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Clinical Pharmacokinetics May 2010A microdialysis study of meropenem distribution in the peritoneal fluid of patients with peritonitis has suggested that there is significant peripheral drug degradation.... (Comparative Study)
Comparative Study
BACKGROUND AND OBJECTIVES
A microdialysis study of meropenem distribution in the peritoneal fluid of patients with peritonitis has suggested that there is significant peripheral drug degradation. The aims of the present study were to investigate the plasma and peritoneal fluid pharmacokinetics of imipenem, a relatively unstable antibacterial, in patients with severe peritonitis, and to relate measured unbound concentrations to the minimum inhibitory concentrations required for susceptible and intermediately susceptible bacteria.
METHODS
Microdialysis catheters were placed into the peritoneal cavity through peritoneal drains in nine critically patients. Imipenem concentrations in plasma and in peritoneal fluid were analysed using compartmental modelling.
RESULTS
A model that considered elimination from a peripheral compartment described the data and was used to simulate steady-state concentration profiles in plasma and peritoneal fluid during various dosing regimens. Using recommended dosing regimens (500 mg every 6 hours, 1000 mg every 8 hours and 1000 mg every 6 hours), simulated unbound peritoneal fluid concentrations of imipenem in patients with severe peritonitis reached values sufficient for antibacterial effects against susceptible bacteria. However, the adequacy of regimens in patients with severe peritonitis whose infections involve intermediately susceptible bacteria is questionable.
CONCLUSION
The results of this study are consistent with those previously observed with meropenem and confirm the usefulness of microdialysis for assessment of peritoneal fluid distribution of antibacterials.
Topics: Aged; Anti-Bacterial Agents; Ascitic Fluid; Critical Illness; Female; Humans; Imipenem; Male; Microdialysis; Middle Aged; Models, Chemical; Peritonitis; Severity of Illness Index
PubMed: 20384394
DOI: 10.2165/11319370-000000000-00000 -
Cytokine profiles in serum and peritoneal fluid from infertile women with and without endometriosis.The Journal of Obstetrics and... Aug 2007To study the serum and peritoneal fluid cytokine profiles in infertile women with minimal/mild active endometriosis.
OBJECTIVE
To study the serum and peritoneal fluid cytokine profiles in infertile women with minimal/mild active endometriosis.
METHODS
Fifty-seven consecutive infertile women undergoing laparoscopy for unexplained infertility had peritoneal fluid and serum samples obtained at the time of laparoscopy. The levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1 beta (IL-1 beta), vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-alpha), monocyte chemotatic protein-1 (MCP-1), RANTES, platelet derived growth factor (PDGF), soluble Fas (sFas), and soluble Fas Ligand (sFasL) in peritoneal fluid and serum were measured to compare the concentration in both biological fluids, in women who have minimal/mild red endometriosis using women with no endometriosis as controls.
RESULTS
Peritoneal fluid levels of MCP-1, IL-8 and IL-6 were significantly higher in the endometriosis group (P < 0.012, P = 0.003, and P = 0.015, respectively). There was no significant difference in the peritoneal fluid levels of IL-1 beta, TNF-alpha, RANTES, VEGF, PDGF, sFas and sFasL in the two groups. Although serum levels of IL-8 were higher in women with endometriosis, the difference was not significant (P = 0.07). Serum levels of PDGF, IL-6, RANTES, IL-1 beta, TNF-alpha, and sFas, were not significantly different in the two groups.
CONCLUSION
The elevated levels of MCP-1, IL-6, and IL-8 in peritoneal fluid but not serum may indicate the importance of local macrophage activating factors in the pathogenesis of endometriosis.
Topics: Ascitic Fluid; Cytokines; Endometriosis; Female; Humans; Immunoassay; Infertility; Statistics, Nonparametric
PubMed: 17688616
DOI: 10.1111/j.1447-0756.2007.00569.x -
Gynecological Endocrinology : the... 2014Peptidomic profiling of peritoneal fluid by Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF-MS) may represent a promising,...
