Peritoneal lavage

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Original Article Peritoneal lavage with ulinastatin reduced the expression levels of P-selectin protein in severe acute pancreatitis rats

Original Article Peritoneal lavage with ulinastatin reduced the expression levels of P-selectin protein in severe acute pancreatitis rats

Abstract: Objective: To observe the effect and mechanisms of peritoneal lavage with ulinastatin on the inflammatory reaction and expression and staining intensity of P-selectin in SAP rats. Methods: Severe acute pancreatitis (SAP) model of rat was made by retrograde infusion of 5% sodium taurocholate into the pancreatic duct. After establish- ment of SAP model, intraperitoneal lavage was performed immediately in saline lavage group and peritoneal lavage with ulinastatin group, ulinastatin injection was also performed immediately in ulinastatin injection group. At 3 h after induction of SAP in all groups, TNF-α, and IL-10 and the expression levels, staining intensity of P-selectin pro- tein of multiple organs in each group were detected. Results: Group IU and UL reduced the level of serum TNF-α and increased IL-10 effectively, Group UL exert the better effect. In Group SL, IU and UL, the expression levels and the staining intensity of P-selectin protein in the multiple organs were significantly lower than those in Group SAP and Group UL exert the best effect. Conclusions: Inflammatory condition could be well improved by intraperitoneal lavage with ulinastatin and may through inhibiting P-selectin protein expression in multiple organs.
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EVALUATION OF POST OPERATIVE PERITONEAL LAVAGE TO PREVENT RECURRENT ADHESIVE INTESTINAL OBSTRUCTION

EVALUATION OF POST OPERATIVE PERITONEAL LAVAGE TO PREVENT RECURRENT ADHESIVE INTESTINAL OBSTRUCTION

Objective: to evaluate the effectiveness of postoperative peritoneal lavage (PPL) in prevention of recurrent Adhesive Small Bowel Obstruction (ASBO).Patients and methods: a total of 36 patients were included in this study. All of these patients suffered from ASBO. They were randomized into two groups. Group I (18 patients) were treated with adhesiolysis followed by PPL and group II (18 patients) were treated with adhesiolysis alone . Patients w e r e followed up for an average period of 15 months to detect the incidence of recurrent ASBO. Results: :In group1 only one (5.6%) patient had an attack of ASBO which responded to conservative management and did not need redo operation while in group II s e v e n ( 3 8 . 9 % ) p a t i e n t s developed a recurrent episode of ASBO f o u r o f t h e m ( 2 2 . 2 % ) n e e d e d s u r g i c a l r e e x p l o r a t i o n . So the rate of surgical reoperation in group 1 was zero in comparison to group 2 which was( 16.6%). Conclusion: PPL is a new hope for prevention of recurrent ASBO that achieved statistically significant reduction in the recurrence rate and surgical redo.
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Clinical effects of laparotomy with perioperative continuous peritoneal lavage and postoperative hemofiltration in patients with severe acute pancreatitis

Clinical effects of laparotomy with perioperative continuous peritoneal lavage and postoperative hemofiltration in patients with severe acute pancreatitis

concentrations in the abdominal cavity and diminishes their systemic absorption thus halting the progression of SIRS and MODS [2,18]. The higher the cytokine concen- trations in the peritoneal cavity the greater is the quantity absorbed into the blood. In an experimental model of acute pancreatitis Mikami et al found increased IL-1β and TNF-α levels in the lavage fluids in all models during the first 6 hours after induction, and the peak levels accorded with the severity of pancreatitis [18]. In a large study, including 577 patients, Dugerneir et al observed signifi- cantly lower mortality for acute pancreatitis in patients who underwent surgical treatment with postoperative peritoneal lavage than in others who had surgery alone (mortality 24.3% vs 43.2%) [2]. An early study already showed that peritoneal lavage had a role in the treatment of acute pancreatitis even before "cytokine storm" became a recognized feature in the pathogenesis of acute pancrea- titis [41].
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In Adult Horses With Septic Peritonitis, Does Peritoneal Lavage Combined With Antibiotic Therapy Compared to Antibiotic Therapy Alone Improve Survival Rates?

In Adult Horses With Septic Peritonitis, Does Peritoneal Lavage Combined With Antibiotic Therapy Compared to Antibiotic Therapy Alone Improve Survival Rates?

