M. Gallo, S. Aterini, S. Bandini, F. Bergesio, A. Ciciani, Lorenzo Aterini, Francesca Calderini, F. Balboni
We report a case of an 81-year-old man with end stage renal disease (ESRD) in chronic hemodialysis with severe hypocalcaemia secondary to the intake of a parapharmaceutical containing sodium and potassium citrate and in association with poor dialysis efficiency, due to malfunction of the vascular access, which promptly resolved after discontinuation of the supplement. The patient never showed signs or symptoms of hypocalcaemia. This case highlightens the importance of a correct pharmacological reconciliation in dialysis patients in order to avoid the onset of adverse events due to the uncontrolled intake of drugs or parapharmaceuticals.
{"title":"Severa ipocalcemia conseguente all’assunzione orale di citrato in un paziente in emodialisi cronica","authors":"M. Gallo, S. Aterini, S. Bandini, F. Bergesio, A. Ciciani, Lorenzo Aterini, Francesca Calderini, F. Balboni","doi":"10.33393/gcnd.2021.2322","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2322","url":null,"abstract":"We report a case of an 81-year-old man with end stage renal disease (ESRD) in chronic hemodialysis with severe hypocalcaemia secondary to the intake of a parapharmaceutical containing sodium and potassium citrate and in association with poor dialysis efficiency, due to malfunction of the vascular access, which promptly resolved after discontinuation of the supplement. The patient never showed signs or symptoms of hypocalcaemia. This case highlightens the importance of a correct pharmacological reconciliation in dialysis patients in order to avoid the onset of adverse events due to the uncontrolled intake of drugs or parapharmaceuticals.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86127517","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}
Human phenotype, the set of characteristics manifested by a living organism, is determined by genetic information expression dependent on genome, epigenome and microbiome. There is a kind of bidirectionality between humans and their genome with significant influence by environment and human behaviour. In the timeline of evolution we see that genetic modifications take millions of years to take place and consolidate, as per Darwinian principles, but environment and our habits are able much more rapidly to influence our phenotypic response, through epigenetic and microbiotic pathways, as per Lamarckian hypothesis (Fig. 1). Our habits (physical, psychological, environment) are able to determine changes in gene expression and potentially influence our children’s one. The evidence of these new concepts should be a further stimulus to a more conscious lifestyle.
{"title":"Abitudini ed ereditarietà: la rivincita di Lamarck?","authors":"A. Capitanini, Francesca Capitanini","doi":"10.33393/GCND.2021.2289","DOIUrl":"https://doi.org/10.33393/GCND.2021.2289","url":null,"abstract":"Human phenotype, the set of characteristics manifested by a living organism, is determined by genetic information expression dependent on genome, epigenome and microbiome. There is a kind of bidirectionality between humans and their genome with significant influence by environment and human behaviour. In the timeline of evolution we see that genetic modifications take millions of years to take place and consolidate, as per Darwinian principles, but environment and our habits are able much more rapidly to influence our phenotypic response, through epigenetic and microbiotic pathways, as per Lamarckian hypothesis (Fig. 1). Our habits (physical, psychological, environment) are able to determine changes in gene expression and potentially influence our children’s one. The evidence of these new concepts should be a further stimulus to a more conscious lifestyle.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73443072","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}
Maria Teresa Sciarrone Alibrandi, Giancarlo Joli, R. F. Rivera, Elena Brioni, Romina Bucci, Marta Vespa
The SARS-CoV-2 (Covid-19) infection affected about 106 million people worldwide and the total amount of casualties now sits at a staggering 2 millions. Chronic Kidney Disease (CKD) emerged as the first risk factor in worst patients, not considering old age. Kidney disease and acute kidney injury have been correlated with a higher chance of death. This combination of CKD and higher Covid-19 related mortality requires immediate response from a prevention point of view at first and then from a therapeutic one. There is not a clear relation between Covid-19 and ADPKD. What can be inferred is the following: Covid uses the ACE2 receptors on cell membranes to “lock on” its target. It is well-established in fact that the RAAS is more active in ADPKD patients and it may represent an additional risk factor for these patients. At the moment three Covid-19 vaccines have been approved, and two of them have been already administered, such as Pfizer BioNTech and Moderna, sharing the same mechanism. AstraZeneca released a third option. All of them are completely safe and reliable, each one with its own feature. Therefore, considering how delicate ADPKD patients are, vaccination is strongly recommended.
