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Sample records for haemodialysis equipment

  1. Multipass haemodialysis

    DEFF Research Database (Denmark)

    Heaf, James Goya; Axelsen, Mette; Pedersen, Robert Smith

    2013-01-01

    INTRODUCTION: Most home haemodialysis (HD) modalities are limited to home use since they are based on a single-pass (SP) technique, which requires preparation of large amounts of dialysate. We present a new dialysis method, which requires minimal dialysate volumes, continuously recycled during tr...... traditional HD and HD 5 × 2.5 h/week. This modality will increase patients' freedom of movement compared with traditional home HD. The new method can also be used in the intensive care unit and for automated peritoneal dialysis.......INTRODUCTION: Most home haemodialysis (HD) modalities are limited to home use since they are based on a single-pass (SP) technique, which requires preparation of large amounts of dialysate. We present a new dialysis method, which requires minimal dialysate volumes, continuously recycled during...

  2. Effect of Nocturnal Haemodialysis on Body Composition

    NARCIS (Netherlands)

    Ipema, K.J.R.; Westerhuis, R.; van der Schans, C.P.; de Jong, P.E.; Gaillard, C.A. J. M.; Krijnen, W.P.; Slart, R.H.J.A.; Franssen, C.F.M.

    2014-01-01

    Background: Haemodialysis patients have a high risk of malnutrition which is associated with increased mortality. Nocturnal haemodialysis (NHD) is associated with a significant increase in protein intake compared with conventional haemodialysis (CHD). It is unclear whether this leads to improved

  3. Vascular access for home haemodialysis.

    Science.gov (United States)

    Al Shakarchi, Julien; Day, C; Inston, N

    2018-03-01

    Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it. A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital. Access-related hospital admissions and interventions were used as primary outcome measures. Our cohort consisted of 74 patients. On initiation of home haemodialysis, 62 individuals were using an arteriovenous fistula as vascular access, while the remaining were on a tunnelled dialysis catheter. Of the 12 patients who started on a tunnelled dialysis catheter, 5 were subsequently converted to either an arteriovenous fistula ( n = 4) or an arteriovenous graft ( n = 1). During the period of home haemodialysis use, four arteriovenous fistula failed or thrombosed with patients continuing on home haemodialysis using an arteriovenous graft ( n = 3) or a tunnelled dialysis catheter ( n = 1). To maintain uninterrupted home haemodialysis, interventional rates were 0.32 per arteriovenous fistula/arteriovenous graft access-year and 0.4 per tunnelled dialysis catheter access-year. Hospital admission rates for patients on home haemodialysis were 0.33 per patient-year. Our study has shown that home haemodialysis can be safely and independently performed at home within a closely managed home haemodialysis programme. The authors also advocate the use of arteriovenous fistulas for this cohort of patients due to both low complication and intervention rates.

  4. An error taxonomy system for analysis of haemodialysis incidents.

    Science.gov (United States)

    Gu, Xiuzhu; Itoh, Kenji; Suzuki, Satoshi

    2014-12-01

    This paper describes the development of a haemodialysis error taxonomy system for analysing incidents and predicting the safety status of a dialysis organisation. The error taxonomy system was developed by adapting an error taxonomy system which assumed no specific specialty to haemodialysis situations. Its application was conducted with 1,909 incident reports collected from two dialysis facilities in Japan. Over 70% of haemodialysis incidents were reported as problems or complications related to dialyser, circuit, medication and setting of dialysis condition. Approximately 70% of errors took place immediately before and after the four hours of haemodialysis therapy. Error types most frequently made in the dialysis unit were omission and qualitative errors. Failures or complications classified to staff human factors, communication, task and organisational factors were found in most dialysis incidents. Device/equipment/materials, medicine and clinical documents were most likely to be involved in errors. Haemodialysis nurses were involved in more incidents related to medicine and documents, whereas dialysis technologists made more errors with device/equipment/materials. This error taxonomy system is able to investigate incidents and adverse events occurring in the dialysis setting but is also able to estimate safety-related status of an organisation, such as reporting culture. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  5. Continuous venovenous haemodialysis

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Bistrup, C; Pedersen, R S

    1996-01-01

    A simple three-pump-based system for the performance of continuous venovenous haemodialysis is described. The method employs access to the circulation via a double-lumen catheter, and by means of a standard extracorporeal peristaltic pump the blood is circulated through a haemofiltration filter....... Standard solutions for peritoneal dialysis are administered in a single-pass manner countercurrent to the blood flow. To control the dialysate flow through the filter, two separate pumps designed for intravenous infusion are used. Anticoagulation is achieved by means of continuous heparin infusion....... This three-pump system is effective in controlling the fluid balance and the level of azotemia. Furthermore, this system makes haemodialysis possible in spite of severe haemodynamic instability. The system is easy to use and inexpensive. 3 patients participated in the study....

  6. Continuing education: online monitoring of haemodialysis dose.

    Science.gov (United States)

    Vartia, Aarne

    2018-01-25

    Kt/V urea reflects the efficacy of haemodialysis scaled to patient size (urea distribution volume). The guidelines recommend monthly Kt/V measurements based on blood samples. Modern haemodialysis machines are equipped with accessories monitoring the dose online at every session without extra costs, blood samples and computers. To describe the principles, devices, benefits and shortcomings of online monitoring of haemodialysis dose. A critical literature overview and discussion. UV absorbance methods measure Kt/V, ionic dialysance Kt (product of clearance and treatment time; cleared volume without scaling). Both are easy and useful methods, but comparison is difficult due to problems in scaling of the dialysis dose to the patient's size. The best dose estimation method is the one which predicts the quality of life and survival most accurately. There is some evidence on the predictive value of ionic dialysance Kt, but more documentation is required on the UV method. Online monitoring is a useful tool in everyday quality assurance, but blood samples are still required for more accurate kinetic modelling. After reading this article the reader should be able to: Understand the elements of the Kt/V equation for dialysis dose. Compare and contrast different methods of measurement of dialysis dose. Reflect on the importance of adequate dialysis dose for patient survival and life quality. © 2018 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  7. Economic evaluation of centre haemodialysis and continuous ambulatory peritoneal dialysis in Ministry of Health hospitals, Malaysia.

    Science.gov (United States)

    Hooi, Lai Seong; Lim, Teck Onn; Goh, Adrian; Wong, Hin Seng; Tan, Chwee Choon; Ahmad, Ghazali; Morad, Zaki

    2005-02-01

    This is a multi-centre study to determine cost efficiency and cost effectiveness of the Ministry of Health centre haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) programme. Forty-four haemodialysis and 11 CAPD centres were enrolled in this study in 2001. Sixty patients, 30 from each modality, were evaluated. Micro-costing was used to determine costs. The number of haemodialyses conducted ranged from 402 to 23,000 procedures per year, while for CAPD, output ranged from 70 to 2300 patient months/year. Cost ranged from RM79.61 to RM475.79 per haemodialysis treatment, with a mean cost of RM169 per HD (USD 1 = RM 3.80). The cost of CAPD treatment ranged from RM1400 to RM3200 per patient month, with a mean of RM2186. Both modalities incurred similar outpatient costs. The cost of erythropoeitin per year is RM4500 and RM2500 for haemodialysis and CAPD, respectively. The number of life years saved is 10.96 years for haemodialysis and 5.21 years for CAPD. Cost per life year saved is RM33 642 for haemodialysis and RM31 635 for CAPD. The cost for land, building, equipment, overheads, and staff were higher for haemodialysis, while consumables and hospitalization cost more for CAPD. Sensitivity analysis was performed for two discount rates (3 and 5%), varying erythropoietin doses and maximum and minimum overheads. Relative cost effectiveness of haemodialysis and CAPD was unchanged in all sensitivity scenarios, except for overhead costs, which influenced the cost effectiveness of HD. It is economically viable to promote the use of both CAPD and haemodialysis because the cost effectiveness of both are nearly equal.

  8. Erectile dysfunction in haemodialysis patients

    International Nuclear Information System (INIS)

    Mumtaz, A.; Hussain, S.; Nazir, M.

    2009-01-01

    There is a very high prevalence of Erectile Dysfunction (ED) in dialysis patients. There is no as such available data on ED and factors affecting it in our patients. Analytical, cross-sectional, hospital based study conducted from January to March 2008, Haemodialysis unit of Shalimar and Mayo Hospital, Lahore. All male patients of end stage renal disease (ESRD) on maintenance haemodialysis therapy, whose spouses are alive and able to perform intercourse, were included in the study. Patient with cognitive and communication deficits were excluded from study. International index of erectile function-5 (IIEF-5), adopted in Urdu was used for the determination of prevalence of erectile function. Categorization of erectile dysfunction was done as mild, moderate and severe. Demographic data were collected and certain laboratory parameters (haemoglobin, haematocrit, urea, HBsAg and Anti HCV) were sent. Total numbers of patient were fifty. Major cause of ESRD was diabetes mellitus 28 (56%). Most of the patients 33 (66%) have passed 10th grade or they were under 10th grade. Prevalence of ED was 86% with mean IIEF-5 score of 10.36+-7.13. Majority of patients 33 (64.7%) were suffering from severe degree of ED. Factors responsible for ED are diabetes mellitus, age more than 50 year, high pre dialysis urea and Anti HCV positive patients. In this study, smoking, duration of dialysis and monthly spending is not related with ED. Majority of the patients suffering from ESRD, on maintenance haemodialysis are having ED. None of the patients suffering from ED were taking any treatment for it. Haemodialysis does not improve sexual dysfunction. Major factors responsible for ED are diabetes mellitus, age more than 50 years, high pre dialysis urea and Anti HCV positive patients. (author)

  9. Problems experienced by haemodialysis patients in Greece.

    Science.gov (United States)

    Kaba, E; Bellou, P; Iordanou, P; Andrea, S; Kyritsi, E; Gerogianni, G; Zetta, S; Swigart, V

    Even though Greece has a disproportionate number of haemodialysis stations for the treatment of end-stage renal disease (ESRD), and a rapidly rising number of patients on dialysis, there has been no study of the lived experience of haemodialysis treatment in Greece. ESRD and dialysis drastically impact patients' everyday life, therefore expectations and desires play a major role in adapting to alterations and restrictions. An understanding of these culturally-influenced expectations and desires is essential for the delivery of holistic nursing care. This study aimed to explore how Greek patients receiving long-term haemodialysis perceived their problems and to describe the impact of haemodialysis on their lives. Using a grounded theory approach, 23 patients with ESRD receiving haemodialysis were purposively recruited from two hospital dialysis centres in Athens, Greece. Data were collected during 2006 by personal interviews. Given a distinctive patient experience of haemodialysis, some insight into their common concerns can facilitate provision of healthcare services that adequately meets their needs. By developing an understanding of the experience of renal illness and therapy for a group of people using dialysis, this study was intended as a contribution towards enabling healthcare professionals to provide more effective support to people who are living with this chronic condition.

  10. Cost Evaluation of Haemodialysis for End Stage Renal Disease ...

    African Journals Online (AJOL)

    Cost Evaluation of Haemodialysis for End Stage Renal Disease Patients: Experience from Benin City, Nigeria. ... Annals of Biomedical Sciences ... Objectives: To assess the costs and use of haemodialysis in a Nigerian Teaching Hospital.

  11. Patients' experiences of safety during haemodialysis treatment - a qualitative study

    NARCIS (Netherlands)

    Lovink, M.H.; Kars, M.C.; Man-van Ginkel, J.M. de; Schoonhoven, L.

    2015-01-01

    AIM: To explore the experiences of safety of adult patients during their haemodialysis treatment. BACKGROUND: Haemodialysis is a complex treatment with a risk for harm that causes anxiety among many patients. To date, no in-depth study of haemodialysis patients' emotional responses to conditions of

  12. Haemodialysis and Transplantation Facilities in South Africa

    African Journals Online (AJOL)

    1974-04-13

    Apr 13, 1974 ... The provIsion of services in South Africa for patients suffering from chronic renal failure is inadequate in terms· of nationai requirements. A survey of the available facili- ties made in July 1973 showed that 14 maintenance haemodialysis centres had a total of 39 dialysing stations capable of treating 143 ...

  13. Oxygen status during haemodialysis. The Cord-Group

    DEFF Research Database (Denmark)

    Nielsen, A L; Jensen, H Æ; Hegbrant, J

    1995-01-01

    Hypoxia during haemodialysis, mainly acetate, has been reported several times. In our study we have monitored oxygen status during 258 bicarbonate haemodialyses. A significant drop below 80 mmHg in mean oxygen tension occurred. Mean oxygen saturation reflected this drop but did not reach levels...... below 90%. The mean oxygen concentration was on the whole critical low, though slightly increasing during each haemodialysis session due to ultrafiltration. It is concluded that both hypoxia and hypoxaemia do occur during bicarbonate haemodialysis. To a group of patients generally having limited cardiac...... reserves, a poor oxygen status is a potentially serious complication to haemodialysis. Monitoring oxygen status is thus advisable....

  14. Work environment, job satisfaction, stress and burnout among haemodialysis nurses.

    Science.gov (United States)

    Hayes, Bronwyn; Douglas, Clint; Bonner, Ann

    2015-07-01

    To examine the relationships among nurse and work characteristics, job satisfaction, stress, burnout and the work environment of haemodialysis nurses. Haemodialysis nursing is characterised by frequent and intense contact with patients in a complex and intense environment. A cross-sectional online survey of 417 haemodialysis nurses that included nurse and work characteristics, the Brisbane Practice Environment Measure, Index of Work Satisfaction, Nursing Stress Scale and the Maslach Burnout Inventory. Haemodialysis nurses reported an acceptable level of job satisfaction and perceived their work environment positively, although high levels of burnout were found. Nurses who were older and had worked in haemodialysis the longest had higher satisfaction levels, experienced less stress and lower levels of burnout than younger nurses. The in-centre type of haemodialysis unit had greater levels of stress and burnout than home training units. Greater satisfaction with the work environment was strongly correlated with job satisfaction, lower job stress and emotional exhaustion. Haemodialysis nurses experienced high levels of burnout even though their work environment was favourable and they had acceptable levels of job satisfaction. Targeted strategies are required to retain and avoid burnout in younger and less experienced nurses in this highly specialised field of nursing. © 2013 John Wiley & Sons Ltd.

  15. Illness perceptions predict survival in haemodialysis patients.

    Science.gov (United States)

    Chilcot, Joseph; Wellsted, David; Farrington, Ken

    2011-01-01

    Illness perceptions have been shown to be important determinants of functional and psychosocial outcomes, including quality of life and treatment adherence in end-stage renal disease patients. The aim of this prospective study was to determine whether haemodialysis patients' illness perceptions impact upon survival. Haemodialysis patients from a UK renal service completed the Revised Illness Perception Questionnaire. Over the study period (May 2007 to December 2010), all-cause mortality was recorded as the endpoint. 223 patients were followed up for a median of 15.9 months (min. 10 days, max. 42.7 months). The median dialysis vintage was 17.6 months (min. 4 days, max. 391.3 months). Treatment control perceptions demonstrated a significant association with mortality (HR = 0.91, 95% CI: 0.83-0.99, p = 0.03). After controlling for covariates, including age, albumin, extra renal comorbidity and depression scores, perception of treatment control remained a significant predictor of mortality (HR = 0.89, 95% CI: 0.80-0.99, p = 0.03). Patients' perceptions of treatment control (dialysis therapy) predict survival independently of survival risk factors, including comorbidity. Studies are required to test whether psychological interventions designed to modify maladaptive illness perceptions influence clinical outcomes in this patient setting. Copyright © 2011 S. Karger AG, Basel.

  16. Pulp Stone, Haemodialysis, End-stage Renal Disease, Carotid Atherosclerosis

    OpenAIRE

    Patil, Santosh; Sinha, Nidhi

    2013-01-01

    Objectives: The aim of this study was to determine the relationship between the presence of pulp calcification and carotid artery calcification on the dental panoramic radiographs in End Stage Renal Disease (ESRD) patients who were on haemodialysis.

  17. Patients' experiences of safety during haemodialysis treatment--a qualitative study

    NARCIS (Netherlands)

    Lovink, Marleen H; Kars, Marijke C; de Man-van Ginkel, Janneke M; Schoonhoven, Lisette

    2015-01-01

    AIM: To explore the experiences of safety of adult patients during their haemodialysis treatment. BACKGROUND: Haemodialysis is a complex treatment with a risk for harm that causes anxiety among many patients. To date, no in-depth study of haemodialysis patients' emotional responses to conditions of

  18. Freedom and Confinement: Patients’ Experiences of Life with Home Haemodialysis

    Directory of Open Access Journals (Sweden)

    C. Vestman

    2014-01-01

    Full Text Available Patients with chronic end stage renal disease need dialysis to survive; however, they also need a treatment that suits their life situation. It is important that healthcare providers provide reliable, up-to-date information about different dialysis treatment options. Since home haemodialysis is a relatively new treatment, it is necessary to gather more knowledge about what the treatment entails from the patient’s perspective. The aim of this study was to describe patients’ experiences of having home haemodialysis. To gain access to the patients’ experiences, they were asked to write narratives, which describe both their good and bad experiences of life with the treatment. The narratives were analysed with a qualitative method. The results of this analysis are subdivided into five themes: freedom to be at home and control their own treatment, feeling of being alone with the responsibility, changes in the home environment, need for support, and security and well-being with home haemodialysis. The conclusion is that home haemodialysis provides a certain level of freedom, but the freedom is limited as the treatment itself is restrictive. In order to improve patients’ experiences with home haemodialysis, more research based on patients’ experiences is needed and it is necessary to involve the patients in the development of the care.

  19. Nutritional status of vegetarians on maintenance haemodialysis.

    Science.gov (United States)

    Wu, Tai-Te; Chang, Chieh-Ying; Hsu, Wei-Min; Wang, I-Kwan; Hsu, Chih-Hao; Cheng, Shu-Hwa; Liang, Chih-Chia; Chang, Chiz-Tzung; Huang, Chiu-Ching

    2011-08-01

    Vegetarian diets have long been thought of as beneficial to health. However, vegetarian diets are often low in protein, which is contradictory to the high protein diet guideline for uraemia patients. The purpose of the study was to investigate the impact of a vegetarian diet on the nutritional status of haemodialysis (HD) patients. Patients on chronic HD for over 6 months were included in the study. The normalized protein catabolic rate (nPCR) was used to reflect daily protein intake. Biochemical markers of nutrition, anthropometric parameters, subjective global assessment (SGA) and functional activity of daily living were assessed to evaluate the nutritional status of vegetarians on chronic HD. Nineteen out of 318 HD patients were vegetarians. The nPCR was lower in the vegetarian group (1.20 ± 0.24 vs 1.10 ± 0.29 g/kg per day, non-Veg vs Veg, P strength evaluated by the hand-grip test, SGA and activities of daily living were similar in vegetarians and non-vegetarians. The present study revealed that HD patients on vegetarian diets might have a smaller BMI, but SGA and function of daily activities were similar to those of the non-vegetarians. The haematocrit of vegetarians can be maintained with a higher erythropoietin dose. © 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology.

  20. Long-term clinical parameters after switching to nocturnal haemodialysis : a Dutch propensity-score-matched cohort study comparing patients on nocturnal haemodialysis with patients on three-times-a-week haemodialysis/haemodiafiltration

    NARCIS (Netherlands)

    Jansz, Thijs Thomas; Özyilmaz, Akin; Grooteman, Muriel P C; Hoekstra, Tiny; Romijn, Marieke; Blankestijn, Peter J; Bots, Michael L; van Jaarsveld, Brigit C

    2018-01-01

    OBJECTIVES: Nocturnal haemodialysis (NHD), characterised by 8-hour sessions ≥3 times a week, is known to improve clinical parameters in the short term compared with conventional-schedule haemodialysis (HD), generally 3×3.5-4 hours a week. We studied long-term effects of NHD and used patients on

  1. The HRQoL of Chinese patients undergoing haemodialysis.

    Science.gov (United States)

    Yu, Hui-Dan; Petrini, Marcia A

    2010-03-01

    With the transition from infectious disease and acute illness to chronic disease and degenerative illness as leading causes of death, health-related quality of life has become an important aspect in assessing the burden of chronic disease. The quality of life of haemodialysis patients has been studied extensively; however, very limited research using exploratory descriptive design has been carried out in this area in China. The aim of this study was to explore health-related quality of life of end-stage renal disease patients undergoing haemodialysis in China. This study used the qualitative research design approach. A semi-structured, in-depth interview was conducted with 16 haemodialysis patients in two hospitals using Colaizzi's phenomenological method to transcribe and analyse the data. The results of this study showed that dialysis patients show improvement in physical competence, but they also experienced emotional instability and psychological distress, financial burdens, inadequate disease knowledge and less social support which influenced their quality of life. To optimise the patients undergoing dialysis health-related quality of life, support of psycho-social-economical aspects should be enhanced. Health care providers should give haemodialysis patients thorough health education, individualised psychological and emotional intervention and adequate social support to optimise health-related quality of life.

  2. Use of vascular access for haemodialysis in Europe

    DEFF Research Database (Denmark)

    Noordzij, Marlies; Jager, Kitty J; van der Veer, Sabine N

    2014-01-01

    BACKGROUND: Although arteriovenous fistulas (AVFs) are actively promoted, their use at the start of haemodialysis (HD) seems to be decreasing worldwide. In this paper, we describe recent trends in incidence and prevalence of vascular access types in Europe from 2005 to 2009 and their relationship...

  3. Frequency spectrum analysis of finger photoplethysmographic waveform variability during haemodialysis.

    Science.gov (United States)

    Javed, Faizan; Middleton, Paul M; Malouf, Philip; Chan, Gregory S H; Savkin, Andrey V; Lovell, Nigel H; Steel, Elizabeth; Mackie, James

    2010-09-01

    This study investigates the peripheral circulatory and autonomic response to volume withdrawal in haemodialysis based on spectral analysis of photoplethysmographic waveform variability (PPGV). Frequency spectrum analysis was performed on the baseline and pulse amplitude variabilities of the finger infrared photoplethysmographic (PPG) waveform and on heart rate variability extracted from the ECG signal collected from 18 kidney failure patients undergoing haemodialysis. Spectral powers were calculated from the low frequency (LF, 0.04-0.145 Hz) and high frequency (HF, 0.145-0.45 Hz) bands. In eight stable fluid overloaded patients (fluid removal of >2 L) not on alpha blockers, progressive reduction in relative blood volume during haemodialysis resulted in significant increase in LF and HF powers of PPG baseline and amplitude variability (P analysis of finger PPGV may provide valuable information on the autonomic vascular response to blood volume reduction in haemodialysis, and can be potentially utilized as a non-invasive tool for assessing peripheral circulatory control during routine dialysis procedure.

  4. NURSE STAFFING AND RENAL ANAEMIA OUTCOMES IN HAEMODIALYSIS CARE.

    Science.gov (United States)

    Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus

    2016-09-01

    Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  5. Haemodialysis in a rural area: a demanding form of treatment.

    Science.gov (United States)

    Brammah, A; Young, G; Allan, A; Robertson, S; Norrie, J; Isles, C

    2001-09-01

    To determine distances travelled and time spent waiting for transport among hospital haemodialysis patients living in a rural area. Cross sectional survey comparing the subregional dialysis unit in south west Scotland with 12 of the other 13 Scottish Adult Renal Units. Forty three Dumfries and Galloway patients and 935 other Scottish patients receiving hospital haemodialysis in November 1999. At the time of the survey 8/43 (19%) Dumfries patients travelled in excess of 100 miles per dialysis day (15,000 miles per year) solely for the purpose of dialysis, compared to 20/935 (2%) elsewhere in Scotland (p Scottish Units relied on hospital car, Patient Transport Service bus or ambulance for the journey home after treatment. Dumfries patients who travelled by Patient Transport Service or hospital ambulance had to wait twice as long before they left the renal unit as patients using a dedicated hospital car or private car. Haemodialysis in a rural area has every reason to be considered a demanding form of treatment. Greater promotion of home based treatment would improve the quality of life for many of these patients, while dedicated hospital cars would reduce 'car to needle time' for those who remain on hospital haemodialysis.

  6. The carbon footprint of an Australian satellite haemodialysis unit.

    Science.gov (United States)

    Lim, Allan E K; Perkins, Anthony; Agar, John W M

    2013-06-01

    This study aimed to better understand the carbon emission impact of haemodialysis (HD) throughout Australia by determining its carbon footprint, the relative contributions of various sectors to this footprint, and how contributions from electricity and water consumption are affected by local factors. Activity data associated with HD provision at a 6-chair suburban satellite HD unit in Victoria in 2011 was collected and converted to a common measurement unit of tonnes of CO2 equivalents (t CO2-eq) via established emissions factors. For electricity and water consumption, emissions factors for other Australian locations were applied to assess the impact of local factors on these footprint contributors. In Victoria, the annual per-patient carbon footprint of satellite HD was calculated to be 10.2t CO2-eq. The largest contributors were pharmaceuticals (35.7%) and medical equipment (23.4%). Throughout Australia, the emissions percentage attributable to electricity consumption ranged from 5.2% to 18.6%, while the emissions percentage attributable to water use ranged from 4.0% to 11.6%. State-by-state contributions of energy and water use to the carbon footprint of satellite HD appear to vary significantly. Performing emissions planning and target setting at the state level may be more appropriate in the Australian context. What is known about the topic? Healthcare provision carries a significant environmental footprint. In particular, conventional HD uses substantial amounts of electricity and water. In the UK, provision of HD and peritoneal dialysis was found to have an annual per-patient carbon footprint of 7.1t CO2-eq. What does this paper add? This is the first carbon-footprinting study of HD in Australia. In Victoria, the annual per-patient carbon footprint of satellite conventional HD is 10.2t CO2-eq. Notably, the contributions of electricity and water consumption to the carbon footprint varies significantly throughout Australia when local factors are taken into

  7. Haemodialysis is an effective treatment in acute metabolic decompensation of maple syrup urine disease

    Directory of Open Access Journals (Sweden)

    P.S. Atwal

    2015-09-01

    Full Text Available Acute metabolic decompensation in maple syrup urine disease can occur during intercurrent illness and is a medical emergency. A handful of reports in the medical literature describe the use of peritoneal dialysis and haemodialysis as therapeutic inventions. We report the only patient from our centre to have haemodialysis performed in this setting. Combined with dietary BCAA restriction and calorific support, haemodialysis allows rapid reduction in plasma leucine concentrations considerably faster than conservative methods.

  8. Revealed access to haemodialysis facilities in northeastern Iran: Factors that matter in rural and urban areas.

    Science.gov (United States)

    Kiani, Behzad; Bagheri, Nasser; Tara, Ahmad; Hoseini, Benyamin; Tabesh, Hamed; Tara, Mahmood

    2017-11-07

    Poor access to haemodialysis facilities is associated with high mortality and morbidity rates. This study investigated factors affecting revealed access to the haemodialysis facilities considering patients living in rural and urban areas without any haemodialysis facility (Group A) and those living urban areas with haemodialysis facilities (Group B). This study is based on selfreported Actual Access Time (AAT) to referred haemodialysis facilities and other information regarding travel to haemodialysis facilities from patients. All significant variables on univariate analysis were entered into a univariate general linear model in order to identify factors associated with AAT. Both spatial (driving time and distance) and non-spatial factors (sex, income level, caregivers, transportation mode, education level, ethnicity and personal vehicle ownership) influenced the revealed access identified in Group A. The non-spatial factors for Group B patients were the same as for Group A, but no spatial factor was identified in Group B. It was found that accessibility is strongly underestimated when driving time is chosen as accessibility measure to haemodialysis facilities. Analysis of revealed access determinants provides policymakers with an appropriate decision base for making appropriate decisions and finding solutions to decrease the access time for patients under haemodialysis therapy. Driving time alone is not a good proxy for measuring access to haemodialysis facilities as there are many other potential obstacles, such as women's special travel problems, poor other transportation possibilities, ethnicity disparities, low education levels, low caregiver status and low-income.

  9. A holistic approach to factors affecting depression in haemodialysis patients.

    Science.gov (United States)

    Gerogianni, Georgia; Kouzoupis, Anastasios; Grapsa, Eirini

    2018-05-19

    Depression in dialysis populations is affected by co-morbid diseases, such as cardiovascular disease, diabetes, and immune dysfunction, and it also includes high suicide risk and frequent hospitalizations. Depressive disorders have a close association with malnutrition and chronic inflammation, as well as with cognitive impairment. Impaired cognitive function may be manifested as low adherence to dialysis treatment, leading to malnutrition. Additionally, chronic pain and low quality of sleep lead to high rates of depressive symptoms in haemodialysis patients, while an untreated depression can cause sleep disturbances and increased mortality risk. Depression can also lead to sexual dysfunction and non-adherence, while unemployment can cause depressive disorders, due to patients' feelings of being a financial burden on their family. The present review provides a holistic approach to the factors affecting depression in haemodialysis, offering significant knowledge to renal professionals.

  10. The beliefs and expectations of patients and caregivers about home haemodialysis: an interview study

    Science.gov (United States)

    Tong, Allison; Palmer, Suetonia; Manns, Braden; Craig, Jonathan C; Ruospo, Marinella; Gargano, Letizia; Johnson, David W; Hegbrant, Jörgen; Olsson, Måns; Fishbane, Steven; Strippoli, Giovanni F M

    2013-01-01

    Objectives To explore the beliefs and expectations of patients and their caregivers about home haemodialysis in Italy where the prevalence of home haemodialysis is low. Design Semistructured, qualitative interview study with purposive sampling and thematic analysis. Setting Four dialysis centres in Italy without home haemodialysis services (Bari, Marsala, Nissoria and Taranto). Participants 22 patients receiving in-centre haemodialysis and 20 of their identified caregivers. Results We identified seven major themes that were central to patient and caregiver perceptions of home haemodialysis in regions without established services. Three positive themes were: flexibility and freedom (increased autonomy, minimised wasted time, liberation from strict dialysis schedules and gaining self-worth); comfort in familiar surroundings (family presence and support, avoiding the need for dialysis in hospital) and altruistic motivation to do home haemodialysis as an exemplar for other patients and families. Four negative themes were: disrupting sense of normality; family burden (an onerous responsibility, caregiver uncertainty and panic and visually confronting); housing constraints; healthcare by ‘professionals’ not ‘amateurs’ (relinquishing security and satisfaction with in-centre services) and isolation from peer support. Conclusions Patients without direct experience or previous education about home haemodialysis and their caregivers recognise the autonomy of home haemodialysis but are very concerned about the potential burden and personal sacrifice home haemodialysis will impose on caregivers and feel apprehensive about accepting the medical responsibilities of dialysis. To promote acceptance and uptake of home haemodialysis among patients and caregivers who have no experience of home dialysis, effective strategies are needed that provide information about home haemodialysis to patients and their caregivers, assure access to caregiver respite, provide continuous

  11. Clinical, analytical and bioimpedance characteristics of persistently overhydrated haemodialysis patients.

    Science.gov (United States)

    Castellano, Sandra; Palomares, Inés; Molina, Manuel; Pérez-García, Rafael; Aljama, Pedro; Ramos, Rosa; Merello, J Ignacio

    2014-11-17

    Fluid overload is an important and modifiable cardiovascular risk factor for haemodialysis patients. So far, the diagnosis was based on clinical methods alone. Nowadays, we have new tools to assess more objectively the hydration status of the patients on haemodialysis, as BCM (Body Composition Monitor). A Relative Overhydration (AvROH) higher than 15% (it means, Absolute Overhydration or AWOH higher than 2.5 Litres) is associated to greater risk in haemodialysis. However, there is a group of maintained hyperhydrated patients. The aim of the present study is to identify the characteristics of patients with maintained hyperhydrated status (AvROH higher than 15% or AWOH higher than 2.5 liters). The secondary aim is to show the hemodynamic and analytical changes that are related to the reduction in hyperhydration status. Longitudinal cohort study during six months in 2959 patients in haemodialysis (HD) that are grouped according to their hydration status by BCM. And we compare their clinical, analytical and bioimpedance spectroscopy parameters. The change in overhydration status is followed by a decrease in blood pressure and the need for hypotensive drugs (AHT) and erythropoiesis stimulating agents (ESA). The target hydration status is not reached by two subgroups of patients. First, in diabetic patients with a high comorbidity index and high number of hypotensive drugs (AHT) but a great positive sodium gradient during dialysis sessions; and, younger non-diabetic patients with longer time on hemodialysis and positive sodium gradient, lower fat tissue index (FTI) but similar lean tissue index (LTI) and albumin than those with a reduction in hyperhydration status. Those patients with a reduction in hyperhydration status, also show a better control in blood pressure and anemia with less number of AHT and ESA. The maintained hyperhydrated patients, diabetic patients with many comorbidities and young men patients with longer time on hemodialysis and non-adherence treatment

  12. Evaluation of spiritual well-being in haemodialysis patients.

    Science.gov (United States)

    Reig-Ferrer, Abilio; Arenas, M Dolores; Ferrer-Cascales, Rosario; Fernández-Pascual, M Dolores; Albaladejo-Blázquez, Natalia; Gil, M Teresa; de la Fuente, Vanesa

    2012-01-01

    Spirituality can be defined as a personal search for meaning and purpose in life that may or may not encompass religion. In this article we report on the development and testing of an instrument for measuring spiritual well-being within a sample of haemodialysis patients. The main instrument, a 21-item Meaning in Life Scale (MiLS), comprises four scales: Life Perspective, Purpose and Goals, Confusion and Lessened Meaning, Harmony and Peace, and Benefits of Spirituality. A total score for spiritual well-being is also produced. We also used the following variables: clinical (time on haemodialysis, modified Charlson comorbidity index), sociodemographic (age, gender), and self-assessments of health, quality of life (general and recent), personal happiness, religiosity, and belief in the afterlife. A cross-sectional study was carried out on 94 haemodialysis patients. This study demonstrates that the MiLS-Sp is a psychometrically sound measure of spiritual well-being for dialysis patients (reliability, validity) as they manage the complex demands of a chronic illness. Spiritual well-being was significantly associated with various quality of life variables, health status, personal happiness, or religiosity in patients on dialysis. There was no relationship between spirituality scores and comorbidity, HD duration, gender, or age. Spiritual well-being is relatively low in dialysis patients. Spirituality may play an important role on psychological well-being, quality of life, and self-rated health for patients on haemodialysis. Spiritual well-being in these patients is relatively low. Results suggest that assessing and addressing spiritual well-being in dialysis patients may be helpful in clinical practice.

  13. A Modified Technique of Basilic Vein Transposition for Haemodialysis

    International Nuclear Information System (INIS)

    Chaudhary, F. A.; Parvez, Z.

    2014-01-01

    Objective: To modify the technique of basilic vein transposition for vascular accesss for haemodialysis aiming at better maturation rate, longer survival of fistula and lesser complications. Study Design: Case series. Place and Duration of Study: Shaikh Zayed Hospital and Omer Hospital, Lahore, from February 2008 to July 2011. Methodology: Patients referred for basilic vein transposition for haemodialysis vascular access were prospectively enrolled. The surgical technique included small tracking incisions, an extra 3 - 4 cm of vein length harvesting to avoid tension in the vein in its new course, an oval arteriotomy and a smooth curved pathway, away from vein harvesting incision to avoid entrapment of vein in the scar. Maturation rate, fistula survival and other complications were noted. Results: There was no immediate failure in 51 patients. The complications during follow-up period were infection and thrombosis, bleeding and non-development of basilic vein in 2 patients each; and false aneurysm formation in one. Four patients died during follow-up period. The maturation time was 4.9 A +- 1.1 weeks. The early patency rate was 92.2%, same at 6 months and 90.7% at 12 months. Conclusion: Arteriovenous fistula constructed with modified technique of basilic vein transposition is an acceptable and valid option of vascular access for haemodialysis. (author)

  14. The effect of aromatherapy on haemodialysis patients' pruritus.

    Science.gov (United States)

    Cürcani, Mehtap; Tan, Mehtap

    2014-12-01

    To determine the effect of aromatherapy on pruritus observed in haemodialysis patients. Although the prevalence of pruritus in kidney failure has decreased in the recent years, pruritus is a difficult and serious problem which concerns the majority of haemodialysis patents and is hard to cure. A prospective, pretest-post-test quasi-experimental design was used. The research is quasi-experimental clinical trial conducted as pretest and post-test with control groups between January 2011-April 2012, in haemodialysis units of hospitals in Erzurum. The collection of the data is achieved using a questionnaire to detect the patients' individual and pruritus score scale and to clarify certain laboratory parameters regarding the pruritus. Chi-square analysis and t-test are used for the analysis of data. The experimental group's mean post-test pruritus scores (7·20 ± 3·14) were found to be lower than that of control group patients (10·00 ± 2·47), and a highly significant difference was found between the groups (p aromatherapy was found to decrease the pruritus problem of haemodialyses patients and led to positive changes in some laboratory parameters related to pruritus. One of the roles of health professionals is to advise individuals, who are living on this problem, using the nonpharmacological methods in checking the itching. By preventing or reducing uraemic pruritus, aromatherapy may also improve quality of life in this patient group. © 2014 John Wiley & Sons Ltd.

  15. Psychosocial influencers and mediators of treatment adherence in haemodialysis patients.

    Science.gov (United States)

    Oh, Hyun Soo; Park, Ji Suk; Seo, Wha Sook

    2013-09-01

    This article is a report of the development and testing of the hypothetical model that illustrates relationships between treatment adherence and its psychosocial influencing factors and to elucidate the direct and indirect (mediating) effects of factors on treatment adherence. Poor adherence has been consistently reported in haemodialysis patients. Much research has showed various influencing factors of adherence, but these studies have failed to identify consistent influencing factors. This study was performed using a non-experimental, cross-sectional design. The study subjects were 150 end-stage renal failure patients on haemodialysis at a university hospital located in Incheon, South Korea. Data were collected over 10 months (June 2010-April 2011). The hypothetical model provided a good fit with data. Haemodialysis-related knowledge, perceived barrier to adherence, self-efficacy on adherence, and healthcare provider support had significant effects on adherence. Self-efficacy was found to mediate barrier-adherence and family support-adherence relationships. Self-efficacy in combination with barrier, family support, and healthcare provider support was found to mediate the depression-adherence relationship. Strategies aimed at the development of successful adherence interventions should focus on reducing perceived barriers and enhancing self-efficacy and knowledge. It can be suggested that efforts to improve the healthcare provider-patient relationship would enhance adherence. In depressive patients, strategies that promote self-efficacy and the support of family or healthcare providers could diminish the negative impact of depression on adherence. © 2013 Blackwell Publishing Ltd.

  16. Infective endocarditis in patients on haemodialysis - possible strategies for prevention.

    Science.gov (United States)

    Oun, Hadi A; Price, Andrew J; Traynor, Jamie P

    2016-05-01

    Infective endocarditis is an important cause of morbidity and mortality in patients receiving haemodialysis for established renal failure. We carried out a prospective audit of patients developing infective endocarditis in a single renal unit. From 1 January 2000 to 31 December 2013, we collected data on all cases of endocarditis occurring in patients receiving haemodialysis at Monklands Hospital, Airdrie. Twenty-nine patients developed endocarditis during our audit period. Twenty-three (79.3%) of the patients had pre-existing cardiac valve abnormalities such as regurgitation or calcification. Staphylococcus aureus was the most common microorganism cultured from the blood of 22 patients (75.9%). MRSA bacteraemia was identified in eight of these patients and all eight patients died during that first presentation. Different strategies were introduced within the unit during the audit period aiming to reduce the rate of bacteraemia. Since 2011, a successful strategy has been introduced under the auspices of the Scottish Patient Safety Programme. This led to our Staph aureus bacteraemia rate related to non-tunnelled venous catheters going from an average of 15 days between episodes to having had no episodes between 2 December 2011 and the end of the study period (760 days). This also appears to have had a positive impact on reducing the rate of endocarditis. Infective endocarditis remains a devastating consequence of bacteraemia in patients receiving haemodialysis. An effective strategy aimed at reducing the rate of bacteraemia appears to have a similar effect on the rate of endocarditis. © The Author(s) 2016.

  17. Haemodialysis followed by continuous veno-venous haemodiafiltration in lithium intoxication; a model and a case

    NARCIS (Netherlands)

    Meertens, John H J M; Jagernath, Danny R; Eleveld, Douglas J; Zijlstra, Jan G; Franssen, Casper F M

    2009-01-01

    For severe lithium intoxication haemodialysis is recommended to lower serum lithium levels rapidly. Frequently, serum lithium levels rebound after dialysis and repeated dialysis is needed. This is the first report of an adult patient with severe lithium intoxication who underwent haemodialysis (HD)

  18. PLASMA CYTOKINES LEVELS IN PATIENTS UNDERGOING LONG-TERM HAEMODIALYSIS

    Directory of Open Access Journals (Sweden)

    D. S. Polyakov

    2011-01-01

    Full Text Available Аbstract.  Patients  with  end-stage  renal  disease  need  their  kidney  functions  to  be  replaced.  Chronic haemodialysis represents a most common method of such substitution treatment. This procedure results in successful survival of such patients for years. Chronic haemodialysis is accompanied by a complication which is known as β2-microglobulin amyloidosis. In this case, amyloid substance consisting of β2-microglobulin (β2-MG accumulates in bones, ligaments and joints. Biological causes of β2-MG amyloidosis are still not established. To elucidate the role of inflammation in the pathogenesis of β2-MG amyloidosis, the levels of  IL-2,  IL-4,  IL-6,  IL-8,  IL-10,  GM-CSF,  IFNγ, TNFα were quantified in plasma of patients undergoing  long-term haemodialysis. Mean amounts of all the mentioned cytokines in haemodialysis patients proved to be significantly higher than in control group consisting of healthy subjects. When comparing a group receiving standard  dialysis  procedure  versus  a  subgroup  receiving  haemodiafiltration,  a  single  reliable  difference  was revealed for GM-CSF levels (p < 0.04, without any differences shown for other cytokines. With increasing terms of chronic haemodialysis, the levels of IL-2, IL-4, IL-6, IL-8, GM-CSF, IFNγ, TNFα were increased, or, at least, they did not decrease. After three years of dialysis, IL-10 concentrations were statistically indistinguishable from normal levels. In patients undergoing haemodiafiltration, plasma levels of IL-2, IL-4, IL-8, GM-CSF, IFNγ, TNFα did not drop with increasing terms of dialysis. The levels of IL-6 and IL-10 decreased after three years of dialysis, to near-normal levels.In general, these results suggest that IL-10 and IL-6 may be regarded as candidates for further studies as potential markers of β2-microglobulin amyloidosis. (Med. Immunol., 2011, vol. 13, N 2-3, pp 211-218

  19. Tunnelled haemodialysis catheter and haemodialysis outcomes: a retrospective cohort study in Zagreb, Croatia.

    Science.gov (United States)

    Pašara, Vedran; Maksimović, Bojana; Gunjača, Mihaela; Mihovilović, Karlo; Lončar, Andrea; Kudumija, Boris; Žabić, Igor; Knotek, Mladen

    2016-05-17

    Studies have reported that the tunnelled dialysis catheter (TDC) is associated with inferior haemodialysis (HD) patient survival, in comparison with arteriovenous fistula (AVF). Since many cofactors may also affect survival of HD patients, it is unclear whether the greater risk for survival arises from TDC per se, or from associated conditions. Therefore, the aim of this study was to determine, in a multivariate analysis, the long-term outcome of HD patients, with respect to vascular access (VA). Retrospective cohort study. This retrospective cohort study included all 156 patients with a TDC admitted at University Hospital Merkur, from 2010 to 2012. The control group consisted of 97 patients dialysed via AVF. The groups were matched according to dialysis unit and time of VA placement. The site of choice for the placement of the TDC was the right jugular vein. Kaplan-Meier analysis with log-rank test was used to assess patient survival. Multivariate Cox regression analysis was used to determine independent variables associated with patient survival. Patient survival with respect to VA. The cumulative 1-year survival of patients who were dialysed exclusively via TDC was 86.4% and of those who were dialysed exclusively via AVF, survival was 97.1% (p=0.002). In multivariate Cox regression analysis, male sex and older age were independently negatively associated with the survival of HD patients, while shorter HD vintage before the creation of the observed VA, hypertensive renal disease and glomerulonephritis were positively associated with survival. TDC was an independent risk factor for survival of HD patients (HR 23.0, 95% CI 6.2 to 85.3). TDC may be an independent negative risk factor for HD patient survival. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. The prehistory of haemodialysis as a treatment for uraemia.

    Science.gov (United States)

    Cameron, J Stewart

    2016-02-01

    Less is generally known about the ideas, events and personalities which drove developments permitting the evolution of haemodialysis as a clinically useful form of palliation and treatment, than its subsequent success and failures. This pre-history of haemodialysis is summarized here. One must remember that with hindsight we can now discern connections between ideas and developments which were not perceptible in their time, and that progress towards any new idea, material or piece of hardware was usually random and undirected, and outcomes uncertain. We must also remember the many blind alleys we can now safely ignore, to give a spurious continuity to the development of ideas. The prehistory of dialysis begins with study of the diffusion of solute and solvent in osmosis in living systems and experimental settings, and the retention of potentially toxic substances in kidney failure, during the 18th and early 19th centuries. These two areas came together in work in the mid-19th century on diffusion of gases and liquids, and showed that natural and synthetic membranes could selectively hinder different solutes. This explained osmosis and allowed semi-permeable membranes to be used and designed. These ideas underpinned the subsequent history of both dialysis using body cavities such as the peritoneum (not discussed here) and ex vivo dialysis of blood. To perform this, new membranes and anticoagulants were needed. These led to the first attempts in animals in 1912-3, and human patients in 1924-8, but only the purification and synthesis of newer materials such as cellulose and heparin allowed practical and successful haemodialysis to evolve in the 1940s.

  1. Estimation of quality of life in haemodialysis patients.

    Science.gov (United States)

    Abraham, S; Ramachandran, A

    2012-11-01

    Since haemodialysis is an expensive treatment modality for chronic renal failure patients, it is very essential to assess the outcome of therapy in terms of quality of life. The primary objective of the study was to estimate the effect of patient counselling in quality of life of end stage renal disease patients opting haemodialysis using World Health Organisation Quality of life scale and to assess the variables affecting the quality of life of these patients. Quality of life was determined by World Health Organisation Quality of life scale questionnaire comprised of 26 items which measures four domains: physical, psychological, social and environmental domain. A total of 81 patients were selected and divided into test and control group and the test group patients received counselling regarding their disease, use of medications, importance of adherence and the complications experienced during and after dialysis. The quality of life data was collected at the interval of 1, 2, 3, 6 and 12 months and the patients were counselled at each interval. The demographic profiles revealed that majority of the patients were in the age group of 31-50 and there exists a male predominance. About the socioeconomic status, upper middle class people were mostly affected. Assessment of impact of patient counselling in the quality of life of haemodialysis indicated a significant improvement in each domain after counselling. And also found that the psychological domain showed a significant increase in the score compared to others. Patient counselling helped to gain benefits in terms of improvement in quality of life and delayed progression of renal failure. Early recognition and prevention is necessary to improve the quality of life of chronic renal failure patients. Patient counselling should be made mandatory by incorporating clinical pharmacist in the nephrology team to make the patient understand his illness and modifications in lifestyle also create a positive environment and

  2. Medtronic Freestyle aortic bioprosthesis: a potential option for haemodialysis patients†.

    Science.gov (United States)

    Hegazy, Yasser Y; Rayan, Amr; Sodian, Ralf; Hassanein, Wael; Ennker, Jürgen

    2016-04-01

    End-stage renal disease patients on regular haemodialysis are at higher risk of calcification. Therefore, many surgeons have concerns regarding the implantation of bioprostheses in such patients. The haemodynamic advantages of stentless aortic bioprostheses support their use; however, these have not been studied yet in end-stage renal disease patients. We studied accordingly the early and mid-term outcomes of aortic valve replacement (AVR) using Medtronic Freestyle stentless aortic bioprostheses in this subset of patients in comparison with stented aortic bioprostheses. We retrospectively studied two groups of consecutive patients on regular haemodialysis who required AVR between 2007 and 2013. Non-Freestyle (NFS) group received stented aortic bioprostheses (36 patients) and Freestyle (FS) group received Medtronic Freestyle aortic bioprostheses (48 patients). Follow-up ranged from 2 to 76 months with a mean follow-up of 36.3 ± 25 months. Patients in both groups showed similar demographic characters regarding age (76.4 ± 8.1 vs 74.9 ± 7.2 years; P = 0.35), male gender (58 vs 60%; P = 0.57) and diabetes mellitus (42 vs 48%; P = 0.57). Smaller aortic bioprostheses were implanted in the NFS (23.3 ± 1.2 vs 25.4 ± 2.1; P < 0.001) with consequently higher postoperative mean gradients (14.1 ± 4.1 vs 11.9 ± 5.3 mmHg; P = 0.004). No significant differences were noted regarding postoperative neurological disorder (8 vs 12%; P = 0.73), deep sternal wound infection (3 vs 4%; P = 0.68), re-exploration (8 vs 8%; P = 0.91) and in-hospital mortality (6 vs 4%; P = 0.92). Mid-term follow-up showed higher prosthetic valve calcification and/or sclerosis in NFS group (25 vs 6%; P = 0.015), whereas no significant differences were noticed between the two groups regarding stroke (0 vs 8%; P = 0.13), endocarditis (0 vs 4%; P = 0.50), 36- and 72-month survival (51 ± 2%, 14 ± 4% vs 55 ± 2%, 19 ± 3%, respectively; P = 0.45). Aortic bioprostheses are a good option for haemodialysis

  3. Successful use of haemodialysis to treat phenobarbital overdose.

    Science.gov (United States)

    Hoyland, Kimberley; Hoy, Michael; Austin, Richard; Wildman, Martyn

    2013-11-21

    A 50-year-old woman presented with coma caused by a phenobarbital overdose, requiring intubation and admission to critical care. She was an international visitor and had been prescribed the drug for night-sedation. Phenobarbital is a long-acting barbiturate, which in an overdose can cause central nervous system depression, respiratory failure and haemodynamic instability; these patients can remain obtunded for many days. After initial supportive therapy, she was dialysed to help in the elimination of the drug. Haemodialysis resulted in a markedly reduced plasma level of phenobarbital, which decreased the length of intubation and stay in the critical care unit and aided full recovery.

  4. A qualitative study of treatment burden among haemodialysis recipients.

    Science.gov (United States)

    Karamanidou, Christina; Weinman, John; Horne, Rob

    2014-04-01

    This study aims to explore the experience of renal patients undergoing dialysis treatment focusing on beliefs about their illness, prescribed treatment and the challenge of adherence. Interpretative phenomenological analysis was used to analyse the accounts of seven haemodialysis patients. Patients have a range of beliefs about their illness and their treatment consistent with the self-regulatory model of illness, that is, identity, cause, consequences, timeline and cure. Patients sometimes consciously did not act in accordance to advice when they considered an aspect of treatment less important or less easy to adhere to. Psychological factors like beliefs might play a role in non-adherence behaviour.

  5. Association of versican turnover with all-cause mortality in patients on haemodialysis

    DEFF Research Database (Denmark)

    Genovese, Federica; Karsdal, Morten A; Leeming, Diana J

    2014-01-01

    with cardiovascular diseases. The objective of the study was to investigate the association of versican turnover assessed in plasma with survival in haemodialysis patients. METHODS: A specific matrix metalloproteinase-generated neo-epitope fragment of versican (VCANM) was measured in plasma of 364 haemodialysis...... patients with a 5-years follow-up, using a robust competitive enzyme-linked immunosorbent assays. Association between VCANM plasma concentration and survival was assessed by Kaplan-Meier analysis and adjusted Cox model. RESULTS: Haemodialysis patients with plasma VCANM concentrations in the lowest quartile...

  6. Nursing Care For Patients Experiencing Clinical Complications During Haemodialysis

    Directory of Open Access Journals (Sweden)

    Viviane Queiroga Linhares

    2017-02-01

    Full Text Available Introduction: Patients with chronic renal disease treated by haemodialysis experience various changes in their daily lives, which they and their families need to adapt to and cope with. Objective: To analyse the nursing care of patients with chronic renal failure on haemodialysis who experience clinical complications. Method: A descriptive, exploratory study was conducted, using a quantitative approach. Data collection was performed using a sample of 73 patients at the Hemodialysis Center located at city of Patos-PB. The sample comprised 73 patients. Results: 27 (37.0% were female, aged between 20 and 88 years old. It was found that employees are 49.3% of respondents, in consonance to farmers with 31.5%. The most common complications were weakness (76.7%, headache (46.6%, cramp (43.8% and pain (32.9%. Conclusion: The trusting relationship between professionals and patients is paramount, because helps to improve adherence to treatment and, consequently, the reduction of complications; furthermore, educational and preventive actions are facilitated.

  7. Spanish Clinical Guidelines on Vascular Access for Haemodialysis.

    Science.gov (United States)

    Ibeas, José; Roca-Tey, Ramon; Vallespín, Joaquín; Moreno, Teresa; Moñux, Guillermo; Martí-Monrós, Anna; Del Pozo, José Luis; Gruss, Enrique; Ramírez de Arellano, Manel; Fontseré, Néstor; Arenas, María Dolores; Merino, José Luis; García-Revillo, José; Caro, Pilar; López-Espada, Cristina; Giménez-Gaibar, Antonio; Fernández-Lucas, Milagros; Valdés, Pablo; Fernández-Quesada, Fidel; de la Fuente, Natalia; Hernán, David; Arribas, Patricia; Sánchez de la Nieta, María Dolores; Martínez, María Teresa; Barba, Ángel

    2017-11-01

    Vascular access for haemodialysis is key in renal patients both due to its associated morbidity and mortality and due to its impact on quality of life. The process, from the creation and maintenance of vascular access to the treatment of its complications, represents a challenge when it comes to decision-making, due to the complexity of the existing disease and the diversity of the specialities involved. With a view to finding a common approach, the Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology [S.E.N.], vascular surgery [SEACV], vascular and interventional radiology [SERAM-SERVEI], infectious diseases [SEIMC] and nephrology nursing [SEDEN]), along with the methodological support of the Cochrane Center, has updated the Guidelines on Vascular Access for Haemodialysis, published in 2005. These guidelines maintain a similar structure, in that they review the evidence without compromising the educational aspects. However, on one hand, they provide an update to methodology development following the guidelines of the GRADE system in order to translate this systematic review of evidence into recommendations that facilitate decision-making in routine clinical practice, and, on the other hand, the guidelines establish quality indicators which make it possible to monitor the quality of healthcare. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Flash pulmonary oedema after relief of haemodialysis graft stenosis.

    Science.gov (United States)

    Vélez-Martínez, Mariella; Weinberg, Brent D; Mishkin, Joseph D

    2013-08-01

    Heart failure (HF) and chronic kidney disease (CKD) are undoubtedly very much interrelated, especially in patients with end-stage renal disease (ESRD) who are dependent on renal replacement therapy. Haemodialysis (HD) is of particular interest in cardiovascular patients due to the creation of a haemodialysis vascular access and the haemodynamic changes associated with it. Adequate HD though is very dependent on a properly functioning vascular access. Unfortunately, these surgical vascular accesses are vulnerable to stenoses and occlusions. Percutaneous endovascular treatment of these stenoses is often performed and has been found to be safe and effective. Despite its frequent use, acute medical complications of this percutaneous procedure have not been well-documented. In this report, we describe a patient who developed flash pulmonary oedema after balloon angioplasty treatment of an arteriovenous graft (AVG) stenosis. Copyright © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  9. Duplex sonography in the planning and evaluation of arteriovenous fistulae for haemodialysis

    International Nuclear Information System (INIS)

    Kerr, S.F.; Krishan, S.; Lapham, R.C.; Weston, M.J.

    2010-01-01

    This paper describes how to perform duplex sonography in the planning and evaluation of arteriovenous fistulae in haemodialysis patients, discusses its roles in these settings, and presents a review of commonly encountered complications.

  10. Development of certified environmental management in hospital and outpatient haemodialysis units

    Directory of Open Access Journals (Sweden)

    Sergio García Vicente

    2015-11-01

    Discussion: There is no official documentation of the implementation of EMS in dialysis units. Making this list provides an approach to the situation, with special reference to haemodialysis because of its significant environmental impact.

  11. Starting on haemodialysis: a qualitative study to explore the experience and needs of incident patients.

    Science.gov (United States)

    Lai, Alden Yuanhong; Loh, Angela Ping Ping; Mooppil, Nandakumar; Krishnan, Deby Sarojiuy Pala; Griva, Konstadina

    2012-01-01

    Dialysis can be very stressful with the initial months onto treatment being highly critical in terms of both adaptation and mortality. This qualitative study aimed to explore the lived experiences of incident haemodialysis patients in Singapore. Topics related to the end-stage renal disease diagnosis and haemodialysis treatment were raised with 13 incident haemodialysis patients in the form of semi-structured interviews, and interpretative phenomenological analysis was undertaken as the framework for data analysis. Emotional distress, treatment-related concerns and social support emerged as main issues following a critical review of themes. Our study revealed that incident haemodialysis patients have emotional and informational needs, highlighting the importance of intervention programmes in particular to this patient group to promote better psychosocial adjustment to the disease and its treatment.

