Profile of deglutition speech evaluation in an intensive care unit

The combination of an increase in long-term survival and the availability of a relatively sensitive parathyroid hormone (PTH) assay has led to an increasing incidence of hyperparathyroidism (HPT) diagnosis in patients on regular dialysis treatment (RDT). Hitherto the diagnosis has been based on biochemical data and clinical grounds, as parathyroid (PT) imaging is limited in accuracy, reproducibility, safety and invasiveness [1, 2]. Today, 201TI and 99mTc subtraction imaging (sq, high resolution ultrasonography (US) and up-to-date computed tomography (CT) have been proposed as sensitive and specific tests for primary HPT imaging [4-7]. The aim of the present study was to assess on a group of patients on RDT the accuracy of these methods in relation to the degree of HP

Consumato dal fuoco. Il cinema di Guy Debord

Uno dei maggiori protagonisti del Novecento, membro fondatore dell\u2019Internazionale Situazionista, Guy Debord non fu solo un saggista, un pensatore e uno stratega dei movimenti sociali, ma anche un cineasta di folgorante originalit\ue0. I suoi sette film, realizzati in un arco di tempo compreso tra il 1952 e il 1994, sono un\u2019illuminante traduzione in immagini della sua produzione teorica, ancora oggi di intramontabile attualit\ue0. Questo volume raccoglie una serie di contributi dedicati all\u2019analisi di questa parte tuttora poco nota dell\u2019opera di Debord, nel tentativo di offrire alcuni strumenti critici utile a penetrare la struttura cristallina che informa tutto il suo cinema, dall'opera prima Hurlements en faveur de Sade (1952, appartenente al periodo della militanza lettrista), a La Soci\ue9t\ue9 du spectacle (1973, trasposizione in immagini dell\u2019omonimo testo del 1967), al magnifico, letteralmente vertiginoso In girum imus nocte et consumimur igni (1978)

Vascular access for haemodialysis: from surgical procedure to an integrated therapeutic approach.

During the past 10 years the type of vascular access for haemodialysis procedures have changed markedly in our centre: more elbow AV fistulae and more central venous catheters are now used. Nevertheless, early referral to nephrologists and availability of central venous catheters and peritoneal dialysis allow elderly people to be admitted for dialysis treatment. Since vascular access for haemodialysis plays a key role in patient well-being, it is mandatory to apply quality assurance criteria to vascular access for haemodialysis surgery. Based on the results of a national survey, in Italy this policy is still in its early stages: monitoring of vascular access differs amongst centres, interventional radiology is used in a differing way, planning of vascular access for haemodialysis in pre-dialysis patients often remains an unsolved problem. According to our initial experience, we propose the use and validation of a quality-index [(minimum success rate) in elective vascular access for haemodialysis surgery], allowing accreditation of a department and a single surgeon for access management. Prevalence of central venous catheters at first dialysis of chronic renal failure patients is also proposed to evaluate the efficiency in access planning. Better knowledge of vascular access management by different teams could eventually lead to definition of guidelines for this 'Cinderella of dialysis'

Evaluation of dialysis access care by means of process quality indicators

Improvement of dialysis access management depends on technical skill but also on effective choice, construction, monitoring and revision of the access. Surgical procedure is only one step of a complex course, beginning with the referral of patients to nephrologists. Using two process quality indicators, we describe the evolution of access management at our centre, where access surgery and access-related activities are performed by nephrologist. The first process indicator is based on the prevalence of temporary access at first dialysis (TA1st) in end stage renal disease ESRD patients, the second one measures the prevalence of permanent central venous catheters (%CVC) in dialysis population. TA1st increased to 27.1% in 1999, more than twofold compared to the previous year. There was also an increase in %CVC from 20.6 to 26.3%. Native access remained the most utilised, well above 70% of dialysis patients. Our process monitoring suggests a rapid worsening of late referral, as indicated by the increasing use of temporary catheters at the beginning of chronic dialysis. Increasing surgical activity and diagnostic procedures were only partly effective in containing the rise in CVC. Venous sparing, early referral, Continuous Quality Improvement and a multiprofessional access-team co-ordinated by a nephrologist could be the key-elements in facing the never-ending-story of dialysis vascular access

Sviluppo comportamentale dell'ex prematuro

In this work author investigate ex-premature neurological development characteristics in the first childhooh and expose the results of a longitudinal search that estimate the development of the following behavioral characterisitics: vigilance and interactive ability, irritability and tears, consolability and spleeping organisation an their influence on affective and relational development.Authors conclude stressing on imporrtance to give parents all informations about these developmental charactgerisitcs to aid comunication between parents and childre

Granulocytopoiesis in chronic uremia patients undergoing periodic hemodialysis (granulocyte kinetics studied with Se75-seleniomethionine)

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