialysis ◽  
Significant Decline ◽  
Nitric Oxide Synthesis ◽  
Dialysis Fluid ◽  
Large Molecules ◽  
Acute Peritonitis ◽  
Important Mediator ◽  
Peritoneal Transport ◽  
Nitric Oxide Inhibitor

Objective To assess the effect of an inhibitor of nitric oxide synthesis [NG-nitro-L-arginine methyl ester (L-NAME)] on peritoneal transport during peritoneal dialysis (PD) and peritonitis in rats. Methods The authors studied peritoneal transport of small and large solutes, and net ultrafiltration (UF) in rats during PD with Dianeal 3.86 (Baxter, McGaw Park, IL, U.S.A.). They evaluated the effect of L-NAME used as an additive to dialysis fluid in concentrations 0.5 -5 mg/m L on peritoneal transport of small and large molecules and on transperitoneal UF. In addition, they studied the effect of L-NAME (5 mg/mL) during acute peritonitis induced by lipopolysaccharides (5 μg/mL) given intraperitoneally. Results The addition of L-NAME to dialysis fluid increased the selectivity of the peritoneum and net UF during dialysis. Lipopolysaccharides used as an additive to the dialysis fluid, together with L-NAME, did not induce changes in transperitoneal transport of small and large solutes and did not cause a significant decline in net UF. L-NAME given intraperitoneally reduced both local and systemic production of nitric oxide, which might explain its effects on peritoneal transport. Conclusions Nitric oxide is an important mediator of changes in peritoneal transport and its effect is especially significant during peritonitis.

scholarly journals THE EPIDEMIOLOGY OF PNEUMOCOCCUS INFECTION

1931 ◽  
Vol 53 (4) ◽  
pp. 535-552 ◽  
Author(s):  
Leslie T. Webster ◽  
Thomas P. Hughes
Keyword(s):  
Seasonal Variation ◽  
Host Resistance ◽  
The Other ◽  
Colony Morphology ◽  
Type Transformation ◽  
Wide Ph Range ◽  
Adults And Children ◽  
Nasal Passages ◽  
Ph Range

1. Pneumococci were obtained at one time or another from the nasal passages or throats of 80 per cent of 105 adults and children studied. In adults, they were obtained more frequently from the throat; in children, as often from the nasal passages as from the throat. 2. Of 500 pneumococcus strains studied, 97 per cent proved to be serologically specific. They formed smooth colonies and were for the most part avirulent for mice. Types I and II were obtained from one and two individuals respectively on one occasion only. Type III was obtained from nine individuals; Type XIII from nine individuals; Type XVI and Type XVIII from three individuals, for varying periods in each case. Atypical pneumococci were secured from 13 persons on single and scattered occasions. They varied in colony morphology, did not kill mice, or agglutinate in saline, but flocculated in all types of antipneumococcus sera employed and over a wide pH range in acid buffers. Their occurrence was apparently not associated with any type-transformation or virulence-enhancement process in vivo. 3. Strains of pneumococcus obtained on successive cultures from a given carrier were, with rare exceptions, of the same serological type and were similar in colony morphology, virulence for mice, and other tested biological characteristics. 4. Pneumococci of Types I and II were obtained under conditions suggestive that they lacked a capacity to spread readily; pneumococci of Types III and XIII, on the other hand, were obtained under conditions suggestive that they were spreading from person to person. 5. The persons studied differed consistently with respect to the occurrence of pneumococci. Some were pneumococcus-free, some were transient carriers, some periodic, and some chronic carriers. Data are given which suggest that the differences were due to variations in host resistance. 6. The incidence of pneumococci in all individuals studied underwent a seasonal variation paralleling that of coryza and sore throats in the same persons.