  12. Internal jugular vein access for the interventional management of nonfunctioning artero-venous haemodialysis fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Basile, A. E-mail: antodoc@yahoo.com; Garcia Medina, J.; Lupattelli, T.; Garcia Medina, V.; Leal, R

    2004-12-01

    We report our experience and results with the use of internal jugular vein as secondary approach for the endovascular treatment of twelve nonfunctioning artero-venous (AV) fistulas in haemodialysis patients.

  13. Effect of plasma colloid osmotic pressure on intraocular pressure during haemodialysis

    OpenAIRE

    Tokuyama, T.; Ikeda, T.; Sato, K.

    1998-01-01

    BACKGROUND—In a previous case report, it was shown that an increase in plasma colloid osmotic pressure induced by the removal of fluid during haemodialysis was instrumental in decreasing intraocular pressure. The relation between changes in intraocular pressure, plasma osmolarity, plasma colloid osmotic pressure, and body weight before and after haemodialysis is evaluated.
METHODS—Intraocular pressure, plasma osmolarity, plasma colloid osmotic pressure, and body weight were evaluated before a...

  14. Successful delivery of chemotherapy to treat small-cell prostate cancer in a patient undergoing haemodialysis

    OpenAIRE

    McPartlin, Andrew; Grimaldo, Claudia; Lyons, Jeanette; Burke, Daniel; Mitra, Sandip; Choudhury, Ananya

    2014-01-01

    We report on the successful treatment of small-cell prostate cancer in a patient undergoing haemodialysis. The therapeutic regimen included 300 mg/m2 of carboplatin and 50 mg/m2 of etoposide coupled with radical radiotherapy. Adjustments to the patient's haemodialysis prescription included the use of high flux, a larger dialyser surface area and an increased dialysis time. The parameters used aided tolerance to the drug, allowing the delivery of safe, effective treatment. At an interval of ov...

  15. Cardiovascular disease in haemodialysis: role of the intravascular innate immune system.

    Science.gov (United States)

    Ekdahl, Kristina N; Soveri, Inga; Hilborn, Jöns; Fellström, Bengt; Nilsson, Bo

    2017-05-01

    Haemodialysis is a life-saving renal replacement modality for end-stage renal disease, but this therapy also represents a major challenge to the intravascular innate immune system, which is comprised of the complement, contact and coagulation systems. Chronic inflammation is strongly associated with cardiovascular disease (CVD) in patients on haemodialysis. Biomaterial-induced contact activation of proteins within the plasma cascade systems occurs during haemodialysis and initially leads to local generation of inflammatory mediators on the biomaterial surface. The inflammation is spread by soluble activation products and mediators that are generated during haemodialysis and transported in the extracorporeal circuit back into the patient together with activated leukocytes and platelets. The combined effect is activation of the endothelium of the cardiovascular system, which loses its anti-thrombotic and anti-inflammatory properties, leading to atherogenesis and arteriosclerosis. This concept suggests that maximum suppression of the intravascular innate immune system is needed to minimize the risk of CVD in patients on haemodialysis. A potential approach to achieve this goal is to treat patients with broad-specificity systemic drugs that target more than one of the intravascular cascade systems. Alternatively, 'stealth' biomaterials that cause minimal cascade system activation could be used in haemodialysis circuits.

  16. Empathy and stress in nurses working in haemodialysis: a qualitative study.

    Science.gov (United States)

    Vioulac, Christel; Aubree, Colette; Massy, Ziad A; Untas, Aurélie

    2016-05-01

    To explore the concepts of empathy and stress in nurses working in haemodialysis units in France and their possible interactions. Nurses' work in haemodialysis is rather complex. It requires technical expertise, because of the peculiarity of the treatment, and emotional skills, to care for patients throughout a long-lasting therapy. Empathy is considered as a key in the concept of caring, which allows nurses to give appropriate answers to their patients' needs. In addition, nurses' work environment can generate stress. A qualitative descriptive design. Nurses (N = 23) working in haemodialysis units were interviewed in three different sites in 2014. The analysis of nurses' speech emphasized a predominance of the cognitive attributes of empathy: understanding, communication, adjusted response (43%), and a special feature of the relationship due to the chronicity of the care (23%). The main stressors highlighted were time management (14%), emergencies (12%) and technical nature of the task (8%). Nurses' experience in haemodialysis seemed to be a modulating factor regarding empathy and stress. The main stressors highlighted were time management (14%), emergencies (12%) and technical nature of the task (8%). Nurses' experience in haemodialysis seemed to be a modulating factor regarding empathy and stress. The results showed the special features of nurses' work in haemodialysis and the need for further studies to investigate these concepts. The influence of stress on empathy needs to be explored more precisely, especially regarding nurses' experience and its impact on patients. © 2016 John Wiley & Sons Ltd.

  17. HCV viraemia in anti-HCV-negative haemodialysis patients: Do we need HCV RNA detection test?

    Science.gov (United States)

    Papadopoulos, Nikolaos; Griveas, Ioannis; Sveroni, Eirini; Argiana, Vasiliki; Kalliaropoulos, Antonios; Martinez-Gonzalez, Beatriz; Deutsch, Melanie

    2018-03-01

    Hepatitis C virus (HCV) infection is still common among dialysis patients, but the natural history of HCV in this group is not completely understood. The KDIGO HCV guidelines of 2009 recommend that chronic haemodialysis patients be screened for HCV antibody upon admission to the dialysis clinic and every 6 months thereafter if susceptible to HCV infection. However, previous studies have shown the presence of HCV viraemia in anti-HCV-negative haemodialysis patients as up to 22%. To evaluate the presence of HCV viraemia, using HCV RNA detection, among anti-HCV-negative haemodialysis patients from a tertiary dialysis unit in Athens. We enrolled 41 anti-HCV-negative haemodialysis patients diagnosed with third-generation enzyme immunoassay. HCV viraemia was evaluated using a sensitive (cut-off: 12 IU/mL) reverse transcriptase polymerase chain reaction (COBAS AmpliPrep/TaqMan system) for HCV RNA. None of the 41 anti-HCV-negative haemodialysis patients were shown to be viraemic. Routine HCV RNA testing appears not to be necessary in anti-HCV-negative haemodialysis patients.

  18. A user-friendly tool for incremental haemodialysis prescription.

    Science.gov (United States)

    Casino, Francesco Gaetano; Basile, Carlo

    2018-01-05

    There is a recently heightened interest in incremental haemodialysis (IHD), the main advantage of which could likely be a better preservation of the residual kidney function of the patients. The implementation of IHD, however, is hindered by many factors, among them, the mathematical complexity of its prescription. The aim of our study was to design a user-friendly tool for IHD prescription, consisting of only a few rows of a common spreadsheet. The keystone of our spreadsheet was the following fundamental concept: the dialysis dose to be prescribed in IHD depends only on the normalized urea clearance provided by the native kidneys (KRUn) of the patient for each frequency of treatment, according to the variable target model recently proposed by Casino and Basile (The variable target model: a paradigm shift in the incremental haemodialysis prescription. Nephrol Dial Transplant 2017; 32: 182-190). The first step was to put in sequence a series of equations in order to calculate, firstly, KRUn and, then, the key parameters to be prescribed for an adequate IHD; the second step was to compare KRUn values obtained with our spreadsheet with KRUn values obtainable with the gold standard Solute-solver (Daugirdas JT et al., Solute-solver: a web-based tool for modeling urea kinetics for a broad range of hemodialysis schedules in multiple patients. Am J Kidney Dis 2009; 54: 798-809) in a sample of 40 incident haemodialysis patients. Our spreadsheet provided excellent results. The differences with Solute-solver were clinically negligible. This was confirmed by the Bland-Altman plot built to analyse the agreement between KRUn values obtained with the two methods: the difference was 0.07 ± 0.05 mL/min/35 L. Our spreadsheet is a user-friendly tool able to provide clinically acceptable results in IHD prescription. Two immediate consequences could derive: (i) a larger dissemination of IHD might occur; and (ii) our spreadsheet could represent a useful tool for an ineludibly

  19. Analysis of nutrition and nutritional status of haemodialysis patients

    Science.gov (United States)

    Bogacka, Anna; Sobczak-Czynsz, Anna; Kucharska, Elżbieta; Madaj, Małgorzata; Stucka, Katarzyna

    2018-01-01

    Chronic kidney disease (CKD) is a common disease of civilization where nutrition is part of the treatment. Diet therapy is difficult as it is necessary to control the intake of: energy, protein and minerals – Na, K, Ca and P in the daily food rations (DFR). The aim of the study was to assess the nutritional status and diets of haemodialysis (HD) patients. The study involved 141 haemodialysis patients, at the average age of 65.9. The patients were divided into groups taking into consideration their sex and diagnosis for diabetes. The information on the diets were collected using a 7-day dietary recall. In the DFRs the amount of energy and 22 nutrients were calculated. Obtained results were compared with requirements for HD patients. Appropriate nutritional status (measured with BMI) was reported for majority of women (70.6%) and almost half of men, however, excessive weight was recognized in every third female patient and more than half male patients, and type I obesity was noted in 7.8% of men. The analysis of the results showed that diets of all examined patients were deficient in energy and protein (except women with diabetes), whereas the consumption of fat was appropriate in both groups of women. The recommendations with respect to the amount of cholesterol were met but dietary fibre was too low. Intake of vitamins B1, D, C, folates and Ca and Mg was lower and intake of vitamin B12 was higher than recommended. Assessment of the coverage of the demand on nutrients in HD patients should not be based on the analysis of their nutritional status (BMI) only but also on the analysis of diets, especially in case of diabetes.

  20. Altering plasma sodium concentration rapidly changes blood pressure during haemodialysis.

    Science.gov (United States)

    Suckling, Rebecca J; Swift, Pauline A; He, Feng J; Markandu, Nirmala D; MacGregor, Graham A

    2013-08-01

    Plasma sodium is increased following each meal containing salt. There is an increasing interest in the effects of plasma sodium concentration, and it has been suggested that it may have direct effects on blood pressure (BP) and possibly influences endothelial function. Experimental increases of plasma sodium concentration rapidly raise BP even when extracellular volume falls. Ten patients with end-stage renal failure established on haemodialysis were studied during the first 2 h of dialysis without fluid removal during this period. They were randomized to receive haemodialysis with (i) dialysate sodium concentration prescribed to 135 mmol/L and (ii) 145 mmol/L in random order in a prospective, single-blinded crossover study. BP measurements and blood samples were taken every 30 min. Pre-dialysis sitting BP was 137/76 ± 7/3 mmHg. Lower dialysate sodium concentration (135 mmol/L) reduced plasma sodium concentration [139.49 ± 0.67 to 135.94 ± 0.52 mmol/L (P area under the curve (AUC) 15823.50 ± 777.15 (mmHg)min] compared with 145 mmol/L [AUC 17018.20 ± 1102.17 (mmHg)min], mean difference 1194.70 ± 488.41 (mmHg)min, P < 0.05. There was a significant positive relationship between change in plasma sodium concentration and change in systolic BP. This direct relationship suggests that a fall of 1 mmol/L in plasma sodium concentration would be associated with a 1.7 mmHg reduction in systolic BP (P < 0.05). The potential mechanism for the increase in BP seen with salt intake may be through small but significant changes in plasma sodium concentration.

  1. The effects of lavender essential oil aromatherapy on anxiety and depression in haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Masoumeh Bagheri-Nesami

    2017-05-01

    Full Text Available This study was intended to examine the effects of lavender essential oil aromatherapy on anxiety and depression in haemodialysis patients. This randomised clinical trial was conducted on 72 haemodialysis patients divided into control and experimental groups. The control group only received the routine care. The experimental group received aromatherapy with 3 drops of lavender essential oil 5% for 10 minutes every time they underwent haemodialysis for a period of one month. Anxiety and depression were measured in both groups at baseline and by the end of the second and fourth weeks during the first hour of a dialysis session. The rANOVA showed no significant difference between the two groups in terms of the severity of anxiety before the intervention and by the end of the second and fourth weeks (p  =  0.783. However, the  rANOVA revealed a significant difference with respect to the severity of depression between the two groups (p  =  0.005. Current research suggests that we need various concentrations of lavender essential oil to relieve anxiety compared to depression. In sum, future studies are required to investigate different concentrations of lavender essential oil at different times during haemodialysis sessions to obtain specific doses for lavender essential oil to be used on haemodialysis patients suffering from anxiety and depression.

  2. Low vitamin K1 intake in haemodialysis patients.

    Science.gov (United States)

    Fusaro, Maria; D'Alessandro, Claudia; Noale, Marianna; Tripepi, Giovanni; Plebani, Mario; Veronese, Nicola; Iervasi, Giorgio; Giannini, Sandro; Rossini, Maurizio; Tarroni, Giovanni; Lucatello, Sandro; Vianello, Alberto; Santinello, Irene; Bonfante, Luciana; Fabris, Fabrizio; Sella, Stefania; Piccoli, Antonio; Naso, Agostino; Ciurlino, Daniele; Aghi, Andrea; Gallieni, Maurizio; Cupisti, Adamasco

    2017-04-01

    Vitamin K acts as a coenzyme in the γ-carboxylation of vitamin K-dependent proteins, including coagulation factors, osteocalcin, matrix Gla protein (MGP), and the growth arrest-specific 6 (GAS6) protein. Osteocalcin is a key factor for bone matrix formation. MGP is a local inhibitor of soft tissue calcification. GAS6 activity prevents the apoptosis of vascular smooth muscle cells. Few data on vitamin K intake in chronic kidney disease patients and no data in patients on a Mediterranean diet are available. In the present study, we evaluate the dietary intake of vitamin K1 in a cohort of patients undergoing haemodialysis. In this multi-centre controlled observational study, data were collected from 91 patients aged >18 years on dialysis treatment for at least 12 months and from 85 age-matched control subjects with normal renal function. Participants completed a food journal of seven consecutive days for the estimation of dietary intakes of macro- and micro-nutrients (minerals and vitamins). Compared to controls, dialysis patients had a significant lower total energy intake, along with a lower dietary intake of proteins, fats, carbohydrates, fibres, and of all the examined minerals (Ca, P, Fe, Na, K, Zn, Cu, and Mg). With the exception of vitamin B12, vitamins intake followed a similar pattern, with a lower intake in vitamin A, B1, B2, C, D, E, folates, K1 and PP. These finding were confirmed also when normalized for total energy intake or for body weight. In respect to the adequate intakes recommended in the literature, the prevalence of a deficient vitamin K intake was very high (70-90%) and roughly double than in controls. Multivariate logistic model identified vitamin A and iron intake as predictors of vitamin K deficiency. Haemodialysis patients had a significantly low intake in vitamin K1, which could contribute to increase the risk of bone fractures and vascular calcifications. Since the deficiency of vitamin K intake seems to be remarkable, dietary

  3. A STUDY ON INCIDENCE OF ACUTE CARDIOVASCULAR COMPLICATIONS DURING MAINTENANCE HAEMODIALYSIS OF END-STAGE RENAL FAILURE PATIENTS

    Directory of Open Access Journals (Sweden)

    Darimireddi Siva Kumar

    2016-09-01

    Full Text Available BACKGROUND To study the incidence of acute cardiovascular complications during haemodialysis in patients with chronic kidney disease with end-stage renal failure on maintenance haemodialysis. METHODS Patients with chronic kidney disease with end-stage renal failure on maintenance haemodialysis at King George Hospital, Andhra Medical College, Visakhapatnam, India, were studied during the period of June 2015 to August 2016. In our study, all the 100 patients underwent 8510 haemodialysis sessions during 1-year period of study. RESULTS Cardiovascular complications are the most common intradialytic complications occurred during the study. Hypotension is the commonest of all the intradialytic as well as cardiovascular complications with a frequency of 1278, which account for 15.01% of the haemodialysis sessions. This was followed by 879 episodes of hypertension (10.32%, 190 episodes of cardiac arrhythmias (2.23%, which include complex ventricular arrhythmias and supraventricular arrhythmias and 162 episodes of chest pain (1.90%. Of the 100 patients, 37% of patients developed cardiac arrhythmias during haemodialysis. The frequency of arrhythmic episodes was 190 (2.23%. Among these, Supraventricular Arrhythmias (SVA and Complex Ventricular Arrhythmic (CVA episodes account for 159 (83.68% and 31 (16.31%, respectively. CVA and SVA occurred in 29% and 19% of patients in the study group, respectively. Both CVA and SVA occurred in 12% of patients. CONCLUSION Intradialytic hypotension is the most common acute intradialytic complication in patients with chronic kidney disease with endstage renal failure undergoing maintenance haemodialysis. This is followed by intradialytic hypertension. Sudden cardiac arrest is the most common cause of death during haemodialysis in patients with end-stage renal disease on haemodialysis. Mortality is high in patients with end-stage renal failure in maintenance haemodialysis with ischaemic heart disease.

  4. The effect of reflexology applied on haemodialysis patients with fatigue, pain and cramps.

    Science.gov (United States)

    Ozdemir, Gülistan; Ovayolu, Nimet; Ovayolu, Ozlem

    2013-06-01

    The research was conducted to evaluate the effect of foot reflexology on fatigue, pain and cramps in haemodialysis patients. The sample consisted of 80 patients in total, 40 intervention and 40 control patients, receiving treatment in the haemodialysis units of two institutions. Data were collected by using a questionnaire, Piper Fatigue Scale and visual analogue scale for measuring the severity of cramp and pain. The intervention group received reflexology treatment for 1 week in three sessions following haemodialysis, each session lasting approximately 30 min. Parametric and non-parametric tests were used in data analysis. It was determined that reflexology reduced the fatigue subscale scores and total scale scores as well as pain and cramp mean scores in the intervention group. The research results revealed that the severity of fatigue, pain and cramp decreased in patients receiving reflexology. © 2013 Wiley Publishing Asia Pty Ltd.

  5. Haemodialysis work environment contributors to job satisfaction and stress: a sequential mixed methods study.

    Science.gov (United States)

    Hayes, Bronwyn; Bonner, Ann; Douglas, Clint

    2015-01-01

    Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction (IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.

  6. Nutritional parameters as mortality predictors in haemodialysis: Differences between genders.

    Science.gov (United States)

    Oliveira, Telma Sobral; Valente, Ana Tentúgal; Caetano, Cristina Guerreiro; Garagarza, Cristina Antunes

    2017-06-01

    Malnutrition is common in patients undergoing haemodialysis (HD). Several studies have described different nutritional parameters as mortality predictors but few have studied whether there are differences between genders. This study aimed to evaluate which nutrition parameters may be associated with mortality in patients undergoing long-term HD depending on their gender. Longitudinal prospective multicentre study with 12 months of follow-up. Anthropometric and laboratory measures were obtained from 697 patients. Men who died were older, had lower dry weight, body mass index, potassium, phosphorus and albumin, compared with male patients who survived. Female patients who died had lower albumin and nPCR compared with survivors. Kaplan-Meier analysis displayed a significantly worse survival in patients with albumin mortality was related to body mass index mortality risk continued to be significant after adjustments for age, length of time on dialysis and diabetes for males. However, in women, only albumin persisted as an independent predictor of death. Depending on the gender, different parameters such as protein intake, potassium, phosphorus, body mass index and albumin are associated with mortality in patients undergoing HD. Albumin mortality predictor in both genders, whereas a body mass index <23 kg/m 2 is an independent predictor of death, but only in men. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  7. Beware: The femoral haemodialysis catheter – a surgeon’s perspective

    Directory of Open Access Journals (Sweden)

    Tinus du Toit

    2017-06-01

    Full Text Available The ability to identify and address factors that threaten the optimal utilisation of donor organs is quintessential in obtaining satisfactory transplant outcomes. We share our concerns regarding the prolonged use of femoral haemodialysis catheters and its potential to jeopardise successful renal transplantation. Despite a paucity of literature on the topic, we review relevant aspects related to this pernicious form of vascular access and clarify its limited role in the modern haemodialysis unit, particularly in patients who are still considered for transplantation.

  8. Successful delivery of chemotherapy to treat small-cell prostate cancer in a patient undergoing haemodialysis.

    Science.gov (United States)

    McPartlin, Andrew; Grimaldo, Claudia; Lyons, Jeanette; Burke, Daniel; Mitra, Sandip; Choudhury, Ananya

    2014-12-01

    We report on the successful treatment of small-cell prostate cancer in a patient undergoing haemodialysis. The therapeutic regimen included 300 mg/m(2) of carboplatin and 50 mg/m(2) of etoposide coupled with radical radiotherapy. Adjustments to the patient's haemodialysis prescription included the use of high flux, a larger dialyser surface area and an increased dialysis time. The parameters used aided tolerance to the drug, allowing the delivery of safe, effective treatment. At an interval of over 12 months post-treatment the patient shows no clinical evidence of recurrent disease. This case provides evidence to encourage the use of chemotherapy in otherwise potentially undertreated haemodialysed patients.

  9. Risk factors associated with xerostomia in haemodialysis patients.

    Science.gov (United States)

    López-Pintor, R-M; López-Pintor, L; Casañas, E; de Arriba, L; Hernández, G

    2017-03-01

    To determine the prevalence of xerostomia and hyposalivation in Haemodialysis (HD) patients, to clarify risk factors, assess patient's quality of life, and to establish a possible correlation among interdialytic weight gain (IDWG) and xerostomia. This study was performed on a group of 50 HD patients. Data were collected using a questionnaire containing demographic and clinical variables, a visual analogue scale (VAS) for xerostomia, IDWG, and an oral health impact profile questionnaire (OHIP-14). Unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were collected. A total of 28 HD patients (56%) suffered xerostomia. Dry mouth was associated with hypertension (OR, 5.24; 95% CI, 1.11-24.89) and benzodiazepine consumption (OR, 5.96; 95% CI, 1.05-33.99). The mean xerostomia VAS and OHIP-14 scores were 31.74±14.88 and 24.38±11.98, respectively. No significant correlation was observed between IDWG% and VAS and OHIP total score. Nonetheless, a positive correlation between VAS level of thirst and IDWG% was found (r=0.48 p=0.0001). UWS and SWS means (determined in 30 patients) were 0.16±0.17 and 1.12±0.64, respectively. Decreased values of UWS and SWS were reported in 53.33% and 36.66% of HD patients. Xerostomia in HD has a multifactorial aetiology due to accumulative risks as advanced age, systemic disorders, drugs, fluid intake restriction, and salivary parenchymal fibrosis and atrophy. Therefore, it is important to detect possible xerostomia risk factors to treat correctly dry mouth in HD patients and avoid systemic complications.

  10. Usefulness of questionnaires on advance directives in haemodialysis units.

    Science.gov (United States)

    Jornet, Angel Rodríguez; Castellanos, Loreley Ana Betancourt; Contador, Maria Isabel Bolós; Morera, Juan Carlos Oliva; López, José Antonio Ibeas

    2017-10-01

    As renal replacement therapy has become universal practice in medicine, there is a need to consider whether this treatment is suitable for elderly people. These patients have high comorbidity and may require dialysis withdrawal in certain clinical circumstances. Advance directives (ADs) drawn up by patients facilitate treatment-related decisions if they lose cognitive capacity. Questionnaires dealing with possible extreme clinical circumstances can thus help clinicians and relatives reach pertinent decisions in such cases. We studied the usefulness of questionnaires on ADs in patients who started periodic haemodialysis over a period of 10 years. Telephone interviews were conducted to assess satisfaction level among relatives/representatives of deceased patients who had been advised to limit therapeutic efforts in certain clinical situations. The questionnaire was assessed using a six-factor degree of satisfaction. Four hundred and forty-three questionnaires were distributed over a period of 10 years. A total of 41.3% of patients stated that they wished to limit therapeutic efforts in the serious clinical situations presented; 37.9% refused to complete the questionnaire; 14.7% expressed their wishes without any written confirmation; and 6.1% expressed their wish to continue on dialysis in all situations. Two hundred and twenty-four patients had died by the study end date. The cause of death in 20.2% was scheduled dialysis withdrawal. Representatives reported an extremely high degree of satisfaction with the questionnaire (94.7%). Younger people, however, were more reluctant to consider and answer questionnaires on ADs. Questionnaires on ADs are a useful tool in daily nephrology practice and should be distributed to those patients willing to consider the limitation of therapeutic efforts in extreme clinical circumstances. In general terms, these questionnaires should be given to all elderly patients. © The Author 2017. Published by Oxford University Press on

  11. Impact of extracorporeal blood flow rate on blood pressure, pulse rate and cardiac output during haemodialysis

    DEFF Research Database (Denmark)

    Schytz, Philip Andreas; Mace, Maria Lerche; Soja, Anne Merete Boas

    2015-01-01

    BACKGROUND: If blood pressure (BP) falls during haemodialysis (HD) [intradialytic hypotension (IDH)] a common clinical practice is to reduce the extracorporeal blood flow rate (EBFR). Consequently the efficacy of the HD (Kt/V) is reduced. However, only very limited knowledge on the effect...

  12. Use of vascular access for haemodialysis in Europe: a report from the ERA-EDTA Registry

    NARCIS (Netherlands)

    Noordzij, Marlies; Jager, Kitty J.; van der Veer, Sabine N.; Kramar, Reinhard; Collart, Frederic; Heaf, James G.; Stojceva-Taneva, Olivera; Leivestad, Torbjørn; Buturovic-Ponikvar, Jadranka; Benítez Sánchez, Manuel; Moreso, Fransesc; Prütz, Karl G.; Severn, Alison; Wanner, Christoph; Vanholder, Raymond; Ravani, Pietro

    2014-01-01

    Although arteriovenous fistulas (AVFs) are actively promoted, their use at the start of haemodialysis (HD) seems to be decreasing worldwide. In this paper, we describe recent trends in incidence and prevalence of vascular access types in Europe from 2005 to 2009 and their relationship with patient

  13. MALNUTRITION SCREENING IN AN IN-CENTRE HAEMODIALYSIS UNIT: APPETITE FOR CHANGE?

    Directory of Open Access Journals (Sweden)

    Lauren Dasey

    2012-06-01

    Asking patients to rate their appetite on a five point scale appears to be an effective way to screen for malnutrition in the haemodialysis population. In centres with limited dietitian support, this may be preferable to screening with albumin due to the reduced number of inappropriate referrals and therefore enabling the priority to lie with the patients with malnutrition.

  14. A care study exploring a patient's non-compliance to haemodialysis.

    Science.gov (United States)

    Murphy, Fiona

    This care study is based on the nursing assessment of a 26-year-old man (MT) who attends a local haemodialysis unit for treatment using Gordon's (1994) functional health patterns. There will be a discussion of this framework and the methods used to assess this patient including an exploration of one of the problem areas identified--that of non-compliance.

  15. The cost-utility of haemodiafiltration versus haemodialysis in the Convective Transport Study

    NARCIS (Netherlands)

    Mazairac, A.H.; Blankestijn, P.J.; Grooteman, M.P.C.; Penne, E.L.; Weerd, N.C. van der; Hoedt, C.H. den; Buskens, E.; Dorpel, M.A. van den; Wee, P.M. ter; Nube, M.J.; Bots, M.L.; Wit, G.A. de; Hamersvelt, H.W. van; et al.,

    2013-01-01

    BACKGROUND: Despite the growing interest in haemodiafiltration (HDF), there is no information on the costs and cost-utility of this dialysis modality yet. It was therefore our objective to study the cost-utility of HDF versus haemodialysis (HD). METHODS: A cost-utility analysis was performed using a

  16. The cost-utility of haemodiafiltration versus haemodialysis in the Convective Transport Study

    NARCIS (Netherlands)

    Mazairac, Albert H. A.; Blankestijn, Peter J.; Grooteman, Muriel P. C.; Penne, E. Lars; van der Weerd, Neelke C.; den Hoedt, Claire H.; Buskens, Erik; van den Dorpel, Marinus A.; ter Wee, Piet M.; Nube, Menso J.; Bots, Michiel L.; de Wit, G. Ardine

    Background. Despite the growing interest in haemodiafiltration (HDF), there is no information on the costs and cost-utility of this dialysis modality yet. It was therefore our objective to study the cost-utility of HDF versus haemodialysis (HD). Methods. A cost-utility analysis was performed using a

  17. COPING SKILLS OF IRANIAN FAMILY CAREGIVERS' IN CARETAKING OF PATIENTS UNDERGOING HAEMODIALYSIS: A QUALITATIVE STUDY.

    Science.gov (United States)

    Eslami, Ahmad Ali; Rabiei, Leili; Abedi, Heidar Ali; Shirani, Majid; Masoudi, Reza

    2016-09-01

    Coping skills enable caregivers to establish and maintain supportive relationships with the haemodialysis patients they care for. These skills are very important in terms of social support, promotion of mental health and social and family relations. The aim of this study is to investigate the coping skills of Iranian family caregivers as they take care of patients undergoing haemodialysis. Twenty participants were selected for the study through purposive sampling. The data gathering techniques used for the research were in-depth and unstructured interviews. The researchers used an inductive thematic analysis approach to analyse the data generated from the interviews. Four main themes emerged from the data: help-seeking skills, self-nurturing skills, time management skills and stress management skills. The focus of attention was on the stress management coping skills of the caregivers of haemodialysis patients together with their ability to cope with complex problems. Healthcare providers, by taking into account these skills and strategies of empowerment, can help other caregivers of haemodialysis patients cope with their heavy care conditions and better define their purposes in caretaking. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  18. The management of xerostomia in patients on haemodialysis : Comparison of artificial saliva and chewing gum

    NARCIS (Netherlands)

    Bots, CP; Brand, HS; Veerman, ECI; Valentijn-Benz, M; Van Amerongen, BM; Amerongen, AVN; Valentijn, RM; Vos, PI; Bijlsma, JA; ter Wee, PM

    2005-01-01

    Many patients on haemodialysis (HD) therapy suffer from a dry mouth and xerostomia. This can be relieved by mechanical and gustatory stimulation or palliative care. The aim of this crossover study was to investigate the effect and preferences of a sugar-free chewing gum (Freedent White(TM)) and a

  19. The management of xerostomia in patients on haemodialysis: comparison of artificial saliva and chewing gum

    NARCIS (Netherlands)

    Bots, Casper P.; Brand, Henk S.; Veerman, Enno C. I.; Valentijn-Benz, Marianne; van Amerongen, Barbara M.; Nieuw Amerongen, Arie V.; Valentijn, Robert M.; Vos, Pieter F.; Bijlsma, Joost A.; Bezemer, Pieter D.; ter Wee, Piet M.

    2005-01-01

    Many patients on haemodialysis (HD) therapy suffer from a dry mouth and xerostomia. This can be relieved by mechanical and gustatory stimulation or palliative care. The aim of this crossover study was to investigate the effect and preferences of a sugar-free chewing gum (Freedent White) and a

  20. Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Soraya Abad

    2017-03-01

    In summary, we conclude that new DAAs for the treatment of HCV in haemodialysis patients are highly effective with minimal adverse effects; it is a very important advance in HCV management. These patients are therefore expected to have a much better prognosis than they have had until very recently.

  1. Comparison of amino acid oxidation and urea metabolism in haemodialysis patients during fasting and meal intake

    NARCIS (Netherlands)

    Veeneman, JM; Kingma, HA; Stellaard, F; de Jong, PE; Reijngoud, DJ; Huisman, RM

    Background. The PNA (protein equivalent of nitrogen appearance) is used to calculate protein intake from urea kinetics. One of the essential assumptions in the calculation of PNA is that urea accumulation in haemodialysis (HD) patients is equivalent to amino acid oxidation. However, urea is

  2. Assessing skin hydration status in haemodialysis patients using terahertz spectroscopy: a pilot / feasibility study

    Czech Academy of Sciences Publication Activity Database

    Kadlec, Filip; Berta, Milan; Kužel, Petr; Lopot, F.; Polakovič, V.

    2008-01-01

    Roč. 53, č. 24 (2008), 7063-7071 ISSN 0031-9155 R&D Projects: GA MŠk LC512 Institutional research plan: CEZ:AV0Z10100520 Keywords : terahertz radiation * haemodialysis * skin turgor * epidermis Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 2.784, year: 2008

  3. Effect of vitamin E-bonded dialyzer on eosinophilia in haemodialysis patients.

    Science.gov (United States)

    Kojima, Kenichiro; Oda, Kuniyoshi; Homma, Hitoshi; Takahashi, Kazushi; Kanda, Yoshiko; Inokami, Taketoshi; Uchida, Shunya

    2005-09-01

    Eosinophilia in haemodialysis patients probably results from allergy to haemodialysis-related materials, including dialyzer membranes. We examined the effects of vitamin E-bonded dialyzers on eosinophil counts in haemodialysis patients. We enrolled seven patients who were on regular haemodialysis and had sustained eosinophilia. White blood cell, eosinophil, CD4- and CD8-positive lymphocyte counts, and serum interleukin-5 (IL-5) and IgE levels were determined before, 2 and 4 weeks after switching to vitamin E-bonded dialyzers. Eosinophil and CD4-positive lymphocyte counts and serum IL-5 were significantly (P = 0.003, 0.003 and 0.031, respectively) decreased after switching to vitamin E-bonded dialyzers. CD8-positive lymphocyte counts and serum IgE levels were unaltered. Crossover tests in two cases reproduced the higher eosinophilia within 4 weeks after returning to the original non-vitamin E-bonded dialyzer. Vitamin E-bonded dialyzers may ameliorate eosinophilia through a mechanism mediated by a decrease in IL-5 secretion by CD4-positive lymphocytes.

  4. Stressors and coping methods among chronic haemodialysis patients in Hong Kong.

    Science.gov (United States)

    Mok, E; Tam, B

    2001-07-01

    The purpose of the study was to determine the stressors and coping methods of chronic haemodialysis patients in Hong Kong. Relationships among treatment-related stressors, coping methods and length of time on haemodialysis were explored. Fifty subjects completed the Haemodialysis Stressor Scale (HSS) and Jalowiec Coping Scale (JCS). Results revealed that limitation of fluid was the most frequently identified stressor, followed by limitation of food, itching, fatigue and cost. The most common coping methods are 'accepted the situation because very little could be done', followed by 'told oneself not to worry because everything would work out fine' and 'told oneself that the problem was really not that important.' It was found that the traditional philosophies of the Chinese--Confucianism, Buddhism, and Taoism--share an approach to the understanding and management of life stressors as different from that adopted by Western philosophies. The findings of this study can further facilitate nurse practitioners in providing support, information, and alternative solutions when assisting patients in coping with long-term haemodialysis.

  5. Plasma concentrations of alpha-melanocyte-stimulating hormone are elevated in patients on chronic haemodialysis.

    Science.gov (United States)

    Airaghi, L; Garofalo, L; Cutuli, M G; Delgado, R; Carlin, A; Demitri, M T; Badalamenti, S; Graziani, G; Lipton, J M; Catania, A

    2000-08-01

    Clinical and/or laboratory signs of systemic inflammation occur frequently in patients undergoing long-term haemodialysis. It is likely, therefore, that a compensatory release of endogenous anti-inflammatory molecules occurs to limit host reactions. The aim of the present research was to determine if the potent anti-inflammatory peptide alpha-melanocyte-stimulating hormone (alpha-MSH), a pro-opiomelanocortin derivative, is increased in plasma of haemodialysis patients. Because endotoxin and cytokines induce alpha-MSH in vivo and in vitro, we also measured plasma concentrations of endotoxin, interleukin-6 (IL-6), and tumour necrosis factor alpha (TNF-alpha), and the two circulating products of activated monocytes, nitric oxide (NO) and neopterin. Thirty-five chronic haemodialysis patients, 20 patients with chronic renal failure not yet on dialysis, and 35 normal controls were included in the study. In the haemodialysis group, blood samples were obtained before and at the end of a dialysis session. Plasma alpha-MSH was measured using a double antibody radioimmunoassay, and IL-6, TNF-alpha, and neopterin using specific enzyme-linked immunosorbent assays. Plasma nitrites were determined by a colorimetric method, and endotoxin with the quantitative chromogenic LAL (limulus amoebocyte lysate) method. Mean plasma alpha-MSH was higher in haemodialysis patients than in control subjects, with the peptide concentrations being particularly elevated in dialysed patients with detectable endotoxin. High alpha-MSH concentrations were observed in the pre-dialysis samples, with no substantial change at the end of the dialysis session. Plasma concentrations of IL-6, TNF-alpha, neopterin, and NO were generally elevated in chronic haemodialysis patients and there was a negative correlation between circulating alpha-MSH and IL-6. In patients with renal failure not yet on dialysis, mean plasma alpha-MSH was similar to that of normal subjects. alpha-MSH is increased in the circulation of

  6. Equipment considerations

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Trace or ultratrace analyses require that the HPLC equipment used, including the detector, be optimal for such determinations. HPLC detectors are discussed at length in Chapter 4; discussion here is limited to the rest of the equipment. In general, commercial equipment is adequate for trace analysis; however, as the authors approach ultratrace analysis, it becomes very important to examine the equipment thoroughly and optimize it, where possible. For this reason they will review the equipment commonly used in HPLC and discuss the optimization steps. Detectability in HPLC is influenced by two factors (1): (a) baseline noise or other interferences that lead to errors in assigning the baseline absorbance; (b) peak width. 87 refs

  7. Factors influencing the quality of life of haemodialysis patients according to symptom cluster.

    Science.gov (United States)

    Shim, Hye Yeung; Cho, Mi-Kyoung

    2018-05-01

    To identify the characteristics in each symptom cluster and factors influencing the quality of life of haemodialysis patients in Korea according to cluster. Despite developments in renal replacement therapy, haemodialysis still restricts the activities of daily living due to pain and impairs physical functioning induced by the disease and its complications. Descriptive survey. Two hundred and thirty dialysis patients aged >18 years. They completed self-administered questionnaires of Dialysis Symptom Index and Kidney Disease Quality of Life instrument-Short Form 1.3. To determine the optimal number of clusters, the collected data were analysed using polytomous variable latent class analysis in R software (poLCA) to estimate the latent class models and the latent class regression models for polytomous outcome variables. Differences in characteristics, symptoms and QOL according to the symptom cluster of haemodialysis patients were analysed using the independent t test and chi-square test. The factors influencing the QOL according to symptom cluster were identified using hierarchical multiple regression analysis. Physical and emotional symptoms were significantly more severe, and the QOL was significantly worse in Cluster 1 than in Cluster 2. The factors influencing the QOL were spouse, job, insurance type and physical and emotional symptoms in Cluster 1, with these variables having an explanatory power of 60.9%. Physical and emotional symptoms were the only influencing factors in Cluster 2, and they had an explanatory power of 37.4%. Mitigating the symptoms experienced by haemodialysis patients and improving their QOL require educational and therapeutic symptom management interventions that are tailored according to the characteristics and symptoms in each cluster. The findings of this study are expected to lead to practical guidelines for addressing the symptoms experienced by haemodialysis patients, and they provide basic information for developing nursing

  8. Haemodialysis patients and end-of-life decisions: a theory of personal preservation.

    Science.gov (United States)

    Calvin, Amy Olivier

    2004-06-01

    Lack of knowledge about the end-of-life treatment preferences of patients undergoing haemodialysis is problematic in the acute care setting as, often, patients are unable to communicate their treatment wishes effectively and have not previously documented their desires in the form of advance directives. Existing theoretical models offer an incomplete explanation of end-of-life treatment decisions in haemodialysis patients. This paper reports a study exploring decisions about end-of-life treatment (e.g. cardiopulmonary resuscitation, mechanical ventilation) in people with kidney failure undergoing haemodialysis. Grounded theory was used. Theoretical sampling led to selection of 20 haemodialysis patients (11 men and nine women with a mean age of 56) who attended three dialysis outpatient centres in central Texas. They were interviewed about end-of-life treatment plans and the use of advance directives (i.e. living wills and durable powers of attorney for health care). Interviews, transcripts and field notes from the first 12 patients were analysed by making constant comparisons. The remaining eight interviews were used for validation purposes. Data collection and analysis spanned the years 1997-2000. When prompted to think about and discuss end-of-life treatments, haemodialysis patients chose to focus on living rather than dying. A substantive theory of 'personal preservation' was developed. This consists of three phases: knowing the odds for survival, defining individuality (beating the odds, discovering meaning, being optimistic and having faith in a higher force) and personal preservation (being responsible and taking chances). The theory of personal preservation furthers understanding of illness behaviour and the process by which patients make decisions about end-of-life treatments. It can be used to sensitize health care professionals to patients' desires and to enhance patient-professional communication.

  9. Rationale and design for SHAREHD: a quality improvement collaborative to scale up Shared Haemodialysis Care for patients on centre based haemodialysis.

    Science.gov (United States)

    Fotheringham, James; Barnes, Tania; Dunn, Louese; Lee, Sonia; Ariss, Steven; Young, Tracey; Walters, Stephen J; Laboi, Paul; Henwood, Andy; Gair, Rachel; Wilkie, Martin

    2017-11-24

    The study objective is to assess the effectiveness and economic impact of a structured programme to support patient involvement in centre-based haemodialysis and to understand what works for whom in what circumstances and why. It implements a program of Shared Haemodialysis Care (SHC) that aims to improve experience and outcomes for those who are treated with centre-based haemodialysis, and give more patients the confidence to dialyse independently both at centres and at home. The 24 month mixed methods cohort evaluation of 600 prevalent centre based HD patients is nested within a 30 month quality improvement program that aims to scale up SHC at 12 dialysis centres across England. SHC describes an intervention where patients who receive centre-based haemodialysis are given the opportunity to learn, engage with and undertake tasks associated with their treatment. Following a 6-month set up period, a phased implementation programme is initiated across 12 dialysis units using a randomised stepped wedge design with 6 centres participating in each of 2 steps, each lasting 6 months. The intervention utilises quality improvement methodologies involving rapid tests of change to determine the most appropriate mechanisms for implementation in the context of a learning collaborative. Running parallel with the stepped wedge intervention is a mixed methods cohort evaluation that employs patient questionnaires and interviews, and will link with routinely collected data at the end of the study period. The primary outcome measure is the number of patients performing at least 5 dialysis-related tasks collected using 3 monthly questionnaires. Secondary outcomes measures include: the number of people choosing to perform home haemodialysis or dialyse independently in-centre by the end of the study period; end-user recommendation; home dialysis establishment delay; staff impact and confidence; hospitalisation; infection and health economics. The results from this study will provide

  10. Impact of high-flux haemodialysis on the probability of target attainment for oral amoxicillin/clavulanic acid combination therapy.

    Science.gov (United States)

    Hui, Katrina; Patel, Kashyap; Kong, David C M; Kirkpatrick, Carl M J

    2017-07-01

    Clearance of small molecules such as amoxicillin and clavulanic acid is expected to increase during high-flux haemodialysis, which may result in lower concentrations and thus reduced efficacy. To date, clearance of amoxicillin/clavulanic acid (AMC) during high-flux haemodialysis remains largely unexplored. Using published pharmacokinetic parameters, a two-compartment model with first-order input was simulated to investigate the impact of high-flux haemodialysis on the probability of target attainment (PTA) of orally administered AMC combination therapy. The following pharmacokinetic/pharmacodynamic targets were used to calculate the PTA. For amoxicillin, the time that the free concentration remains above the minimum inhibitory concentration (MIC) of ≥50% of the dosing period (≥50%ƒT >MIC ) was used. For clavulanic acid, the time that the free concentration was >0.1 mg/L of ≥45% of the dosing period (≥45%ƒT >0.1 mg/L ) was used. Dialysis clearance reported in low-flux haemodialysis for both compounds was doubled to represent the likely clearance during high-flux haemodialysis. Monte Carlo simulations were performed to produce concentration-time profiles over 10 days in 1000 virtual patients. Seven different regimens commonly seen in clinical practice were explored. When AMC was dosed twice daily, the PTA was mostly ≥90% for both compounds regardless of when haemodialysis commenced. When administered once daily, the PTA was 20-30% for clavulanic acid and ≥90% for amoxicillin. The simulations suggest that once-daily orally administered AMC in patients receiving high-flux haemodialysis may result in insufficient concentrations of clavulanic acid to effectively treat infections, especially on days when haemodialysis occurs. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  11. The effect of holiday haemodialysis treatments on patient mood, adverse symptoms and subjective wellbeing using the Big Red Kidney Bus.

    Science.gov (United States)

    Sims, Jane; Bennett, Paul N; Ockerby, Cherene; Ludlow, Marie; Fairbairn, Jo; Wilson, Anne; Kerr, Peter G

    2017-02-01

    People with end-stage kidney disease receiving haemodialysis are restricted to holidays where dialysis services are readily available. Holiday dialysis in regional, rural and remote areas is particularly challenging. The aims of this study were to evaluate the wellbeing of those who received dialysis in a holiday haemodialysis bus and to measure patient well-being with that of a comparable cohort of haemodialysis patients. A three machine haemodialysis bus, the Big Red Kidney Bus, was built to enable people, their families and carers to take holidays across a range of tourist destinations in Victoria, Australia. Measures included pre-post subjective well-being, dialysis symptoms and mood questionnaires complemented by post semi-structured telephone interviews. Participating holidaymakers were positive about the haemodialysis bus service and the standard of care experienced. They reported decreased dialysis side effects of fatigue, muscle cramp and dry skin. The overall number of reported symptoms decreased, and the perceived level of bother associated with symptoms also decreased. No changes in subjective well-being and mood were detected. Mean Personal Wellbeing Index scores were significantly higher than in a comparative haemodialysis sample. The Big Red Kidney Bus provided a safe and feasible holiday dialysis service. Holidaymakers' well-being was reflected by the decreased dialysis patient side effects. © 2016 Asian Pacific Society of Nephrology.

  12. Factors associated with early failure of arteriovenous fistulae for haemodialysis access.

    Science.gov (United States)

    Wong, V; Ward, R; Taylor, J; Selvakumar, S; How, T V; Bakran, A

    1996-08-01

    The radiocephalic arteriovenous fistula remains the method of choice for haemodialysis access. In order to assess their suitability for fistula formation, the radial arteries and cephalic veins were examined preoperatively by ultrasound colour flow scanner in conjunction with a pulse-generated run-off system. Intraoperative blood flow was measured after construction of the fistulae. Post-operative follow-up was performed at various intervals to monitor the development of the fistulae. Radial artery and cephalic vein diameter less than 1.6 mm was associated with early fistula failure. The intraoperative fistula blood flow did not correlate with the outcome of the operation probably due to vessel spasm from manipulation. However, blood flow velocities measured non-invasively 1 day after the operation were significantly lower in fistulae that failed early compared with those that were adequate for haemodialysis. Most of the increase in fistula diameter and blood flow occur within the first 2 weeks of surgery.

  13. An Approach to Optimise Therapeutic Vancomycin Dosage in a Haemodialysis Population

    LENUS (Irish Health Repository)

    Gunning, H

    2016-10-01

    Haemodialysis patients are at risk of gram-positive bacteraemia and commonly require intravenous vancomycin. Intravenously administered vancomycin is primarily excreted by the kidney and exhibits complex pharmacokinetics in haemodialysis patients; achieving therapeutic levels can be challenging. An audit in our unit showed current practises of vancomycin administration resulted in a high proportion of sub-therapeutic levels. A new protocol was developed with fixed weight-based loading and subsequent dosing guided by pre-dialysis levels, target levels were 10-20mg\\/L. Its effectiveness was prospectively evaluated between 24th September 2012, and 8th February 2013. During this period 25 patients commenced vancomycin, 15 were included. In total, 112 vancomycin levels were taken, 94 (84%) were therapeutic, this was a significant improvement compared to previous practise (odds ratio 5.4, CI 3.1-9.4, p < 0.0001). In conclusion, our study shows this protocol can consistently and reliably achieve therapeutic vancomycin levels

  14. Ranking of factors determining potassium mass balance in bicarbonate haemodialysis.

    Science.gov (United States)

    Basile, Carlo; Libutti, Pasquale; Lisi, Piero; Teutonico, Annalisa; Vernaglione, Luigi; Casucci, Francesco; Lomonte, Carlo

    2015-03-01

    One of the most important pathogenetic factors involved in the onset of intradialysis arrhytmias is the alteration in electrolyte concentration, particularly potassium (K(+)). Two studies were performed: Study A was designed to investigate above all the isolated effect of the factor time t on intradialysis K(+) mass balance (K(+)MB): 11 stable prevalent Caucasian anuric patients underwent one standard (∼4 h) and one long-hour (∼8 h) bicarbonate haemodialysis (HD) session. The latter were pair-matched as far as the dialysate and blood volume processed (90 L) and volume of ultrafiltration are concerned. Study B was designed to identify and rank the other factors determining intradialysis K(+)MB: 63 stable prevalent Caucasian anuric patients underwent one 4-h standard bicarbonate HD session. Dialysate K(+) concentration was 2.0 mmol/L in both studies. Blood samples were obtained from the inlet blood tubing immediately before the onset of dialysis and at t60, t120, t180 min and at end of the 4- and 8-h sessions for the measurement of plasma K(+), blood bicarbonates and blood pH. Additional blood samples were obtained at t360 min for the 8 h sessions. Direct dialysate quantification was utilized for K(+)MBs. Direct potentiometry with an ion-selective electrode was used for K(+) measurements. Study A: mean K(+)MBs were significantly higher in the 8-h sessions (4 h: -88.4 ± 23.2 SD mmol versus 8 h: -101.9 ± 32.2 mmol; P = 0.02). Bivariate linear regression analyses showed that only mean plasma K(+), area under the curve (AUC) of the hourly inlet dialyser diffusion concentration gradient of K(+) (hcgAUCK(+)) and AUC of blood bicarbonates and mean blood bicarbonates were significantly related to K(+)MB in both 4- and 8-h sessions. A multiple linear regression output with K(+)MB as dependent variable showed that only mean plasma K(+), hcgAUCK(+) and duration of HD sessions per se remained statistically significant. Study B: mean K(+)MBs were -86.7 ± 22.6 mmol

  15. Development of certified environmental management in hospital and outpatient haemodialysis units.

    Science.gov (United States)

    García Vicente, Sergio; Morales Suárez-Varela, María; Martí Monrós, Anna; Llopis González, Agustín

    2015-01-01

    The environmental impact of haemodialysis is very high. Institutional activity in this sense is important, even in the production of references. Voluntary environmental management systems (EMS), environmental management and auditing systems (EMAS) and the International Organization for Standardization standards (ISO 14001) are important tools for environmental protection, together with legislation, taxation and tax benefits. To determine the degree of implementation of EMS in hospital units and outpatient haemodialysis in the Spanish National Health System to provide a group of reference centres in environmental management in this healthcare activity. Development of a list by autonomous communities showing hospital and outpatient dialysis units using an EMAS and/or ISO 14001 in 2012-2013. The sources of information were the Spanish National Catalogue of Hospitals, Spanish Registry of Healthcare Certification and Accreditation, European and regional EMAS records, world ISO registrations, dialysis centre lists from scientific societies and patients, responses from accredited entities in Spain for environmental certification and the institutional website of each haemodialysis centre identified. Of the 210 hospitals with a dialysis unit, 53 (25%) have the ISO 14001 and 15 of these also have an EMAS). This constitutes 30% of all hospital dialysis chairs in Spain: 1,291 (of 4,298). Only 11 outpatient clinics are recorded, all with the ISO 14001. There is no official documentation of the implementation of EMS in dialysis units. Making this list provides an approach to the situation, with special reference to haemodialysis because of its significant environmental impact. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  16. [Cervical disc hernia decompensation complicated by postoperative transitory tetraparesia about long-term haemodialysis patient].

    Science.gov (United States)

    Caltot, E; Hélaine, L; Cadic, A; Muller, C; Arvieux, C-C

    2011-01-01

    We report a case of a 51-year-old man who underwent a third kidney transplantation that was complicated by tetraparesia due to a C5-C6 cervical disc hernia decompensation in the immediate postoperative period. Preoperative consultation for long-term haemodialysis patients could be perfected by further neurological investigation and additional imagery. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  17. More hostile dyslipidaemia in chronic kidney disease patients on maintenance haemodialysis than on conservative management.

    Science.gov (United States)

    Rathi, Teerath Kumar; Dhrolia, Murtaza Fakhruddin; Imtiaz, Salman

    2016-08-01

    To study the pattern of dyslipidaemia in patients with stage-V chronic kidney disease on conservative management and those on maintenance haemodialysis. This comparative observational study was conducted at the Jinnah Postgraduate Medical Centre, Karachi, from February to July, 2008, and comprised stage-V chronic kidney disease patients. The patients were divided in two groups. Those who were on conservative management were placed in Group A, and those who were on maintenance haemodialysis were in Group B. Serum total lipid, cholesterol, triglycerides and high-density lipoprotein for both groups were assayed on chemical analyser and low-density lipoprotein was calculated by Friedwald equation. SPSS 17 was used for data analysis. Of the 120 patients, there were 60(50%) in each group. The mean age of patients in Group A was 46.33±14.56 years and in Group B was 43.4±14.1years. Of all, 64(53.3%) were men and 56(46.7%) were women. Mean systolic and diastolic blood pressure was 134±19.58mmHg and 83.6±14.14mmHg in Group A and 129±19.7mmHg and 79.7±12.1mmHg in Group B. Mean serum total lipid was significantly higher (pmaintenance haemodialysis was more hostile than those on conservative management, and posed increased risk of coronary heart disease.

  18. Defining the culture and attitude towards dietary management actions in people undergoing haemodialysis.

    Science.gov (United States)

    Onbe, Hiromi; Oka, Michiyo; Shimada, Mikiko; Motegi, Emiko; Motoi, Yuji; Okabe, Ayako

    2013-06-01

    The present study was designed to clarify the structure of culture and the three components of attitude in a desirable attitude toward dietary management actions in outpatient haemodialysis patients who are in the maintenance phase of treatment. The participants in the study included nine patients undergoing chronic maintenance haemodialysis who have received guidance related to diet and had good test results. Ethnography, by means of participant observation and semi-structured interviews, was chosen as the research method. Desirable attitude of haemodialysis patients in dietary management actions was found to have a chronological progression in one of the components of attitude: propensity of behaviour. Change in behaviour was influenced by affect and cognition. At the base of the structure of attitude lay three factors: valuing cooking with seasonal ingredients and creating special meals for seasonal occasions; family draws near, shows care and gives support; and belief in information perceived to be good for the health, which was influenced by three components of attitude: affect, cognition, and propensity of behaviour, as well as culture. Participants continue to value the food culture that they grew up with, which involves their affect towards, and cognition of, dietary management. © 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  19. Poor value of surveillance cultures for prediction of septicaemia caused by coagulase-negative staphylococci in patients undergoing haemodialysis with central venous catheters

    DEFF Research Database (Denmark)

    Nielsen, J; Kolmos, H J; Rosdahl, V T

    1998-01-01

    Surveillance cultures for the demonstration of coagulase-negative staphylococci in patients on catheter haemodialysis were performed in an attempt to predict dialysis catheter-related septicaemia. In all, 43 patients with 67 haemodialysis catheters were followed for a 1-y period. Once a week, swab...

  20. Thinking ahead – the need for early Advance Care Planning for people on haemodialysis: A qualitative interview study

    Science.gov (United States)

    Horsley, Helen L; Shepherd, Kate; Brown, Heather; Carey, Irene; Matthews, Beverley; O’Donoghue, Donal; Vinen, Katie; Murtagh, Felicity EM

    2015-01-01

    Background: There is a need to improve end-of-life care for people with end-stage kidney disease, particularly due to the increasingly elderly, frail and co-morbid end-stage kidney disease population. Timely, sensitive and individualised Advance Care Planning discussions are acceptable and beneficial for people with end-stage kidney disease and can help foster realistic hopes and goals. Aim: To explore the experiences of people with end-stage kidney disease regarding starting haemodialysis, its impact on quality of life and their preferences for future care and to explore the Advance Care Planning needs of this population and the timing of this support. Study design: Semi-structured qualitative interview study of people receiving haemodialysis. Interviews were analysed using thematic analysis. Recruitment ceased once data saturation was achieved. Setting/participants: A total of 20 patients at two UK National Health Service hospitals, purposively sampled by age, time on haemodialysis and symptom burden. Results: Themes emerged around: Looking Back, emotions of commencing haemodialysis; Current Experiences, illness and treatment burdens; and Looking Ahead, facing the realities. Challenges throughout the trajectory included getting information, communicating with staff and the ‘conveyor belt’ culture of haemodialysis units. Participants reported a lack of opportunity to discuss their future, particularly if their health deteriorated, and variable involvement in treatment decisions. However, discussion of these sensitive issues was more acceptable to some than others. Conclusion: Renal patients have considerable unmet Advance Care Planning needs. There is a need to normalise discussions about preferences and priorities in renal and haemodialysis units earlier in the disease trajectory. However, an individualised approach is essential – one size does not fit all. PMID:25527527

  1. Effect of a self-efficacy promotion training programme on the body weight changes in patients undergoing haemodialysis.

