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1.
《Journal of microbiology, immunology, and infection》2021,54(4):680-686
BackgroundVitamin D is essential in the host defense against tuberculosis (TB). Suboptimal vitamin D status is common in the hemodialysis population. Hemodialysis patients have an increased risk compared to the general population latent tuberculosis infection (LTBI). However, the association between vitamin D deficiency and LTBI in this population remains unclear.Materials and methodsWe conducted a cross-sectional study between March and May 2017. Interferon-gamma release assay (IGRA) through QuantiFERON-TB Gold In-Tube was used to assess LTBI. Plasma 25-hydroxycholecalciferol (25-OHD) levels were measured by Elecsys Vitamin D Total assay. Suboptimal vitamin D levels included vitamin D insufficiency 20–29 ng/mg and vitamin D deficiency <20 ng/mL. Predictors for LTBI were analyzed.ResultsA total of 287 participants were enrolled. The suboptimal vitamin D level was 31.4% (90/287), which including the vitamin D deficiency was 13.9% (40/287). A total of 49.1% (141/287) people received nutritional vitamin D supplementation. The prevalence of IGRA positivity in this study was 25.1% (72/287). There was no significant difference in vitamin D concentrations or the proportion of vitamin D supplementation among the IGRA-positive and IGRA-negative groups (p = 0.789 and 0.496, respectively). In multivariate analysis, age >65 years old (odds ratio (OR), 1.89; 95% CI, 1.08–3.31; p = 0.026) and TB history (OR, 3.51; 95% CI, 1.38–8.91; p = 0.008) were independent predictors of IGRA positivity.ConclusionThis is the first study to report that vitamin D deficiency was not associated with IGRA positivity in a hemodialysis population. Aging and TB history were both independent predictors for LTBI. 相似文献
2.
Claire Letournel François Babinet Bénédicte Allard Vincent Montecot 《Néphrologie & thérapeutique》2019,15(1):51-58
Objective
The “Centre Hospitalier Francois Dunan” is located on an isolated island and ensures patients care in hemodialysis thanks to telemedicine support. Many research studies have demonstrated the importance of hemodialysis fluids composition to reduce morbidity in patients on chronic hemodialysis. The aim of this study was to identify the risks inherent in the production of dialysis fluids in a particular context, in order to set up an improvement action plan to improve risk control on the production of dialysis fluids.Methods
The risk analysis was conducted with the FMECA methodology (Failure Mode, Effects and Criticality Analysis) by a multi professional work group. Three types of risk have been reviewed: technical risks that may impact the production of hemodialysis fluids, health risks linked with chemical composition and health risks due to microbiological contamination of hemodialysis fluids.Results
The work group, in close cooperation with the expert staff of the dialysis center providing telemedicine assistance, has developed an action plan in order to improve the control of the main risks brought to light by the risk analysis.Conclusion
The exhaustive analysis of the risks and their prioritisation have permitted to establish a relevant action plan in this improving quality of dialysis fluids approach. The risk control of dialysis fluids is necessary for the security of dialysis sessions for patients, even more when these sessions are realized by telemedicine in Saint-Pierre-et-Miquelon. 相似文献3.
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5.
目的探讨目标教学法在手术室护理教学中的应用效果。方法选取2017年10月-2018年10月期间80名手术室的实习护生,按照完全随机对照原则分组,对照组(n=40)采用传统带教法,观察组(n=40)采用目标教学法,分析技能操作考核成绩、护生对教学方式的满意度评分以及教师对学生表现的满意度评分。结果观察组技能操作考核成绩、护生对教学方式的满意度评分以及教师对学生表现的满意度评分高于对照组,差异有统计学意义(P<0.05)。结论在手术室护理教学中应用目标教学法效果较好,有助于护生将理论与实践更好地结合,进而有效提高实习质量以及护生的临床思维能力。 相似文献
6.
