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Un malato di rene policistico ha diritto all’esenzione del ticket e all’invalidità? 多囊肾病患者是否有权获得免赔额和残疾?
Pub Date : 2022-04-30 DOI: 10.33393/gcnd.2022.2396
Luisa Sternfeld Pavia
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引用次数: 0
Io, Lei e … il pupo 我,她和孩子
Pub Date : 2022-04-30 DOI: 10.33393/gcnd.2022.2397
Rossella Jannello
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引用次数: 0
Grazie di cuore per il vostro 5x1000 非常感谢您的5x1000
Pub Date : 2022-04-30 DOI: 10.33393/gcnd.2022.2395
Luisa Sternfeld Pavia
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引用次数: 0
La malattia renale cronica: qualità di vita, ansia e depressione in un gruppo di pazienti in fase pre-dialitica 慢性肾病:一组辩证前患者的生活质量、焦虑和抑郁
Pub Date : 2022-04-12 DOI: 10.33393/gcnd.2022.2400
Gianfranca Gerbino, Giorgio Soragna, D. Curci, Derli Fazzari, Maggiorina Bauducco, Aspasia Panunzi, L. Fabbrini, Giorgia Damilano, E. Bruno, Antonella Laezza, C. Vitale
Patients with chronic diseases frequently show a marked deterioration in their quality of life (QoL). This paper was aimed at investigating on both the prevalence of psychological disorders and the impact on QoL in patients with chronic renal failure.The survey was conducted on 155 patients, aged 77±11 years, 104/51 M/F, with renal failure on conservative treatment (stages IV-V) referring to Nephrology Unit in Mauriziano Hospital, Turin. 13 of them (8.4%) were aged 30-64 years, 63 (40.6%) were aged 65-79 years and 79 (51%) 80 years and older. Two validated questionnaires were administered, namely the SF-12 (general state of health) and the HADS (anxiety and depression).Sixty-five percent of patients believed to have a low QoL associated with health, finding difficulties in daily life activities. The prevalence of all psychologic disturbances was higher in females (p = 0.09) and in patients with more comorbidities (p = 0.05). Depression was more frequent in elderly (p = 0.05) and in females (p = 0.012). Among patients aged 80 years or over, we found a prevalence rate of 36% for anxiety and of 51% for depression.In all patients, anxiety and depression were strongly associated (p < 0.01).In conclusion, compared to the general population, patients with chronic renal failure have a higher rate of either anxiety or depression, or both, and present with lower QoL scores. Clinical teams dedicated to the management of chronic renal diseases should pursue an interdisciplinary approach to their patients, in order to provide them with a suitable monitoring of QoL and psychological support if needed.
慢性疾病患者往往表现出生活质量(QoL)的明显恶化。本文旨在探讨慢性肾功能衰竭患者心理障碍的患病率及其对生活质量的影响。研究对象为都灵Mauriziano医院肾内科经保守治疗(iv ~ v期)肾衰患者155例,年龄77±11岁,104/51 M/F,其中30 ~ 64岁13例(8.4%),65 ~ 79岁63例(40.6%),80岁及以上79例(51%)。使用两份有效问卷,即SF-12(一般健康状况)和HADS(焦虑和抑郁)。65%的患者认为与健康相关的生活质量较低,在日常生活活动中发现困难。所有心理障碍的患病率在女性中较高(p = 0.09),在有更多合并症的患者中较高(p = 0.05)。抑郁症在老年人(p = 0.05)和女性(p = 0.012)中更为常见。在80岁或以上的患者中,我们发现焦虑的患病率为36%,抑郁的患病率为51%。在所有患者中,焦虑和抑郁呈强相关(p < 0.01)。总之,与一般人群相比,慢性肾衰竭患者有更高的焦虑或抑郁率,或两者兼而有之,并且存在较低的生活质量评分。致力于慢性肾脏疾病管理的临床团队应该采用跨学科的方法来治疗他们的患者,以便为他们提供适当的生活质量监测和必要的心理支持。
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引用次数: 0
La Nefrologia incontra il Nursing e la Medicina Narrativa: una ricerca di triangolazione. Un nuovo approccio alla malattia 肾病与护理相结合,叙事医学:三角定位研究。一种治疗疾病的新方法
Pub Date : 2022-04-12 DOI: 10.33393/gcnd.2022.2402
Lapo Raugei, M. Lombardi