There is a small quantity of evidence and the quality of the evidence is low, with comparison of the two treatment modalities in equids only performed in case series. There is a single study which performed the most robust analysis possible of a retrospective case series by using multivariate analysis to examine the effect of multiple variables on survival (Nogradi et al., 2011). Inherent to case series is the risk that case selection will have introduced significant bias into the results; peritoneal lavage maybe used more commonly in more severely affected cases or where the abdomen has been contaminated with intestinal or uterine contents. There have been no randomised trials to compare the efficacy of the treatment options discussed.
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Laparoscopic diagnostic peritoneal lavage (L-DPL): A method for evaluation of penetrating abdominal stab wounds

Laparoscopic diagnostic peritoneal lavage (L-DPL): A method for evaluation of penetrating abdominal stab wounds

There were 2 lower thoracic stab wounds, 2 abdominal stab wounds and one stab wound at the costal margin. When peritoneal penetration was suspected or proven, a thorough diagnostic laparoscopic survey was performed, actively bleeding vessels were coagulated, and diaphrag- matic or abdominal wall lacerations repaired laparoscop- ically. Laparoscopic peritoneal lavage (L-DPL) was then performed and proved to be negative in all 5 patients. RBC lavage counts above 100,000/mcrl were not consid- ered as a positive lavage result, because the bleeding source was directly observed and controlled laparoscopi- cally. All patients recovered uneventfully and were released within 3 days. In no patient was repeated perito- neal lavage necessary, and the J-P drains were removed on POD 1.
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Evaluation of the efficacy of antiseptic gel solution for peritoneal lavage in generalized peritonitis

Evaluation of the efficacy of antiseptic gel solution for peritoneal lavage in generalized peritonitis

In generalized peritonitis, an antiseptic gel solution for peritoneal lavage showed higher efficacy than water-based antiseptic due to its ability to cover the entire parietal and visceral peritoneal surface as well as maximum exposure, thus reducing the number of strains of microorganisms from 94 to 49, the number of colonies from 43,69 lg CFU / ml to 20.08 lg CFU / ml, whereas the use of water-based antiseptic helped to decrease the number of strains of microorganisms from 93 to 68, the number of colonies from 42.68 lg CFU / ml to 30.87 lg CFU / ml.
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Diagnostic peritoneal lavage: a review of indications, technique, and interpretation

Diagnostic peritoneal lavage: a review of indications, technique, and interpretation

Diagnostic peritoneal lavage (DPL) is an invasive, rapid, and highly accurate test for evaluating intraperitoneal hemorrhage or a ruptured hollow viscus. DPL plays a role in both blunt and penetrating abdominal trauma. First described in 1965, DPL replaced the four-quadrant abdominal tap, boasting a higher sensitivity and specifi- city in identifying intraabdominal injury [1]. Today DPL is performed less frequently, as it has been replaced by focused abdominal sonography for trauma (FAST) and helical computed tomography (CT). Yet, each of these diagnostic modalities has unique advantages and disad- vantages.
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The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitisA and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitisB in perforated diverticulitis (NTR2037)

The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitisA and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitisB in perforated diverticulitis (NTR2037)

The objective of this study is to determine whether LaparOscopic LAvage and drainage is a safe and effective treatment for patients with purulent peritonitis (LOLA-arm) and to determine the optimal resectional strategy in patients with a purulent or faecal peritonitis (DIVA-arm: perforated DIVerticulitis: sigmoidresection with or without Anastomosis). Methods/Design: In this multicentre randomised trial all patients with perforated diverticulitis are included. Upon laparoscopy, patients with purulent peritonitis are treated with laparoscopic lavage and drainage, Hartmann ’ s procedure or sigmoidectomy with primary anastomosis in a ratio of 2:1:1 (LOLA-arm). Patients with faecal peritonitis will be randomised 1:1 between Hartmann’s procedure and resection with primary anastomosis (DIVA- arm). The primary combined endpoint of the LOLA-arm is major morbidity and mortality. A sample size of 132:66:66 patients will be able to detect a difference in the primary endpoint from 25% in resectional groups compared to 10% in the laparoscopic lavage group (two sided alpha = 5%, power = 90%). Endpoint of the DIVA- arm is stoma free survival one year after initial surgery. In this arm 212 patients are needed to significantly demonstrate a difference of 30% (log rank test two sided alpha = 5% and power = 90%) in favour of the patients
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PERITONEAL LAVAGE IN THE TREATMENT OF ANURIA IN CHILDREN

