SEARCH · PubMed Health

Results for “Sorption Detoxification”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources

PubMed1991

[Efferent detoxification therapy in the complex treatment of diffuse suppurative peritonitis].

Upon the analysis of efferent combined therapy for diffuse purulent peritonitis in 130 patients, it was found that efferent detoxication promotes elimination of intoxication, correction of homeostasis abnormalities, recovery of basic systems of the body, a decrease of postoperative lethality and complications. The choice of the optimal detoxication method should be individual and adjusted for a peritonitis stage and a concrete clinical purpose.

Adult↗

PubMed2003

Detoxification on top of enhanced, diamine-extended glutaraldehyde fixation significantly reduces bioprosthetic root calcification in the sheep model.

BACKGROUND AND AIM OF THE STUDY: Increased concentrations of glutaraldehyde (GA), diamine-extension (DA) of crosslinks and subsequent extraction of excess GA all reduce bioprosthetic calcification in the subdermal rat model. The study aim was to demonstrate the combined effect of all three treatments in a circulatory sheep model. METHODS: Two fixation treatments were used for GA detoxification (urazole in acetate buffer, 0.1 M; pH 4.5; 37 degrees C; 7 days): (i) conventional 0.2% GA fixation (4 degrees C; 7 days); and (ii) enhanced 3.0% GA fixation (4 degrees C; 2 days, followed by a DA interim step; 100 mM L-lysine; 37 degrees C; 2 days, followed by GA; 3.0%; 37 degrees C; 5 days). Entire porcine root prostheses were implanted in the distal aortic arch of young sheep for 12 weeks (n = 5 per group). Non-detoxified 0.2% GA-treated roots served as controls (n = 5). Calcium analysis was based on atomic absorption spectrophotometry; morphology was assessed using light and transmission electron microscopy. RESULTS: Detoxification alone resulted in an 83% reduction of leaflet calcification (p = 0.086), but achieved only 23% (p = 0.145) and 12% (p = 0.362) mitigation of calcification in aortic wall and sinus tissue, respectively. When combined with DA-enhanced 3% GA fixation, detoxification led to a 95% reduction in leaflet calcification (p = 0.057), followed by 79% in sinus (p = 0.003) and 79% in aortic wall tissue (p = 0.0003). Morphologically, detoxification primarily affected leaflets and the subadventitial layer of aortic wall tissue, whereas enhanced fixation seemed to affect all structures. CONCLUSION: It was shown in a circulatory sheep model that a combination of DA-enhanced fixation with an extraction process of excess GA leads to a distinct mitigation of leaflet and aortic wall calcification.

Animals↗

PubMed2005

Increase in delta- and beta-wave activity of the EEG during rapid opiate detoxification (ROD)-reversal by administration of the non-specific NMDA-antagonist S+ ketamine-.

Little is known on effects taking place in the CNS during rapid opioid detoxification (ROD) while the patient is under anesthesia. We therefore measured EEG-power spectra in the beta, alpha, Theta, and delta-band in 36 patients undergoing ROD. Measurements were taken before, during steady-state anesthesia and following administration of the antagonist naltrexone. In addition, the non-specific NMDA-antagonist S+ ketamine was given for reduction of CNS-hyperexcitation, while the efficacy of this adjunct was determined using EEG power spectra analysis. Compared to steady-state anesthesia, EEG power spectra were characterized by a marked decrease of power by 251% in the delta (0.5-3 Hz) and an increase by 209% in the beta- (13-30 Hz) domain when withdrawal was induced with naltrexone. Subsequent administration of S+-ketamine induced a reversal of acute abstinence-related EEG power changes: compared to anesthesia with naltrexone on board, power in the EEG increased by 65% in the delta- and decreased by 723% in the beta-band. While sympathetically induced hemodynamic alterations in anesthesia-assisted opioid detoxification can be attenuated by the alpha2-agonist clonidine and sedation, central nervous sensory activation can be attenuated by the administration of S+-ketamine (1.5 mg/kg). Since EEG alterations during acute withdrawal with naltrexone can be controlled by the non-specific NMDA-antagonist S+-ketamine, this latter presents a useful adjunct during ROD management.

Adult↗

PubMed1994

[Combined detoxification and immunocorrective therapy in patients with peritonitis].

