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Strongyloidiasis
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
Robert M. Genta, Peter D. Walzer
Clinical signs of hepatitis are rare, but at autopsy the liver is often found to be affected by the larval dissemination. The pathological characteristics (granulomas forming around fragments of larvae) are suggestive of a chronic process (85,134). Peritonitis accompanied by the pesence of parasites in the peritoneal fluid has been described (126) but is not a common manifestation. Likewise, while the larval invasion of virtually every organ has been reported in pathological studies (119), the clinical picture of overwhelming S. stercoralis infections is usually dominated by the intestinal, pulmonary, and central nervous system involvement.
Distribution and Toxicity of Retroviral Vectors after Intracavitary Delivery in Mouse and Man
Published in Eric Wickstrom, Clinical Trials of Genetic Therapy with Antisense DNA and DNA Vectors, 2020
Patrice S. Obermiller, Carlos L. Arteaga, Jeffrey T. Holt, Anne M. Pilaro
Slight traces of intraperitoneally injected LXSN-BRCA1 vector were found by PCR in the following tissues at the 4 hour time point: pancreas, spleen, liver, ovary and colon. Because intraperitoneal injection of LXSN-BRCAlsv produced peritonitis in the above preclinical studies, patients were carefully evaluated for clinical and laboratory signs of acute peritonitis. Three of the 12 patients developed peritonitis as evidenced by patient discomfort, fever, peritoneal fluid counts, and negative bacterial cultures, which resolved within 24-48 hours after treatment was stopped. No recurrence of peritonitis was observed, even after two additional dose escalations. Other toxicities included fever in four patients and nausea in two patients, presumably from abdominal distension produced by the intraperitoneal infusion of vector plus 1 liter of saline.
Infertility attributed to endometriosis
Published in Seema Chopra, Endometriosis, 2020
Shalini Gainder, Neethi Mala Mekala
Peritoneal fluid—a liquid that acts as a lubricant in the abdominal cavity—is rich in various inflammatory cells, cytokines, and growth factors. Multiple defective cellular and humoral immunological factors regulate the growth of ectopic endometrial implants and modulate their inflammatory behavior in endometriosis [28–32]. As a result, women with endometriosis not only have an increased amount of peritoneal fluid but also there are increased concentrations of various activated macrophages, inflammatory cytokines (TNF), interleukins (IL-1), prostaglandins, and reactive oxygen species, and there are decreased concentrations of antioxidants [33,34]. All these variations in endometriosis may affect fertility by several pathways through detrimental effects on the sperm, oocyte, embryo, or tubal functions (each will be described under the respective headings).
Tuberculous peritonitis in patients on peritoneal dialysis: a 35-year experience from a large medical center in Northern Taiwan
Published in Renal Failure, 2023
Tzu-Yi Yang, Ya-Chung Tian, Tzung-Hai Yen, Ming-Yang Chang, Chan-Yu Lin, Shou-Hsuan Liu
In our retrospective cohort study, we initially reviewed 2084 PD patients at Linkou CGMH over a period of 35 years (from January 1985 to December 2019). Peritonitis was diagnosed when the patient met at least two out of the following three characteristics: (1) consistent clinical features, including abdominal pain or cloudy effluent, (2) peritoneal fluid white blood cell (WBC) count greater than 100/mm3 (or 0.1 x 109/L after a dwell time of at least two hours), with > 50% neutrophils, and (3) positive dialysis effluent culture [20]. In terms of TB infection detection, we adopted acid fast stain (AFS) smear, polymerase chain reaction (PCR) and culture for Mycobacterium tuberculosis (MTB). The definite diagnosis of TBP in our study was established only by positive peritoneal fluid culture for MTB.
Progress in the study of nutritional status and selenium in dialysis patients
Published in Annals of Medicine, 2023
Meiran Cao, Shuai Zheng, Wenhua Zhang, Guicai Hu
Delayed gastric emptying (gastroparesis) is also very common in patients with ESRD [117,121]. Due to long-term chronic delayed gastric emptying, patients experience gastrointestinal symptoms such as dyspepsia, bloating, nausea and vomiting, gastroesophageal reflux, and early satiety; these gastrointestinal symptoms reduce the patient’s appetite, resulting in decreased nutrient intake and progressive malnutrition [122–124]. When patients improve delayed gastric emptying with the application of pro-gastric motility drugs, their nutritional status improves along with it [125]. In patients on peritoneal dialysis, high retention of peritoneal fluid (which can increase intra-abdominal pressure) and reabsorption of glucose from the peritoneal fluid can cause delayed gastric emptying [126,127]. Other factors affecting delayed gastric emptying include diabetes mellitus and abnormal gastric electromyographic activity [128]. In conclusion, aggressive treatment of gastrointestinal dysfunction not only leads to improvement of malnutrition in patients, but also delays the progression of renal disease.
A case report of peritoneal tuberculosis diagnosed by laparoscopy in a low prevalence setting
Published in Acta Chirurgica Belgica, 2021
Jan Van Slambrouck, Johan Vlasselaers, Bart Devos
Paracentesis is the least invasive procedure that can confirm the diagnosis of peritoneal TB. Results of biochemical analysis and cytology of peritoneal fluid can increase the clinicians’ index of suspicion. A low serum-ascites albumin gradient (SAAG) of <1.1 g/dL and presence of lymphocytes in ascitic fluid are compatible with peritoneal TB [3]. Measurement of ascitic adenosine deaminase (ADA) activity is a recently established test with a high diagnostic yield that is especially helpful as a screening test for patients with ascites in high prevalence countries. However, it is not widely used in the Western European setting. Biochemical and cytological findings after ascitic fluid analysis only suggest the diagnosis of peritoneal TB. An ascitic fluid smear test for Ziehl–Neelsen acid-fast bacilli staining is very specific but sensitivity is low [11]. Conventional mycobacterial cultures take 4–6 weeks and isolation of bacilli is rare [5]. Molecular PCR assays are a new alternative that can reveal presence of M. tuberculosis complex in peritoneal fluid within a short amount of time [10,11]. As PCR techniques evolve, diagnostic yield and availability increases [11].