Safety Management of Dialysis Fluid in Japan: Important Duties and Responsibilities of Clinical Engineers

2021 ◽  
pp. 1-6
Author(s):  
Masanori Shibata
Keyword(s):  
Renal Failure ◽  
Safety Management ◽  
Standard Procedure ◽  
Medical Personnel ◽  
Maintenance Hemodialysis ◽  
Dialysis Fluid ◽  
Fluid Delivery ◽  
Technical Ability ◽  
Number Of Patients ◽  
Clinical Engineers

Dialysis therapy is the predominant choice for renal failure in Japan, and almost 30% of the patients with renal failure have been treated for 10 years or more. Dialysis became the standard procedure to treat renal failure nationwide in the 1980s. However, at that time, managing the increased number of patients on maintenance hemodialysis as well as operating and maintaining the newly developed advanced medical technologies at extensive numbers of clinical sites proved problematic. To help address this, the clinical engineer system was established in 1987 and certain aspects of the clinical engineers’ role remain unique to Japan today. For the last 30 years, clinical engineers have worked as frontline medical personnel not only operating dialysis-related devices but also placing their hands directly on patients when providing care, routinely performing puncture, and administering drugs through the blood circuit under physicians’ instructions. As part of their work, they crucially maintain the use of central dialysis fluid delivery systems (CDDSs) – also unique to Japan – which prepare and deliver a large quantity of dialysis fluid through a central circuit to individual dialysis consoles. CDDSs are widely used because they effectively alleviated the early confusion at clinical sites caused by the rapidly increasing hemodialysis population and the serious shortage in medical personnel. Moreover, clinical engineers alone have the technical ability to provide safe dialysis fluids adjusted to strict standards at clinical sites. In this review article, we focus on the crucial roles that clinical engineers have in maintaining the safety of dialysis-related medical devices and the preparation and delivery of dialysis fluid at many dialysis facilities across the country.

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

Correlation Between Serological Makers and Immunofluorescence Deposits i n Kidney Tissue of Patients with Lupus Nephritis

2019 ◽  
Vol 9 (02) ◽  
Author(s):  
Haider S Al-Hadad ◽  
Aqeel Abbas Matrood ◽  
Maha Abdalrasool Almukhtar ◽  
Haider Jabur Kehiosh ◽  
Riyadh Muhi Al-Saegh
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Pearson Correlation ◽  
Standard Procedure ◽  
Kidney Tissue ◽  
P Value ◽  
American College Of Rheumatology ◽  
Immune Deposits ◽  
Number Of Patients

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease. Few biomarkers for SLE have been validated and widely accepted for the laboratory follow-up of inflammatory activity. In SLE patients, with lupus nephritis (LN), complement activation leads to fluctuation of serum C3 and C4 that are frequently used as clinicalm biomarker of disease activity in SLE. Patients and Methods: In this study the number of patients were 37, seven patients were excluded for incomplete data collection, 28 were females ,2 were males. The duration of the study is two years from 2015 to 2017. Patients were considered to have SLE and LN according to American College of Rheumatology (ACR) criteria, and International Society of Nephrology/ Renal Pathology Society (ISN/RPS). All patients were evaluated withm clinical presentation, laboratory investigations. Our patients underwent kidney biopsy according to standard procedure by Kerstin Amann, and their tissue specimens were studied in the laboratory with light microscope (LM) and immunofluorescence microscope reagents. The relationship between the serological markers and immunofluorescence deposits in kidney biopsy of all patients were studied using the statistical analysis of Pearson correlation and single table student's T test. A P value 0.05 was considered statistically significant. Results: The granular pattern of IF deposits was present in all LN patients, and in more than two third of patients these IF deposits presented in glomerular, tubular, and mesangium sites. While less than one third of patients had IF deposits in the mesangium only. There was no statistically significant correlation between serum ANA, anti-dsDNA, and IF deposits of different types. There was significant correlation between serum C3 and C4 hypocomplementemia and IgG immune deposits in kidney biopsy, and there was significant relationship between serum C3 hypocomplementemia and full house immunofluorescence (FHIF) deposits inm kidney biopsy.Conclusions:Immunofluorescence deposits is mainly granular pattern in LN patients. There was no significant association between serum ANA, anti-dsDNA, and immune deposits in kidney tissue. Immunofluorescence deposits of IgG type correlates significantly with serum C3 and C4 hypocomplemetemia, and these immune deposits in association with low complement levels correlates with LN flare. There was significant correlation between C3 hypocomplementemia and FHIF.