The authors examined 48 patients with peritonitis (20 with the generalized and 28 with the localized form). The content of T-lymphocytes, theophylline-resistant and theophylline-sensitive T-lymphocytes, leukocyte chemotaxic activity, and the lymphocyte ATP content were studied. It was found that the state of the immune system in the early postoperative period allows the severity of the disease and its outcome to be prognosticated. A sharp decrease in the T-lymphocyte content and decrease of the amount of ATP in the lymphocytes in stable reduction of chemotaxic activity is an unfavorable prognostic sign. Introduction of indirect electrochemical oxidation with a sodium hypochlorite solution into the complex of intensive therapy produces, in addition to a marked detoxification effect, a stabilizing effect on metabolic processes in the lymphocytes and activates the cellular link of immunity. Combined immunocorrection with the agents tactivin and leukinferon possesses a high potential of an immunobiological effect and can be recommended for correction of severe secondary immunodeficiency in patients with generalized peritonitis.

Adenosine Triphosphate↗

PubMed1994

[Prevention of postoperative complications in diffuse purulent peritonitis in children].

A complex pathogenetic approach to the prevention of postoperative complications in generalized fibrinopyogenic peritonitis is suggested. It includes a wide operative access, one-stage cleansing with antiseptics and detoxification solutions, ultrasonic cavitation of the abdominal cavity, creation of laparostomy, local infiltration of the wound edges with 0.01% thymalin solution, correction of hemostasis disorders, and increase of the organism's general reactivity. With the use of this complex the results of treatment were significantly improved in 21 children and the number of complications was much less than in the control group of patients subjected to operation.

Adjuvants, Immunologic↗

PubMed1992

[Extracorporeal methods for detoxification in the combined treatment of gunshot peritonitis].

On the basis of examination results and treatment of 49 patients with abdominal gunshot injuries the article emphasizes that the clinical picture of gunshot peritonitis develops much faster, and the syndrome of intoxication proceeds far harder, than in cases of peritonitis with another etiology. The authors make a conclusion that an early application of extracorporal methods of detoxication (hemosorption, plasmapheresis, ultraviolet irradiation of autologous blood, xenospleen connection) could minimize the level of intoxication and contribute to the correction of the immune status.

Adolescent↗

PubMed2006

[MARS (Molecular Absorbent Recirculating System) as hepatic extracorporeal care in serious acute liver failure of alcoholic etiology].

Acute liver failure with criteria of seriousness and alcoholic etiology is a picture of worldwide distribution, with an elevated mortality, of approximately 50%, that requires admission to the ICU. Acute serious alcoholic hepatitis is defined by a Maddrey score value > 32 and/or spontaneous encephalopathy. Together with the classical treatment with corticosteroids and nutritional supplements, alcoholic abstinence and others such as anti-TNF therapy, we introduce MARS (Molecular Adsorbent recirculating System) as a extracorporeal liver assistance system with detoxification function, that is presented as a support measure that makes it possible to maintain the patient in good conditions until an organ becomes available or until the functional recovery of the native liver. In our case, MARS has shown some spectacular results and above all, results maintained over time, associated to the rest of the therapeutic measures characteristic of this disease.

Adult↗

PubMed2006

Sorbent suspensions vs. sorbent columns for extracorporeal detoxification in hepatic failure.

Hepatic failure is a significant medical problem which has been unsuccessfully treated by hemodialysis. However, similar therapies using recirculated dialysate regenerated by sorbents in place of single-pass dialysate have been beneficial in treating acute-on-chronic liver failure. The advantages of sorbent-based treatments include some selectivity of toxin removal and improved removal of protein-bound toxins. Activated carbon has been extensively used in detoxification systems, but has often had insufficient toxin capacity. Powdered activated carbon, because of its large surface area, can provide greater binding capacity for bilirubin and other toxins than granular carbon commonly used in detoxifying columns. Methods of using powdered carbon in extracorporeal blood treatment devices are reviewed in the present paper, including liver dialysis and a new sorbent suspension reactor (SSR); and the abilities and limitations of the SSR and columns to process protein solutions are discussed.

Carbon↗

PubMed1993

[The use of xenogeneic splenic perfusates for treating suppurative-septic diseases].

