Human evolution lasting millennia has allowed us to develop mechanisms in physiology capable of defending ourselves from the main difficulties. We can accumulate fat as a reserve, and we have acute inflammation as a response to pathogens and platelets to defend us from bleeding, but precisely the main defenses are now transformed due to the changed living conditions of part of humanity into potential enemies, creating a very dangerous paradox.
{"title":"Le nuove abitudini e il paradosso evolutivo","authors":"David Mariani","doi":"10.33393/gcnd.2021.2354","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2354","url":null,"abstract":"Human evolution lasting millennia has allowed us to develop mechanisms in physiology capable of defending ourselves from the main difficulties. We can accumulate fat as a reserve, and we have acute inflammation as a response to pathogens and platelets to defend us from bleeding, but precisely the main defenses are now transformed due to the changed living conditions of part of humanity into potential enemies, creating a very dangerous paradox.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85925690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Burrai, Margherita Gambella, Angelica Scarpa, Stefano Cabula
This article has the aim of informing the reader about methodology and production of Clinical Practice Guidelines (CPG) and the instruments in order to be able to approach the whole process, from the production to the publication and distribution, but also to updated CPG. The importance of the issue is given by: 1) the need to avoid the CPG duplication, which is the reason of waste of resources and that raises confusion among users; 2) the need to ensure the independence of the experts involved and without conflict of interests; 3) the use of methodologies that respect the best quality standards; 4) the inhomogeneity of healthcare processes in the Italian territory and practices not based on scientific evidences; 5) the consultation and the commentary of stakeholders on the recommendations produced.
{"title":"Metodologia e produzione delle Linee Guida","authors":"Francesco Burrai, Margherita Gambella, Angelica Scarpa, Stefano Cabula","doi":"10.33393/gcnd.2021.2268","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2268","url":null,"abstract":"This article has the aim of informing the reader about methodology and production of Clinical Practice Guidelines (CPG) and the instruments in order to be able to approach the whole process, from the production to the publication and distribution, but also to updated CPG. The importance of the issue is given by: 1) the need to avoid the CPG duplication, which is the reason of waste of resources and that raises confusion among users; 2) the need to ensure the independence of the experts involved and without conflict of interests; 3) the use of methodologies that respect the best quality standards; 4) the inhomogeneity of healthcare processes in the Italian territory and practices not based on scientific evidences; 5) the consultation and the commentary of stakeholders on the recommendations produced.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86979129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luigi Apuzzo, Maddalena Iodice, Margherita Gambella, Angelica Scarpa, Francesco Burrai
In recent years, the incidence rate of chronic diseases shows a steady increase in every industrialized Country. The almost logarithmic trend of the number of people living with chronic diseases is constantly on the rise. Each predictive statistical model indicates a strong impact for national health systems at the level of the organization of care and management costs. It is urgent to systematically introduce an evidence-based care model in chronic care management such as the Chronic Care Model. The Chronic Care Model is the reference model for WHO. The Chronic Care Model allows for personalized, holistic, multi-professional assistance, characterized by a strong humanization of care, by preventive interventions and relationships between healthcare professionals, patients and caregivers as a system of care and assistance. The fundamental roles are social integration and the improvement of the quality of life of patients. The Chronic Care Model involves the use of a computerized system of information flow and telemedicine and trained healthcare professionals. The Chronic Care Model showed an improvement in the quality of life, a reduction in the number of hospitalizations, a better adherence to therapies, and a reduction in costs.
