The Italian Multicentric Study on the Prevalence of Vascular Calcifications and Vertebral Fractures in parathyroidectomised (PTX) Dialysis Patients (Cave PTX Study): Phase I Results

Lo studio CAVE PTX ha lo scopo di valutare la reale prevalenza della paratiroidectomia nei pazienti dializzati in Italia, verificare l’aderenza ai targets ematochimici proposti dalle linee guida internazionali K/DOQI e ricercare la presenza di fratture vertebrali e calcificazioni vascolari. Al momento attuale riportiamo i dati preliminari sulla prevalenza e le caratteristiche cliniche generali dei pazienti finora arruolati. Il nostro studio ha ricevuto contributi da 149 centri dialisi italiani, su un totale di 670, pari al 22%. La popolazione dialitica dalla quale sono stati ottenuti i casi di paratiroidectomia è risultata pari a 12515 pazienti;l’87,7% dei pazienti effettuava l’emodialisi mentre il 12,3% la dialisi peritoneale. Cinquecentoventotto, pari al 4,22%, avevano effettuato un intervento di paratiroidectomia (4,5%emodializzati, 1,9% in dialisi peritoneale;p300 pg/ml). I valori medi di PTH e calcemia sono risultati significativamente diversi (più alti) tra casi e controlli nei due gruppi con PTH basso (PTX = 40±39 vs controllo = 92±42 pg/ml; p300) in 19 vs 38%. Ca, P and PTH values in the three K/DOQI PTH range groups are in table 2. Prescribed drugs, respectively in PTX and C, were: Vitamin D (61 vs 64%); Phosphate binders (88 vs 75%) and Calcimimetic (13 and 35%). Notably, Calcitriol and Ca based binders in PTX, and Paricalcitol and Sevelamer in C, were the most frequently prescribed drugs. PTX has a low prevalence in Italy, and mainly involves relatively young, females and long-term haemodialysis patients. In these patients PTH values are mostly low and therapeutic choices are accordingly different. Different hard outcomes can be hypothesize

Indagine epidemiologica relativa alla prevenzione e terapia delle alterazioni del metabolismo calcio-fosforo nel paziente uremico in trattamento emodialitico in Toscana

Abstract non disponibil

Machine Learning in Hypertension Detection: A Study on World Hypertension Day Data.

Many modifiable and non-modifiable risk factors have been associated with hypertension. However, current screening programs are still failing in identifying individuals at higher risk of hypertension. Given the major impact of high blood pressure on cardiovascular events and mortality, there is an urgent need to find new strategies to improve hypertension detection. We aimed to explore whether a machine learning (ML) algorithm can help identifying individuals predictors of hypertension. We analysed the data set generated by the questionnaires administered during the World Hypertension Day from 2015 to 2019. A total of 20206 individuals have been included for analysis. We tested five ML algorithms, exploiting different balancing techniques. Moreover, we computed the performance of the medical protocol currently adopted in the screening programs. Results show that a gain of sensitivity reflects in a loss of specificity, bringing to a scenario where there is not an algorithm and a configuration which properly outperforms against the others. However, Random Forest provides interesting performances (0.818 sensitivity - 0.629 specificity) compared with medical protocols (0.906 sensitivity - 0.230 specificity). Detection of hypertension at a population level still remains challenging and a machine learning approach could help in making screening programs more precise and cost effective, when based on accurate data collection. More studies are needed to identify new features to be acquired and to further improve the performances of ML models

Gestione e Prevenzione delle ferite da taglio e da punta in studenti di area sanitaria della Scuola di Scienze Mediche e Farmaceutiche dell\u2019Universit\ue0 degli Studi di Genova

Management and prevention of sharps and needlestick injuries in nursing students. Aim:Investigate the knowledge, the personal perception of risk and describe the epidemiology of sharps and needlestick injuries in nursing students during clinical placements developing a validated questionnaire. Design: a cross-sectional observational study. Methods: a self-administered questionnaire consisting of three sections (demographic data; injury epidemiology; and predictive factors of sharps and needlestick injuries) was developed. Data were collected between July 2018 - January 2019 from nursing students during their clinical placements. Content validity was assessed by a panel of experts, who scored each item on a 4-point Likert scale. This study followed the STROBE guidelines. Results: Of the 238 participants, 39% had been injured at least once with a sharp or a needle, of which 67.3% in the second year. A higher perception of \u2018Personal exposure\u2019 (4.06, SD 3.78) was reported by third-year students, whereas higher scores for \u2018Perceived benefits\u2019 of implementing preventive behaviours (13.63, SD 1.46) were reported by second-year students. Conclusion Our findings on the prevalence of sharps and needlestick injuries were in line with the literature. The questionnaire effectively investigated the epidemiology of occupational needlestick and sharps injuries, and knowledge and risk perception in nursing students

L'importanza del vaccino anti Covid-19 nei pazienti affetti da malattia del rene policistico autosomico dominante dell'adulto (ADPKD)

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

Strategie ed efficacia della medicina narrativa nei pazienti nefrologici: una revisione della letteratura. Parte 2

Abstract non disponibil

ICT in Sanità: vecchi problemi e nuove sfide

Abstract non disponibile (Clinical_Management