Peritoneal Dialysis

2019 ◽  
Author(s):  
Karlien François ◽  
Joanne M. Bargman
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Dialysis Fluid ◽  
Keywords Peritoneal Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Developed World

In peritoneal dialysis (PD), the peritoneum serves as a biological dialyzing membrane. The endothelium of the vast capillary network perfusing the peritoneum functions as a semipermeable membrane and allows bidirectional solute and water transfer between the intravascular space and dialysate fluid dwelling in the peritoneal cavity. PD is a renal replacement strategy for patients presenting with end-stage renal disease. It can also be offered for ultrafiltration in patients with diuretic-resistant fluid overload even in those without advanced renal failure. PD can also be used for patients with acute kidney injury, although in the developed world this occurs rarely compared to the use of extracorporeal therapies. This review contains 9 videos,  8 figures, 4 tables, and 73 references.  Keywords: peritoneal dialysis, peritoneal cavity, catheter, dialysis fluid, ultrafiltration, tunnel infection, osmotic pressure, renal failure

HALF-WAY TECHNOLOGIES ARE PROFITABLE

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 681-681
Keyword(s):  
The Other ◽  
Other Hand ◽  
Per Se ◽  
Commercial Organizations

Decisive interventions, like vaccines, can be quite inexpensive. But commercial organizations make money by selling commodities; they cannot produce and sell "health" per se. The most profitable commodities are those embodying the "half-way" technologies, for those with the means to pay for them-again and again and again. Vaccines, on the other hand, "may never prove as enticing as drugs for pharmaceutical makers. They can be quite expensive to develop, and they produce less income-repeated refills not required ... "

The relationship among freezing tolerance, vernalization requirement, Ppd alleles and winter hardiness in European wheat cultivars

2017 ◽  
Vol 155 (9) ◽  
pp. 1353-1370 ◽  
Author(s):  
A. GORASH ◽  
R. ARMONIENĖ ◽  
Ž. LIATUKAS ◽  
G. BRAZAUSKAS
Keyword(s):  
Molecular Markers ◽  
Western Europe ◽  
Complex Trait ◽  
Winter Hardiness ◽  
Photoperiod Sensitivity ◽  
The Other ◽  
Wheat Cultivars ◽  
Crucial Component ◽  
Per Se ◽  
The Relationship

SUMMARYWinter hardiness of wheat is a complex trait involving a system of structural, regulatory and developmental genes, which interact in a complex pathway. The objective of the present work was to study the relationship among the main traits determining the level of adaptation and the possibility for target manipulation of breeding material by using molecular markers and phenological parameters. Wheat cultivars from different ecoclimatic environments of Europe were included for analysis. Gene-specific assay showed that photoperiod sensitivity of the studied cultivars was determined by polymorphism in the Ppd-D1 allele. The study established the relationship among winter hardiness, LT50 (the temperature at which 50% of plants are killed), photoperiod sensitivity, vernalization duration and earliness per se genes in the environment of Lithuania. The cultivars from Northern and Western Europe exhibited stronger requirement for vernalization and photoperiod. Although the group of cultivars from the southern latitudes were characterized by earliness, they possessed a stronger level of LT50. The level of LT50 was found to be the most crucial component of winter hardiness, the other traits served as supplementary components.

Semantic Congruency Improves Recognition Memory Performance for Both Audiovisual and Visual Stimuli

2017 ◽  
Vol 30 (7-8) ◽  
pp. 763-781 ◽  
Author(s):  
Jenni Heikkilä ◽  
Kimmo Alho ◽  
Kaisa Tiippana
Keyword(s):  
Recognition Memory ◽  
Congruency Effect ◽  
Memory Performance ◽  
Visual Stimuli ◽  
The Other ◽  
Memory Encoding ◽  
Semantic Congruency ◽  
Recognition Memory Performance ◽  
Visual Encoding ◽  
Per Se

Audiovisual semantic congruency during memory encoding has been shown to facilitate later recognition memory performance. However, it is still unclear whether this improvement is due to multisensory semantic congruency or just semantic congruencyper se. We investigated whether dual visual encoding facilitates recognition memory in the same way as audiovisual encoding. The participants memorized auditory or visual stimuli paired with a semantically congruent, incongruent or non-semantic stimulus in the same modality or in the other modality during encoding. Subsequent recognition memory performance was better when the stimulus was initially paired with a semantically congruent stimulus than when it was paired with a non-semantic stimulus. This congruency effect was observed with both audiovisual and dual visual stimuli. The present results indicate that not only multisensory but also unisensory semantically congruent stimuli can improve memory performance. Thus, the semantic congruency effect is not solely a multisensory phenomenon, as has been suggested previously.

Sign in / Sign up

Export Citation Format

Share Document