    Science.gov (United States)

    Aliasgharpour, Mansooreh; Shomali, Maryam; Moghaddam, Masoumeh Zakeri; Faghihzadeh, Sograt

    2012-09-01

    Haemodialysis is the most common form of medical management of patients affected by end-stage renal disease (ESRD). For haemodialysis to be successful, strict fluid and weight control is recommended. Education, in terms of self-care activities, is an important intervention for improving patients' outcomes. A self-efficacy promotion training programme can be an effective strategy to bring about behavioural change. The aim of this study was to investigate the effect of a self-efficacy promotion training programme on the body weight changes in patients undergoing haemodialysis. In this single-blind quasi-experimental study, we recruited a convenience sample of 63 patients undergoing haemodialy-sis from two teaching hospitals and allocated them randomly to the experimental or control group. Patients in the experimental group received a six-session self-efficacy promotion training programme while the control group received the routine care of the institute. Mean body weight gain and self-efficacy were measured before, immediately and two months after the study. The groups did not differ significantly regarding the study variable before the study. However, immediately and two months after the study, the mean body weight gain and self-efficacy in the experimental group were significantly lower and higher, respectively, than the control group (p training programme is effective in decreasing weight gain and increasing self-efficacy in patients undergoing haemodialysis. Nurses in haemodialysis units can use self-efficacy promotion training programmes as an effective intervention for improving patients' outcomes. © 2012 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  2. Contributing factors for therapeutic diet adherence in patients receiving haemodialysis treatment: an integrative review.

    Science.gov (United States)

    Oquendo, Lissete González; Asencio, José Miguel Morales; de Las Nieves, Candela Bonill

    2017-12-01

    The objective of this integrative review is to identify the factors that contribute to diet adherence in people suffering from kidney disease who are receiving haemodialysis treatment. Adherence to the therapeutic regimen determines therapeutic success, quality of life and survival in patients on haemodialysis. Lack of diet adherence ranges from 25%-86% in patients receiving haemodialysis treatment and affects patient morbidity and mortality. An integrative literature review was conducted based on the criteria of Whittemore & Knafl. A literature review was performed by two members of the team using twelve databases including PubMed, CUIDEN, CINAHL, The Cochrane Library and ScienceDirect. The main issues identified after analysing the results were as follows: the intrinsic barriers (age, dialysis time, motivation, perceived benefit, distorted perception of adherence) and facilitators (self-efficacy, perception of disease, perception of control), extrinsic barriers (family dysfunction, lack of social support, cultural patterns of consumption of food) and facilitators (social support, relationship with healthcare providers), and interventions to encourage diet adherence, such as the use of motivational interviewing in educational interventions, and the training and education of relevant professionals in communication skills. Diet nonadherence remains a serious health problem and suffers from a lack of solid criteria to identify this condition. The onset of depression signs and the level of social support available to the patient should be assessed, because these are important factors that determine adherence to treatment. Professionals should be trained in health education and communication techniques to contribute to the patient's self-management and motivation for diet adherence. Controlled and randomised clinical studies involving predialysis stages should be performed to investigate the impact of the assessment and control of barriers to diet adherence. © 2017

  3. Outcomes of AV Fistulas and AV Grafts after Interventional Stent-Graft Deployment in Haemodialysis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Raab, Udo, E-mail: udo.raab@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany); Lazarus, Friedrich, E-mail: friedrich.lazarus@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Nephrology (Germany); Ruppert, Volker, E-mail: volker.ruppert@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Vascular Surgery (Germany); Vorwerk, Dierk, E-mail: dierk.vorwerk@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany)

    2015-08-15

    PurposeThe study was designed to assess outcomes of arteriovenous (AV) accesses after interventional stent-graft deployment in haemodialysis patients.Materials and Methods63 haemodialysis patients with 66 AV fistulas and AV grafts were treated by interventional stent-graft deployment from 2006 to 2012 at our hospital. Data of these patients were retrospectively analysed for location of deployed stent-grafts, occurrence and location of (re-)stenosis and (re-)thrombosis. Complex stenosis was the most frequent indication for stent-graft deployment (45.5 %), followed by complications of angioplasty with vessel rupture or dissection (31.8 %).ResultsA high rate of procedural success was achieved (98.5 %). The most frequent location of the deployed stent-graft was the draining vein (66.7 %). Stent-graft deployment was more frequent in AV grafts than in AV fistulas. Primary patency was 45.5 % at 6 month, 31.3 % at 12 month and 19.2 % at 24 month. Primary patency was significantly better for AV fistulas than for AV grafts with deployed stent-grafts. Patency of the deployed stent-graft was much better than overall AV access primary patency with deployed stent-graft. Re-stenosis with thrombosis was the most frequent indication for re-intervention. Most frequent location of re-stenosis was the draining vein (37.1 %), followed by stenosis at the AV access (29.5 %) and the deployed stent-graft (23.5 %).ConclusionRe-stenosis and re-thrombosis remain frequent in AV fistulas and AV grafts in haemodialysis patients despite stent-graft deployment. Re-stenosis of the deployed stent-graft is, only in the minority of the cases, responsible for AV access dysfunction.

  4. Validity and reliability of Turkish Caregiver Burden Scale among family caregivers of haemodialysis patients.

    Science.gov (United States)

    Cil Akinci, Ayse; Pinar, Rukiye

    2014-02-01

    To investigate the validity and reliability of the Caregiver Burden Scale in family members who provide primary care for haemodialysis patients. In Turkey, there is a need for a multi-dimensional instrument to evaluate the caregiver burden in people who provide care for patients with chronic diseases. A methodological study. The study sample consisted of 161 family members who provide primary care for haemodialysis patients. The forward-backward translation method was used to develop the Turkish Caregiver Burden Scale. The reliability was based on internal consistency investigated by Cronbach's alpha and item-total correlation. The factorial construct validity of the scale was tested with confirmatory factor analysis. By means of convergent and divergent validity, correlation between Caregiver Burden Scale and 36-Item Short Form Health Survey (SF-36) and correlation between Caregiver Burden Scale and the Maslach Burnout Scale were investigated. Cronbach's alpha and item-total correlations results suggested that there was good internal reliability. We found five underlying factors similar to original Scale's five-factor solution. The confirmatory factor analysis five-factor model represented an acceptable fit. Factor loadings were significant, with standardised loadings ranging from 0·43-0·81. By means of divergent validity, all sub-dimension scores and the total score of the Caregiver Burden Scale were negatively correlated with the SF-36, whereas there was a positive correlation with the emotional exhaustion and depersonalisation subscales of the Maslach Burnout Scale as expected. These results suggest that the Caregiver Burden Scale is a reliable and valid instrument which can be used with confidence in Turkish caregivers for haemodialysis patients to screen caregiver burden. The burden experienced by people who provide care for patients with chronic diseases can be evaluated with the Caregiver Burden Scale. Additionally, the Caregiver Burden Scale can be used

  5. Patient satisfaction with in-centre haemodialysis care: an international survey.

    Science.gov (United States)

    Palmer, Suetonia C; de Berardis, Giorgia; Craig, Jonathan C; Tong, Allison; Tonelli, Marcello; Pellegrini, Fabio; Ruospo, Marinella; Hegbrant, Jörgen; Wollheim, Charlotta; Celia, Eduardo; Gelfman, Ruben; Ferrari, Juan Nin; Törok, Marietta; Murgo, Marco; Leal, Miguel; Bednarek-Skublewska, Anna; Dulawa, Jan; Strippoli, Giovanni F M

    2014-05-19

    To evaluate patient experiences of specific aspects of haemodialysis care across several countries. Cross-sectional survey using the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) questionnaire. Haemodialysis clinics within a single provider in Europe and South America. 2748 adults treated in haemodialysis. The primary outcome was patient satisfaction with overall care. Secondary outcomes included patient experiences of individual aspects of dialysis care. 2145 (78.1%) adults responded to the questionnaire. Fewer than half (46.5% (95% CI 44.5% to 48.6%)) rated their overall care as excellent. Global perceptions of care were uninfluenced by most respondent characteristics except age and depressive symptoms; older respondents were less critical of their care (adjusted OR for excellent rating 1.44 (1.01 to 2.04)) and those with depressive symptoms were less satisfied (0.56 (0.44 to 0.71)). Aspects of care that respondents most frequently ranked as excellent were staff attention to dialysis vascular access (54% (52% to 56%)); caring of nurses (53% (51% to 55%)); staff responsiveness to pain or discomfort (51% (49% to 53%)); caring, helpfulness and sensitivity of dialysis staff (50% (48% to 52%)); and ease of reaching dialysis staff by telephone (48% (46% to 50%)). The aspects of care least frequently ranked as excellent were information provided when choosing a dialysis modality (23% (21% to 25%)), ease of seeing a social worker (28% (24% to 32%)), information provided about dialysis (34% (32% to 36%)), accuracy of information from nephrologist (eg, about prognosis or likelihood of a kidney transplant; 37% (35% to 39%)) and accuracy of nephrologists' instructions (39% (36% to 41%)). Haemodialysis patients are least satisfied with the complex aspects of care. Patients' expectations for accurate information, prognosis, the likelihood of kidney transplantation and their options when choosing dialysis treatment need to be considered when

  6. Assessment of insulin, lectin and vitamin C in chronic renal failure patients before and after haemodialysis

    International Nuclear Information System (INIS)

    Ahmed, A.M.; El-Yamani, N.A.; Youssif, Z.A.; Abdel-Razik, D.E.

    2006-01-01

    The present study was carried out to investigate the relative interaction between insulin, leptin and vitamin C in male patients with chronic renal failure and undergo regular haemodialysis (3 times/week). The study was carried out on 20 healthy volunteers as control (group I) and 20 with chronic renal failure (group II) which were studied before dialysis (A) and after dialysis (B). The serum results showed significant increases in creatinine, insulin and leptin levels in patient groups as compared to the control. On the other hand, significant decreases in the levels of glucose and vitamin C were recorded

  7. [Hydrotherapy equipment].

    Science.gov (United States)

    Tsibikov, V B; Ragozin, S I; Mikheeva, L V

    1985-01-01

    A flow-chart is developed demonstrating the relation between medical and prophylactic institutions within the organizational structure of the rehabilitation system and main types of rehabilitation procedures. In order to ascertain the priority in equipping rehabilitation services with adequate hardware the special priority criterion is introduced. The highest priority is assigned to balneotherapeutic and fangotherapeutic services. Based on the operation-by-operation analysis of clinical processes related to service and performance of balneologic procedures the preliminary set of clinical devices designed for baths, basins and showers in hospitals and rehabilitation departments is defined in a generalized form.

  8. Association of quality of sleep with cognitive decline among the patients of chronic kidney disease undergoing haemodialysis

    International Nuclear Information System (INIS)

    Zubair, U.B.; Butt, B.

    2017-01-01

    This study was conducted to determine the association between the subjective quality of sleep and cognitive decline among the patients of chronic kidney disease (CKD) undergoing haemodialysis. Methods: In this cross-sectional study 106 patients of chronic kidney disease (CKD) undergoing haemodialysis at a tertiary care hospital in Rawalpindi, Pakistan were included in the final analysis. Cognitive decline was measured by British Columbia Cognitive Complaints Inventory (BC-CCI). Sleep quality was measured by using the Pittsburgh Sleep Quality Index (PSQI). Relationship of age, gender, marital status, education, occupation, BMI, duration of dialysis, dialysis count per week, family income, tobacco smoking and use of naswar was assessed with the cognitive decline. Results: Out of 106 patients screened through BC-CCI and PSQI, 13.1% had no cognitive decline while 86.9% had significant cognitive decline. Relationship between quality of sleep and cognitive decline was significant on binary logistic regression. Conclusion: This study showed significant relationship between the sleep quality and cognitive decline among the patients of CKD undergoing haemodialysis. The findings of our study also call for a greater degree of understanding of the physical and psychological state of patients of CKD undergoing haemodialysis. (author)

  9. Cryogenic equipment

    International Nuclear Information System (INIS)

    Leger, L.; Javellaud, J.; Caro, C.; Gilguy, R.; Testard, O.

    1966-06-01

    The cryostats presented here were built from standard parts; this makes it possible to construct a great variety of apparatus at minimum cost. The liquid nitrogen and helium reservoirs were designed so as to reduce losses to a minimum, and so as to make the cryostats as autonomous as possible. The experimental enclosure which is generally placed in the lower part of the apparatus requires a separate study in every case. Furthermore, complete assemblies such as transfer rods, isolated traps and high vacuum valves, were designed with a similar regard for the economic aspects and for the need for standardization. This equipment thus satisfies a great variety of experimental needs; it is readily adaptable and the consumptions of helium and liquid nitrogen are very low. (authors) [fr

  10. Novel Use of a Pneumatic Compression Device for Haemostasis of Haemodialysis Fistula Access Catheterisation Sites

    Energy Technology Data Exchange (ETDEWEB)

    O’Reilly, Michael K., E-mail: moreilly1@mater.ie; Ryan, David; Sugrue, Gavin; Geoghegan, Tony; Lawler, Leo P.; Farrelly, Cormac T. [Mater Misericordiae University Hospital, Department of Interventional Radiology (Ireland)

    2016-12-15

    PurposeTransradial pneumatic compression devices can be used to achieve haemostasis following radial artery puncture. This article describes a novel technique for acquiring haemostasis of arterio-venous haemodialysis fistula access sites without the need for suture placement using one such compression device.Materials and MethodsA retrospective review of fistulograms with or without angioplasty/thrombectomy in a single institution was performed. 20 procedures performed on 12 patients who underwent percutaneous intervention of failing or thrombosed arterio-venous fistulas (AVF) had 27 puncture sites. Haemostasis was achieved using a pneumatic compression device at all access sites. Procedure details including size of access sheath, heparin administration and complications were recorded.ResultsTwo diagnostic fistulograms, 14 fistulograms and angioplasties and four thrombectomies were performed via access sheaths with an average size (±SD) of 6 Fr (±1.12). IV unfractionated heparin was administered in 11 of 20 procedures. Haemostasis was achieved in 26 of 27 access sites following 15–20 min of compression using the pneumatic compression device. One case experienced limited bleeding from an inflow access site that was successfully treated with reinflation of the device for a further 5 min. No other complication was recorded.ConclusionsHaemostasis of arterio-venous haemodialysis fistula access sites can be safely and effectively achieved using a pneumatic compression device. This is a technically simple, safe and sutureless technique for acquiring haemostasis after AVF intervention.

  11. BIOIMPEDANCE ANALYSIS IN HAEMODIALYSIS PRACTICE: SHORT REVIEW AND SINGLE CENTER EXPERIENCE

    Directory of Open Access Journals (Sweden)

    A.G. Strokov

    2012-01-01

    Full Text Available Bioimpedance analysis has been widely used to estimate a hydration state, lean and fat mass in haemodialysis patients. The aim of our study was to investigate the validity and usefulness of bioimpedance analysis in routine dialysis practice. Last two years we used the body composition monitoring (BCM, Fresenius Medical Care, method based on whole body multifrequency bioimpedance spectroscopy (BIS, compared with traditional clinical data. For BIS data verification, hydration status of 32 stable HD patients with dialysis vintage more than 3 years and clinically well established dry weight were studied. Only in three cases BIS data seems underestimated in serial measurements. Next step, 28 healthy subjects and 116 dialysis patients were studied. Total body water and extracellular volume (ECV were significantly higher in dialysis group (P<0.01, and there was not any difference in intracellular volume (ICV. Mean AP was similar in patients with moderate (<15% and massive (>15% relative overhydration (RO = overhydration / ECV, at the same time, average number of antihypertensive medications was significantly higher in more overhydrated patients (3.1 vs 1.2. In clinical practice RO is more convenient indicator as compared to standard overhydration volume /dry weight ratio. Mutual application of the BIS and blood volume monitoring allows more rapid and safe dry weight achievement. BIS was useful tool for hydration status monitoring in routine haemodialysis practice, and further work need to be done to clarify BIS validity for nutritional status estimation. 

  12. Reprinted article "Factors associated with early failure of arteriovenous fistulae for haemodialysis access".

    Science.gov (United States)

    Wong, V; Ward, R; Taylor, J; Selvakumar, S; How, T V; Bakran, A

    2011-09-01

    The radiocephalic arteriovenous fistula remains the method of choice for haemodialysis access. In order to assess their suitability for fistula formation, the radial arteries and cephalic veins were examined preoperatively by ultrasound colour flow scanner in conjunction with a pulse-generated run-off system. Intraoperative blood flow was measured after construction of the fistulae. Post-operative follow-up was performed at various intervals to monitor the development of the fistulae. Radial artery and cephalic vein diameter less than 1.6 mm was associated with early fistula failure. The intraoperative fistula blood flow did not correlate with the outcome of the operation probably due to vessel spasm from manipulation. However, blood flow velocities measured non-invasively 1 day after the operation were significantly lower in fistulae that failed early compared with those that were adequate for haemodialysis. Most of the increase in fistula diameter and blood flow occur within the first 2 weeks of surgery. Copyright © 2011. Published by Elsevier Ltd.

  13. [Thrombosis in vascular accesses for haemodialysis: rescue treatment using invasive vascular radiological techniques].

    Science.gov (United States)

    García Medina, J; Lacasa Pérez, N; Muray Cases, S; Pérez Garrido, I; García Medina, V

    2009-01-01

    The purpose of this paper is to communicate our experience in the salvage of thrombosed haemodialysis vascular accesses using interventional radiology techniques. In the last four years, we have treated, by radiological means, 101 thrombosed haemodialysis vascular accesses. There were 44 autologous arteriovenous fistulas (43.56%) and 57 PTFE grafts (56.44%). There were 69 men (68.3%) and 32 women (31.7%). The mean age was 67.73 years (range 33-84). The mean vascular access age was 23.79 months (range 1-132). Manual catheter-directed aspiration was used. Fragmented, triturated or pushed the thrombus against the pulmonary circulation was avoided in all cases. 78 accesses were salvaged (77.2%). Autologous fistulas average and PTFE grafts success rate were 84.44% and 71.42% respectively. Angioplasty in one or more lesions after thromboaspiration was performed in all accesses, except six (5.9%). Metallic endoprostheses were implanted in 14 accesses (13.9%). Mean follow-up was 9 months (range 0-44). Primary patency was 42.3% +/- 5 at 6 months and 32% +/- 4 at one year. Autologous fistulas patency was better than PTFE grafts patency (p better than PTFE grafts. This justifies interventional radiology techniques in these situations.

  14. Haemodialysis at home: review of current dialysis machines.

    Science.gov (United States)

    Haroon, Sabrina; Davenport, Andrew

    2018-04-26

    Only a minority of patients with chronic kidney disease treated by hemodialysis are currently treated at home. Until relatively recently, the only type of hemodialysis machine available for these patients was a slightly smaller version of the standard machines used for in-center dialysis treatments. Areas covered: There are now an alternative generation of dialysis machines specifically designed for home hemodialysis. The home dialysis patient wants a smaller machine, which is intuitive to use, easy to trouble shoot, robust and reliable, quick to setup and put away, requiring minimal waste disposal. The machines designed for home dialysis have some similarities in terms of touch-screen patient interfaces, and using pre-prepared cartridges to speed up setting up the machine. On the other hand, they differ in terms of whether they use slower or standard dialysate flows, prepare batches of dialysis fluid, require separate water purification equipment, or whether this is integrated, or use pre-prepared sterile bags of dialysis fluid. Expert commentary: Dialysis machine complexity is one of the hurdles reducing the number of patients opting for home hemodialysis and the introduction of the newer generation of dialysis machines designed for ease of use will hopefully increase the number of patients opting for home hemodialysis.

  15. CT-Guided Superior Vena Cava Puncture: A Solution to Re-Establishing Access in Haemodialysis-Related Central Venous Occlusion Refractory to Conventional Endovascular Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Khalifa, Mohamed, E-mail: mkhalifa@nhs.net; Patel, Neeral R., E-mail: neeral.patel06@gmail.com; Moser, Steven, E-mail: steven.moser@imperial.nhs.uk [Hammersmith Hospital, Department of Radiology, Imperial College Healthcare NHS Trust (United Kingdom)

    2016-04-15

    PurposeThe purpose of this technical note is to demonstrate the novel use of CT-guided superior vena cava (SVC) puncture and subsequent tunnelled haemodialysis (HD) line placement in end-stage renal failure (ESRF) patients with central venous obstruction refractory to conventional percutaneous venoplasty (PTV) and wire transgression, thereby allowing resumption of HD.MethodsThree successive ESRF patients underwent CT-guided SVC puncture with subsequent tract recanalisation. Ultrasound-guided puncture of the right internal jugular vein was performed, the needle advanced to the patent SVC under CT guidance, with subsequent insertion of a stabilisation guidewire. Following appropriate tract angioplasty, twin-tunnelled HD catheters were inserted and HD resumed.ResultsNo immediate complications were identified. There was resumption of HD in all three patients with a 100 % success rate. One patient’s HD catheter remained in use for 2 years post-procedure, and another remains functional 1 year to the present day. One patient died 2 weeks after the procedure due to pancreatitis-related abdominal sepsis unrelated to the Tesio lines.ConclusionCT-guided SVC puncture and tunnelled HD line insertion in HD-related central venous occlusion (CVO) refractory to conventional recanalisation options can be performed safely, requires no extra equipment and lies within the skill set and resources of most interventional radiology departments involved in the management of HD patients.

  16. The effects of intermittent fasting during the month of Ramadan in chronic haemodialysis patients in a tropical climate country.

    Science.gov (United States)

    Wan Md Adnan, Wan Ahmad Hafiz; Zaharan, Nur Lisa; Wong, Mun Hoe; Lim, Soo Kun

    2014-01-01

    Chronic kidney disease is an emerging problem in the majority Muslim countries. Despite the uncertainties of the risks involved, some Muslim patients undergoing chronic haemodialysis choose to observe intermittent fasting during the month of Ramadan. This study aims to investigate the effect of Ramadan fasting in haemodialysis patients residing in a tropical climate country. This prospective cross sectional study recruited Muslim patients on regular haemodialysis from three haemodialysis centres in Kuala Lumpur from 15th July 2011 to 29th August 2011. Patients who fasted for any number of days were included (n = 35, 54% female, age 54±11 years). 89% of patients fasted for more than 15 days and 49% were diabetics. Dialysis parameters and blood samples were obtained one week prior to Ramadan and during the last week of Ramadan. The differences in dialysis parameters and biochemical values pre- and end-Ramadan were examined using paired t-test. Both pre- and post-dialysis weight were significantly decreased during Ramadan fasting compared to the month prior (p = <0.001). There was a significant decrease in the amount of ultrafiltration (p = 0.002). There were no significant differences in dry weight, inter-dialytic weight gain, mean urea reduction ratio or blood pressure measurements comparing pre- and end of Ramadan fasting. There was a significant increase in serum albumin level (p = 0.006) and decrease in serum phosphate level (p = 0.02) at the end of Ramadan. Ramadan fasting is associated with reduced weight, improved serum albumin and phosphate level in our population of haemodialysis patients. A larger multi-centre study will allow us to understand more about the effects of fasting in this population.

  17. The effects of intermittent fasting during the month of Ramadan in chronic haemodialysis patients in a tropical climate country.

    Directory of Open Access Journals (Sweden)

    Wan Ahmad Hafiz Wan Md Adnan

    Full Text Available BACKGROUND: Chronic kidney disease is an emerging problem in the majority Muslim countries. Despite the uncertainties of the risks involved, some Muslim patients undergoing chronic haemodialysis choose to observe intermittent fasting during the month of Ramadan. This study aims to investigate the effect of Ramadan fasting in haemodialysis patients residing in a tropical climate country. METHODS: This prospective cross sectional study recruited Muslim patients on regular haemodialysis from three haemodialysis centres in Kuala Lumpur from 15th July 2011 to 29th August 2011. Patients who fasted for any number of days were included (n = 35, 54% female, age 54±11 years. 89% of patients fasted for more than 15 days and 49% were diabetics. Dialysis parameters and blood samples were obtained one week prior to Ramadan and during the last week of Ramadan. The differences in dialysis parameters and biochemical values pre- and end-Ramadan were examined using paired t-test. RESULTS: Both pre- and post-dialysis weight were significantly decreased during Ramadan fasting compared to the month prior (p = <0.001. There was a significant decrease in the amount of ultrafiltration (p = 0.002. There were no significant differences in dry weight, inter-dialytic weight gain, mean urea reduction ratio or blood pressure measurements comparing pre- and end of Ramadan fasting. There was a significant increase in serum albumin level (p = 0.006 and decrease in serum phosphate level (p = 0.02 at the end of Ramadan. CONCLUSION: Ramadan fasting is associated with reduced weight, improved serum albumin and phosphate level in our population of haemodialysis patients. A larger multi-centre study will allow us to understand more about the effects of fasting in this population.

  18. Cognitive-behavioural therapy (CBT) for renal fatigue (BReF):a feasibility randomised-controlled trial of CBT for the management of fatigue in haemodialysis (HD) patients

    OpenAIRE

    Picariello, Federica; Moss-Morris, Rona; Macdougall, Iain C.; Norton, Sam; Da Silva-Gane, Maria; Farrington, Ken; Clayton, Hope; Chilcot, Joseph

    2018-01-01

    Introduction Fatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients.Methods We aim t...

  19. The Impact of Exercising During Haemodialysis on Blood Pressure, Markers of Cardiac Injury and Systemic Inflammation - Preliminary Results of a Pilot Study

    Directory of Open Access Journals (Sweden)

    Maurice Dungey

    2015-11-01

    Full Text Available Background/Aims: Patients requiring haemodialysis have cardiovascular and immune dysfunction. Little is known about the acute effects of exercise during haemodialysis. Exercise has numerous health benefits but in other populations has a profound impact upon blood pressure, inflammation and immune function; therefore having the potential to exacerbate cardiovascular and immune dysfunction in this vulnerable population. Methods: Fifteen patients took part in a randomised-crossover study investigating the effect of a 30-min bout of exercise during haemodialysis compared to resting haemodialysis. We assessed blood pressure, plasma markers of cardiac injury and systemic inflammation and neutrophil degranulation. Results: Exercise increased blood pressure immediately post-exercise; however, 1 hour after exercise blood pressure was lower than resting levels (106±22 vs. 117±25 mm Hg. No differences in h-FABP, cTnI, myoglobin or CKMB were observed between trial arms. Exercise did not alter circulating concentrations of IL-6, TNF-α or IL-1ra nor clearly suppress neutrophil function. Conclusions: This study demonstrates fluctuations in blood pressure during haemodialysis in response to exercise. However, since the fall in blood pressure occurred without evidence of cardiac injury, we regard it as a normal response to exercise superimposed onto the haemodynamic response to haemodialysis. Importantly, exercise did not exacerbate systemic inflammation or immune dysfunction; intradialytic exercise was well tolerated.

  20. Looking into the effect of Diabetes Mellitus on Vascular Access in Haemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Stavroula Tsinikori

    2017-03-01

    Full Text Available Introduction: The creation and maintenance of a good vascular access is mandatory for a successful haemodialysis sessions and the survival of a Chronic Kidney Disease patient. Aim: The aim of the present cross-sectional study was to look into the vascular access complications in haemodialysed patients with or without Diabetes Mellitus (DM and to find any possible correlation of these complications with Diabetes Mellitus. Methods: For this cross-sectional study data from patients’ records of private Dialysis Unit (n=77 and a big General Hospital in a Northern Greece city (n=33 were studied. Demographics, data on medication therapy and vascular access (area, type, dialysis parameters and complications were recorded. Statistical analysis was performed with SPSS 20.0. Results: The sample was 66.7 (±12.5 years old, mainly male (58%, n=58 and on dialysis for 37.3 (±34.3 months. DM was the primary disease of 53% (n=53 of the patients and Hypertension for 13% (n=13,whereas the mean of comorbidities was 5,3 (±2,6. Thirty-seven patients (37% had more than one VA created or placed. On the total of the sample (n=100 156 VA were accessed with the 63% (n=63 of them with arteriovenous fistula (AVF, 35% (n=35 with central venous catheter (CVC and 2% (n=2 with arteriovenous graft (AVG. A statistical significance (U=2560,5, p=0,1 was found regarding the number of VA of the two group of patients (DM=2,2 VA, non DM=1,8. On survival analysis it was found that DM increases the relative risk of “death” of a VA with odds ratio of 1,7 (95% confidence interval 1,1-2,6. Conclusions: DM, as primary disease or co-morbidity, in haemodialysis patients affects negatively the VA survival. Effective blood glucose control, management and methods of puncturing VA play a crucial role in maintaining the VA in DM haemodialysis patients.

  1. Medical Issues: Equipment

    Science.gov (United States)

    ... Information Packets Equipment Pool Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily Life At ... curesma.org > support & care > living with sma > medical issues > equipment Equipment Individuals with SMA often require a ...

  2. Semiconductor Manufacturing equipment introduction

    International Nuclear Information System (INIS)

    Im, Jong Sun

    2001-02-01

    This book deals with semiconductor manufacturing equipment. It is comprised of nine chapters, which are manufacturing process of semiconductor device, history of semiconductor manufacturing equipment, kinds and role of semiconductor manufacturing equipment, construction and method of semiconductor manufacturing equipment, introduction of various semiconductor manufacturing equipment, spots of semiconductor manufacturing, technical elements of semiconductor manufacturing equipment, road map of technology of semiconductor manufacturing equipment and semiconductor manufacturing equipment in the 21st century.

  3. Impact of low- or high-flux haemodialysis and online haemodiafiltration on inflammatory markers and lipid profile in chronic haemodialysis patients.

    Science.gov (United States)

    Akoglu, Hadim; Dede, Fatih; Piskinpasa, Serhan; Falay, Mesude Y; Odabas, Ali Riza

    2013-01-01

    We aimed to evaluate the impact of low- or high-flux haemodialysis (HD) and online haemodiafiltration (OL-HDF) on inflammation and the lipid profile in HD patients. 50 HD patients were assigned to two groups for HD with low-flux (n = 25) or high-flux (n = 25) polysulphone dialysers for 6 weeks. Subsequently, all patients were haemodialysed with a low-flux polysulphone dialyser for 6 weeks, then transferred to OL-HDF for another 6 weeks. Blood samples for lipids and inflammatory markers (IL-6, IL-8, TNF-α, hs-CRP) were obtained at baseline and every 6 weeks. Changes in inflammatory markers and lipids from baseline to the 6-week dialysis period did not differ between low- and high-flux groups. When patients were transferred from low-flux HD to OL-HDF, IL-6, IL-8, and TNF-α levels significantly decreased whereas HDL and LDL cholesterol significantly increased. Low- and high-flux polysulphone membranes had similar effects on lipids and inflammatory markers, whereas OL-HDF potently reduced pro-inflammatory cytokines. Copyright © 2013 S. Karger AG, Basel.

  4. YKL-40 in patients with end-stage renal disease receiving haemodialysis

    DEFF Research Database (Denmark)

    Nielsen, Ture Lange; Plesner, Louis Lind; Warming, Peder Emil

    2018-01-01

    PURPOSE: This study aimed to determine serum YKL-40 in patients with end-stage renal disease (ESRD) on haemodialysis (HD) and to evaluate the prognostic value of serum YKL-40. METHODS: Patients >18 years on maintenance HD were included. Serum YKL-40 was measured using ELISA before and after...... a single HD treatment. RESULTS: A total of 306 patients were included. Median serum YKL-40 concentration was 238 µgL-1(IQR: 193-291 µgL-1) before HD treatment and 198 µgL-1(IQR: 147-258 µgL-1) after HD treatment, which corresponded to age-corrected 93th percentile in healthy subjects. All-cause mortality...

  5. Job satisfaction, stress and burnout associated with haemodialysis nursing: a review of literature.

    Science.gov (United States)

    Hayes, Bronwyn; Bonnet, Ann

    2010-12-01

    Job dissatisfaction, stress and burnout are linked to high rates of nurses leaving the profession, poor morale and poor patient outcomes. Haemodialysis (HD) nursing is uniquely characterised by the intense-prolonged interaction with patients who require complex technological care. A review of nine papers found that factors affecting job satisfaction were aspects of nursing care, organisational factors and length of time that a nurse has been working in nephrology nursing. Factors affecting job stress and burnout were due to interpersonal relationships with physicians, patient care activities, violence and abuse from patients, organisational factors and a lack of access to ongoing education. © 2010 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  6. Self-rated health and employment status in chronic haemodialysis patients

    DEFF Research Database (Denmark)

    Molsted, Stig; Aadahl, Mette; Schou, Lone

    2004-01-01

    OBJECTIVE: Along with survival and other types of clinical outcome, physical, mental and social well-being are important indicators of the effectiveness of the medical care that haemodialysis (HD) patients receive. The present cross-sectional study was designed to assess self-rated health in HD...... patients were included. They were asked to complete the Short Form 36 (SF-36) questionnaire and additional questions concerning education and employment status. The SF-36 consists of eight scales representing physical, social, mental and general health. Clinical, biochemical and dialysis adequacy data were...... patients from a large Danish HD centre compared to a Danish general population sample with similar sex and age distributions. Furthermore, employment status and associations between self-rated health and clinical, social and demographic factors were investigated. MATERIAL AND METHODS: A total of 150...

  7. The effect of L-carnitine on lipid metabolism in patients on chronic haemodialysis

    DEFF Research Database (Denmark)

    Yderstræde, Knud Bonnet; Pedersen, Fritz Bangsgaard; Dragsholt, C.

    1987-01-01

    Twenty-one patients (median 49 years; range 20-72 years) on chronic haemodialysis (median: 54 months; range 16-154 months) were examined in a clinical controlled trial for the effect of carnitine on hyperlipoproteinaemia. Initial values of serum carnitine were within the normal range. Carnitine...... was added to the dialysis fluid to a final concentration of 100 mumol/l. The trial was carried out for 6 months, and the serum of fasting patients was analysed at monthly intervals for carnitine, triglycerides, HDL-cholesterol, LDL-cholesterol and apolipoprotein A and B. The loss of carnitine...... to the dialysis fluid also was examined, as was the retained amount in those receiving carnitine. We could not confirm the findings of others that carnitine produces lowering of serum triglycerides and increases of serum HDL-cholesterol. The study was extended for another year with ten patients; however...

  8. The management of xerostomia in patients on haemodialysis: comparison of artificial saliva and chewing gum.

    Science.gov (United States)

    Bots, Casper P; Brand, Henk S; Veerman, Enno C I; Valentijn-Benz, Marianne; Van Amerongen, Barbara M; Nieuw Amerongen, Arie V; Valentijn, Robert M; Vos, Pieter F; Bijlsma, Joost A; Bezemer, Pieter D; ter Wee, Piet M

    2005-04-01

    Many patients on haemodialysis (HD) therapy suffer from a dry mouth and xerostomia. This can be relieved by mechanical and gustatory stimulation or palliative care. The aim of this crossover study was to investigate the effect and preferences of a sugar-free chewing gum (Freedent White) and a xanthan gum-based artificial saliva (Xialine) in the management of xerostomia in chronic HD patients. Sixty-five HD patients participated in a 6-week crossover trial. The artificial saliva was rated significantly lower than the chewing gum for effectiveness, taste and a global assessment. No preference differences were found for gender and age, although older subjects rated the artificial saliva with a higher mark. Thirty-nine subjects (60%) preferred chewing gum, 15% (n=10) preferred the artificial saliva. Therefore, both chewing gum and artificial saliva could play an important role in the palliative care of xerostomia in HD patients.

  9. Ultrasound-Guided Angioplasty of Dysfunctional Vascular Access for Haemodialysis. The Pros and Cons

    Energy Technology Data Exchange (ETDEWEB)

    García-Medina, J., E-mail: josegmedina57@gmail.com [“Reina Sofia” University Hospital, Vascular and Interventional Radiology Unit, Department of Radiology (Spain); García-Alfonso, J. J., E-mail: juanjozarandieta@gmail.com [University of Murcia, Faculty of Medicine (Spain)

    2017-05-15

    PurposeTo describe the benefits and the disadvantages of angioplasty in dialysis fistulas using only ultrasound guidance.Materials and MethodsThis is a prospective study in 132 failing or non-maturing arteriovenous accesses that underwent 189 ultrasound-guided balloon angioplasties. The technical success was defined as non-use of X-ray fluoroscopy during the procedure.Results127 procedures (67%) were successfully completed without fluoroscopy. Most failures were due to difficulty to traverse aneurismal segments, as well as anastomotic stenoses. Including initial failures, the primary patency rates at 6, 12 months and 2 years were 75 ± 3, 41 ± 3 and 14 ± 2%, respectively.ConclusionEndovascular repair of the dysfunctional vascular access for haemodialysis under ultrasound guidance is feasible and safe in roughly two-thirds of cases.

  10. Low-dose cholecalciferol supplementation and dual vitamin D therapy in haemodialysis patients.

    Science.gov (United States)

    Dusilová-Sulková, Sylvie; Šafránek, Roman; Vávrová, Jaroslava; Horáček, Jiří; Pavlíková, Ladislava; Palička, Vladimír

    2015-01-01

    Traditionally, secondary hyperparathyroidism (SHPT) due to low calcitriol synthesis in failing kidneys has been treated with synthetic vitamin D receptor (VDR) activators. Recently, also the importance of low native vitamin D status beyond the issue of SHPT has been recognized in these patients. The aim of this work was to evaluate the effect of cholecalciferol supplementation in haemodialysis patients with low vitamin D serum levels. Another aim was to evaluate dual vitamin D therapy (cholecalciferol supplementation plus paricalcitol) in haemodialysis patients with vitamin D deficiency and concomitant SHPT. Ninety clinically stable maintenance haemodialysis patients were included. Supervised cholecalciferol supplementation was administered due to low vitamin D status. Patients with SHPT were also treated with synthetic VDR activator. Two pre hoc subgroups for statistical analysis were formed: patients treated solely with cholecalciferol (N=34; 5,000 IU once weekly) and patients treated with a combination of cholecalciferol (identical dose, i.e. 5,000 IU/week) plus paricalcitol (N=34, median dose 10 μg/week). Follow-up visit was scheduled 15 weeks later. Serum concentrations of calcidiol (25-D), parathyroid hormone (PTH) and beta-cross laps (CTX) were assessed at baseline and at follow-up. Serum calcium, phosphate and alkaline phosphatase (ALP) were monitored monthly. Only non-calcium gastrointestinal phosphate binders were administered. Dialysate calcium was 1.5 mmol/L in all patients, and no oral calcium-containing preparations were prescribed. Depending on data distribution, parametric or nonparametric statistical methods were used for comparison within each group (i.e. baseline vs. follow-up data) as well as between groups. In the whole group of 90 patients, mean baseline 25-D serum level was 20.3 (standard deviation 8.7) nmol/L, and it increased to 66.8 (19) nmol/L (pvitamin D supplementation was almost identical. In cholecalciferol monotherapy, 25-D levels

  11. Effects of haemodialysis on taste for salt in relation to changes in blood constituents.

    Science.gov (United States)

    Farleigh, C A; Shepherd, R; Jevons, S; Pryor, J S

    1987-11-01

    Taste sensitivity and preference for sodium chloride in bread and pea soup were assessed before and after haemodialysis in 12 female chronic renal failure patients. Blood samples were also taken pre- and post-dialysis and analysed for zinc, sodium and renin. The patients demonstrated an increased sensitivity to, and decreased preference for, sodium chloride in both bread and pea soup following dialysis. These taste changes were found to correlate with pre- to post-dialysis changes in the zinc levels in the blood. Patients receiving a more severely sodium-restricted diet showed a greater sensitivity to the taste of sodium chloride in the foods tested. Renin levels dropped in all patients following dialysis, the size of the change correlating with the size of the change in body weight.

  12. Estimated dietary sodium intake in haemodialysis patients using food frequency questionnaires.

    Science.gov (United States)

    Gkza, Anastasia; Davenport, Andrew

    2017-10-01

    In clinical practice, dietary sodium assessment requires reliable and rapid screening tools. We wished to evaluate the usefulness of food frequency questionnaires (FFQ) in estimating dietary sodium intakes in haemodialysis patients. We used the Derby Salt Questionnaire (DSQ), and Scored Sodium Questionnaire (SSQ) to estimate sodium intake. Body composition was determined by bioimpedance. In total, 139 haemodialysis patients (95 men) completed the FFQs, with mean ± standard deviation age 67 ± 15 years. The mean FFQ scores were DSQ 3.5 ± 2.0 and SSQ 68.4 ± 24.5. Men had higher estimated dietary sodium intakes [DSQ median (range) 3.6 (0.6-10.1) versus female 2.2 (0.5-9.1), P = 0.007)]. Younger patients and those aged >75 years had the higher SSQ dietary sodium scores; 70.7 ± 27.8 and 76.8 ± 24.6 versus those aged 55-75 years, 61.8 ± 22.3, P = 0.04. Patients with greater estimated sodium intake had higher extracellular water (ECW) to intracellular water (ICW) ratios pre-dialysis [75.1 ±12.5 versus 67.7 ± 4.8, P sodium group (0.9 ± 13.7% versus 6.5 ± 14.1%, P = 0.04). Both questionnaires were acceptable to patients and identified higher estimated dietary sodium intake for men, those with greater ECW and, somewhat surprisingly, we found that older patients had a greater dietary sodium intake than expected. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

  13. Renal unit practitioners’ knowledge, attitudes and practice regarding the safety of unfractionated heparin for chronic haemodialysis

    Directory of Open Access Journals (Sweden)

    Debra Ockhuis

    2015-09-01

    Full Text Available Background: Chronic haemodialysis for adult patients with end-stage kidney failure requires a patent extracorporeal circuit, maintained by anticoagulants such as unfractionated heparin (UFH. Incorrect administration of UFH has safety implications for patients. Objectives: Firstly, to describe renal practitioners’ self-reported knowledge, attitudes and practice (KAP regarding the safe use of UFH and its effects; secondly, to determine an association between KAP and selected independent variables. Method: A cross-sectional descriptive survey by self-administered questionnaire and non-probability convenience sampling was conducted in two tertiary hospital dialysis units and five private dialysis units in 2013. Results: The mean age of 74/77 respondents (96.1%, was 41.1 years. Most (41/77, 53.2% had 0–5 years of renal experience. The odds of enrolled nurses having poorer knowledge of UFH than registered nurses were 18.7 times higher at a 95% Confidence Interval (CI (1.9–187.4 and statistically significant (P = 0.013. The odds of delivering poor practice having ≤ five years of experience and no in-service education were 4.6 times higher at a 95% CI (1.4–15.6, than for respondents who had ≥ six years of experience (P = 0.014 and 4.3 times higher (95% CI 1.1–16.5 than for respondents who received in-service education (P = 0.032, the difference reaching statistical significance in both cases. Conclusion: Results suggest that the category of the professional influences knowledge and, thus, safe use of UFH, and that there is a direct relationship between years of experience and quality of haemodialysis practice and between having in-service education and quality of practice.

  14. Identification of the needs of haemodialysis patients using the concept of Maslow's hierarchy of needs.

    Science.gov (United States)

    Bayoumi, Magda

    2012-03-01

    Along with basic survival and other clinical outcomes, patients' quality of life is an important indicator to reflect the needs of these patients. Human needs are classified in Maslow's hierarchy, where the most essential basic physiological need provides the base, and self actualisation is at the top of pyramid. The aim of this study is to identify the patients' needs who are on maintenance haemodialysis using concept of Maslow's hierarchy. The descriptive study was conducted in the dialysis unit of Suez Canal University Hospitals. The study included 50 patients attending the dialysis unit. The findings showed that the patients' highest need was for self-esteem (92.0%), whereas the lowest was for love and belonging (38.0%). Statistically significant relationships were revealed between the identified love and belonging needs and patients' age and the duration of dialysis (p = 0.008). The total needs score was lower with the longer duration of dialysis (59.6 ± 7.3), compared to those with a duration less than 24 months (65.7 ± 8.1), p = 0.02. Based on the main study findings it is concluded that haemodialysis patients' highest need was for self-esteem, and the lowest was for love and belonging. These needs increased with longer duration of dialysis. Nurses need to be aware of these findings in order to be able to supply the necessary support to help the patient regain his/her self-concept. © 2011 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  15. Economic evaluations of interventions to manage hyperphosphataemia in adult haemodialysis patients: A systematic review.

    Science.gov (United States)

    Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Evers, Silvia Maa

    2016-03-01

    Managing hyperphosphataemia in haemodialysis patients is resource-intensive. A search for cost-effective interventions in this field is needed to inform decisions on the allocation of healthcare resources. NHSEED, MEDLINE, EMBASE and CINAHL were searched for full economic evaluations of hyperphosphataemia-managing interventions in adult haemodialysis patients, published between 2004 and 2014, in English, French, Dutch or German. Incremental cost-effectiveness ratios of the interventions were up-rated to 2013US$ using Purchasing Power Parity conversion rates and Consumer Price Indices. The quality of included studies was assessed using the Extended Consensus on Health Economic Criteria List. Twelve out of the 1681 retrieved records fulfilled the inclusion criteria. They reported only on one aspect of hyperphosphataemia management, which is the use of phosphate binders (calcium-based and calcium-free, in first-line and sequential use). No economic evaluations of other phosphorus-lowering interventions were found. The included articles derived from five countries and most of them were funded by pharmaceutical companies. The incremental cost-effectiveness ratios of phosphate binders ranged between US$11 461 and US$157 760 per quality-adjusted life-year gained. Calcium-based binders (especially calcium acetate) appear to be the optimal cost-effective first- and second-line therapy in prevalent patients, while the calcium-free binder, lanthanum carbonate, might provide good value for money, as second-line therapy, in incident patients. The studies' overall quality was suboptimal. Drawing firm conclusions was not possible due to the quality heterogeneity and inconsistent results. Future high-quality economic evaluations are needed to confirm the findings of this review and to address other interventions to manage hyperphosphataemia in this population. © 2015 Asian Pacific Society of Nephrology.

  16. Effectiveness of an educational intervention and physical exercise on the functional capacity of patients on haemodialysis.

    Science.gov (United States)

    Molina-Robles, Esmeralda; Colomer-Codinachs, Marta; Roquet-Bohils, Marta; Chirveches-Pérez, Emilia; Ortiz-Jurado, Pep; Subirana-Casacuberta, Mireia

    2018-03-02

    To describe the impact of a standard hospital educational intervention including active physical exercises on personal well-being, functional capacity and knowledge of the benefits of prescribed physical activity for patients undergoing haemodialysis. An uncontrolled, quasi-experimental, before-and-after study with repeated measures of response variables at 4, 8 and 12 weeks after participating in an educational and physical exercise hospital intervention. It was performed at the Nephrology Unit at the Hospital Complex in Vic within september and december 2014. The patients' well-being, functional capacity and knowledge were assessed. Assessment tools: NOC nursing indicators, Barthel index scale, FAC Holden, Timed Get Up and Go test and Daniels scale. We included 68 (80.0%) patients and 58 (85.3%) completed, with a mean age of 70.16±13.5 years; 62.1% were males. After 12 weeks, the patients had better scores of personal well-being (2.33±1.2, 3.88±0.8), more autonomy to perform activities of daily living (Barthel: 92.8±12.8; 93.5±13.9), more muscle strength (Daniels Scale: 3.81±0.7, 4.19±0.6) and walked more briskly (Get Up and Go test: 14.98±8.5; 15.65±10.5). All of the score differences were statistically significant (P<05) except the Barthel Index. The standard educational intervention and active exercise performed at hospital level improved the personal well-being, knowledge and functional capacity of patients on haemodialysis. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  17. Central venous stenosis in haemodialysis patients without a previous history of catheter placement

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

    2005-01-01

    Objective: To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Material and methods: Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Results: Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Conclusion: Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term

  18. Central venous stenosis in haemodialysis patients without a previous history of catheter placement.

    Science.gov (United States)

    Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

    2005-08-01

    To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

  19. Studies on kinetics of albumin in uraemic patients on chronic haemodialysis: evidence of interstitial albumin wash-down

    DEFF Research Database (Denmark)

    Hildebrandt, P; Jensen, H A; Henriksen, Jens Henrik Sahl

    1983-01-01

    Albumin-kinetic studies were performed in nine uraemic patients without oedema on chronic haemodialysis and in seven normal controls in order to determine microvascular leakiness and thereby, during steady state, lymph drainage of albumin. Transvascular escape rate of albumin [TERalb i.......e. the fraction of intravascular mass (IVMalb) passing into, or returning from, the extravascular space per unit time] and the distribution ratio (DRalb) between IVMalb and total albumin mass were determined from intravenously injected radioiodinated serum albumin. Before haemodialysis, TERalb was significantly...... with respect to controls (mean 0 X 44, range 0 X 42-0 X 48, P less than 0 X 01), and the extravascular mass of albumin was significantly decreased (mean 27 X 9 mumol kg-1, range 14.1 - 41.2 v. mean 35.9, range 27.1 - 43.8, P less than 0.05). We interpret the results as to indicate increased transvascular...

  20. [Recurrent vascular access trombosis associated with the prothrombin mutation G20210A in a adult patient in haemodialysis].

    Science.gov (United States)

    Quintana, L F; Coll, E; Monteagudo, I; Collado, S; López-Pedret, J; Cases, A

    2005-01-01

    Vascular access-related complications are a frequent cause of morbidity in haemodialysis patients and generate high costs. We present the case of an adult patient with end-stage renal disease and recurrent vascular access thrombosis associated with the prothrombin mutation G20210A and renal graft intolerance. The clinical expression of this heterozygous gene mutation may have been favoured by inflammatory state, frequent in dialysis patients. In this patient, the inflammatory response associated with the renal graft intolerance would have favored the development of recurrent vascular access thrombosis in a adult heterozygous for prothrombin mutation G20210A. In the case of early dysfunction of haemodialysis vascular access and after ruling out technical problems, it is convenient to carry out a screening for thrombophilia.

  1. AN EXPERIENCE OF HANDLING MICROBIAL CONTAMINATION OF PRODUCT WATER AT A HAEMODIALYSIS UNIT IN NORTH KARNATAKA OF INDIA

    Directory of Open Access Journals (Sweden)

    Archana Aravindrao Dambal

    2017-09-01

    Full Text Available BACKGROUND Dialysis units need regular prophylactic disinfection of the dialysis water production and distribution circuit without which there can be chronic inflammation among patients using the facility. The aim of the study is to present here our experience in containing an episode of microbial contamination of dialysis water. MATERIALS AND METHODS Our haemodialysis unit had a single pass reverse osmosis plant with facility for pretreatment of raw water and a distribution loop of medical grade PVC (polyvinyl chloride feeding haemodialysis machines, bicarbonate preparation and dialyser reprocessing areas. After installation, the Reverse Osmosis (RO membranes and distribution loop were disinfected every fortnight using formalin. Cultures of product water were sent from various sites in the product water loop every month. RESULTS From January to April 2011, 15 water samples out of 52 water samples grew Pseudomonas aeruginosa with a colony count over 200 Colony-Forming Units (CFU. The average monthly number of haemodialysis was reduced from 84.75 to 65. Two patients had intradialytic pyrexia and two others had mild lower respiratory infection. So, the reverse osmosis plant and product water distribution system were repeatedly disinfected using 2% formalin and 1% bleach ensuring contact time and thorough rinsing to address persistent cultures. When these measures could not eradicate microbial growth, the system was sanitised with Gramicid (48% w/w H2O2 + 500 ppm Ag and all traces of the disinfectant were rinsed away before resuming haemodialysis. CONCLUSION The microbial contamination of dialysis water was eradicated by Gramicid and not by bleach or formalin without any adverse effects after thorough rinsing.

  2. Successful use of combined high cut-off haemodialysis and bortezomib for acute kidney injury associated with myeloma cast nephropathy.

    LENUS (Irish Health Repository)

    Ward, F

    2012-05-01

    We present the case of a 58-year old female with de novo dialysis-dependent acute kidney injury (AKI) secondary to myeloma cast nephropathy. The patient underwent extended high cut-off haemodialysis (HCO-HD), in conjunction with bortezomib-based chemotherapy, and soon became dialysis independent with normal renal function. To our knowledge, this is the first time this treatment strategy has been employed successfully in an Irish centre.

  3. Non-contrast-enhanced imaging of haemodialysis fistulas using quiescent-interval single-shot (QISS) MRA: a feasibility study

    International Nuclear Information System (INIS)

    Okur, A.; Kantarci, M.; Karaca, L.; Yildiz, S.; Sade, R.; Pirimoglu, B.; Keles, M.; Avci, A.; Çankaya, E.; Schmitt, P.

    2016-01-01

    Aim: To assess the efficiency of a novel quiescent-interval single-shot (QISS) technique for non-contrast-enhanced magnetic resonance angiography (MRA) of haemodialysis fistulas. Materials and methods: QISS MRA and colour Doppler ultrasound (CDU) images were obtained from 22 haemodialysis patients with end-stage renal disease (ESRD). A radiologist with extensive experience in vascular imaging initially assessed the fistulas using CDU. Two observers analysed each QISS MRA data set in terms of image quality, using a five-point scale ranging from 0 (non-diagnostic) to 4 (excellent), and lumen diameters of all segments were measured. Results: One hundred vascular segments were analysed for QISS MRA. Two anastomosis segments were considered non-diagnostic. None of the arterial or venous segments were evaluated as non-diagnostic. The image quality was poorer for the anastomosis level compared to the other segments (p<0.001 for arterial segments, and p<0.05 for venous segments), while no significant difference was determined for other vascular segments. Conclusion: QISS MRA has the potential to provide valuable complementary information to CDU regarding the imaging of haemodialysis fistulas. In addition, QISS non-enhanced MRA represents an alternative for assessment of haemodialysis fistulas, in which the administration of iodinated or gadolinium-based contrast agents is contraindicated. - Highlights: • Close monitoring and early intervention in hemodialysis fistulas may prolong longevity fistulas. • DopplerUS, contrast enhanced CT and MRI are using assessment of hemodialysis fistulas. • QISS nonenhanced MR angiography represents an alternative for assessment of hemodialysis fistulas.

  4. Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term haemodialysis patients

    Science.gov (United States)

    Maniam, Radha; Subramanian, Pathmawathi; Singh, Surindar Kaur Surat; Lim, Soo Kun; Chinna, Karuthan; Rosli, Roshaslina

    2014-01-01

    INTRODUCTION Fatigue and quality of sleep are the main factors that contribute to a poor quality of life among patients on long-term haemodialysis. Studies have also emphasised the importance of exercise for improving the wellbeing of dialysis patients. This study aimed to determine the effectiveness of a predialysis low-to-moderate-intensity exercise programme for reducing fatigue and improving sleep disorders among long-term haemodialysis patients. METHODS In this quasi-experimental study, an exercise programme was conducted three times a week for 12 weeks before long-term haemodialysis patients underwent dialysis at two centres. The patients were categorised into either the exercise group (n = 28) or control group (n = 27). The latter was asked to maintain their current lifestyles. Assessments of fatigue and sleep disorder levels were performed for both groups using self-reported questionnaires at baseline and after intervention. The patients’ perception of the exercise programme was also determined using self-reported questionnaires. RESULTS Paired sample t-test indicated improvements in fatigue level in the exercise group (mean fatigue score: post-treatment 40.5 ± 7.9 vs. pre-treatment 30.0 ± 10.9). Improvements in sleep disorders were also observed in the exercise group (mean score: post-treatment 7.6 ± 3.3 vs. pre-treatment 10.1 ± 3.8). However, sleep quality deteriorated in the control group (mean score: post-treatment 10.7 ± 2.9 vs. pre-treatment 9.3 ± 2.9). CONCLUSION Simple low-to-moderate-intensity exercise is effective for improving fatigue, sleep disorders and the overall quality of life among haemodialysis patients. PMID:25273932

  5. Selection of equipment for equipment qualification

    International Nuclear Information System (INIS)

    Torr, K.G.

    1989-01-01

    This report describes the methodology applied in selecting equipment in the special safety systems for equipment qualification in the CANDU 600 MW nuclear generating stations at Gentilly 2 and Point Lepreau. Included is an explanation of the selection procedure adopted and the rationale behind the criteria used in identifying the equipment. The equipment items on the list have been grouped into three priority categories as a planning aid to AECB staff for a review of the qualification status of the special safety systems

  6. [The relationship between the oral health and socioeconomic characteristics of chronic kidney disease patients undergoing haemodialysis treatment or kidney transplant].

    Science.gov (United States)

    Navia-Jutchenko, María F; Muñoz-López, Eliana E; López-Soto, Olga P

    2013-01-01

    Characterising the oral health of patients undergoing different types of dialysis or kidney transplant. This was a descriptive study which involved multivariate analysis of information taken from an initial database regarding 336 patients; 49 % were receiving haemodialysis, 34 % peritoneal dialysis, 7 % pre-dialysis and 10 % kidney transplant. Illustrative variables were age, gender, marital status, occupation, education, oral hygiene and gingival indexes, flossing, decayed, missing, and filled teeth (DMFT) index, renal disease aetiology and type of dialysis being received. A hierarchical clustering method was used. Four groups of patients were identified. Class 1 (37.8 %) consisted of unmarried men having had secondary education and having good oral hygiene, very high DMFT, with haemodialysis but no stomatological pathology. Class 2 (20.24 %) included haemodialysis patients who had received elementary education, were unemployed, had inadequate oral hygiene, severe gingivitis, very high DMF rate and high Candida frequency. Class 3 (31.2 %) included women undergoing peritoneal dialysis who were over 70 years old, had received elementary education, were housewives, edentulous and who had loss of vertical dimension. Class 4 (10.7 %) included men who had received renal transplant, secondary education and were employees; one third of them were edentulous and had soft tissue alterations. Multivariate analysis indicated a possible relationship between the type of dialysis received and patients' socioeconomic characteristics regarding oral health status.

