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Biomedical subjects

G Triolo

Publications and source records attributed to G Triolo.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

[Census 2004 of the Italian Renal and Dialysis Units--Piemonte, Liguria and Valle d'Aosta].

The Italian Society of Nephrology (SIN) promoted a national survey in order to obtain detailed information from all Renal and/or Dialysis Units using the on-line questionnaire (158 items) regarding structural and technological resources, medical workforce organisation and activity features. The purposes of this initiative were to obtain regional benchmarks as references for renal units and to describe the current Italian renal network in order to plan further interventions for the next 5 years. In this paper data of the first three Italian Regions (Piemonte, Liguria and Valle d'Aosta) which completed the survey (100% of the units) are reported. Main findings in the 3 Regions. A) Epidemiology: prevalence of dialysis patients = 709, 720, 787 pmp (per million population); prevalence of transplanted patients = 325, 387, 279 pmp; incidence of dialysis patients = 166, 191, 156 pmp; gross mortality of dialysis patients = 13.7, 15.0, 13.0%; distribution of vascular access in prevalent dialysis patients: arteriovenous fistula = 74, 83, 76%, central venous catheter = 18, 12, 15%, vascular graft = 8, 5, 9%. B) Structural resources: hospital's number of beds = 49, 72, 49 pmp, dialysis places = 166, 158, 164 pmp. C) Personnel resources: renal physicians = 44, 47, 41 pmp, renal nurses = 186, 194, 205 pmp; each renal physician takes care of 16, 15, 19 dialysis patients and each renal nurse cares for 3.8, 3.7, 3.8 dialysis patients. D) Activity: admission to hospital = 1507, 2392, 1606 pmp, renal biopsies = 109, 133, 57 pmp. Despite discrepancies in population density in the three Regions, most indexes are surprisingly similar and show the satisfactory level of renal care attained in the Northwestern Italian area. Further improvements in health care management can be predicted as a consequence of a direct comparison between needs and results in the various Regions of the Country.

Censuses↗
PubMedDate not supplied

[Update of the Italian Society of Nephrology Project No. 1 of the 2004-2006 SIN programme].

In the last few years the Italian Society of Nephrology has addressed many technical-scientific and management aspects to better patient satisfaction. Project No. 1 of the 2004-2006 programme on 'Quality and Accreditation of National Renal Units' focuses on four essential points. The first is the questionnaire mailed to all the Presidents and Regional Delegates on the relationship between Nephrology units, Local Government Health-System and the Regional Healthcare Agency. The results evidence that the 'political' decision-making power of nephrologists decreases in the absence of a national strategy. The second point, in collaboration with the National Census Group, includes the quality analysis and the standardization of resources (human and structural) and management of the Renal Units. The third point is based on 'Educational Courses for Quality and Accreditation' held in Rome (3-5 October 2005: L'Accreditamento all'Eccellenza dell'Unita' Operativa di Nefrologia, Dialisi e Trapianto; 17-19 October 2005: Il Manuale di Accreditamento della Specialità di Nefrologia). The courses aim at training members responsible for each region to hold courses in their specific region to create a network including each single Renal Unit to create an acceptable homogenous language on the models of analysis and on the correct use of 'The Guide for Excellence Accreditation'. The fourth point concerns both the on-line Guide for Excellence Accreditation and 'Peer Review Accreditation' and the NEQUASY (Nephrology Quality System) project. The manual must be 'user friendly' allowing each Centre to self-evaluate using national and regional standards.

Accreditation↗
PubMedDate not supplied

[The Italian Society of Nephrology Guidelines (3rd Edition): principles and methods].

Scientific Societies at both a local and international level are making big effort to prepare their clinical practice guidelines. The Italian Society of Nephrology has already published in two previous editions a series of guidelines relating to various aspects of management and diagnosis of different renal diseases. In this review we present the criteria of the 3(rd) edition of the Italian Society of Nephrology guidelines. This 3(rd) edition of guidelines will be based on the availability of scientific evidence in different areas of nephrology, dialysis and transplantation. Ten key intervention questions have been identified, based on the availability of systematic reviews of randomized trials or individual randomized address them. Systematic reviews and randomized trials are the optimal study design to address intervention questions. These have been summarized based upon rigid methodological criteria and strictly reflect the evidence basis. The different phases of development and publication of the 3(rd) edition of the Italian Society of Nephrology guidelines are presented.

Italy↗
PubMedDate not supplied

[Substitutive therapies in sepsis and acute renale failure].

