bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of preputial cytology in diagnosing oestrogen producing testicular tumours in dogs
Authors: Dreimanis U. , Vargmar K. , Falk T. , Cigut M. , Toresson L.
Published: August 2012

Objectives

The purpose of this study was to evaluate the diagnostic sensitivity and specificity of preputial cytology in oestrogen producing testicular tumours in dogs.

Methods

Forty‐five dogs with palpable testicular masses and 30 healthy control dogs were included. Dogs were evaluated for signs of alopecia and/or feminisation. Analyses of preputial cytology, haematology and serum oestradiol were performed. Dogs with testicular masses were neutered and the testes were submitted for histopathological examination.

The dogs were divided into three groups (1) control dogs (n=30), (2) dogs with a testicular mass and serum oestradiol concentration <40 pmol/L (n=35), (3) dogs with a testicular mass and serum oestradiol concentration >40 pmol/L (n=10).

Results

More than 20% superficial cells in preputial smear was significantly associated with serum oestradiol concentration >40 pmol/L (P<0·001). The number of superficial cells was significantly increased (P<0·001) in preputial smears from dogs with alopecia.

Clinical Significance

It appears that the preputial cytology has a high sensitivity and specificity for the diagnosis of oestrogen producing testicular tumours in dogs.
Centronuclear myopathy in a Border collie dog
Authors: Eminaga S. , Cherubini G. B. , Shelton G. D.
Published: August 2012

A two‐year old, male entire Border collie was presented with a one‐year history of exercise‐induced collapsing on the pelvic limbs. Physical examination revealed generalised muscle atrophy. Neurological examination supported a generalised neuromuscular disorder. Electromyography revealed spontaneous electrical activity in almost all muscles. Unfixed and formaldehyde‐fixed biopsy samples were collected from the triceps brachii, longissimus and vastus lateralis muscles. Histopathological, histochemical and ultrastructural examinations of biopsy specimens were consistent with either centronuclear or myotubular myopathy. The dog clinically improved with supportive treatment with L‐carnitine, co‐enzyme Q10 and vitamin B compound. To the authors’ knowledge, this is the first report of centronuclear/myotubular myopathy in a Border collie.
Cervicothoracic syringohydromyelia associated with a prosencephalic mass in a dog
Authors: Szabo D. , Saveraid T. C. , Rodenas S.
Published: August 2012

A five‐year‐old, female, neutered boxer, with neuroanatomical signs consistent with a C1‐C5 myelopathy, was diagnosed with a prosencephalic mass and associated severe cervicothoracic syringohydromyelia. After treatment with corticosteroids and lomustine, neurological examination was normal. Imaging repeated three months later showed significant reduction in both the size of the mass and the syringohydromyelia. To the authors’ knowledge, this is the first reported case of a dog with syringohydromyelia secondary to a rostral brain mass that had clinical signs on presentation solely due to the syrinx, and the first reported case in a dog of partial resolution of syringohydromyelia after treatment solely with chemotherapy.
The Influence of Ovarian Fluid pH of Stripped Unfertilized Channel Catfish, Ictalurus punctatus, Eggs on the Hatching Success of Channel Catfish ♀ x Blue Catfish, Ictalurus furcatus♂, Hybrid Catfish Eggs
Authors: Chatakondi Nagaraj G. , Torrans Eugene L.
Published: August 2012

This study was designed to determine the effect of ovarian fluid pH of stripped unfertilized channel catfish, Ictalurus punctatus, eggs on fertilization and hatch rate of channel catfish ♀ x blue catfish, Ictalurus furcatus♂, hybrid catfish eggs. A significant correlation was established between ovarian fluid pH of stripped channel catfish eggs and hybrid embryo hatch rate (R2 = 0.75, P = 0.01), suggesting ovarian fluid pH of stripped catfish eggs prior to fertilization can be predictive of the hatching success of hybrid catfish embryos. These data were used to categorize pH of stripped eggs: pH <7.0 as “low pH eggs,” pH 7.0–7.4 as “medium pH eggs,” or pH >7.4 as “high pH eggs” quality eggs. The range in percent hatch rate for these pH categories was <15%, 15–30%, and >30%, respectively. Higher calcium concentrations during incubation do not appear to improve hatching success of “low pH eggs.” The predictive model presented herein describes a quick method for evaluating stripped catfish eggs for hybrid fry production in catfish hatcheries.
Seasonal Fouling Stress on the Farmed Pearl Oyster, Pinctada fucata, from Southeastern Arabian Sea
Authors: Kripa Vasant , Mohamed Kolliyil S. , Velayudhan Tharammal S.
Published: August 2012