  7. Gender differences in the effect of fish oil on appetite, inflammation and nutritional status in haemodialysis patients.

    Science.gov (United States)

    Zabel, R; Ash, S; King, N; Naslund, E; Bauer, J

    2010-08-01

    Haemodialysis patients show signs of chronic inflammation and reduced appetite, which is associated with a worse clinical status and an increased mortality risk. Fish oil has anti-inflammatory properties and may be useful as a therapeutic treatment. There is limited evidence to indicate the feasibility and efficacy of this intervention in dialysis patients. The present study aimed to compare the effect of 12 weeks of supplementation with fish oil on markers of appetite and inflammation in male and female haemodialysis patients. The study was conducted in 28 haemodialysis patients. All patients were prescribed 3 g of fish oil per day for 12 weeks. Changes in appetite, plasma fatty acid profiles and inflammatory markers were measured at baseline and at 12 weeks. The mean (SD) increase in percent plasma eicosapentaenoic acid was statistically significant [1.1 (0.8) to 4.1 (2.2), P appetite and certain inflammatory markers (although no change in dietary intake) and this effect was more pronounced in males. However, the levels of some inflammatory markers increased in females and this requires further study. The high level of adherence achieved indicates that an intervention requiring patients to consume four fish oil capsules per day is achievable. This was a short-term study and the effects need to be confirmed in a randomised controlled trial.

  8. The effects of aromatherapy with lavender essential oil on fatigue levels in haemodialysis patients: A randomized clinical trial.

    Science.gov (United States)

    Bagheri-Nesami, Masoumeh; Shorofi, Seyed Afshin; Nikkhah, Attieh; Espahbodi, Fatemeh; Ghaderi Koolaee, Fahimeh-Sadat

    2016-02-01

    This study was intended to examine the efficacy of lavender essential oil for the alleviation of fatigue in haemodialysis patients. This randomized clinical trial was conducted on 59 haemodialysis patients in two groups. The routine care group received the routine care, but the experimental group inhaled lavender essence 5% for 10 min, three times a week for 4 consecutive weeks. The Fatigue Severity Scale was used to assess fatigue before the intervention and after the last intervention in the second and fourth weeks. No statistically significant differences were observed between the two groups in terms of the fatigue scores before, and after the last intervention in the second and fourth weeks. Our result does not support other studies suggesting that lavender essential oil is effective on fatigue in haemodialysis patients. This conflicting result can mostly be ascribed to a variety of factors such as duration of aromatherapy and differences in concentrations of lavender essential oil. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Haemodialysis in an emerging centre in a developing country: a two year review and predictors of mortality

    Directory of Open Access Journals (Sweden)

    Ikpeme Enobong E

    2011-10-01

    Full Text Available Abstract Background Haemodialysis is the most common form of renal replacement therapy in Nigeria. The high cost of haemodialysis has made optimal therapy of end-stage renal disease difficult in Nigeria. This paper is a review of data collected over two years of provision of dialysis services in a new tertiary hospital in Southern Nigeria. Methods This retrospective analysis is done on data obtained from the patient case files and dialysis records in the first two years of provision of dialysis services in our centre. A gender comparison of the patients' baseline sociodemographic, clinical and biochemical was performed and a logistic regression model used to assess the predictors of mortality. Results A total of 98 patients had 471 sessions in the two years under review. Males and females had similar characteristics at baseline except for a higher median serum urea in the males. The commonest causes of end-stage renal disease were chronic glomerulonephritis (34.5%, hypertension (32.1% and diabetes mellitus (17.9%. The main predictor of mortality was under treatment with haemodialysis due to inability to pay for more than a few dialysis sessions. Conclusions This study has highlighted the unchanging demographics of our advanced kidney failure patients. Efforts should be aimed at subsidizing the cost of dialysis for our teeming population of dialysis dependent chronic kidney disease patients.

  10. Peritoneal dialysis vs. haemodialysis in the management of paediatric acute kidney injury in Kano, Nigeria: a cost analysis.

    Science.gov (United States)

    Obiagwu, Patience N; Abdu, Aliyu

    2015-01-01

    To determine the cost of the dialytic management of paediatric acute kidney injury in a low-income country. All children under the age of 15 years, who had either peritoneal dialysis or haemodialysis for acute kidney injury in Aminu Kano Teaching Hospital over a 1-year period, were studied. The average cost of each dialysis modality was estimated. Of 20 children, who had dialysis for acute kidney injury, 12 (60%) had haemodialysis and 8 (40%) had peritoneal dialysis. The mean cost for haemodialysis exceeded that of peritoneal dialysis ($363.33 vs. $311.66, t = 1.04, P = 0.313) with the mean cost of consumables significantly accounting for most of the cost variation ($248.49 vs. $164.73, t = 2.91, P = 0.009). Mean costs of nephrologist visit and nursing were not found to be significant. Peritoneal dialysis is the less costly alternative for managing acute kidney injury in children in our environment. © 2014 John Wiley & Sons Ltd.

  11. An exploration of the relationship between fatigue and physical functioning in patients with end stage renal disease receiving haemodialysis.

    Science.gov (United States)

    O'Sullivan, Dawn; McCarthy, Geraldine

    2007-11-01

    To measure fatigue and physical functioning in patients with end stage renal disease (ESRD) receiving haemodialysis and to investigate the relationships between fatigue and physical functioning. Fatigue and reduced physical functioning are among the most bothersome symptoms experienced by individuals receiving haemodialysis for ESRD. Research has shown that increasing activity levels has resulted in decreased fatigue levels and improved physical functioning in individuals with cancer. Establishing whether or not a relationship exists between both concepts in haemodialysis patients is a preliminary step in identifying potential fatigue reducing strategies necessary for improved wellbeing. A quantitative exploratory correlational design was used with 46 individuals completing the Multi-dimensional Fatigue Inventory, the Medical Outcomes Study Short-Form 36-item questionnaire and a Demographic Questionnaire. Results indicated fatigue was prevalent with highest scores achieved for physical fatigue; reduced activity and general fatigue. Substantial limitations in physical functioning were found. A significant moderate negative relationship between general fatigue and physical functioning indicated that, as physical functioning levels increased, fatigue levels decreased. A significant difference was also found between general fatigue scores for males and females. Significant relationships were found between overall physical functioning, older age and employment status. The research indicates the prevalence of fatigue and limitations in physical functioning in individuals with ESRD. However, as physical functioning increased fatigue decreased; a finding relevant to clinical nursing. Understanding the levels of fatigue and the value of exercise is of relevance to clinical practice thus assessment of fatigue and physical functioning ability in the clinical setting is necessary.

  12. A 12-year review of Staphylococcus aureus bloodstream infections in haemodialysis patients: more work to be done.

    LENUS (Irish Health Repository)

    Fitzgerald, S F

    2012-02-01

    Staphylococcus aureus bloodstream infections (BSI) are a significant cause of morbidity and mortality in haemodialysis patients. This study describes a 12-year retrospective review of S. aureus BSI in a large haemodialysis centre in a tertiary referral hospital. The overall rate of S. aureus BSI was 17.9 per 100 patient-years (range 9.7-36.8). The rate of meticillin-resistant S. aureus (MRSA) BSI was 5.6 per 100 patient-years (range 0.9-13.8). Infective complications occurred in 11% of episodes, the most common being infective endocarditis (7.6%). Ten percent of patients died within 30 days of S. aureus being isolated from blood. Most cases of S. aureus BSI (83%) were related to vascular catheters. The provision of lower-risk vascular access, such as arteriovenous fistulae, and reduced use of intravascular catheters should be priorities in all haemodialysis units. Where alternative vascular access cannot be established, interventions to reduce the risk of catheter-related infections should be implemented to reduce morbidity and mortality in this vulnerable patient group.

  13. Serratia marcescens bacteraemia outbreak in haemodialysis patients with tunnelled catheters due to colonisation of antiseptic solution. Experience at 4 hospitals.

    Science.gov (United States)

    Merino, José L; Bouarich, Hanane; Pita, Mª José; Martínez, Patricia; Bueno, Blanca; Caldés, Silvia; Corchete, Elena; Jaldo, Mª Teresa; Espejo, Beatriz; Paraíso, Vicente

    The application of antiseptic solution for handling tunnelled catheters is recommended in patients undergoing haemodialysis. These routine antiseptic procedures in handling catheters are crucial to avoid complications. We report an outbreak of Serratia marcescens (S. marcescens) bacteraemia in numerous haemodialysis units of the Community of Madrid. The first cases of bacteraemia due to S. marcescens were isolated in December 2014. The Preventive Medicine Services were informed of the detection of an atypical pathogen in several patients, suspecting a probable nosocomial outbreak. Information from 4 centres with similar S. marcescens bacteraemia was analysed. Twenty-one cases of bacteraemia related to S. marcescens were identified. The mean age of affected patients was 72±10 years. The mean time on haemodialysis of affected patients was 33±13 months (range: 3-83 months), the median time of tunnelled catheter was 22±13 months. In 11 cases the clinical picture was similar, with hypotension and general malaise during the haemodialysis session. Fever was present in a further 7 cases. In 3 cases the presentation was asymptomatic and was detected by blood cultures. All patients had tunnelled catheters (12 patients with catheter in the right jugular vein, 5 in the left jugular, 2 in the right femoral artery and 2 in the left subclavian artery). Gentamicin intravenous doses (1mg/kg) with catheter lock solution with ciprofloxacin post-dialysis were administered for 3 weeks in 6 patients. In 12 patients the treatment was ceftazidime (2g IV) plus catheter lock solution with the same antibiotic, for 2 weeks. Four patients received oral ciprofloxacin for 2 weeks, in one case together with IV vancomycin. The patients were asymptomatic and without new episodes 48hours after the treatment. No major complications were observed. The teams informed the health authorities of the situation, which then reported the presence of batches of antiseptic (chlorhexidine 0.05 and 2

  14. Barriers to successful implementation of care in home haemodialysis (BASIC-HHD):1. Study design, methods and rationale.

    Science.gov (United States)

    Jayanti, Anuradha; Wearden, Alison J; Morris, Julie; Brenchley, Paul; Abma, Inger; Bayer, Steffen; Barlow, James; Mitra, Sandip

    2013-09-17

    Ten years on from the National Institute of Health and Clinical Excellence' technology appraisal guideline on haemodialysis in 2002; the clinical community is yet to rise to the challenge of providing home haemodialysis (HHD) to 10-15% of the dialysis cohort. The renal registry report, suggests underutilization of a treatment type that has had a lot of research interest and several publications worldwide on its apparent benefit for both physical and mental health of patients. An understanding of the drivers to introducing and sustaining the modality, from organizational, economic, clinical and patient perspectives is fundamental to realizing the full benefits of the therapy with the potential to provide evidence base for effective care models. Through the BASIC-HHD study, we seek to understand the clinical, patient and carer related psychosocial, economic and organisational determinants of successful uptake and maintenance of home haemodialysis and thereby, engage all major stakeholders in the process. We have adopted an integrated mixed methodology (convergent, parallel design) for this study. The study arms include a. patient; b. organization; c. carer and d. economic evaluation. The three patient study cohorts (n = 500) include pre-dialysis patients (200), hospital haemodialysis (200) and home haemodialysis patients (100) from geographically distinct NHS sites, across the country and with variable prevalence of home haemodialysis. The pre-dialysis patients will also be prospectively followed up for a period of 12 months from study entry to understand their journey to renal replacement therapy and subsequently, before and after studies will be carried out for a select few who do commence dialysis in the study period. The process will entail quantitative methods and ethnographic interviews of all groups in the study. Data collection will involve clinical and biomarkers, psychosocial quantitative assessments and neuropsychometric tests in patients. Organizational

  15. The treatment of secondary hyperparathyroidism in haemodialysis patients' refractory to alfacalcidol

    Directory of Open Access Journals (Sweden)

    L V Egshatyan

    2012-06-01

    Full Text Available Background. Secondary hyperparathyroidism (sHPT is one of the serious complications in chronic kidney disease and is associated with progressive bone disease and vascular calcification.The objective of the study was to determine the impact of Mimpara (Cinacalcet HCl on mineral disorder, bone turnover and bone mineral density (BMD versus parathyroidectomy (PTx in haemodialysis patients’ refractory to alfacalcidol. Materials and methods. 62 haemodialysis patients with sHPT were enrolled in this 6=months prospective study. All of them had surgical indications for PTx. Surgical indications was established according to clinical or biological assessment. 40 patients underwent Mimpara treatment. Dose of Mimpara was titrated every 4 weeks. Sequential doses included 30–180 (mean 59.1 ± 34.2 mg/day. 22 patients underwent PTx. The surgical technique was depended on quantity of hyperplastic parathyroid glands.Results. In 6 months mean iPTH, Ca, Са×Р, CTx and OC levels significantly decreased by 55.7%, 13.8%,34.3%, 21.4 and 1.4% in the Mimpara group vs. 90.7%, 14%, 55.5%, 58.7% and 26.9% in the PTx group. Median serum iPTH level decreased by 30% after initiation of Mimpara in 94.3% patients, from them by 50%in 74.3%. Achieved the KDOQI treatment targets for PTH in 28.6% patients.In 6 months after PTx median serum iPTH level was <100 pg/ml in 50% patients, achieved the KDOQI treatment targets in 27.3%, <300 pg/ml in 18.2%. Median serum 25(ОНD after PTx significantly increase by 127.3% vs 6.72% in the Mimpara group. In 6 months active restoration of BMD was found in the PTx patients, and patients treated with Cinacalcet showed stabilization of BMD.Mimpara therapy led to a reduction in glandular volume during the course of the study: in both glands with a baseline volume <500 mm3 and with a baseline volume ≥500 mm3. Conclusions. PTx and Cinacalcet therapy improves phosphorus=calcium homeostasis, bone turnover, but bone resorption and formation

  16. Two years experience with tunneled dialysis catheters in patients requiring haemodialysis

    International Nuclear Information System (INIS)

    Raheem, A.; Rana, A. I.; Ramzan, M.; Shah, R. A.; Mehmood, S. N.; Naseem, S.

    2014-01-01

    Objective: To look for survival rate and major reasons behind the failure of tunnelled dialysis catheters in patients on haemodialysis. Methods: The retrospective study was conducted at the Department of Interventional Radiology, Shifa International Hospital, Islamabad, and comprised records of 100 consecutive subjects from a list of patients in whom tunnelled cuffed catheters were placed from February 2009 to January 2011 and were followed up for two years. Data was collected on a proforma from the hospital database and medical records of patients. SPSS 19 was used for statistical analysis. Results: Of the total 122 catheters placed in 100 patients, 49(40.16%) were lost to follow-up. Of the remaining 73(59.83%) catheters, 38(52%) had achieved their desired function, while 35(48%) failed to achieve the target duration. Among the reasons of catheter failure, infection was the commonest at 13(37.14%) with infection rate of 0.24 per 1000 catheter days. According to Kaplan Meier analysis, catheter survival rates at 60, 90 and 180 days were 89%, 77% and 64% respectively. Mean effective duration of catheter was 129+-117 days. Conclusion: Tunnelled dialysis catheters can be safely used as vascular access till the maturation of fistula and may be an alternative to Arterio-Venous Fistula or graft for long-term vascular access if indicated. (author)

  17. The role of religion and spirituality in coping with kidney disease and haemodialysis in Thailand.

    Science.gov (United States)

    Yodchai, Kantaporn; Dunning, Trisha; Savage, Sally; Hutchinson, Alison M

    2017-06-01

    People with chronic kidney disease (CKD) face various problems including psychological, socioeconomic and physical effects associated with CKD and its treatment. They need to develop strategies to help them cope with CKD and life challenges. Religion and spirituality are important coping strategies, but their role in helping people cope with CKD and haemodialysis (HD) in Thailand is relatively unknown. To investigate the role of religion and spirituality in coping with CKD and its treatment in Thailand. An exploratory, qualitative approach was undertaken using semistructured individual interviews. Purposive sampling was used to recruit participants. Face-to-face, in-depth individual interviews using open questions were conducted during January and February 2012. Interviews were audio-recorded and transcribed verbatim. Data were analysed using the framework method of qualitative data analysis. Twenty people receiving HD participated: age range 23-77 years, mean 53.7 (±16.38 SD). Ten were women. Participants reported use of religious and spiritual practices to cope with CKD and its treatment, including religious and spiritual explanations for developing CKD, karmic disease, making merit, reading Dharma books, praying and chanting to save life and making a vow to Pran-Boon. Religion and spirituality provide powerful coping strategies that can help Thai people with CKD overcome the associated distress and difficulties. Religion and spirituality cannot be separated in Thai culture because Thai people are both religious and spiritual. © 2016 Nordic College of Caring Science.

  18. Relations between diabetes, blood pressure and aortic pulse wave velocity in haemodialysis patients

    DEFF Research Database (Denmark)

    Peters, Christian Daugaard; Kjærgaard, Krista Dybtved; Dzeko, Mirela

    (HD) and 32 HD patients with DM (HD+DM). The SphygmoCor system was used for estimation of PWV. HD-duration, age, gender and BP medication were similar in the two groups. Mean DM-duration was 23±11 years and 25(78%) had type 2 DM. HD+DM had higher BMI (26±5 vs. 29±5 kg/m2, p=0.02), systolic BP (142......Diabetes (DM) is common in haemodialysis (HD) patients and affects both blood pressure (BP) and arterial stiffness. Carotid femoral pulse wave velocity (PWV) reflects the stiffness of the aorta and is regarded as a strong risk factor for cardiovascular (CV) mortality in HD patients. However, PWV......±20 vs. 152±21 mmHg, p=0.02) and pulse pressure (65±17 vs. 80±18 mmHg, p2.5 in HD and 12.3±3.1 m/s in HD+DM. The mean PWV difference HD vs. HD+DM was 3.1(1.9-4.3)m/s, p

  19. Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation

    Directory of Open Access Journals (Sweden)

    Bernd Stegmayr

    2014-04-01

    Full Text Available Severe kidney disease results in retention of uremic toxins that inhibit key enzymes for lipid breakdown such as lipoprotein lipase (LPL and hepatic lipase (HL. For patients in haemodialysis (HD and peritoneal dialysis (PD the LPL activity is only about half of that of age and gender matched controls. Angiopoietin, like protein 3 and 4, accumulate in the uremic patients. These factors, therefore, can be considered as uremic toxins. In animal experiments it has been shown that these factors inhibit the LPL activity. To avoid clotting of the dialysis circuit during HD, anticoagulation such as heparin or low molecular weight heparin are added to the patient. Such administration will cause a prompt release of the LPL and HL from its binding sites at the endothelial surface. The liver rapidly degrades the release plasma compound of LPL and HL. This results in a lack of enzyme to degrade triglycerides during the later part of the HD and for another 3–4 h. PD patients have a similar baseline level of lipases but are not exposed to the negative effect of anticoagulation.

  20. Impaired exercise performance and muscle Na(+),K(+)-pump activity in renal transplantation and haemodialysis patients.

    Science.gov (United States)

    Petersen, Aaron C; Leikis, Murray J; McMahon, Lawrence P; Kent, Annette B; Murphy, Kate T; Gong, Xiaofei; McKenna, Michael J

    2012-05-01

    We examined whether abnormal skeletal muscle Na(+),K(+)-pumps underlie impaired exercise performance in haemodialysis patients (HDP) and whether these are improved in renal transplant recipients (RTx). Peak oxygen consumption ( O(2peak)) and plasma [K(+)] were measured during incremental exercise in 9RTx, 10 HDP and 10 healthy controls (CON). Quadriceps peak torque (PT), fatigability (decline in strength during thirty contractions), thigh muscle cross-sectional area (TMCSA) and vastus lateralis Na(+),K(+)-pump maximal activity, content and isoform (α(1)-α(3), β(1)-β(3)) abundance were measured. O(2peak) was 32 and 35% lower in RTx and HDP than CON, respectively (P Na(+),K(+)-pump activity was 28 and 31% lower in RTx and HDP, respectively than CON (P Na(+),K(+)-pump activity (r = 0.45, P = 0.02). O(2peak) and muscle Na(+),K(+)-pump activity were depressed and muscle fatigability increased in HDP, with no difference observed in RTx. These findings are consistent with the possibility that impaired exercise performance in HDP and RTx may be partially due to depressed muscle Na(+),K(+)-pump activity and relative TMCSA.

  1. Comparison of FLIXENE™ and standard PTFE arteriovenous graft for early haemodialysis.

    Science.gov (United States)

    Chiang, Nathaniel; Hulme, Katherine Ria; Haggart, Paul Charles; Vasudevan, Thodur

    2014-01-01

    The purpose is to compare the outcomes of FLIXENE™ arteriovenous graft (AVG) to standard polytetrafluoroethylene (PTFE) AVG for early haemodialysis. This is a prospective observational study of all AVGs placed over a 40-month period between 2008 and 2011 at our vascular unit. Primary outcome was to examine early cannulation rates for FLIXENE™. Secondary outcomes included patency rates, usability of grafts, complications in particular infections, interventions and death in comparison to standard PTFE grafts. Forty-five FLIXENE™ and 19 standard PTFE AVGs were placed in the study period; 89% of FLIXENE™ grafts were used for dialysis, with 78% cannulated within 3 days. At 18 months, primary patency (FLIXENE™ 34% vs standard PTFE 24%), primary assisted patency (35% vs 36%) and secondary patency rate (51% vs 48%) were not statistically different; 20.2% of FLIXENE™ grafts were infected at 18 months requiring explantation compared with 40.3% of standard PTFE grafts (p=0.14). FLIXENE™ can be cannulated for dialysis within 3 days. It has similar patency and complication rates as other prosthetic grafts in the market. In patients who have no access and require urgent dialysis, FLIXENE™ is a viable option.

  2. Psychosocial factors and adherence to drug treatment in patients on chronic haemodialysis.

    Science.gov (United States)

    Huertas-Vieco, María P; Pérez-García, Rafael; Albalate, Marta; de Sequera, Patricia; Ortega, Mayra; Puerta, Marta; Corchete, Elena; Alcázar, Roberto

    2014-11-17

    The daily pill burden in hemodialysis patients is one of the highest reported to date in any chronic disease. The adherence to prescribed treatment has implications on the quality of life, the survival of patients, and the economic cost of their treatment, this being a priority public health issue. To evaluate the adherence to pharmacological treatment examining, among the possible causes of non-adherence, psychosocial factors such as depression, anxiety, cognitive impairment and social support. Transversal-observational study of thirty five patients that suffer from chronic renal disease and who are on manteinance hemodialysis, evaluated by self-reported measures. Non-adherent patients have significant higher depression index than adherent patients. Anxiety, cognitive impairment and social support do not show a significant relation with the degree of adherence or compliance with farmacological treatment. These results suggest that psychological intervention in chronic haemodialysis patients with a severe depression index could increase the degree of fulfillment and general well-being of renal patients.

  3. Clinicians' and researchers' perspectives on establishing and implementing core outcomes in haemodialysis: semistructured interview study.

    Science.gov (United States)

    Tong, Allison; Crowe, Sally; Gill, John S; Harris, Tess; Hemmelgarn, Brenda R; Manns, Braden; Pecoits-Filho, Roberto; Tugwell, Peter; van Biesen, Wim; Wang, Angela Yee Moon; Wheeler, David C; Winkelmayer, Wolfgang C; Gutman, Talia; Ju, Angela; O'Lone, Emma; Sautenet, Benedicte; Viecelli, Andrea; Craig, Jonathan C

    2018-04-20

    To describe the perspectives of clinicians and researchers on identifying, establishing and implementing core outcomes in haemodialysis and their expected impact. Face-to-face, semistructured interviews; thematic analysis. Twenty-seven centres across nine countries. Fifty-eight nephrologists (42 (72%) who were also triallists). We identified six themes: reflecting direct patient relevance and impact (survival as the primary goal of dialysis, enabling well-being and functioning, severe consequences of comorbidities and complications, indicators of treatment success, universal relevance, stakeholder consensus); amenable and responsive to interventions (realistic and possible to intervene on, differentiating between treatments); reflective of economic burden on healthcare; feasibility of implementation (clarity and consistency in definition, easily measurable, requiring minimal resources, creating a cultural shift, aversion to intensifying bureaucracy, allowing justifiable exceptions); authoritative inducement and directive (endorsement for legitimacy, necessity of buy-in from dialysis providers, incentivising uptake); instituting patient-centredness (explicitly addressing patient-important outcomes, reciprocating trial participation, improving comparability of interventions for decision-making, driving quality improvement and compelling a focus on quality of life). Nephrologists emphasised that core outcomes should be relevant to patients, amenable to change, feasible to implement and supported by stakeholder organisations. They expected core outcomes would improve patient-centred care and outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Midterm Experience of Ipsilateral Axillary-Axillary Arteriovenous Loop Graft as Tertiary Access for Haemodialysis

    Directory of Open Access Journals (Sweden)

    J. P. Hunter

    2014-01-01

    Full Text Available Objectives. To present a series of ipsilateral axillary artery to axillary vein loop arm grafts as an alternative vascular access procedure for haemodialysis in patients with difficult access. Design. Retrospective case series. Methods. Patients who underwent an axillary loop arteriovenous graft from September 2009 to September 2012 were included. Preoperative venous imaging to exclude central venous stenosis and to image arm/axillary veins was performed. A cuffed PTFE graft was anastomosed to the distal axillary artery and axillary vein and looped on the arm. Results. 25 procedures were performed on 22 patients. Median age was 51 years, with 9 males and 13 females. Median number of previous access procedures was 3 (range 0–7. Median followup was 16.4 months (range 1–35. At 3 months and 1 year, the primary and secondary patency rates were 70% and 72% and 36% and 37%, respectively. There were 11 radiological interventions in 6 grafts including 5 angioplasties and 6 thrombectomies. There were 19 surgical procedures in 10 grafts, including thrombectomy, revision, repair for bleeding, and excision. Conclusions. Our series demonstrates that the axillary loop arm graft yields acceptable early patency rates in a complex group of patients but to maintain graft patency required high rates of surgical and radiological intervention, in particular graft thrombectomy.

  5. Thyroid hormone levels in patients with chronic renal failure under haemodialysis

    International Nuclear Information System (INIS)

    Khalid, Ahmed Shukralla M.

    1998-06-01

    This study was conducted with three main objectives, to study thyroid hormones (T 4 , T 3 ) and TSH levels in patients with CRF under haemodialysis and to compare them with normal subjects, to study best means of treatment and to compare these findings with results from other parts of the world. This study was done on 61 patients with renal failure in Khartoum dialysis and kidney transplant centre U of K, 45 males and 16 females with ages ranging from 17-75 years and 42 symptoms-free subjects 14 males and 23 females with age ranging from 16-60 years. The radioimmunoassay (RIA) technique was used for the determination of serum T 4 , T 3 and TSH. By using t-test found that the mean concentrations of T 4 , T 3 of normal subjects were much higher than those of the patients (p 0.05). These results also illustrated that 45.9% of patients with renal failure of low T 4 , and 91.8%, 90.26 of patients had T 3 and TSH hormone levels in the normal range, respectively. No significant difference was observed in the mean of thyroid hormones (T 4 , T 3 ) and thyroid-stimulating hormones between males and females (p>0.05). The T 3 and T '4 concentrations in patients at all age groups (year) was less than the age groups of the control group, and this decrease was statistically significant (p 0.05).(Author)

  6. Cephalic Arch Stenosis in Autogenous Haemodialysis Fistulas: Treatment With the Viabahn Stent-Graft

    Energy Technology Data Exchange (ETDEWEB)

    Shawyer, Andrew, E-mail: andrew.shawyer@bartsandthelondon.nhs.uk [The Royal London Hospital, Radiology Department (United Kingdom); Fotiadis, Nicos I., E-mail: fotiadis.nicholas@gmail.com [Royal Marsden Hospital, Radiology Department, The Royal Marsden NHS Foundation Trust (United Kingdom); Namagondlu, Girish, E-mail: girish.namagondlu@bartsandthelondon.nhs.uk [The Royal London Hospital, Renal Medicine Department (United Kingdom); Iyer, Arun, E-mail: arun.iyer@bartsandthelondon.nhs.uk [The Royal London Hospital, Radiology Department (United Kingdom); Blunden, Mark, E-mail: mark.blunden@bartsandthelondon.nhs.uk; Raftery, Martin, E-mail: martin.raftery@bartsandthelondon.nhs.uk; Yaqoob, Magdi, E-mail: magdi.yaqoob@bartsandthelondon.nhs.uk [The Royal London Hospital, Renal Medicine Department (United Kingdom)

    2013-02-15

    Cephalic arch stenosis (CAS) is an important and common cause of dysfunction in autogenous haemodialysis fistulas that requires multiple reinterventions and aggressive surveillance. We evaluated the safety and efficacy of the Viabahn stent-graft for the management of CAS. Between April 2005 and October 2011, 11 consecutive patients [four men and seven women (mean age 56.7 years)] with CAS and dysfunctional fistulas were treated with insertion of 11 Viabahn stent-grafts. Six stent-grafts were inserted due to residual stenosis after angioplasty and five for fistuloplasty-induced rupture. No patient was lost to follow-up. The technical and clinical success rate was 100 %. Primary access patency rates were 81.8 % [95 % confidence interval (CI) 0.482-0.977] at 6 months and 72.7 % (95 % CI 0.390-0.939) at 12 months. Secondary access patency rates were 90.9 % at 6 months (95 % CI 0.587-0.997). There were no procedure-related complications. Mean follow-up was 543.8 days (range 156-2,282). The use of the Viabahn stent-graft in the management of CAS is technically feasible and, in this small series, showed patency rates that compare favorably with historical data of angioplasty and bare stents.

  7. Cephalic Arch Stenosis in Autogenous Haemodialysis Fistulas: Treatment With the Viabahn Stent-Graft

    International Nuclear Information System (INIS)

    Shawyer, Andrew; Fotiadis, Nicos I.; Namagondlu, Girish; Iyer, Arun; Blunden, Mark; Raftery, Martin; Yaqoob, Magdi

    2013-01-01

    Cephalic arch stenosis (CAS) is an important and common cause of dysfunction in autogenous haemodialysis fistulas that requires multiple reinterventions and aggressive surveillance. We evaluated the safety and efficacy of the Viabahn stent-graft for the management of CAS. Between April 2005 and October 2011, 11 consecutive patients [four men and seven women (mean age 56.7 years)] with CAS and dysfunctional fistulas were treated with insertion of 11 Viabahn stent-grafts. Six stent-grafts were inserted due to residual stenosis after angioplasty and five for fistuloplasty-induced rupture. No patient was lost to follow-up. The technical and clinical success rate was 100 %. Primary access patency rates were 81.8 % [95 % confidence interval (CI) 0.482–0.977] at 6 months and 72.7 % (95 % CI 0.390–0.939) at 12 months. Secondary access patency rates were 90.9 % at 6 months (95 % CI 0.587–0.997). There were no procedure-related complications. Mean follow-up was 543.8 days (range 156–2,282). The use of the Viabahn stent-graft in the management of CAS is technically feasible and, in this small series, showed patency rates that compare favorably with historical data of angioplasty and bare stents.

  8. Comparison of Volume Status in Asymptomatic Haemodialysis and Peritoneal Dialysis Outpatients

    Directory of Open Access Journals (Sweden)

    Eugenia Papakrivopoulou

    2012-03-01

    Full Text Available Background: The majority of haemodialysis (HD patients gain weight between dialysis sessions and thereby become volume overloaded, whereas peritoneal dialysis (PD is a more continuous technique. Cardiovascular mortality and hypertension is increased with both treatment modalities. We therefore wished to compare volume status in PD and HD to determine whether PD patients are chronically volume overloaded, as a risk factor for cardiovascular mortality. Study Design, Setting and Participants:We retrospectively audited 72 healthy HD patients and 115 healthy PD patients attending a university hospital dialysis centre for routine outpatient treatment, who had multi-frequency bioimpedance measurements of extracellular water to total body water (ECW/TBW. Results: The groups were well matched for age, sex, weight and ethnicity, PD patients had greater urine output [1,075 (485–1,613 vs. 42.5 (0–1,020 ml/day, p Conclusions: Overhydration is common in healthy stable PD outpatients, and ECW volumes in PD patients are not dissimilar to those of pre-dialysis HD patients. The role of chronic volume overload as a risk factor for cardiovascular disease needs further investigation.

  9. Mycobacterium aquaticum sp. nov., a rapidly growing species isolated from haemodialysis water.

    Science.gov (United States)

    Hashemi Shahraki, Abdolrazagh; Trovato, Alberto; Droz, Sara; Haidarieh, Parvin; Borroni, Emanuele; Mirsaeidi, Mehdi; Mannino, Roberta; Hashemzadeh, Mohamad; Mariottini, Alessandro; Cirillo, Daniela Maria; Tortoli, Enrico

    2017-09-01

    The characterization of five Iranian isolates, four from hospital haemodialysis water and one from the sputum of a patient, led to the detection of a novel mycobacterium species. The strains were characterized by mucoid colonies developing in 3-5 days at temperatures ranging from 25 to 37 °C. The biochemical test pattern was unremarkable while the HPLC profile of mycolic acids resembled that of Mycobacterium fortuitum. The sequences of three major housekeeping genes (16S rRNA, hsp65 and rpoB) were unique and differed from those of any other mycobacterium. Mycobacterium brisbanense, which is the species that shared the highest 16S rRNA gene sequence similarity (99.03 %), was distinct, as shown by the average nucleotide identity and by the genome to genome distance values (91.05 and 43.10 %, respectively). The strains are thus considered to represent a novel species of the genus Mycobacterium, for which the name Mycobacterium aquaticum sp. nov. is proposed. The type strain is RW6T (=DSM 104277T=CIP111198T).

  10. Non-matured arteriovenous fistulae for haemodialysis: diagnosis, endovascular and surgical treatment

    Directory of Open Access Journals (Sweden)

    Marko Malovrh

    2010-04-01

    Full Text Available Non-maturation is a feature of autologous vascular access. The autologous arteriovenous fistula needs time to mature and for the vein to enlarge to a size where it can be needled for dialysis. A fistula that fails early is one that either never develops adequately to support dialysis or fails within the first three months of its use. Two variables are required for fistula maturation. Firstly, the fistula should have adequate blood flow to support dialysis and secondly, it should have enough size to allow for successful repetitive cannulation. Three main reasons for maturation failure are: arterial and venous problems and the presence of accessory veins. Early diagnostics and intervention for fistula maturation minimizes catheter use and its associated complications. The identification of immature fistulae is relatively simple. Physical examination has been highlighted to be a valuable tool in assessing fistula. Any fistula that fails to mature adequately and demonstrates abnormal physical findings should be studied aggressively. Ultrasonography can successfully identify candidates who fail to meet the recently developed criteria for immature fistulae. In recent years, digital subtraction angiography and contrast-enhanced magnetic resonance angiography has been introduced for assessment of dysfunctional haemodialysis conduits, including immature fistulae. A great majority of non-matured fistulae can be successfully salvaged using percutaneous techniques. In addition to endovascular techniques, surgical intervention can also be an option. This paper reviews the process of fistula maturation and presents information regarding how to obtain a mature fistula.

  11. Comparison of haemodialysis patients and non-haemodialysis patients with respect to clinical characteristics and 3-year clinical outcomes after sirolimus-eluting stent implantation: insights from the Japan multi-centre post-marketing surveillance registry.

    Science.gov (United States)

    Otsuka, Yoritaka; Ishiwata, Sugao; Inada, Tsukasa; Kanno, Hiroyuki; Kyo, Eisho; Hayashi, Yasuhiko; Fujita, Hiroshi; Michishita, Ichiro

    2011-04-01

    Long-term outcomes after sirolimus-eluting stent (SES) implantation in haemodialysis (HD) patients have remained controversial. We investigated the impact of HD on outcomes after SES implantation. We analysed the data on 2050 patients who underwent SES implantation in a multi-centre prospective registry in Japan. Three-year clinical outcomes were compared between the HD group (n = 106) and the non-haemodialysis (NH) group (n = 1944). At the 3-year clinical follow-up, the rates of unadjusted cardiac mortality (HD: 16.3 vs. NH: 2.3%) and target-lesion revascularization (TLR) (HD: 19.4 vs. NH: 6.6%) were significantly higher in the HD group than the NH group (P statistical significance. Using Cox's proportional-hazard models with propensity score adjustment for baseline differences, the HD group had higher risks of TLR [HD: 16.3 vs. NH: 6.1%; hazard ratio, 2.83; 95% confidence interval (CI): 1.62-4.93, P = 0.0003] and cardiac death (HD: 12.3 vs. NH: 2.3%; hazard ratio, 5.51; 95% CI: 2.58-11.78, P < 0.0001). The consistent results of analyses, whether unadjusted or adjusted for other baseline clinical and procedural differences, identify HD as an independent risk factor for cardiac death and TLR. Percutaneous coronary intervention with SES in HD patients has a higher incidence of repeat revascularization and mortality compared with those in NH patients. Haemodialysis appears to be strongly associated with mortality and repeat revascularization even after SES implantation.

  12. Influence of Erythropoiesis-Stimulating Agents on HbA1c and Fructosamine in Patients with Haemodialysis.

    Science.gov (United States)

    Rasche, Franz Maximilian; Ebert, Thomas; Beckmann, Julia; Busch, Volker; Barinka, Filip; Rasche, Wilma Gertrud; Lindner, Tom H; Schneider, Jochen G; Schiekofer, Stephan

    2017-06-01

    HbA1c is the most accepted laboratory parameter for the long term observation of glucose control. There is still much of a debate about the use of HbA1c as a metabolic indicator in diabetic patients (DM) on haemodialysis (HD) and erythropoiesis-stimulating agent (ESA) therapy because of the altered erythrocyte turn over in patients with chronic kidney disease and haemodialysis (CKD5D). In 102 CKD5 patients with and without diabetes mellitus, we examined the dose dependent variability in HbA1c and fructosamine levels under haemodialysis and treated with epoetin α (n=48) and a new generation agent with continuous stimulation of methoxy polyethylene glycol epoetin beta (C.E.R.A.; n=54). HbA1c levels were affected by therapy with ESA treatments. ESA dose was inversely correlated with HbA1c and an escalation of 10.000 IU per week induced an estimated decrease of HbA1c of 0.6 percent. In addition, the increase of reticulocyte number as a marker for erythropoiesis was significantly inversely correlated with the increase of ΔHbA1c. ESA treatments had no such effect on the alternative metabolic parameter fructosamine. When compared, both therapeutic agents had comparable success in attaining haemoglobin (Hb) target values. C.E.R.A. showed better correlation and was more effective over a longer dose interval. Our results show that HbA1c levels in patients should be carefully interpreted based on interfering factors. Nevertheless, HbA1c is currently the most consistent parameter for use ascertaining metabolic status of patients suffering from diabetes mellitus. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Dental and periodontal health, and microbiological and salivary conditions in patients with or without diabetes undergoing haemodialysis.

    Science.gov (United States)

    Schmalz, Gerhard; Schiffers, Nora; Schwabe, Sandra; Vasko, Radovan; Müller, Gerhard A; Haak, Rainer; Mausberg, Rainer F; Ziebolz, Dirk

    2017-06-01

    The aim of this cross-sectional study was to evaluate the dental and periodontal health, as well as the microbiological and salivary conditions, of patients with and without diabetes mellitus (DM) who are receiving haemodialysis. One-hundred and fifty-nine haemodialysis patients were included and divided into groups according to the pre-existing diabetes status: DM or no DM. The oral examination included dental findings and assessment of the periodontal situation. The periodontal condition was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were analysed using the polymerase chain reaction. The salivary diagnostics included measurement of unstimulated and stimulated salivary flow, pH and buffer capacity. Statistical analyses used Fisher's test, the t-test and the Mann-Whitney U-test (α = 5%). The dental findings showed no significant difference between patients with and without DM (P = 0.44). The prevalence of periodontitis was high (96% in patients with DM and 97% in patients who did not have DM) and there was no significant difference between the groups (P = 0.71). There was a higher prevalence of Porphyromonas gingivalis, Parvimonas micros, Eubacterium nucleatum and Capnocytophaga spp. in patients without DM (P salivary pH was significantly higher in patients without DM (P salivary pH were detected between the groups, the dental and periodontal status was comparable between patients with and without DM. Accordingly, DM appears to have no decisive influence on the oral health in patients treated with haemodialysis who have well-controlled diabetes. © 2017 FDI World Dental Federation.

  14. Shipboard and laboratory equipment

    Digital Repository Service at National Institute of Oceanography (India)

    Shyamprasad, M.; Ramaswamy, V.

    The polymetallic nodules occur at an average depth of 4500 m. Adequate equipment and techniques are required for the exploration at such depths. Shipboard and various laboratory equipments for the sampling of polymetallic nodules is described...

  15. Remote handling equipment

    International Nuclear Information System (INIS)

    Clement, G.

    1984-01-01

    After a definition of intervention, problems encountered for working in an adverse environment are briefly analyzed for development of various remote handling equipments. Some examples of existing equipments are given [fr

  16. Exercise Equipment: Neutral Buoyancy

    Science.gov (United States)

    Shackelford, Linda; Valle, Paul

    2016-01-01

    Load Bearing Equipment for Neutral Buoyancy (LBE-NB) is an exercise frame that holds two exercising subjects in position as they apply counter forces to each other for lower extremity and spine loading resistance exercises. Resistance exercise prevents bone loss on ISS, but the ISS equipment is too massive for use in exploration craft. Integrating the human into the load directing, load generating, and motion control functions of the exercise equipment generates safe exercise loads with less equipment mass and volume.

  17. BP volume reduction equipment

    International Nuclear Information System (INIS)

    Kitamura, Yoshinori; Muroo, Yoji; Hamanaka, Isao

    2003-01-01

    A new type of burnable poison (BP) volume reduction system is currently being developed. Many BP rods, a subcomponent of spent fuel assemblies are discharged from nuclear power reactors. This new system reduces the overall volume of BP rods. The main system consists of BP rod cutting equipment, equipment for the recovery of BP cut pieces, and special transport equipment for the cut rods. The equipment is all operated by hydraulic press cylinders in water to reduce operator exposure to radioactivity. (author)

  18. Colour Doppler ultrasound assessment of well-functioning mature arteriovenous fistulas for haemodialysis access

    International Nuclear Information System (INIS)

    Pietura, Radoslaw; Janczarek, Marzena; Zaluska, Wojciech; Szymanska, Anna; Janicka, Lucyna; Skublewska-Bednarek, Anna; Szczerbo-Trojanowska, Malgorzata

    2005-01-01

    Background: A well-functioning mature arteriovenous fistula is essential for the maintenance of haemodialysis in patients with chronic renal failure. The Brescia-Cimino arteriovenous fistula has the best survival characteristics and low rate of complications. The most common reason of fistula failure is thrombosis caused by stenosis. Colour Doppler ultrasonography has proven to be effective in the assessment of anatomical vascular features. The majority of studies were done in patients with clinically presumed arteriovenous fistula complications. However, only limited data are available about the well-functioning mature arteriovenous fistulas. The purpose of the present study was to evaluate completely asymptomatic, mature arteriovenous fistulas with colour Doppler ultrasound. Materials and methods: From July 2001 to April 2003, we examined 139 patients with the end-stage renal disease. They were in the range of 19-79 years of age (mean, 46.7 years). The study included only the patients who met the following criteria: (1) no difficulties with haemodialysis (as reported by nurses); (2) normal venous diastolic blood pressure (<150 mmHg) at monthly evaluation; (3) normal urea clearance x time/urea volume of distribution; (4) blood cells count, plasma electrolytes, and liver function at monthly evaluation. The mean fistula age was 26 months (S.D. = 21.9). The mean time of dialysis therapy was 49 months. Thirty-eight percent patients had primary fistulas, 23%-secondary, 11%-third and 11%-fourth, 4%-fifth, 5%-sixth, and 8% patients had more than sixth. Results: There was no correlation between: (1) patient's age and fistula age; (2) patient's age and number of fistulas in one patient; (3) fistula age and number of fistulas in one patient; (4) localization of fistula and fistula age. There was a strong correlation between dialysis therapy period and number of fistulas in one patient. The mean flow volume was 1204.1 ml/min (S.D. = 554). It was significantly higher in the

  19. Linezolid extracorporeal removal during haemodialysis with high cut-off membrane in critically ill patients.

    Science.gov (United States)

    Villa, Gianluca; Cassetta, Maria Iris; Tofani, Lorenzo; Valente, Serafina; Chelazzi, Cosimo; Falsini, Silvia; De Gaudio, Angelo Raffaele; Novelli, Andrea; Ronco, Claudio; Adembri, Chiara

    2015-10-01

    Continuous venovenous haemodialysis with high cut-off membrane (HCO-CVVHD) is often used in critically ill septic patients with acute kidney injury (AKI) to sustain renal function and to remove circulating inflammatory mediators. The aim of this study was to analyse the extracorporeal removal of linezolid and related alterations in pharmacokinetic/pharmacodynamic (PK/PD) parameters during HCO-CVVHD. Three critically ill septic patients with AKI, treated with linezolid and HCO-CVVHD, were prospectively observed. To calculate the extracorporeal clearance of linezolid and the PK parameters, effluent, pre-filter and post-filter samples were contemporaneously collected before linezolid infusion, just after 1-h infusion (maximum serum concentration; C(max)), at 3 h and 6 h after dosing, and before the next dose (trough serum concentration; C(min)). Linezolid C(max) and C(min) (pre-filter) ranged from 10.4-23.5 mg/L and from 2.9-10.3 mg/L. The dialysate saturation coefficient was 0.66-0.85 and the extracorporeal clearance with a diffusive dose of 35 m L/kg/h ranged from 2.1-2.5 L/h. Total linezolid clearance was between 1.7 L/h and 6.3 L/h. The total area under the plasma concentration-time curve (AUC0-∞) ranged from 95.1 mgh/L to 352.9 mgh/L, in accordance with the different clinical conditions. AUCfree/MIC ratios were always linezolid total clearance, the clinical features of critically ill septic patients appear to be mainly responsible for the high variability of linezolid serum concentrations. Copyright © 2015. Published by Elsevier B.V.

  20. Haemodialysis for post-traumatic acute renal failure - factors predicting outcome.

    Science.gov (United States)

    Machemehl, Thomas; Hsu, Peter; Pahad, Hussein; Williams, Paul; Yilmaz, Tugba H; Vassiliu, Pantelis; Boffard, Kenneth D; Degiannis, Elias; Doll, Dietrich

    2013-07-29

    Post-traumatic acute renal failure requiring renal replacement therapy in an intensive care unit (ICU) is associated with high mortality. To assess indicators of improved survival. This was a retrospective cohort study of 64 consecutive trauma patients (penetrating and blunt trauma and burns) who underwent haemodialysis (HD) over a period of 5 years. Information on pre-hospital and in-hospital resuscitation, trauma scores and physiological scores and daily ICU records were collected. The majority of the patients were dialysed with continuous venovenous haemofiltration in the early years of the study and later with sustained low-efficiency dialysis. Of the 64 patients 47 died, giving an overall mortality rate of 73%. Mortality was highest in the burns patients (84%). Survival in all patients, irrespective of injury, was unrelated to the Revised Trauma Score, Injury Severity Score, Acute Physiology and Chronic Health Evaluation Score or Trauma Injury Severity Score. The duration of HD did not differ significantly between the three trauma groups, and age was not a significant predictor of survival. Patients who were polyuric at the time of the initiation of HD had a lower mortality rate than those who were oliguric, anuric or normouric, although this did not reach statistical significance (p=0.09). Acute renal failure in trauma patients is associated with a low survival rate. Controversial conclusions have been presented in the literature. In this study, none of the parameters previously reported to affect survival proved to be valid, although the number of patients was comparable with those in other studies. Since understanding of the predictors and course of renal failure in trauma patients is still at an early stage, there is a need for multicentre prospective studies.

  1. A comparison of self-reported quality of life for an Australian haemodialysis and haemodiafiltration cohort.

    Science.gov (United States)

    Hill, Kathleen E; Kim, Susan; Crail, Susan; Elias, Tony J; Whittington, Tiffany

    2017-08-01

    Haemodiafiltration (HDF) has been widely studied for evidence of superior outcomes in comparison with conventional haemodialysis (HD), and there is increasing interest in determining if HDF confers any benefit in relation to quality of life. Studies have been conducted with randomized incident patients; however, little is known regarding HDF and quality of life for prevalent patients. This study examined and compared self-reported quality of life at two time points, 12 months apart in a cohort of satellite HD and HDF patients, using a disease specific questionnaire to determine if HDF conferred an advantage. A longitudinal study with a linear mixed-effect model measuring quality of life in a cohort of 171 patients (HD, n = 85, HDF, n = 86) in seven South Australian satellite dialysis centres. Factors associated with significant reduction across the Kidney Disease Quality Of Life™ domains measured were younger age (- 20 to - 29) and comorbid diabetes (- 4.8 to - 11.1). HDF was not associated with moderation of this reduction at either time point (P > 0.05). Baseline physical functioning was reported as very low (median 33.9) and further reduced at time point two. In addition, dialysing for more than 12 h per week in a satellite dialysis unit was associated with reduced quality of life in relation to the burden of kidney disease (- 13.69). This study has demonstrated that younger age and comorbid diabetes were responsible for a statistically significant reduction in quality of life, and HDF did not confer any advantage. © 2016 Asian Pacific Society of Nephrology.

  2. DETECTION OF MALNUTRITION IN PATIENTS UNDERGOING MAINTENANCE HAEMODIALYSIS: A QUANTITATIVE DATA ANALYSIS ON 12 PARAMETERS.

    Science.gov (United States)

    Nafzger, Sonja; Fleury, Lea-Angelica; Uehlinger, Dominik E; Plüss, Petra; Scura, Ninetta; Kurmann, Silvia

    2015-09-01

    Protein-energy-malnutrition (PEM) is common in people with end stage kidney disease (ESKD) undergoing maintenance haemodialysis (MHD) and correlates strongly with mortality. To this day, there is no gold standard for detecting PEM in patients on MHD. The aim of this study was to evaluate if Nutritional Risk Screening 2002 (NRS-2002), handgrip strength measurement, mid-upper arm muscle area (MUAMA), triceps skin fold measurement (TSF), serum albumin, normalised protein catabolic rate (nPCR), Kt/V and eKt/V, dry body weight, body mass index (BMI), age and time since start on MHD are relevant for assessing PEM in patients on MHD. The predictive value of the selected parameters on mortality and mortality or weight loss of more than 5% was assessed. Quantitative data analysis of the 12 parameters in the same patients on MHD in autumn 2009 (n = 64) and spring 2011 (n = 40) with paired statistical analysis and multivariate logistic regression analysis was performed. Paired data analysis showed significant reduction of dry body weight, BMI and nPCR. Kt/Vtot did not change, eKt/v and hand grip strength measurements were significantly higher in spring 2011. No changes were detected in TSF, serum albumin, NRS-2002 and MUAMA. Serum albumin was shown to be the only predictor of death and of the combined endpoint "death or weight loss of more than 5%". We now screen patients biannually for serum albumin, nPCR, Kt/V, handgrip measurement of the shunt-free arm, dry body weight, age and time since initiation of MHD. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  3. VALIDITY AND RELIABILITY OF THE SPIRITUAL COPING STRATEGIES SCALE ARABIC VERSION IN SAUDI PATIENTS UNDERGOING HAEMODIALYSIS.

    Science.gov (United States)

    Cruz, Jonas P; Baldacchino, Donia R; Alquwez, Nahed

    2016-06-01

    Patients often resort to religious and spiritual activities to cope with physical and mental challenges. The effect of spiritual coping on overall health, adaptation and health-related quality of life among patients undergoing haemodialysis (HD) is well documented. Thus, it is essential to establish a valid and reliable instrument that can assess both the religious and non-religious coping methods in patients undergoing HD. This study aimed to assess the validity and reliability of the Spiritual Coping Strategies Scale Arabic version (SCS-A) in Saudi patients undergoing HD. A convenience sample of 60 Saudi patients undergoing HD was recruited for this descriptive, cross-sectional study. Data were collected between May and June 2015. Forward-backward translation was used to formulate the SCS-A. The SCS-A, Muslim Religiosity Scale and the Quality of Life Index Dialysis Version III were used to procure the data. Internal consistency reliability, stability reliability, factor analysis and construct validity tests were performed. Analyses were set at the 0.05 level of significance. The SCS-A showed an acceptable internal consistency and strong stability reliability over time. The EFA produced two factors (non-religious and religious coping). Satisfactory construct validity was established by the convergent and divergent validity and known-groups method. The SCS-A is a reliable and valid tool that can be used to measure the religious and non-religious coping strategies of patients undergoing HD in Saudi Arabia and other Muslim and Arabic-speaking countries. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  4. How to set the stage for a full-fledged clinical trial testing 'incremental haemodialysis'.

    Science.gov (United States)

    Casino, Francesco Gaetano; Basile, Carlo

    2017-07-21

    Most people who make the transition to maintenance haemodialysis (HD) therapy are treated with a fixed dose of thrice-weekly HD (3HD/week) regimen without consideration of their residual kidney function (RKF). The RKF provides an effective and naturally continuous clearance of both small and middle molecules, plays a major role in metabolic homeostasis, nutritional status and cardiovascular health, and aids in fluid management. The RKF is associated with better patient survival and greater health-related quality of life. Its preservation is instrumental to the prescription of incremental (1HD/week to 2HD/week) HD. The recently heightened interest in incremental HD has been hindered by the current limitations of the urea kinetic model (UKM), which tend to overestimate the needed dialysis dose in the presence of a substantial RKF. A recent paper by Casino and Basile suggested a variable target model (VTM), which gives more clinical weight to the RKF and allows less frequent HD treatments at lower RKF as opposed to the fixed target model, based on the wrong concept of the clinical equivalence between renal and dialysis clearance. A randomized controlled trial (RCT) enrolling incident patients and comparing incremental HD (prescribed according to the VTM) with the standard 3HD/week schedule and focused on hard outcomes, such as survival and health-related quality of life of patients, is urgently needed. The first step in designing such a study is to compute the 'adequacy lines' and the associated fitting equations necessary for the most appropriate allocation of the patients in the two arms and their correct and safe follow-up. In conclusion, the potentially important clinical and financial implications of the incremental HD render it highly promising and warrant RCTs. The UKM is the keystone for conducting such studies. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  5. Atrial fibrillation in patients on haemodialysis in Andalusia. Prevalence, clinical profile and therapeutic management.

    Science.gov (United States)

    Sánchez Perales, Carmen; Vázquez Sánchez, Teresa; Salas Bravo, Daniel; Ortega Anguiano, Sonia; Vázquez Ruiz de Castroviejo, Eduardo

    Atrial fibrillation (AF) represents an important social and healthcare problem. There is wide variability in the prevalence of this arrhythmia in studies analysing patients on haemodialysis (HD). To investigate the prevalence, clinical profile and therapeutic management of patients with AF on HD in Andalusia. We asked the public healthcare system of Andalusia to provide us with the number of patients who were being treated with HD. We asked attending nephrologists from all hospital and outpatient centres in 5 of the 8 Andalusian provinces to perform an electrocardiogram and to fill out a questionnaire on patients selected by simple random sampling. A total of 2,348 patients were being treated with HD in the 5provinces included in the study. The estimated sample size was 285 patients. We obtained an electrocardiogram and information from 252 patients (88.4%); mean age 65.3±16 years; 40.9% women. Sixty-three patients (25%) had AF. Of these, 36 (14.3%) had AF in the recorded ECG and in the rest it had been documented previously. In the multivariate analysis, older age (OR: 1.071; 95% CI: 1.036-1.107; P=0.000) and greater time on HD (OR: 1.009; 95% CI: 1.004-1.014; P=0.000) were independently associated with the presence of AF. Of the patients with AF, 41.3% were on anticoagulant treatment at the time of the study; and 41.2% were on antiplatelet agents. AF in dialysis units is an important finding. Establishing the risk-benefit ratio of anticoagulant treatment constitutes a real challenge. Well-designed clinical trials are pivotal in order to define the rational use of antithrombotic drugs. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Peripheral i.v. analysis (PIVA) of venous waveforms for volume assessment in patients undergoing haemodialysis.