Peptidomic profiling of peritoneal fluid by Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF-MS) may represent a promising, suitable, rapid method for early diagnosis and staging of endometriosis. In a case-control study, peritoneal fluid was collected from 23 patients affected by endometriosis (eight minimal/mild endometriosis and 15 moderate/severe endometriosis) and six "endometriosis free" women undergoing laparoscopy. MALDI-TOF mass spectra of the peptide fraction extracted from peritoneal fluid samples lead to identify biomarkers potentially suitable for discriminating between peritoneal fluid samples from women affected by minimal/mild endometriosis and those from women affected by moderate/severe endometriosis. Peptidomic analysis of peritoneal fluid samples may define putative peptide biomarkers suitable for staging endometriosis and improve our understanding of the pathogenesis of endometriosis.
Topics: Adult; Ascitic Fluid; Biomarkers; Case-Control Studies; Endometriosis; Female; Humans; Proteomics; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
PubMed: 25111755
DOI: 10.3109/09513590.2014.943718 -
Fertility and Sterility Sep 2013To study altered hemopexin concentrations in peritoneal fluid (PF) samples from patients with endometriosis. Recent data implicate a role of altered iron metabolism in...
OBJECTIVE
To study altered hemopexin concentrations in peritoneal fluid (PF) samples from patients with endometriosis. Recent data implicate a role of altered iron metabolism in endometriosis patients. Hemopexin is the major transport protein for heme. Like iron, heme exposure to the epithelial surface can provoke oxidative stress on the peritoneal epithelium. Therefore, altered hemopexin concentrations and heme scavenging in PF might play a role in the pathophysiology of endometriosis.
DESIGN
Prospective explorative study.
SETTING
Academic tertiary care center.
PATIENT(S)
Eighty symptomatic patients scheduled for laparoscopy for the diagnosis and/or therapy of endometriosis.
INTERVENTION(S)
Aspiration of PF samples during laparoscopy.
MAIN OUTCOME MEASURE(S)
Hemopexin and heme concentration in PF.
RESULT(S)
At laparoscopy, 47 of 80 (58.8%) patients exhibited endometriosis, and 33 (41.2%) were proven disease-free (CO). By means of ELISA significantly lower concentrations of hemopexin in the samples from patients with endometriosis (endometriosis 0.377 ± 0.16 mg/mL) compared with controls (disease-free 0.479 ± 0.20 mg/mL) could be demonstrated. Heme levels in the samples were not significantly different between groups (endometriosis 9.130 ± 6.124 μM and disease-free 9.990 ± 4.485 μM). There was no significant correlation between heme and hemopexin levels (Pearson's correlation coefficient r = -0.146). Demographic data between the groups were comparable.
CONCLUSION(S)
These data provide further evidence that hemopexin is significantly down-regulated in PF samples from patients with endometriosis compared with controls. This study confirms recent findings in two-dimensional gel electrophoresis demonstrating a down-regulation of hemopexin in PF from patients with endometriosis in a larger series of samples.
Topics: Adult; Ascitic Fluid; Down-Regulation; Endometriosis; Enzyme-Linked Immunosorbent Assay; Female; Heme; Hemopexin; Humans; Laparoscopy; Ovarian Diseases; Young Adult
PubMed: 23755951
DOI: 10.1016/j.fertnstert.2013.05.010 -
JPMA. the Journal of the Pakistan... Aug 1998This study was undertaken to evaluate the effects of long-term persistent peritoneal fluid eosinophilia on the peritoneal membrane as reflected by a change in dialysis...
This study was undertaken to evaluate the effects of long-term persistent peritoneal fluid eosinophilia on the peritoneal membrane as reflected by a change in dialysis function. This was a prospective study undertaken at a community-based peritoneal dialysis unit, where thirty-one patients were enrolled over a 9-month period. Chronic, long-term peritoneal fluid eosinophilia was noted in 12/31 (38.7%) patients. Significant differences were not noted between values of creatinine clearance, D/P urea and Kt/V, compared to their baseline values. This study shows that long-term peritoneal fluid eosinophilia does not significantly affect peritoneal membrane function in patients on maintenance peritoneal dialysis.
Topics: Ascitic Fluid; Chronic Disease; Eosinophilia; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Peritoneal Dialysis
PubMed: 10067037
DOI: No ID Found -
PloS One 2018This study was conducted to develop a novel algorithm for determining the origin of tumors by combining analysis of cluster patterns with immunocytochemistry (ICC) for...