Introduction: In the late 20th Century, Kleinman and Good created Narrative Medicine (NM). In the following years, this method made its way in healthcare, reaching the peak in 2009 when R. Charon set up the first academic course of Narrative Medicine. Nevertheless, NM is still not well known and used. The main goal of this survey is attempting to understand the emotions felt by the patient while telling his/her own illness’ experience and then understand whether this approach improves therapy.Methods: The survey is developed through a methodological triangulation research consisting of a qualitative part, where 24 stories selected from the first two editions of “Quirino Maggiore” National Competition were analysed through the Van Kaam method, and a quantitative research, performed through a questionnaire submitted to patients suffering from chronic kidney disease thanks to the National Association of Hemodialysis Patients (ANED) and to Onlus Santa Maria Annunziata, Bagno a Ripoli, Florence. We received responses from 219 patients between 24 September 2021 and 18 October 2021.Results: The qualitative research identified 94 expressions grouped in 10 labels in which the most representative themes come to light. Through the questionnaire we can see that most people are not familiar with Nursing and Narrative Medicine, but that they consider the relationship between patients and healthcare workers very important.Conclusions: Although it’s impossible to generalize the results, we can understand that Nursing and Narrative Medicine should be more integrated into the care pathway. Furthermore, healthcare workers should be trained in a suitable way.
20世纪后期,Kleinman和Good创立了叙事医学(NM)。在接下来的几年里,这种方法在医疗保健领域得到了发展,并在2009年达到顶峰,当时R. Charon开设了第一个叙事医学学术课程。然而,NM仍然不为人所知和使用。本调查的主要目的是试图了解患者在讲述自己的疾病经历时所感受到的情绪,然后了解这种方法是否能改善治疗。方法:该调查是通过方法学三角测量研究进行的,其中包括定性部分,其中通过Van Kaam方法分析了从“Quirino Maggiore”全国比赛的前两个版本中选出的24个故事,并通过向患有慢性肾病的患者提交的问卷调查进行了定量研究,这要多亏了全国血液透析患者协会(ANED)和佛罗伦萨Bagno a Ripoli的Onlus Santa Maria Annunziata。在2021年9月24日至2021年10月18日期间,我们收到了219名患者的回复。结果:定性研究确定了94种表情,分为10个标签,其中最具代表性的主题出现。通过问卷调查我们可以看到,大多数人对护理和叙事医学并不熟悉,但他们认为患者与医护人员之间的关系非常重要。结论:虽然结果无法一概而论,但我们可以理解护理和叙事医学应更多地融入护理路径。此外,应以适当的方式对卫生保健工作者进行培训。
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引用次数: 0
ANTROPOCENE: la “salute” del villaggio globale e il “Cigno Nero” 人类世:地球村的“健康”和“黑天鹅”
Pub Date : 2022-03-17 DOI: 10.33393/gcnd.2022.2368
A. Capitanini
Over the past three centuries, the effects of humans on the global environment have increased. It seems appropriate to assign the term “Anthropocene” to the current geological epoch, which is in many ways dominated by humans. The Anthropocene can be said to have begun in the latter part of the 18th century, when analyses of air trapped in polar ice showed the beginning of the rise in global concentrations of carbon dioxide and methane. This date also coincides with the design of the steam engine by James Watt in 1784. In particular, the 21st century witnessed an unforeseen but predictable resurgence of infectious diseases, not least the COVID-19 pandemic, which had a devastating impact on lives and livelihoods worldwide. The 2003 severe acute respiratory syndrome coronavirus outbreak, the 2009 swine flu pandemic, the 2012 Middle East respiratory syndrome coronavirus outbreak, and the 2013-2016 Ebola virus outbreak in West Africa all caused significant morbidity and mortality as they spread through the global village across borders to infect people in multiple countries. In the last 70 years, the speed at which human habits have changed through technological, demographic and climatic changes is unprecedented: airline flights have doubled since 2000, more people live in urban than rural areas since 2007, climate change poses a growing threat to society, and humans have stopped following the high road shown by nature with proper nutrition and regular exercise. In this review, we consider the extent to which these recent global changes have increased the risk of infectious disease outbreaks, even though improved sanitation and access to health care have led to significant progress worldwide.