    Science.gov (United States)

    Hocking, K M; Alvis, B D; Baudenbacher, F; Boyer, R; Brophy, C M; Beer, I; Eagle, S

    2017-12-01

    The assessment of intravascular volume status remains a challenge for clinicians. Peripheral i.v. analysis (PIVA) is a method for analysing the peripheral venous waveform that has been used to monitor volume status. We present a proof-of-concept study for evaluating the efficacy of PIVA in detecting changes in fluid volume. We enrolled 37 hospitalized patients undergoing haemodialysis (HD) as a controlled model for intravascular volume loss. Respiratory rate (F0) and pulse rate (F1) frequencies were measured. PIVA signal was obtained by fast Fourier analysis of the venous waveform followed by weighing the magnitude of the amplitude of the pulse rate frequency. PIVA was compared with peripheral venous pressure and standard monitoring of vital signs. Regression analysis showed a linear correlation between volume loss and change in the PIVA signal (R2=0.77). Receiver operator curves demonstrated that the PIVA signal showed an area under the curve of 0.89 for detection of 20 ml kg-1 change in volume. There was no correlation between volume loss and peripheral venous pressure, blood pressure or pulse rate. PIVA-derived pulse rate and respiratory rate were consistent with similar numbers derived from the bio-impedance and electrical signals from the electrocardiogram. PIVA is a minimally invasive, novel modality for detecting changes in fluid volume status, respiratory rate and pulse rate in spontaneously breathing patients with peripheral i.v. cannulas. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  7. Anti-parathyroid treatment effectiveness and persistence in incident haemodialysis patients with secondary hyperparathyroidism.

    Science.gov (United States)

    de Francisco, Angel Luis Martín; Gillespie, Iain Andrew; Gioni, Ioanna; Floege, Jürgen; Kronenberg, Florian; Marcelli, Daniele; Wheeler, David Collins; Froissart, Marc; Drueke, Tilman Bernhard

    2016-01-01

    Anti-parathyroid treatment initiation and discontinuation are important decisions in chronic haemodialysis (HD) patients, where pill burden is often excessive. The present study aimed to describe secondary hyperparathyroidism (sHPT) drug therapy changes in HD patients. Retrospective observational cohort study of incident European HD patients with sHPT who were prescribed calcitriol or alfacalcidol (alpha calcitriol), paricalcitol or cinacalcet. Treatment-naïve patients prescribed alpha calcitriol (N=2259), paricalcitol (N=1689) and cinacalcet (N=1245) were considered for analysis. Serum intact parathyroid hormone (iPTH) levels decreased post-initiation with all treatment modalities; serum calcium and phosphate levels increased in response to activated vitamin D derivatives but decreased with cinacalcet. Approximately one-third of alpha calcitriol and paricalcitol patients but less than one-quarter of cinacalcet patients discontinued treatment. Although the three groups had comparable serum iPTH control at the time of treatment discontinuation, they differed in terms of calcium and phosphate levels. Following discontinuation, the evolution of laboratory parameters differed by treatment modality: whilst iPTH increased for all three treatment groups, calcium and phosphate decreased in patients who were being treated with alpha calcitriol and paricalcitol at the time of discontinuation, and increased in those who had been treated with cinacalcet. In conditions of daily clinical practice, attaining and maintaining recommended biochemical control of sHPT appears to be more frequently achievable with cinacalcet than with activated vitamin D compounds. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Phosphate, urea and creatinine clearances: haemodialysis adequacy assessed by weekly monitoring.

    Science.gov (United States)

    Debowska, Malgorzata; Wojcik-Zaluska, Alicja; Ksiazek, Andrzej; Zaluska, Wojciech; Waniewski, Jacek

    2015-01-01

    The specific distribution of phosphate and the control mechanisms for its plasma level makes phosphate kinetics during haemodialysis (HD) considerably different from those of urea and creatinine and makes the quantitative evaluation of adequacy of phosphate removal difficult. We propose the application of equivalent continuous clearance (ECC) as a phosphate adequacy parameter and compare it with ECC for creatinine and urea. Three consecutive dialysis sessions were evaluated for 25 patients on maintenance HD. Concentrations of phosphate, urea and creatinine in plasma were measured every 1h during the treatment and 45 min after, and every 30 min in dialysate. ECC was calculated using the removed solute mass assessed in dialysate and weekly solute profile in plasma. Similar calculations were performed also for the midweek dialysis session only. Different versions of the reference concentration for ECC were applied. ECC with peak average reference concentration was 5.4 ± 1.0 for phosphate, 7.0 ± 1.0 for urea and 4.7 ± 1.0 mL/min for creatinine. ECC for urea and creatinine were well correlated in contrast to the correlations of ECC for phosphate versus urea and creatinine. Midweek ECC were higher than weekly ECC, but they were well correlated for urea and creatinine, but only weakly for phosphate. HD adequacy monitoring for phosphate may be performed using ECC, but it is less predictable than similar indices for urea and creatinine. The values of ECC for phosphate are within the range expected for its molecular size compared with those for urea and creatinine. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  9. Increased brain iron deposition is a risk factor for brain atrophy in patients with haemodialysis: a combined study of quantitative susceptibility mapping and whole brain volume analysis.

    Science.gov (United States)

    Chai, Chao; Zhang, Mengjie; Long, Miaomiao; Chu, Zhiqiang; Wang, Tong; Wang, Lijun; Guo, Yu; Yan, Shuo; Haacke, E Mark; Shen, Wen; Xia, Shuang

    2015-08-01

    To explore the correlation between increased brain iron deposition and brain atrophy in patients with haemodialysis and their correlation with clinical biomarkers and neuropsychological test. Forty two patients with haemodialysis and forty one age- and gender-matched healthy controls were recruited in this prospective study. 3D whole brain high resolution T1WI and susceptibility weighted imaging were scanned on a 3 T MRI system. The brain volume was analyzed using voxel-based morphometry (VBM) in patients and to compare with that of healthy controls. Quantitative susceptibility mapping was used to measure and compare the susceptibility of different structures between patients and healthy controls. Correlation analysis was used to investigate the relationship between the brain volume, iron deposition and neuropsychological scores. Stepwise multiple regression analysis was used to explore the effect of clinical biomarkers on the brain volumes in patients. Compared with healthy controls, patients with haemodialysis showed decreased volume of bilateral putamen and left insular lobe (All P brain iron deposition is negatively correlated with the decreased volume of bilateral putamen (P brain iron deposition and dialysis duration was risk factors for brain atrophy in patients with haemodialysis. The decreased gray matter volume of the left insular lobe was correlated with neurocognitive impairment.

  10. Trivalent influenza vaccine in patients on haemodialysis: impaired seroresponse with differences for A-H3N2 and A-H1N1 vaccine components

    NARCIS (Netherlands)

    W.E.Ph. Beyer (Walter); D.J. Versluis; P. Kramer; P.P.N.M. Diderich (Philip); W. Weimar (Willem); N. Masurel (Nic)

    1987-01-01

    textabstractOne hundred and one patients on haemodialysis, 21 patients on peritoneal dialysis and 30 healthy controls received a trivalent split vaccine containing 15 micrograms haemagglutinin of a recent influenza A-H3N2, influenza A-H1N1 and influenza B strain, respectively. Antibody production

  11. Effect of prescribing a high protein diet and increasing the dose of dialysis on nutrition in stable chronic haemodialysis patients : a randomized, controlled trial

    NARCIS (Netherlands)

    Kloppenburg, Wybe; Stegeman, CA; Kremer Hovinga, T; Vastenburg, G; Vos, P; de Jong, PE; Huisman, RM

    Background. Protein requirements in stable, adequately dialysed haemodialysis patients are not known and recommendations vary. It is not known whether increasing the dialysis dose above the accepted adequate level has a favourable effect on nutrition. The aim of this study was to determine whether

  12. Electrical equipment qualification

    International Nuclear Information System (INIS)

    Farmer, W.S.

    1983-01-01

    Electrical equipment qualification research programs being carried out by CEA, JAERI, and Sandia Laboratories are discussed. Objectives of the program are: (1) assessment of accident simulation methods for electrical equipment qualification testing; lower coarse (2) evaluation of equipment aging and accelerated aging methods; (3) determine radiation dose spectrum to electrical equipment and assess simulation methods for qualification; (4) identify inadequacies in electrical equipment qualification procedures and standards and potential failure modes; and (5) provide data for verifying and improving standards, rules and regulatory guides

  13. A novel bioactive haemodialysis system using dissolved dihydrogen (H2) produced by water electrolysis: a clinical trial.

    Science.gov (United States)

    Nakayama, Masaaki; Nakano, Hirofumi; Hamada, Hiromi; Itami, Noritomo; Nakazawa, Ryoichi; Ito, Sadayoshi

    2010-09-01

    Chronic inflammation in haemodialysis (HD) patients indicates a poor prognosis. However, therapeutic approaches are limited. Hydrogen gas (H(2)) ameliorates oxidative and inflammatory injuries to organs in animal models. We developed an HD system using a dialysis solution with high levels of dissolved H(2) and examined the clinical effects. Dialysis solution with H(2) (average of 48 ppb) was produced by mixing dialysate concentrates and reverse osmosis water containing dissolved H(2) generated by a water electrolysis technique. Subjects comprised 21 stable patients on standard HD who were switched to the test HD for 6 months at three sessions a week. During the study period, no adverse clinical signs or symptoms were observed. A significant decrease in systolic blood pressure (SBP) before and after dialysis was observed during the study, and a significant number of patients achieved SBP <140 mmHg after HD (baseline, 21%; 6 months, 62%; P < 0.05). Changes in dialysis parameters were minimal, while significant decreases in levels of plasma monocyte chemoattractant protein 1 (P < 0.01) and myeloperoxidase (P < 0.05) were identified. Adding H(2) to haemodialysis solutions ameliorated inflammatory reactions and improved BP control. This system could offer a novel therapeutic option for control of uraemia.

  14. Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

    Science.gov (United States)

    Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

    2018-04-01

    The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

  15. Application of FTIR-ATR Spectroscopy to Determine the Extent of Lipid Peroxidation in Plasma during Haemodialysis

    Directory of Open Access Journals (Sweden)

    Adam Oleszko

    2015-01-01

    Full Text Available During a haemodialysis (HD, because of the contact of blood with the surface of the dialyser, the immune system becomes activated and reactive oxygen species (ROS are released into plasma. Particularly exposed to the ROS are lipids and proteins contained in plasma, which undergo peroxidation. The main breakdown product of oxidized lipids is the malondialdehyde (MDA. A common method for measuring the concentration of MDA is a thiobarbituric acid reactive substances (TBARS method. Despite the formation of MDA in plasma during HD, its concentration decreases because it is removed from the blood in the dialyser. Therefore, this research proposes the Fourier Transform Infrared Attenuated Total Reflectance (FTIR-ATR spectroscopy, which enables determination of primary peroxidation products. We examined the influence of the amount of hydrogen peroxide added to lipid suspension that was earlier extracted from plasma specimen on lipid peroxidation with use of TBARS and FTIR-ATR methods. Linear correlation between these methods was shown. The proposed method was effective during the evaluation of changes in the extent of lipid peroxidation in plasma during a haemodialysis in sheep. A measurement using the FTIR-ATR showed an increase in plasma lipid peroxidation after 15 and 240 minutes of treatment, while the TBARS concentration was respectively lower.

  16. Clearance of glucoregulatory peptide hormones during haemodialysis and haemodiafiltration in non-diabetic end-stage renal disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Morten B; Idorn, Thomas; Knop, Filip K

    2015-01-01

    BACKGROUND: Patients with end-stage renal disease (ESRD) have increased fasting concentrations and disturbed postprandial responses of several glucoregulatory hormones. We aimed to evaluate the impact of high-flux haemodialysis (HD) and high-volume haemodiafiltration (HDF) on fasting and postpran......BACKGROUND: Patients with end-stage renal disease (ESRD) have increased fasting concentrations and disturbed postprandial responses of several glucoregulatory hormones. We aimed to evaluate the impact of high-flux haemodialysis (HD) and high-volume haemodiafiltration (HDF) on fasting...... and postprandial plasma levels of glucoregulatory pancreatic and gut peptide hormones in ESRD patients. METHODS: Ten non-diabetic HD-treated ESRD patients were included to undergo a 3-h standardized liquid mixed meal test 1 h into an HD and an HDF, respectively. On a third, optional, examination day, the meal test...... during HDF and four completed the optional meal test without dialysis. All plasma hormone concentrations declined significantly during the first fasting hour of dialysis with no differences between HD and HDF. Significant clearance of the investigated hormones was observed for both dialysis modalities...

  17. Body composition analysis and adipocytokine concentrations in haemodialysis patients: abdominal fat gain as an additional cardiovascular risk factor.

    Science.gov (United States)

    González, Elena; Díez, Juan J; Pérez Torres, Almudena; Bajo, María Auxiliadora; Del Peso, Gloria; Sánchez-Villanueva, Rafael; Grande, Cristina; Rodríguez, Olaia; Coronado, Mónica; Gómez Candela, Carmen; Díaz-Almirón, Mariana; Iglesias, Pedro; Selgas, Rafael

    Abdominal fat and its increment over time in particular has become a cardiovascular risk factor in uraemic patients. To analyse changes in abdominal fat in haemodialysis patients over one year and study their possible correlation with the variation in adipocytokine serum levels. As a secondary objective, we tried to validate the data obtained by bioelectrical impedance analysis (BIA) with data obtained by dual X-ray absorptiometry (DXA). A prospective one-year study was performed in 18 patients on haemodialysis (HD). In each patient, body composition by BIA and DXA was estimated at baseline and after one year. Several adipocytokine and biochemical parameters were determined. A significant increase in phase angle [4.8° (4.1-5.6) vs. 5.2° (4.4-5.8), Pfat measured by DXA [1.00 (0.80-1.26) vs. 1.02 (0.91-1.30), Pfat mass measured by BIA, as well as the abdominal fat percentage estimated by DXA, was found (Pfat mass over time, especially in the abdomen, evidenced by an increased A/G ratio. These findings might explain the increased cardiovascular risk in these patients. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  18. Isolation as a strategy for controlling the transmission of hepatitis C virus (HCV) infection in haemodialysis units.

    Science.gov (United States)

    Bravo Zuñiga, Jessica I; Loza Munárriz, César; López-Alcalde, Jesús

    2016-08-11

    The hepatitis C virus (HCV) infection affects about 2% of the world's population and can cause chronic liver infection and persistent long-term sequelae such as cirrhosis and liver cancer.The prevalence of HCV infection among people on haemodialysis is often higher than the general population. The virus is easily transmitted parenterally, and blood transfusions have previously played a significant role in transmission; however, erythropoietin therapy has reduced the need for transfusions, and coupled with improved screening of donated blood, has significantly decreased transmission by transfusion. Although control of hospital-acquired infection has improved with the advent of biosafety measures, stopping HCV transmission in haemodialysis units remains challenging.Isolating people infected with HCV involves physical separation from others to limit direct or indirect transmission and includes a number of strategies during dialysis. The evidence for isolating people infected with HCV during haemodialysis is sparse with some inconsistencies. To evaluate the benefits and harms of isolation of HCV-infected patients during haemodialysis on the transmission of HCV to other patients. We searched the Cochrane Kidney and Transplant Specialised Register to 26 November 2015 through contact with the Information Specialist using search terms relevant to this review. We also searched the Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to 2015), Web of Science Conference Proceedings Citation Index-Science (CPCI-S, 1990 to 2015), ProQuest Dissertations & Theses Database (1990 to 2015), and Open Grey (1990 to 2015). We included randomised controlled trials (RCTs), quasi-RCTs and cluster RCTs evaluating the clinical benefits and harms of isolating HCV-infected patients during haemodialysis on the transmission of HCV to other patients. We considered incidence of dialysis-acquired HCV infection, all-cause mortality, and adverse effects associated with

  19. Space Heating Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Rafferty, Kevin D.

    1998-01-01

    The performance evaluation of space heating equipment for a geothermal application is generally considered from either of two perspectives: (a) selecting equipment for installation in new construction, or (b) evaluating the performance and retrofit requirements of an existing system. With regard to new construction, the procedure is relatively straightforward. Once the heating requirements are determined, the process need only involve the selection of appropriately sized hot water heating equipment based on the available water temperature. It is important to remember that space heating equipment for geothermal applications is the same equipment used in non-geothermal applications. What makes geothermal applications unique is that the equipment is generally applied at temperatures and flow rates that depart significantly from traditional heating system design. This chapter presents general considerations for the performance of heating equipment at non-standard temperature and flow conditions, retrofit of existing systems, and aspects of domestic hot water heating.

  20. Renewal of radiological equipment.

    Science.gov (United States)

    2014-10-01

    In this century, medical imaging is at the heart of medical practice. Besides providing fast and accurate diagnosis, advances in radiology equipment offer new and previously non-existing options for treatment guidance with quite low morbidity, resulting in the improvement of health outcomes and quality of life for the patients. Although rapid technological development created new medical imaging modalities and methods, the same progress speed resulted in accelerated technical and functional obsolescence of the same medical imaging equipment, consequently creating a need for renewal. Older equipment has a high risk of failures and breakdowns, which might cause delays in diagnosis and treatment of the patient, and safety problems both for the patient and the medical staff. The European Society of Radiology is promoting the use of up-to-date equipment, especially in the context of the EuroSafe Imaging Campaign, as the use of up-to-date equipment will improve quality and safety in medical imaging. Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or renewal. This plan should look forward a minimum of 5 years, with annual updates. Teaching points • Radiological equipment has a definite life cycle span, resulting in unavoidable breakdown and decrease or loss of image quality which renders equipment useless after a certain time period.• Equipment older than 10 years is no longer state-of-the art equipment and replacement is essential. Operating costs of older equipment will be high when compared with new equipment, and sometimes maintenance will be impossible if no spare parts are available.• Older equipment has a high risk of failure and breakdown, causing delays in diagnosis and treatment of the patient and safety problems both for the patient and the medical staff.• Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or replacement. This plan should look forward a

  1. Prognostic significance of stress myocardial ECG-gated perfusion imaging in asymptomatic patients with diabetic chronic kidney disease on initiation of haemodialysis

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuru; Kondo, Chisato; Kobayashi, Hideki; Kusakabe, Kiyoko [Tokyo Women' s Medical University, School of Medicine, Department of Radiology, Shinjuku-ku, Tokyo (Japan); Babazono, Tetsuya [Tokyo Women' s Medical University, School of Medicine, Diabetes Centre, Shinjuku-ku, Tokyo (Japan); Nakajima, Takatomo [Tokyo Women' s Medical University, School of Medicine, Department of Cardiology, Shinjuku-ku, Tokyo (Japan)

    2009-08-15

    Diabetic patients with chronic kidney disease (CKD) frequently develop cardiac events within several years of the initiation of haemodialysis. The present study assesses the prognostic significance of stress myocardial ECG-gated perfusion imaging (MPI) in patients with diabetic CKD requiring haemodialysis. Fifty-five asymptomatic patients with diabetic stage V CKD and no history of heart disease scheduled to start haemodialysis were enrolled in this study (56{+-}11 years old; 49 with type 2 diabetes mellitus). All patients underwent {sup 201}Tl stress ECG-gated MPI 1 month before or after the initiation of haemodialysis to assess myocardial involvement. We evaluated SPECT images using 17-segment defect scores graded on a 5-point scale, summed stress score (SSS) and summed difference scores (SDS). The patients were followed up for at least 2 years (42{+-}15 months) to determine coronary intervention (CI) and heart failure (HF) as soft events and acute myocardial infarction (AMI) and all causes of deaths as hard events. The frequencies of myocardial ischaemia, resting perfusion defects, low ejection fraction and left ventricular (LV) dilatation were 24,20,29 and 49%, respectively. Ten events (18%) developed during the follow-up period including four CI, one HF, one AMI and four sudden deaths. Multivariate Cox analysis selected SDS (p=0.0011) and haemoglobin A{sub 1c} (HbA{sub 1c}) (p=0.0076) as independent prognostic indicators for all events. Myocardial ischaemia, in addition to glycaemic control, is a strong prognostic marker for asymptomatic patients with diabetic CKD who are scheduled to start haemodialysis. Stress MPI is highly recommended for the management and therapeutic stratification of such patients. (orig.)

  2. RETRIEVAL EQUIPMENT DESCRIPTIONS

    International Nuclear Information System (INIS)

    J. Steinhoff

    1997-01-01

    The objective and the scope of this document are to list and briefly describe the major mobile equipment necessary for waste package (WP) retrieval from the proposed subsurface nuclear waste repository at Yucca Mountain. Primary performance characteristics and some specialized design features of the equipment are explained and summarized in the individual subsections of this document. There are no quality assurance requirements or QA controls in this document. Retrieval under normal conditions is accomplished with the same fleet of equipment as is used for emplacement. Descriptions of equipment used for retrieval under normal conditions is found in Emplacement Equipment Descriptions, DI: BCAF00000-01717-5705-00002 (a document in progress). Equipment used for retrieval under abnormal conditions is addressed in this document and consists of the following: (1) Inclined Plane Hauler; (2) Bottom Lift Transporter; (3) Load Haul Dump (LHD) Loader; (4) Heavy Duty Forklift for Emplacement Drifts; (5) Covered Shuttle Car; (6) Multipurpose Vehicle; and (7) Scaler

  3. Medical equipment management

    CERN Document Server

    Willson, Keith; Tabakov, Slavik

    2013-01-01

    Know What to Expect When Managing Medical Equipment and Healthcare Technology in Your Organization As medical technology in clinical care becomes more complex, clinical professionals and support staff must know how to keep patients safe and equipment working in the clinical environment. Accessible to all healthcare professionals and managers, Medical Equipment Management presents an integrated approach to managing medical equipment in healthcare organizations. The book explains the underlying principles and requirements and raises awareness of what needs to be done and what questions to ask. I

  4. Data communication equipment

    International Nuclear Information System (INIS)

    Kim, Hak Seon; Lee, Sang Mok

    1998-02-01

    The contents of this book are introduction of data communication on definition, purpose and history, information terminal about data communication system and data transmission system, data transmit equipment of summary, transmission cable, data port, concentrator and front-end processor, audio communication equipment like phones, radio communication equipment of summary on foundation of electromagnetic waves, AM transmitter, AM receiver, FM receiver and FM transmitter, a satellite and mobile communication equipment such as earth station, TT and C and Cellular phone, video telephone and new media apparatus.

  5. Plasma Levels of Middle Molecules to Estimate Residual Kidney Function in Haemodialysis without Urine Collection.

    Directory of Open Access Journals (Sweden)

    Enric Vilar

    Full Text Available Residual Kidney Function (RKF is associated with survival benefits in haemodialysis (HD but is difficult to measure without urine collection. Middle molecules such as Cystatin C and β2-microglobulin accumulate in renal disease and plasma levels have been used to estimate kidney function early in this condition. We investigated their use to estimate RKF in patients on HD.Cystatin C, β2-microglobulin, urea and creatinine levels were studied in patients on incremental high-flux HD or hemodiafiltration(HDF. Over sequential HD sessions, blood was sampled pre- and post-session 1 and pre-session 2, for estimation of these parameters. Urine was collected during the whole interdialytic interval, for estimation of residual GFR (GFRResidual = mean of urea and creatinine clearance. The relationships of plasma Cystatin C and β2-microglobulin levels to GFRResidual and urea clearance were determined.Of the 341 patients studied, 64% had urine output>100 ml/day, 32.6% were on high-flux HD and 67.4% on HDF. Parameters most closely correlated with GFRResidual were 1/β2-micoglobulin (r2 0.67 and 1/Cystatin C (r2 0.50. Both these relationships were weaker at low GFRResidual. The best regression model for GFRResidual, explaining 67% of the variation, was: GFRResidual = 160.3 · (1/β2m - 4.2. Where β2m is the pre-dialysis β2 microglobulin concentration (mg/L. This model was validated in a separate cohort of 50 patients using Bland-Altman analysis. Areas under the curve in Receiver Operating Characteristic analysis aimed at identifying subjects with urea clearance≥2 ml/min/1.73 m2 was 0.91 for β2-microglobulin and 0.86 for Cystatin C. A plasma β2-microglobulin cut-off of ≤19.2 mg/L allowed identification of patients with urea clearance ≥2 ml/min/1.73 m2 with 90% specificity and 65% sensitivity.Plasma pre-dialysis β2-microglobulin levels can provide estimates of RKF which may have clinical utility and appear superior to cystatin C. Use of cut-off levels

  6. Intradialytic Laughter Yoga therapy for haemodialysis patients: a pre-post intervention feasibility study.

    Science.gov (United States)

    Bennett, Paul N; Parsons, Trisha; Ben-Moshe, Ros; Neal, Merv; Weinberg, Melissa K; Gilbert, Karen; Ockerby, Cherene; Rawson, Helen; Herbu, Corinne; Hutchinson, Alison M

    2015-06-09

    Laughter Yoga consists of physical exercise, relaxation techniques and simulated vigorous laughter. It has been associated with physical and psychological benefits for people in diverse clinical and non-clinical settings, but has not yet been tested in a haemodialysis setting. The study had three aims: 1) to examine the feasibility of conducting Laughter Yoga for patients with end stage kidney disease in a dialysis setting; 2) to explore the psychological and physiological impact of Laughter Yoga for these patients; and 3) to estimate the sample size required for future research. Pre/post intervention feasibility study. Eighteen participants were recruited into the study and Laughter Yoga therapists provided a four week intradialytic program (30-min intervention three times per week). Primary outcomes were psychological items measured at the first and last Laughter Yoga session, including: quality of life; subjective wellbeing; mood; optimism; control; self-esteem; depression, anxiety and stress. Secondary outcomes were: blood pressure, intradialytic hypotensive episodes and lung function (forced expiratory volume). Dialysis nurses exposed to the intervention completed a Laughter Yoga attitudes and perceptions survey (n = 11). Data were analysed using IBM SPSS Statistics v22, including descriptive and inferential statistics, and sample size estimates were calculated using G*Power. One participant withdrew from the study for medical reasons that were unrelated to the study during the first week (94 % retention rate). There were non-significant increases in happiness, mood, and optimism and a decrease in stress. Episodes of intradialytic hypotension decreased from 19 pre and 19 during Laughter Yoga to 4 post Laughter Yoga. There was no change in lung function or blood pressure. All nurses agreed or strongly agreed that Laughter Yoga had a positive impact on patients' mood, it was a feasible intervention and they would recommend Laughter Yoga to their patients. Sample

  7. Fluid overload correction and cardiac history influence brain natriuretic peptide evolution in incident haemodialysis patients.

    Science.gov (United States)

    Chazot, Charles; Vo-Van, Cyril; Zaoui, Eric; Vanel, Thierry; Hurot, Jean Marc; Lorriaux, Christie; Mayor, Brice; Deleaval, Patrick; Jean, Guillaume

    2011-08-01

    Brain natriuretic peptide (BNP) is a cardiac peptide secreted by ventricle myocardial cells under stretch constraint. Increased BNP has been shown associated with increased mortality in end-stage renal disease patients. In patients starting haemodialysis (HD), both fluid overload and cardiac history are frequently present and may be responsible for a high BNP plasma level. We report in this study the evolution of BNP levels in incident HD patients, its relationship with fluid removal and cardiac history as well as its prognostic value. Forty-six patients (female/male: 21/25; 68.6 ± 14.5 years old) surviving at least 6 months after HD treatment onset were retrospectively analysed. Plasma BNP (Chemoluminescent Microparticule ImmunoAssay on i8200 Architect Abbott, Paris, France; normal value < 100 pg/mL) was assessed at HD start and during the second quarter of HD treatment (Q2). At dialysis start, the plasma BNP level was 1041 ± 1178 pg/mL (range: 14-4181 pg/mL). It was correlated with age (P = 0.0017) and was significantly higher in males (P = 0.0017) and in patients with cardiac disease history (P = 0.001). The plasma BNP level at baseline was not related to the mortality risk. At Q2, predialysis systolic blood pressure (BP) decreased from 140.5 ± 24.5 to 129.4 ± 20.6 mmHg (P = 0.0001) and the postdialysis body weight by 7.6 ± 8.4% (P < 0.0001). The BNP level decreased to 631 ± 707 pg/mL (P = 0.01) at Q2. Its variation was significantly correlated with systolic BP decrease (P = 0.006). A high BNP level was found associated with an increased risk of mortality. Hence, plasma BNP levels decreased during the first months of HD treatment during the dry weight quest. Whereas initial BNP values were not associated with increased mortality risk, the BNP level at Q2 was independently predictive of mortality. Hence, BNP is a useful tool to follow patient dehydration after dialysis start. Initial fluid overload may act as a confounding factor for its value as a

  8. Cooling of electronic equipment

    DEFF Research Database (Denmark)

    A. Kristensen, Anders Schmidt

    2003-01-01

    Cooling of electronic equipment is studied. The design size of electronic equipment decrease causing the thermal density to increase. This affect the cooling which can cause for example failures of critical components due to overheating or thermal induced stresses. Initially a pin fin heat sink...

  9. Capital Equipment Replacement Decisions

    OpenAIRE

    Batterham, Robert L.; Fraser, K.I.

    1995-01-01

    This paper reviews the literature on the optimal replacement of capital equipment, especially farm machinery. It also considers the influence of taxation and capital rationing on replacement decisions. It concludes that special taxation provisions such as accelerated depreciation and investment allowances are unlikely to greatly influence farmers' capital equipment replacement decisions in Australia.

  10. Atrial fibrillation in patients on haemodialysis in Andalusia. Prevalence, clinical profile and therapeutic management

    Directory of Open Access Journals (Sweden)

    Carmen Sánchez Perales

    2018-05-01

    Full Text Available Atrial fibrillation (AF represents an important social and healthcare problem. There is wide variability in the prevalence of this arrhythmia in studies analysing patients on haemodialysis (HD. Objective: To investigate the prevalence, clinical profile and therapeutic management of patients with AF on HD in Andalusia. Methods: We asked the public healthcare system of Andalusia to provide us with the number of patients who were being treated with HD. We asked attending nephrologists from all hospital and outpatient centers in 5 of the 8 Andalusian provinces to perform an electrocardiogram and to fill out a questionnaire on patients selected by simple random sampling. Results: A total of 2348 patients were being treated with HD in the 5 provinces included in the study. The estimated sample size was 285 patients. We obtained an electrocardiogram and information from 252 patients (88.4%; mean age 65.3 ± 16 years; 40.9% women. Sixty-three patients (25% had AF. Of these, 36 (14.3% had AF in the recorded ECG and in the rest it had been documented previously. In the multivariate analysis, older age (OR: 1.071; 95% CI: 1.036–1.107; p = 0.000 and greater time on HD (OR: 1.009; 95% CI: 1.004–1.014; p = 0.000 were independently associated with the presence of AF. Of the patients with AF, 41.3% were on anticoagulant treatment at the time of the study; and 41.2% were on antiplatelet agents. Conclusions: AF in dialysis units is an important finding. Establishing the risk–benefit ratio of anticoagulant treatment constitutes a real challenge. Well-designed clinical trials are pivotal in order to define the rational use of antithrombotic drugs. Resumen: La fibrilación auricular (FA es un importante problema social y sanitario. Existe una amplia variación en la prevalencia de esta arritmia en los estudios que analizan a los pacientes en hemodiálisis (HD. Objetivo: Investigar la prevalencia, perfil clínico y manejo terapéutico de los pacientes con

  11. Barriers and facilitators to healthcare professional behaviour change in clinical trials using the Theoretical Domains Framework: a case study of a trial of individualized temperature-reduced haemodialysis.

    Science.gov (United States)

    Presseau, Justin; Mutsaers, Brittany; Al-Jaishi, Ahmed A; Squires, Janet; McIntyre, Christopher W; Garg, Amit X; Sood, Manish M; Grimshaw, Jeremy M

    2017-05-22

    Implementing the treatment arm of a clinical trial often requires changes to healthcare practices. Barriers to such changes may undermine the delivery of the treatment making it more likely that the trial will demonstrate no treatment effect. The 'Major outcomes with personalized dialysate temperature' (MyTEMP) is a cluster-randomised trial to be conducted in 84 haemodialysis centres across Ontario, Canada to investigate whether there is a difference in major outcomes with an individualized dialysis temperature (IDT) of 0.5 °C below a patient's body temperature measured at the beginning of each haemodialysis session, compared to a standard dialysis temperature of 36.5 °C. To inform how to deploy the IDT across many haemodialysis centres, we assessed haemodialysis physicians' and nurses' perceived barriers and enablers to IDT use. We developed two topic guides using the Theoretical Domains Framework (TDF) to assess perceived barriers and enablers to IDT ordering and IDT setting (physician and nurse behaviours, respectively). We recruited a purposive sample of haemodialysis physicians and nurses from across Ontario and conducted in-person or telephone interviews. We used directed content analysis to double-code transcribed utterances into TDF domains, and inductive thematic analysis to develop themes. We interviewed nine physicians and nine nurses from 11 Ontario haemodialysis centres. We identified seven themes of potential barriers and facilitators to implementing IDTs: (1) awareness of clinical guidelines and how IDT fits with local policies (knowledge; goals), (2) benefits and motivation to use IDT (beliefs about consequences; optimism; reinforcement; intention; goals), (3) alignment of IDTs with usual practice and roles (social/professional role and identity; nature of the behaviour; beliefs about capabilities), (4) thermometer availability/accuracy and dialysis machine characteristics (environmental context and resources), (5) impact on workload (beliefs

  12. Quality of life and well-being of people receiving haemodialysis treatment in Scotland: a cross-sectional survey.

    Science.gov (United States)

    Alshraifeen, Ali; McCreaddie, May; Evans, Josie M M

    2014-10-01

    End-stage renal disease is a complex, progressive and debilitating illness that affects patients' quality of life, physical and mental health, well-being, social functioning and emotional health. A cross-sectional survey was carried out in renal dialysis centres in Scotland to assess patients' health status and the impact of haemodialysis treatment on quality of life and well-being. Participants scored considerably lower than the UK general population in all domains of health-related quality of life, although mental health components were nearer to general population norms than physical health components. However, nearly half of the participants achieved a score on a general well-being questionnaire that was indicative of stress and anxiety. Increasing age was associated with better overall mental health but worse physical functioning. Increasing levels of hope and support were associated with improved general well-being. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Streptococcus uberis and Staphylococcus aureus forefoot and blood stream co-infection in a haemodialysis patient: a case report.

    Science.gov (United States)

    Valentiny, Christine; Dirschmid, Harald; Lhotta, Karl

    2015-05-28

    Streptococcus uberis, the most frequent cause of mastitis in lactating cows, is considered non-pathogenic for humans. Only a few case reports have described human infections with this microorganism, which is notoriously difficult to identify. We report the case of a 75-year-old male haemodialysis patient, who developed a severe foot infection with osteomyelitis and bacteraemia. Both Streptococcus uberis and Staphylococcus aureus were identified in wound secretion and blood samples using mass spectrometry. The presence of Streptococcus uberis was confirmed by superoxide dismutase A sequencing. The patient recovered after amputation of the forefoot and antibiotic treatment with ampicillin/sulbactam. He had probably acquired the infection while walking barefoot on cattle pasture land. This is the first case report of a human infection with Streptococcus uberis with identification of the microorganism using modern molecular technology. We propose that Staphylococcus aureus co-infection was a prerequisite for deep wound and bloodstream infection with Streptococcus uberis.

  14. Haemodialysis prescription, adherence and nutritional indicators in five European countries: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

    Science.gov (United States)

    Hecking, Erwin; Bragg-Gresham, Jennifer L; Rayner, Hugh C; Pisoni, Ronald L; Andreucci, Vittorio E; Combe, Christian; Greenwood, Roger; McCullough, Keith; Feldman, Harold I; Young, Eric W; Held, Philip J; Port, Friedrich K

    2004-01-01

    The Dialysis Outcomes and Practice Patterns Study (DOPPS) is a prospective, observational study designed to evaluate practice patterns in random samples of haemodialysis facilities and patients across three continents. Participating countries include France, Germany, Italy, Spain and the UK (Euro-DOPPS), Japan and the USA. DOPPS data collection has used the same questionnaires and protocols across all participating countries to assess components of dialysis therapy and outcomes. This study focuses on dialysis prescription, adherence and nutrition among the Euro-DOPPS countries. In each Euro-DOPPS country, patients were selected randomly from 20-21 representative facilities. Simple means and frequencies were calculated to compare relevant data elements to gain insights into differences in therapeutic aspects among nationally representative patients. Participants entering the study within 90 days of beginning dialysis therapy were excluded from these analyses. Among the five countries, mean delivered dose as measured by normalized urea clearance (Kt/V) varied from 1.28 to 1.50 and was accompanied by differences in dialysis prescription components, including blood flow rates, treatment times, and dialyser membrane and flux characteristics. By country, a nearly 2-fold difference was observed in indicators of patient adherence and management (skipping and shortening dialysis, hyperkalaemia, hyperphosphataemia and high interdialytic weight gain). Indicators of malnutrition varied substantially. This study demonstrates differences in the management of haemodialysis patients across Euro-DOPPS and offers opportunities for improving dialysis dose, adherence and nutrition. Correlation of differences in practice patterns at the dialysis unit level with patient outcomes will offer new insights into improving dialysis therapy.

  15. Vascular access and infection prevention and control: a national survey of routine practices in Irish haemodialysis units.

    Science.gov (United States)

    McCann, Margaret; Clarke, Michael; Mellotte, George; Plant, Liam; Fitzpatrick, Fidelma

    2013-04-01

    National and international guidelines recommend the use of effective vascular access (VA) and infection prevention and control practices within the haemodialysis environment. Establishing an arterio-venous fistula (AVF) and preventing central venous catheter (CVC)-related infections are ongoing challenges for all dialysis settings. We surveyed VA and routine infection prevention and control practices in dialysis units, to provide national data on these practices in Ireland. A descriptive survey was emailed to nurse managers at all adult (n = 19) and children (n = 1) outpatient haemodialysis units in the Republic of Ireland. Data collected included AVF formation, CVC insertion and maintenance practices, VA use and surveillance of infection and screening protocols. Nineteen of the 20 units responded to the survey. The AVF prevalence was 49% for 1370 patients in 17 units who provided these data [mean prevalence per unit: 45.7% (SD 16.2)]; the CVC mean prevalence per unit was 52.5% (SD 16.0). Fourteen dialysis units experienced inadequate access to vascular surgical procedures either due to a lack of dedicated theatre time or hospital beds. Six units administered intravenous prophylactic antimicrobials prior to CVC insertion with only two units using a CVC insertion checklist at the time of catheter insertion. In general, dialysis units in Ireland show a strong adherence to national guidelines. Compared with the 12 countries participating in the Dialysis Outcomes Practice Patterns Study (DOPPS 4), in 2010, AVF prevalence in Irish dialysis units is the second lowest. Recommendations include establishing an AVF national prevalence target rate, discontinuing the administration of intravenous prophylactic antimicrobials prior to CVC insertion and promoting the use of CVC insertion checklists.

  16. HVAC systems and equipment

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, S.T. (Linford Air and Refrigeration Company, Oakland, CA (US))

    1990-02-01

    The author discusses the section of the ASHRAE Standard 90.1-1989 which addresses HVAC systems and equipment. New features of HVAC systems mandatory general requirements are described. New prescriptive requirements are detailed.

  17. Personal Protective Equipment

    National Research Council Canada - National Science Library

    1998-01-01

    ... of personal protective equipment A safety program for new employees is a necessary part of any orientation program An on-going safety program should be used to motivate employees to continue to use...

  18. Electronic equipment packaging technology

    CERN Document Server

    Ginsberg, Gerald L

    1992-01-01

    The last twenty years have seen major advances in the electronics industry. Perhaps the most significant aspect of these advances has been the significant role that electronic equipment plays in almost all product markets. Even though electronic equipment is used in a broad base of applications, many future applications have yet to be conceived. This versatility of electron­ ics has been brought about primarily by the significant advances that have been made in integrated circuit technology. The electronic product user is rarely aware of the integrated circuits within the equipment. However, the user is often very aware of the size, weight, mod­ ularity, maintainability, aesthetics, and human interface features of the product. In fact, these are aspects of the products that often are instrumental in deter­ mining its success or failure in the marketplace. Optimizing these and other product features is the primary role of Electronic Equipment Packaging Technology. As the electronics industry continues to pr...

  19. CV equipment responsibilities

    CERN Document Server

    Pirollet, B

    2008-01-01

    This document describes the limits of the responsibilities of the TS/CV for fire fighting equipment at the LHC. The various interfaces, providers and users of the water supply systems and clean water raising systems are described.

  20. Equipment for hydraulic testing

    International Nuclear Information System (INIS)

    Jacobsson, L.; Norlander, H.

    1981-07-01

    Hydraulic testing in boreholes is one major task of the hydrogeological program in the Stripa Project. A new testing equipment for this purpose was constructed. It consists of a downhole part and a surface part. The downhole part consists of two packers enclosing two test-sections when inflated; one between the packers and one between the bottom packer and the bottom of the borehole. A probe for downhole electronics is also included in the downhole equipment together with electrical cable and nylon tubing. In order to perform shut-in and pulse tests with high accuracy a surface controlled downhole valve was constructed. The surface equipment consists of the data acquisition system, transducer amplifier and surface gauges. In the report detailed descriptions of each component in the whole testing equipment are given. (Auth.)

  1. Comparison of malnutrition inflammation score, anthropometry and biochemical parameters in assessing the difference in protein-energy wasting between normal weight and obese patients undergoing haemodialysis.

    Science.gov (United States)

    Alipoor, Elham; Hosseinzadeh-Attar, Mohammad Javad; Mahdavi-Mazdeh, Mitra; Yaseri, Mehdi; Zahed, Narges S

    2017-07-01

    Protein-energy wasting (PEW) is prevalent in haemodialysis. Obesity is an independent risk factor of kidney insufficiency, but it is proposed to have beneficial roles in better outcomes in the final stage of disease. Better nutritional status and body reserves are among probable mechanisms, but direct examinations are limited. The present study aimed to investigate whether obese patients have preferable nutritional status compared to normal weight patients based on malnutrition inflammation score (MIS) and other PEW parameters in haemodialysis. This case-control study investigated 52 normal weight (18.5 < body mass index (BMI) < 25 kg/m 2 ) and 48 obese (BMI≥30 kg/m 2 ) patients on regular haemodialysis. PEW was assessed based on anthropometric and biochemical factors, recent weight changes, appetite, anorexia, dietary intake and MIS. Obese patients had better MIS compared with the normal weight group (P < 0.001), although varying degrees of wasting were prevalent among this group too (75% mild and 25% moderate wasting). The obese group had less significant weight loss (4.2 vs 8%) and anorexia and better appetite. However, a considerable percentage of patients in both groups showed muscle (94.6% of normal weight and 19.5% of obese) and peripheral fat tissue (89.2% of normal weight and 31.7% of obese) losses compared to the 50th percentile. Biochemical parameters were not significantly different between groups except for triglyceride (P = 0.001), transferrin and total iron-binding capacity (P = 0.028). MIS was significantly better in obese patients; however, both groups showed degrees of wasting based on MIS and other PEW parameters. Nutritional status of obese haemodialysis patients should be monitored regularly because of high risk of PEW like other BMI categories. © 2017 Dietitians Association of Australia.

  2. Association of vascular access flow with short-term and long-term mortality in chronic haemodialysis patients: a retrospective cohort study

    OpenAIRE

    Wu, Chung-Kuan; Wu, Chia-Lin; Lin, Chia-Hsun; Leu, Jyh-Gang; Kor, Chew-Teng; Tarng, Der-Cherng

    2017-01-01

    Objectives To investigate the impact of vascular access flow (Qa) on vascular and all-cause mortality in chronic haemodialysis (HD) patients. Design Observational cohort study. Setting Single centre. Participants Adult chronic HD patients at the HD unit of Shin Kong Wu Ho-Su Memorial Hospital between 1 January 2003 and 31 December 2003 were recruited. Patients were excluded if they had arteriovenous fistula or arteriovenous graft failure within 3 months before the date of Qa measurement, were...

  3. Fatal outcomes among patients on maintenance haemodialysis in sub-Saharan Africa: a 10-year audit from the Douala General Hospital in Cameroon.

    Science.gov (United States)

    Halle, Marie Patrice; Ashuntantang, Gloria; Kaze, Francois Folefack; Takongue, Christian; Kengne, Andre-Pascal

    2016-11-03

    End-Stage Renal disease (ESRD) is associated with increased morbidity and mortality. We assessed the occurrence, time-trend and determinants of fatal outcomes of haemodialysis-treated ESRD patients over a 10-year period in a major referral hospital in Cameroon. Medical records of ESRD patients who started chronic haemodialysis at the Douala General Hospital between 2002 and 2012 were reviewed. Baseline characteristics and fatal outcomes on dialysis were recorded. Accelerated-failure time and logistic regression models were used to investigate the determinants of death. A total of 661 patients with 436 (66 %) being men were included in the study. Mean age at dialysis initiation was 46.3 ± 14.7 years. The median [25 th -75 th percentiles] duration on dialysis was 187 [34-754] days. A total of 297 (44.9 %) deaths were recorded during follow-up with statistical difference over the years (p risk of mortality, relative to hypertension alone. Mortality in dialysis is excessively high in this setting. Because most of these premature deaths are potentially preventable, additional efforts are needed to offset the risk and maximise the benefits from the ongoing investments of the government to defray the cost of haemodialysis. Potential actions include sensitisation of the population and healthcare practitioners, early detection and referral of individuals with CKD; and additional subsidies to support the cost of managing co-morbidities in patients with CKD in general.

  4. Impact of hydration status on body composition as measured by dual energy X-ray absorptiometry in normal volunteers and patients on haemodialysis

    International Nuclear Information System (INIS)

    Horber, F.F.; Thomi, F.; Casez, J.P.; Fonteille, J.; Jaeger, Ph.

    1992-01-01

    To evaluate the influence of hydration status on the estimation of body composition using dual-energy X-ray absorptiometry (DXA), six normal volunteers and seven patients on maintenance haemodialysis were investigated using two different DXA machines (Lunar DPX, Hologic QDR 1000/W). Normal volunteers were studied (Hologic QDR 1000/W) before and 1 h after ingestion of breakfast, lunch and dinner (drinking various amounts of liquids at each meal, 0.5-2.4 kg). Whereas bone mineral content and body fat mass did not change, lean body mass of the trunk increased as a consequence of the meals. Conversely in patients on haemodialysis (Lunar DPX), lean body mass decreased in all segments of the body as a consequence of removal of 0.9-4.4 kg of salt-containing fluid by haemodialysis (trunk 61%, legs 30%, arms 5.5% and rest of the body 3.5%), whereas bone mineral content and body fat mass remained unchanged. (author)

  5. The effects of a simulated laughter programme on mood, cortisol levels, and health-related quality of life among haemodialysis patients.

    Science.gov (United States)

    Heo, Eun Hwa; Kim, Sehyun; Park, Hye-Ja; Kil, Suk Yong

    2016-11-01

    This study aimed to evaluate the effects of a simulated laughter programme on mood, cortisol levels, and health-related quality of life among haemodialysis patients. Forty participants were randomly assigned to a laughter group (n = 20) or a control group (n = 20). Eleven participants completed the laughter programme after haemodialysis sessions and 18 control participants remained. The 4-week simulated laughter programme included weekly 60 min group sessions of simulated laughter, breathing, stretching exercises, and meditation, as well as daily 15 s individual laughter sessions administered via telephone. Mood, cortisol levels, and health-related quality of life were analysed using the rank analysis of covariance, and Wilcoxon's signed rank test. The laughter group exhibited improvements in mood, symptoms, social interaction quality, and role limitations due to physical health. The simulated laughter programme may help improve mood and health-related quality of life among haemodialysis patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Equipment abnormality monitoring device

    International Nuclear Information System (INIS)

    Ando, Yasumasa

    1991-01-01

    When an operator hears sounds in a plantsite, the operator compares normal sounds of equipment which he previously heard and remembered with sounds he actually hears, to judge if they are normal or abnormal. According to the method, there is a worry that abnormal conditions can not be appropriately judged in a case where the number of objective equipments is increased and in a case that the sounds are changed gradually slightly. Then, the device of the present invention comprises a plurality of monitors for monitoring the operation sound of equipments, a recording/reproducing device for recording and reproducing the signals, a selection device for selecting the reproducing signals among the recorded signals, an acoustic device for converting the signals to sounds, a switching device for switching the signals to be transmitted to the acoustic device between to signals of the monitor and the recording/reproducing signals. The abnormality of the equipments can be determined easily by comparing the sounds representing the operation conditions of equipments for controlling the plant operation and the sounds recorded in their normal conditions. (N.H.)

  7. Prioritizing equipment for replacement.

    Science.gov (United States)

    Capuano, Mike

    2010-01-01

    It is suggested that clinical engineers take the lead in formulating evaluation processes to recommend equipment replacement. Their skill, knowledge, and experience, combined with access to equipment databases, make them a logical choice. Based on ideas from Fennigkoh's scheme, elements such as age, vendor support, accumulated maintenance cost, and function/risk were used.6 Other more subjective criteria such as cost benefits and efficacy of newer technology were not used. The element of downtime was also omitted due to the data element not being available. The resulting Periop Master Equipment List and its rationale was presented to the Perioperative Services Program Council. They deemed the criteria to be robust and provided overwhelming acceptance of the list. It was quickly put to use to estimate required capital funding, justify items already thought to need replacement, and identify high-priority ranked items for replacement. Incorporating prioritization criteria into an existing equipment database would be ideal. Some commercially available systems do have the basic elements of this. Maintaining replacement data can be labor-intensive regardless of the method used. There is usually little time to perform the tasks necessary for prioritizing equipment. However, where appropriate, a clinical engineering department might be able to conduct such an exercise as shown in the following case study.

  8. Radioactive decontamination of equipment

    International Nuclear Information System (INIS)

    1982-03-01

    After a recall of some definitions relating to decontamination techniques and of the regulation into effect, the principles to be respected to arrange rationally work zones are quoted while insisting more particularly on the types of coatings which facilitate maintenance operations and the dismantling of these installations. Then, the processes and equipments to use in decontamination units for routine or particular operations are described; the list of recommended chemical products to decontaminate the equipment is given. The influence of these treatments on the state and the duration of life of equipments is studied, and some perfectible methods are quoted. In the appendix, are given: the limits of surface contamination accepted in the centers; a standard project which defines the criteria of admissible residual contamination in wastes considered as cold wastes; some remarks on the interest that certain special ventilation and air curtain devices for the protection of operators working on apparatus generating contaminated dusts [fr

  9. Equipment Operational Requirements

    Energy Technology Data Exchange (ETDEWEB)

    Greenwalt, B; Henderer, B; Hibbard, W; Mercer, M

    2009-06-11

    The Iraq Department of Border Enforcement is rich in personnel, but poor in equipment. An effective border control system must include detection, discrimination, decision, tracking and interdiction, capture, identification, and disposition. An equipment solution that addresses only a part of this will not succeed, likewise equipment by itself is not the answer without considering the personnel and how they would employ the equipment. The solution should take advantage of the existing in-place system and address all of the critical functions. The solutions are envisioned as being implemented in a phased manner, where Solution 1 is followed by Solution 2 and eventually by Solution 3. This allows adequate time for training and gaining operational experience for successively more complex equipment. Detailed descriptions of the components follow the solution descriptions. Solution 1 - This solution is based on changes to CONOPs, and does not have a technology component. It consists of observers at the forts and annexes, forward patrols along the swamp edge, in depth patrols approximately 10 kilometers inland from the swamp, and checkpoints on major roads. Solution 2 - This solution adds a ground sensor array to the Solution 1 system. Solution 3 - This solution is based around installing a radar/video camera system on each fort. It employs the CONOPS from Solution 1, but uses minimal ground sensors deployed only in areas with poor radar/video camera coverage (such as canals and streams shielded by vegetation), or by roads covered by radar but outside the range of the radar associated cameras. This document provides broad operational requirements for major equipment components along with sufficient operational details to allow the technical community to identify potential hardware candidates. Continuing analysis will develop quantities required and more detailed tactics, techniques, and procedures.

  10. Charging equipment. Ladegeraet

    Energy Technology Data Exchange (ETDEWEB)

    Neumann, E

    1981-09-17

    The invention refers to a charging equipment, particularly on board charging equipment for charging traction batteries of an electric vehicle from the AC mains supply, consisting of a DC converter, which contains a controlled power transistor, a switching off unloading circuit and a power transmitter, where the secondary winding is connected in series with a rectifier diode, and a smoothing capacitor is connected in parallel with this series circuit. A converter module is provided, which consists of two DC voltage converters, whose power transistors are controlled by a control circuit in opposition with a phase displacement of 180/sup 0/.

  11. Experimental equipment, ch. 6

    International Nuclear Information System (INIS)

    Boomstra, F.; Hoogenboom, A.M.; Prins, C.M.; Strasters, B.A.; Vermeer, A.; Wit, P. de; Zwol, N.A. van.

    1977-01-01

    The experimental equipment in use at Utrecht university is discussed. Attention is paid to the tandem Van de Graaff accelerator and the 4MV and 1MV accelerators. The detection systems for gamma-ray spectroscopy are reviewed with emphasis on the compton-suppression spectrometer. The data-handling system used for experiments with the tandem is also briefly discussed

  12. Equipment gift to Monaco

    International Nuclear Information System (INIS)

    1970-01-01

    Research work at the Agency's Laboratory of Marine Radioactivity in Monaco, including that concerned with pollution of the sea, has been made more effective by its latest acquisition of equipment. This is a spectrophotometer donated by the Federal Republic of Germany. (author)

  13. Lifetime of Mechanical Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Leland, K.

    1999-07-01

    The gas plant at Kaarstoe was built as part of the Statpipe gas transport system and went on stream in 1985. In 1993 another line was routed from the Sleipner field to carry condensate, and the plant was extended accordingly. Today heavy additional supply- and export lines are under construction, and the plant is extended more than ever. The main role of the factory is to separate the raw gas into commercial products and to pump or ship it to the markets. The site covers a large number of well-known mechanical equipment. This presentation deals with piping, mechanical and structural disciplines. The lifetime of mechanical equipment is often difficult to predict as it depends on many factors, and the subject is complex. Mechanical equipment has been kept in-house, which provides detailed knowledge of the stages from a new to a 14 years old plant. The production regularity has always been very high, as required. The standard of the equipment is well kept, support systems are efficient, and human improvisation is extremely valuable.

  14. Safeguards techniques and equipment

    International Nuclear Information System (INIS)

    1997-01-01

    The current booklet is intended to give a full and balanced description of the techniques and equipment used for both nuclear material accountancy and containment and surveillance measures, and for the new safeguards measure of environmental sampling. As new verification measures continue to be developed, the material in the booklet will be periodically reviewed and updated versions issued. (author)

  15. Equipping tomorrow's fire manager

    Science.gov (United States)

    Christopher A. Dicus

    2008-01-01

    Fire managers are challenged with an ever-increasing array of both responsibilities and critics. As in the past, fire managers must master the elements of fire behavior and ecology using the latest technologies. In addition, today’s managers must be equipped with the skills necessary to understand and liaise with a burgeoning group of vocal stakeholders while also...

  16. Electrical equipment design library

    International Nuclear Information System (INIS)

    1994-01-01

    This book guides the design supervision, construction order for electrical equipment. The contents of this library are let's use electricity like this, leading-in-pole and casual power, electric pole install below 300KVA, electric pole install below 301∼1000KVA, electric pole install exceed 1000KVA, rooftop install exceed 1000KVA, CUBICLE type, 154KV services. It adds an appendix.

  17. Orphee reactor experimental equipment

    International Nuclear Information System (INIS)

    1987-01-01

    Experimental equipment around the ORPHEE reactor is presented. The neutron source; and the spectrometers and sample environment (inelastic and quasi-elastic scattering, elastic scattering, spread scattering, small angle scattering) are described. An experiment proposal and reports guide is supplied [fr

  18. Seismic qualification of equipment

    International Nuclear Information System (INIS)

    Heidebrecht, A.C.; Tso, W.K.

    1983-03-01

    This report describes the results of an investigation into the seismic qualification of equipment located in CANDU nuclear power plants. It is particularly concerned with the evaluation of current seismic qualification requirements, the development of a suitable methodology for the seismic qualification of safety systems, and the evaluation of seismic qualification analysis and testing procedures

  19. Underground coal equipment

    Energy Technology Data Exchange (ETDEWEB)

    Chadwick, J.

    2002-12-01

    This paper reports on increasing automation and enhanced productivity on longwalls, new development cutting and bolting technologies and haulage systems. Amongst equipment discussed is DBT's Electra series EL3000 shearer, the Dosco LH1400 roadheader with onboard bolters, and Joy 12 CM30 continuous miners. 4 photos.

  20. Visual communication and terminal equipment

    International Nuclear Information System (INIS)

    Kang, Cheol Hui

    1988-06-01

    This book is divided two parts about visual communication and terminal equipment. The first part introduces visual communication, which deals with foundation of visual communication, technique of visual communication, equipment of visual communication, a facsimile and pictorial image system. The second part contains terminal equipment such as telephone, terminal equipment for data transmission on constitution and constituent of terminal equipment for data transmission, input device and output device, terminal device and up-to-date terminal device.

  1. Visual communication and terminal equipment

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Cheol Hui

    1988-06-15

    This book is divided two parts about visual communication and terminal equipment. The first part introduces visual communication, which deals with foundation of visual communication, technique of visual communication, equipment of visual communication, a facsimile and pictorial image system. The second part contains terminal equipment such as telephone, terminal equipment for data transmission on constitution and constituent of terminal equipment for data transmission, input device and output device, terminal device and up-to-date terminal device.