{"title":"L’importanza del vaccino anti Covid-19 nei pazienti affetti da malattia del rene policistico autosomico dominante dell’adulto (ADPKD)","authors":"Maria Teresa Sciarrone Alibrandi, Giancarlo Joli, R. F. Rivera, Elena Brioni, Romina Bucci, Marta Vespa","doi":"10.33393/gcnd.2021.2256","DOIUrl":"https://doi.org/10.33393/gcnd.2021.2256","url":null,"abstract":"The SARS-CoV-2 (Covid-19) infection affected about 106 million people worldwide and the total amount of casualties now sits at a staggering 2 millions. \u0000Chronic Kidney Disease (CKD) emerged as the first risk factor in worst patients, not considering old age. Kidney disease and acute kidney injury have been correlated with a higher chance of death. This combination of CKD and higher Covid-19 related mortality requires immediate response from a prevention point of view at first and then from a therapeutic one. \u0000There is not a clear relation between Covid-19 and ADPKD. What can be inferred is the following: Covid uses the ACE2 receptors on cell membranes to “lock on” its target. It is well-established in fact that the RAAS is more active in ADPKD patients and it may represent an additional risk factor for these patients. \u0000At the moment three Covid-19 vaccines have been approved, and two of them have been already administered, such as Pfizer BioNTech and Moderna, sharing the same mechanism. AstraZeneca released a third option. All of them are completely safe and reliable, each one with its own feature. \u0000Therefore, considering how delicate ADPKD patients are, vaccination is strongly recommended.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"146 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78501303","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}
For some years now, the health care world has also been interested and influenced by issues related to immigration, integration, no integration, historical changes in our socio-anthropological field and cultural and linguistic differences; different worldviews and expectations, beliefs and non-evidence-based practices; prejudices and defense mechanisms for ethical and professional inability to care with patients with different cultures; scientific culture alongside a traditional and popular culture; little or no anthropological knowledge of many health professionals; improvised approaches to foreign patients, misunderstandings, tensions. The use of the cultural mediator is a very small part in the solution of the problem. Cross-cultural assistance represents the solution and it is a model, a discipline, a communication that allows an appropriate health care based on the cultural differences of the patients.
{"title":"Assistenza transculturale e comunicazione transculturale","authors":"Valentina Micheluzzi, Francesco Burrai","doi":"10.33393/GCND.2021.2244","DOIUrl":"https://doi.org/10.33393/GCND.2021.2244","url":null,"abstract":"For some years now, the health care world has also been interested and influenced by issues related to immigration, integration, no integration, historical changes in our socio-anthropological field and cultural and linguistic differences; different worldviews and expectations, beliefs and non-evidence-based practices; prejudices and defense mechanisms for ethical and professional inability to care with patients with different cultures; scientific culture alongside a traditional and popular culture; little or no anthropological knowledge of many health professionals; improvised approaches to foreign patients, misunderstandings, tensions. The use of the cultural mediator is a very small part in the solution of the problem. Cross-cultural assistance represents the solution and it is a model, a discipline, a communication that allows an appropriate health care based on the cultural differences of the patients.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86426915","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, Elena Brioni, Cristiano Magnaghi, Marianna Parisotto, Francesco Burrai
Background: Nurses guarantee assistance using different nursing theories, which present different conceptual frameworks, but which have a common vision in the whole of the human being, his holistic needs and the connection with the environment. Florence Nightingale was the first to introduce aspects of the scientific method, structuring a theory focused on the connection between the management of the physical environment and the actions of nurses. Methods: The aim is the evaluation of Nightingale's theory in reference to its contemporary integration, through a narrative review of the literature. Results: The action of nurses on the environment according to Nightingale's theory in care settings and hand hygiene are identified as fundamental in the fight against the spread of infections and in the implementation of the holistic vision. Discussion: Nightingale's theory shows elements of applicability and modernity, such as the acquisition of a greater awareness of healthcare professionals in relation to the care of environments and hand hygiene. Conclusions: Florence Nightingale's theory presents aspects of validity, but further studies are needed to contribute to the evolution of her model, especially in its contemporary contextualization.
