Search results for: peritoneal dialysis.

Authors: I-En Lin, Feng-Jung Yang

Abstract:

In addition to kidney transplant, renal replacement therapy involves hemodialysis and peritoneal dialysis (PD). PD possesses advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home dialysis treatment. However, potential danger still exists despite the numerous advantages of PD, particularly when patients require dialysis exchange four to five times a day, during which improper operation can easily lead to peritonitis. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. Connecting the transfer set requires sterile technique. Transfer set may require a new cap each time that it disconnects from the bag after an exchange. There are many chances to get infection due to unsafe behavior (ex: hand tremor, poor eyesight and weakness, cap fall-down). The proposed semi-automatic connection mechanism used in the PD can greatly reduce infection chances. This light-weight connection device is portable. The device also does not require using throughout the entire process. It is capable of significantly improving quality of life. Therefore, it is very promising to adopt in home care application.

Keywords: Automatic connection, catheter, glomerulonephritis, peritoneal dialysis.

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Authors: Jinn-Yi Yeh, Tai-Hsi Wu

Abstract:

Hemodialysis patients might suffer from unhealthy care behaviors or long-term dialysis treatments. Ultimately they need to be hospitalized. If the hospitalization rate of a hemodialysis center is high, its quality of service would be low. Therefore, how to decrease hospitalization rate is a crucial problem for health care. In this study we combined temporal abstraction with data mining techniques for analyzing the dialysis patients' biochemical data to develop a decision support system. The mined temporal patterns are helpful for clinicians to predict hospitalization of hemodialysis patients and to suggest them some treatments immediately to avoid hospitalization.

Keywords: Hemodialysis, Temporal abstract, Data mining, Healthcare quality.

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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Authors: Gomes C. C. Izabel, Lanzotti B. Rafaela, Orlandi S. Fabiana

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Chronic Kidney Disease is considered a serious public health problem. The exploitation of resilience has been guided by studies conducted in various contexts, especially in hemodialysis, since the impact of diagnosis and restrictions produced during the treatment process because, despite advances in treatment, remains the stigma of the disease and the feeling of pain, hopelessness, low self-esteem and disability. The objective was to evaluate the level of resilience of patients in chronic renal dialysis. This is a descriptive, correlational, cross and quantitative research. The sample consisted of 100 patients from a Renal Replacement Therapy Unit in the countryside of São Paulo. For data collection were used the characterization instrument of Participants and the Resilience Scale. There was a predominance of males (70.0%) were Caucasian (45.0%) and had completed elementary education (34.0%). The average score obtained through the Resilience Scale was 131.3 (± 20.06) points. The resiliency level submitted may be considered satisfactory. It is expected that this study will assist in the preparation of programs and actions in order to avoid possible situations of crises faced by chronic renal patients.

Keywords: Hemodialysis units, hospital, renal dialysis, renal insufficiency chronic, resilience psychological.

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Authors: Anjan Babu G, Sumana G, Rajasekhar M

Abstract:

Many inherited diseases and non-hereditary disorders are common in the development of renal cystic diseases. Polycystic kidney disease (PKD) is a disorder developed within the kidneys in which grouping of cysts filled with water like fluid. PKD is responsible for 5-10% of end-stage renal failure treated by dialysis or transplantation. New experimental models, application of molecular biology techniques have provided new insights into the pathogenesis of PKD. Researchers are showing keen interest for developing an automated system by applying computer aided techniques for the diagnosis of diseases. In this paper a multilayered feed forward neural network with one hidden layer is constructed, trained and tested by applying back propagation learning rule for the diagnosis of PKD based on physical symptoms and test results of urinalysis collected from the individual patients. The data collected from 50 patients are used to train and test the network. Among these samples, 75% of the data used for training and remaining 25% of the data are used for testing purpose. Further, this trained network is used to implement for new samples. The output results in normality and abnormality of the patient.

Keywords: Dialysis, Hereditary, Transplantation, Polycystic, Pathogenesis.

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Authors: Mu-Jen Young, Cheng-Yen Wu, Wen-Yuan Hsieh

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Iron oxide nanoparticle was synthesized by reactive-precipitation method followed by high speed centrifuge and phase transfer in order to stabilized nanoparticles in the solvent. Particle size of SPIO was 8.2 nm by SEM, and the hydraulic radius was 17.5 nm by dynamic light scattering method. Coercivity and saturated magnetism were determined by VSM (vibrating sample magnetometer), coercivity of nanoparticle was lower than 10 Hc, and the saturated magnetism was higher than 65 emu/g. Stabilized SPIO was then transferred to aqueous phase by reacted with excess amount of poly (ethylene glycol) (PEG) silane. After filtration and dialysis, the SPIO T2 contrast agent was ready to use. The hydraulic radius of final product was about 70~100 nm, the relaxation rates R2 (1/T2) measured by magnetic resonance imaging (MRI) was larger than 200(sec-1).