在过去的三个世纪里,人类对全球环境的影响有所增加。把当前的地质时代称为“人类世”似乎是恰当的,因为这个时代在许多方面都是由人类主导的。人类世可以说是从18世纪后半叶开始的,当时对极地冰中空气的分析表明,全球二氧化碳和甲烷浓度开始上升。1784年,詹姆斯·瓦特发明了蒸汽机。特别是,在21世纪,传染病,尤其是2019冠状病毒病大流行,在全球范围内对人们的生活和生计造成了毁灭性的影响。2003年的严重急性呼吸综合征冠状病毒疫情、2009年的猪流感大流行、2012年的中东呼吸综合征冠状病毒疫情,以及2013-2016年西非的埃博拉病毒疫情,都通过地球村传播,在多个国家感染,造成了严重的发病率和死亡率。在过去的70年里,由于技术、人口和气候的变化,人类习惯的改变速度是前所未有的:自2000年以来,航空公司的航班数量增加了一倍;自2007年以来,城市人口比农村人口多;气候变化对社会构成了越来越大的威胁;人类已经不再遵循自然的道路,即适当的营养和定期锻炼。在本次审查中,我们考虑了这些最近的全球变化在多大程度上增加了传染病爆发的风险,尽管卫生条件的改善和获得保健的机会已经在世界范围内取得了重大进展。
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引用次数: 0
La complessità della relazione medico-paziente in nefrologia: perché è ancora più importante occuparsene oggi? 肾病中医患关系的复杂性:为什么今天处理这个问题更重要?
Pub Date : 2022-03-16 DOI: 10.33393/gcnd.2022.2381
Marilena Cara
Medicine is more than just a science: it is a human contact between men. We must not forget that “Psyche depends on the body and the body depends on the psyche”. The 21st Century man’s Psyche is more stressed than in the past, as we live in a complexity increasingly understood with the passage of time. The only way to take care of the sick person in the body, and therefore suffering in the psyche, can only be that which rests on the relationship, since the relationship, in my opinion, can be considered the bridge between the psyche and the soma. If the medical technique today does not pass through the relationship could it be effective in the cure? Trust in the doctor today is no longer a certainty, as medicine has lost its character of sacredness, but must be acquired and conquered through a dedicated and continuous relationship. Unlike other pathologies, nephrology does not end in a diagnosis or in a therapy that is provided at home, but the patient’s only point of reference is the nephrology nursing staff. Effective communication will lead to a reduction in the time taken for communication, improving the patient’s ability to understand and trust, reducing the operator’s effort and improving the therapeutic result. Today’s medicine, and today’s “healers” can no longer fail to deal with the management of the operator-patient relationship in order to meet the demands that today’s society and healthcare organization make in the medical field.