Substitutive treatment of sepsis associated acute renal failure is an emergent challenge in the intensive care unit due to the number of cases and to the high mortality rate. Standard hemofiltration is unable to improve survival, since a high mortality rate is sustained by the septic process. New therapeutic approaches currently available are based on the increased clearance of molecules ranging 10-30 kDa considered important in the physiopathology of sepsis and multiorgan failure. Clinical experiences in progress are: (1) adsorption resins able to bind bacterial products, cytokines, anaphylotoxins and several inflammation mediators; (2) the bioartificial kidney, that is the addition to hemofilter of human tubular cell culture grown in devices in order to mimic metabolic tubular function to a traditional hemofilter; (3) increased exchange volumes (high volume hemofiltration), up to 0-100 L/24 hr and; (4) increased membrane permeability associated with either discarded ultrafiltrate (high cut-off membranes) or plasma substitution plasmapheresis with regeneration by sorbents technology (C FA). Generally, by applying these new technologies to septic shock patients, the observed survival was higher than that predicted by the gravity score. While these results are encouraging, they are not conclusive and need further study.

Acute Kidney Injury↗
PubMedDate not supplied

[Role of nutritional support and physical exercise in the dyslipidemia of renal transplantation].

The purpose of the study is to evaluate the effect of diet and physical exercise on the dyslipemia of renal transplant (RT) patients 52 pts, transplanted between 12/85 and 4/87, subdivided into 2 groups (A and B), were studied. Characteristics of the diet adopted in patients in group A are: low carbohydrates, moderate animal protein, unsaturated and polyunsaturated fat in high rate. The second group had a lower animal protein and more fiber rich diet than the first one and a program of PE. By comparing A and B1 we noticed and increase in body weight, more slight in the group B, at the 24 months (56 +/- 8 59 +/- 10 vs 59 +/- 10 61 +/- 10). The study of lipid behaviour has showed a trend to normalization of triglycerides at 24 months in A (189 +/- 88 106 +/- 33) and in B1 (173 +/- 81 103 +/- 40), more evident normalization of cholesterol in group B1 (195 +/- 72 185 +/- 42), and increase of CT-HDL in A (42 +/- 12 63 +/- 17) and in B1 (44 +/- 10 61 +/- 14, p less than 0.05). It should be noted that CT-LDL increase in A (100 +/- 34 131 +/- 40) but not in B1 (103 +/- 35 111 +/- 33). With the aim of this program we obtained a positive effect on DL with a slight increase in body weight, a significant increase in CT-HDL without variation of total CT and CT-LDL levels.

Adult↗
PubMedDate not supplied

[Velocity of nerve conduction in children and adolescents with type I diabetes mellitus: clinical, metabolic and immunologic correlations].

Clinical, metabolic, neurophysiologic and immunological data were obtained in a group of 50 patients with type I diabetes mellitus Results were compared with those obtained in 30 healthy subjects of comparable age. M.N.C. (median nerve conduction) velocities and sensitive latency were observed to be significant lower in the diabetic patients rather than in the controls. These abnormalities were correlated with the duration of diabetes rather than with the glucose control. The positivity for circulating immune complexes was found to be associated with a significant reduction of median sensory nerve conduction velocity. There results suggest that in addition to metabolic, genetic, vascular and hormonal abnormalities also immunologic factors may play a role in the pathogenesis of diabetic neuropathy.

Adolescent↗
PubMedDate not supplied

[Glycosylated hemoglobins and erythrocyte 2,3-diphosphoglycerate in diabetes mellitus].

Investigations carried out on 43 diabetic not ketoacidotic patients (32 women and 11 men) showed that the percentage of glycosylated hemoglobins (GHb) is significantly (p less than 0.01) inversely related to the intra-erythrocytic concentration of 2,3-DPG and to the calculated P50. Preliminary data from a prospective study suggest that the inverse relationship could be referred to the degree of control of the disease. In poorly controlled diabetes, where at the highest percentages of GHb the lowest levels of 2,3-DPG are found, less oxigen can be delivered to peripheral tissues.

2,3-Diphosphoglycerate↗
PubMedDate not supplied

[Hemorheological factors and metabolic parameters in a group of diabetic subjects].

Blood viscosity factors and some metabolic parameters were estimated in thirty-eight insulin-treated diabetics. The evaluation was carried out on admission and after eight weeks of controlled therapy. From this study it follows that blood viscosity factors do not permit us to distinguish, at these two stages, diabetics with complications from diabetics without while there is this possibility at the initial observation in diabetics subdivided for sex. Furthermore there are no significant variations, except for the haematocrit, of the average of blood viscosity factors and metabolic parameters at the initial and final observation. Very interesting is the negative relation between the Vrbc, parameter which studies the erythrocyte deformability, and the red cell 2,3-diphosphoglycerate (2,3-DPG) that seems more evident in diabetics with complications. Contrary to what has been reported in literature no relation between Vrbc and glycosylated haemoglobin (GHb) is present.

Adolescent↗