  2. Sex and gender differences in chronic kidney disease: progression to end-stage renal disease and haemodialysis.

    Science.gov (United States)

    Cobo, Gabriela; Hecking, Manfred; Port, Friedrich K; Exner, Isabella; Lindholm, Bengt; Stenvinkel, Peter; Carrero, Juan Jesús

    2016-07-01

    Sex and gender differences are of fundamental importance in most diseases, including chronic kidney disease (CKD). Men and women with CKD differ with regard to the underlying pathophysiology of the disease and its complications, present different symptoms and signs, respond differently to therapy and tolerate/cope with the disease differently. Yet an approach using gender in the prevention and treatment of CKD, implementation of clinical practice guidelines and in research has been largely neglected. The present review highlights some sex- and gender-specific evidence in the field of CKD, starting with a critical appraisal of the lack of inclusion of women in randomized clinical trials in nephrology, and thereafter revisits sex/gender differences in kidney pathophysiology, kidney disease progression, outcomes and management of haemodialysis care. In each case we critically consider whether apparent discrepancies are likely to be explained by biological or psycho-socioeconomic factors. In some cases (a few), these findings have resulted in the discovery of disease pathways and/or therapeutic opportunities for improvement. In most cases, they have been reported as merely anecdotal findings. The aim of the present review is to expose some of the stimulating hypotheses arising from these observations as a preamble for stricter approaches using gender for the prevention and treatment of CKD and its complications. © 2016 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  3. UK National Survey of Practice Patterns of Fluid Volume Management in Haemodialysis Patients: A Need for Evidence.

    Science.gov (United States)

    Dasgupta, Indranil; Farrington, Ken; Davies, Simon J; Davenport, Andrew; Mitra, Sandip

    2016-01-01

    Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice. An online questionnaire was distributed to all UK renal centres. Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance-based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this. There is an urgent need for establishing an evidence base on the optimal approaches to fluid management. © 2016 S. Karger AG, Basel.

  4. Why take the chance? A qualitative grounded theory study of nocturnal haemodialysis recipients who decline kidney transplantation.

    Science.gov (United States)

    Rosenthal, Meagen M; Molzahn, Anita E; Chan, Christopher T; Cockfield, Sandra L; Kim, S Joseph; Pauly, Robert P

    2016-05-18

    The objective of this study was to examine the factors that influence decision-making to forgo transplantation in favour of remaining on nocturnal haemodialysis (NHD). A grounded theory approach using in-depth telephone interviewing was used. Participants were identified from 2 tertiary care renal programmes in Canada. The study participants were otherwise eligible patients with end-stage renal disease who have opted to remain off of the transplant list. A total of 7 eligible participants were interviewed. 5 were male. The mean age was 46 years. A constant comparative method of analysis was used to identify a core category and factors influencing the decision-making process. In this grounded theory study of people receiving NHD who refused kidney transplantation, the core category of 'why take a chance when things are going well?' was identified, along with 4 factors that influenced the decision including 'negative past experience', 'feeling well on NHD', 'gaining autonomy' and 'responsibility'. This study provides insight into patients' thought processes surrounding an important treatment decision. Such insights might help the renal team to better understand, and thereby respect, patient choice in a patient-centred care paradigm. Findings may also be useful in the development of education programmes addressing the specific concerns of this population of patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Daily intake and serum concentration of menaquinone-4 (MK-4) in haemodialysis patients with chronic kidney disease.

    Science.gov (United States)

    Wyskida, Katarzyna; Żak-Gołąb, Agnieszka; Łabuzek, Krzysztof; Suchy, Dariusz; Ficek, Rafał; Pośpiech, Kornel; Olszanecka-Glinianowicz, Magdalena; Okopień, Bogusław; Więcek, Andrzej; Chudek, Jerzy

    2015-12-01

    Decreased concentration of menaquinone-4 (MK-4) seems to be an important risk factor of vascular calcification in haemodialysis (HD) patients. Optimal dietary intake, as well as serum MK-4 reference range, in HD has not been determined, yet. The aim of the present study was to assess daily vitamin K1 and MK-4 intakes and their relation to serum MK-4 concentration in HD patients. Daily vitamin K1 and MK-4, micro- and macronutrients and energy intakes were assessed using 3-day food diary completed by patients and serum MK-4 concentration was measured by HPLC [limit of quantification (LOQ): 0.055 ng/mL] in 85 HD patients (51 males) and 22 apparently healthy subjects. Daily MK-4 intake was significantly lower (by 29%) among HD, while K1 consumption was similar in both groups. Daily MK-4 intake was associated with fat and protein consumption in HD (r=0.43, pintakes were weaker in HD (r=0.38 and r=0.30 respectively) than in the control group (r=0.47 and r=0.45, respectively). In multiple regression analysis the variability of serum MK-4 concentrations in HD patients was explained by its daily intake. Decreased serum MK-4 concentration in HD patients is caused by lower dietary MK-4 intake, mainly due to diminished meat consumption, and in addition, probably reduced K1 conversion. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  6. Equipment cost optimization

    International Nuclear Information System (INIS)

    Ribeiro, E.M.; Farias, M.A.; Dreyer, S.R.B.

    1995-01-01

    Considering the importance of the cost of material and equipment in the overall cost profile of an oil company, which in the case of Petrobras, represents approximately 23% of the total operational cost or 10% of the sales, an organization for the optimization of such costs has been established within Petrobras. Programs are developed aiming at: optimization of life-cycle cost of material and equipment; optimization of industrial processes costs through material development. This paper describes the methodology used in the management of the development programs and presents some examples of concluded and ongoing programs, which are conducted in permanent cooperation with suppliers, technical laboratories and research institutions and have been showing relevant results

  7. X-ray equipment

    International Nuclear Information System (INIS)

    Redmayne, I.G.B.

    1988-01-01

    The patent concerns a warning and protection system for mobile x-ray equipment used for 'on site' radiography, so that workers in the vicinity of such a working unit can be alerted to its presence. The invention is a local repeater warning system which gives a preliminary warning that energisation of the tubehead is imminent, as well as a switch near the tubehead to abort or inhibit energisation. The latter switch allows personnel caught in the vicinity of the tubehead to prevent energisation. The preliminary warning may be flashing lamps or by a klaxon. The control unit for the equipment may include a monitoring circuit to detect failure of the warning light or klaxon. (U.K.)

  8. X-ray equipment

    Energy Technology Data Exchange (ETDEWEB)

    Redmayne, I.G.B.

    1988-01-06

    The patent concerns a warning and protection system for mobile x-ray equipment used for 'on site' radiography, so that workers in the vicinity of such a working unit can be alerted to its presence. The invention is a local repeater warning system which gives a preliminary warning that energisation of the tubehead is imminent, as well as a switch near the tubehead to abort or inhibit energisation. The latter switch allows personnel caught in the vicinity of the tubehead to prevent energisation. The preliminary warning may be flashing lamps or by a klaxon. The control unit for the equipment may include a monitoring circuit to detect failure of the warning light or klaxon. (U.K.).

  9. Tube for irradiation equipment

    International Nuclear Information System (INIS)

    Goehrich, K.; Vogt, H.

    1979-01-01

    This patent describes a tube for irradiation equipment for limiting an emergent beam, with a baseplate, possessing a central aperture, intended for attaching to the equipment, as well as four carrier plates, each of which possesses a limiting edge and a sliding edge located at right angles thereto. The carrier plates are located parallel to the baseplate, the limiting edge of each carrier plate resting against the sliding edge of the adjacent carrier plate and each of the two mutually opposite pairs of carrier plates being displaceable, parallel to the direction of its sliding edges and symmetrically to the center of the transmission aperture, for the purpose of continuously varying the transmission aperture defined by the limiting edges, during which displacement each of the displaced carrier plates carries with it the carrier plate, resting against the limiting edge of the former plate, parallel to the direction of the limiting edge of the latter plate. 8 claims

  10. Equipment for isotope diagnostics

    International Nuclear Information System (INIS)

    Platz, W.

    1976-01-01

    The invention concerns an improvement of equipment for isotope diagnostics allowing to mark special intensity ranges of the recorded measurements by means of different colors. For undisturbed operation it is of advantage to avoid electric circuits between movable and unmovable parts of the color recorder. According to the invention, long gear wheels of glass fiber-reinforced polyamide are used for these connections. (ORU) [de

  11. Soviet equipment flies in

    CERN Multimedia

    CERN PhotoLab

    1978-01-01

    End of February 1977 a Soviet Ilyushin-76 heavy freight aircraft landed at Cointrin airport having on board fifty large wire proprtional chambers and associated apparatus, together weighing 10 tons, supplied by the Joint Institute for Nuclear Research, Dubna, USSR. The equipment was for the CERN- Dubna-Munich-Saclay experiment NA4 on deep inelastic muon scattering being set up in the North Area of SPS. See Weekly Bulletin 11/78.

  12. Labelling of equipment dispensers.

    Science.gov (United States)

    Gray, D C

    1993-01-01

    A new labelling system for use on medical equipment dispensers is tested. This system uses one of the objects stored in each unit of the dispenser as the 'label', by attaching it to the front of the dispenser with tape. The new system was compared to conventional written labelling by timing subjects asked to select items from two dispensers. The new system was 27% quicker than the conventional system. Images Fig. 1 PMID:8110335

  13. Equipment Obsolescence Management Program

    Energy Technology Data Exchange (ETDEWEB)

    Redmond, J.

    2014-07-01

    Nuclear Power Plant (NPP) Operators are challenged with securing reliable supply channels for safety related equipment due to equipment obsolescence. Many Original Equipment Manufacturers (OEMs) have terminated production of spare parts and product life-cycle support. The average component life cycles are much shorter than the NPP design life, which means that replacement components and parts for the original NPP systems are not available for the complete design life of the NPPs. The lack or scarcity of replacement parts adversely affects plant reliability and ultimately the profitability of the affected NPPs. This problem is further compounded when NPPs pursue license renewal and approval for plant-life extension. A reliable and predictable supply of replacement co components is necessary for NPPs to remain economically competitive and meet regulatory requirements and guidelines. Electrical and I and C components, in particular, have short product life cycles and obsolescence issues must be managed pro actively and not reactively in order to mitigate the risk to the NPP to ensure reliable and economic NPP operation. (Author)

  14. Personal protective equipment

    International Nuclear Information System (INIS)

    2004-01-01

    This Practical Radiation Technical Manual is one of a series that has been designed to provide guidance on radiological protection for employers, radiation protection officers, managers and other technically competent persons who have responsibility for ensuring the safety of employees working with ionizing radiation. The Manual may be used with the appropriate IAEA Practical Radiation Safety Manuals to provide training, instruction and information for all employees engaged in work with ionizing radiation. Personal protective equipment (PPE) includes clothing or other special equipment that is issued to individual workers to provide protection against actual or potential exposure to ionizing radiations. It is used to protect each worker against the prevailing risk of external or internal exposure in circumstances in which it is not reasonably practicable to provide complete protection by means of engineering controls or administrative methods. Adequate personal protection depends on PPE being correctly selected, fitted and maintained. Appropriate training for the users and arrangements to monitor usage are also necessary to ensure that PPE provides the intended degree of protection effectively. This Manual explains the principal types of PPE, including protective clothing and respiratory protective equipment (RPE). Examples of working procedures are also described to indicate how PPE should be used within a safe system of work. The Manual will be of most benefit if it forms part of a more comprehensive training programme or is supplemented by the advice of a qualified expert in radiation protection. Some of the RPE described in this Manual should be used under the guidance of a qualified expert

  15. 11C-methionine PET/CT in 99mTc-sestamibi-negative hyperparathyroidism in patients with renal failure on chronic haemodialysis

    International Nuclear Information System (INIS)

    Rubello, Domenico; Fanti, Stefano; Nanni, Cristina; Farsad, Mohsen; Castellucci, Paolo; Boschi, Stefano; Franchi, Roberto; Mariani, Giuliano; Fig, Lorraine M.; Gross, Milton D.

    2006-01-01

    Scintigraphic localisation of parathyroid glands is often unsuccessful in patients with renal failure on chronic haemodialysis who have secondary hyperparathyroidism (HPT). The purpose of this study was to investigate the use of 11 C-methionine PET/CT to detect hyperfunctioning parathyroid glands in patients with renal failure on chronic haemodialysis who had 99m Tc-sestamibi-negative HPT. 11 C-methionine PET/CT was performed in 18 patients (11 women and 7 men, aged 42-79 years; mean age 57.8 years) on haemodialysis for renal failure (2-14 years' duration), with normo-, hypo- or hypercalcaemia and HPT not localised by either dual-tracer 99m Tc-pertechnetate/ 99m Tc-sestamibi subtraction scans or dual-phase 99m Tc-sestamibi scans. In three of ten patients with normo- or hypocalcaemic HPT there was increased 11 C-methionine accumulation in one gland. Seven of eight patients with hypercalcaemic HPT showed increased uptake: in five of these patients increased 11 C-methionine accumulation was present in one gland, while in two it was demonstrated in two glands. All patients also had high-resolution ultrasound of the neck and were treated with subtotal parathyroidectomy, leaving a remnant of the smallest of the four glands. Regardless of their size, all glands with abnormal 11 C-methionine parathyroid uptake were removed, and all demonstrated parathyroid hyperplasia. All patients developed post-parathyroidectomy hypoparathyroidism and one patient with normocalcaemic HPT relapsed 8 months after surgery. These data suggest that 11 C-methionine PET/CT may be used to identify hyperfunctioning parathyroid glands in non-primary HPT, and especially hypercalcaemic HPT, when conventional 99m Tc-sestamibi imaging is non-localising. (orig.)

  16. Scientific Equipment Division - Overview

    International Nuclear Information System (INIS)

    Halik, J.

    2001-01-01

    Full text: The Scientific Equipment Division consists of the Design Group and the Mechanical Workshop. The activity of the Division includes the following: - designing of devices and equipment for experiments in physics, their mechanical construction and assembly. In particular, there are vacuum chambers and installations for HV and UHV; - maintenance and upgrading of the existing installations and equipment in our Institute; - participation of our engineers and technicians in design works, equipment assembly and maintenance for experiments in foreign laboratories. The Design Group is equipped with PC-computers and AutoCAD graphic software (release 2000 and Mechanical Desktop 4.0) and a AO plotter, what allows us to make drawings and 2- and 3-dimensional mechanical documentation to the world standards. The Mechanical Workshop can offer a wide range of machining and treatment methods with satisfactory tolerances and surface quality. It offers the following possibilities: - turning - cylindrical elements of a length up to 2000 mm and a diameter up to 400 mm, and also disc-type elements of a diameter up to 600 mm and a length not exceeding 300 mm; - milling - elements of length up to 1000 mm and gear wheels of diameter up to 300 mm; - grinding - flat surfaces of dimensions up to 300 mm x 1000 mm and cylindrical elements of a diameter up to 200 mm and a length up to 800 mm; - drilling - holes of a diameter up to 50 mm; - welding - electrical and gas welding, including TIG vacuum-tight welding; - soft and hard soldering; - mechanical works including precision engineering; - plastics treatment - machining and polishing using diamond milling, modelling, lamination of various shapes and materials, including plexiglas, scintillators and light-guides; - painting - paint spraying with possibility of using furnace-fred drier of internal dimensions of 800 mm x 800 mm x 800 mm. Our workshop posses CNC milling machine which can be used for machining of work-pieces up to 500 kg

  17. Investigations of the folic acid content in plasma and erythrocytes by RIA, with special regard to the effects of oral contraceptives, chronic alcohol abuse, and constant haemodialysis

    International Nuclear Information System (INIS)

    Poblotzki, E.

    1978-01-01

    With the aid of a new radioassay using 3 H folic acid as tracer and folic acid as standard, 500 folic acid as tracer and folic acid as standard, 500 folic acid measurements have been carried out in plasma and in the erythrocytes of normal persons and patients with chronic alcoholism, haemodialysis patients, patients with idiopathic sprue, and women taking oral contraceptives. According to the findings, folic acid therapy seems to be necessary in chronic alcoholics, patients with renal insufficiency under constant haemolysis, and in patients with idiopathic sprue. (AJ) [de

  18. Mining face equipment

    Energy Technology Data Exchange (ETDEWEB)

    G, Litvinskiy G; Babyuk, G V; Yakovenko, V A

    1981-01-07

    Mining face equipment includes drilling advance wells, drilling using explosives on the contour bore holes, loading and transporting the crushed mass, drilling reinforcement shafts, injecting reinforcement compounds and moving the timber. Camouflet explosives are used to form relaxed rock stress beyond the mining area to decrease costs of reinforcing the mining area by using nonstressed rock in the advance well as support. The strengthening solution is injected through advanced cementing wells before drilling the contour bores as well as through radial cementing wells beyond the timbers following loading and transport of the mining debris. The advance well is 50-80 m.

  19. Coal ash monitoring equipment

    Energy Technology Data Exchange (ETDEWEB)

    Clayton, C G; Wormald, M R

    1978-10-02

    The monitoring equipment is used to determine the remainder from combustion (ash slack) of coal in wagons designed for power stations. Next to the rails, a neutron source (252 Cf, 241 Am/Be) is situated, which irradiates the coal with neutrons at a known dose, which produces the reaction 27 Al (n ..gamma..) Al 28. The aluminium content is a measure of the remainder. The 1.78 MeV energy is measured downstream of the rail with a detector. The neutron source can only act in the working position of a loaded wagon.

  20. Management of Transportation Equipment.

    Science.gov (United States)

    1982-11-01

    Record% % %. "jP -M -. M LIh TRANSPORTATION MAENTKENAI4CE SHOP WORKLOAD CONTROL WORK CENTER SADR A-OR .a’* tLR 4.,R53 8114LM 0 o 251 50 75 100 125 ISO ...PDBP 06 7 4892 TRACTOR, WHEEL, INDUST, 14001-20000 PDBP 06 7 4893 TRACTOR, WHEEL, INDUST, 20001-27000 PDBP 06 7 4894 TRACTOR, WHEEL, INDUST, 27001 PDBP...27K TRACTOR, WHEEL, INDUST, 27001 PDBP & UP P-i LINE ITEM 07 LIGHTING AND POWER GENERATION EQUIPMENT 5110 T FLOODLIGHT ELEC FLOODLIGHT, ELEC, TRUCK

  1. Californium-252 Program Equipment Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Chattin, Fred Rhea [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wilson, Kenton [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Ezold, Julie G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-12-01

    To successfully continue the 252Cf production and meet the needs of the customers, a comprehensive evaluation of the Building 7920 processing equipment was requested to identify equipment critical to the operational continuity of the program.

  2. The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Wolfgang Marx

    2017-12-01

    Full Text Available End-stage kidney disease is a strong risk factor for cardiovascular-specific mortality. Polyphenol-rich interventions may attenuate cardiovascular disease risk factors; however, this has not been systematically evaluated in the hemodialysis population. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines, the following databases were searched: Cochrane Library (http://www.cochranelibrary.com/, MEDLINE (https://health.ebsco.com/products/medline-with-full-text, Embase (https://www.elsevier.com/solutions/embase-biomedical-research, and CINAHL (https://www.ebscohost.com/nursing/products/cinahl-databases/cinahl-complete. Meta-analyses were conducted for measures of lipid profile, inflammation, oxidative stress, and blood pressure. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool and quality of the body of evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE methodology. Twelve studies were included for review. Polyphenol-rich interventions included soy, cocoa, pomegranate, grape, and turmeric. Polyphenol-rich interventions significantly improved diastolic blood pressure (Mean Difference (MD −5.62 mmHg (95% Confidence Interval (CI −8.47, −2.78; I2 = 2%; p = 0.0001, triglyceride levels (MD −26.52 mg/dL (95% CI −47.22, −5.83; I2 = 57%; p = 0.01, and myeloperoxidase (MD −90.10 (95% CI −135.84, −44.36; I2 = 0%; p = 0.0001. Included studies generally had low or unclear risks of bias. The results of this review provide preliminary support for the use of polyphenol-rich interventions for improving cardiovascular risk markers in haemodialysis patients. Due to the limited number of studies for individual polyphenol interventions, further studies are required to provide recommendations regarding individual polyphenol intervention and dose.

  3. Circulating Interferon-λ3, Responsiveness to HBV Vaccination, and HBV/HCV Infections in Haemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Alicja E. Grzegorzewska

    2017-01-01

    Full Text Available The IFN-λ3 gene (IFNL3 plays a role in HCV clearance. We investigated circulating IFN-λ3 and IFNL3 SNPs in haemodialysis patients who differed in their response to HBV vaccination and their HBV/HCV infection status. In 201 patients, plasma IFN-λ3 was determined using ELISA. IFNL3 SNPs (rs12979860, rs8099917 were genotyped using HRM analysis. Differences in IFN-λ3 levels were shown between responders and nonresponders to HBV vaccination and between HBsAg-positive patients and those who developed anti-HBs after infection and became HBsAg negative. HBV vaccine responders without HCV resolution revealed lower IFN-λ3 than noninfected responders. HBsAg/HCV RNA-positive subjects showed lower IFN-λ3 than patients positive only for HCV RNA or subjects who resolved both infections. Circulating IFN-λ3 correlated positively with anti-HBs and negatively with positive HCV RNA testing in the adjusted regression analyses. HBV vaccine nonresponders, HBsAg-positive patients, and subjects with replicating HCV composed a group with unfavourable outcomes. Responders to HBV vaccination, subjects who became HBsAg negative, and those who cleared HCV were analysed as having favourable outcomes. The latter showed higher IFN-λ3 but did not differ in distribution of IFNL3 SNPs compared with subjects with unfavourable outcomes. Higher IFN-λ3 concentrations are associated with response to HBV vaccination, self-limited HBV infection, and HCV resolution.

  4. The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Marx, Wolfgang; Kelly, Jaimon; Marshall, Skye; Nakos, Stacey; Campbell, Katrina; Itsiopoulos, Catherine

    2017-12-11

    End-stage kidney disease is a strong risk factor for cardiovascular-specific mortality. Polyphenol-rich interventions may attenuate cardiovascular disease risk factors; however, this has not been systematically evaluated in the hemodialysis population. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the following databases were searched: Cochrane Library (http://www.cochranelibrary.com/), MEDLINE (https://health.ebsco.com/products/medline-with-full-text), Embase (https://www.elsevier.com/solutions/embase-biomedical-research), and CINAHL (https://www.ebscohost.com/nursing/products/cinahl-databases/cinahl-complete). Meta-analyses were conducted for measures of lipid profile, inflammation, oxidative stress, and blood pressure. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool and quality of the body of evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Twelve studies were included for review. Polyphenol-rich interventions included soy, cocoa, pomegranate, grape, and turmeric. Polyphenol-rich interventions significantly improved diastolic blood pressure (Mean Difference (MD) -5.62 mmHg (95% Confidence Interval (CI) -8.47, -2.78); I ² = 2%; p = 0.0001), triglyceride levels (MD -26.52 mg/dL (95% CI -47.22, -5.83); I ² = 57%; p = 0.01), and myeloperoxidase (MD -90.10 (95% CI -135.84, -44.36); I ² = 0%; p = 0.0001). Included studies generally had low or unclear risks of bias. The results of this review provide preliminary support for the use of polyphenol-rich interventions for improving cardiovascular risk markers in haemodialysis patients. Due to the limited number of studies for individual polyphenol interventions, further studies are required to provide recommendations regarding individual polyphenol intervention and dose.

  5. [Surgical learning curve for creation of vascular accesses for haemodialysis: value of medico-radio-surgical collaboration].

    Science.gov (United States)

    Van Glabeke, Emmanuel; Belenfant, Xavier; Barrou, Benoît; Adhemar, Jean-Pierre; Laedrich, Joëlle; Mavel, Marie-Christine; Challier, Emmanuel

    2005-04-01

    Creation of a vascular access (VA) for haemodialysis is a surgical procedure which comprises a failure rate related to the quality of the vessels and the operator's experience. The authors report the first 2 years of a young urologist's experience with this procedure in a local hospital in collaboration with the nephrology team. Patients undergoing creation of VA were divided into 2 chronological groups. The patient's age and gender, the cause of renal failure, the presence of diabetes, clinical examination of the upper limb, preoperative assessment of upper limb vessels, the type of anaesthesia, the operating time and the start of dialysis after the operation, as well as the functional results of the VA at 6 months were studied. Results concerning the patients of the first period were discussed by the operator and the nephrology team. During the first 9 months, 28 patients were operated, corresponding to 36 operations including 32 direct fistulas. Over the following 15 months, 61 patients were operated, with the creation of 63 VAs, including 55 direct fistulas. The failure rate (thrombosis or non-functioning VA) decreased from 32.1% to 11.1% (p=0.07), while the 2 groups were globally comparable. Evaluation of a new surgical procedure shows a number of failures, as for all learning curves. However, it helps to improve the results. Collaboration with nephrologists must comprise a discussion allowing the acceptance of certain failures, as they reflect compliance with a strategy of preservation of the vascular capital and a rational attempt to avoid a non-essential proximal access or bypass graft. The support of a motivated radiology team (preoperative assessment and management of complications) and the assistance of a more experienced operator are essential.

  6. A Systematic Review and Meta-Analysis of Circulating Biomarkers Associated with Failure of Arteriovenous Fistulae for Haemodialysis.

    Directory of Open Access Journals (Sweden)

    Susan K Morton

    Full Text Available Arteriovenous fistula (AVF failure is a significant cause of morbidity and expense in patients on maintenance haemodialysis (HD. Circulating biomarkers could be valuable in detecting patients at risk of AVF failure and may identify targets to improve AVF outcome. Currently there is little consensus on the relationship between circulating biomarkers and AVF failure. The aim of this systematic review was to identify circulating biomarkers associated with AVF failure.Studies evaluating the association between circulating biomarkers and the presence or risk of AVF failure were systematically identified from the MEDLINE, EMBASE and Cochrane Library databases. No restrictions on the type of study were imposed. Concentrations of circulating biomarkers of routine HD patients with and without AVF failure were recorded and meta-analyses were performed on biomarkers that were assessed in three or more studies with a composite population of at least 100 participants. Biomarker concentrations were synthesized into inverse-variance random-effects models to calculate standardized mean differences (SMD and 95% confidence intervals (CI.Thirteen studies comprising a combined population of 1512 participants were included after screening 2835 unique abstracts. These studies collectively investigated 48 biomarkers, predominantly circulating molecules which were assessed as part of routine clinical care. Meta-analysis was performed on twelve eligible biomarkers. No significant association between any of the assessed biomarkers and AVF failure was observed.This paper is the first systematic review of biomarkers associated with AVF failure. Our results suggest that blood markers currently assessed do not identify an at-risk AVF. Further, rigorously designed studies assessing biological plausible biomarkers are needed to clarify whether assessment of circulating markers can be of any clinical value. PROSPERO registration number CRD42016033845.

  7. Influence of religiosity and spiritual coping on health-related quality of life in Saudi haemodialysis patients.

    Science.gov (United States)

    Cruz, Jonas Preposi; Colet, Paolo C; Alquwez, Nahed; Inocian, Ergie P; Al-Otaibi, Raid Salman; Islam, Sheikh Mohammed Shariful

    2017-01-01

    Patients undergoing haemodialysis (HD) are frequently troubled by psychiatric disorders and coping problems, which can pose a serious threat to their physical and mental well-being. Using religious and spiritual interventions as a means of coping with physical and mental challenges is widely recognized. Although this topic has been well studied, in the Middle East regions, where Islam is the dominant religion, studies are limited. Thus, this study was performed to explore the influence of religiosity and spiritual coping (SC) on the health-related quality of life (HRQoL) of Saudi patients receiving HD. A total of 168 HD patients from three hospitals in Saudi Arabia formed a convenient sample for this descriptive, cross-sectional hospital-based study. Data collection was done via questionnaire-guided interviews using the Muslim Religious Index as well as the Arabic Versions of the Spiritual Coping Strategies scale and Quality of Life Index Dialysis. Regression analysis enabled identification of the factors influencing HRQoL. Older patients were found to reveal higher levels of religiosity, whereas the younger ones expressed a lesser degree of religious and nonreligious coping. Unemployed patients reported greater involvement in religious practices (RP) and more frequently used religious coping than those employed. The latter showed lower intrinsic religiosity and nonreligious coping usage than the unemployed. The respondents reported the greatest satisfaction scores on their psychological/spiritual dimension and the least scores on the social and economic dimension. Therefore, the factors that could influence the HRQoL of the respondents were identified as involvement in RP, intrinsic religious beliefs, religious coping usage and age. This study revealed significant findings regarding the importance of religiosity and SC on the HRQoL of the Saudi HD patients. Therefore, it has been highly recommended to integrate religiosity into the health-care process for such

  8. Diagnosis and prevalence of protein-energy wasting and its association with mortality in Japanese haemodialysis patients.

    Science.gov (United States)

    Kanazawa, Yoshie; Nakao, Toshiyuki; Murai, Seizo; Okada, Tomonari; Matsumoto, Hiroshi

    2017-07-01

    The International Society of Renal Nutrition and Metabolism (ISRNM) has proposed the diagnostic criteria for protein-energy wasting (PEW). We studied Japanese haemodialysis (HD) patients to verify the diagnostic method, especially with respect to the body mass index (BMI) criterion, as well as the prevalence of PEW and its association with mortality. Japanese patients receiving maintenance HD at three outpatient clinics in Tokyo (n = 210) were enrolled, and prospectively followed-up for 3 years. PEW was diagnosed at baseline, according to the four categories (serum chemistry, body mass, muscle mass and dietary intake) recommended by the ISRNM. For the category of body mass, we select a body mass index (BMI) and set up three thresholds, energy wasting, when the threshold of a BMI among the diagnostic criteria was defined as <18.5 kg/m 2 , was recognized as an independent risk factor for mortality. However, PEW was not recognized as a risk factor when the BMI diagnostic criterion was set at <20.0 or <23.0 kg/m 2 . Overall, 14.8% of the patients had PEW. The survival rate of PEW patients was significantly lower than that of non-PEW patients (log rank, P < 0.001). The diagnosis algorithm of PEW proposed by an expert panel of the ISRNM strongly associates with mortality. However, given differences in body size in Japan, we suggest to revise the BMI criterion from <23.0 kg/m 2 to <18.5 kg/m 2 . © 2016 Asian Pacific Society of Nephrology.

  9. The Effect of Haemodialysis Access Types on Cardiac Performance and Morbidities in Patients with Symptomatic Heart Disease.

    Science.gov (United States)

    Chuang, Min-Kai; Chang, Chin-Hao; Chan, Chih-Yang

    2016-01-01

    Little is known about whether the arteriovenous type haemodialysis access affects cardiac function and whether it is still advantageous to the uremic patient with symptomatic heart disease. We conducted a retrospective comparative study. Patients with heart disease and end-stage renal disease that had a new chronic access created between January 2007 and December 2008 and met the inclusion criteria were assessed. The endpoint was major adverse event (MAE)-free survivals of arteriovenous access (AVA) and tunneled cuffed double-lumen central venous catheter (CVC) groups. Whether accesses worsened heart failure was also evaluated. There were 43 CVC patients and 60 AVA patients. The median follow-up time from access creation was 27.6 months (IQR 34.7, 10.9~45.6). Although CVC patients were older than AVA patients (median age 78.0, IQR 14.0 vs. 67.5, IQR 16.0, respectively, p = .009), they manifested non-inferior MAE-free survival (mean 17.1, 95% CI 10.3~24.0 vs. 12.9, 95% CI 8.5~17.4 months in CVC and AVA patients, respectively, p = .290). During follow-up, more patients in the AVA group than in the CVC group deteriorated in heart failure status (35 of 57 vs. 10 of 42, respectively, odds ratio 5.1, p heart disease and end stage renal disease (ESRD), CVC patients showed non-inferior MAE-free survival in comparison to those in the AVA group. AV type access could deteriorate heart failure. Accordingly, uremic patients with symptomatic heart disease are not ideal candidates for AV type access creation.

  10. Age- and weight-based differences in haemodialysis prescription and delivery in children, adolescents and young adults.

    Science.gov (United States)

    Gotta, Verena; Marsenic, Olivera; Pfister, Marc

    2018-04-18

    Limited systematic data are available on prescription and dosing of haemodialysis (HD) in children and adolescents compared with adults. We aimed to characterize age- and weight-based differences in HD delivery in children, adolescents and young adults. This is a retrospective observational study including 1852 patients aged 1-18 years; weight range 8.3-168 kg). Median individual prescriptions per year were calculated and overall 50% (IQR) and 90% distribution ranges over age and weight were derived. Repeated measurements analysis of variance assessed differences between age and weight groups. Prescriptions significantly differed among age and weight groups (P range, IQR) weight-normalized blood flow rate (highest in 100 kg: QB/kg = 3.1-4.0 mL/min/kg, spKt/V = 1.22-1.47, respectively). Adolescents had significantly lower QB/kg, KD/kg and spKt/V (1.34-1.71) compared with adults (1.45-1.79) and children range of 25th percentiles: 1.37-1.44). Dialytic clearance derived from a mechanistic equation underpredicted KD in children but not in young adults. Significant growth retardation was observed, with the proportion of patients age) decreasing from 71% (1-2 years) to 15% (>18 years). Delivered HD treatment varies with age and weight and is more intensified in children aged young adults, who appear to be at highest risk of receiving suboptimal treatment. Still, delivery of target or higher spKt/V values did not result in appropriate growth in these children, questioning the value of spKt/V as a measure of HD adequacy in children. Provided ranges of outpatient HD prescription can help clinicians and researchers in personalizing and optimizing delivery of dialysis treatment.

  11. Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study

    NARCIS (Netherlands)

    Palmer, S.C.; Ruospo, M.; Campbell, K.L.; Garcia Larsen, V.; Saglimbene, V.; Natale, P.; Gargano, L.; Craig, J.C.; Johnson, D.W.; Tonelli, M.; Knight, J.; Bednarek-Skublewska, A.; Celia, E.; Castillo, D. Del; Dulawa, J.; Ecder, T.; Fabricius, E.; Frazao, J.M.; Gelfman, R.; Hoischen, S.H.; Schon, S.; Stroumza, P.; Timofte, D.; Torok, M.; Hegbrant, J.; Wollheim, C.; Frantzen, L.; Strippoli, G.F.; Steiner, K.; et al.,

    2015-01-01

    INTRODUCTION: Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are

  12. Characterization equipment essential drawing plan

    International Nuclear Information System (INIS)

    WILSON, G.W.

    1999-01-01

    The purpose of this document is to list the Characterization equipment drawings that are classified as Essential Drawings. Essential Drawings: Are those drawings identified by the facility staff as necessary to directly support the safe operation of the facility or equipment (HNF 1997a). The Characterization equipment drawings identified in this report are deemed essential drawings as defined in HNF-PRO-242, Engineering Drawing Requirements (HNF 1997a). These drawings will be prepared, revised, and maintained per HNF-PRO-440, Engineering Document Change Control (HNF 1997b). All other Characterization equipment drawings not identified in this document will be considered Support drawings until the Characterization Equipment Drawing Evaluation Report is completed

  13. Coal mining equipment

    International Nuclear Information System (INIS)

    Stein, R.R.; Martin, T.W.

    1991-01-01

    The word in longwall components is big, and these larger components have price tags to match. The logic behind the greater investment is that it will yield high production rates and good uptime statistics. This is true in most cases. More important than single-shift tonnage records, average shift production continues to climb upwards. This paper reports on the quality, and more significantly, the quantity of service supplied for long-wall equipment, which has reached levels that would have been seen as unachievable when longwall mining was first introduced in the U.S. The school of thought then was that longwall would increase productivity in part by reducing the number of production units and thus reducing the number of personnel employed underground. The expectation of fewer employees turned out to be unrealistic. That was probably one reason that some early attempts to install longwall system looked more like failures than vision of the future

  14. Reactor fuel charging equipment

    International Nuclear Information System (INIS)

    Wade, Elman.

    1977-01-01

    In many types of reactor fuel charging equipment, tongs or a grab, attached to a trolley, housed in a guide duct, can be used for withdrawing from the core a selected spent fuel assembly or to place a new fuel assembly in the core. In these facilities, the trolley may have wheels that roll on rails in the guide duct. This ensures the correct alignment of the grab, the trolley and fuel assembly when this fuel assembly is being moved. By raising or lowering such a fuel assembly, the trolley can be immerged in the coolant bath of the reactor, whereas at other times it can be at a certain level above the upper surface of the coolant bath. The main object of the invention is to create a fuel handling apparatus for a sodium cooled reactor with bearings lubricated by the sodium coolant and in which the contamination of these bearings is prevented [fr

  15. Chapter 12. Space Heating Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Rafferty, Kevin D.

    1998-01-01

    The performance evaluation of space heating equipment for a geothermal application is generally considered from either of two perspectives: (a) selecting equipment for installation in new construction, or (b) evaluating the performance and retrofit requirements of an existing system. With regard to new construction, the procedure is relatively straightforward. Once the heating requirements are determined, the process need only involve the selection of appropriately sized hot water heating equipment based on the available water temperature. It is important to remember that space heating equipment for geothermal applications is the same equipment used in non-geothermal applications. What makes geothermal applications unique is that the equipment is generally applied at temperatures and flow rates that depart significantly from traditional heating system design. This chapter presents general considerations for the performance of heating equipment at non-standard temperature and flow conditions, retrofit of existing systems, and aspects of domestic hot water heating.

  16. Evidence of improved fluid management in patients receiving haemodialysis following a self-affirmation theory-based intervention: A randomised controlled trial.

    Science.gov (United States)

    Wileman, Vari; Chilcot, Joseph; Armitage, Christopher J; Farrington, Ken; Wellsted, David M; Norton, Sam; Davenport, Andrew; Franklin, Gail; Da Silva Gane, Maria; Horne, Robert; Almond, Mike

    2016-01-01

    Haemodialysis patients are at risk of serious health complications; yet, treatment non-adherence remains high. Warnings about health risks associated with non-adherence may trigger defensive reactions. We studied whether an intervention based on self-affirmation theory reduced resistance to health-risk information and improved fluid treatment adherence. In a cluster randomised controlled trial, 91 patients either self-affirmed or completed a matched control task before reading about the health-risks associated with inadequate fluid control. Patients' perceptions of the health-risk information, intention and self-efficacy to control fluid were assessed immediately after presentation of health-risk information. Interdialytic weight gain (IDWG), excess fluid removed during haemodialysis, is a clinical measure of fluid treatment adherence. IDWG data were collected up to 12 months post-intervention. Self-affirmed patients had significantly reduced IDWG levels over 12 months. However, contrary to predictions derived from self-affirmation theory, self-affirmed participants and controls did not differ in their evaluation of the health-risk information, intention to control fluid or self-efficacy. A low-cost, high-reach health intervention based on self-affirmation theory was shown to reduce IDWG over a 12-month period, but the mechanism by which this apparent behaviour change occurred is uncertain. Further work is still required to identify mediators of the observed effects.

  17. Cost effectiveness of paricalcitol versus cinacalcet with low-dose vitamin D for management of secondary hyperparathyroidism in haemodialysis patients in the USA.

    Science.gov (United States)

    Sharma, Amit; Marshall, Thomas S; Khan, Samina S; Johns, Beverly

    2014-02-01

    The IMPACT SHPT [Improved Management of Intact Parathyroid Hormone (iPTH) with Paricalcitol-Centered Therapy Versus Cinacalcet Therapy with Low-Dose Vitamin D in Hemodialysis Patients with Secondary Hyperparathyroidism] study compared the effectiveness of paricalcitol and cinacalcet in the management of secondary hyperparathyroidism in haemodialysis patients but did not report the costs or cost effectiveness of these treatments. The aim of this study was to compare the cost effectiveness of a paricalcitol-based regimen versus cinacalcet with low-dose vitamin D for management of secondary hyperparathyroidism in haemodialysis patients from a US payer perspective, using a 1-year time horizon. This was a post hoc cost-effectiveness analysis of data collected for US patients enrolled in the IMPACT SHPT study-a 28-week, randomized, open-label, phase 4, multinational study (ClinicalTrials.gov identifier: NCT00977080). Patients eligible for the IMPACT SHPT study were aged≥18 years with stage 5 chronic kidney disease, had been receiving maintenance haemodialysis three times weekly for at least 3 months before screening and were to continue haemodialysis during the study. Only US patients who reached the evaluation period (weeks 21-28) were included in this secondary analysis. US subjects in the IMPACT SHPT study were randomly assigned to receive intravenous paricalcitol, or oral cinacalcet plus fixed-dose intravenous doxercalciferol, for 28 weeks. Patients in the paricalcitol group could also receive supplemental cinacalcet for hypercalcaemia. The primary effectiveness endpoint in the IMPACT SHPT study was the proportion of subjects who achieved a mean intact parathyroid hormone (iPTH) level of 150-300 pg/mL during the evaluation period. In this secondary analysis, we estimated the incremental cost-effectiveness ratio (ICER), comparing paricalcitol-treated patients with cinacalcet-treated patients on the basis of this primary endpoint and several secondary endpoints

  18. Equipment repair in coal mines

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, S

    1982-01-01

    Most equipment in Chinese coal mines consists of machinery and equipment produced in the 1950s; the efficiency of 4-62, CTD-57 and 70B/sub 2/ ventilators is 15% lower than that of new ones; that of SSM and AYaP pumps, 10% lower than of modern ones. Equipment renovation is done in three ways: replacing obsolete equipment with new equipment of the same type; improving the performance of existing equipment by introducing efficiency and reconstruction; and replacing obsolete equipment with advanced equipment. It is indicated that the second way, for example, replacement of 4-62 ventilator blades with a maximum efficiency of 73% by 4-72 ventilator blades raises its efficiency to 90%. Replacing the 8DA-8x3 water pump, having a maximum efficiency of 63%, with the 200D 43x3 pump with a maximum efficiency of 78%, enables an electricity savings of 7000 yuan per year, which exceeds all replacement costs (600 yuan). The need to improve equipment maintenance and preventive work to increase equipment service life and to introduce new techniques and efficiency is noted.

  19. 21 CFR 866.4540 - Immunonephelometer equipment.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866.4540 Immunonephelometer equipment. (a) Identification. Immunonephelometer equipment for clinical use...

  20. 21 CFR 866.4520 - Immunofluorometer equipment.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866.4520 Immunofluorometer equipment. (a) Identification. Immunofluorometer equipment for clinical use with...

  1. Equipment standards for interventional cardiology

    International Nuclear Information System (INIS)

    Dowling, A.; Gallagher, A.; Walsh, C.; Malone, J.

    2005-01-01

    Interventional radiology has seen rapid growth in cardiology and represents an alternative to hazardous surgery. Recently there has been a substantial growth in the number of procedures being performed and interventional cardiology (IC) procedures are the most common interventional procedures in Europe. Advances in imaging technology have facilitated the development of increasingly complex radiological IC equipment. Currently, the technology is developing at a rate ahead of supporting research, equipment standards and a regulatory framework. International standards play a key role in the design, manufacture and performance of radiological IC equipment. A survey of 12 IC systems (15 imaging chains) was conducted in Irish hospitals. The aim of the study was to assess the imbalance between rapidly advancing technology and existing standards and to propose recommendations for new IC equipment standards. The results demonstrate the need for definitive equipment requirements and standardisation in the design, manufacture, acceptance and maintenance of IC equipment. (authors)

  2. Generation of equipment response spectrum considering equipment-structure interaction

    International Nuclear Information System (INIS)

    Lee, Sang Hoon; Yoo, Kwang Hoon

    2005-01-01

    Floor response spectra for dynamic response of subsystem such as equipment, or piping in nuclear power plant are usually generated without considering dynamic interaction between main structure and subsystem. Since the dynamic structural response generally has the narrow-banded shapes, the resulting floor response spectra developed for various locations in the structure usually have high spectral peak amplitudes in the narrow frequency bands corresponding to the natural frequencies of the structural system. The application of such spectra for design of subsystems often leads to excessive design conservatisms, especially when the equipment frequency and structure are at resonance condition. Thus, in order to provide a rational and realistic design input for dynamic analysis and design of equipment, dynamic equipment-structure interaction (ESI) should be considered in developing equipment response spectrum which is particularly important for equipment at the resonance condition. Many analytical methods have been proposed in the past for developing equipment response spectra considering ESI. However, most of these methods have not been adapted to the practical applications because of either the complexities or the lack of rigorousness of the methods. At one hand, mass ratio among the equipment and structure was used as an important parameter to obtain equipment response spectra. Similarly, Tseng has also proposed the analytical method for developing equipment response spectra using mass ratio in the frequency domain. This method is analytically rigorous and can be easily validated. It is based on the dynamic substructuring method as applied to the dynamic soil-structure interaction (SSI) analysis, and can relatively easily be implemented for practical applications without to change the current dynamic analysis and design practice for subsystems. The equipment response spectra derived in this study are also based on Tseng's proposed method

  3. Overall Equipment Effectiveness Implementation Criteria

    Science.gov (United States)

    Abramova, I. G.; Abramov, D. A.

    2018-01-01

    This article documents the methods applied in production control technics specifically focused on commonly used parameter OEE (Overall Equipment Effectiveness). The indicators of extensive and intensive use of equipment are considered. Their appointment this is comparison in the same type of production within the industry and comparison of single-type and / or different types of equipment in terms of capacity. However, it is shown that there is no possibility of revealing the reasons for the machine’s operation: productive / unproductive, with disturbances. Therefore, in the article reveals the approaches to calculating the indicator characterizing the direct operation of the equipment. The Machine Load coefficient is approaching closely to the indicator of the efficiency of the use of equipment. Methods analysis is proceeded through the historically applied techniques such as “Stopwatch” and “Motion” studies. Was performed the analysis of the efficiency index of OEE equipment using the comparable indexes performance of equipment in the Russian practice. An important indicator of OEE contains three components. The meaning of each of them reflects historically applicable indicators. The value of the availability of equipment indicator is close to the value of the equipment extensibility index. The value of the indicator of the efficiency of work can be compared with the characteristic of the capacity of the equipment and the indicator of the quality level can meet the requirements for compliance with the manufacturing technology. Shown that the sum of the values of the coefficient of “Availability” of the equipment and the value of the “Factor of compaction of working hours” are one. As well as the total value of the indicator “level of quality” and the coefficient of marriage given in the result unit. The measurability of the indicators makes it possible to make a prediction about efficiency of the equipment.

  4. Information technology equipment cooling system

    Science.gov (United States)

    Schultz, Mark D.

    2014-06-10

    According to one embodiment, a system for removing heat from a rack of information technology equipment may include a sidecar indoor air to liquid heat exchanger that cools warm air generated by the rack of information technology equipment. The system may also include a liquid to liquid heat exchanger and an outdoor heat exchanger. The system may further include configurable pathways to connect and control fluid flow through the sidecar heat exchanger, the liquid to liquid heat exchanger, the rack of information technology equipment, and the outdoor heat exchanger based upon ambient temperature and/or ambient humidity to remove heat from the rack of information technology equipment.

  5. Management methodology for pressure equipment

    Science.gov (United States)

    Bletchly, P. J.

    Pressure equipment constitutes a significant investment in capital and a major proportion of potential high-risk plant in many operations and this is particularly so in an alumina refinery. In many jurisdictions pressure equipment is also subject to statutory regulation that imposes obligations on Owners of the equipment with respect to workplace safety. Most modern technical standards and industry codes of practice employ a risk-based approach to support better decision making with respect to pressure equipment. For a management system to be effective it must demonstrate that risk is being managed within acceptable limits.

  6. Cryogenic equipment; Materiel cryogenique

    Energy Technology Data Exchange (ETDEWEB)

    Leger, L; Javellaud, J; Caro, C; Gilguy, R; Testard, O

    1966-06-01

    The cryostats presented here were built from standard parts; this makes it possible to construct a great variety of apparatus at minimum cost. The liquid nitrogen and helium reservoirs were designed so as to reduce losses to a minimum, and so as to make the cryostats as autonomous as possible. The experimental enclosure which is generally placed in the lower part of the apparatus requires a separate study in every case. Furthermore, complete assemblies such as transfer rods, isolated traps and high vacuum valves, were designed with a similar regard for the economic aspects and for the need for standardization. This equipment thus satisfies a great variety of experimental needs; it is readily adaptable and the consumptions of helium and liquid nitrogen are very low. (authors) [French] De nombreuses experiences utilisant les basses temperatures, necessitent l'emploi d'un materiel cryogenique complexe n'existant pas dans le commerce. Les cryostats presentes ici ont ete realises a partir d'elements standard, ce qui permet, malgre la diversite des appareils, de realiser un ensemble a moindre frais. Les reservoirs d'azote et d'helium liquides ont ete concus de facon a limiter les pertes et a conferer au cryostat la plus grande autonomie possible. L'enceinte experimentale situee en general dans la partie inferieure de l'appareil necessite dans tous les cas une etude speciale. D'autre part des ensembles complets tels que les cannes de transfert, piege isole, robinet pour vide secondaire, ont ete concus dans le meme souci de rentabilite et de standardisation. Ce materiel peut donc repondre a un grand nombre d'exigences experimentales, il est facilement adaptable, et les consommations d'helium et d'azote liquide sont tres reduites. (auteurs)

  7. Relationship between plasma levels of zonulin, bacterial lipopolysaccharides, D-lactate and markers of inflammation in haemodialysis patients.

    Science.gov (United States)

    Ficek, Joanna; Wyskida, Katarzyna; Ficek, Rafał; Wajda, Jarosław; Klein, Dariusz; Witkowicz, Joanna; Rotkegel, Sylwia; Spiechowicz-Zatoń, Urszula; Kocemba-Dyczek, Joanna; Ciepał, Jarosław; Więcek, Andrzej; Olszanecka-Glinianowicz, Magdalena; Chudek, Jerzy

    2017-04-01

    Increased permeability of the intestinal wall and intestinal dysbiosis may contribute to chronic systemic inflammation, one of the causes of accelerated atherosclerosis and cardiovascular morbidity and mortality burden in patients with chronic kidney disease. The aim of this study was to evaluate the association between markers of intestinal permeability and inflammation in haemodialysis (HD) patients. Plasma concentration of zonulin, haptoglobin, TNFα, IL6, D-lactates and bacterial lipopolysaccharides (LPS) was assessed in blood samples obtained after overnight fast before midweek morning HD session in 150 stable, prevalent HD patients. Daily intake of energy and macronutrients was assessed on the basis of a food frequency questionnaire. Serum hsCRP level was increased in over 70% of patients. Plasma levels of zonulin [11.6 (10.9-12.3) vs 6.8 (5.8-7.8) ng/mL], IL6 [6.2 (1.0-10.3) vs 1.3 (1.0-2.0) pg/mL] and TNFα [5.9 (2.9-11.8) vs 1.6 (1.3-1.8) pg/mL], but not LPS and D-lactates were significantly higher in HD than in healthy controls. D-lactates and LPS levels were weakly associated with IL6 (R = 0.175; p = 0.03, and R = 0.241; p = 0.003). There was a borderline correlation between plasma zonulin and serum hsCRP (R = 0.159; p = 0.07), but not with IL6, LPS and D-lactates. In multiple regression, both serum CRP and plasma IL6 variability were explained by LPS (β = 0.143; p = 0.08 and β = 0.171; p = 0.04, respectively), only. The weak association between plasma D-lactate, LPS and IL6 levels indicates that intestinal flora overgrowth or increased intestinal permeability contributes very slightly to the chronic inflammation development in HD patients.

  8. Social relationships and their impact on health-related outcomes in peritoneal versus haemodialysis patients: a prospective cohort study.

    Science.gov (United States)

    Neumann, Denise; Lamprecht, Juliane; Robinski, Maxi; Mau, Wilfried; Girndt, Matthias

    2018-01-23

    Social relationships are important determinants of health-related outcomes for patients with chronic conditions. However, the effects of social networks and social support on health outcomes of dialysis patients in different treatment modalities have been under studied. We surveyed peritoneal dialysis (PD) and haemodialysis (HD) patients in the Choice of Renal Replacement Therapy project about their social relationships and health-care outcomes at baseline and 1-year follow-up. Two propensity score-matched groups (n = 353; HD = 200, PD = 153) with similar age, comorbidity level, education and employment status were compared. We used an ego-centred Network Generator to assess quantitative and qualitative aspects of social networks and the Berlin Social Support Scales to evaluate dimensions of social support, and analysed the effects of the social variables on anxiety, depression, autonomy preferences, and physical and psychological quality of life. Over time, the non-family networks (e.g. friends) of both groups decreased (P = 0.04) and the absolute number of types of relationships increased (P = 0.01). The family-network size, quality of relationships and social support remained stable. Larger social networks were associated with higher participation-seeking preferences (B = 1.39, P = 0.002) and lower anxiety (B = -0.11, P = 0.03). Closer and more satisfying relationships were associated with better psychological well-being (B = 3.41, P = 0.003). PD patients had larger networks, more types of relationships and received more social support than HD patients (P ≤ 0.05). These differences may reflect the degree of autonomy and self-care associated with the different treatment modalities. In practice, our findings suggest that the early identification and inclusion of persons providing social support for patients may have a positive effect on different aspects of their care and quality of life. © The Author(s) 2018

  9. 29 CFR 1926.952 - Mechanical equipment.

    Science.gov (United States)

    2010-07-01

    ... equipment that are not covered with insulating protective equipment. (c) Derrick trucks, cranes and other lifting equipment. (1) All derrick trucks, cranes and other lifting equipment shall comply with subpart N...

  10. 22 CFR 135.32 - Equipment.

    Science.gov (United States)

    2010-04-01

    ... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

  11. 21 CFR 1403.32 - Equipment.

    Science.gov (United States)

    2010-04-01

    ... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

  12. 45 CFR 602.32 - Equipment.

    Science.gov (United States)

    2010-10-01

    ... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

  13. 49 CFR 18.32 - Equipment.

    Science.gov (United States)

    2010-10-01

    ... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

  14. 34 CFR 80.32 - Equipment.

    Science.gov (United States)

    2010-07-01

    ... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

  15. 10 CFR 600.232 - Equipment.

    Science.gov (United States)

    2010-01-01

    ... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

  16. 45 CFR 1183.32 - Equipment.

    Science.gov (United States)

    2010-10-01

    ... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

  17. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

    Directory of Open Access Journals (Sweden)

    Tomaras V

    2008-11-01

    Full Text Available Abstract Background The study examines differences regarding quality of life (QoL, mental health and illness beliefs between in-centre haemodialysis (HD and continuous ambulatory peritoneal dialysis (CAPD/PD patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients consisted of: a 77 in-centre haemodialysis (HD and 58 continuous ambulatory peritoneal dialysis (CAPD/PD patients, all currently being treated by dialysis for varied length of time. Patients were compared for differences after being grouped into those who recently commenced treatment ( 4 years. Next, cases were selected as to form two equivalent groups of HD and CAPD/PD patients in terms of length of treatment and sociodemographic variables. The groups consisted of: a 41 in-centre haemodialysis (HD and b 48 continuous ambulatory peritoneal dialysis (CAPD/PD patients, fitting the selection criteria of recent commencement of treatment and similar sociodemographic characteristics. Patient-reported assessments included: WHOQOL-BREF, GHQ-28 and the MHLC, which is a health locus of control inventory. Results Differences in mean scores were mainly observed in the HD patients with > 4 years of treatment, providing lower mean scores in the QoL domains of physical health, social relationships and environment, as well as in overall mental health. Differences in CAPD/PD groups, between those in early and those in later years of treatment, were not found to be large and significant. Concerning the analysis on equivalent groups derived from selection of cases, HD patients indicated significantly lower mean scores in the QoL domain of environment and higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression, indicating more symptoms in these areas

  18. Eco-dialysis: the financial and ecological costs of dialysis waste products: is a 'cradle-to-cradle' model feasible for planet-friendly haemodialysis waste management?

    Science.gov (United States)

    Piccoli, Giorgina Barbara; Nazha, Marta; Ferraresi, Martina; Vigotti, Federica Neve; Pereno, Amina; Barbero, Silvia

    2015-06-01

    Approximately 2 million chronic haemodialysis patients produce over 2,000,000 tons of waste per year that includes about 600,000 tons of potentially hazardous waste. The aim of the present study was to analyse the characteristics of the waste that is produced through chronic haemodialysis in an effort to identify strategies to reduce its environmental and financial impact. The study included three dialysis machines and disposables for bicarbonate dialysis, haemodiafiltration (HFR) and lactate dialysis. Hazardous waste is defined as waste that comes into contact with bodily fluids. The weight and cost of waste management was evaluated by various policies of differentiation, ranging from a careful-optimal differentiation to a careless one. The amount of time needed for optimal management was recorded in 30 dialysis sessions. Non-hazardous materials were assessed for potential recycling. The amount of plastic waste that is produced per dialysis session ranges from 1.5 to 8 kg (from 1.1 to 8 kg of potentially hazardous waste), depending upon the type of dialysis machine and supplies, differentiation and emptying policies. The financial cost of waste disposal is high, and is mainly related to hazardous waste disposal, with costs ranging from 2.2 to 16 Euro per session (2.7-21 USD) depending on the waste management policy. The average amount of time needed for careful, optimal differentiation disposal is approximately 1 minute for a haemodialysis session and 2 minutes for HFR. The ecological cost is likewise high: less than one-third of non-hazardous waste (23-28%) is potentially recyclable, while the use of different types of plastic, glues, inks and labels prevents the remaining materials from being recycled. Acknowledging the problem of waste management in dialysis could lead to savings of hundreds of millions of Dollars and to the reuse and recycling of hundreds of tons of plastic waste per year on a world-wide scale with considerable financial and ecological savings

  19. Use of complementary and alternative medicine by patients with end-stage renal disease on haemodialysis in Trinidad: A descriptive study.