{"title":"Il Chronic Care Model","authors":"Luigi Apuzzo, Maddalena Iodice, Margherita Gambella, Angelica Scarpa, Francesco Burrai","doi":"10.33393/gcnd.2021.2242","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2242","url":null,"abstract":"In recent years, the incidence rate of chronic diseases shows a steady increase in every industrialized Country. The almost logarithmic trend of the number of people living with chronic diseases is constantly on the rise. Each predictive statistical model indicates a strong impact for national health systems at the level of the organization of care and management costs. It is urgent to systematically introduce an evidence-based care model in chronic care management such as the Chronic Care Model. The Chronic Care Model is the reference model for WHO. The Chronic Care Model allows for personalized, holistic, multi-professional assistance, characterized by a strong humanization of care, by preventive interventions and relationships between healthcare professionals, patients and caregivers as a system of care and assistance. The fundamental roles are social integration and the improvement of the quality of life of patients. The Chronic Care Model involves the use of a computerized system of information flow and telemedicine and trained healthcare professionals. The Chronic Care Model showed an improvement in the quality of life, a reduction in the number of hospitalizations, a better adherence to therapies, and a reduction in costs.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76879541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abstracts XXXIX Congresso Nazionale SIAN ITALIA Malattia Renale Cronica (MRC): consapevolezza e competenze infermieristiche dopo un anno di pandemia da SARS-COV2 Bologna 3-4 Ottobre 2021","authors":"","doi":"10.33393/gcnd.2021.2336","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2336","url":null,"abstract":"","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75718681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Obblighi, incentivi, motivazioni: strategie per indurre a vaccinarsi","authors":"S. Spinsanti","doi":"10.33393/gcnd.2021.2330","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2330","url":null,"abstract":"","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79053994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
n 2017, thanks to an initiative of IPASVI College (the Order of Nursing Professionals of the province of Bologna) in response to 2014 legislations referring to the Guidelines about Chronic Kidney Disease (CKD), nephrology professionals and members of EDTNA/ERCA Italian Branch Association (which in 2018 became Società Infermieri Area Nefrologica, SIAN) in 2021 were requested to contribute to define the role and skills performed by nurses on a daily basis. The management of the CKD patient has been structured into 7 phases: the model for each phase takes into consideration the professionals involved, the care settings and the tools used. To support this approach, we decided to introduce two elements which broaden the clinical and care approach to the patient and at the same time highlight the contribution of nursing professionals, with a referring workflow for the CKD patient, the nurses’ role and skills required throughout the patient’s journey. Furthermore, to ensure the best continuity of care, we believe that it is necessary to apply a logical model based on the principles of early recognition of health and welfare needs; guarantee the most appropriate healthcare response; ensure early care; standardize the procedures of professionals to improve the quality of life of the patient and manage the social and economic impact.
2017年，由于IPASVI学院(博洛尼亚省护理专业人员命令)响应2014年关于慢性肾脏疾病(CKD)指南的立法，肾脏病专业人员和EDTNA/ERCA意大利分会协会(2018年成为societ Infermieri Area Nefrologica, SIAN)的成员于2021年被要求为定义护士每天所扮演的角色和技能做出贡献。慢性肾病患者的管理分为7个阶段:每个阶段的模型都考虑到所涉及的专业人员、护理环境和使用的工具。为了支持这种方法，我们决定引入两种元素，拓宽临床和护理方法，同时突出护理专业人员的贡献，为CKD患者提供参考工作流程，护士的角色和整个患者旅程所需的技能。此外，为了确保护理的最佳连续性，我们认为有必要采用一种基于及早认识保健和福利需要原则的逻辑模式;保证采取最适当的医疗应对措施;确保早期护理;规范专业人员的程序，以提高患者的生活质量，并管理社会和经济影响。
{"title":"Presa in carico infermieristica nella Malattia Renale Cronica","authors":"M. Zito, Roberta Toschi","doi":"10.33393/gcnd.2021.2326","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2326","url":null,"abstract":"n 2017, thanks to an initiative of IPASVI College (the Order of Nursing Professionals of the province of Bologna) in response to 2014 legislations referring to the Guidelines about Chronic Kidney Disease (CKD), nephrology professionals and members of EDTNA/ERCA Italian Branch Association (which in 2018 became Società Infermieri Area Nefrologica, SIAN) in 2021 were requested to contribute to define the role and skills performed by nurses on a daily basis.\u0000The management of the CKD patient has been structured into 7 phases: the model for each phase takes into consideration the professionals involved, the care settings and the tools used.\u0000To support this approach, we decided to introduce two elements which broaden the clinical and care approach to the patient and at the same time highlight the contribution of nursing professionals, with a referring workflow for the CKD patient, the nurses’ role and skills required throughout the patient’s journey.\u0000Furthermore, to ensure the best continuity of care, we believe that it is necessary to apply a logical model based on the principles of early recognition of health and welfare needs; guarantee the most appropriate healthcare response; ensure early care; standardize the procedures of professionals to improve the quality of life of the patient and manage the social and economic impact.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86211568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. La Rosa, C. Guglielmo, Alessandra Ocello, C. Sessa, G. Seminara, A. Granata
In recent years, there has been increased awareness of a concept of medicine based on individual differences taking into consideration genetic variability, environment, characteristics of the microbiome and individual lifestyles. It makes use of genomics, transcriptomics, proteomics and metabolomics techniques, obtaining a large amount of information which enables a more precise characterization of the patient. This model expands to the principles of prediction, prevention, personalization and participation, including all medical specialties. In nephrology, the application of precision medicine could play a central role, thanks to the information available today in multiple fields: for example the impact of alterations in the intestinal microbiota on the progression of chronic renal failure, in polycystic disease, in diabetic nephropathy and in the personalized approach to the transition period before the beginning of hemodialysis therapy.