It was shown in experiments on a model of fatal staphylococcal sepsis in 200 mice and 15 dogs that the perfusate of a pig's spleen obtained by perfusion of the isolated organ with a dextran solution (rheopolyglucin, polyglucin) is capable of preventing the animals' death. Intravenous infusion of 400-500 ml of a xenospleen perfusate at an interval of 1-3 days, which was included in the complex of postoperative treatment of 45 patients with destructive diseases of the abdominal organs complicated by peritonitis and sepsis, contributed to reduction of lethality and the terms of recovery. It is shown that the main effect, besides detoxification, is based on immunomodulation at the cost of biologically active substances produced by the cells of a xenospleen and contained in the perfusate. The best results were produced with the use of the perfusate of a xenospleen in the early periods after radical operation and thorough cleansing of the source of the infection.

Acute Disease↗

PubMed1993

[Early detoxification therapy in radiation exposures].

According to the structural metabolic theory of radiation injuries radiotoxins perform a leading role in the development of disorders. The experiments have disclosed the characteristic features of the development of toxemia in irradiated organism. These data have served as a ground for studying the efficiency of various methods of detoxication. Metabolic plasmapheresis is seemed to be of most pronounced effect in comparison with other methods of detoxication. On the basis of the results of these studies several practical recommendations were provided for performing an early disintoxicative therapy in patients with radiation injuries.

Adult↗

PubMed2006

Depression among heroin users: 12-Month outcomes from the Australian Treatment Outcome Study (ATOS).

A cohort comprising 495 heroin users were interviewed for the Australian Treatment Outcome Study and were re-interviewed at 12-month follow-up. The rate of current major depression declined significantly from 26% to 11% for the follow-up period. Those with current major depression on follow-up experienced fewer total days in treatment, but engaged in more treatment episodes. In comparison to those without depression, depressed individuals had less exposure to methadone/buprenorphine maintenance and residential rehabilitation for the follow-up period, but spent more time in detoxification. Those with current major depression on follow-up also reported heavier heroin and other drug use, more risk-taking behaviors, poorer physical health, and greater psychopathology than those without a diagnosis of current major depression. Although caution in interpreting these relationships is advised given the potential for confounding by client characteristics, the findings of this study illustrate the need to consider depression in the treatment of heroin dependence.

Adolescent↗

PubMedDate not supplied

Implementation and clinical audit of alcohol detoxification guidelines.

This article describes the implementation and clinical audit of alcohol detoxification guidelines at the Royal Cornwall Hospital. The progress in developing a hospital alcohol strategy as recommended by the Royal College of Physicians (2001) is also reviewed. The Clinical Institute Withdrawal Assessment for Alcohol (revised) (Sullivan et al, 1989) is used to assess the alcohol-dependent patient's baseline requirement for their detoxification regimen in the first 24 hours of their care. The prevention and treatment of Wernicke's encephalopathy by parenteral and oral vitamin supplementation is also given a high priority in the guidelines. The clinical audit demonstrates high levels of compliance with the guidelines that were used effectively by the nursing and medical staff in their care of patients with alcohol withdrawal, with high levels of referral to the psychiatric liaison nurse service for brief intervention alcohol counselling and referral to community alcohol services.

Alcohol Withdrawal Delirium↗

PubMed2005

[Artificial liver support systems: update on albumin dialysis (MARS)].

Mortality among patients with liver insufficiency continues to be unacceptably high. The prognosis of patients with acute episodes of chronic liver insufficiency is almost as poor as that of patients with acute liver failure. Therefore, systems that support liver function, either until liver transplantation can be performed or until resolution of the situation before acute injury occurs, are essential. Albumin dialysis is a system of artificial liver support that allows detoxification of albumin-related and hydrosoluble substances, thus maintaining the patient's homeostasis. Current clinical experience of this therapy is still limited, although beneficial effects on clinical, laboratory and hemodynamic parameters have been demonstrated. Multicenter, controlled trials to evaluate the effect of this therapy on survival in distinct diseases are needed.

Adsorption↗

PubMed1992

[Antibacterial and detoxification therapy in acute appendicitis].

An analysis of clinical effectiveness of antibacterial therapy, photomodification of autoblood, hemosorption and their combinations was made in 395 patients with acute appendicitis. It was established that no antibacterial and desintoxicating therapy is required in catarrhal appendicitis. The prophylactic application of photomodification of autoblood is thought to be most expedient for phlegmonous appendicitis at the postoperative period, a combination of antibacterial therapy and photomodified autoblood--for gangrenous appendicitis, a combination of antibacterial therapy, photomodification of autoblood and hemosorption--for appendicular diffuse suppurative peritonitis.

Acute Disease↗

PubMed1991

[Experience with using extracorporeal methods of detoxification in acute diseases of the organs of the abdominal cavity].