Biofouling on the periostracum of pearl oysters and on the cages has been considered as a stress factor causing mortality of the farmed stock, reducing growth rates and also affecting pearl quality. In farming experiments using the pearl oyster, Pinctada fucata, at Kollam Bay (India), biofouling was found to be a problem. This study was conducted to understand the effect of fouling on the mortality of pearl oysters kept in suspended culture, to identify the main foulers, the seasonal variation in biofouling and species successions in the community with reference to abiotic factors. The average monthly mortality rate (MR) was estimated as 0.117 ± 0.002 and the monthly variations were significantly different (P < 0.01). The total fouling (0.163 ± 0.002 g/g oyster) and biofouling weights (0.166 ± 0.007 g/g oyster) were high in December when the fouling community was composed of several species and dominated by the ascidian, Didemnum sp. December was also the period when the MRs peaked indicating that this organism was the main cause of mortality in pearl farms in Kollam Bay. A clear seasonality in the fouling community (25 species belonging to nine phyla) has been observed in the present study. On the basis of this study, monthly cleaning of oysters is advocated except during December, January, and March when the cleaning should be fortnightly.
Survival of Listeria monocytogenes, Escherichia coli O157:H7, and Salmonella spp. on Catfish Fillets Exposed to Microwave Heating in a Continuous Mode
Authors: Sheen Shiowshuh , Huang Lihan , Sommers Christopher
Published: August 2012

Abstract:  Microwave (MW) heating using continuous power output with feedback control and a modified ingredient formulation may provide better and consistent cooking of foods. Currently, household units with build‐in inverter power supply units are available. These new generation MW ovens provide continuous, adjustable output and cooking, in contrast to the traditional rectifier‐based ovens that rely on the on–off mechanism for control. This study attempted to apply a feedback power control (termed as modified or “smart” MW oven) and phosphate treatment to further improve heating uniformity and enhance food quality and safety. Listeria monocytogenes (Lm, 4‐strain cocktail), Escherichia coli O157:H7 (Ec, 5‐strain cocktail), and Salmonella spp. (Sal, 6‐strain cocktail), surface inoculated onto catfish fillets (75 × 100 × 15 mm; weight 110 g), were heated using the modified MW oven to study the inactivation of the pathogens. The sensitivity of these 3 bacteria to MW heating was in the order of Ec (most), Lm, and Sal (least). Greater than 4 to 5 log CFU reductions of Ec, Lm, or Sal counts on catfish fillet surfaces were inactivated within 2 min of 1250 W MW heating, where the fillet surface temperature increased from 10 to 20 °C to 80 to 90 °C. MW heating caused degradation of catfish fillet texture, which was noticeable as early as 10 to 15 s after the heating started, as evidenced by bumping sounds. Bumping can be significantly reduced by soaking fillets in phosphate solution. However, the results may need verification if applied in different MW ovens and/or with foods positioned away the geometric oven center. This study successfully demonstrated the feasibility of applying MW energy to eliminate foodborne pathogens on fish fillets.

Practical Application:  The results demonstrated in this report with the “smart” microwave oven design may enhance microwaveable food safety and quality, and therefore promote the microwaveable food business.
The Invisible Link: Using State Space Representations to Investigate the Connection Between Variables and Their Referents
Authors: Pollack Courtney
Published: August 2012

The ability to represent numerical quantities in symbolic form is a necessary foundation for mathematical competence. Variables are particularly important symbolic representations for learning algebra and succeeding in higher mathematics, but the mechanisms of how students link a variable to what it represents are not well understood. Research using cognitive neuroscience methods may be able to shed light on this process by building on related work involving number symbols. Utilizing state space representations, this article presents a first effort to consider what might constitute educationally relevant stimuli for future research on student understanding of the concept of variable. Might algebra problems elicit a symbolization process that can be captured using cognitive neuroscience methods? Results suggest it depends on the role of the variable in a given problem and the structure of that problem. Suggestions for potential research avenues are also discussed.
Identification of a novel Baeyer‐Villiger monooxygenase from Acinetobacter radioresistens: close relationship to the Mycobacterium tuberculosis prodrug activator EtaA
Authors: Minerdi Daniela , Zgrablic Ivan , Sadeghi Sheila J. , Gilardi Gianfranco
Published: August 2012

This work demonstrates that Acinetobacter radioresistens strain S13 during the growth on medium supplemented with long‐chain alkanes as the sole energy source expresses almA gene coding for a Baeyer‐Villiger monooxygenase (BVMO) involved in alkanes subterminal oxidation. Phylogenetic analysis placed the sequence of this novel BVMO in the same clade of the prodrug activator ethionamide monooxygenase (EtaA) and it bears only a distant relation to the other known class I BVMO proteins. In silico analysis of the 3D model of the S13 BVMO generated by homology modelling also supports the similarities with EtaA by binding ethionamide to the active site. In vitro experiments carried out with the purified enzyme confirm that this novel BVMO is indeed capable of typical Baeyer‐Villiger reactions as well as oxidation of the prodrug ethionamide.
Critical Patriotism: Incorporating Nationality into MFT Education and Training
Authors: Platt Jason J. , Laszloffy Tracey A.
Published: August 2012

