1,721,082 research outputs found
L’imposta comunale sugli immobili e il federalismo municipale. Analisi degli aspetti sperequativi presenti e futuri.
No full textPatients' wishes, pregnancy and vascular access: When one size does not fit all
Full text linkPregnancy in dialysis patients is a rare but important event that challenges our knowledge and demands re-thinking many aspects of our practice, including vascular access. This editorial briefly discusses some open questions on vascular access in this situation that challenge the motto ‘fistula first’ and underline the need for personalised approaches. Information on vascular access in pregnant women is scant. Different approaches may be considered between women on dialysis already on a well-functioning tunnelled catheter and newly placed catheters: while a tunnelled catheter in a woman already stabilised on outpatient dialysis, who has shown being able to take correct care of it and who has freely chosen this option, is a reasonable choice, central venous catheters placed during pregnancy, especially in the hospital setting, may have a high risk of complications. Conversely, pregnancy may increase the risk of development of fistula aneurysms, but the frequency of this complication is still unknown. The problem of whether or not shifting pregnant patients on peritoneal dialysis to daily haemodialysis sessions is still open, as well as the role of patients’ preference for avoidance of an invasive procedure, or refuse of pain. In the wait for answers, reflecting on the problems encountered by pregnant women on dialysis should make us reflect on how to improve vascular access management for all our patients
News on Peritoneal Dialysis = Novità in tema di dialisi peritoneale
No full textTra le novità in tema di Dialisi Peritoneale di particolare rilevanza sono le linee guida sulla prevenzione e trattamento delle peritoniti pubblicate nel marzo 2022 dalla Società Internazionale di Dialisi Peritoneale (ISPD). La ISPD aggiorna periodicamente tali Linee Guida, il precedente update risaliva al 2016. La peritonite, la cui incidenza è sicuramente diminuita, rimane tuttavia una spina nel fianco della DP perché costituisce ancora una importante causa di morbilità, mortalità e di drop-out dalla metodica. Le linee guida ISPD 2022 aggiornano le precedenti raccomandazioni e ne introducono delle nuove. Queste raccomandazioni sono basate sull’evidenza laddove l’evidenza è disponibile
Kidney Diseases and Pregnancy: A Multidisciplinary Approach for Improving Care by Involving Nephrology, Obstetrics, Neonatology, Urology, Diabetology, Bioethics, and Internal Medicine
Full text linkThis multidisciplinary series is aimed at offering readers many opportunities to appreciate how a clinical and ethical approach to pregnancy has changed in patients with kidney diseases and with related conditions, including diabetes, hypertension, and immunologic diseases. Furthermore, this series aims to focus on the fact that many issues remain unreslved, that there are enormous gaps in knowledge, and that the bioethical approach needs to integrated in the clinical
practice, which would allow for a deeper appreciation of different cultural and religious backgrounds. Much still needs to be done to allow women suffering from all stages of chronic kidney disease (CKD) and those with predisposed conditions, so that they may experience safe pregnancies, starting from an increased awareness of the importance of CKD, even in its early stages, to the detection of risk factors. Women who have experienced preeclampsia or acute kidney injury in pregnancy need to have follow-up checks. The role of urinary infections, kidney stones, and urinary malformations
is not fully acknowledged, nor have univocal control schedules and treatment schemas yet been defined for the different kidney diseases. In this regard, the fight for equitable treatment for all women with acute or chronic kidney disease in pregnancy and for the widespread prevention of adverse pregnancy-related and long-term outcomes is ultimately a battle for equitable healthcare
Pregnancy and kidney disease: from medicine based on exceptions to exceptional medicine
No full textThe Webster dictionary defines exception as an anomaly, a person or thing that does not follow a rule, while the adjective exceptional has a different nuance, and means “above average”. These two words may describe how obstetric nephrology has shifted from the description of very rare cases, to the development of a complex new and fascinating branch of medicine, that counterbalances obstetricians’ usually optimistic outlook by focusing on subtle challenges posed by chronic diseases, and mitigate the frequently grim approach of nephrologists, with a message of hope: women with kidney disease can have the same basic life goals as healthy women their age. Although studies relating to kidney disease in pregnancy are being published more frequently, not all questions have been considered or answered, and clinicians are often challenged by a lack of detailed information and practical guidelines. Thus in this complex, difficult, but also fascinating and evolving panorama, the Journal of Nephrology is publishing a issue dedicated to obstetric nephrology, in an attempt to contribute to the development of this field, with the specific aim of offering practical insights and critical contributions capable of helping clinicians in the management of these “exceptional exceptions”
The local property taxes and municipal federalism. Current and future inequity condition of Italian Property Taxation
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Un ciclo chiuso = A closed cycle
No full textA young girl was admitted to the Renal Unit of our Hospital because of loin pain and mild renal failure with bilateral hydronephrosis. The abdomen ultrasound was very helpful to get the right diagnosis
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