Results of treatment of 295 patients are presented. Among them there were 128 patients with diffuse purulent peritonitis, 109 with acute pancreatitis and 58 with destructive cholecystitis. In the complex treatment extracorporeal methods of detoxication therapy were included: plasmapheresis, hemo- or lymphosorption, perfusion ofautologous blood through the xenogenous spleen. Indications to each of the methods are considered. It was found that when using the therapy in question clinical symptoms of endotoxicosis were eliminated 1.5 times quicker and the leukocytic intoxication index was corrected more successfully as well as was the level of toxins of middle molecular mass, functional activity of blood neutrophils, immune link of homeostasis and ++cardio-hemodynamic parameters.

Acute Disease↗

PubMed2002

Successful application of MARS therapy in a 7 year-old patient with hepatic chronic rejection and severe cholestatic syndrome.

Liver transplant currently represents the therapeutic method for irreversible acute and chronic liver diseases without any other available therapy. In some cases, before or after liver transplantation, it is necessary to replace the functions of the liver. We report the case of a 7 year-old female patient with type I glycogenosis who was transplanted in July 2001 using living-related donor transplantation and who developed chronic rejection two months later. In this case, we used MARS (Molecular Adsorbents Recirculating System) detoxification therapy to optimise the patient's clinical and biological status and to create a bridge that allowed the patient's survival until retransplantation was available. The therapy was well tolerated, with no major incidents. We noted favourable clinical effects and significant improvement in serum bilirubin level, urea nitrogen level and serum creatinine level. We consider that MARS treatment is a temporary solution for patients with acute and acute-on-chronic liver failure, indicated in those cases with real chances of recovery of the hepatic functions or in patients on the liver transplantation waiting list.

Child↗

PubMed1991

[The choice of an adequate method for detoxification and immunocorrection in destructive experimental pancreatitis].

Thus, basing on the data obtained it was stated that the destructive pancreatitis is always accompanied by intoxication. A certain weakening of the immune mechanisms took place, mainly of its T-cellular chain. Detox methods of treatment had different effects on the organism. The most effective among them happened to be plasmapheresis and spleen-xeno as they significantly decrease hyperfermentation and toxemia. The application of hemosorption and ultra-violet irradiation of blood had favourable immunocorrective effect at the early stage. It should be noted that the application of spleen-xeno was normalizing the immune mechanisms at the later stage of experimental acute pancreatitis.

Acute Disease↗

PubMed2006

Liver support technology--an update.

BACKGROUND: Currently, there is no direct treatment for hepatic failure, and patients must receive a transplant or endure prolonged hospitalization, with significant morbidity and mortality. Because of the scarcity of donor organs, liver support strategies are being developed with the aim of either supporting patients with borderline functional liver cell mass until an appropriate organ becomes available for transplantation or until their livers recover from injury. METHODS: A literature review was performed using MEDLINE and library searches. Only major blood detoxification/purification devices and cell-based techniques are included in this review. RESULTS: Currently, a number of blood purification systems and devices utilizing viable liver cells are in various stages of clinical development. Non-biological systems include plasma exchange, albumin dialysis, hemo(dia)filtration, and sorbent-based devices (charcoal, resin). These systems are able to remove toxins of hepatic failure, and their utility is limited by their inability to provide missing liver-specific functions. In contrast, hepatocyte-based devices are able to provide whole liver functions, including detoxification, biosynthesis, and biotransformation. Molecular adsorbent recycling system (MARS) blood detoxification system has been tested in thousands of patients, but additional well-conducted controlled studies are warranted to better define the role of MARS in the treatment of patients with acute hepatic failure and acute exacerbation of chronic liver disease. HepatAssist was tested in a phase II/III controlled clinical trial that demonstrated safety and proof of concept for use of biological liver support systems to improve patient survival in acute hepatic failure. CONCLUSIONS: Developing an effective liver assist technology has proven difficult, because of the complexity of liver functions that must be replaced, as well as heterogeneity of the patient population. Non-biological systems may have a role in the treatment of specific forms of liver failure where the primary goal is to provide blood detoxification/purification. Biological systems appear to be useful in treating liver failure where the primary objective is to provide whole liver functions which are impaired or lost. It is suggested that there will be a role for hybrid liver support systems that offer liver cell therapy and various forms of blood purification (sorption, hemofiltration and diafiltration) to treat patients with specific forms of liver failure at various stages of their illness.

Animals↗