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Abdominal Radiology (New York) Aug 2023The purpose is to discuss abdominal tuberculosis mimicking malignancy involving the abdominal viscera. TB of the abdominal viscera is common, especially in countries... (Review)
Review
The purpose is to discuss abdominal tuberculosis mimicking malignancy involving the abdominal viscera. TB of the abdominal viscera is common, especially in countries where tuberculosis is endemic and in pockets of non-endemic countries. Diagnosis is challenging as clinical presentations are often non-specific. Tissue sampling may be necessary for definitive diagnosis. Awareness of the early and late disease imaging appearances of abdominal tuberculosis involving the viscera that can mimic malignancy can aid detecting TB, providing a differential diagnosis, assessing extent of spread, guiding biopsy, and evaluating response.
Topics: Humans; Peritonitis, Tuberculous; Tuberculosis, Gastrointestinal; Abdomen; Neoplasms; Biopsy
PubMed: 37204509
DOI: 10.1007/s00261-023-03939-5 -
Renal Failure Dec 2023This study aimed to investigate the association between patient clinical characteristics and technique failure in peritoneal dialysis-related peritonitis (PDRP). The...
OBJECTIVE
This study aimed to investigate the association between patient clinical characteristics and technique failure in peritoneal dialysis-related peritonitis (PDRP). The effect of peritonitis-associated technique failure on patient survival was also assessed.
METHODS
Patients diagnosed with PDRP from January 1, 2010 to June 30, 2022 were retrospectively reviewed and analyzed. Relevant demographic, biochemical, and clinical data were collected. Univariate and multivariate logistic regression analyses were used to determine the predictors of peritonitis-associated technique failure in PD. Patients were divided into technique failure (F group) and nontechnique failure (NF group) groups. Patients were followed until death or until the date of Oct 1, 2022. Kaplan-Meier survival curves and landmark analysis were used to assess the survival of the PDRP cohort. Cox regression models were used to assess the association between potential risk factors and mortality.
RESULTS
A total of 376 patients with 648 cases of PDRP were included in this study. Multivariate logistic regression analysis demonstrated that peritoneal dialysis (PD) duration (OR = 1.12 [1.03, 1.21], = 0.005), dialysate WBC count on Day 3 after antibiotic therapy (OR = 1.41 [1.22, 1.64], 0.001), blood neutrophil-to-lymphocyte ratio (NLR) (OR = 1.83 [1.25, 2.70], = 0.002), and serum lactate dehydrogenase (LDH) (OR = 4.13 [1.69, 10.11], = 0.002) were independent predictors for technique failure in PDRP. Furthermore, serum high-density lipoprotein (HDL) (OR = 0.28 [0.13, 0.64], = 0.002) was a protective factor against technique failure. According to the Kaplan-Meier analysis, patients experiencing peritonitis-associated technique failure had lower postperitonitis survival (log-rank = 4.326, = 0.038). According to the landmark analysis, patients with a history of peritonitis-associated technical failures had a higher 8-year mortality after peritoneal dialysis. A Cox model adjusted for plausible predetermined confounders showed that technique failure was independently associated with all-cause mortality.
CONCLUSIONS
Dialysate WBC count on Day 3, PD duration, NLR, and LDH were independent risk factors for technique failure, whereas HDL was a protective factor. Peritonitis-associated technique failure had a higher risk of mortality and adverse effects on postperitonitis survival.
Topics: Humans; Retrospective Studies; Peritoneal Dialysis; Dialysis Solutions; Risk Factors; Peritonitis; Kidney Failure, Chronic
PubMed: 37125594
DOI: 10.1080/0886022X.2023.2205536 -
Laboratory Medicine Sep 2023Anaplasmosis or human granulocytic anaplasmosis is a tick-borne illness caused by the bacteria, Anaplasma phagocytophilum, resulting from an infected tick bite....
Anaplasmosis or human granulocytic anaplasmosis is a tick-borne illness caused by the bacteria, Anaplasma phagocytophilum, resulting from an infected tick bite. Examination of a blood smear within the first week of exposure may show microcolonies of anaplasmae (morulae) in the cytoplasm of neutrophils that are highly suggestive of anaplasmosis but not definitive. We present the first case describing Anaplasma-related peritonitis and morulae in peritoneal fluid granulocytes in a peritoneal dialysis patient who developed anaplasmosis.
Topics: Animals; Humans; Anaplasma; Anaplasmosis; Granulocytes; Neutrophils; Anaplasma phagocytophilum
PubMed: 36972513
DOI: 10.1093/labmed/lmad016 -
Langenbeck's Archives of Surgery Aug 2023Although intraoperative peritoneal lavage often is performed routinely with the aim of reducing peritoneal contamination, evidence of lavage benefit in elective...