Tetsuo Shoji Yoshiki Nishizawa 《Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy》2006,10(Z1):S27-S33
Abstract: The risk of cardiovascular death is high in hemodialysis (HD) patients, and thickening, stiffening and calcification of the arterial wall have been shown as its predictive factors. Activated vitamin D preparations are used for the treatment of secondary hyperparathyroidism in HD patients, but as they increase serum phosphate and calcium concentrations, there is a concern that they promote vascular calcification and, consequently, exacerbate the outcomes. In this article, the effects of vitamin D therapy on survival, cardiac function, arteriosclerosis, immunity, and inflammation are evaluated by reviewing the literature. In HD patients, the risk of death (particularly cardiovascular death) is significantly lower in those treated than in those not treated with vitamin D. Moreover, activated vitamin D improves cardiac function and alleviates cardiac hypertrophy in HD patients. Experimental data in cultured macrophages, vascular smooth muscle cells, and vascular endothelial cells suggest that it has antiatherosclerotic effects. In vivo, the administration of vitamin D improves immune functions and normalizes inflammatory reactions. In HD patients, vascular calcification is related to the dose of calcium carbonate, but its relationship with the administration of vitamin D is not significant. These observations suggest that, contrary to the general concerns, activated vitamin D exerts favorable effects on the cardiovascular system in HD patients as long as it is used in appropriate clinical doses. 相似文献
7.
目的比较血管紧张素转换酶抑制剂(ACEI)、钙离子拮抗剂(CCB)和β-受体阻滞剂等抗高血压药对糖尿病肾病及高血压透析患者的血糖和代谢的影响。方法糖尿病肾病血液透析患者分别经福辛普利(Fosinopril)、维拉帕米(Verapamil)和普萘洛尔(Propranol01)治疗5个月后记录透析前后心率和血压改变,检测透析前空腹血糖、糖化血红蛋白(HbA1c)、果糖胺、胰岛素、胆固醇和甘油三脂等。结果Fosinopril、Verapamil对血糖及物质代谢无不良影响,Propranolol可引起血糖、果糖胺、HbA1c和甘油三脂升高及透析过程中低血压和心率减慢。结论Fosinopril、Verapamil和Propranolol均为控制糖尿病肾病透析患者轻、中度高血压的较可靠药物,且Fosinopril和Verapamil对糖尿病患者血糖和物质代谢无不良影响。 相似文献
8.
S. Horita T. Shinoda H. Yoshimoto M. Masuo Y. Miura 《Clinical and experimental nephrology》2002,6(1):71-74
We report a case of infectious endocarditis in a 77-year-old woman who was undergoing maintenance hemodialysis therapy, and
who was also having a prosthetic aortic valve replacement. The disease resulted from a local skin infection at the needle
puncture site of the arteriovenous fistula. Ampicillin-resistant Staphylococcus aureus was the causal organism. Surgical treatment could not be performed because of associated intracranial hemorrhage due to septic
embolism. In spite of intensive treatment with several antibiotics, a ventricular septal abscess just beneath the prosthetic
aortic valve progressed to form a ventricular septal fistula. The resultant intracardiac left-to-right shunt led to refractory
congestive heart failure. The patient finally died of heart failure. The formation of a ventricular septal fistula is considered
to be a rare and extraordinary complication of infectious endocarditis in a hemodialysis patient with aortic valve replacement.
Received: July 25, 2001 / Accepted: November 3, 2001 相似文献
9.
血液透析动脉穿刺术临床研究 总被引:1,自引:0,他引:1
目的:研究动脉穿刺技术,提高1次穿刺成功率。方法:将166例急、慢性肾功能衷竭接受血液透析的患者,随机分为观察组84例和对照组82例。观察组用新的穿刺方法,即先在动脉(桡动脉或足背动脉)搏动最明显或最清晰处按一印记,然后进针,对照组用传统的穿刺方法穿刺。比较两组所需时间、1次成功率、血流量、针眼处渗血、疼痛程度以及并发症。结果:两组穿刺所需时间、血流量、针眼处渗血,均有统计学意义(P<0.01)。结论:观察组用新的穿刺方法,能明显提高1次穿刺成功率,缩短穿刺时间,减轻患者痛苦,减少并发症发生。 相似文献
10.
目的 探讨纯氧和空气复苏对新生儿发育的影响,为新生儿复苏用氧选择提供依据.方法 对2005年1月-2007年1月在保定市妇幼保健院进行窒息复苏的30例患儿在24个月时进行随访,依据复苏用氧浓度分为纯氧复苏组(20例)和空气复苏组(10例),内容包括出生时胎龄、出生体重、身长、头围、阿氏评分(1 min,5 min)、心率(1 min,5 min)、随访时体重、身长、头围及运动发育标志(坐、爬、站、走时间).结果 出生时患儿身体数据差异无统计学意义,24个月随访,患儿身高、体重、头围及运动发育标志差异均无统计学意义(P>0.05).结论 空气复苏对新生儿窒息患者是安全有效的. 相似文献