Topics such as national identity, patriotism, nationalism, and international issues often lead to polarization within the United States and as a result, critical dialogue about these complex topics often does not occur in a meaningful way. The lack of critical inquiry and interaction about these topics is manifest at the macro and the micro level, including within the context of marriage and family therapy training and practice. While the field of MFT has devoted greater attention to addressing issues of diversity in recent years, limited attention has been focused on examining nationality and nationalism. This article presents a critical patriotism framework that training programs can use to examine nationality and expand awareness of international issues and perspectives. Special attention is focused on examining how nationalism, a problematic extreme version of patriotism, infiltrates MFT training and practice. Recommendations are provided for how training programs can focus on nationality, expand awareness of international issues and perspectives, and guide trainees in exploring how their national identity, beliefs about patriotism, and nationalistic attitudes may influence their clinical work.
Peritoneal membrane transport for low molecular weight substances with the use of one bag dialysate collection
Authors: Ikonomou M. , Katopodis K. , Nousia P. , Tzalavra E. , Koliousi E. , Tsaliou B. , Katsaraki A. , Betsiou V. , Dimitriou A. , Theodorou J. , Siamopoulos K.C.
Published: July 2012

The 24‐hour collection of dialysate provides an accurate method for evaluation of both adequacy of dialysis and peritoneal membrane transport characteristics in patients on chronic ambulatory peritoneal dialysis. However, this test requires 24 hours to complete and therefore it is inconvenient for both patients and nurses in the every day practice. We determined the peritoneal membrane transport characteristics for low molecular weight substances of ten patients by using the dialysate collection of only one bag. Dialysate/plasma creatinine ratios were calculated for each of the 4 bags (DATT1, DATT2, DATT3, DATT4) as well as for the 24 hour dialysate (DATT0). We found a very good correlation between DATT0 and the four DATTs. We therefore propose that the evaluation of the peritoneal membrane transport, at least for creatinine could be determined with the use of one bag dialysate collection.
Comparative evaluation of CAPD and PD‐plus effectiveness
Authors: Iles‐Smith H. , Curwell J. , Gokal R.
Published: July 2012

Decline in residual renal function in CAPD patients often leads to reduced overall solute clearances. Inadequate dialysis has been linked to malnutrition and increased morbidity and mortality rates. Achieving dialysis adequacy targets is often difficult by the conventional method of increasing CAPD exchange volumes. In comparison, substantial increases in solute clearances can be achieved with the use of automated peritoneal dialysis with large fill volumes and an extra daytime exchange.
The utilisation of shared governance to improve vascular access catheter care
Authors: Gilding C. , Goodeve J. , Metcalf S. , Smith S. , Anderson D. , Natali J. , Warwick H. , Kay J. , Carr S.
Published: July 2012

This article looks at the implementation of shared governance at directorate level and its role in improving vascular access catheter care.
Another choice for the blind
Authors: Bareham F.
Published: July 2012

Automated Peritoneal Dialysis has proved to be an effective treatment for many patients. This presentation outlines the training issues and management of a 48‐year‐old registered blind, insulin dependent diabetic, who developed renal failure.
How total correction of renal anaemia effects patients
Authors: Preuss R. , Säglitz C. , Beschorner K.
Published: July 2012

Quality of life for patients on dialysis is markedly impaired due to renal anaemia. Substitution of rh Erythropoietin allows compensation and total correction of anaemia. At present, international guidelines propose a correction of haemoglobin to values of 10–12 g/dl, and international studies have demonstrated an improvement in quality of life when haemoglobin values are increased to 12g/dl. A survey completed in our unit showed, that increasing haemoglobin values even further to 12–14 g/dl resulted in a further improvement of quality of life. The internationally discussed side effects of this complete correction of anaemia were not observed in the patients we studied.
The biographical approach in Renal Care
Authors: Howlett Cherryl
Published: July 2012

This paper explores the value of the biographical approach and indicates its relevance for health care intervention in relation to renal nursing. As care and technology in Renal Services has become more refined, effective and safe the service is now offered to many elderly people who would not have necessarily received treatment in the past. Nursing staff work in a highly technological environment following critical care pathways but with little emphasis on the specific needs of elderly patients. In the past much literature concerning elderly care has concentrated on the negative aspects of old age and authors advocating the biographical approach highlight this. A biographical approach is a broad idea encompassing different perspectives such as reminiscence and life review and the associated aspects of identity maintenance and “managing”.
Recent developments in pancreatic transplantation
Authors: Hesse U.J.
Published: July 2012

At this moment there are more than 10,000 pancreases transplanted into those with diabetes mellitus worldwide. The introduction of new immunosuppressants and refined technical procedures have resulted in a survival of 90% of the grafts and patients. In most cases a simultaneous kidney transplant is performed in patients requiring haemodialysis or peritoneal dialysis. This results in a normal daily life without insulin injections or dialysis treatment. A successful pancreas transplantation in combination with a kidney transplantation can protect the transplanted kidney from diabetic changes. The day in, day out, quality of life of these patients is dramatically increased. The longest pancreas transplant known to be still working is now more than 20 years old. The results from the DCCT study (1) are demonstrating that tight blood sugar control, in those with type I diabetes reduces the complications of diabetes. This is best accomplished by transplanting pancreas grafts into diabetic patients.
The other “Midnight Express”
Authors: de Clerck Eddy
Published: July 2012

The “Renal Disaster Relief Task Force” was founded around 8 years ago, after the earthquake in Armenia, under the direction of Professor Lameire from the UZ Gent (Ghent University Hospital). This task force was set up in the bosom of the “International Society of Nephrologists” (ISN). The objective was to offer nephrological help in case of disasters, in the region encompassing Europe and the Western part of Asia. In Belgium, this organisation works together with ORPADT (the association of dialysis personnel).