    Science.gov (United States)

    Bahall, Mandreker

    2017-05-04

    Despite the paucity of scientific evidence, complementary and alternative medicine (CAM) is widely used for the prevention and treatment of illness, holistic care, and counteracting the adverse effects of conventional medicine (CM). This study investigates the use of CAM by patients with end-stage renal disease (ESRD) on haemodialysis. This quantitative study was conducted from November 1, 2014 to December 31, 2014 in the haemodialysis unit at San Fernando General Hospital (San Fernando, Trinidad). Face-to-face questionnaire-based interviews were held with101of 125 eligible patients (response rate, 80.5%) at the chairside during haemodialysis. The completed questionnaires were entered into a secure computer database. Data analysis included descriptive analysis, χ 2 tests, and binary logistic regression analysis. A minority of the patients were CAM users (n = 19; 18.8%). All 19 CAM users took medicinal herbs, 78.9% (n = 15) used spiritual therapy, and 10.5% (n = 2) used alternative systems. Medicinal tea (n = 15; 78.9%), garlic (Allium sativum) (n = 17; 73.7%), and ginger (Zingiber officinale roscoe) (n = 13; 68.4%) were the most commonly used medicinal herbs. Seven (36.8%) patients used Chinese herbal medicines and 3 (15.8%) patients used Aloe vera. All CAM users were willing to use CAM without supervision or monitoring by their doctors while receiving CM. The use of CAM could not be predicted by age, sex, ethnicity, education, religion, marital status, or employment. Nearly all (98%) patients were satisfied with CAM. More than one-third (36.8%) of patients did not disclose their use of CAM to their doctors, who were generally indifferent to such therapy. The use of CAM by patients with ESRD was relatively infrequent. All patients used medicinal herbs, most patients used spiritual therapy, and a minority of patients used alternative systems. Complementary and alternative medicine was primarily used for spiritual reasons and the likelihood of its use

  20. Food Service Equipment and Appurtenances.

    Science.gov (United States)

    National Sanitation Foundation, Ann Arbor, MI.

    Equipment design specifications are presented relating to tables of all kinds, counters, sinks and drainboards, bins, shelves, drawers, hoods and similar kitchen appurtenances, not including baking, roasting, toasting, broiling or frying equipment, food preparation machinery such as slicers, choppers, and cutters, mixers and grinders, steam…

  1. Equipe de trabalho

    Directory of Open Access Journals (Sweden)

    Gabriel Gerber Hornink

    2014-08-01

    Full Text Available   Equipe de Trabalho 2014 1. Equipe editorial Editor-Chefe Bayardo Bapstista Torres, Instituto de Química - USP, Brasil Eduardo Galembeck, Departamento de Bioquímica Instituto de Biologia UNICAMP, Brasil   Editores Gabriel Gerber Hornink, Depto. Bioquímica, Instituto de Ciências Biomédicas, Universidade - Federal de Alfenas - Unifal-MG, Brasil Vera Maria Treis Trindade, Instituto de Ciências Básicas da Saúde, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Brasil   Corpo Editorial Adriana Cassina, Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Uruguai Angel Herráez, Departamento de Bioquímica y Biología molecular, Universidad de Alcalá de Henares, Madrid, Espanha André Amaral Gonçalves Bianco, Universidade Federal de São Paulo (Unifesp, Brasil Denise Vaz de Macedo, Departamento de Bioquímica, Instituto de Biologia, Universidade Estadual de Campinas - Unicamp, Brasil Eneida de Paula, Departamento de Bioquímica, Instituto de Biologia, Universidade Estadual de Campinas - Unicamp, Brasil Guilherme Andrade Marson, Instituto de Química - USP, Brasil Jose Antonio Martinez Oyanedel, Universidad de Concepción, Chile Josep Maria Fernández Novell, Dept. Bioquímica i Biologia Molecular Universitat de Barcelona, Espanha Leila Maria Beltramini, Instituto de Física de São Carlos, Universidade Estadual de São Paulo - USP, Brasil Manuel João da Costa, Escola de Ciências da Saúde, Universidade do Minho, Portugal Maria Lucia Bianconi, Instituto de Bioquímica Médica Universidade Federal do Rio de Janeiro (UFRJ, Brasil María Noel Alvarez, Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Uruguai Miguel Ángel Medina Torres, Department of Molecular Biology & Biochemistry Faculty of Sciences University of Málaga, Espanha Nelma Regina Segnini Bossolan, Instituto de Física de São Carlos, Universidade de São Paulo - USP, Brasil Paulo De Avila

  2. Information technology equipment cooling method

    Science.gov (United States)

    Schultz, Mark D.

    2015-10-20

    According to one embodiment, a system for removing heat from a rack of information technology equipment may include a sidecar indoor air to liquid heat exchanger that cools air utilized by the rack of information technology equipment to cool the rack of information technology equipment. The system may also include a liquid to liquid heat exchanger and an outdoor heat exchanger. The system may further include configurable pathways to connect and control fluid flow through the sidecar heat exchanger, the liquid to liquid heat exchanger, the rack of information technology equipment, and the outdoor heat exchanger based upon ambient temperature and/or ambient humidity to remove heat generated by the rack of information technology equipment.

  3. Strategies to increase patient safety in haemodialysis: Application of the modal analysis system of errors and effects (FEMA system

    Directory of Open Access Journals (Sweden)

    María Dolores Arenas Jiménez

    2017-11-01

    Full Text Available Background: Haemodialysis (HD patients are a high-risk population group. For these patients, an error could have catastrophic consequences. Therefore, system that ensures the safety of these patients in an environment with high technology and great interaction of the human factor is a requirement. Objectives: To show a systematic working approach, reproducible in any HD unit, which consists of recording the complications and errors that occurred during the HD session; defining which of those complications could be considered adverse event (AE, and therefore preventable; and carrying out a systematic analysis of them, as well as of underlying real or potential errors, evaluating their severity, frequency and detection; as well as establishing priorities for action (Failure Mode and Effects Analysis system [FMEA systems]. Methods: Retrospective analysis of the graphs of all HD sessions performed during one month (October 2015 on 97 patients, analysing all recorded complications. The consideration of these complications as AEs was based on a consensus among 13 health professionals and 2 patients. The severity, frequency and detection of each AE were evaluated by the FMEA system. Results: We analysed 1303 HD treatments in 97 patients. A total of 383 complications (1 every 3.4 HD treatments were recorded. Approximately 87.9% of them were deemed AEs and 23.7% complications related with patients’ underlying pathology. There was one AE every 3.8 HD treatments. Hypertension and hypotension were the most frequent AEs (42.7 and 27.5% of all AEs recorded, respectively. Vascular-access related AEs were one every 68.5 HD treatments. A total of 21 errors (1 every 62 HD treatments, mainly related to the HD technique and to the administration of prescribed medication, were registered. The highest risk priority number, according to the FMEA, corresponded to errors related to patient body weight; dysfunction/rupture of the catheter; and needle extravasation

  4. Effects of angiotensin II blockade on intermediate cardiovascular endpoints in haemodialysis patients: a randomised double-blind placebo-controlled one-year intervention trial (SAFIR study)

    DEFF Research Database (Denmark)

    Peters, Christian Daugaard; Kjærgaard, Krista Dybtved; Jensen, Jens Dam

    Agents blocking the renin-angiotensin-aldosterone system are frequently used in end-stage renal disease patients, but whether they exert beneficial cardiovascular (CV) effects is unclear. The long-term effects of the angiotensin II receptor blocker irbesartan was investigated in 82 haemodialysis...... renal function. Brachial BP decreased significantly in both groups, but there was no significant difference between placebo and irbesartan treated. Use of additional antihypertensive medication, ultrafiltration volume, and dialysis dosage were not different in the two groups. Intermediate CV endpoints...... such as central aortic BP, carotid-femoral pulse wave velocity, left ventricular mass index, N-terminal prohormone of brain natriuretic peptide, heart rate variability, and plasma catecholamines were not significantly affected by irbesartan treatment. Changes in systolic BP during the study period correlated...

  5. Development of manufacturing equipment and QC equipment for DUPIC fuel

    International Nuclear Information System (INIS)

    Yang, Myung Seung; Park, J.J.; Lee, J.W.; Kim, S.S.; Yim, S.P.; Kim, J.H.; Kim, K.H.; Na, S.H.; Kim, W.K.; Shin, J.M.; Lee, D.Y.; Cho, K.H.; Lee, Y.S.; Sohn, J.S.; Kim, M.J.

    1999-05-01

    In this study, DUPIC powder and pellet fabrication equipment, welding system, QC equipment, and fission gas treatment are developed to fabricate DUPIC fuel at IMEF M6 hot cell. The systems are improved to be suitable for remote operation and maintenance with the manipulator at hot cell. Powder and pellet fabrication equipment have been recently developed. The systems are under performance test to check remote operation and maintenance. Welding chamber and jigs are designed and developed to remotely weld DUPIC fuel rod with manipulators at hot cell. Remote quality control equipment are being tested for analysis and inspection of DUPIC fuel characteristics at hot cell. And trapping characteristics is analyzed for cesium and ruthenium released under oxidation/reduction and sintering processes. The design criteria and process flow diagram of fission gas treatment system are prepared incorporating the experimental results. The fission gas treatment system has been successfully manufactured. (Author). 33 refs., 14 tabs., 91 figs

  6. Assessing the Association between Serum Ferritin, Transferrin Saturation, and C-Reactive Protein in Northern Territory Indigenous Australian Patients with High Serum Ferritin on Maintenance Haemodialysis

    Directory of Open Access Journals (Sweden)

    Sandawana William Majoni

    2017-01-01

    Full Text Available Objective. To determine the significance of high serum ferritin observed in Indigenous Australian patients on maintenance haemodialysis in the Northern Territory, we assessed the relationship between ferritin and transferrin saturation (TSAT as measures of iron status and ferritin and C-reactive protein (CRP as markers of inflammation. Methods. We performed a retrospective cohort analysis of data from adult patients (≥18 years on maintenance haemodialysis (>3 months from 2004 to 2011. Results. There were 1568 patients. The mean age was 53.9 (11.9 years. 1244 (79.3% were Indigenous. 44.2% (n=693 were male. Indigenous patients were younger (mean age [52.3 (11.1 versus 57.4 (15.2, p<0.001] and had higher CRP [14.7 mg/l (7–35 versus 5.9 mg/l (1.9–17.5, p<0.001], higher median serum ferritin [1069 µg/l (668–1522 versus 794.9 µg/l (558.5–1252.0, p<0.001], but similar transferrin saturation [26% (19–37 versus 28% (20–38, p=0.516]. We observed a small positive correlation between ferritin and TSAT (r2=0.11, p<0.001, no correlation between ferritin and CRP (r2 = 0.001, p<0.001, and positive association between high serum ferritin and TSAT (p<0.001, Indigenous ethnicity (p<0.001, urea reduction ratio (p=0.001, and gender (p<0.001 after adjustment in mixed regression analysis. Conclusion. Serum ferritin and TSAT may inadequately reflect iron status in this population. The high ferritin was poorly explained by inflammation.

  7. TRANSPORT AND EMPLACEMENT EQUIPMENT DESCRIPTIONS

    International Nuclear Information System (INIS)

    1997-01-01

    The objective and the scope of this document are to list and briefly describe the major mobile equipment necessary for waste package (WP) Transport and Emplacement in the proposed subsurface nuclear waste repository at Yucca Mountain. Primary performance characteristics and some specialized design features of the equipment are explained and summarized in the individual subsections of this document. The Transport and Emplacement equipment described in this document consists of the following: (1) WP Transporter; (2) Reusable Rail Car; (3) Emplacement Gantry; (4) Gantry Carrier; and (5) Transport Locomotive

  8. Containment and Surveillance Equipment Compendium

    International Nuclear Information System (INIS)

    Luetters, F.O.

    1980-02-01

    The Containment and Surveillance Equipment Compendium contains information sections describing the application and status of seals, optical surveillance systems, and monitors for international safeguards systems. The Compendium is a collection of information on equipment in use (generally by the IAEA) or under development in the US in diverse programs being conducted at numerous facilities under different sponsors. The Compendium establishes a baseline for the status and applications of C/S equipment and is a tool to assist in the planning of future C/S hardware development activities. The Appendix contains design concepts which can be developed to meet future goals

  9. Data Center Equipment Location and Monitoring System

    DEFF Research Database (Denmark)

    2013-01-01

    Abstract: Data center equipment location systems include hardware and software to provide information on the location, monitoring, and security of servers and other equipment in equipment racks. The systems provide a wired alternative to the wireless RFID tag system by using electronic ID tags...... connected to each piece of equipment, each electronic ID tag connected directly by wires to an equipment rack controller on the equipment rack. The equipment rack controllers link to a central control computer that provides an operator ...

  10. EAS Equipment Authorization Grantee Registrations

    Data.gov (United States)

    Federal Communications Commission — EAS (Equipment Authorization System). Radio Frequency (RF) devices are required to be properly authorized under 47 CFR Part 2 prior to being marketed or imported...

  11. ENERGY STAR Certified Imaging Equipment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Imaging Equipment that are effective as of...

  12. EMR Measurements on NDA Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Macdonell, Alexander Thomas [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Meierbachtol, Krista Cruse [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Evans, James Walter Jr. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Mayo, Douglas R. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-07-10

    Electromagnetic radiation (EMR) emission strength measurements were performed on a suite of passive non-destructive assay (NDA) radiation detection equipment. Data were collected from 9 kHz up to 6 GHz on each of the assembled systems.

  13. Mongolia - Vocational Education - Equipment Upgrades

    Data.gov (United States)

    Millennium Challenge Corporation — Evaluation design The impact evaluation sought to identify the causal impact of exposure to equipment upgrades on subsequent outcomes. Insofar as we were not able to...

  14. Origins of eponymous orthopaedic equipment.

    Science.gov (United States)

    Meals, Clifton; Wang, Jeffrey

    2010-06-01

    Orthopaedists make great use of eponymous equipment, however the origins of these tools are unknown to many users. This history enriches, enlightens, and enhances surgical education, and may inspire modern innovation. We explored the origins of common and eponymous orthopaedic equipment. We selected pieces of equipment named for their inventors and in the broadest use by modern orthopaedists. We do not describe specialized orthopaedic implants and instruments owing to the overwhelming number of these devices. The history of this equipment reflects the coevolution of orthopaedics and battlefield medicine. Additionally, these stories evidence the primacy of elegant design and suggest that innovation is often a process of revision and refinement rather than sudden inspiration. Their history exposes surgical innovators as brilliant, lucky, hardworking, and sometimes odd. These stories amuse, enlighten, and may inspire modern orthopaedists to develop creative solutions of their own. The rich history of the field's eponymous instruments informs an ongoing tradition of innovation in orthopaedics.

  15. Operation monitor for plant equipment

    International Nuclear Information System (INIS)

    Kondo, Tetsufumi; Kanemoto, Shigeru.

    1991-01-01

    In a nuclear power plant, states of each of equipment in the plant are monitored accurately even under such a operation condition that the power is changed. That is, the fundamental idea is based on a model comparison method. A deviation between an output signal upon normal plant state obtained in a forecasting model device and that of the objective equipment in the plant are compared with a predetermined value. The result of the comparison is inputted to an alarm device to alarm the abnormality of the states of the equipment to an operator. The device of the present invention thus constituted can monitor the abnormality of the operation of equipment accurately even under such a condition that a power level fluctuates. As a result, it can remarkably contribute to mitigate operator's monitoring operation under the condition such as during load following operation. (I.S.)

  16. Equipment improvements for performance enhancement

    International Nuclear Information System (INIS)

    Gaestel, P.; Guesnon, H.; Sauze, G.

    1994-01-01

    In order to enhance the reactor availability, several improvements on reactor equipment have been developed: design optimization for stator maintenance replacement in the main alternator; adjustment modification of stator coils in the main alternator for an easier maintenance; improvement of the fuel handling line (pole crane, transfer equipment, loading machine); development of a loose part trapping system in the steam generator secondary circuit. 1 tab

  17. Low level photoneutron detection equipment

    International Nuclear Information System (INIS)

    Ji Changsong; Zhang Yuqin; Li Yuansui

    1991-01-01

    A low level photoneutron detection equipment has been developed. The photoneutrons produced by interaction of 226 Ra gamma quanta and deutron (D) target are detected with n-n discrimination detector made up of 3 He proportional counter array. The D-content information in the target can be obtained from the measured photoneutron counts. The equipment developed is mainly used for nondestructive D-content measurement of D-devices

  18. FUSRAP equipment concept development study

    International Nuclear Information System (INIS)

    Hinerman, K.B.; Smith, R.E.

    1981-01-01

    Under DOE contract, Dalton-Dalton-Newport, Inc. is performing an engineering evaluation of three selected FUSRAP sites in an effort to generate equipment concepts to perform remedial action for retrieval, packaging, storing, and transporting contaminated soil and other debris. Along with this engineering evaluation, an analysis of state and Federal regulations was made which had significant impact on the selected equipment and costs for each remedial action concept

  19. Remotely operated replaceable process equipment

    International Nuclear Information System (INIS)

    Westendorf, H.

    1987-01-01

    The coupling process of pneumatic and electrical auxiliary lines of a pneumatic control pressure line in a large cell of the reprocessing plant is carried out, together with the coupling process of the connecting flange of the process equipment. The coupling places of the auxiliary lines, such as control or supply lines, are laid in the flange parts of the flanges to be connected. The pipe flange on the frame side remains flush with the connecting flange of the process equipment. (DG) [de

  20. Partners in qualified equipment supply

    International Nuclear Information System (INIS)

    Rygg, D.E.; O'Hare, G.J.

    1993-01-01

    Industry initiatives have been taken to improve procurement practices and commercial dedication programs, formation of procurement engineering groups, emphasis on product quality, and increased engineering involvement in procurement and maintenance of qualified equipment. This poses new challenges for many licensees in terms of resources, product knowledge, and access to information normally held proprietary by equipment suppliers. Alternative approaches to future licensee/Westinghouse relationships which will allow licensees to adapt to the changing environment are discussed. 2 figs

  1. 29 CFR 97.32 - Equipment.

    Science.gov (United States)

    2010-07-01

    ...) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be replaced as... equipment (including replacement equipment), whether acquired in whole or in part with grant funds, until... established to ensure the highest possible return. (e) Disposition. When original or replacement equipment...

  2. 44 CFR 13.32 - Equipment.

    Science.gov (United States)

    2010-10-01

    ...) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be replaced as... equipment (including replacement equipment), whether acquired in whole or in part with grant funds, until... established to ensure the highest possible return. (e) Disposition. When original or replacement equipment...

  3. 24 CFR 85.32 - Equipment.

    Science.gov (United States)

    2010-04-01

    ...) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be replaced as... equipment (including replacement equipment), whether acquired in whole or in part with grant funds, until... established to ensure the highest possible return. (e) Disposition. When original or replacement equipment...

  4. 41 CFR 105-71.132 - Equipment.

    Science.gov (United States)

    2010-07-01

    .... (4) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be... managing equipment (including replacement equipment), whether acquired in whole or in part with grant funds... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Equipment. 105-71.132...

  5. 43 CFR 12.72 - Equipment.

    Science.gov (United States)

    2010-10-01

    ...) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be replaced as... equipment (including replacement equipment), whether acquired in whole or in part with grant funds, until... established to ensure the highest possible return. (e) Disposition. When original or replacement equipment...

  6. 1968 Listing of Swimming Pool Equipment.

    Science.gov (United States)

    National Sanitation Foundation, Ann Arbor, MI. Testing Lab.

    An up-to-date listing of swimming pool equipment including--(1) companies authorized to display the National Sanitation Foundation seal of approval, (2) equipment listed as meeting NSF swimming pool equipment standards relating to diatomite type filters, (3) equipment listed as meeting NSF swimming pool equipment standard relating to sand type…

  7. Performance monitoring of safeguards equipment

    International Nuclear Information System (INIS)

    Sirisena, K.; Peltoranta, M.; Goussarov, V.; Vodrazka, P.

    1999-01-01

    SGTCS is responsible for monitoring and reporting the performance of the SG equipment. Performance monitoring (PM) has been implemented in most important safeguards equipment operating unattended in nuclear facilities. Inspectors acquire equipment performance data in facilities. After inspection, the data package is submitted to SGTCS for processing and analysis. The performance data is used for identification of systems or components, which should be changed in the field and for identification of modules which, should be diagnosed at HQ in order to determine the cause of failure. Moreover, the performance data is used for preventive maintenance and spares distribution planning, and to provide statistics for official reports and management decision making. An important part of the performance monitoring is reporting. Equipment performance reports contain information about equipment inventory, utilization, failure types, failure distribution, and reliability. Trends in performance are given in graphical form in cases, where past data is available. Reliability estimates such as expected times between failures are provided. The automated reporting tools are obtainable through EMIS database application. (author)

  8. AVM branch vibration test equipment

    International Nuclear Information System (INIS)

    Anne, J.P.

    1995-01-01

    An inventory of the test equipment of the AVM Branch ''Acoustic and Vibratory Mechanics Analysis Methods'' group has been undertaken. The purpose of this inventory is to enable better acquaintance with the technical characteristics of the equipment, providing an accurate definition of their functionalities, ad to inform potential users of the possibilities and equipment available in this field. The report first summarizes the various experimental surveys conduced. Then, using the AVM equipment database to draw up an exhaustive list of available equipment, it provides a full-scope picture of the vibration measurement systems (sensors, conditioners and exciters) and data processing resources commonly used on industrial sites and in laboratories. A definition is also given of a mobile test unit, called 'shelter', and a test bench used for the testing and performance rating of the experimental analysis methods developed by the group. The report concludes with a description of two fixed installations: - the calibration bench ensuring the requisite quality level for the vibration measurement systems ; - the training bench, whereby know-how acquired in the field in the field of measurement and experimental analysis processes is made available to others. (author). 27 refs., 15 figs., 2 appends

  9. 78 FR 25916 - Authorization of Radiofrequency Equipment

    Science.gov (United States)

    2013-05-03

    ...] Authorization of Radiofrequency Equipment AGENCY: Federal Communications Commission. ACTION: Proposed rule... bodies, and measurement procedures used to determine RF equipment compliance. The Commission believes... Commission is responsible for an equipment authorization program for radiofrequency (RF) devices under part 2...

  10. Another donation of computer equipment

    CERN Multimedia

    Anaïs Schaeffer

    2014-01-01

    On Thursday 27 February, CERN was pleased to donate computer equipment to a physics institute in the Philippines.   H.E. Leslie J. Baja and Rolf Heuer. Following donations of computer equipment to institutes in Morocco, Ghana, Bulgaria, Serbia and Egypt, CERN is to send 50 servers and 4 network switches to the National Institute of Physics at the University of the Philippines Diliman. CERN’s Director-General Rolf Heuer and the Ambassador of the Philippines to Switzerland and Lichtenstein, H.E. Leslie J. Baja, spoke of their enthusiasm for the project during an official ceremony. The equipment will be used for various high energy physics research programmes in the Philippines and for the University’s development of digital resources for science.

  11. Waste Electrical and Electronic Equipment

    DEFF Research Database (Denmark)

    Bigum, Marianne Kristine Kjærgaard; Christensen, Thomas Højlund

    2011-01-01

    Waste electrical and electronic equipment (WEEE) is one of the fastest growing special waste types with an estimated growth of 3–5% per year (Cui and Forssberg, 2003). WEEE is a very heterogeneous waste type that contains many compounds that are considered to be harmful to both humans and the env......Waste electrical and electronic equipment (WEEE) is one of the fastest growing special waste types with an estimated growth of 3–5% per year (Cui and Forssberg, 2003). WEEE is a very heterogeneous waste type that contains many compounds that are considered to be harmful to both humans...

  12. The development of superconducting equipment

    CERN Document Server

    Ueda, T; Hiue, H

    2003-01-01

    Fuji Electric has been developing various types of superconducting equipment for over a quarter of a century. This paper describes the development results achieved for superconducting equipment and especially focuses on large-capacity current leads and superconducting transmission systems, the development of which is being promoted for application to the field of nuclear fusion. High temperature superconductor (HTS) is becoming the mainstream in the field of superconductivity, and the HTS floating coil and conduction-cooled HTS transformed are also introduced as recent developments for devices that utilize this technology. (author)

  13. Mechanical (turbines and auxiliary equipment)

    CERN Document Server

    Sherry, A; Cruddace, AE

    2013-01-01

    Modern Power Station Practice, Volume 3: Mechanical (Turbines and Auxiliary Equipment) focuses on the development of turbines and auxiliary equipment used in power stations in Great Britain. Topics covered include thermodynamics and steam turbine theory; turbine auxiliary systems such as lubrication systems, feed water heating systems, and the condenser and cooling water plants. Miscellaneous station services, and pipework in power plants are also described. This book is comprised of five chapters and begins with an overview of thermodynamics and steam turbine theory, paying particular attenti

  14. Incidencia y tipo de efectos adversos durante el procedimiento de hemodiálisis Incidence and type of adverse effects during the haemodialysis procedure

    Directory of Open Access Journals (Sweden)

    Estela María Matarán Robles

    2013-03-01

    organizations. Objective: To describe the incidence and types of adverse effects deriving from haemodialysis in a nephrology unit. Methodology: Design: Transversal study in 28-bed haemodialysis unit. Variables: as a dependent variable, the present of adverse effects and typology was considered, using the International Classification for Patient Safety. Statistical analyses: a description of the sample was carried out, using graphs (histograms, bar diagrams, and dispersion diagrams and also percentages, means, standard deviations, medians, etc. Results: During the period studied a total of 4797 haemodialysis procedures were carried out, with adverse effects arising in a total of 681 sessions, which represents an incidence rate of 141.96 per 1000 dialyses. As far as severity is concerned, 97.5% of the adverse effects were classified as mild, compared to 1.8% and 0.7% which were considered moderate and serious, respectively. Conclusions: Our incidence rate and severity of adverse effects is similar to other centres. This study lets us identify safety problems in our Unit and in a second phase establish a joint protocol which will allow us to reduce the current incident rate. Hypotension was the most common adverse effect.

  15. Damage limits of accelerator equipment

    CERN Document Server

    Rosell, Gemma

    2014-01-01

    Beam losses occur in particle accelerators for various reasons. The effect of lost particles on accelerator equipment becomes more severe with the increasing energies and intensities. The present study is focused on the damage potential of the proton beam as a function of particle energy and beam size. Injection and extraction energies of different accelerators at CERN were considered.

  16. Pocket dictionary of laboratory equipment

    International Nuclear Information System (INIS)

    Junge, H.D.

    1987-01-01

    This pocket dictionary contains the 2500 most common terms for scientific and technical equipment in chemical laboratories. It is a useful tool for those who are used to communicating in German and English, but have to learn the special terminology in this field. (orig.) [de

  17. Using Gaming Equipment to Teach

    Science.gov (United States)

    Curriculum Review, 2009

    2009-01-01

    Gaming equipment (such as Nintendo's Wii[TM]) is making its way to schools and classrooms. However, most of the discussion regarding how to use this technology and integrate it into lesson plans is happening in blogs on the Internet. An advocate of interactive media in the classroom, Dr. Dawn Hawkins, a faculty member for the Art Institute of…

  18. Isotope-equipped measuring instruments

    International Nuclear Information System (INIS)

    Miyagawa, Kazuo; Amano, Hiroshi

    1980-01-01

    In the steel industry, though the investment in isotope-equipped measuring instruments is small as compared with that in machinery, they play important role in the moisture measurement in sintering and blast furnaces, the thickness measurement in rolling process and others in automatic control systems. The economic aspect of the isotope-equipped measuring instruments is described on the basis of the practices in Kimitsu Works of Nippon Steel Corporation: distribution of such instruments, evaluation of economic effects, usefulness evaluation in view of raising the accuracy, and usefulness evaluation viewed from the failure of the isotope instruments. The evaluation of economic effects was made under the premise that the isotope-equipped measuring instruments are not employed. Then, the effects of raising the accuracy are evaluated for a γ-ray plate thickness gauge and a neutron moisture gauge for coke in a blast furnace. Finally, the usefulness was evaluated, assuming possible failure of the isotope-equipped measuring instruments. (J.P.N.)

  19. Hydraulic turbines and auxiliary equipment

    Energy Technology Data Exchange (ETDEWEB)

    Luo Gaorong [Organization of the United Nations, Beijing (China). International Centre of Small Hydroelectric Power Plants

    1995-07-01

    This document presents a general overview on hydraulic turbines and auxiliary equipment, emphasizing the turbine classification, in accordance with the different types of turbines, standard turbine series in China, turbine selection based on the basic data required for the preliminary design, general hill model curves, chart of turbine series and the arrangement of application for hydraulic turbines, hydraulic turbine testing, and speed regulating device.

  20. Apolipoprotein A-IV concentrations and clinical outcomes in haemodialysis patients with type 2 diabetes mellitus--a post hoc analysis of the 4D Study.

    Science.gov (United States)

    Kollerits, B; Krane, V; Drechsler, C; Lamina, C; März, W; Ritz, E; Wanner, C; Kronenberg, F

    2012-12-01

    Apolipoprotein A-IV (apoA-IV) is an anti-atherogenic and anti-oxidative plasma glycoprotein involved in reverse cholesterol transport. The aim of this study was to examine the association between apoA-IV and all-cause mortality, cardiovascular endpoints and parameters of protein-energy wasting and nutrition in haemodialysis patients. This post hoc analysis was performed in the German Diabetes Dialysis Study (4D Study) evaluating atorvastatin in 1255 haemodialysis patients with type 2 diabetes mellitus, followed for a median of 4 years. The association between apoA-IV and relevant outcomes was analysed using Cox proportional hazards regression analyses. Body mass index (BMI) was used as a marker of protein-energy wasting. In addition, a definition of extended wasting was applied, combining median values of BMI, serum albumin, creatinine and sensitive C-reactive protein, to classify patients. Mean (±SD) apoA-IV concentration was 49.8 ± 14.2 mg dL(-1). Age- and gender-adjusted apoA-IV concentrations were strongly associated with the presence of congestive heart failure at baseline [odds ratio = 0.81, 95% confidence interval (CI) 0.74-0.88 per 10 mg dL(-1) increase; P 1). During the prospective follow-up, the strongest association was found for all-cause mortality [hazard ratio (HR) = 0.89, 95% CI 0.85-0.95, P = 0.001), which was mainly because of patients with BMI > 23 kg m(-2) (HR = 0.87, 95% CI 0.82-0.94, P 1) and those in the nonwasting group according to the extended definition (HR = 0.89, 95% CI 0.84-0.96, P = 0.001). This association remained significant after additionally adjusting for parameters associated with apoA-IV at baseline. Further associations were observed for sudden cardiac death. ApoA-IV was less strongly associated with atherogenic events such as myocardial infarction. Low apoA-IV levels seem to be a risk predictor of all-cause mortality and sudden cardiac death. This association might be modified by nutritional status. © 2012 The Association

  1. Drug Utilisation Pattern and Adverse Events in Patients with Chronic Kidney Disease Undergoing Maintenance Haemodialysis at a Tertiary Care Hospital of Odisha

    Directory of Open Access Journals (Sweden)

    P. Ansuman Abhisek

    2017-10-01

    Full Text Available Introduction: The number of patients receiving renal replacement therapy in the form of dialysis or transplant has been increasing in recent years. Increased frequency of monitoring due to complex therapeutic regimen and inappropriate use of drugs may lead to increased Adverse Events (AEs, hospital stay, cost of treatment as well as increased morbidity and mortality. Aim: To analyse utilisation pattern of drugs and AEs in Chronic Kidney Disease (CKD patients undergoing maintenance haemodialysis. Materials and Methods: This prospective, observational study was conducted in the Department of Pharmacology in collaboration with Department of Nephrology, SCB Medical College and Hospital, Cuttack, from 1st June to 31st December, 2015. Demographic, clinical and medicine details were collected from patients’ case sheet, matched with nursing case records and tabulated in a predesigned case study form. The data were analysed in a descriptive manner using percentage calculation and Spearman’s correlation, multiple logistic regression using trial version SPSS v24. Results: A total number of 115 cases were included in this study. Average number of drugs used, per prescription was 12.8 during the dialysis and non-dialysis days. Most frequently used drugs were antihypertensives, 25% dextrose and heparin (before dialysis and on dialysis days were prescribed to all patients followed by haematinics in 90.43% of the patients and proton pump inhibitors were prescribed in 70.43% of the patients. Among 1472 drugs prescribed, 40.96% of the drugs were prescribed in generic name. It was observed that 72.62% of the prescribed drugs were from National List of Essential Medicine. AEs were observed with varying severity in all the patients. Frequently observed AEs as per the laboratory investigations were hyperphosphataemia, hyponatraemia, metabolic acidosis, hyperkalemia, hypoglycaemia, hypocalcaemia and hypokalemia. AEs were statistically significant with age group

  2. Alternative Fuels Data Center: Biodiesel Equipment Options

    Science.gov (United States)

    Equipment Options to someone by E-mail Share Alternative Fuels Data Center: Biodiesel Equipment Options on Facebook Tweet about Alternative Fuels Data Center: Biodiesel Equipment Options on Twitter Bookmark Alternative Fuels Data Center: Biodiesel Equipment Options on Google Bookmark Alternative Fuels

  3. 40 CFR 792.61 - Equipment design.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Equipment design. 792.61 Section 792.61...) GOOD LABORATORY PRACTICE STANDARDS Equipment § 792.61 Equipment design. Equipment used in the... of appropriate design and adequate capacity to function according to the protocol and shall be...

  4. 40 CFR 160.61 - Equipment design.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Equipment design. 160.61 Section 160... LABORATORY PRACTICE STANDARDS Equipment § 160.61 Equipment design. Equipment used in the generation... appropriate design and adequate capacity to function according to the protocol and shall be suitably located...

  5. 21 CFR 58.61 - Equipment design.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Equipment design. 58.61 Section 58.61 Food and... PRACTICE FOR NONCLINICAL LABORATORY STUDIES Equipment § 58.61 Equipment design. Equipment used in the... of appropriate design and adequate capacity to function according to the protocol and shall be...

  6. 34 CFR 74.34 - Equipment.

    Science.gov (United States)

    2010-07-01

    ... as program income. (e) When acquiring replacement equipment, the recipient may use the equipment to... replacement equipment subject to the approval of the Secretary. (f) The recipient's property management... 34 Education 1 2010-07-01 2010-07-01 false Equipment. 74.34 Section 74.34 Education Office of the...

  7. 20 CFR 437.32 - Equipment.

    Science.gov (United States)

    2010-04-01

    ... contemplated by Federal statute. (4) When acquiring replacement equipment, the grantee or subgrantee may use.... Procedures for managing equipment (including replacement equipment), whether acquired in whole or in part... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Equipment. 437.32 Section 437.32 Employees...

  8. 45 CFR 2541.320 - Equipment.

    Science.gov (United States)

    2010-10-01

    ... replacement equipment, the grantee or subgrantee may use the equipment to be replaced as a trade-in or sell... replacement equipment), whether acquired in whole or in part with grant funds, until disposition takes place... ensure the highest possible return. (e) Disposition. When original or replacement equipment acquired...

  9. 45 CFR 1174.32 - Equipment.

    Science.gov (United States)

    2010-10-01

    ... contemplated by Federal statute. (4) When acquiring replacement equipment, the grantee or subgrantee may use... requirements. Procedures for managing equipment (including replacement equipment), whether acquired in whole or... original or replacement equipment acquired under a grant or subgrant is no longer needed for the original...

  10. 45 CFR 1157.32 - Equipment.

    Science.gov (United States)

    2010-10-01

    ... contemplated by Federal statute. (4) When acquiring replacement equipment, the grantee or subgrantee may use... requirements. Procedures for managing equipment (including replacement equipment), whether acquired in whole or... original or replacement equipment acquired under a grant or subgrant is no longer needed for the original...

  11. The Cost of Maintaining Educational Communications Equipment.

    Science.gov (United States)

    Humphrey, David A.

    Tentative formulas for calculating the cost of maintaining educational communications equipment are proposed. The formulas are based on a survey of campuses of the State University of New York. The survey analyzed the types of equipment to be maintained, types of maintenance, who uses the equipment, who services the equipment, and the cost…

  12. Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas

    International Nuclear Information System (INIS)

    Das, Neelan; Bratby, Mark J.; Shrivastava, Vivek; Cornall, Alison J.; Darby, Christopher R.; Boardman, Philip; Anthony, Susan; Uberoi, Raman

    2011-01-01

    Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa ® , Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4–270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graft at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.

  13. Comparison of resting energy equations and total energy expenditure in haemodialysis patients and body composition measured by multi-frequency bioimpedance.

    Science.gov (United States)

    Oliveira, Ben; Sridharan, Sivakumar; Farrington, Ken; Davenport, Andrew

    2017-07-13

    Waste products of metabolism are retained in haemodialysis (HD) patients. Cellular metabolism generates energy, and patients with greater energy expenditure may therefore require more dialysis. To determine the amount of dialysis required, equations estimating resting and total energy expenditure (REE,TEE) are required. We compared estimates of REE in HD patients using established equations with a novel equation recently validated in HD patients (HD equation). TEE was derived from REE (HD equation) and estimates of physical activity obtained by questionnaire. REE and TEE relationships with bioimpedance measured body composition were then determined. We studied 317 HD patients; 195 males (61.5%), 123 diabetic (38.9%), mean age 65.0 ± 15.3 and weight 73.1 ± 16.8 kg. REE from HD Equation was 1509 ± 241 kcal/day, which was greater than for Mifflin St Joer 1384 ± 259, Harris-Benedict 1437 ± 244, Katch-McArdle 1345 ± 232 (all p employment (β 406.5, p appearance (β 2.7, p = 0.015), and negatively with age (β -7.9, p appearance, lower co-morbidity, age, and dialysis vintage, and the employed. More metabolically active patients may require greater dialytic clearances. This article is protected by copyright. All rights reserved.

  14. Single- and multi-frequency bioelectrical impedance analyses to analyse body composition in maintenance haemodialysis patients: comparison with dual-energy x-ray absorptiometry

    International Nuclear Information System (INIS)

    Donadio, C; Halim, A Ben; Caprio, F; Grassi, G; Khedr, B; Mazzantini, M

    2008-01-01

    The aim of this study was to evaluate the adequacy of single-frequency (sf-BIA) and multi-frequency bioelectrical impedance analyses (mf-BIA), in comparison with dual-energy x-ray absorptiometry (DXA), to evaluate body composition in maintenance haemodialysis (MHD) patients. Body composition of 27 adult MHD patients (9 f, 18 m), BMI 17.5–34.4 kg m −2 , was examined with DXA and BIA, with two different sf-BIA and 1 mf-BIA analysers. Biochemical markers of nutritional status and adequacy of dialytic treatment were also determined. Fat mass (FM) estimated by the different BIA analysers was found to be slightly but significantly higher than FM measured by DXA. In contrast, fat-free mass (FFM) obtained with BIA was found to be slightly but significantly lower than FFM DXA. No significant differences were found between LBM-DXA (that is FFM-DXA minus bone mass) and the different FFM BIA. The lowest mean prediction error versus DXA values was found with sf1BIA. In any case, a close correlation was found between all BIA values and DXA values, particularly for FFM. Furthermore, FFM and LBM results were significantly correlated with serum creatinine, which in MHD patients is an indicator of muscle mass. These results indicate that BIA can be used to evaluate body composition in MHD patients

  15. Washout of water-soluble vitamins and of homocysteine during haemodialysis: effect of high-flux and low-flux dialyser membranes.

    Science.gov (United States)

    Heinz, Judith; Domröse, Ute; Westphal, Sabine; Luley, Claus; Neumann, Klaus H; Dierkes, Jutta

    2008-10-01

    Vitamin deficiencies are common in patients with end-stage renal disease (ESRD) owing to dietary restrictions, drug-nutrient interactions, changes in metabolism, and vitamin losses during dialysis. The present study investigated the levels of serum and red blood cell (RBC) folate, plasma pyridoxal-5'-phosphate (PLP), serum cobalamin, blood thiamine, blood riboflavin, and plasma homocysteine (tHcy) before and after haemodialysis treatment. Vitamin and tHcy blood concentrations were measured in 30 patients with ESRD before and after dialysis session either with low-flux (n = 15) or high-flux (n = 15) dialysers. After the dialysis procedure, significantly lower concentrations of serum folate (37%), plasma PLP (35%), blood thiamine (6%) and blood riboflavin (7%) were observed. No significant changes were found for serum cobalamin or for RBC folate. There were no differences in the washout of water-soluble vitamins between treatments with low-flux and high-flux membranes. Furthermore, a 41% lower concentration in tHcy was observed. The percentage decrease in tHcy was significantly greater in the patients treated with high-flux dialysers (48% vs 37%; P vitamins measured (r =-0.867, P water-soluble vitamins after dialysis, independently of the dialyser membrane. The monitoring of the vitamin status is essential in patients treated with high-flux dialysers as well as in patients treated with low-flux dialysers.

  16. Defected red blood cell membranes and direct correlation with the uraemic milieu: the connection with the decreased red blood cell lifespan observed in haemodialysis patients

    International Nuclear Information System (INIS)

    Stamopoulos, D; Manios, E; Gogola, V; Grapsa, E; Bakirtzi, N

    2012-01-01

    Together with impaired production of erythropoietin and iron deficiency, the decreased lifespan of red blood cells (RBCs) is a main factor contributing to the chronic anaemia observed in haemodialysis (HD) patients. Atomic force microscopy is employed in this work to thoroughly survey the membrane of intact RBCs (iRBCs) of HD patients in comparison to those of healthy donors, aiming to obtain direct information on the structural status of RBCs that can be related to their decreased lifespan. We observed that the iRBC membrane of the HD patients is overpopulated with extended circular defects, termed ‘orifices’, that have typical dimension ranging between 0.2 and 1.0 μm. The ‘orifice’ index—that is, the mean population of ‘orifices’ per top membrane surface—exhibits a pronounced relative increase of order 54 ± 12% for the HD patients as compared to healthy donors. Interestingly, for the HD patients, the ‘orifice’ index, which relates to the structural status of the RBC membrane, correlates strongly with urea concentration, which is a basic index of the uraemic milieu. Thus, these results indicate that the uraemic milieu downgrades the structural status of the RBC membrane, possibly triggering biochemical processes that result in their premature elimination from the circulation. This process could decrease the lifespan of RBCs, as observed in HD patients. (paper)

  17. Association of vascular access flow with short-term and long-term mortality in chronic haemodialysis patients: a retrospective cohort study.

    Science.gov (United States)

    Wu, Chung-Kuan; Wu, Chia-Lin; Lin, Chia-Hsun; Leu, Jyh-Gang; Kor, Chew-Teng; Tarng, Der-Cherng

    2017-09-24

    To investigate the impact of vascular access flow (Qa) on vascular and all-cause mortality in chronic haemodialysis (HD) patients. Observational cohort study. Single centre. Adult chronic HD patients at the HD unit of Shin Kong Wu Ho-Su Memorial Hospital between 1 January 2003 and 31 December 2003 were recruited. Patients were excluded if they had arteriovenous fistula or arteriovenous graft failure within 3 months before the date of Qa measurement, were aged Short-term and long-term vascular (cardiovascular or cerebrovascular) and all-cause mortality. Qa was positively correlated with CI ( r =0.48, plong-term all-cause mortality (adjusted HR, 1.62; 95% CI 1.11 to 2.37; p=0.013); however, the risk of vascular mortality did not significantly increase after adjustment for confounders. Qa is moderately correlated with cardiac function, and a Qa level of short-term and long-term all-cause mortality in chronic HD patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. [Equipment and technology in robotics].

    Science.gov (United States)

    Murphy, Declan; Challacombe, Ben; Nedas, Tim; Elhage, Oussama; Althoefer, Kaspar; Seneviratne, Lakmal; Dasgupta, Prokar

    2007-05-01

    We review the evolution and current status of robotic equipment and technology in urology. We also describe future developments in the key areas of virtual reality simulation, mechatronics and nanorobotics. The history of robotic technology is reviewed and put into the context of current systems. Experts in the associated fields of nanorobotics, mechatronics and virtual reality simulation simulation review the important future developments in these areas.

  19. Remote handling equipment for SNS

    International Nuclear Information System (INIS)

    Poulten, B.H.

    1983-01-01

    This report gives information on the areas of the SNS, facility which become highly radioactive preventing hands-on maintenance. Levels of activity are sufficiently high in the Target Station Area of the SNS, especially under fault conditions, to warrant reactor technology to be used in the design of the water, drainage and ventilation systems. These problems, together with the type of remote handling equipment required in the SNS, are discussed

  20. Margins related to equipment design

    International Nuclear Information System (INIS)

    Devos, J.

    1994-01-01

    Safety margins related to design of reactor equipment are defined according to safety regulations. Advanced best estimate methods are proposed including some examples which were computed and compared to experimental results. Best estimate methods require greater computation effort and more material data but give better variable accuracy and need careful experimental validation. Simplified methods compared to the previous are less sensitive to material data, sometimes are more accurate but very long to elaborate

  1. Temperature radiation measuring equipment. Temperaturstrahlungsmessgeraet

    Energy Technology Data Exchange (ETDEWEB)

    Lotzer, W

    1981-01-22

    The invention is concerned with a temperature radiation measuring equipment for non-contact temperature measurement by the light intensity variation method, with a photoelectric resistance as the measuring element. By having a circuit with a transistor, the 'dark resistance' occurring in the course of time is compensated for and thus gives a genuine reading (ie. the voltage drop across the photoelectric resistance remains constant).

  2. CERN computing equipment for Senegal

    CERN Multimedia

    Anaïs Schaeffer

    2014-01-01

    On 26 May, CERN once again had the honour of donating computing equipment to a foreign institute.   This time, around 100 servers and five network hubs were sent to Senegal, making it the seventh country, after Morocco, Ghana, Bulgaria, Serbia, Egypt and the Philippines, to receive a donation of computing equipment from the Organization. The official ceremony was held at CERN on 26 May in the presence of the Director-General, Rolf Heuer, and Senegal's ambassador to Geneva, Fodé Seck, who both expressed their enthusiasm for the project. The equipment is intended for Cheikh Anta Diop University (UCAD) in Dakar and will be of particular use to students attending the African School of Fundamental Physics and its Applications (ASP 2014) taking place from 3 to 23 August, for which CERN is a partner. The ASP allows a large number of African students to hone their skills in high-energy physics and to forge professional links with fellow physicists in Africa and Europe. ...

  3. JCE Online: Equipment Buyers Guide

    Science.gov (United States)

    Holmes, Jon L.

    1999-01-01

    The Equipment Buyers Guide was edited by Jo Rita Jordan. The new Equipment Buyers Guide, bound into the back of this issue, is also a new resource of JCE Internet. This resource provides an online source for the information contained in the printed guide. Placing this information online allows us to regularly update it and to provide live links to the suppliers' WWW sites. The organization of the online version parallels that of the print version. There is an alphabetical list of suppliers and a categorical listing. Links to these lists are provided on every page in the left-hand navigation bar. To quickly find information about a particular supplier, you click Supplier List, click the letter that begins the supplier's name, and scroll through the list to find the supplier. To find which suppliers provide a particular type of instrument or equipment, use the Categories link; click the category of the equipment you are looking for and then click the link to a supplier. You will then be taken to an alphabetical supplier listing page where you can scroll until you find the particular supplier of the item for which you are looking. Once you have found a supplier, the online Equipment Buyers Guide gives you the traditional contact information. But in addition, you also get one-click access to the WWW sites of the suppliers that have them. Depending on the site, you should be able to find information about the items that you seek and may even be able to order the items online! We think that you will find the online version of the Equipment Buyers Guide useful. To make it more useful, please send your suggestions, any errors or omissions you find, and any additional categories to the editor at jjordan@world.std.com The online Equipment Buyers Guide can be found at JCE Online at http://JChemEd.chem.wisc.edu/JCEWWW/Resources/EBG/ JCE Online in '99 JCE Online is your online source of "all things JCE". In order to provide you with an even more useful online resource, JCE

  4. Division of Scientific Equipment - Overview

    International Nuclear Information System (INIS)

    Halik, J.

    2002-01-01

    Full text: The Scientific Equipment Division consists of the Design Group and the Mechanical Workshop. The activity of the Division includes the following: * designs of devices and equipment for experiments in physics; their mechanical construction and assembly. In particular, these are vacuum chambers and installations for HV and UHV;* maintenance and upgrading of the existing installations and equipment in our Institute; * participation of our engineers and technicians in design works, equipment assembly and maintenance for experiments in foreign laboratories. The Design Group is equipped with PC-computers and AutoCAD graphic software (release 2000 and Mechanical Desktop 4.0) and an A0 plotter, which allow us to make drawings and 2- and 3-dimensional mechanical documentation to the world standards. The Mechanical Workshop offers a wide range of machining and treatment methods with satisfactory tolerances and surface quality. They include: * turning - cylindrical elements of a length up to 2000 mm and a diameter up to 400 mm, and also disc type elements of a diameter up to 600 mm and a length not exceeding 300 mm, * milling - elements of length up to 1000 mm and gear wheels of diameter up to 300 mm, * grinding - flat surfaces of dimensions up to 300 mm x 1000 mm and cylindrical elements of a diameter up to 200 mm and a length up to 800 mm, * drilling - holes of a diameter up to 50 mm, * welding - electrical and gas welding, including TIG vacuum-tight welding, * soft and hard soldering, * mechanical works including precision engineering, * plastics treatment - machining and polishing using diamond milling, modelling, lamination of various shapes and materials, including plexiglas, scintillators and light-guides, * painting - paint spraying with possibility of using furnace-fired drier of internal dimensions of 800 mm x 800 mm x 800 mm. Our workshop is equipped with the CNC milling machine which can be used for machining of work pieces up to 500 kg. The machine

  5. Used energy-related laboratory equipment grant program for institutions of higher learning. Eligible equipment catalog

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-01

    This is a listing of energy related equipment available through the Energy-Related Laboratory Equipment Grant Program which grants used equipment to institutions of higher education for energy-related research. Information included is an overview of the program, how to apply for a grant of equipment, eligibility requirements, types of equipment available, and the costs for the institution.

  6. Data center equipment location and monitoring system

    DEFF Research Database (Denmark)

    2011-01-01

    A data center equipment location system includes both hardware and software to provide for location, monitoring, security and identification of servers and other equipment in equipment racks. The system provides a wired alternative to the wireless RFID tag system by using electronic ID tags...... connected to each piece of equipment, each electronic ID tag connected directly by wires to a equipment rack controller on the equipment rack. The equipment rack controllers then link over a local area network to a central control computer. The central control computer provides an operator interface......, and runs a software application program that communicates with the equipment rack controllers. The software application program of the central control computer stores IDs of the equipment rack controllers and each of its connected electronic ID tags in a database.; The software application program...

  7. Rationale and design of the HEALTHY-CATH trial: A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Broom Jennifer K

    2009-08-01

    Full Text Available Abstract Background Catheter-related bacteraemias (CRBs contribute significantly to morbidity, mortality and health care costs in dialysis populations. Despite international guidelines recommending avoidance of catheters for haemodialysis access, hospital admissions for CRBs have doubled in the last decade. The primary aim of the study is to determine whether weekly instillation of 70% ethanol prevents CRBs compared with standard heparin saline. Methods/design The study will follow a prospective, open-label, randomized controlled design. Inclusion criteria are adult patients with incident or prevalent tunneled intravenous dialysis catheters on three times weekly haemodialysis, with no current evidence of catheter infection and no personal, cultural or religious objection to ethanol use, who are on adequate contraception and are able to give informed consent. Patients will be randomized 1:1 to receive 3 mL of intravenous-grade 70% ethanol into each lumen of the catheter once a week and standard heparin locks for other dialysis days, or to receive heparin locks only. The primary outcome measure will be time to the first episode of CRB, which will be defined using standard objective criteria. Secondary outcomes will include adverse reactions, incidence of CRB caused by different pathogens, time to infection-related catheter removal, time to exit site infections and costs. Prospective power calculations indicate that the study will have 80% statistical power to detect a clinically significant increase in median infection-free survival from 200 days to 400 days if 56 patients are recruited into each arm. Discussion This investigator-initiated study has been designed to provide evidence to help nephrologists reduce the incidence of CRBs in haemodialysis patients with tunnelled intravenous catheters. Trial Registration Australian New Zealand Clinical Trials Registry Number: ACTRN12609000493246

  8. Establishment for Nuclear Equipment: Overview

    International Nuclear Information System (INIS)

    Pracz, J.

    2001-01-01

    Full text: The activity of ZdAJ in 2000 was focused on realisation of the Government-Ordered Project - 6/15 MeV Accelerator. The realisation was accomplished in two stages: - stage I should result in deriving principal operational parameters of the accelerator - stage 2 will result in full implementation of the control system providing optimum control of the equipment and automatic maintaining of its parameters. Within the frames of the first stage, a klystron modulator panel was finished and the design documentation of the mechanical supporting structure, the arm, accelerating structure, collimator and control panel were advanced. Manufacturing of the above sub-units in the workshop has started. In the frames of the Specific Project of the State Committee for Scientific Research, the improvement of Neptun lOPC accelerator was undertaken. The read-out of the monitor dose with atmospheric pressure and ambient temperature compensation has been introduced. New filters for equalising the photon and electron beam and new wedge filters have been designed. Changes in programming have been introduced, which improve the patient's safety by eliminating possible personnel errors and increase the accuracy of radiation fields read-out. In 2000 ZdAJ progressed in development of the Quality System conforming EN-ISO 9001 Standard by including the provisions of EN 46001 Standard. The Standard EN 46001: ''Quality Systems - Medical Equipment''. Detailed requirements related to application of EN ISO 9001 is an European Quality Standard extending the provisions of EN ISO 9001 Standard over the manufacturers of medical equipment. (author)

  9. Reactor vital equipment determination techniques

    International Nuclear Information System (INIS)

    Bott, T.F.; Thomas, W.S.

    1983-01-01

    The Reactor Vital Equipment Determination Techniques program at the Los Alamos National Laboratory is discussed. The purpose of the program is to provide the Nuclear Regulatory Commission (NRC) with technical support in identifying vital areas at nuclear power plants using a fault-tree technique. A reexamination of some system modeling assumptions is being performed for the Vital Area Analysis Program. A short description of the vital area analysis and supporting research on modeling assumptions is presented. Perceptions of program modifications based on the research are outlined, and the status of high-priority research topics is discussed

  10. The replace repair decision for heavy equipment.

    Science.gov (United States)

    2004-01-01

    The fleet of equipment operated by the Virginia Department of Transportation (VDOT) constitutes a large investment, on the order of half a billion dollars. A means of identifying earlier and more accurately those pieces of equipment whose timely repl...

  11. Proceedings of FED remote maintenance equipment workshop

    International Nuclear Information System (INIS)

    Sager, P.; Garin, J.; Hager, E.R.; Spampinato, P.T.; Tobias, D.; Young, N.

    1981-11-01

    A workshop was convened in two sessions in January and March 1981, on the remote maintenance equipment for the Fusion Engineering Device (FED). The objectives of the first session were to familiarize the participants with the status of the design of the FED and to develop a remote maintenance equipment list for the FED. The objective of the second session was to have the participants present design concepts for the equipment which had been identified in the first session. The equipment list was developed for general purpose and special purpose equipment. The general purpose equipment was categorized as manipulators and other, while the special purpose equipment was subdivided according to the reactor subsystem it serviced: electrical, magnetic, and nuclear. Both mobile and fixed base manipulators were identified. Handling machines were identified as the major requirement for special purpose equipment

  12. Musical Sound, Instruments, and Equipment

    Science.gov (United States)

    Photinos, Panos

    2017-12-01

    'Musical Sound, Instruments, and Equipment' offers a basic understanding of sound, musical instruments and music equipment, geared towards a general audience and non-science majors. The book begins with an introduction of the fundamental properties of sound waves, and the perception of the characteristics of sound. The relation between intensity and loudness, and the relation between frequency and pitch are discussed. The basics of propagation of sound waves, and the interaction of sound waves with objects and structures of various sizes are introduced. Standing waves, harmonics and resonance are explained in simple terms, using graphics that provide a visual understanding. The development is focused on musical instruments and acoustics. The construction of musical scales and the frequency relations are reviewed and applied in the description of musical instruments. The frequency spectrum of selected instruments is explored using freely available sound analysis software. Sound amplification and sound recording, including analog and digital approaches, are discussed in two separate chapters. The book concludes with a chapter on acoustics, the physical factors that affect the quality of the music experience, and practical ways to improve the acoustics at home or small recording studios. A brief technical section is provided at the end of each chapter, where the interested reader can find the relevant physics and sample calculations. These quantitative sections can be skipped without affecting the comprehension of the basic material. Questions are provided to test the reader's understanding of the material. Answers are given in the appendix.