{"title":"Dalla medicina reattiva alla medicina di precisione","authors":"S. La Rosa, C. Guglielmo, Alessandra Ocello, C. Sessa, G. Seminara, A. Granata","doi":"10.33393/gcnd.2021.2316","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2316","url":null,"abstract":"In recent years, there has been increased awareness of a concept of medicine based on individual differences taking into consideration genetic variability, environment, characteristics of the microbiome and individual lifestyles. It makes use of genomics, transcriptomics, proteomics and metabolomics techniques, obtaining a large amount of information which enables a more precise characterization of the patient. This model expands to the principles of prediction, prevention, personalization and participation, including all medical specialties. In nephrology, the application of precision medicine could play a central role, thanks to the information available today in multiple fields: for example the impact of alterations in the intestinal microbiota on the progression of chronic renal failure, in polycystic disease, in diabetic nephropathy and in the personalized approach to the transition period before the beginning of hemodialysis therapy.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"22 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82919164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Concetto Sessa, Walter Morale, Antonino Reina, G. Battaglia, Sandra La Rosa, Daniela Puliatti, G. Seminara, Luca Zanoli
Dialysis patients have a wide range of pathologies that contribute to their frailty. Maintaining a good nutritional status is useful to prevent and treat the so-called Protein-Energy Wasting (PEW), a complex clinical-laboratory condition in which a protein-energy depletion occurs. Adherence to a proper nutritional therapy in CKD requires considerable effort from both patients and health personnel (doctors and nurses). In order to slow down the effects of malnutrition and the disasters that complicate PEW, nephrologists can use supplementation products. In our observational, prospective, multicentre study, we administered an intradialytic parenteral nutrition of a three-compartment emulsion for intravenous infusion through an infusion pump connected to the venous line. After 12 weeks of treatment, subjects with severe malnutrition were reduced from 61.1% to 33.3%, serum creatinine increased by 16% (from 6.00 ± 1.48 mg/dL to 6.98 ± 2.46 mg/dL; P < 0.001), total protein and albumin levels respectively by 13% (from 5.46 ± 0.63 g/dL to 6.19 ± 0.66 g/dL; P < 0.001) and 19% (from 2.70 ± 0.48 g/dL to 3.20 ± 0.57 g/dL; P < 0.001), body weight by 3% (from 55.7 ± 13.2 kg to 57.6 ± 13.0 kg; P < 0.001).