{"title":"L’eredità di Florence Nightingale nel 2020, Anno Internazionale dell’infermiere: una revisione narrativa","authors":"Luigi Apuzzo, Maddalena Iodice, Elena Brioni, Cristiano Magnaghi, Marianna Parisotto, Francesco Burrai","doi":"10.33393/gcnd.2020.2211","DOIUrl":"https://doi.org/10.33393/gcnd.2020.2211","url":null,"abstract":"Background: Nurses guarantee assistance using different nursing theories, which present different conceptual frameworks, but which have a common vision in the whole of the human being, his holistic needs and the connection with the environment. Florence Nightingale was the first to introduce aspects of the scientific method, structuring a theory focused on the connection between the management of the physical environment and the actions of nurses. Methods: The aim is the evaluation of Nightingale's theory in reference to its contemporary integration, through a narrative review of the literature. Results: The action of nurses on the environment according to Nightingale's theory in care settings and hand hygiene are identified as fundamental in the fight against the spread of infections and in the implementation of the holistic vision. Discussion: Nightingale's theory shows elements of applicability and modernity, such as the acquisition of a greater awareness of healthcare professionals in relation to the care of environments and hand hygiene. Conclusions: Florence Nightingale's theory presents aspects of validity, but further studies are needed to contribute to the evolution of her model, especially in its contemporary contextualization.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89909146","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}
Copia di questo articolo puo’ essere richiesta a: AIRP Associazione Italiana Rene PolicisticoVia Bazzini 2, 20131 Milano - ItaliaSegreteria.airp@renepolicistico.it
{"title":"Lettera del Presidente, Dicembre 2020","authors":"Luisa Sternfeld Pavia","doi":"10.33393/gcnd.2020.2217","DOIUrl":"https://doi.org/10.33393/gcnd.2020.2217","url":null,"abstract":"Copia di questo articolo puo’ essere richiesta a: \u0000AIRP Associazione Italiana Rene PolicisticoVia Bazzini 2, 20131 Milano - ItaliaSegreteria.airp@renepolicistico.it","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84297787","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}
The World Health Organization (WHO) defines therapeutic adherence as “the extent to which a patient’s behavior – in taking medications, following a diet and/or making lifestyle changes – corresponds to the recommendations of health professionals in charge”.Chronic disease is permanent and requires by the patient an active attitude to reach and maintain a state of well-being, and to be often subject to long periods of supervision, observation and care.Trust must therefore be established between patient and healthcare professionals.This is the reason why it is not correct to discuss compliance. The main difference is that therapeutic adherence requires the patient’s agreement with the prescriptions: patients should be an active partner in their own care and communication between the patient and healthcare professionals is required for an efficient clinical practice.
{"title":"Primary nursing: a Varese un Progetto sinergico tra infermieri e medici per aumentare l’adesione terapeutica dei pazienti nefropatici","authors":"Laura Bardelli, Stefania Bordiga, Roberta Foglia","doi":"10.33393/gcnd.2020.2200","DOIUrl":"https://doi.org/10.33393/gcnd.2020.2200","url":null,"abstract":"The World Health Organization (WHO) defines therapeutic adherence as “the extent to which a patient’s behavior – in taking medications, following a diet and/or making lifestyle changes – corresponds to the recommendations of health professionals in charge”.Chronic disease is permanent and requires by the patient an active attitude to reach and maintain a state of well-being, and to be often subject to long periods of supervision, observation and care.Trust must therefore be established between patient and healthcare professionals.This is the reason why it is not correct to discuss compliance. The main difference is that therapeutic adherence requires the patient’s agreement with the prescriptions: patients should be an active partner in their own care and communication between the patient and healthcare professionals is required for an efficient clinical practice.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86432399","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":"Riflessioni","authors":"M. Canzi","doi":"10.33393/gcnd.2020.2176","DOIUrl":"https://doi.org/10.33393/gcnd.2020.2176","url":null,"abstract":"(narrative nephrology)","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79853920","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}
Il documento della SIAARTI “Raccomandazioni di etica clinica per l’ammissione a trattamenti intensivi e per la loro sospensione” ha suscitato reazioni contrastanti. Sullo sfondo emergono le “decisioni tragiche” che i clinici possono essere chiamati a prendere: quali pazienti accettare e quali rifiutare nelle unità di rianimazione, che l’epidemia ha rivelato di misura inferiore alle necessità. In particolare siamo invitati a riflettere sul concetto di responsabilità nelle scelte. A fronte di un’accezione medico-legale si profila una responsabilità etica, che si traduce nell’esplicitazione dei criteri con cui si fanno le scelte e nell’assunzione del peso morale delle stesse. Lo scenario delle scelte tragiche conferma l’intuizione contenuta nella figura mitologica del “guaritore ferito”.
{"title":"La cura: una questione di merito?","authors":"S. Spinsanti","doi":"10.33393/gcnd.2020.2112","DOIUrl":"https://doi.org/10.33393/gcnd.2020.2112","url":null,"abstract":"Il documento della SIAARTI “Raccomandazioni di etica clinica per l’ammissione a trattamenti intensivi e per la loro sospensione” ha suscitato reazioni contrastanti. Sullo sfondo emergono le “decisioni tragiche” che i clinici possono essere chiamati a prendere: quali pazienti accettare e quali rifiutare nelle unità di rianimazione, che l’epidemia ha rivelato di misura inferiore alle necessità. In particolare siamo invitati a riflettere sul concetto di responsabilità nelle scelte. A fronte di un’accezione medico-legale si profila una responsabilità etica, che si traduce nell’esplicitazione dei criteri con cui si fanno le scelte e nell’assunzione del peso morale delle stesse. Lo scenario delle scelte tragiche conferma l’intuizione contenuta nella figura mitologica del “guaritore ferito”.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75165754","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}
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