PERITONEAL LAVAGE IN THE TREATMENT OF ANURIA IN CHILDREN

To answer the 2nd question, concerning the effect of the strength of glucose solution on the water balance, observations were made of the degree of edema and of the changes in body weigh[r]

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Interleukin 26 is overexpressed in human sepsis and contributes to inflammation, organ injury, and mortality in murine sepsis

Interleukin 26 is overexpressed in human sepsis and contributes to inflammation, organ injury, and mortality in murine sepsis

For isolation of peritoneal macrophages, mice were injected with 5 ml PBS. Macrophages were isolated from peritoneal lavage by plastic adherence. For isolation of granulocytes, mice were injected intraperitoneally with 1.5 ml sterile thioglycollate (3%). Elicited cells were har- vested 4 h later by peritoneal lavage with 5 ml of cold PBS, and neutrophils were further purified from periton- eal lavage by magnetic cell sorting (Miltenyi Biotec). FITC-labeled E. coli were prepared by incubation with 0.5 mg/ml FITC (Sigma) for 20 min at 37 °C. Peritoneal macrophages (1 × 10 5 cells) or neutrophils (1 × 10 6 cells) were incubated with FITC-labeled bacteria at a multipli- city of infection of 100 for 30 min at 37 °C. After wash- ing steps, cell nuclei were stained with DAPI (Invitrogen), followed by visualization using confocal laser scanning microscopy (LSM 510, Zeiss). The ratio of engulfed bacteria (as determined by overlay of green bacteria) was quantified by an independent researcher from 300 counted cells per well. In some experiments, peritoneal macrophages and neutrophils were pretreated with recombinant human IL-26 (100 ng/ml, R&D sys- tems) before infection by FITC-labeled E. coli.
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Angiopoietin-1 enhances neutrophil chemotaxis in vitro and migration in vivo through interaction with CD18 and release of CCL4

Angiopoietin-1 enhances neutrophil chemotaxis in vitro and migration in vivo through interaction with CD18 and release of CCL4

In conclusion, this study demonstrates that Ang-1 has a role as a pro-inflammatory mediator, inducing mouse neutrophil migration both in vitro and in vivo. In vitro, this response was dependent on Tie2 and CD18 but was not due to an alteration in surface receptor expression. Furthermore, our in vivo data demonstrates a role for Ang-1 in neutrophil trafficking, potentially through a direct effect on neutrophils, but also through macrophage Figure 4. MAT.Ang-1 induced neutrophil migration after depletion of peritoneal macrophages. (A) C57/ Bl6 mice were administered with 250 µ l control or clodronate liposomes i.p. After 48 h, peritoneal lavage was performed and the total monocyte/macrophage count was calculated using total and differential cell counts. (B) Liposomes were administered as above 48 h prior to injection of MAT.Ang-1 (33 µ g/mouse i.p.). After 4 h, peritoneal lavage was performed and the total neutrophil count was calculated using total and differential cell counts. (C) CCL4 levels in peritoneal lavage fluid were measured by cytometric bead array 4 h after MAT.Ang-1 administration (D) Rat anti-mouse CCL4 (MAB451) or rat IgG2a (both 50 µ g/ml) were administered together with MAT.Ang-1 and neutrophil levels in lavage fluid measured after 4 h. Results are expressed as mean ± SEM (n = 3–5 mice). Statistical significance was analysed using an unpaired t-test. *P < 0.05, **P < 0.01,
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Gentamicin-loaded nanoparticles show improved antimicrobial effects towards <em>Pseudomonas aeruginosa</em> infection

Gentamicin-loaded nanoparticles show improved antimicrobial effects towards <em>Pseudomonas aeruginosa</em> infection