Keywords: Contrast Agent, Iron Oxide Nanoparticle, Magnetic Resonance Imaging, Nanoparticle Stabilization

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Authors: Mee-Lin Lim Chai Teo, Darryl M. Small

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Wheat has a bimodal starch granule population and the dependency of the rate of enzymatic hydrolysis on particle size has been investigated. Ungelatinised wheaten starch granules were separated into two populations by sedimentation and decantation. Particle size was analysed by laser diffraction and morphological characteristics were viewed using SEM. The sedimentation technique though lengthy, gave satisfactory separation of the granules. Samples (<10μm, >10μm and original) were digested with a-amylase using a dialysis model. Granules of <10μm showed significantly higher rate of reducing sugar release than those >10μm (p<0.05). In contrast, the rate was not significantly different between the original sample and granules >10μm. Moreover, the digestion rate was dependent on particle size whereby smaller granules produced higher rate of release. The methodology and results reported here can be used as a basis for further evaluations designed to delay the release of glucose during the digestion of native starches.

Keywords: in vitro Digestion, a-amylase, wheat starch, granule size.

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Authors: Mont Kumpugdee-Vollrath, Khaled Abdallah

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Liposomes and pegylated liposomes were widely used as drug delivery system in pharmaceutical field since a long time. However, in the former time, polyethylene glycol (PEG) was connected into phospholipid after the liposomes were already prepared. In this paper, we intend to study the possibility of applying phospholipids which already connected with PEG and then they were used to prepare liposomes. The model drug resveratrol was used because it can be applied against different diseases. Cholesterol was applied to stabilize the membrane of liposomes. The thin film technique in a laboratory scale was a preparation method. The liposomes were then characterized by nanoparticle tracking analysis (NTA), photon correlation spectroscopy (PCS) and light microscopic techniques. The stable liposomes can be produced and the particle sizes after filtration were in nanometers. The 2- and 3-chains-PEG-phospholipid (PL) caused in smaller particle size than the 4-chains-PEG-PL. Liposomes from PL 90G and cholesterol were stable during storage at 8 °C of 56 days because the particle sizes measured by PCS were almost not changed. There was almost no leakage of resveratrol from liposomes PL 90G with cholesterol after diffusion test in dialysis tube for 28 days. All liposomes showed the sustained release during measuring time of 270 min. The maximum release amount of 16-20% was detected with liposomes from 2- and 3-chains-PEG-PL. The other liposomes gave max. release amount of resveratrol only of 10%. The release kinetic can be explained by Korsmeyer-Peppas equation. 

Keywords: Liposome, NTA, resveratrol, pegylation, cholesterol.

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy, yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visit, with subsequent readmission and additional procedures. Thus, this study sought to examine whether bile spillage is indeed associated with increased risk of postoperative wound infections after laparoscopic cholecystectomy. We hypothesize that patients who experience bile spillage (BS) during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per Center for disease control and prevention (CDC) defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and absent in the rest i.e., 92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in non-bile spillage cases SSI was found in 8 cases (8.7%). However, it was statistically not significant (p value > 0.05). 11 (92%) cases were superficial SSI and one was organ-space infection. No mortality or 30-day readmission was found in our study period. Spillage of gallbladder content does not lead to an increase in SSIs. However, as the rate of SSI is still higher, surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage, thorough peritoneal irrigation with normal saline should be done.

Keywords: Biliary spillage, organ space infection, Laparoscopic cholecystectomy, surgical site infection.

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Authors: R. Prakash, B. Meenakshipriya, R. Kumaravelan

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Fresh water is one of the resources which is getting depleted day by day. A wise method to address this issue is by the application of renewable energy-sun irradiation and by means of decentralized, cheap, energetically self-sufficient, robust and simple to operate plants, distillates can be obtained from sea, river or even sewage. Solar desalination is a technique used to desalinate water using solar energy. The present work deals with the comprehensive design and simulation of solar tracking system using LabVIEW, temperature and mass flow rate control of the solar desalination plant using LabVIEW and also analysis of single phase inverter circuit with LC filters for solar pumping system in MATLAB. The main objective of this work is to improve the performance of solar desalination system using automatic tracking system, output control using temperature and mass flow rate control system and also to reduce the harmonic distortion in the solar pumping system by means of LC filters. The simulation of single phase inverter was carried out using MATLAB and the output waveforms were analyzed. Simulations were performed for optimum output temperature control, which in turn controls the mass flow rate of water in the thermal collectors. Solar tracking system was accomplished using LABVIEW and was tested successfully. The thermal collectors are tracked in accordance with the sun’s irradiance levels, thereby increasing the efficiency of the thermal collectors.

Keywords: Desalination, Electro dialysis, LabVIEW, MATLAB, PWM inverter, Reverse osmosis.

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