Peritoneal dialysis （PD） is associated with a high risk of infection of the peritoneum, subcutaneous tunnel and catheter exit site. Although quality standards demand an infection rate 〈 0.67 episodes/patient/year o...Peritoneal dialysis （PD） is associated with a high risk of infection of the peritoneum, subcutaneous tunnel and catheter exit site. Although quality standards demand an infection rate 〈 0.67 episodes/patient/year on dialy-sis, the reported overall rate of PD associated infection is 0.24-1.66 episodes/patient/year. It is estimated that for every 0.5-per-year increase in peritonitis rate, the risk of death increases by 4% and 18% of the episodes resulted in removal of the PD catheter and 3.5% re-sulted in death. Improved diagnosis, increased aware-ness of causative agents in addition to other measures will facilitate prompt management of PD associated infection and salvage of PD modality. The aims of this review are to determine the magnitude of the infection problem, identify possible risk factors and provide an update on the diagnosis and management of PD as-sociated infection. Gram-positive cocci such as Staphy-lococcus epidermidis , other coagulase negative staphy-lococcoci, and Staphylococcus aureus （S. aureus ） are the most frequent aetiological agents of PD-associated peritonitis worldwide. Empiric antibiotic therapy must cover both gram-positive and gram-negative organ-isms. However, use of systemic vancomycin and cip-rofoxacin administration for example, is a simple and efficient first-line protocol antibiotic therapy for PD peritonitis - success rate of 77%. However, for fungal PD peritonitis, it is now standard practice to remove PD catheters in addition to antifungal treatment for a minimum of 3 wk and subsequent transfer to hemodi-alysis. To prevent PD associated infections, prophylactic antibiotic administration before catheter placement, adequate patient training, exit-site care, and treatment for S. aureus nasal carriage should be employed. Mupi-rocin treatment can reduce the risk of exit site infection by 46% but it cannot decrease the risk of peritonitis due to all organisms.展开更多
Using the modal dispersion equation with the phase-integral approaches, and con-sidering an eddy (or water mass) as a sound channel disturbance, the effects of the undisturbed channel, cold-core eddy and warm-core edd...Using the modal dispersion equation with the phase-integral approaches, and con-sidering an eddy (or water mass) as a sound channel disturbance, the effects of the undisturbed channel, cold-core eddy and warm-core eddy on the acoustic propagation characteristics are dis-cussed. According to the solutions of the dispersion equation, the relation between the modal Parameters (phase velocity, group velocity and interference distance) and the eddy intensity is obtained. When the plane wave (with an incident angle a) travels toward the center of a warm-core eddy (disturbed intensity BM ) 'double channel phenomenon' will take place in case of sin2 α < BM < 2(1 - cosα), and then the modal phase velocity and interference distance will have anomalous changes which are completely different from the case of the cold-core eddy.展开更多
文摘Peritoneal dialysis （PD） is associated with a high risk of infection of the peritoneum, subcutaneous tunnel and catheter exit site. Although quality standards demand an infection rate 〈 0.67 episodes/patient/year on dialy-sis, the reported overall rate of PD associated infection is 0.24-1.66 episodes/patient/year. It is estimated that for every 0.5-per-year increase in peritonitis rate, the risk of death increases by 4% and 18% of the episodes resulted in removal of the PD catheter and 3.5% re-sulted in death. Improved diagnosis, increased aware-ness of causative agents in addition to other measures will facilitate prompt management of PD associated infection and salvage of PD modality. The aims of this review are to determine the magnitude of the infection problem, identify possible risk factors and provide an update on the diagnosis and management of PD as-sociated infection. Gram-positive cocci such as Staphy-lococcus epidermidis , other coagulase negative staphy-lococcoci, and Staphylococcus aureus （S. aureus ） are the most frequent aetiological agents of PD-associated peritonitis worldwide. Empiric antibiotic therapy must cover both gram-positive and gram-negative organ-isms. However, use of systemic vancomycin and cip-rofoxacin administration for example, is a simple and efficient first-line protocol antibiotic therapy for PD peritonitis - success rate of 77%. However, for fungal PD peritonitis, it is now standard practice to remove PD catheters in addition to antifungal treatment for a minimum of 3 wk and subsequent transfer to hemodi-alysis. To prevent PD associated infections, prophylactic antibiotic administration before catheter placement, adequate patient training, exit-site care, and treatment for S. aureus nasal carriage should be employed. Mupi-rocin treatment can reduce the risk of exit site infection by 46% but it cannot decrease the risk of peritonitis due to all organisms.
文摘Using the modal dispersion equation with the phase-integral approaches, and con-sidering an eddy (or water mass) as a sound channel disturbance, the effects of the undisturbed channel, cold-core eddy and warm-core eddy on the acoustic propagation characteristics are dis-cussed. According to the solutions of the dispersion equation, the relation between the modal Parameters (phase velocity, group velocity and interference distance) and the eddy intensity is obtained. When the plane wave (with an incident angle a) travels toward the center of a warm-core eddy (disturbed intensity BM ) 'double channel phenomenon' will take place in case of sin2 α < BM < 2(1 - cosα), and then the modal phase velocity and interference distance will have anomalous changes which are completely different from the case of the cold-core eddy.
