Peritonitis is still a major cause of drop-out in peritoneal dialysis (PD) and is often the consequence of the migration of bacteria across the intestinal wall, configuring an enteric peritonitis (EP). EP is usually caused by commensals of the gastrointestinal (GI) tract, it relapses commonly and may result in catheter removal.

Currently, no specific therapeutic measures are available to effectively prevent recurrence of EP, thus we reported our clinical experience with use of probiotics

(EcN).

This is a case-series study performed in PD patients affected by recurrent peritonitis due to GI commensals. In these patients, we added prophylactic treatment with EcN 100 mg twice a day (in addition to 10 days monthly of 200 mg rifaximin) to the standard management of peritonitis.

We enrolled 14 PD patients (mean age 53.1 ± 11.9 years; 67% males; dialysis vintage 7.5 (3.1-27.7) months; 64% automated PD). Causative organisms were

(N=5),

(N=3),

(N=2),

(N=2),

(N=1),

(N=1). No exit-site infection was associated with peritonitis. Patients were successfully treated with intra-peritoneal antibiotics adjusted to culture results and antibiotic sensitivities for 14-21 days. During the subsequent 18 months of follow-up, no recurrence of EP was registered. No adverse effect was reported.

In PD patients, the use of EcN is associated with no recurrence of EP. Further studies or clinical trials are needed to confirm our results.

In PD patients, the use of EcN is associated with no recurrence of EP. Further studies or clinical trials are needed to confirm our results.

Varenicline is an efficacious aid for smoking cessation. In this study, the pharmacokinetics and safety were compared between film-coated tablets of varenicline tartrate (reference drug) and the newly developed orally disintegrating films of varenicline salicylate (test drug), both of them contained 1 mg of varenicline.

A randomized, open-label, single-dose, two-sequence, two-period crossover study was conducted in healthy male subjects. Serial blood samples were obtained for up to 72 hours in each period, with a washout period of 7 days or more. The pharmacokinetic parameters were calculated using the noncompartmental method. Safety profiles were assessed throughout the study.

A total of 28 subjects completed the study. The plasma varenicline concentration-time profiles were similar for the two study drugs. The maximum plasma varenicline concentration (C

) was 5,768.95 ng/L (mean) and 5,780.55 ng/L for the test drug and reference drug, respectively. The areas under the concentration-time curve from time 0 to the last measurable time point (AUC

) were 94,086.30 h×ng/L and 89,958.55 h×ng/L for the test drug and reference drug, respectively. The geometric mean ratios (90% confidence intervals) of the test drug to the reference drug for C

and AUC

were 0.9955 (0.9488 – 1.0444) and 1.0449 (0.9848 – 1.1088), respectively, which fell within the bioequivalence range of 0.8 – 1.25. There was no difference in safety between the study drugs.

The pharmacokinetics and safety profiles were similar between the two study drugs. The orally disintegrating film of varenicline salicylate can be an alternative to varenicline tartrate tablets.

The pharmacokinetics and safety profiles were similar between the two study drugs. The orally disintegrating film of varenicline salicylate can be an alternative to varenicline tartrate tablets.

Vancomycin dose needs to be reduced for decreased kidney function; however, impact of urinary albumin excretion (UAE) on serum vancomycin level is unknown. In this study, we examined the factors associated with the onset of renal impairment induced by vancomycin by focusing on UAE.

The study included 52 patients who received vancomycin for methicillin-resistant

at Ehime University Hospital between April 2010 and March 2015. To determine the presence of renal impairment, patients whose common terminology criteria for adverse-events (CTCAE) grade worsened by 1 or more comprised the renal impairment group, and multivariate logistic regression analysis was performed.

13 patients (25%) had renal impairment as indicated by a CTCAE grade change by 1 or more. The results of multivariate logistic regression analysis only of UAE (OR = 18.03; 95% CI = 1.97 – 164.89) was identified as a significant factor.

We investigated the factors associated with the onset of renal impairment induced by vancomycin and identified UAE as a potential risk factor.

We investigated the factors associated with the onset of renal impairment induced by vancomycin and identified UAE as a potential risk factor.

Obstructive sleep apnea is an important and common disorder with associated health risks. Assuring successful longitudinal management is vital to patient health and sleep-related quality of life. This paper provides guidance from the American Academy of Sleep Medicine (AASM) regarding the use of polysomnography (PSG) and home sleep apnea tests (HSATs) after a diagnosis of obstructive sleep apnea has been established and, in most cases, treatment implemented.

The AASM commissioned a task force of five sleep medicine experts. A literature search was conducted to identify studies that included adult patients with OSA who underwent follow-up PSG or an HSAT. The task force developed clinical guidance statements based on a review of these studies and expert opinion. The AASM Board of Directors approved the final clinical guidance statements.

The AASM supports the following clinical guidance statements on indications for follow-up PSG and HSAT in adult patients with OSA. 1. read more Follow-up PSG or HSAT is not recommeents with unexplained PAP device-generated data. The ultimate judgment regarding propriety of any specific care must be made by the clinician, in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options and resources.

The objective of this study was to determine the efficacy of ramelteon in treating abnormal eating behavior in cases with sleep-related eating disorder (SRED) and/or night eating syndrome (NES).

We retrospectively reviewed the medical records of patients with SRED/NES at Yoyogi Sleep Disorder Center from November 2013 to November 2018. We categorized patients as ramelteon treatment responders when the frequency of nighttime eating per week decreased to less than half of that before treatment.

Forty-nine patients were included in the analysis. The mean frequency of eating behavior (/week) (standard deviation) at baseline and post-ramelteon treatment was significantly different, at 5.3 (2.2) and 3.2 (3.0), respectively (p < .001). Twenty-one patients (42.9%) were classified as responders. Adverse events, all of which were mild daytime somnolence, were observed in 5 cases. There were significantly more individuals using benzodiazepine derivatives and Z-drugs (BZDs) before treatment and those with coexisting delayed sleep-wake phase disorder (DSWPD) in the responder group than in the non-responder group (p < .