Comparison of peritoneal transport characteristics at the second week and at six months of peritoneal dialysis commencement.

Peritoneal equilibration test (PET) is an important tool for managing peritoneal dialysis (PD) prescription. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines suggest that the first PET be performed 4-8 weeks after PD commencement. The main reason for this delay is because of the peritoneal membrane might change its character once it is exposed to the glucose based dialysate. In this study, we compared PET 2 weeks after PD commencement to PET after 6 months to evaluate the changes in the peritoneal membrane character with time. This study included 126 patients who underwent PD initiation between March 2007 and December 2011. The PET was performed as per the standard protocol at 2(nd) week and 6(th) month after PD initiation. Transport status was categorized as low, low average, high average, and high as per the standard definition. There was no change in transport character in 115 patients (91.2%) between the two PET measurements. When the Early PET at 2(nd) week and 6(th) month PET data were analyzed, no significant changes were observed in measured D/P creatinine (0.59 ± 0.14 vs. 0.62 ± 0.14 respectively P = 0.26) and D/D0 Glucose (0.46 ± 0.12 vs. 0.46 ± 0.11, P = 0.65). Using the Bland-Altman analysis the repeatability coefficients were 0.27 and 0.25 for creatinine and glucose values respectively. In our study, the PET performed at the 2(nd) week are similar to that of the 6(th) month PET in 91.2% of our patients and the test did not significantly change with time. In conclusion, we could do PET early at 2(nd) week to assess the peritoneal membrane character and this would help in proper dialysis prescription to the patients.

D-serine regulation: a possible therapeutic approach for central nervous diseases and chronic pain.

D-Serine, an endogenous modulator of NMDA receptors has been shown to play a vital role in many neuropsychiatric functions such as learning, memory, nociception and implicated in pathological conditions like schizophrenia and Alzheimer's disease. We propose possible therapeutic approaches for some CNS diseases and chronic pain, targeting the D-serine levels by manipulating its uptake, biosynthesis and metabolism.

Contributions of theory to method development in solid-phase extraction.

The kinetic and retention properties of solid-phase extraction devices are reviewed from the perspective of method development strategies. Models based on frontal analysis are used to correct retention properties of solid-phase extraction devices to account for the fact that too few theoretical plates are provided for retention to be independent of kinetic factors. The available pressure drop for the sampling device largely dictates the choice of useful particle sizes and maximum bed length. The use of octanol--water partition coefficients and extrapolated values of the retention factor obtained by liquid chromatography are poor empirical models for the estimation of breakthrough volumes with water as the sample solvent. The solvation parameter model provides an adequate description of sorbent retention for the estimation of breakthrough volumes, rinse solvent volume and composition, and elution solvent volume and composition. Combining the frontal analysis and solvation parameter models offers a comprehensive approach to computer-aided method development in solid-phase extraction. This is the first step in the development of a structure-driven approach to method development in solid-phase extraction that should be more reliable and less tedious than traditional trial and error approaches.

Anaesthesia in Poland syndrome.

PURPOSE: To describe the anaesthetic management of a child with Poland syndrome for CT scan. CLINICAL FEATURES: An eight-month-old child presented with left upper limb hypoplasia and chest wall deformity with absence of ribs on the left side for CT scan of thorax. Pulsations of the heart could be seen along with paradoxical respiration over the defect. The trachea was intubated and the lungs ventilated manually to avoid inadequate ventilation and hypoxia. CONCLUSIONS: The unilateral absence of ribs leads to poor development of subatmospheric pressure in the thorax and paradoxical respiration, and may cause inadequate pulmonary ventilation and hypoxia. In the present case, positive pressure ventilation was chosen to maintain ventilation during the procedure.