Biomedical subjects

Ayse Bilgic

Publications and source records attributed to Ayse Bilgic.

3 recordsLinked to original sources

PubMed2006

Isolated Brucella peritonitis in a CAPD patient.

Peritonitis is the most common complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Brucellosis is a rare cause of bacterial peritonitis. Only 1 case was reported of a patient with brucella peritonitis during CAPD therapy. In that case, CAPD peritonitis was accompanied by acute brucellosis. We present the case of a patient with isolated brucella peritonitis receiving CAPD therapy without systemic manifestations of brucellosis who works as a farmer. Results of a serum agglutination test and blood cultures were negative; however, the patient's peritoneal fluid agglutination titer was 1:160 and samples inoculated into BACTEC (Becton Dickinson, NJ) bottles yielded Brucella melitensis. Because we were unable to isolate the organism in blood samples, transmission seems to be the result of direct inoculation, rather than hematogenous spreading. Therefore, our patient represents the first case of isolated brucella peritonitis during CAPD therapy. Successful treatment was obtained by using a treatment regimen of rifampin and doxycycline.

Adult↗

PubMed2006

Effect of supportive extracorporeal treatment in liver transplantation recipients and advanced liver failure patients.

Recently, continuous venovenous hemodiafiltration (CVVHDF) and plasmapheresis (PF) were suggested as supportive therapy options in combination with standard treatment in advanced liver failure. The aim of this study was to analyze the effects of supportive extracorporeal treatment (SET) in a group of patients with advanced hepatic failure. A total of 25 patients (7 women, 18 men; mean age, 39.3+/-15.4 years; 13 were transplant recipients [6 women, 7 men; mean age, 37.7+/-16.9 years]) were included. All patients were in hepatic coma and receiving standard coma and liver failure management when they received SET. Number of SET sessions; levels of serum blood urea nitrogen, creatinine, albumin, calcium, phosphorus, ammonia, alanine and aspartate aminotransferase, and total/conjugated bilirubin; and prothrombin times (PTT) before and after SET were recorded retrospectively. 7.7+/-7.9 SET sessions were performed. Thirteen liver transplant recipients required SET for an average of 9.7+/-8.3 days after transplantation. Serum ammonia and bilirubin levels were lower after termination of supportive therapy when compared with initial levels (p<0.0001 and p<0.005 respectively). During follow-up, hepatic encephalopathy and liver failure resolved in 11 patients, while 14 patients (7 transplant recipients) died. There was no significant difference between patients in either group except that PTT was shorter in patients who survived (p<0.01). Further analyses revealed that in surviving patients, ammonia clearance was higher (p<0.01). In patients with advanced liver failure, or liver transplants, CVVHDF and/or PF could be supportive options combined with standard treatment.

Adolescent↗

PubMed2006

Clinical outcome after transfer from peritoneal dialysis to hemodialysis.

Guidelines for the clinical care and management of intra-abdominal complications in patients transferred from peritoneal dialysis (PD) to hemodialysis (HD) are not well established. In this study, we analyzed the indications for transfer, presence of abdominal complications, and clinical outcome on HD of 26 patients who were followed up between 1996 and 2004. Laboratory and radiology data for the patients (computerized tomographic and ultrasonographic examinations performed during the transfer and annually thereafter) were collected retrospectively. The indications for transfer from PD to HD were peritonitis (19%), mechanical problems (39%), and ultrafiltration failure (42%). At the time of transfer, 11 patients had no intra-abdominal complications, 8 had intra-abdominal loculated fluid collection, and 7 had intra-abdominal free fluid. One year after transfer, intra-abdominal fluid collection was observed in 6 patients, 3 of whom received percutaneous drainage. Patients who had intra-abdominal complications at the time of transfer exhibited significantly lower albumin (p < 0.01), higher levels of C-reactive protein (p < 0.02), and erythropoietin resistance at the time of transfer (p < 0.0001). During the first year after transfer, we observed a tendency toward an increase in albumin and a decrease in C-reactive protein level in the group that had complications, and yet nutritional interventions were still necessary in that group. A high ratio of intra-abdominal problems, which have adverse nutritional and inflammatory impacts, are seen after patients are transferred from peritoneal dialysis.

Ascites↗