scholarly journals Introductory Chapter: The Role of Peritoneal Dialysis Today

Author(s):  
Robert Ekart
Keyword(s):  
Author(s):  
Samuel Freeman

This introductory chapter begins with a discussion of liberalism, which is best understood as an expansive, philosophical notion. Liberalism is a collection of political, social, and economic doctrines and institutions that encompasses classical liberalism, left liberalism, liberal market socialism, and certain central values. This chapter then introduces subsequent chapters, which are divided into three parts. Part I, “Liberalism, Libertarianism, and Economic Justice,” clarifies the distinction between classical liberalism and the high liberal tradition and their relation to capitalism, and then argues that libertarianism is not a liberal view. Part II, “Distributive Justice and the Difference Principle,” analyzes and applies John Rawls’s principles of justice to economic systems and private law. Part III, “Liberal Institutions and Distributive Justice,” focuses on the crucial role of liberal institutions and procedures in determinations of distributive justice and addresses why the first principles of a moral conception of justice should presuppose general facts in their justification.


Author(s):  
Chris Lorenz

This introductory chapter assesses the role of theory in history and traces the developments in the discipline of history. Theoretical reflection about the ‘true nature’ of history fulfils three interrelated practical functions. First, theory legitimizes a specific historical practice—a specific way of ‘doing history’—as the best one from an epistemological and a methodological point of view. Second, theory sketches a specific programme of doing history. Third, theoretical reflections demarcate a specific way of ‘doing history’ from other ways of ‘doing history’, which are excluded or degraded. The chapter then considers three phases of theoretical changes from analytical to narrative philosophy of history, and then on to ‘history from below’ and the ‘presence’ of history, ultimately leading to the current return of fundamental ontological and normative questions concerning the status of history and history-writing.


2003 ◽  
Vol 27 (9) ◽  
pp. 853-857 ◽  
Author(s):  
Kostas P. Katopodis ◽  
Elli L. Koliousi ◽  
Emilios K. Andrikos ◽  
Michael V. Pappas ◽  
Moses S. Elisaf ◽  
...  

2021 ◽  
Vol 7 (2) ◽  
pp. 90-99
Author(s):  
Leon Hsueh ◽  
Susie L. Hu ◽  
Ankur D. Shah

Background: Peritonitis is a leading complication of peritoneal dialysis (PD). One strategy that the International Society for Peritoneal Dialysis (ISPD) has used to help mitigate the morbidity and mortality associated with peritonitis is through prevention, including antibiotic prophylaxis utilization in high-risk situations. The aim of this study is to summarize our current understanding of postprocedural peritonitis and discuss the existing data behind periprocedural antibiotic prophylaxis, focusing primarily on PD catheter insertion, dental procedures, colonoscopies, upper endoscopies with gastrostomy, and gynecologic procedures. Summary: The ISPD currently recommends intravenous antibiotics prior to PD catheter insertion, colonoscopies, and invasive gynecologic procedures, though prophylaxis has only demonstrated benefit in a prospective, randomized control setting for PD catheter insertion. However, multiple retrospective studies exist that support the use of antibiotic prophylaxis for the other 2 procedures. No specific antibiotic regimen has been established as most optimal to prevent peritonitis for any of the 3 procedures. Antibiotic coverage should include the Enterobacteriaceae family, as well as Gram-positive organisms commonly found on the skin flora for PD catheter insertion, anaerobes for colonoscopies, and common organisms from the urogenital flora in gynecologic procedures. Additionally, the ISPD currently recommends oral amoxicillin prior to dental procedures. There is currently no ISPD recommendation to provide antibiotic prophylaxis prior to an upper endoscopy with or without gastrostomy, though this is a potential area for research. Key Messages: PD patients are at high risk for developing peritonitis after typical procedures. Antibiotic prophylaxis is a potential strategy that the ISPD utilizes to prevent these infections. However, further research needs to be done to determine the optimal antibiotic regimen.


Author(s):  
Helen M. Gunter ◽  
Michael W. Apple ◽  
David Hall

This book reports on primary research into the role and influence of corporate elites in regard to the reform of public education. This introductory chapter outlines this purpose, with a focus on corporatised governance. We outline the trends in reform, and the role of elites and corporate elites in particular, and we then provide an over view of the book and the main contributions of the reported research.


2018 ◽  
Vol 315 (6) ◽  
pp. F1732-F1746 ◽  
Author(s):  
Daiki Iguchi ◽  
Masashi Mizuno ◽  
Yasuhiro Suzuki ◽  
Fumiko Sakata ◽  
Shoichi Maruyama ◽  
...  