BACKGROUND
Although intraoperative peritoneal lavage often is performed routinely with the aim of reducing peritoneal contamination, evidence of lavage benefit in elective pancreatic surgery is limited.
METHODS
We retrospectively classified patients who had undergone pancreatic surgery to groups given or not given peritoneal lavage, then comparing clinical results. This saline lavage was performed at the end of the operation. The primary endpoint was rate of surgical site infection. Frequency of peritoneal recurrence also was evaluated.
RESULTS
Among all 104 patients in the study, incidence of infectious complications in the lavage group (n = 65) was significantly higher than in the non-lavage group (n = 39; 35% vs. 15%, P = 0.041), while incidences of postoperative complications overall and surgical site infection did not differ between lavage (80% and 26%) and non-lavage groups (67% and 10%, P = 0.162 and 0.076, respectively). Among 63 patients undergoing pancratoduodenectomy, frequencies of positive bacterial cultures of drainage fluids on postoperative days 1 and 3 were greater in the non-lavage group (P < 0.001 and P = 0.012), but surgical site infection was significantly more frequent in the lavage group (P = 0.043). Among patients with pancreatic and biliary cancers, lavage did not affect frequency of peritoneal recurrence.
CONCLUSION
Intraoperative lavage did not prevent surgical site infection or peritoneal recurrence of pancreatobiliary cancer.
Topics: Humans; Peritoneal Neoplasms; Peritoneal Lavage; Surgical Wound Infection; Retrospective Studies; Neoplasm Recurrence, Local
PubMed: 37624419
DOI: 10.1007/s00423-023-03080-3 -
Peritoneal Dialysis International :... Nov 2023When a patient on peritoneal dialysis (PD) presents with suspected PD-related peritonitis (e.g. cloudy PD fluid and abdominal pain), one of the most important initial... (Review)
Review
When a patient on peritoneal dialysis (PD) presents with suspected PD-related peritonitis (e.g. cloudy PD fluid and abdominal pain), one of the most important initial aspects of management is for the nephrology nurse/home dialysis nurse to collect PD effluent specimens for white blood cells count, Gram stain, culture and sensitivity for inspection and to send for laboratory testing before antibiotics are started. A review by seven members of the International Society for Peritoneal Dialysis (ISPD) Nursing Committee of all 133 questions posted to the ISPD website 'Questions about PD' over the last 4 years (January 2018-December 2021), revealed 97 posted by nephrology nurses from around the world. Of these 97 questions, 10 were noted to be related to best practices for PD effluent specimen collection. For our review, we focused on these 10 questions along with their responses by the members of the ISPD 'Ask The Experts Team', whereby existing best practice recommendations were considered, if available, relevant literature was cited and differences in international practice discussed. We revised the original responses for clarity and updated the references. We found that these 10 questions were quite varied but could be organised into four categories: how to collect PD effluent safely; how to proceed with PD effluent collection; how to collect PD effluent for assessment; and how to proceed with follow-up PD effluent collection after intraperitoneal antibiotics have been started. In general, we found that there was limited evidence in the PD literature to answer several of these 10 questions posted to the ISPD website 'Questions about PD' by nephrology nurses from around the world on this important clinical topic of best practices for PD effluent specimen collection. Some of these questions were also not addressed in the latest ISPD Peritonitis Guidelines. Moreover, when polling members of our ISPD Nursing Committee we found when answering a few of these questions, nursing practice varied within and among countries. We encourage PD nurses to conduct their own research on this important topic, focusing on areas where research evidence is lacking.
Topics: Humans; Peritoneal Dialysis; Anti-Bacterial Agents; Peritonitis; Dialysis Solutions
PubMed: 36475557
DOI: 10.1177/08968608221136389 -
Journal of Feline Medicine and Surgery Dec 2023The aim of this study was to describe the abdominal ultrasonographic findings in cats with confirmed or presumed feline infectious peritonitis (FIP).
OBJECTIVES
The aim of this study was to describe the abdominal ultrasonographic findings in cats with confirmed or presumed feline infectious peritonitis (FIP).
METHODS
This was a retrospective study performed in an academic veterinary hospital. The diagnosis of FIP was reached on review of history, signalment, clinical presentation, complete blood count, biochemistry panel, peritoneal fluid analysis, cytology and/or histopathology results from abnormal organs, and/or molecular testing (immunohistochemical or FIP coronavirus [FCoV] RT-PCR). Cats with confirmed FIP by molecular testing or with a highly suspicious diagnosis of FIP were included. Abdominal ultrasound examination findings were reviewed.