{"title":"Nutrizione parenterale intradialitica in pazienti con malnutrizione moderata-severa: studio prospettico osservazionale multicentrico","authors":"Concetto Sessa, Walter Morale, Antonino Reina, G. Battaglia, Sandra La Rosa, Daniela Puliatti, G. Seminara, Luca Zanoli","doi":"10.33393/gcnd.2021.2335","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2335","url":null,"abstract":"Dialysis patients have a wide range of pathologies that contribute to their frailty. Maintaining a good nutritional status is useful to prevent and treat the so-called Protein-Energy Wasting (PEW), a complex clinical-laboratory condition in which a protein-energy depletion occurs. Adherence to a proper nutritional therapy in CKD requires considerable effort from both patients and health personnel (doctors and nurses). In order to slow down the effects of malnutrition and the disasters that complicate PEW, nephrologists can use supplementation products. In our observational, prospective, multicentre study, we administered an intradialytic parenteral nutrition of a three-compartment emulsion for intravenous infusion through an infusion pump connected to the venous line. After 12 weeks of treatment, subjects with severe malnutrition were reduced from 61.1% to 33.3%, serum creatinine increased by 16% (from 6.00 ± 1.48 mg/dL to 6.98 ± 2.46 mg/dL; P < 0.001), total protein and albumin levels respectively by 13% (from 5.46 ± 0.63 g/dL to 6.19 ± 0.66 g/dL; P < 0.001) and 19% (from 2.70 ± 0.48 g/dL to 3.20 ± 0.57 g/dL; P < 0.001), body weight by 3% (from 55.7 ± 13.2 kg to 57.6 ± 13.0 kg; P < 0.001).","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76890713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Healthcare workers represent a population that is well analysed by health studies: since 1976, the Nurses’ Health Study has been examining American nurses for health-related risks and is currently recruiting its third cohort. The survey models used are predominantly biomedical, i.e. based on the disease-healing scheme which focuses on purely biological factors with little or no assessment of psychological, behavioural and environmental aspects. The biopsychosocial assessment model, in its multifaceted nature, is probably more suitable for assessing occupational distress as a progressive cause of health worker burnout. It attributes the outcome of illness, as well as that of health, to the numerous, complex interactions of biological, psychological and social factors. In this work, we decided to evaluate the lifestyle and habits of a homogeneous population of nurses, all belonging to an Operative Unit of Nephrology (Pistoia). Methods: We decided to use unconventional instruments: a “selfie” questionnaire on habits, constructed with scientifically validated items, aimed at the self-assessment of habits, scientifically recognised as determinants of health (nutritional, behavioural, relational, physiological...), correlating it with the analysis of the receipts of the weekly shopping of the family unit of the nurse in the study, according to the principle that “we eat what we buy”. Results and conclusion: Nurses evaluated in the study showed a frequent unhealthy lifestyle which can have negative effects on their health, on their family and, consequently, on their work environment. Questionnaire and focus group discussions were appreciated and potentially useful and effective in changing bad habits.
{"title":"Un “selfie” in dialisi: valutazione delle abitudini personali degli infermieri di un centro dialisi","authors":"A. Capitanini","doi":"10.33393/gcnd.2021.2320","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2320","url":null,"abstract":"Introduction: Healthcare workers represent a population that is well analysed by health studies: since 1976, the Nurses’ Health Study has been examining American nurses for health-related risks and is currently recruiting its third cohort. The survey models used are predominantly biomedical, i.e. based on the disease-healing scheme which focuses on purely biological factors with little or no assessment of psychological, behavioural and environmental aspects. The biopsychosocial assessment model, in its multifaceted nature, is probably more suitable for assessing occupational distress as a progressive cause of health worker burnout. It attributes the outcome of illness, as well as that of health, to the numerous, complex interactions of biological, psychological and social factors. In this work, we decided to evaluate the lifestyle and habits of a homogeneous population of nurses, all belonging to an Operative Unit of Nephrology (Pistoia).