In a previous study of fungal peritoneal injury in peritoneal dialysis patients, complement (C)-dependent pathological changes were developed in zymosan (Zy)-induced peritonitis by peritoneal scraping. However, the injuries were limited to the parietal peritoneum and did not show any fibrous encapsulation of the visceral peritoneum, which differs from human encapsular peritoneal sclerosis (EPS). We investigated peritoneal injury in a rat model of Zy-induced peritonitis pretreated with methylglyoxal (MGO) instead of scraping (Zy/MGO peritonitis) to clarify the role of C in the process of fibrous encapsulation of the visceral peritoneum. Therapeutic effects of an anti-C5a complementary peptide, AcPepA, on peritonitis were also studied. In Zy/MGO peritonitis, peritoneal thickness, fibrin exudation, accumulation of inflammatory cells, and deposition of C3b and C5b-9 with loss of membrane C regulators were increased along the peritoneum until day 5. On day 14, fibrous encapsulation of the visceral peritoneum was observed, resembling human EPS. Peritoneal injuries and fibrous changes were significantly improved with AcPepA treatment, even when AcPepA was administered following injection of Zy in Zy/MGO peritonitis. The data show that C5a might play a role in the development of encapsulation-like changes in the visceral peritoneum in Zy/MGO peritonitis. AcPepA might have therapeutic effects in fungal infection-induced peritoneal injury by preventing subsequent development of peritoneal encapsulation.


2019 ◽  
Vol 41 (3) ◽  
pp. 427-432 ◽  
Author(s):  
Arbey Aristizabal-Alzate ◽  
John Fredy Nieto-Rios ◽  
Catalina Ocampo-Kohn ◽  
Lina Maria Serna-Higuita ◽  
Diana Carolina Bello-Marquez ◽  
...  

Abstract Methotrexate is an effective medication to control several diseases; however, it can be very toxic, being myelosuppression one of its main adverse effects, which increases in severity and frequency in patients with renal failure. We present the case of a 68-year-old man with chronic, end-stage renal disease associated with ANCA vasculitis, under treatment with peritoneal dialysis, who received the medication at a low dose, indicated by disease activity, which presented as a complication with severe pancytopenia with mucositis that improved with support measures and multiple-exchange peritoneal dialysis. We reviewed 20 cases published to date of pancytopenia associated with methotrexate in patients on dialysis and found high morbidity and mortality, which is why its use in this type of patient is not recommended. However, when this complication occurs, a therapeutic option could be the use of multiple-exchange peritoneal dialysis in addition to supportive therapy for drug-related toxicity, although it is recognized that studies are required to show the role of multiple-exchange peritoneal dialysis in the removal of this medication.


2018 ◽  
Vol 38 (5) ◽  
pp. 381-384 ◽  
Author(s):  
Ali M. Shendi ◽  
Nathan Davies ◽  
Andrew Davenport

Previous reports linked systemic endotoxemia in dialysis patients to increased markers of inflammation, cardiovascular disease, and mortality. Many peritoneal dialysis (PD) patients use acidic, hypertonic dialysates, which could potentially increase gut permeability, resulting in systemic endotoxemia. However, the results from studies measuring endotoxin in PD patients are discordant. We therefore measured systemic endotoxin in 55 PD outpatients attending for routine assessment of peritoneal membrane function; mean age 58.7 ± 16.4 years, 32 (58.2%) male, 21 (38.2%) diabetic, median duration of PD treatment 19.5 (13 – 31) months, 32 (58.2%) using 22.7 g/L dextrose dialysates, and 47 (85.5%) icodextrin. The median systemic endotoxin concentration was 0.0485 (0.0043 – 0.103) Eu/mL. We found no association between endotoxin levels and patient demographics, markers of inflammation, serum albumin, N-terminal pro-brain natriuretic peptide, extracellular volume measured by bioimpedance, blood pressure, PD prescriptions or peritoneal membrane transporter status, or medications. The measurement of endotoxin can be lowered by failure to effectively release protein-bound endotoxin prior to analysis and increased by contamination when taking blood samples and processing and storing the samples. Additionally, contamination with β–glucan from fungal cell walls and the use of different assays to analyze endotoxin can also give differing results. These factors may help to explain the disparate results reported in different studies. Our study would suggest that exposure to standard peritoneal dialysates does not substantially increase systemic endotoxin. However, until endotoxin assays can measure free and bound endotoxin separately, the role of endotoxin causing inflammation in PD patients remains to be determined.


Author(s):  
T.V. Paul

This introductory chapter offers an overview of the core themes addressed in The Oxford Handbook of Peaceful Change in International Relations. It begins with a discussion of the neglect of peaceful change and the overemphasis on war as the source of change in the discipline of international relations. Definitions of peaceful change in their different dimensions, in particular the maximalist and minimalist varieties, are offered. Systemic, regional, and domestic level changes are explored. This is followed by a discussion of the study and understanding of peaceful change during the interwar, Cold War, and post–Cold War eras. The chapter offers a brief summary of different theoretical perspectives in IR—realism, liberalism, constructivism, and critical as well as eclectic approaches—and how they explore peaceful change, its key mechanisms, and its feasibility. The chapter considers the role of great powers and key regional states as agents of change. The economic, social, ideational, ecological, and technological sources of change are also briefly discussed.


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