Overview of blood purification in uremia

1980 ◽  
Vol 3 (4) ◽  
pp. 203-208
Author(s):  
B.T. Burton
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Rejection Rate ◽  
Blood Purification ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Transplant Patients ◽  
Maintenance Dialysis ◽  
Transplanted Kidneys

Today, management of irreversible renal failure is based primarily on maintenance hemodialysis and renal transplantation with a growing minority of patients treated by peritoneal dialysis. With regard to renal transplantation — the early promise of renal transplantation in the mid 1960's has given way to the realities of the late 1970's. There have been no major changes in the rejection rate of transplanted kidneys in recent years though today's mortality of transplant patients is considerably reduced over what it used to be. Moreover, universally the lack of availability of a sufficient number of organs for transplantation poses a formidable problem. It is all too apparent that current methods of blood purification in uremia are far from optimal. Even though the mortality in maintenance dialysis is relatively low, hemodialysis is characterized by a variety of complications and most maintenance dialysis patients are not optimally rehabilitated.

scholarly journals Temporal trends in treatment and outcomes of patients with acute coronary syndrome and concomitant moderate to severe renal failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Bossard ◽  
F Witassek ◽  
D Radovanovic ◽  
F Moccetti ◽  
P Erne ◽  
...  
Keyword(s):  
Renal Failure ◽  
Temporal Trends ◽  
Limited Information ◽  
Severe Renal Failure ◽  
P2y12 Inhibitors ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Percutaneous Coronary ◽  
Coronary Syndromes ◽  
To Receive

Abstract Introduction Limited information about the management and outcomes of patients with acute coronary syndromes (ACS) and moderate to severe renal failure (RF) is available owing to underrepresentation of this population in most studies. Methods We evaluated the use of guideline-recommended therapies and in-hospital outcomes of totally 49'191 ACS patients with normal-mild renal failure (RF) (defined as eGFR >45ml/min/m2) versus moderate-severe RF (eGFR <45ml/min/m2) enrolled in the prospective Acute Myocardial Infarction in Switzerland (AMIS) cohort between 2002 and 2019 according to 2-year periods. Results Overall, 3'478 (7.1%) patients had moderate-severe RF. They were older (65.2+12.9 versus 77.2+10.6 years) and had significantly more comorbidities (including heart failure, cerebrovascular and peripheral vascular disease). Moderate-severe RF patients received less frequently guideline-recommended drugs, including P2Y12 inhibitors, ACEI/ARBs and statins (p<0.0001). Between the first and last 2-year periods, the number of patients with moderate-severe RF and number of performed percutaneous coronary interventions (PCI) increased in this cohort (p-for-trend=0.001). At the same time, in-hospital mortality significantly decreased among ACS patients with and without RF (17.5% to 10.5% and 6.0% to 3.9%, respectively, p-for-trend=0.001 for both, see Figure). Similar trends were observed for other complications, namely cardiogenic shock and reinfarction. However, major bleedings increased significantly over time in patients with and without RF (p-for-trend=0.038 and <0.001, respectively). Conclusions Outcomes of ACS patients with moderate to severe RF improved over the last two decades. Even though the rate of PCI increased in ACS patients with moderate-severe RF, they were less likely to receive guideline-recommended therapies and still suffer a high in-hospitality mortality (>10%). With respect to the increasing burden of ACS patients with RF, our study implicates that more efforts should be undertaken to further improve outcomes of those patients. Funding Acknowledgement Type of funding source: None

scholarly journals Caretaker Obstreperous Behavior Rating Scale

1997 ◽  
Vol 8 (S3) ◽  
pp. 321-324 ◽  
Author(s):  
Joan M. Swearer ◽  
David A. Drachman
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Rating Scale ◽  
Late Onset ◽  
Senile Dementia ◽  
Medical Personnel ◽  
Original Description ◽  
Behavior Rating Scale ◽  
Large Patient ◽  
Number Of Patients