RESULTS
In total, 25 cats were included. Common clinical signs/pathology findings included hyperglobulinemia (96%), anorexia/hyporexia (80%) and lethargy (56%). Abdominal ultrasound findings included effusion in 88% and lymphadenopathy in 80%. Hepatic changes were noted in 80%, the most common being hepatomegaly (58%) and a hypoechoic liver (48%). Intestinal changes were noted in 68% of cats, characterized by asymmetric wall thickening and/or loss of wall layering, with 52% being ileocecocolic junction and/or colonic in location. Splenic changes were present in 36% of cats, including splenomegaly, mottled parenchyma and hypoechoic nodules. Renal changes were present in 32%, encompassing a hypoechoic subcapsular rim and/or cortical nodules. Mesenteric and peritoneal abnormalities were seen in 28% and 16% of cats, respectively. Most cats (92%) had two or more locations of abdominal abnormalities on ultrasound.
CONCLUSIONS AND RELEVANCE
The present study documents a wider range and distribution of ultrasonographic lesions in cats with FIP than previously reported. The presence of effusion and lymph node, hepatic and/or gastrointestinal tract changes were the most common findings, and most of the cats had a combination of two or more abdominal abnormalities.
Topics: Cats; Animals; Feline Infectious Peritonitis; Retrospective Studies; Coronavirus, Feline; Abdomen; Coronavirus Infections; Cat Diseases
PubMed: 38095890
DOI: 10.1177/1098612X231216000 -
Acta Pharmacologica Sinica Oct 2023Activation of NLR family pyrin domain-containing 3 (NLRP3) inflammasome plays important role in defending against infections, but its aberrant activation is causally...
Activation of NLR family pyrin domain-containing 3 (NLRP3) inflammasome plays important role in defending against infections, but its aberrant activation is causally linked to many inflammatory diseases, thus being a therapeutic target for these diseases. Theaflavin, one major ingredient of black tea, exhibits potent anti-inflammatory and anti-oxidative activities. In this study, we investigated the therapeutic effects of theaflavin against NLRP3 inflammasome activation in macrophages in vitro and in animal models of related diseases. We showed that theaflavin (50, 100, 200 μM) dose-dependently inhibited NLRP3 inflammasome activation in LPS-primed macrophages stimulated with ATP, nigericin or monosodium urate crystals (MSU), evidenced by reduced release of caspase-1p10 and mature interleukin-1β (IL-1β). Theaflavin treatment also inhibited pyroptosis as shown by decreased generation of N-terminal fragment of gasdermin D (GSDMD-NT) and propidium iodide incorporation. Consistent with these, theaflavin treatment suppressed ASC speck formation and oligomerization in macrophages stimulated with ATP or nigericin, suggesting reduced inflammasome assembly. We revealed that theaflavin-induced inhibition on NLRP3 inflammasome assembly and pyroptosis resulted from ameliorated mitochondrial dysfunction and reduced mitochondrial ROS production, thereby suppressing interaction between NLRP3 and NEK7 downstream of ROS. Moreover, we showed that oral administration of theaflavin significantly attenuated MSU-induced mouse peritonitis and improved the survival of mice with bacterial sepsis. Consistently, theaflavin administration significantly reduced serum levels of inflammatory cytokines including IL-1β and attenuated liver inflammation and renal injury of mice with sepsis, concomitant with reduced generation of caspase-1p10 and GSDMD-NT in the liver and kidney. Together, we demonstrate that theaflavin suppresses NLRP3 inflammasome activation and pyroptosis by protecting mitochondrial function, thus mitigating acute gouty peritonitis and bacterial sepsis in mice, highlighting a potential application in treating NLRP3 inflammasome-related diseases.
Topics: Mice; Animals; Inflammasomes; NLR Family, Pyrin Domain-Containing 3 Protein; Reactive Oxygen Species; Nigericin; Gout; Peritonitis; Antioxidants; Sepsis; Caspases; Adenosine Triphosphate; Interleukin-1beta
PubMed: 37221235
DOI: 10.1038/s41401-023-01105-7 -
Bulletin of Experimental Biology and... Sep 2023The biological models used in the study of generalized peritonitis can be subdivided into 5 groups (introduction of foreign bodies, cultures of microorganisms,...
The biological models used in the study of generalized peritonitis can be subdivided into 5 groups (introduction of foreign bodies, cultures of microorganisms, suspensions of feces, chemicals, and mechanical damage to the gastrointestinal tract) or into 4 groups (introduction of foreign bodies, chemicals, bacterial contamination of the abdominal cavity, and combined methods). After analysis of published reports, the most justified classification of methods of peritonitis modelling is based on the type of peritonitis-inducing agent and the administration route and on the nature of peritonitis developing in the abdominal cavity. The choice of the model maximally close reproducing clinical conditions of peritonitis should be based on the specific objectives of the study, focusing on the etiology, pathogenesis, and severity of the disease course, planned measures aimed at eliminating the process, and other factors.