This study was conducted to develop a novel algorithm for determining the origin of tumors by combining analysis of cluster patterns with immunocytochemistry (ICC) for markers in cells from fine-needle aspirates of ascites. We used LBC, based on SurePathTM (BD Diagnostics) technology, to screen 96 peritoneal fluid samples from patients with known malignancies and from 10 control patients with cirrhosis. Following dual ICC staining for cytokeratin 7 (CK7) and paired box gene 8 (PAX8), we developed an algorithm using immunoreactivity and three-dimensional (3D) cluster patterns to correlate staining and 3D cluster patterns with common primary origins that included stomach, ovarian, pancreatobiliary tract, colon, lung, and breast cancers. With the application of an automatic digitalized image analyzer, competence performance was analyzed using receiver operating characteristics (ROC) curve analysis. CK7 and PAX8 staining and 3D cluster patterns were used to differentiate primary origins. Samples from patients with stomach cancer were no 3D cluster /CK7+/PAX8- with area under the curve (AUC) of 0.8699 in ROC curve analysis. Samples from ovarian cancer patients were large 3D cluster/CK7+/PAX8+ with AUC of 0.9812. Samples from pancreatobiliary tract cancer patients were small 3D cluster/CK7+/PAX8- with AUC of 0.8772. The remaining cancer samples, including breast, lung and colon cancer samples, had similar patterns of large 3D clusters/CK7+/PAX8- with AUC of 0.882, especially for lung cancer. SurePathTM technology, using 3D cluster patterns and dual ICC for CK7 and PAX8 in peritoneal fluid samples, can provide important information for determining specific primary origins in cases of unknown primary carcinoma.
Topics: Algorithms; Ascites; Ascitic Fluid; Biomarkers, Tumor; Female; Humans; Keratin-7; Male; Neoplasms; PAX8 Transcription Factor
PubMed: 30024911
DOI: 10.1371/journal.pone.0199715 -
Gynecologic and Obstetric Investigation 1988A decreased intraabdominal fibrinolytic activity has been proposed as an etiological factor in the development of endometriosis. To test this hypothesis plasminogen,...
A decreased intraabdominal fibrinolytic activity has been proposed as an etiological factor in the development of endometriosis. To test this hypothesis plasminogen, fibrinogen, alpha 2-antiplasmin, alpha 2-macroglobulin, plasminogen activator (t-PA) and its inhibitor and the degradation products of fibrin were determined in the peritoneal fluid of 25 patients with and 45 patients without endometriosis. No significant difference was found for any of the parameters. Therefore, a role for the fibrinolytic system as an etiological factor in the development of endometriosis is unlikely. A high concentration of t-PA was found in comparison to normal blood levels, leading to a high concentration of fibrin degradation products in the peritoneal fluid, indicating an active system of intraabdominal fibrinolysis. A high concentration of fibrin degradation products further indicates the presence of fibrinogen and its turnover secondary to thrombin action.
Topics: Ascitic Fluid; Endometriosis; Female; Fibrinolysis; Fibrinolytic Agents; Humans; Tissue Plasminogen Activator
PubMed: 3147926
DOI: 10.1159/000293710 -
Fertility and Sterility Jun 1981
Topics: Ascitic Fluid; Cell Count; Endometriosis; Female; Humans; Infertility; Lymphocytes; Macrophages; Male; Neutrophils
PubMed: 7195828
DOI: 10.1016/s0015-0282(16)45567-6 -
Gynecological Endocrinology : the... Mar 2004The present study explored the possible relationships between immune cell subsets and interleukin (IL)-12 or IL-13 levels in the peritoneal fluid of patients with and...
The present study explored the possible relationships between immune cell subsets and interleukin (IL)-12 or IL-13 levels in the peritoneal fluid of patients with and without endometriosis. Peritoneal fluid samples were obtained from 80 women while they were undergoing laparoscopy for pain, infertility, tubal ligation or re-anastomosis. The American Fertility Society scoring system was used to determine the extension of endometriosis. The peritoneal fluid mononuclear cells were analyzed for immunophenotyping using cytometry, whereas peritoneal fluid concentrations of interleukins were measured using two ultrasensitive commercially available enzyme-linked imnunosorbent assay kits. Significantly higher peritoneal fluid IL-12 levels were found in women with moderate or severe endometriosis (stages III and IV) than in healthy controls (p < 0.01). Conversely, subjects with endometriosis showed remarkably lower peritoneal fluid IL-13 concentrations than controls, independent of the severity of the disease (p < 0.05). Considering immune system effectors, patients with endometriosis presented a significantly higher peritoneal fluid CD8+/CD4+ ratio when compared with healthy controls. Moreover, the number of peritoneal fluid CD8+ and CD4+ activated T cells was significantly lower in the former than in the latter group, independent of the endometriosis stage. Connections were observed between peritoneal fluid interleukins and peritoneal fluid T cells: both patients with endometriosis and controls presented an inverse correlation between peritoneal fluid activated T cells and IL-13 levels, and a direct correlation between peritoneal fluid T cells and IL-12 concentrations. These data seem to suggest that a reciprocal modulation exists between peritoneal fluid cytokines and T lymphocyte subsets in patients with endometriosis.