Together with a medical company (Baxter) 2 tonnes of aid material is kept in readiness at all times, in Brucargo in Zaventem. Personnel are sent in cooperation with Médecins sans Frontières (MSF). They take care of the logistic support and the organisation.

Three of us enrolled right from the start (Gina De Brouwer, Stefaan Demeulenaere and myself) to stand in, in the case of a disaster occurring.

The years went by and the Task Force was only ever sporadically mentioned. At the start of this year an update of available volunteers was made. Again, the three of us enrolled.

Then the 17th August came along…
Rehabilitating the frail and elderly on renal replacement therapy
Authors: Williams M.
Published: July 2012

The World Federation of Occupational Therapists defines Occupational Therapy as “ … the treatment of physical and psychiatric conditions through specific activities in order to help people reach their maximum level of function and independence in all aspects of daily life.”

Occupational Therapy has long been associated with the frail and elderly, both in hospital and the community. In the United Kingdom however, it appears formal input to the renal multidisciplinary team is a relatively new development. Certainly across Europe, none of us needs reminding of the increasing incidence of older patients with renal failure. United Kingdom figures released in the Second Annual Report of the UK Renal Registry in December 1999 state that, “At the start of treatment 46% of patients were aged 65 or more” (1).
Improvement in care: A collaborative approach to rehabilitation
Authors: Wilde C. , Macefield J.
Published: July 2012

Examination of the patient experience within our unit, from pre dialysis through to establishment of dialysis in the community identified that the care was fragmented. To improve patient care, a change process was initiated. Four home care teams comprising three qualified nurses and one renal care assistant were established with each team responsible for a caseload of patients within a specified geographical location. To measure the impact on the patient, 100 questionnaires were circulated after twelve months. Results from 60 patients showed 76% of pre dialysis patients and 80% of dialysis patients were very satisfied with the change process. The main advantage of this change for the patient is that they are in a continuous supportive cycle for all their non‐inpatient care throughout their replacement therapy. We conclude that patient focused care is essential and should be a transition catalyst in a change resistant environment.
Hepatitis C virus: Overview of clinical and technical perspectives
Authors: Jayasekera H.
Published: July 2012

The increasing incidence/prevalence of hepatitis C virus (HCV) infection in dialysis patients is a cause for concern. In particular, the problem of possible transmission of HCV within a dialysis unit needs to be investigated from both a clinical and technical perspective and substantial evidence generated to support future management.

Nosocomial transmission has been repeatedly recognised as a major factor in the spread of HCV. Professional negligence and patient naivety can result in the rapid development of nosocomial infection and research has identified that the incidence of transmission, in environments where parental routes are accessible, is higher.

There have been a limited number of investigations into transmission through dialysis equipment and to date this evidence seems to indicate that HCV RNA (cells) do not pass through the dialysis membranes. With so little evidence, there is a need for further clarity.

Currently it appears that there is no general agreement about preventative measures. Despite a limited amount of evidence, there appears to be a wide variation in policies concerning the isolation of patients.

This article will provide an overview of current clinical and technical research that addresses the management of this virus within the haemodialysis environment. It is also the intention of the author that the article acts as a catalyst to promote interest in an international collaborative research project (CRP), which will be launched by the EDTNA/ERCA Research Board.
Improving the nurse‐patient relationship: a multi‐faceted approach
Authors: Bennett Lesley , Woodford Jill , Söderberg Lena , Corl Samuel , Clyne Naomi
Published: July 2012

Aim: A Corporate Education Session was held to provide concrete strategies for overcoming several specific barriers in the daily nurse‐patient relationship that negatively affect the patient, nurse, or both, and to provide the latest information about best practice as it affects nurses in renal care.

Methodology: The session was led by a moderator who presented three video case studies to the audience. Communication strategies for recognising and overcoming nurse‐patient communication barriers were presented. The audience expressed their views about each case study using voting pads, and a panel of experts addressed the comments of the audience and discussed guidelines for best practice in renal care. The panel comprised three experienced renal nurses, a senior nephrologist, and an expert in social interaction.