Topics: Humans; Peritonitis; Abdominal Cavity; Feces; Gastrointestinal Tract; Foreign Bodies
PubMed: 37861910
DOI: 10.1007/s10517-023-05909-9 -
FASEB Journal : Official Publication of... Sep 2023During peritoneal dialysis (PD), the peritoneum is exposed to a bioincompatible dialysate, deteriorating the tissue and limiting the long-term effectiveness of PD....
During peritoneal dialysis (PD), the peritoneum is exposed to a bioincompatible dialysate, deteriorating the tissue and limiting the long-term effectiveness of PD. Peritoneal fibrosis is triggered by chronic inflammation induced by a variety of stimuli, including peritonitis. Exposure to PD fluid alters peritoneal macrophages phenotype. Inflammasome activation triggers chronic inflammation. First, it was determined whether inflammasome activation causes peritoneal deterioration. In the in vivo experiments, the increased expression of the inflammasome components, caspase-1 activity, and concomitant overproduction of IL-1β and IL-18 were observed in a mouse model of peritoneal fibrosis. ASC-positive and F4/80-positive cells colocalized in the subperitoneal mesothelial cell layer. These macrophages expressed high CD44 levels indicating that the CD44-positive macrophages contribute to developing peritoneal deterioration. Furthermore, intravital imaging of the peritoneal microvasculature demonstrated that the circulating CD44-positive leukocytes may contribute to peritoneal fibrosis. Bone marrow transplantation in ASC-deficient mice suppressed inflammasome activation, thereby attenuating peritoneal fibrosis in a high glucose-based PD solution-injected mouse model. Our results suggest inflammasome activation in CD44-positive macrophages may be involved in developing peritoneal fibrosis. The inflammasome-derived pro-inflammatory cytokines might therefore serve as new biomarkers for developing encapsulating peritoneal sclerosis.
Topics: Animals; Mice; Peritoneum; Peritoneal Fibrosis; Inflammasomes; Peritonitis; Disease Models, Animal; Inflammation
PubMed: 37606578
DOI: 10.1096/fj.202201777RRR -
Inflammation Research : Official... Aug 2023Intercellular communication between macrophages and peritoneal mesothelial cells (PMCs) has been suggested as a key factor regulating peritonitis development. Here, we...
BACKGROUND
Intercellular communication between macrophages and peritoneal mesothelial cells (PMCs) has been suggested as a key factor regulating peritonitis development. Here, we explored whether PPARγ (peroxisome proliferator-activated receptor gamma) can be packaged into macrophage exosomes to mediate intercellular communication and regulate peritonitis.
METHODS
Macrophage exosomes were isolated by ultracentrifugation and identified by nanoparticle tracking analysis and transmission electron microscopy. Proteomic analysis of macrophage-derived exosomes was performed using mass spectrometry. Co-culture models of supernatants or exosomes with PMCs, as well as a mouse peritonitis model induced by lipopolysaccharide (LPS), were employed.
RESULTS
In this study, using stable Raw264.7 cells overexpressing GFP-FLAG-PPARγ (OE-PPARγ), we found that PPARγ inhibited LPS-induced inflammatory responses in Raw264.7 cells and that PPARγ was incorporated into macrophage exosomes during this process. Overexpression of PPARγ mainly regulated the secretion of differentially expressed exosomal proteins involved in the biological processes of protein transport, lipid metabolic process, cell cycle, apoptotic process, DNA damage stimulus, as well as the KEGG pathway of salmonella infection. Using co-culture models and mouse peritonitis model, we showed that exosomes from Raw264.7 cells overexpressing PPARγ inhibited LPS-induced inflammation in co-cultured human PMCs and in mice through downregulating CD14 and TLR4, two key regulators of the salmonella infection pathway. Pretreatment of the PPARγ inhibitor GW9662 abolished the anti-inflammatory effect of exosomes from Raw264.7 OE-PPARγ cells on human PMCs.
CONCLUSIONS
These results suggested that overexpression of PPARγ largely altered the proteomic profile of macrophage exosomes and that exosomal PPARγ from macrophages acted as a regulator of intercellular communication to suppress LPS-induced inflammatory responses in vitro and in vivo via negatively regulating the CD14/TLR4 axis.
Topics: Mice; Humans; Animals; PPAR gamma; Lipopolysaccharides; Toll-Like Receptor 4; Proteomics; Macrophages; Peritonitis; Biological Phenomena
PubMed: 37438583
DOI: 10.1007/s00011-023-01765-5