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Objective: Rare disease Background: Pediatric patients with nephrotic syndrome have a high risk of developing spontaneous bacterial peritonitis (SBP). However, SBP in adults with nephrotic syndrome is very rare. We report a case of SBP induced by Escherichia coli in a 60-year-old male patient on immunosuppressive therapy for the treatment of minimal change disease (MCD). Case Report: The patient was hospitalized with abdominal pain and generalized edema that had lasted for 2 weeks. The patient first started treatment with high-dose oral prednisolone after being diagnosed with MCD 6 months ago. Complete remission of nephrotic syndrome was not achieved even after 5 months of treatment. Thus, the treatment was changed to combination therapy with cyclosporine and low-dose prednisolone. At the time of admission, leukocytosis, hypoalbuminemia, decreased serum immunoglobulin G (IgG), azotemia, and nephrotic-range proteinuria were observed. Ascitic fluid analysis showed a leukocyte count of 4960/µL (neutrophils 90%). On the suspicion of SBP associated with MCD, intravenous administration of empirical cefotaxime and supportive therapy were initiated; however, symptoms of peritonitis persisted. Extended-spectrum beta-lactamase-negative E. coli was found in ascites cultures. Laparoscopy-assisted peritoneal biopsy revealed no evidence of fungal infection; however, chronic inflammation without granuloma formation was noted. Afterward, cefotaxime was changed to piperacillin-tazobactam. After 4 weeks of antibacterial therapy, the peritonitis was cured and renal function was improved. Conclusions: Adult patients with steroid-resistant MCD accompanied by refractory ascites, severe hypoalbuminemia, and marked reduction in serum IgG are at a high risk of subsequent SBP and require careful monitoring. [ABSTRACT FROM AUTHOR]

In providing video-on-demand (VoD) services to a number of clients through networks, the bandwidth requirements of video transmission restrict VoD services. For this reason, many significant broadcasting-based VoD schemes have been proposed to efficiently support services. However, the broadcasting-based VoD schemes approach needs frequency channel hopping, using many channels at the same time and managing many segments of a video. These make it difficult to implement. In this paper, we propose a harmonic staggered broadcasting scheme which has a simple structure and substantially improved VoD efficiency. The proposed scheme substantially reduces the number of segments required and the frequency for switching channels. Also this new scheme performs significantly better than the existing VoD schemes in viewer's waiting time and buffer requirements with simplicity. The numerical results demonstrate that the viewer's waiting time of the harmonic staggered broadcasting scheme is close to the harmonic broadcasting scheme and the buffer requirements of this can be adjusted by a video dividing coefficient h. [ABSTRACT FROM AUTHOR]