Conclusions: Optimal treatment of patients with renal disease should include early treatment of anaemia, adequate levels of dialysis, and a multidisciplinary approach, responding to both the medical and the social needs of the patient.
Treatment of patients with acute renal failure during Marmara earthquake
Authors: Yürügen Birsen , Emir Gönül , Ersoy Alpaslan
Published: July 2012

summary

Crush syndrome or traumatic rhabdomyolysis is a serious and epidemic clinical case that develops among casualties of earthquakes or other catastrophic events. Hypocalcaemia is one of the main symptoms that accompanies crush syndrome. It is essential that immediate IV volume replacement treatment be initiated for such patients, which is known to positively affect prognosis and help prevent the development of acute renal failure.

Following the earthquake of 17th August 1999 in the north‐west of Turkey, 333 casualties were hospitalised in the Medical Faculty of Uludag University. 60 (18%) of these patients [34 males (56.6%) and 26 females (43.4%)] received haemodialysis treatment. The average number of HD sessions received by the patients was 48. Intermittent HD applied to 44 patients (73.3%) was the preferred method of treatment. Fluid overload and azotemia were the leading indications (76.6%) for dialysis. The lower extremities were mainly injured in these patients [33 (55%)]. Therefore, subclavian catheterisation was preferred in those patients with trauma at this site. 594 (67.1%) HD sessions were applied with limited heparin due to the risk of bleeding.

Hypotension in 94 patients (61%) and thrombosis in 60 (45.7%) were the main complications. Of the complications not due to HD, infection in 23 patients (38.3%) was the most significant. 21 patients (35%) were lost during the treatment.

It was thanks to the sacrifices and co‐operation among national and international medical teams that the mortality rate was low.
Nutritional screening tools for CAPD patients: Are computers the way forward?
Authors: Gower T.
Published: July 2012

The aim of this study was to develop a computer programme (CP) to identify CAPD patients at risk of malnutrition as well as screen monthly biochemical results of transplant (tx), haemodialysis (HD), CAPD and nephrology (Ne) patients for abnormal levels such as hyperkalaemia.

Methods: The CP was designed using the programme Proton. Proton can automatically download biochemical results from pathology making it possible to generate a list of patients with results outside a desired biochemical range in accordance with national renal standards for adult patients. Biochemical measures of nutritional status were used to define malnutrition as 2 or more results outside of these parameters (see Table 1): 10% weight loss, Kt/V < 1.9, normalised protein catabolic rate (nPCR) < 1.2: predialysis urea < 15 mmol/L, phosphate (PO4) < 0.75 mmol/L, potassium (K), < 3.3 mmol/L. The CP was compared with standardised dietetic assessments (SDA) for validity. An SDA includes a review of medical, social history, biochemistry (blood and urine), dialysis prescriptions, treatment plans, medications, weight changes, BMI, dietary intake compared to therapeutic guidelines with documented aims. The therapeutic guidelines used to complete dietary assessment include: protein 1.2‐1.5 g/kg Ideal Body Weight (IBW), energy: aim for BMI of 20–25 kg/m2, sodium: 100–120 mmol/L, K: 1 mmol/kg IBW, fluid: urine output + medical advice, PO4: 175–200 mg of PO4/10 g of protein.

3005 patients from Richard Bright Renal Unit in Bristol, England, including 4 Satellite HD units, had blood results screened for abnormal levels using CP (see Table 1). In the clinic setting, the length of time taken to review biochemical results was measured before and after implementation.

Results: The CP identified 88% of CAPD patients at risk of malnutrition compared with 67% by SDA. The time taken to look up biochemical results of patients attending the outpatient clinics was reduced by approximately 30 minutes leaving only the diet history computer screen to review for each patient.

Discussion: The CP should be compared with subjective global assessment (SGA) for validity in the identification of malnutrition. Serum cholesterol, prealbumin, protein equivalent of total nitrogen appearance (nPNA), C reactive protein (CRP) and bicarbonate should be incorporated into the CP in order to improve its specificity.

Conclusion: Using the present parameters, the CP over diagnosed the number of CAPD patients at risk of malnutrition. However, the CP improves time management and rationalisation of dietetic activity by screening abnormal biochemistry.
Enhancing patency, safety and cost effectiveness of catheters
Authors: Polaschegg HD. , Sodemann K. , Feldmer B.
Published: July 2012

Catheters are generally known to be the last resort for blood access in dialysis. Because of the many problems related to catheter use, catheters are banned from vascular access courses organized by professional societies and the development of catheters and catheter related equipment relies on a few interested medical doctors with limited knowledge of hydraulics and material science. Rather than accepting the need for catheters and the need for improving catheters and catheter related procedures, vascular access meetings typically begin and end with statements saying that the use of fistulas must be increased and catheters must be banned. Several small companies have developed new catheters and catheter related equipment, which potentially overcome many of the problems related to the use of catheters. The authors had the privilege of participating in one of these developments and report about basic features and clinical experience of the DIALOCK® blood access port and an antimicrobial catheter locking solution (CLS) which is used with conventional catheters as well as with the DIALOCK®.
Improving the nurse‐patient relationship: a multi‐faceted approach
Authors: Jenkins Karen , Bennett Lesley , O'Donoghue Donal , Lancaster Larry , Carillo Frank
Published: July 2012

Aim: The aim of the symposium was to provide strategies to help overcome different types of nurse—patient communication problems, with particular reference to the renal disease setting. In this context, the importance of effective patient education to increase patient compliance played a vital role. The case studies presented and the subsequent discussions helped increase the awareness of important medical aspects, such as the increased risk of anaemia‐related complications in diabetic patients and the importance of early referral and anaemia treatment in patients with renal disease. Strategies proposed were supported by best practice guidelines and the latest scientific data.