Topics: Adult; Ascitic Fluid; CD3 Complex; CD4-CD8 Ratio; Endometriosis; Enzyme-Linked Immunosorbent Assay; Female; Flow Cytometry; HLA-DR Antigens; Humans; Immunophenotyping; Interleukin-12; Interleukin-13; Interleukins; Lymphocyte Count; Lymphocyte Subsets; T-Lymphocytes
PubMed: 15255283
DOI: 10.1080/09513590310001653044 -
Peritoneal Dialysis International :... 2003Hyaluronan (HA) is a glycosaminoglycan found in connective tissues and tissue spaces, including the peritoneal cavity. In vivo studies in a rat model of peritoneal... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
BACKGROUND
Hyaluronan (HA) is a glycosaminoglycan found in connective tissues and tissue spaces, including the peritoneal cavity. In vivo studies in a rat model of peritoneal dialysis (PD) have shown that addition of HA to PD solution during an intraperitoneal dwell can alter peritoneal fluid transport and protect the peritoneal membrane from the effects of inflammation and repeated infusions of dialysis solution. The current study sought to evaluate the safety of intraperitoneal HA and its effect on peritoneal fluid and solute transport when administered during a dialysis dwell in humans.
METHODS
13 PD patients were enrolled in a prospective, randomized crossover study involving three dialysis treatments using the following PD solutions: (1) a commercially available PD solution (Dianeal PD-4, 1.36% glucose; Baxter Healthcare Corporation, Alliston, Ontario, Canada); (2) Dianeal PD-4 containing 0.1 g/L HA, and (3) Dianeal PD-4 containing 0.5 g/L HA. Each 6-hour dialysis exchange was separated from the other exchanges by a 2-week washout period. Radioiodinated human serum albumin (RISA) was administered with the dialysis solution to evaluate intraperitoneal volume, net ultrafiltration (UF), and fluid reabsorption. Peritoneal clearances, dialysate/plasma ratios (D/P), and mass transfer area coefficients (MTACs) were determined for sodium, urea, creatinine, albumin, and glucose. Safety was evaluated by monitoring adverse events and changes in serum chemistries. Ten patients completed all three dialysis exchanges and two additional patients completed at least one treatment exchange.
RESULTS
There were no reported adverse events related to HA administration and no significant changes in serum chemistries. There were no significant differences in net UF or peritoneal volume profiles among the three treatments. Mean net UF calculated using residual volumes, estimated by RISA dilution, tended to be slightly higher during treatment with solution containing 0.1 g/L HA and 0.5 g/L HA [74 +/- 86 (SE) and 41 +/- 99 mL, respectively] compared to control treatment (-58 +/- 129 mL). Although not statistically significant, there was a trend toward decreased fluid reabsorption during treatment with HA. Solute clearances, D/P ratios, and MTACs were similar for the three treatments. Serum levels of HA were also unaffected by the two treatment solutions.
CONCLUSIONS
These data support the acute safety of HA when administered intraperitoneally with the dialysis solution to PD patients. Due to the small sample size and variability in net UF and fluid reabsorption, statistically significant differences were not demonstrated for these parameters. However, a trend toward decreased fluid reabsorption was observed, suggesting that HA may act by a mechanism similar to that observed in animal studies. Further studies are necessary to evaluate whether the beneficial effects of HA observed in animal studies can be shown in humans.
Topics: Adjuvants, Immunologic; Adult; Aged; Ascitic Fluid; Cross-Over Studies; Dialysis Solutions; Double-Blind Method; Female; Humans; Hyaluronic Acid; Male; Middle Aged; Peritoneal Dialysis; Prospective Studies
PubMed: 12691509
DOI: No ID Found