Although Alzheimer's original description of the dementing disorder that bears his name emphasized the prominence of troublesome and disruptive behaviors, a systematic investigation of behavioral disturbances of dementia did not begin in earnest until the 1980s. At that time, as the neuropathologic identity of presenile Alzheimer's disease and late-onset “senile dementia” was recognized, the redefinition of Alzheimer's disease abruptly increased the number of patients diagnosed with this condition. Physicians and other medical personnel working with Alzheimer's disease patients recognized both the importance of abnormal behaviors in this now large patient population and the need to describe, classify, and quantify these behaviors.

Summer Camp Hemodialysis for Children With Chronic Renal Failure

PEDIATRICS ◽  
1977 ◽  
Vol 60 (1) ◽  
pp. 46-50
Author(s):  
William A. Primack ◽  
Ira Greifer
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Medical Treatment ◽  
Summer Camp ◽  
Maintenance Hemodialysis ◽  
Self Confidence ◽  
Self Image ◽  
Hemodialysis Unit ◽  
Pediatric Hemodialysis ◽  
Satellite Unit

A hemodialysis unit was established at a rural summer camp for children. Required medical treatment was planned so as to interfere as little as possible with normal camp programs. Campers who require dialysis were mixed fully into the population of normal campers. Twenty-two children participated during the first summer of operation. Our experience indicates that children on maintenance hemodialysis can be integrated with normal peers in a recreational program and can improve their self-image and self-confidence. The program also demonstrates that chronic pediatric hemodialysis can be safely performed in a rural satellite unit.

Peritoneal Dialysis

2019 ◽  
Author(s):  
Karlien François ◽  
Joanne M. Bargman
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Peritoneal Cavity ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Dialysis Fluid ◽  
Keywords Peritoneal Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Developed World

In peritoneal dialysis (PD), the peritoneum serves as a biological dialyzing membrane. The endothelium of the vast capillary network perfusing the peritoneum functions as a semipermeable membrane and allows bidirectional solute and water transfer between the intravascular space and dialysate fluid dwelling in the peritoneal cavity. PD is a renal replacement strategy for patients presenting with end-stage renal disease. It can also be offered for ultrafiltration in patients with diuretic-resistant fluid overload even in those without advanced renal failure. PD can also be used for patients with acute kidney injury, although in the developed world this occurs rarely compared to the use of extracorporeal therapies. This review contains 9 videos,  8 figures, 4 tables, and 73 references.  Keywords: peritoneal dialysis, peritoneal cavity, catheter, dialysis fluid, ultrafiltration, tunnel infection, osmotic pressure, renal failure

Medical Waste Management during COVID-19 Situation: Perspective Towards Safe Environment

2021 ◽  
Author(s):  
MANOJ KUMAR JINDAL ◽  
Dr. Santosh Kumar Sar
Keyword(s):  
Waste Management ◽  
Natural Resources ◽  
Medical Personnel ◽  
Safe Environment ◽  
Main Challenge ◽  
Number Of Patients ◽  
Open Dumping ◽  
The Government ◽  
Second Wave

The situation in the world of pandemics is rapidly changing, and the second wave of COVID-19 has put a lot of pressure on the government and private sector, which are primarily responsible for controlling the situation. COVID-19 positive cases have increased in recent months relative to last year, and the number of patients admitted to hospitals has also increased, despite the fact that few of them were denied admission due to shortage of beds. Normal people who experience any symptoms immediately isolate themselves and begin taking the COVID medications prescribed by medical personnel and their team. During these times, all domestic people tossed the wrappers and boxes of medicines into the regular trash can, and the waste was handed over to the waste collector, who treated it like any other domestic waste and disposed of it using open dumping or other methods. The goal of this perspective is to suggest the collections of these types of waste from domestics, and protect the natural resources like water, soil, and even living beings like animals from pollution (from the effect of SARS-CoV-2). The main challenge for environmental waste management agencies is determining who has COVID positive and which houses generate these types of waste; thus, proposed strategy may be beneficial to the long-term sustainability of natural resources and animals.

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