Correspondingly, MPO levels in the lavage fluid, an indicator of neutrophil infiltration at the infection site, were also reduced in mice treated with gentamicin-loaded nanoparticles compared to free drug at 96 hours (P = 0.014) (Figure 5). Finally, the inflammatory mediator IL-6, which is used as a surrogate marker of disease severity, was signifi- cantly reduced in the peritoneal lavage fluid of nanoparticle- treated animals compared to nontreated controls (P = 0.03) (Figure 6A). Similar trends were also observed for serum IL-6 levels (Figure 6B). These data agree with the results of in vitro analysis demonstrating that controlled release from nanoparticles elicits improved antimicrobial effects in vivo towards P. aeruginosa infection compared to the free drug, which was effectively cleared from the animals by this time.
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Extraction of phenolic compounds from pinus patula bark using ethanol water mixtures and the anti inflammatory action of the ethanolic extract

Extraction of phenolic compounds from pinus patula bark using ethanol water mixtures and the anti inflammatory action of the ethanolic extract

Taking into account the evidence obtained by HPLC and LC-MS, it can be concluded that the control sample of the rat's peritoneal lavage contains leukotriene B4in addition to other eicosa[r]

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Investigations into the feasibility of the intraperitoneal route for provision of nutritional support to companion animals : a thesis prepared in partial fulfilment of the requirements for the degree of Master of Veterinary Science, Massey University, 200

Investigations into the feasibility of the intraperitoneal route for provision of nutritional support to companion animals : a thesis prepared in partial fulfilment of the requirements for the degree of Master of Veterinary Science, Massey University, 2000

Originally used as a tool to detect intra-abdominal haemorrhage, diagnostic peritoneal lavage (DPL) is now used as an aid in the diagnosis of a wide variety of medical and surgical conditions of the abdomen. Diagnostic peritoneal lavage is reported to be highly sensitive in the detection of septic peritonitis. The technique of DPL would be easily combined with intraperitoneal nutrient instillation and may provide a useful means of monitoring the peritoneal cavity for potential sepsis during intraperitoneal nutrition.
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The value of focused assessment with sonography in trauma examination for the need for operative intervention in blunt torso trauma: a rebuttal to “emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma (review)”, from the Cochrane Co

The value of focused assessment with sonography in trauma examination for the need for operative intervention in blunt torso trauma: a rebuttal to “emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma (review)”, from the Cochrane Collaboration

Indeed, a part of the impetus to bring ultrasound machines into the trauma bay in the first place was the high reported rates of non-therapeutic laparotomies caused by the oversensitivity of the diagnostic peritoneal lavage (DPL), in the range of 20–25%. This is probably a result of growing recognition of the ability of many intra-abdominal injuries to heal without surgical repair. It should be noted that no clear and consistent definition of non-therapeutic laparotomy has been reported. It is also apparent that there is a clinically relevant, albeit small, incidence of compli- cations with DPL, many of which require surgical repair. FAST allows the grading of hemoperitoneum, a great improvement over the ‘Yes/No’ binary response from DPL.
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Efficacy and mechanism of tanshinone IIA liquid nanoparticles in preventing experimental postoperative peritoneal adhesions in vivo and&nbsp;in vitro

Efficacy and mechanism of tanshinone IIA liquid nanoparticles in preventing experimental postoperative peritoneal adhesions in vivo and&nbsp;in vitro

Abstract: Up to 90% of patients develop adhesion following laparotomy. Upregulating fibrinolysis within the peritoneum reduces adhesions. Tanshinone IIA (Tan IIA) promotes fibrinolysis in hepatic fibrosis and the cardiovascular system and may play a role in preventing adhesions. We report preparation and characterization of liquid nanoparticles of Tan IIA for intravenous administration and investigate its feasibility in clinical practice. Tan IIA liquid nano- particles (Tan IIA-NPs) were prepared using the emulsion/solvent evaporation method. Adhesions were induced in Sprague–Dawley rats by injuring the parietal peritoneum and cecum, followed by intravenous administration of various Tan IIA-NP dosages. The adhesion scores for each group were collected 7 days after the initial laparotomy. The activity of tissue-type plasminogen activator (tPA) was measured from the peritoneal lavage fluid. The messenger RNA and protein expression levels of plasminogen activator inhibitor-1 (PAI-1) were measured by quantitative real- time polymerase chain reaction and enzyme-linked immunosorbent assay. TGF-β1 and collagen I expressions were measured immunohistochemically in the ischemic tissues. The effects of Tan IIA-NPs and free-Tan IIA on tPA and PAI-1 were measured in vitro in TGF-β1-induced HMrSV5 cells. Tan IIA-NPs exhibited small particle size, high encapsulation efficiency, good stability for storage, and safety for intravenous administration. Tan IIA-NPs were effective in preventing adhesion. Tan IIA-NPs increased tPA activity in peritoneal lavage fluid, and tPA mRNA and protein expression, and decreased PAI-1 mRNA and protein expression in the ischemic tissues. Moreover, Tan IIA-NPs decreased TGF-β1 and collagen I expressions in the ischemic tissues. Tan IIA-NPs administered via tail veins upregulated fibrinolysis in the peritoneum. In vitro studies showed that these effects may be mediated by the TGF-β signal pathway.
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Dynamics of soluble and cellular inflammatory markers in nasal lavage obtained from Cystic Fibrosis patients during intravenous antibiotic treatment