\u0000Methods: We decided to use unconventional instruments: a “selfie” questionnaire on habits, constructed with scientifically validated items, aimed at the self-assessment of habits, scientifically recognised as determinants of health (nutritional, behavioural, relational, physiological...), correlating it with the analysis of the receipts of the weekly shopping of the family unit of the nurse in the study, according to the principle that “we eat what we buy”.\u0000Results and conclusion: Nurses evaluated in the study showed a frequent unhealthy lifestyle which can have negative effects on their health, on their family and, consequently, on their work environment. Questionnaire and focus group discussions were appreciated and potentially useful and effective in changing bad habits.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75735281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Exit-site (ES) and tunnel infections are the main infectious complication in peritoneal dialysis (PD); they also are risk factors for the development of peritonitis, for catheter removal and for dialysis drop-out. Up to now, besides the recommendations of the Guidelines there is no uniformity, nor on the classification, nor on the treatment strategies of the infected ES. Recent experiences are reported with alternative types of dressings that aim to reduce the incidence of ES infection and consequently of the subcutaneous tunnel. Methods: The Tuscan group conducted a retrospective observational study of 10 patients on PD who, showing signs of a suspected but not ascertained infection (negative microbiological culture), such as redness, edema, secretion, scab, had been medicated with silver-ions releasing Exit-Pad Ag. The aim was to evaluate and classify the evolution of ES lesions, in order to confirm the preventive efficacy of the silver-ions releasing dressing compared to the traditional ones. Results: After 4 weeks of treatment with Exit Pad Ag maintained in situ for 72 h, 6 patients no longer had any signs of inflammation. In 2 cases, several weeks of treatment were necessary to achieve a complete recovery, while in 2 other cases the signs of inflammation became negative in less time (2 weeks, 1 week). Conclusions: With the utilization of an alternative dressing such as Exit-Pad Ag on PD patients showing early signs of inflammation, the onset of a true infection can be prevented, with a progressive improvement of the ES.
腹膜透析(PD)的主要感染并发症为出口部位(ES)和隧道感染;它们也是发展为腹膜炎，导管移除和透析退出的危险因素。到目前为止，除了指南的建议外，对感染ES的分类和治疗策略也没有统一。最近的经验报告了替代类型的敷料，旨在减少ES感染的发生率，从而减少皮下隧道。方法:托斯卡纳组对10例PD患者进行回顾性观察研究，这些患者表现出疑似感染但未确定感染的迹象(微生物培养阴性)，如红肿、水肿、分泌物、结痂，并给予银离子释放的export - pad Ag。目的是评估和分类ES病变的演变，以确认银离子释放敷料与传统敷料相比的预防效果。结果:Exit Pad Ag原位放置72 h，治疗4周后，6例患者不再出现任何炎症迹象。其中2例需要数周的治疗才能完全恢复，而另外2例炎症症状在更短的时间内变为阴性(2周，1周)。结论:对出现早期炎症症状的PD患者使用替代敷料，如Exit-Pad Ag，可以预防真正感染的发生，并逐步改善ES。
{"title":"Medicazione a base d’argento nella gestione dell’emergenza cutanea","authors":"Walter Lunardi, S. Bianchi","doi":"10.33393/gcnd.2021.2296","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2296","url":null,"abstract":"Introduction: Exit-site (ES) and tunnel infections are the main infectious complication in peritoneal dialysis (PD); they also are risk factors for the development of peritonitis, for catheter removal and for dialysis drop-out.\u0000Up to now, besides the recommendations of the Guidelines there is no uniformity, nor on the classification, nor on the treatment strategies of the infected ES.\u0000Recent experiences are reported with alternative types of dressings that aim to reduce the incidence of ES infection and consequently of the subcutaneous tunnel.\u0000Methods: The Tuscan group conducted a retrospective observational study of 10 patients on PD who, showing signs of a suspected but not ascertained infection (negative microbiological culture), such as redness, edema, secretion, scab, had been medicated with silver-ions releasing Exit-Pad Ag. The aim was to evaluate and classify the evolution of ES lesions, in order to confirm the preventive efficacy of the silver-ions releasing dressing compared to the traditional ones.\u0000Results: After 4 weeks of treatment with Exit Pad Ag maintained in situ for 72 h, 6 patients no longer had any signs of inflammation. In 2 cases, several weeks of treatment were necessary to achieve a complete recovery, while in 2 other cases the signs of inflammation became negative in less time (2 weeks, 1 week).\u0000Conclusions: With the utilization of an alternative dressing such as Exit-Pad Ag on PD patients showing early signs of inflammation, the onset of a true infection can be prevented, with a progressive improvement of the ES.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88420972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：