Methodology: A moderator led an interactive session that included two video case studies, scientific presentations and panel discussions. The audience played an active role by expressing their opinions via keypads. The case studies and the views of the audience were discussed by a panel of experts, who related their experiences and advice.

Conclusions: A good nurse‐patient relationship is essential to meet the clinical, psychological and social needs of the patient in order to optimise treatment. Effective patient education is an important tool to meet patient's needs and increase treatment compliance. Moreover, optimal treatment of patients requires a multidisciplinary approach to allow early identification and treatment of associated co‐morbidities. Anaemia‐related co‐morbidities are particularly important in diabetic patients with renal disease, since this patient group develops anaemia at an early stage and has a significantly increased risk of cardiovascular complications. In renal disease, there are well‐defined guidelines and treatment options for anaemia‐related co‐morbidities, which can easily be adapted to a patient's needs in order to offer flexible, individualised treatment with the aim of improving treatment outcomes.
Patient education in renal transplantation
Authors: Akyolcu N.
Published: July 2012

Renal transplantation is the surgical implantation of a human kidney from a compatible donor into a recipient. Renal transplantation is a means of restoring renal function to normal in most patients, thus allowing a return to a healthy lifestyle. Patients and their families often ask nurses for health information. Professional nurses must ensure that patients and families understand the transplantation and therapeutic regimen and provide health education. It should be remembered that certain physiological, psychosocial and pathological conditions might inhibit the education process. Before renal transplantation the patient's understanding of the procedure and follow‐ up regimen and also the patient's ability to cope with a complex medication regimen are assessed. The nurse and the patient and family should work together to set realistic, achievable goals, the aims of which are mutually agreed. The agreed goals of health education should be documented in a care plan, which will also provide reinforcement for both the nurse and patient.
Iron management in renal failure patients — How do we achieve the best results?
Authors: Kosch M. , Schaefer RM.
Published: July 2012

The majority of patients with renal insufficiency suffer from a normochromic, normocytic anaemia (1). This renal anaemia affects the quality of life of these patients and reduces their chance of survival (2). Despite the availability of recombinant human erythropoetin for the treatment of renal anaemia, many patients do not achieve the target haemoglobin concentration of more than 11 g/dl. A major factor contributing to suboptimal correction of renal anaemia and reduced responsiveness to epoetin is a lack of iron availability to the stimulated erythropoesis. Thus, for the majority of patients with renal insufficiency intravenous iron therapy will be the treatment of choice to replete and maintain adequate iron stores (3).
Acute Renal Failure in childhood
Authors: Proesmans Willem
Published: July 2012

The definition of acute renal failure is a sudden reduction in renal function of at least 50 percent and is characterised by rising serum levels of waste products such as urea and creatinine, by disturbed water and electrolyte metabolism and changes in the amount or composition of the urine. The clinical manifestations are extremely variable, there are very many causes and the outcome depends mainly on the underlying condition, which is either in the kidneys or in the body as a whole. This paper will discuss the pathophysiology of acute renal failure and the aetiology including prerenal, renal and postrenal causes. Clinical findings, diagnosis and treatment will be discussed and complications of this life‐threatening condition highlighted. The final part of the paper deals with the prognosis of acute renal failure.
PALLIATIVE CARE PROVISION IN END‐STAGE RENAL FAILURE
Authors: Casey J. , Hodson S.
Published: July 2012

The increasingly aging dialysis population, recent advances in renal medicine and changes in family structure all contribute to a greater demand for palliative care. Renal nursing leadership is paramount to ensure the needs of the dying renal patient are met, within the limited resources available. At the heart of these competing needs lies the concept of a good death with renal nurses having a vital role to play in shaping the delivery of care both locally and nationally.

As a chronic disease with no cure other than organ transplantation, dialysis becomes the maintenance of life and is described as a ‘complex therapeutic procedure used to correct a life‐threatening body dysfunction’ (1). The lack of curative ability can induce the description of ESRF as a terminal illness. The role of palliative care in ESRF patients should encompass physical, spiritual and psychological needs and should include a ‘holistic approach to the care of patients whose disease is incurable’ (2). Recommendations made by the Council of Europe have urged governments and the medical professions to give a higher priority to the provision of appropriate palliative care (3).
MANAGEMENT OF VASCULAR ACCESS IN EUROPE: PART 2 ‐ A MULTI CENTRE STUDY OF RELATED COMPLICATIONS
Authors: Elseviers Monique M. , Van Waeleghem Jean‐Pierre , Lindley Elizabeth
Published: July 2012

Introduction | The pilot project of the Research Board of EDTNA/ERCA handled the management of vascular accesses (VA) in European dialysis centres. In the first part of the study, centre policies related to VA management were investigated. This paper reports on the second part of the project, investigating VA related complications reported during an observational prospective study.