医学不仅仅是一门科学:它是人与人之间的一种联系。我们不能忘记“精神依赖于身体,身体依赖于精神”。随着时间的推移,我们生活在一个越来越复杂的环境中,21世纪的人的心理比过去更加紧张。要照顾身体上有病的人,照顾精神上的痛苦,唯一的办法只能是建立在关系上,因为在我看来,关系可以被认为是心灵和躯体之间的桥梁。如果今天的医学技术没有通过这种关系,它能有效地治愈吗?今天,对医生的信任不再是必然的,因为医学已经失去了它神圣的特性,而是必须通过一种奉献和持续的关系来获得和征服。与其他病理不同,肾脏病不以诊断或在家提供的治疗结束,但患者唯一的参考点是肾脏病护理人员。有效的沟通会减少沟通所需的时间,提高患者的理解和信任能力,减少操作者的努力,提高治疗效果。为了满足当今社会和医疗机构对医疗领域的需求,今天的医学和今天的“治疗师”再也不能不处理好医患关系的管理。
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引用次数: 0
L’assorbimento del glucosio in dialisi peritoneale: strumenti utili per il team multidisciplinare 腹膜透析葡萄糖吸收:多学科团队的工具
Pub Date : 2022-02-08 DOI: 10.33393/gcnd.2022.2365
Anna Laura Fantuzzi, Elisa Berri, L. Tartaglione, Rossella Giannini, Sara Dominjanni, Silvia Porreca
Dialysis patients are often affected by protein energy wasting and the maintenance of an optimal nutritional state is a difficult goal to achieve. Moreover protein energy wasting is one of the strongest risk factors for mortality in chronic dialysis patients.To estimate glucose absorption in peritoneal dialysis is essential to determine patient’s dietary energy requirements and to prevent possible metabolic complications.The currently accepted methods of estimating glucose absorption are two. The first one is based on the average glucose absorption of continuous ambulatory peritoneal dialysis (CAPD) and is calculated with the Grodstein et al. formula. The second one is based on the Peritoneal equilibration test curves (D/D0 formula, Bodnar et al.) and takes into account transport characteristics. None of the two formulas perfectly calculated the absolute glucose absorption, even if the D/D0 is much closer to the true value, compared to Grodstein et al. formula. In this paper we described the multidisciplinary management experience of peritoneal dialysis patients, with a focus on the estimation of the patient’s energy requirements. Analyzing glucose absorption in a systematic way and monitoring the changes in glucose absorption during the time could significantly contribute to adjusting nutritional treatment. However it is always necessary to critically evaluate the results obtained by both formulas.
透析患者经常受到蛋白质能量浪费的影响,维持最佳营养状态是一个难以实现的目标。此外,蛋白质能量浪费是慢性透析患者死亡的最大危险因素之一。估计腹膜透析中葡萄糖的吸收对于确定患者的膳食能量需求和预防可能的代谢并发症至关重要。目前公认的估计葡萄糖吸收的方法有两种。第一个是基于连续动态腹膜透析(CAPD)的平均葡萄糖吸收,使用Grodstein等人的公式计算。第二种方法基于腹膜平衡试验曲线(D/D0公式,Bodnar et al.),并考虑了转运特性。尽管与Grodstein等人的公式相比,D/D0更接近真实值,但这两个公式都不能完美地计算绝对葡萄糖吸收。在本文中,我们描述了腹膜透析患者的多学科管理经验,重点是估计患者的能量需求。系统地分析葡萄糖吸收,监测这段时间内葡萄糖吸收的变化,对调整营养治疗有重要意义。然而,始终有必要对这两个公式得到的结果进行批判性评价。
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引用次数: 0
L’infermiere e la percezione del Moral Distress nella cura del fine vita nel paziente dializzato 在透析病人的临终关怀中,护士和对道德痛苦的感知
Pub Date : 2022-01-08 DOI: 10.33393/gcnd.2022.2357
Elena Brioni, Nadia Pennacchio, Giulia Villa, Noemi Giannetta, Cristiano Magnaghi, G. Vezzoli, D. F. Manara
The phenomenon of Moral Distress in nursing practice is described as a situation of suffering that arises when the nurse recognizes the ethically appropriate action to be taken and yet institutional impediments make it impossible for him to follow the right course of action. Dialysis patients often have a complex disease trajectory that sometimes involves professional and emotional challenges for staff, especially at the end of life. The objective of this review is to identify which strategies are useful for preserving emotional integrity and awareness in operational settings, for the benefit of both operators and patients. 
护理实践中的道德困境现象被描述为一种痛苦的情况,当护士认识到要采取的道德上适当的行动,但制度障碍使他不可能遵循正确的行动方针时,就会出现这种情况。透析患者通常有复杂的疾病轨迹,有时会给工作人员带来专业和情感上的挑战,尤其是在生命的最后阶段。本综述的目的是确定哪些策略有助于在手术环境中保持情感完整性和意识,从而使手术者和患者都受益。
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引用次数: 1
Terza Edizione del Concorso Quirino Maggiore Firenze, 17 ottobre 2021 2021年10月17日,佛罗伦萨奇里诺少将第三届比赛
Pub Date : 2021-11-18 DOI: 10.33393/gcnd.2021.2353
M. Lombardi
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引用次数: 0
期刊
Giornale di Clinica Nefrologica e Dialisi
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