Dynamics of soluble and cellular inflammatory markers in nasal lavage obtained from Cystic Fibrosis patients during intravenous antibiotic treatment

The inflammatory markers MPO, IL-8, IL-6 and IL-1 β were found significantly more often in NLF of CF pa- tients, when compared with healthy controls. This is in line with previous findings from retrospective studies [14]. In addition to the aforementioned cytokines, TNF concentration in the upper airway lavage was found to be higher in CF patients compared with controls. For LAW sampling by BAL, Elizur et al. [39] reported simi- lar results. Furthermore, the median expression levels of MPO, IL-8, IL-6, and IL-1 β in NLF were significantly higher in our CF cohort compared with healthy controls. During i.v. therapy detection the frequency of IL-8, IL-6, IL-1 β and RANTES decreased. Simultaneously, IL-6 levels in NLF declined significantly. RANTES and MMP9 decreased to a lower, but not significant, extent. Notably, the changes of IL-6 in NL are in accordance with the recent publication of Paats et al. [40]. In this study, UAW inflammation in CF patients was assessed MMP9
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Arthroscopic Debridement with Lavage and Arthroscopic Lavage Only as the Treatment of Symptomatic Osteoarthritic Knee

Arthroscopic Debridement with Lavage and Arthroscopic Lavage Only as the Treatment of Symptomatic Osteoarthritic Knee

At long follow up of 6 years most of the patients in two groups had poor knee function, 84% of patients after lavage treatment and 64% of patients after debridement and lavage treatment,[r]

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Dialysate cell-free mitochondrial DNA fragments as a marker of intraperitoneal inflammation and peritoneal solute transport rate in peritoneal dialysis

Dialysate cell-free mitochondrial DNA fragments as a marker of intraperitoneal inflammation and peritoneal solute transport rate in peritoneal dialysis

Baseline clinical data including age, gender cause of ESRD, body mass index (BMI), comorbid conditions, were recorded. The Charlson comorbidity index (CCI) was used to calculate a comorbidity score [17]. The collected bio- chemical data at the time of PET included hemoglobin, serum albumin and high sensitive C-reactive protein. All the biochemical parameters were assessed in the center la- boratory of our hospital. PD-related data including dialysis regimen and dose were recorded. Standard PET was per- formed by the method of Twardowski [18], and peritoneal solute transport rate (PSTR: dialysate-to-plasma creatinine ratio) and ultrafiltration capacity at 4 h with 2.5% glucose were calculated. The glucose exposure was measured as total grams of glucose within the daily dialysate. Residual renal function was calculated as the mean of the urea and creatinine clearance. Total Kt/Vurea and peritoneal Kt/ Vurea were calculated based on 24-h urine and dialysate collection using PD Adequest software (Baxter Healthcare).
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Complications of Peritoneal Dialysis: A Review of 226 Dialysis Episodes in 100 Consecutive Patients Treated with Peritoneal Dialysis

Complications of Peritoneal Dialysis: A Review of 226 Dialysis Episodes in 100 Consecutive Patients Treated with Peritoneal Dialysis

Complications of Peritoneal Dialysis A Review of 226 Dialysis Episodes in 100 Consecutive Patients Treated with Peritoneal Dialysis Med J Malaysia Vol 40 No 2 June 1985 COMPLICATIONS OF PERITONEAL DIA[.]

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