Methods | A cohort of 1380 adult patients, randomly selected in 47 centres out of 16 European countries were followed during one year using a computerised data collection system. Data were collected at baseline, after six and 12 months and each time a VA complication occurred.

Results | At the start of the observation period, 77% had a native AV fistula, 10% had an AV graft and 13% a catheter. A total of 489 complications were noted. Most frequently observed were thrombosis, stenosis, infection, bleeding and flow problems. Hospitalisation (mean duration=6.2 days) was required in 39% of complications and 29% of complications resulted in a definitive loss of VA. Complications were more frequently observed in catheters (27%) and AV grafts (37%) compared to AV fistulae (15%). When compared with AV fistulae, the risk for thrombosis was more than four times higher and for bleeding more than six times higher if an AV graft was used. Catheters showed an eightfold increased risk to develop infections and flow problems.

Conclusion | This study revealed the high complication rate in VA and strengthened the actions to promote AV fistulae as first choice VA.
ENCOURAGING SELF‐ADMINISTRATION OF ERYTHROPOIETIN
Authors: Balshaw‐Greer A. , Casey J.
Published: July 2012

European Best Practice Guidelines of 1999 for managing anaemia in patients with kidney failure state that patients using the subcutaneous route should be encouraged to self‐administer epoetin whenever possible. This article argues for and substantiates the need to develop an education programme, which should consist of group and one‐to‐one teaching sessions with discussion, role‐play, visual aids and demonstration. Information booklets will be provided covering blood pressure monitoring, ordering and storage of medication and safe disposal of syringes. Methods to evaluate the education programme include direct observation, laboratory reports, patient care plans and feedback. The theoretical benefits of such a programme should include; improved cardiovascular function with a more compliant patient enjoying an improved quality of life. The organisation should benefit through lower costs and a structured method of audit.
AWARENESS OF ANAEMIA IN DIABETES PATIENTS
Authors: Jenkins K. , Van Waeleghem J‐P
Published: July 2012

Although the link between diabetes and anaemia has been firmly established in the renal world, patients with diabetes and healthcare workers in this field are clearly failing to recognise many of the common symptoms of anaemia, a key indicator for renal disease. By forging links and instigating an exchange of information, renal health care workers can work with their colleagues in diabetes to raise awareness of the important benefits arising from the early diagnosis and treatment of the anaemia related to kidney disease.
COMPLICATIONS OF VASCULAR ACCESS: RESULTS OF A EUROPEAN MULTI CENTRE STUDY OF THE EDTNA/ERCA RESEARCH BOARD
Authors: Elseviers Monique M. , Van Waeleghem Jean‐Pierre
Published: July 2012

The pilot project of the Research Board of EDTNA/ERCA handled the management of vascular accesses (VA) in European dialysis centres. In the first part of the study, centre policies related to VA management were investigated. In the second part of the study, individual patients were followed prospectively during one year. This paper reports on several topics of the second part of the project, investigating complications of the VA related to centre, patient characteristics and dialysis techniques. used.

Complications most frequently observed were thrombosis, stenosis, infection, bleeding and flow problems. Gradually more infections and flow problems were observed if the centre size and the patients/nurse ratio went up.

Complication rate was not significantly influenced by age, gender, renal diagnosis, time on dialysis or medication used by the patient. In contrast, the number of vascular accesses in the past and interventions in the VA before first use resulted in an increased number of complications.

Nurses have a key role in the prevention, manipulation and outcome of vascular access related complications.
DISCOVERING THE CULTURE OF HAEMODIALYSIS UNITS: AN ETHNOGRAPHY
Authors: Aswanden C.
Published: July 2012

There is an increasing renal population but a lack of resources available to ensure that every renal patient receives the maximum benefit from Renal Replacement Therapy (RRT). The aim of this paper is to illustrate how understanding the culture of dialysis units will facilitate the provision of more therapeutic, patient centred care. This paper describes briefly the research study that was undertaken to uncover the culture which is in dialysis units but as yet undiscovered and therefore not valued. Once this culture is better understood and valued both patients and the health care teams will be facilitated to work towards the common goal of better treatment outcomes.
BURNOUT IN RENAL CARE PROFESSIONALS
Authors: Kotzabassaki S. , Parissopoulos S.
Published: July 2012

Burnout is defined as “a syndrome of emotional exhaustion, depersonalisation and reduced personal accomplishment that can occur among individuals who work with people in some capacity”, and it can be considered as a result of long‐term exposure to occupational stress (1,2). Frequently reported occupational stressors among caring professionals are those intrinsic to the job, related to patient demands, related to roles within the organisation, and those related to relationships at work and career development. In renal care however, there are some unique characteristics such as technologically advanced equipment, the intensive caring environment and the long‐term relationships being established between the carer and chronic renal patients, that one should take into consideration. It seems that job resources may act as moderators to burnout. Furthermore, specific personality characteristics and socio‐demographic variables seem to affect the burnout experience. Individual and social organisational means for burnout prevention and coping are discussed and suggested.
CONVENTIONAL BLOOD SAMPLING VERSUS ON‐LINE CLEARANCE MONITORING
Authors: Thomson D.
Published: July 2012

On‐line Clearance Monitoring (OCM) calculates the Kt/V during a dialysis session using a module incorporated into the Fresenius 4008 H/S haemodialysis machine
COUNSELLING SHOULD BE OFFERED TO PEOPLE WITH END‐STAGE RENAL FAILURE
Authors: Kelly M. , Tibbles R.
Published: July 2012

Having a counsellor as a member of the multiprofessional team has made a positive contribution to the way in which people with end‐stage renal failure manage their illness. This paper will show how families can be supported when someone close to them develops renal failure. A self‐report questionnaire was sent to those who used the renal counselling service over a one‐year period. Findings suggest that those who received a period of short‐term counselling were able to cope more effectively with their illness and lifestyle changes and felt less stress as a result. The limitations of the evaluation will be discussed, however, we are not seeking to generalise our results but to describe our experience in our unit. This points to the value and necessity of having someone with the requisite skills, to offer people a place to talk about often difficult and painful emotions. In our professional opinion, all renal units should consider having a counsellor as part of an integrated approach to patient care.
RENAL ANAEMIA — THE PATIENT EXPERIENCE
Authors: Mahon A. , Docherty B.
Published: July 2012

In progress within the United Kingdom (UK) is the provision of a National Service Framework (NSF) for Renal Services. The Renal NSF aims to raise standards, provide equity of care, reduce variations in services and improve the health care of renal patients (1). The Renal NSF will be published in four distinct modules, each relating to a major area of renal care: effective delivery of dialysis, transplantation, prevention and primary care and alternative models of care. Taking into account the opinions of patients based on national surveys, has been recognised as an essential component in the modernisation programme of the NHS (2), and therefore this national survey represents consultation on current service provision. In 2000, the UK's National Kidney Federation (NKF) (supported by an educational grant from Amgen Ltd) conducted a postal survey of UK patients with renal diseases. This paper provides the patient perspective on anaemia management from this survey together with the implications for clinical practice for nurses and renal healthcare teams.
EUROPEAN PRACTICE DATABASE IN THE CZECH REPUBLIC
Authors: Pancírová Jitka , Kraciková Jindra , Lopot František , De Vos Jean‐Yves , Elseviers Monique
Published: July 2012

The EDTNA/ERCA European Practice Database (EPD) Project has been launched with the aim to collect data on professional practice and outcome of dialysis treatment throughout Europe. The Czech Republic had the privilege of taking part in the pilot phase together with Northern England and part of Italy. We first became involved in the EPD project during the annual EDTNA/ERCA conference in Nice, France. At this time the Research Board started to prepare an EPD questionnaire for the pilot phase. The project was officially launched in the Czech Republic during the Multidisciplinary Conference in Brno organised jointly by the Czech Association of Nurses and the EDTNA/ERCA in 2003. A presentation by Jean Yves De Vos, the EPD Co‐ordinator, who introduced the final EPD questionnaire in detail, was the best promotion of the project.
CHOICE OF RENAL REPLACEMENT THERAPY IN PATIENTS WITH DIABETIC END STAGE RENAL DISEASE
Authors: Giri M.
Published: July 2012

Diabetic nephropathy is becoming the leading cause of end‐stage renal disease (ESRD) worldwide. Although the prognosis of patients with diabetes and ESRD receiving Renal Replacement Therapy (RRT) has improved greatly, the presence of pre‐existing cardiovascular disease means that the survival and medical rehabilitation of diabetics continue to be inferior to that of non‐diabetics. RRT should be initiated earlier in patients with diabetes than in non‐diabetics and the main choices of modalities are: 1) haemodialysis (HD), 2) Peritoneal dialysis (PD), 3) Kidney transplantation alone (KTA) or 4) simultaneous kidney and pancreas transplantation (SPKT). The most common modality of RRT utilised in the diabetic patient remains HD but this method is associated with many clinical problems, in particular the managment of vascular access and frequent intradialytic hypotension. There is accumulating evidence demonstrating that both survival and medcal rehabilitation of patients with diabetes and ESRD is superior after renal transplantation with or without pancreas transplantation.
NUTRITIONAL COUNSELLING FOR DIABETIC RENAL PATIENTS
Authors: Hoogerwerf M.
Published: July 2012

A diabetic patient who develops nephropathy has to cope with two different diets. Healthy food guidelines have to be followed and attention paid to the spread of carbohydrates throughout the day because of the diabetes. Renal failure means that attention also has to be paid to protein, sodium, potassium and fluid intake and the diet can be confusing to patients. When dialysis commences the management of, and attention to the diabetes is sometimes a little forgotten. This article identifies problems and how they may be dealt with.