  13. Concerning equipment procurement for NPPs

    International Nuclear Information System (INIS)

    Pana, N.

    2002-01-01

    After a stagnation in investments for nuclear power which extended over a period of 10-15 years, assessments done by energy forecast institutes, as well as, evaluations by UE institutions, OECD, and DOE (USA) point to the conclusion solid and argued that the electric energy of nuclear origin will record a new boost beginning probably with the year 2005. Particular efforts were concentrated upon improving the performances of existing plants and, on the other hand, towards new, evolutionary concepts in nuclear engineering. Advanced equipment for nuclear reactors and plants resulted and were already implemented. In Europe construction of both advanced PWR and BWR type reactors are underway. The paper consider the issues of Romanian nuclear power and presents the prospects for advanced CANDU reactors in connection with the Romania's infrastructure and necessities. The problem of modernizing the equipment and components for NPP is discussed in the context of financing and investment conditions. In conclusion, the share of nuclear power in Romania is expected to rise in order to compensate the decline in fossil fuel thermal power and to better solve the environmental issues

  14. Equipment available for automating rig operations

    International Nuclear Information System (INIS)

    McNair, W.L.

    1990-01-01

    Several manufacturers are producing automated rig equipment, from complete systems to individual functions for existing drilling rigs. Significant improvements in well site time, costs of operations, and improved drilling performance have led drilling contractors to install this equipment on their rigs. This paper details some of the equipment available for automating rigs

  15. 13 CFR 143.32 - Equipment.

    Science.gov (United States)

    2010-01-01

    ... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Equipment. 143.32 Section 143.32...

  16. 32 CFR 33.32 - Equipment.

    Science.gov (United States)

    2010-07-01

    ... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 32 National Defense 1 2010-07-01 2010-07-01 false Equipment. 33.32 Section 33.32 National Defense...

  17. 45 CFR 92.32 - Equipment.

    Science.gov (United States)

    2010-10-01

    ... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 45 Public Welfare 1 2010-10-01 2010-10-01 false Equipment. 92.32 Section 92.32 Public Welfare...

  18. 40 CFR 31.32 - Equipment.

    Science.gov (United States)

    2010-07-01

    ... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Equipment. 31.32 Section 31.32...

  19. 14 CFR 1273.32 - Equipment.

    Science.gov (United States)

    2010-01-01

    ... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Equipment. 1273.32 Section 1273.32...

  20. 29 CFR 1470.32 - Equipment.

    Science.gov (United States)

    2010-07-01

    ... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 29 Labor 4 2010-07-01 2010-07-01 false Equipment. 1470.32 Section 1470.32 Labor Regulations...

  1. 15 CFR 24.32 - Equipment.

    Science.gov (United States)

    2010-01-01

    ... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Equipment. 24.32 Section 24.32...

  2. 38 CFR 43.32 - Equipment.

    Science.gov (United States)

    2010-07-01

    ... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Equipment. 43.32 Section...

  3. 30 CFR 250.602 - Equipment movement.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Equipment movement. 250.602 Section 250.602... OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Workover Operations § 250.602 Equipment movement. The movement of well-workover rigs and related equipment on and off a platform or from well to well on...

  4. 30 CFR 250.502 - Equipment movement.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Equipment movement. 250.502 Section 250.502... OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations § 250.502 Equipment movement. The movement of well-completion rigs and related equipment on and off a platform or from well to well...

  5. 46 CFR 121.220 - Cooking equipment.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Cooking equipment. 121.220 Section 121.220 Shipping... SYSTEMS AND EQUIPMENT Cooking and Heating § 121.220 Cooking equipment. (a) Doors on a cooking appliance... cooking appliance must be installed to prevent movement in heavy seas. (c) For a grill or similar type of...

  6. 46 CFR 184.220 - Cooking equipment.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Cooking equipment. 184.220 Section 184.220 Shipping...) VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Cooking and Heating § 184.220 Cooking equipment. (a) Doors on a cooking appliance must be provided with hinges and locking devices to prevent...

  7. Special equipment for etching nitrocellulose film

    International Nuclear Information System (INIS)

    Domanus, J.C.

    1983-08-01

    Nitrocellulose film and converter screens used for neutron radiography are described. Difficulties in visualization of radiographs on those films are mentioned. Because there is no equipment for etching nitrocellulose film available on the market Risoe has designed and produced such equipment at an estimated cost of Dkr. 15,000. Design criteria for this equipment are given and its performance described

  8. Developing equipment for AGR remote visual inspection

    International Nuclear Information System (INIS)

    James, P.W.; Walton, P.J.

    1985-01-01

    The Remote Inspection Group is part of the CEGB's Generation Development and Construction Division, and has responsibility for the design, development, procurement, testing and setting to work of the equipment provided to carry out routine remote visual inspections of its AGRs. This equipment includes both the viewing devices and the necessary placement equipment. (author)

  9. 46 CFR 121.210 - Heating equipment.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Heating equipment. 121.210 Section 121.210 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150... SYSTEMS AND EQUIPMENT Cooking and Heating § 121.210 Heating equipment. (a) Each heater must be so...

  10. 46 CFR 184.210 - Heating equipment.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Heating equipment. 184.210 Section 184.210 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Cooking and Heating § 184.210 Heating equipment...

  11. Sample-related peripheral equipment at IPNS

    International Nuclear Information System (INIS)

    Bohringer, D.E.; Crawford, R.K.

    1985-01-01

    This paper describes samples environment equipment provided by IPNS to visiting users and staff scientists. Of the twelve horizontal neutron beam stations, (ten now operational, two under construction) all use one or more form of such support equipment. An in-house support group devotes a significant fraction of its time to development, calibration, and maintenance of this equipment

  12. 14 CFR 121.605 - Airplane equipment.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Airplane equipment. 121.605 Section 121.605..., FLAG, AND SUPPLEMENTAL OPERATIONS Dispatching and Flight Release Rules § 121.605 Airplane equipment. No person may dispatch or release an airplane unless it is airworthy and is equipped as prescribed in § 121...

  13. Fire prevention and protection for trackless equipment

    Energy Technology Data Exchange (ETDEWEB)

    Burger, A.J.

    1988-10-01

    With the increased use of trackless diesel and electrical equipment underground, the fire danger associated with this equipment has increased. The need for adequate fire prevention and protection on all aspects of trackless mechanised mining must be taken into consideration. This paper describes briefly the causes of fires on trackless equipment and the precautions taken to reduce the risk of ignition. 1 tab.

  14. Load Bearing Equipment for Bone and Muscle

    Science.gov (United States)

    Shackelford, Linda; Griffith, Bryan

    2015-01-01

    Resistance exercise on ISS has proven effective in maintaining bone mineral density and muscle mass. Exploration missions require exercise with similar high loads using equipment with less mass and volume and greater safety and reliability than resistance exercise equipment used on ISS (iRED, ARED, FWED). Load Bearing Equipment (LBE) uses each exercising person to create and control the load to the partner.

  15. Incidencia de las demencias en hemodiálisis: Apoyo al cuidador principal Incidence of dementia in haemodialysis: Support for the main carer

    Directory of Open Access Journals (Sweden)

    Mª Ángeles Sánchez Lamolda

    2013-03-01

    Full Text Available Las demencias, aparecen cada día con más frecuencia en pacientes con tratamiento de hemodiálisis; la edad de entrada al tratamiento dialítico ha aumentado en los últimos años, influenciada por el aumento de la esperanza de vida. El deterioro en el estilo de vida del paciente afecta tanto a familiares como cuidadores, presentándose una situación compleja y difícil de manejar. En la actualidad, constituye un serio problema de salud con una repercusión social y económica a gran escala, por la pérdida de independencia del paciente y la carga física y psicológica que sufre la familia. Objetivo: Conocer la incidencia de las demencias y su relación con la edad, sexo, nivel de estudios, patologías asociadas. Material y método: Estudio descriptivo y transversal. Para conocer la incidencia de las demencias utilizamos el cuestionario: (short portable mental status questionarire Pfeiffer. Variables: sexo, edad, nivel de estudios, Convivencia, Hipertensión arterial, Diabetes. Resultados: el 28% de los pacientes presentan demencia, 36% se encuentra entre 75-79 años, afectando considerablemente al sexo femenino. El 58% no han terminado los estudios primarios. Hipertensión arterial no es estadísticamente significativa, Diabetes Mellitus aparece en el 48% de los pacientes que presentan demencia. Conclusión: La edad de los pacientes en hemodiálisis ha aumentado considerablemente, dando lugar a la aparición de las demencias, de ahí la necesidad de establecer las intervenciones de enfermería adecuadas para mejorar la calidad asistencial, ofrecer la información adecuada a familiares y cuidadores sobre las medidas a tener en cuenta en cada situación.Dementia appears with increasing frequency in patients undergoing haemodialysis: the age of starting dialysis treatment has increased in recent years, influenced by the increase in life expectancy. The deterioration in the patient's lifestyle affects both relatives and carers, creating a

  16. Establishment for Nuclear Equipment -Overview

    International Nuclear Information System (INIS)

    Pracz, J.

    2006-01-01

    Research and development works conducted in the Establishment for Nuclear Equipment (ZdAJ) were focused around 3 subject areas: an accelerator for cancer treatment, therapeutical tables, systems and methods for controlling objects that cross international borders. The new, medium energy accelerator for cancer therapy cases is being designed in the Establishment for several years. In 2005 progress was achieved. A physical part, containing an electron beam has been completed and the parameters of that beam make it useful for therapeutical purposes. Consequently, the work on designing and testing of beam control systems, ensuring its high stability, repetition of irradiation parameters and accuracy of dosage have been started. Results of these tests make it very probable that 2006 will be the final year of scientific works and in 2007 the new apparatus will be ready for sales. Therapeutical tables have become a leading product of ZdAJ IPJ. Their technical parameters, reliability and universality in uses are appreciated by many customers of ZdAJ. In 2005, the table Polkam 16 was registered by the national Office for Registration of Medical Equipment as the first product of ZdAJ that meets all technical and formal requirements of the safety mark CE. This allows sales of the product on the market of the European Union. The research and development part of designing a therapeutical table for uses in the total body irradiation technique was also concluded in 2005. After the September 11 terrorist attacks on WTC a matter of controlling international borders have become a priority for many countries. In 2005 in ZdAJ IPJ, we conducted many preliminary calculations and experiments analyzing systems of irradiation sources, both photon and neutron as well as systems of detection and designing of signals triggered by controlling objects crossing the border. The results so far have enabled us to formulate a research project which has been positively evaluated by experts and found

  17. Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: A feasibility randomised controlled trial.

    Science.gov (United States)

    Hudson, Joanna L; Moss-Morris, Rona; Norton, Sam; Picariello, Federica; Game, David; Carroll, Amy; Spencer, Jonathan; McCrone, Paul; Hotopf, Matthew; Yardley, Lucy; Chilcot, Joseph

    2017-11-01

    Psychological distress is prevalent in haemodialysis (HD) patients yet access to psychotherapy remains limited. This study assessed the feasibility and acceptability of online cognitive-behavioural therapy (CBT) tailored for HD patients, with or without therapist support, for managing psychological distress. This feasibility randomised controlled trial recruited patients from a UK HD centre. Following psychological distress screens, patients with mild-moderate psychological distress (Patient Health Questionnaire PHQ-9; score: 5-19 and/or Generalised Anxiety Disorder; GAD-7 score: 5-14) who met remaining inclusion criteria were approached for consent. Consenters were individually randomised (1:1) to online-CBT or online-CBT plus three therapist support calls. Outcomes included recruitment, retention, and adherence rates. Exploratory change analyses were performed for: psychological distress, quality of life (QoL), illness perceptions, and costs. The statistician was blinded to allocation. 182 (44%) out of 410 patients approached completed psychological distress screens. 26% found screening unacceptable; a further 30% found it unfeasible. Psychological distress was detected in 101 (55%) patients, 60 of these met remaining inclusion criteria. The primary reason for ineligibility was poor computer literacy (N=17, 53%). Twenty-five patients were randomised to the supported (N=18) or unsupported arm (N=7); 92% were retained at follow-up. No differences in psychological distress or cost-effectiveness were observed. No trial adverse events occurred. Online CBT appears feasible but only for computer literate patients who identify with the label psychological distress. A definitive trial using the current methods for psychological distress screening and online care delivery is unfeasible. ClinicalTrials.gov Identifier: NCT02352870. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Creatinine index as a surrogate of lean body mass derived from urea Kt/V, pre-dialysis serum levels and anthropometric characteristics of haemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Bernard Canaud

    Full Text Available BACKGROUND AND OBJECTIVES: Protein-energy wasting is common in long-term haemodialysis (HD patients with chronic kidney disease and is associated with increased morbidity and mortality. The creatinine index (CI is a simple and useful nutritional parameter reflecting the dietary skeletal muscle protein intake and skeletal muscle mass of the patient. Because of the complexity of creatinine kinetic modeling (CKM to derive CI, we developed a more simplified formula to estimate CI in HD patients. DESIGN, SETTING, PARTICIPANTS & MEASUREMENTS: A large database of 549 HD patients followed over more than 20 years including monthly CKM-derived CI values was used to develop a simple equation based on patient demographics, predialysis serum creatinine values and dialysis dose (spKt/V using mixed regression models. RESULTS: The equation to estimate CI was developed based on age, gender, pre-dialysis serum creatinine concentrations and spKt/V urea. The equation-derived CI correlated strongly with the measured CI using CKM (correlation coefficient  = 0.79, p-value <0.001. The mean error of CI prediction using the equation was 13.47%. Preliminary examples of few typical HD patients have been used to illustrate the clinical relevance and potential usefulness of CI. CONCLUSIONS: The elementary equation used to derive CI using demographic parameters, pre-dialysis serum creatinine concentrations and dialysis dose is a simple and accurate surrogate measure for muscle mass estimation. However, the predictive value of the simplified CI assessment method on mortality deserves further evaluation in large cohorts of HD patients.

  19. Communication equipment radiation resistance ensurance

    International Nuclear Information System (INIS)

    Myrova, L.O.; Chelizhenko, A.Z.

    1983-01-01

    A review of works on radiation resistance of electronic equipment (epsilon epsilon) for 15 years is presented. The effect of ionizing radiation appearing as a result of nuclear explosions in nuclear facilities and in outerspace on epsilon epsilon has been considered. Types of radiation effects in epsilon epsilon, radiation effect on semiconductor devices and integrated circUits, types of epsilon epsilon failures, as well as the procass of radiation-resistant epsilon epsilon designing and selection of its main parameters have been described. The methods of epsilon epsilon flowsheet optimization, application of mathematical simulation and peculiarities of ensurance of epsilon epsilon radiation resistance of communication systems are considered. Peculiarities of designing of radiation-resistant quartz generators, secondary power supply sources and amplifiers are discussed

  20. Purex: process and equipment performance

    International Nuclear Information System (INIS)

    Orth, D.A.

    1986-01-01

    The Purex process is the solvent extraction system that uses tributyl phosphate as the extractant for separating uranium and plutonium from irradiated reactor fuels. Since the first flowsheet was proposed at Oak Ridge National Laboratory in 1950, the process has endured for over 30 years with only minor modifications. The spread of the technology was rapid, and worldwide use or research on Purex-type processes was reported by the time of the 1955 Geneva Conference. The overall performance of the process has been so good that there are no serious contenders for replacing it soon. This paper presents: process description; equipment performance (mixer-settlers, pulse columns, rapid contactors); fission product decontamination; solvent effects (solvent degradation products); and partitioning of uranium and plutonium

  1. Automation of a thermogravimetric equipment

    International Nuclear Information System (INIS)

    Mussio, L.; Castiglioni, J.; Diano, W.

    1987-01-01

    A low cost automation of some instruments by means of simple electronic circuits and a microcomputer Apple IIe. type is discussed. The electronic circuits described are: a) a position detector including phototransistors connected as differential amplifier; b) a current source that, using the error signal of the position detector, changes the current through the coil of an electromagnetic balance to restore its zero position; c) a proportional temperature controller, zero volt switching to drive a furnace to a desired temperature; d) an interface temperature regulator-microcomputer to control the temperature regulator by software; e) a multiplexer for an analog input of a commercial interface. Those circuits are applied in a thermogravimetric equipment used also for vapours adsorption. A program in block diagram form is included and is able to record change of mass, time, furnace temperature and to drive the temperature regulator in order to have the heating rates or the temperature plateaux needed for the experiment. (author) [pt

  2. Establishment for Nuclear Equipment: Overview

    International Nuclear Information System (INIS)

    Pracz, J.

    2000-01-01

    Full text: The main objective of the activity of the Establishment for Nuclear Equipment (ZdAJ) in 1999 was to obtain the ISO 9001 certificate. Work on this problem has been successfully completed. The changes introduced in agreement with requirements of ISO in supervising the construction, manufacturing and servicing eliminate possible deficiencies of our products and will pay in the future. Two new important ventures have been undertaken: design of an accelerator with two photon energies and a reconstruction of simulator directed towards better geometrical parameters. The completion of the improvements in accelerator is foreseen for the year 2002. The changes comprise almost all sub-assemblies of the device. The modernized simulator will be installed in the hospital already in the year 2000 - the ameliorations concern mainly the arm of the apparatus, collimator, driving gears and control system. Of course - apart from this, the routine production activity of the Establishment was continued in 1999. (author)

  3. Protective equipment use among female rugby players.

    Science.gov (United States)

    Comstock, R Dawn; Fields, Sarah K; Knox, Christy L

    2005-07-01

    Our objective was to assess the prevalence of protective equipment use and the motivation for using protective equipment among a sample of US female rugby players. We surveyed a convenience sample of 234 current US female rugby players from 14 teams participating in a US women's rugby tournament, obtaining self-reported demographic, rugby exposure, and protective equipment use information. Mouthguards were the most commonly used piece of protective equipment: 90.8% of players reported having always worn a mouthguard while playing or practicing rugby within their most recent 3 months of play. Fewer than 15% of players reported having always worn other types of protective equipment. Equipment use varied by playing position. Whereas over 80% of players in all other positions always wore a mouthguard, 66.7% of scrum halves reported always wearing one. Both backs and forwards reported wearing shoulder pads, but only forwards reported always wearing padded headgear. Mouthguards, padded headgear, and shoulder pads were worn "to prevent injury," whereas ankle braces, neoprene sleeves, and athletic tape on joints were worn "to protect a current/recent injury." This is the first study of female rugby players to assess the prevalence of protective equipment use by playing position and the motivation for using protective equipment. With the exception of mouthguards, US female rugby players infrequently use protective equipment. Protective equipment use varies by playing position. Some types of protective equipment appear to be used as primary prevention mechanisms, whereas others are used as secondary or tertiary prevention mechanisms.

  4. Changing nature of equipment and parts qualification

    International Nuclear Information System (INIS)

    Bucci, R.M.

    1988-01-01

    Ideally, the original supplier of a piece of nuclear safety-related equipment has performed a qualification program and will continue to support that equipment throughout the lifetime of the nuclear power plants in which in equipment is installed. The supplier's nuclear quality assurance program will be maintained and he will continue to offer all necessary replacement parts. These parts will be identical to the original parts, certified to the original purchase order requirements, and the parts will be offered at competitive prices. Due to the changing nature of the nuclear plant equipment market, however, one or more of those ideal features are frequently unavailable when safety-related replacement equipment or parts are required. Thus, the process of equipment and parts qualification has had to adjust in order to ensure obtaining qualified replacements when needed. This paper presents some new directions taken in the qualification of replacement equipment and parts to meet changes in the marketplace

  5. Free-world microelectronic manufacturing equipment

    Science.gov (United States)

    Kilby, J. S.; Arnold, W. H.; Booth, W. T.; Cunningham, J. A.; Hutcheson, J. D.; Owen, R. W.; Runyan, W. R.; McKenney, Barbara L.; McGrain, Moira; Taub, Renee G.

    1988-12-01

    Equipment is examined and evaluated for the manufacture of microelectronic integrated circuit devices and sources for that equipment within the Free World. Equipment suitable for the following are examined: single-crystal silicon slice manufacturing and processing; required lithographic processes; wafer processing; device packaging; and test of digital integrated circuits. Availability of the equipment is also discussed, now and in the near future. Very adequate equipment for most stages of the integrated circuit manufacturing process is available from several sources, in different countries, although the best and most widely used versions of most manufacturing equipment are made in the United States or Japan. There is also an active market in used equipment, suitable for manufacture of capable integrated circuits with performance somewhat short of the present state of the art.

  6. 9 CFR 590.502 - Equipment and utensils; PCB-containing equipment.

    Science.gov (United States)

    2010-01-01

    ... Sanitary Standards and accepted practices currently in effect for such equipment. (c) New or replacement equipment or machinery (including any replacement parts) brought onto the premises of any official plant... equipment and machinery, and any replacement parts for such equipment and machinery. Totally enclosed...

  7. Quality assurance for radiodiagnostic equipment in Uruguay

    International Nuclear Information System (INIS)

    Cotelo, Elena D.

    2001-01-01

    Since Uruguay did not have an study on X-ray equipment, students of Radiation Protection course (RP) made this field work throughout the country. The objective is to obtain information on the number and kind of X-ray radiodiagnostic equipment. Some of the results are: there are 666 radiodiagnostic equipment. The ratio of population to equipment is 4.515 to 1 in the capital and the mean rate in the rest of the country is 4.383 to one, with a minimum of 1.707 and a maximum of 8.220. The Public Health Ministry (MSP) and the Instituciones de Asistencia Medica Colectiva (a kind of private heath assurance) (IAMC) have less equipment in the capital than in the rest of the country. The 37% of the capital population receives assistance through the IAMC , with a 42.5 % of the equipment. Uruguay except the capital has 18 districts and 17 computed tomography equipment, from which only 3 belong to the MSP. Five districts do not have any. In Montevideo, there are 11.500 females over forty years of age per X-ray mammography equipment, and this relation in the rest of the country is 13.900. There are 21 X-ray Interventional radiology equipment, 16 of them are in the capital. Is from relating the radiodiagnostic equipment, the population and the procedures, that quality assistance indicators emerge. This owns high importance on the way to create a RP National Programme. (author)

  8. Maintenance program guidelines for programmatic equipment

    International Nuclear Information System (INIS)

    1994-11-01

    The Division Directors at Lawrence Berkeley Laboratory are responsible for implementing a maintenance program for research equipment (also referred to as programmatic equipment) assigned to them. The program must allow maintenance to be accomplished in a manner that promotes operational safety, environmental protection and compliance, and cost effectiveness; that preserves the intended functions of the facilities and equipment; and that supports the programmatic mission of the Laboratory. Programmatic equipment -- such as accelerators, lasers, radiation detection equipment, and glove boxes -- is dedicated specifically to research. Installed equipment, by contrast, includes the mechanical and electrical systems installed as part of basic building construction, equipment essential to the normal functioning of the facility and its intended use. Examples of installed equipment are heating, ventilating, and air conditioning systems; elevators; and communications systems. The LBL Operating and Assurance Program Plan (PUB-3111, Revision 4) requires that a maintenance program be prepared for programmatic equipment and defines the basic maintenance program elements. Such a program of regular, documented maintenance is vital to the safety and quality of research activities. As a part of that support, this document offers guidance to Laboratory organizations for developing their maintenance programs. It clarifies the maintenance requirements of the Operating and Assurance Program (OAP) and presents an approach that, while not the only possibility, can be expected to produce an effective maintenance program for research equipment belonging to the Laboratory's organizations

  9. Inspection device for buried equipment

    International Nuclear Information System (INIS)

    Hanawa, Jun.

    1994-01-01

    In an inspection device for a buried equipment, a rail is suspended at the upper portion of a vessel of a pit-vessel type pump buried in a plant building floor, and a truck movable vertical in the vessel along the rail, and an ultrasonic wave probe contained in the truck and urged to the vessel by an electromagnet are disposed. In addition, an elevator moving vertically along a shaft is disposed, and an arm having the ultrasonic probe disposed at the end portion and driven by a piston are disposed to the elevator. The ultrasonic wave probe moves vertically together with the truck along the rail in the vessel while being urged to the vessel by the electromagnet to inspect and measure the state at the inner and outer surfaces of the vessel. Further, the length of the arm is controlled so as to set a predetermined distance between the ultrasonic wave probe and the vessel. Subsequently, the elevator is moved vertically along a shaft passing through a shaft hole of a mount, and the shaft is rotated thereby enabling to inspect and measure the state of the inner and outer surfaces of the vessel. (N.H.)

  10. Equipment used in nuclear medicine

    International Nuclear Information System (INIS)

    Das, B.K.; Noreen Norfaraheen Lee Abdullah

    2012-01-01

    Detection of radiation is the common purpose of all equipment's and instruments used in radioisotope laboratories. The first and most important instrument that was used in nuclear medicine was Geiger tube developed by H.W. Geiger as early in 1908. He in association with Mueller developed the so called Geiger-Muller tube (GM tube) which could be used to detect beta and gamma radiations. In spite of its severe limitations, GM tube remained the only external counting device until 1949. In 1948, Kallman reported that the scintillations can be detected and amplified with the help of photomultiplier tubes (PMTs). In comparison with gas filled detectors, scintillation detectors have two principal advantages that augment their use in nuclear medicine. Firstly, they are capable of much higher counting rates because of fast resolving times and secondly, because they are much more efficient for gamma ray detection. The scintillation detector is the most basic block of any modern radioisotope detection instrument like rate meter, counter, scanner, gamma camera or single photon emission computed tomography. (author)

  11. Ageing management and equipment qualification

    International Nuclear Information System (INIS)

    Stahl, Gunnar

    2014-01-01

    The knowledge of how the environment and load of organic material in general and especially polymers and lubricants, is affecting the degradation of important properties, have increased during the last decade. However the restrictions using established additives like some color pigments due to their poisonousness e.g. pigments based at cadmium, lead, mercury etc. have caused problems when replacing additives to polymers. The replacement additives have often been used in new design without going through the required material qualification procedure. There have also been observed that some non-qualified and non-approved materials have been installed in some power plants due to false documentation. There are also a lot of new manufacturers, of materials similar to the previously qualified materials, active at the market. This increases the difficulty to ensure that the required material quality is used. New materials, new additives and new manufacturers makes if more and more difficult to assure that the expected material is present. This causes more strict demands of how the new materials often used in equipment at type-testing and in replacement materials are analyzed and documented. By implementing new steps for chemical, mechanical and electrical analysis and increase the general quality assurance content this issue can be managed. (authors)

  12. Equipment selection for atmospheric drying

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, P D; Bhattacharyya, S [Nuclear Power Corporation, Bhabha Atomic Research Centre, Mumbai (India)

    1994-06-01

    Heavy water management is a major factor in deciding the economics of the PHWRs. Hence it is necessary to have an efficient recovery system, for the heavy water vapour escaping from various process systems and maintain a dry atmosphere in the recovery areas. While the basic objective of the atmospheric drying system is to maximize recovery and to minimize stack losses, it is equally important to optimally design the system with due consideration to operational and maintenance aspects. At present, heavy water vapour recovery in the existing Nuclear Power Plants (NPPs) is carried out by dryers of dual fixed bed design. While moving bed design could have some advantages, this has not been adopted so far because of the cumbersome mechanical design involved and special requirements for nuclear application. Developmental work done in this direction has resulted in compact alternative designs. In one of the designs, the change over from adsorption to regeneration is achieved by rotating the bed slowly. This concept is further refined in another alternative using a dessicant wheel. This paper contains brief equipment description of different designs; enumerates the design requirements of an atmospheric drying system for reactor building; describes steps for designing fixed bed type D{sub 2}O vapour recovery system, and highlights advances in dryer technology. (author). 2 refs., 4 figs., 1 ill.

  13. Materials division facilities and equipment

    International Nuclear Information System (INIS)

    Biest, O. v.d.

    1984-01-01

    The research activities of the Division at the Petten Establishment have the aims of characterising the properties of high temperature materials in industrial process environments and of understanding the structures involved in order to gain an insight into behavioural mechanisms. Metallic materials fall within the scope of the programme; the activities are, at present, almost entirely concerned with austenitic steels and nickel based alloys. Starting in 1984, advanced ceramic materials will be studied as well. The equipment available permits the study of mechanical properties in controlled gaseous environments, of the rates and mechanisms of corrosive reactions between materials and those environments, and of the surface and bulk structures by advanced physical techniques. Special preparation and treatment techniques are available. The Division has developed a Data Bank on high temperature alloys. It also operates an information Centre, the activities of which include the organisation of scientific meetings, the commissioning of ''state of the art'' studies on topics in the field of high temperature materials and their applications and the development of a inventory of current research activities in the field in Europe. This booklet is intended to present the facilities and services of the Division to the organizations which are interested in its programmes of work

  14. ISS qualified thermal carrier equipment

    Science.gov (United States)

    Deuser, Mark S.; Vellinger, John C.; Jennings, Wm. M.

    2000-01-01

    Biotechnology is undergoing a period of rapid and sustained growth, a trend which is expected to continue as the general population ages and as new medical treatments and products are conceived. As pharmaceutical and biomedical companies continue to search for improved methods of production and, for answers to basic research questions, they will seek out new avenues of research. Space processing on the International Space Station (ISS) offers such an opportunity! Space is rapidly becoming an industrial laboratory for biotechnology research and processing. Space bioprocessing offers exciting possibilities for developing new pharmaceuticals and medical treatments, which can be used to benefit mankind on Earth. It also represents a new economic frontier for the private sector. For over eight years, the thermal carrier development team at SHOT has been working with government and commercial sector scientists who are conducting microgravity experiments that require thermal control. SHOT realized several years ago that the hardware currently being used for microgravity thermal control was becoming obsolete. It is likely that the government, academic, and industrial bioscience community members could utilize SHOT's hardware as a replacement to their current microgravity thermal carrier equipment. Moreover, SHOT is aware of several international scientists interested in utilizing our space qualified thermal carrier. SHOT's economic financing concept could be extremely beneficial to the international participant, while providing a source of geographic return for their particular region. Beginning in 2000, flight qualified thermal carriers are expected to be available to both the private and government sectors. .

  15. Diagnostics of Electric Equipment Windings

    Directory of Open Access Journals (Sweden)

    I. I. Branovitsky

    2007-01-01

    Full Text Available The paper presents methodology and results of the investigations pertaining to study of influence of short-circuited turns on transient electrical processes in electric motor windings. Dependence of their damped speed and value of the difference signal, obtained at reciprocal subtraction of damped oscillation curves in absence and in presence of short-circuited turns, on number of turns in the tested windings. It has been determined that damped oscillation curves, immediately attributed to short-circuited turns, have peak values along temporary axis which are areas of the largest transient process sensitivity to КЗ turns.Methodology for diagnostics of single- and three-phase electric motor windings and also other electric equipment, being realized in DO-1 device, has been developed in the paper. The men­tioned device makes it possible to carry out visual comparison and quantitative analysis of damped oscillation curves in the tested windings with standard ones which are set in the device memory and their difference signals.

  16. WP EMPLACEMENT CONTROL AND COMMUNICATION EQUIPMENT DESCRIPTIONS

    International Nuclear Information System (INIS)

    Raczka, N.T.

    1997-01-01

    The objective and scope of this document are to list and briefly describe the major control and communication equipment necessary for waste package emplacement at the proposed nuclear waste repository at Yucca Mountain. Primary performance characteristics and some specialized design features of the required equipment are explained and summarized in the individual subsections of this document. This task was evaluated in accordance with QAP-2-0 and found not to be quality affecting. Therefore, this document was prepared in accordance with NAP-MG-012. The following control and communication equipment are addressed in this document: (1) Programmable Logic Controllers (PLC's); (2) Leaky Feeder Radio Frequency Communication Equipment; (3) Slotted Microwave guide Communication Equipment; (4) Vision Systems; (5) Radio Control Equipment; and (6) Enclosure Cooling Systems

  17. Procurement strategic analysis of nuclear safety equipment

    International Nuclear Information System (INIS)

    Wu Caixia; Yang Haifeng; Li Xiaoyang; Li Shixin

    2013-01-01

    The nuclear power development plan in China puts forward a challenge on procurement of nuclear safety equipment. Based on the characteristics of the procurement of nuclear safety equipment, requirements are raised for procurement process, including further clarification of equipment technical specification, establishment and improvement of the expert database of the nuclear power industry, adoption of more reasonable evaluation method and establishment of a unified platform for nuclear power plants to procure nuclear safety equipment. This paper makes recommendation of procurement strategy for nuclear power production enterprises from following aspects, making a plan of procurement progress, dividing procurement packages rationally, establishing supplier database through qualification review and implementing classified management, promoting localization process of key equipment continually and further improving the system and mechanism of procurement of nuclear safety equipment. (authors)

  18. Improved servicing equipment for steam generators

    International Nuclear Information System (INIS)

    Hedtke, James C.

    1998-01-01

    To help keep personnel exposure as low as reasonably achievable and reduce critical path outage time, most nuclear plants of PWR design in the USA are now using improved equipment to service their steam generators (SGs) during outages. Because of the success of this equipment in the USA, two Belgian plants and one English plant have purchased this equipment, and other nuclear plants in Europe are also considering procurement. The improved SG servicing equipment discussed in this paper discusses consists of nozzle dams, segmented multi-stud tensioner, primary manway cover handling tool set, shield door and fastener cleaner. This equipment is specifically designed for the individual plant application and can also be specified for replacement SG projects. All of the equipment can be used without modification of the existing SGs. (author)

  19. Equipment Replacement Decision Making: Opportunities and Challenges

    OpenAIRE

    Fan, Wei (David); Gemar, Mason D.; Machemehl, Randy

    2012-01-01

    The primary function of equipment managers is to replace the right equipment at the right time and at the lowest overall cost. In this paper, the opportunities and challenges associated with equipment replacement optimization (ERO) are discussed in detail. First, a comprehensive review of the state-of-the art and state-of-the practice literature for the ERO problem is conducted. Second, a dynamic programming (DP) based optimization solution methodology is presented to solve the ERO problem. T...

  20. History and development of the tennis equipment

    OpenAIRE

    Horáková, Kateřina

    2007-01-01

    Title: History and development of the tennis equipment. Aim of the work: Process an integral, tabular and synoptic historical development overview of the tennis equipment. This owerview will cover the period since the early beginnings of the game to present days. Methods: Advance work has historical charakter therefore used methods are historiogaphical methods such as chronological method and historical method. Results: Produce tabular description of the tennis equipment by means of reading a...

  1. Mine railway equipments management information system

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, X.; Han, K.; Duan, T.; Liu, Z.; Lu, H. [China University of Mining and Technology, Xuzhou (China)

    2007-06-15

    Based on client/server and browser/server models, the management information system described realized the entire life-cycle management of mine railway equipment which included universal equipment and special equipment in the locomotive depot, track maintenance division, electrical depot and car depot. The system has other online functions such as transmitting reports, graphics management, statistics, searches, graphics wizard and web propaganda. It was applied in Pingdingshan Coal Co. Ltd.'s Railway Transport Department. 5 refs., 4 figs.

  2. Aircraft Wiring Support Equipment Integration Laboratory (AWSEIL)

    Data.gov (United States)

    Federal Laboratory Consortium — Purpose:The Aircraft Wiring Support Equipment Integration Laboratory (AWSEIL) provides a variety of research, design engineering and prototype fabrication services...

  3. Making petroleum equipment safe, a priority

    International Nuclear Information System (INIS)

    1999-01-01

    Changes to the 'Act respecting the use of petroleum products' have been announced effective May 1, 1999. The changes have been made to reduce problems which can be attributed to petroleum product leaks. The new regulations will make owners and users of petroleum equipment, including underground and above-ground storage equipment and commercial storage tanks, more accountable for the use of their own equipment. The emphasis in the new regulations is based upon the storage capacity of petroleum equipment and the risks associated with this equipment, rather than the on the activities of the owners concerned. Accordingly, the new regulations call for stricter requirements for high-risk equipment, a private equipment inspection plan, a two-year operating permit, replacing the current permits and certificates, a tariff structure based on the risks associated with the equipment, and deregulation of commercial activities involving petroleum products that require no equipment. Additionally, the amendments to the Act transfer responsibility for administration to the Regie du batiment and to the Ministere des Transports. Details of each of these changes are explained

  4. Utility equipment systems: promising more for less

    Energy Technology Data Exchange (ETDEWEB)

    1987-10-01

    This paper discusses current developments in utility equipment systems, a term applied to carrier vehicles, mostly evolved from well-known forms of construction or mining equipment modified to work with a variety of different front or back end attachments. One of the equipment ranges discussed is the Normet cassette system produced by the Orion corporation of Finland, which allows a basic chassis to be converted from a personnel carrier to an ANFO carrier within minutes. LHD vehicles which are being adapted to fulfil multipurpose roles, such as carrying roof supports, chocks and other heavy mining equipment underground are also discussed. 5 figs.

  5. Detection of Equipment Faults Before Beam Loss

    CERN Document Server

    Galambos, J.

    2016-01-01

    High-power hadron accelerators have strict limits on fractional beam loss. In principle, once a high-quality beam is set up in an acceptable state, beam loss should remain steady. However, in practice, there are many trips in operational machines, owing to excessive beam loss. This paper deals with monitoring equipment health to identify precursor signals that indicate an issue with equipment that will lead to unacceptable beam loss. To this end, a variety of equipment and beam signal measurements are described. In particular, several operational examples from the Spallation Neutron Source (SNS) of deteriorating equipment functionality leading to beam loss are reported.

  6. 21 CFR 866.4500 - Immunoelectrophoresis equipment.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents... clinical use with its electrical power supply is a device used for separating protein molecules...

  7. PROMSYS, Plant Equipment Maintenance and Inspection Scheduling

    International Nuclear Information System (INIS)

    Morgan, D.L.; Srite, B.E.

    1986-01-01

    1 - Description of problem or function: PROMSYS is a computer system designed to automate the scheduling of routine maintenance and inspection of plant equipment. This 'programmed maintenance' provides the detailed planning and accomplishment of lubrication, inspection, and similar repetitive maintenance activities which can be scheduled at specified predetermined intervals throughout the year. The equipment items included are the typical pumps, blowers, motors, compressors, automotive equipment, refrigeration units, filtering systems, machine shop equipment, cranes, elevators, motor-generator sets, and electrical switchgear found throughout industry, as well as cell ventilation, shielding, containment, and material handling equipment unique to nuclear research and development facilities. Four related programs are used to produce sorted schedule lists, delinquent work lists, and optional master lists. Five additional programs are used to create and maintain records of all scheduled and unscheduled maintenance history. 2 - Method of solution: Service specifications and frequency are established and stored. The computer program reviews schedules weekly and prints, on schedule cards, instructions for service that is due the following week. The basic output from the computer program comes in two forms: programmed-maintenance schedule cards and programmed-maintenance data sheets. The data sheets can be issued in numerical building, route, and location number sequence as equipment lists, grouped for work assigned to a particular foreman as the foreman's equipment list, or grouped by work charged to a particular work order as the work-order list. Data sheets grouped by equipment classification are called the equipment classification list

  8. Equipment Reliability Process in Krsko NPP

    International Nuclear Information System (INIS)

    Gluhak, M.

    2016-01-01

    To ensure long-term safe and reliable plant operation, equipment operability and availability must also be ensured by setting a group of processes to be established within the nuclear power plant. Equipment reliability process represents the integration and coordination of important equipment reliability activities into one process, which enables equipment performance and condition monitoring, preventive maintenance activities development, implementation and optimization, continuous improvement of the processes and long term planning. The initiative for introducing systematic approach for equipment reliability assuring came from US nuclear industry guided by INPO (Institute of Nuclear Power Operations) and by participation of several US nuclear utilities. As a result of the initiative, first edition of INPO document AP-913, 'Equipment Reliability Process Description' was issued and it became a basic document for implementation of equipment reliability process for the whole nuclear industry. The scope of equipment reliability process in Krsko NPP consists of following programs: equipment criticality classification, preventive maintenance program, corrective action program, system health reports and long-term investment plan. By implementation, supervision and continuous improvement of those programs, guided by more than thirty years of operating experience, Krsko NPP will continue to be on a track of safe and reliable operation until the end of prolonged life time. (author).

  9. Additional Equipment for Soil Biodegradation

    Science.gov (United States)

    Vondráčková, Terezie; Kraus, Michal; Šál, Jiří

    2017-12-01

    Intensification of industrial production, increasing citizens’ living standards, expanding the consumer assortment mean in the production - consumption cycle a constantly increasing occurrence of waste material, which by its very nature must be considered as a source of useful raw materials in all branches of human activity. In addition to strict legislative requirements, a number of circumstances characterize waste management. It is mainly extensive transport associated with the handling and storage of large volumes of substances with a large assortment of materials (substances of all possible physical and chemical properties) and high demands on reliability and time coordination of follow-up processes. Considerable differences in transport distances, a large number of sources, processors and customers, and not least seasonal fluctuations in waste and strong price pressures cannot be overlooked. This highlights the importance of logistics in waste management. Soils that are contaminated with oil and petroleum products are hazardous industrial waste. Methods of industrial waste disposal are landfilling, biological processes, thermal processes and physical and chemical methods. The paper focuses on the possibilities of degradation of oil pollution, in particular biodegradation by bacteria, which is relatively low-cost among technologies. It is necessary to win the fight with time so that no ground water is contaminated. We have developed two additional devices to help reduce oil accident of smaller ranges. In the case of such an oil accident, it is necessary to carry out the permeability test of contaminated soil in time and, on this basis, to choose the technology appropriate to the accident - either in-sit biodegradation - at the site of the accident, or on-sit - to remove the soil and biodegrade it on the designated deposits. A special injection drill was developed for in-sit biodegradation, tossing and aeration equipment of the extracted soil was developed for

  10. Lunar construction/mining equipment

    Science.gov (United States)

    Ozdemir, Levent

    1990-01-01

    For centuries, mining has utilized drill and blast as the primary method of rock excavation. Although this technique has undergone significant improvements, it still remains a cyclic, labor intensive operation with inherent safety hazards. Other drawbacks include damage to the surrounding ground, creation of blast vibrations, rough excavation walls resulting in increased ventilation requirements, and the lack of selective mining ability. Perhaps the most important shortcoming of drill and blast is that it is not conducive to full implementation of automation or robotics technologies. Numerous attempts have been made in the past to automate drill and blast operations to remove personnel from the hazardous work environment. Although most of the concepts devised look promising on paper, none of them was found workable on a sustained production basis. In particular, the problem of serious damage to equipment during the blasting cycle could not be resolved regardless of the amount of charge used in excavation. Since drill and blast is not capable of meeting the requirements of a fully automated rock fragmentation method, its role is bound to gradually decrease. Mechanical excavation, in contrast, is highly suitable to automation because it is a continuous process and does not involve any explosives. Many of the basic principles and trends controlling the design of an earth-based mechanical excavator will hold in an extraterrestrial environment such as on the lunar surface. However, the economic and physical limitations for transporting materials to space will require major rethinking of these machines. In concept, then, a lunar mechanical excavator will look and perform significantly different from one designed for use here on earth. This viewgraph presentation gives an overview of such mechanical excavator systems.

  11. Effect of Membrane Permeability on Cardiovascular Risk Factors and β2m Plasma Levels in Patients on Long-Term Haemodialysis: A Randomised Crossover Trial.

    Science.gov (United States)

    Chazot, Charles; Kirchgessner, Judith; Pham, Jenny; Vo-Van, Cyril; Lorriaux, Christie; Hurot, Jean-Marc; Zaoui, Eric; Grassmann, Aileen; Jean, Guillaume; Marcelli, Daniele

    2015-01-01

    Survival of haemodialysis (HD) patients is influenced by many factors. Mortality is mainly of cardiovascular (CV) origin and related to both traditional and nontraditional CV risk factors. Low plasma Beta2-microglobulin (β2m) levels are associated with improved HD patient survival. HD session times that are longer than the conventional 4 h (i.e., extended dialysis) provide better middle molecule clearance and are also associated with a survival advantage. In this crossover randomised trial, we investigated the effect of membrane flux on CV risk factors and on β2m plasma levels in patients treated with extended dialysis. Dialysis session duration was between 5 and 8 h for all patients. Patients were randomly assigned to the treatment sequences low-flux/high-flux dialysis versus high-flux/low-flux dialysis in a crossover design after a 3-month run-in period, with each phase lasting 9 months. Of the initially enrolled 168 patients, 155 patients started the study after the run-in period, 117 patients completed Phase 1, and 83 patients completed the whole study. Lp(a), homocystein, LDL cholesterol, HDL cholesterol and serum albumin were comparable in the low-flux and high-flux treatments. The average β2m level was 43.3 ± 11.1 mg/l at the end of the low-flux phase. Independent of sequence assignation, average β2m was significantly lower at the end of the high-flux phase (27.5 ± 76.0 mg/l, p < 0.0001 versus end of low-flux phase). Both phosphate and nPNA were significantly lower at the end of the high-flux phase compared to the low-flux phase (p = 0.045 and p = 0.002, respectively). Inclusion of those patients who completed Phase 1 and who dropped out of the study during Phase 2 did not significantly change the results. In conclusion, this study did not find an influence of high-flux filters on several traditional CV risk factors in a population of HD patients treated with extended dialysis. However, high-flux filters are necessary to optimise middle molecule

  12. Improving distress in dialysis (iDiD): a feasibility two-arm parallel randomised controlled trial of an online cognitive behavioural therapy intervention with and without therapist-led telephone support for psychological distress in patients undergoing haemodialysis.

    Science.gov (United States)

    Hudson, Joanna L; Moss-Morris, Rona; Game, David; Carroll, Amy; McCrone, Paul; Hotopf, Matthew; Yardley, Lucy; Chilcot, Joseph

    2016-04-12

    Psychological distress is common in end-stage kidney disease (ESKD) and is associated with poorer health outcomes. Cognitive behavioural therapy (CBT) is recommended in UK clinical guidelines for the management of depression in people with long-term conditions. Access to skilled therapists competent in managing the competing mental and physical health demands of ESKD is limited. Online CBT treatments tailored to the needs of the ESKD population offers a pragmatic solution for under-resourced services. This study examines the feasibility and acceptability of implementing a two-arm parallel randomised controlled trial of online CBT with (intervention arm) and without (control arm) therapist support to improve psychological distress in patients undergoing haemodialysis. Patients will be screened for depression and anxiety while attending for their haemodialysis treatments. We aim to recruit 60 adult patients undergoing haemodialysis who meet criteria for mild to moderately severe symptoms of depression and/or anxiety. Patients will be randomised individually (using a 1:1 computerised sequence ratio) to either online CBT with therapist telephone support (intervention arm), or online CBT with no therapist (control arm). Outcomes include feasibility and acceptability descriptive data on rates of recruitment, randomisation, retention and treatment adherence. Self-report outcomes include measures of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), quality of life (Euro-QoL), service use (client service receipt inventory) and illness cognitions (brief illness perception questionnaire). A qualitative process evaluation will also be conducted. The statistician will be blinded to treatment allocation. A National Health Service (NHS) research ethics committee approved the study. Data from this study will provide essential information for the design and testing of further interventions to ameliorate distress in patients undergoing dialysis

  13. Special Equipment and/or Devices.

    Science.gov (United States)

    National Sanitation Foundation, Ann Arbor, MI.

    This standard covers the sanitation requirements for equipment and/or devices used in the storage, preparation, or handling of foods and beverages. The National Sanitation Foundation's basic criteria for the evaluation of special equipment and/or devices has been prepared to fulfill several specific needs, its major function being to serve as a…

  14. 21 CFR 1250.67 - Watering equipment.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Watering equipment. 1250.67 Section 1250.67 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... of drinking water or other beverages, or for food preservation purposes, equipment constructed so as...

  15. Using ADA Tasks to Simulate Operating Equipment

    Science.gov (United States)

    DeAcetis, Louis A.; Schmidt, Oron; Krishen, Kumar

    1990-01-01

    A method of simulating equipment using ADA tasks is discussed. Individual units of equipment are coded as concurrently running tasks that monitor and respond to input signals. This technique has been used in a simulation of the space-to-ground Communications and Tracking subsystem of Space Station Freedom.

  16. Enhancement of equipment services for Kozloduy NPP

    International Nuclear Information System (INIS)

    Schultz, Christophe

    2013-01-01

    Conclusion After 5 years of maintenance services, KNPP and AREVA have continuously intensified their partnership Close cooperation between KNPP, AREVA Local Office Engineers and OEM experts Involvement of sophisticated tools for diagnostics and condition monitoring Performance of engineering services and obsolescence evaluation Possibilities to perform equipment modernization of Electrical and IC equipment in future

  17. Emergency team personnel and technical equipment

    International Nuclear Information System (INIS)

    Muralt, R.

    1989-01-01

    The most important requirements for the emergency team can be summarized in three points. 1) The emergency team must be made up of top personnel from all fields and it should be functionally equiped. 2) The emergency teams must have complete command of their equipment. 3) The members of the team must be well motivated. 1 fig

  18. Weight/balance portable test equipment

    International Nuclear Information System (INIS)

    Whitlock, R.W.

    1994-01-01

    This document shows the general layout, and gives a part description for the weight/balance test equipment. This equipment will aid in the regulation of the leachate loading of tanker trucks. The report contains four drawings with part specifications. The leachate originates from lined trenches

  19. 7 CFR 550.38 - Equipment.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE GENERAL ADMINISTRATIVE POLICY FOR NON-ASSISTANCE COOPERATIVE AGREEMENTS Management of Agreements... Agency, the Cooperator shall use the equipment to be replaced as trade-in or sell the equipment and use...

  20. Quantitative techniques for medical equipment maintenance management

    NARCIS (Netherlands)

    Ben Houria, Zeineb; Masmoudi, Malek; Al Hanbali, Ahmad; Khatrouch, Ikram; Masmoudi, Faouzi

    2016-01-01

    The maintenance department in a hospital is responsible for ensuring the safety of medical equipment and their availability while keeping the operation costs minimal. The selection of the best maintenance strategy is a key decision to reduce the equipment downtime, increase the availability, and

  1. 21 CFR 606.60 - Equipment.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Equipment. 606.60 Section 606.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS CURRENT... following frequency, include but are not limited to: Equipment Performance check Frequency Frequency of...

  2. Plutonium Immobilization Can Loading Equipment Review

    International Nuclear Information System (INIS)

    Kriikku, E.; Ward, C.; Stokes, M.; Randall, B.; Steed, J.; Jones, R.; Hamilton, L.

    1998-05-01

    This report lists the operations required to complete the Can Loading steps on the Pu Immobilization Plant Flow Sheets and evaluates the equipment options to complete each operation. This report recommends the most appropriate equipment to support Plutonium Immobilization Can Loading operations

  3. Radio monitoring problems, methods, and equipment

    CERN Document Server

    Rembovsky, Anatoly; Kozmin, Vladimir; Smolskiy, Sergey

    2009-01-01

    Offers a unified approach to fundamental aspects of Automated Radio Monitoring (ARM). This book discusses the development, modeling, design, and manufacture of ARM systems. It provides classification and descriptions of modern high-efficient hardware-software ARM equipment, including the equipment for detection and radio direction-finding.

  4. Development of Equipment for Use in Sport

    Science.gov (United States)

    James, David

    2012-01-01

    No one has ever been able to create a running shoe that can make one run faster, but in other sports the design of equipment has the potential to offer considerable enhancement. Judgement has to be made as to whether such advantage becomes unfair. This article indicates many possible sports in which the equipment plays an important part in the…

  5. 36 CFR 1207.32 - Equipment.

    Science.gov (United States)

    2010-07-01

    ... 1207.32 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES... as follows: (1) Items of equipment with a current per-unit fair market value of less than $5,000 may...) Items of equipment with a current per unit fair market value in excess of $5,000 may be retained or sold...

  6. 21 CFR 211.65 - Equipment construction.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Equipment construction. 211.65 Section 211.65 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS... construction. (a) Equipment shall be constructed so that surfaces that contact components, in-process materials...

  7. 47 CFR 18.203 - Equipment authorization.

    Science.gov (United States)

    2010-10-01

    ... information already on file with the Commission. (2) A technical report pursuant to §§ 18.207 and 18.311. (b... 47 Telecommunication 1 2010-10-01 2010-10-01 false Equipment authorization. 18.203 Section 18.203 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INDUSTRIAL, SCIENTIFIC, AND MEDICAL EQUIPMENT...

  8. Automatic monitoring of vibration welding equipment

    Science.gov (United States)

    Spicer, John Patrick; Chakraborty, Debejyo; Wincek, Michael Anthony; Wang, Hui; Abell, Jeffrey A; Bracey, Jennifer; Cai, Wayne W

    2014-10-14

    A vibration welding system includes vibration welding equipment having a welding horn and anvil, a host device, a check station, and a robot. The robot moves the horn and anvil via an arm to the check station. Sensors, e.g., temperature sensors, are positioned with respect to the welding equipment. Additional sensors are positioned with respect to the check station, including a pressure-sensitive array. The host device, which monitors a condition of the welding equipment, measures signals via the sensors positioned with respect to the welding equipment when the horn is actively forming a weld. The robot moves the horn and anvil to the check station, activates the check station sensors at the check station, and determines a condition of the welding equipment by processing the received signals. Acoustic, force, temperature, displacement, amplitude, and/or attitude/gyroscopic sensors may be used.

  9. Requirements for industrial x-ray equipment

    International Nuclear Information System (INIS)

    1987-01-01

    This safety code is concerned with the protection of all individuals who may be exposed to radiation emitted by X-ray equipment operating at energies up to 1 MeV as used in industrial radiography. This code presents basic radiation safety information for the protection of personnel operating and servicing X-ray equipment and other workers and the general public in the vicinity of areas where X-ray equipment is in operation. It specifies general safety features of design, construction and functioning of X-ray equipment and facilities; describes the responsibilities of the user, operator and maintenance personnel; contains recommendations to ensure that the X-ray equipment is used and maintained in accordance with the ALARA principle; and describes a program of personnel monitoring and radiation safety surveys. ( 6 refs., 5 tabs., 4 figs.)

  10. Equipment qualification research program: program plan

    International Nuclear Information System (INIS)

    Dong, R.G.; Smith, P.D.

    1982-01-01

    The Lawrence Livermore National Laboratory (LLNL) under the sponsorship of the US Nuclear Regulatory Commission (NRC) has developed this program plan for research in equipment qualification (EQA). In this report the research program which will be executed in accordance with this plan will be referred to as the Equipment Qualification Research Program (EQRP). Covered are electrical and mechanical equipment under the conditions described in the OBJECTIVE section of this report. The EQRP has two phases; Phase I is primarily to produce early results and to develop information for Phase II. Phase I will last 18 months and consists of six projects. The first project is program management. The second project is responsible for in-depth evaluation and review of EQ issues and EQ processes. The third project is responsible for detailed planning to initiate Phase II. The remaining three projects address specific equipment; i.e., valves, electrical equipment, and a pump

  11. Development of Turbulence-Measuring Equipment

    Science.gov (United States)

    Kovasznay, Leslie S G

    1954-01-01

    Hot wire turbulence-measuring equipment has been developed to meet the more stringent requirements involved in the measurement of fluctuations in flow parameters at supersonic velocities. The higher mean speed necessitates the resolution of higher frequency components than at low speed, and the relatively low turbulence level present at supersonic speed makes necessary an improved noise level for the equipment. The equipment covers the frequency range from 2 to about 70,000 cycles per second. Constant-current operation is employed. Compensation for hot-wire lag is adjusted manually using square-wave testing to indicate proper setting. These and other features make the equipment adaptable to all-purpose turbulence work with improved utility and accuracy over that of older types of equipment. Sample measurements are given to demonstrate the performance.

  12. Oil and gas products and energy equipment

    International Nuclear Information System (INIS)

    1996-01-01

    The planned activities of the Canadian oil and gas products and energy equipment industry for 1996-1997, were presented. The sector is made up of approximately 1500 small and medium sized enterprises. The Canadian oil field manufacturing and servicing industry holds only a small 2.5% share of the world export market, but it is recognized internationally as one of the leading suppliers of advanced petroleum equipment. Their exports include specialized equipment for extracting oil sands, gathering and treatment facilities for sour gas, underbalanced drilling technologies, equipment for wells experiencing declining production rates, top motor drives, winter drilling rigs, and horizontal drilling technologies. They also offer petroleum industry software products. Most exploration and production equipment sold abroad by Canadian firms is manufactured in Canada, but there is an increasing trend toward manufacturing in the country of operation. 2 tabs

  13. Equipment for the handling of thorium materials

    International Nuclear Information System (INIS)

    Heisler, S.W. Jr.; Mihalovich, G.S.

    1988-01-01

    The Feed Materials Production Center (FMPC) is the United States Department of Energy's storage facility for thorium. FMPC thorium handling and overpacking projects ensure the continued safe handling and storage of the thorium inventory until final disposition of the materials is determined and implemented. The handling and overpacking of the thorium materials requires the design of a system that utilizes remote handling and overpacking equipment not currently utilized at the FMPC in the handling of uranium materials. The use of remote equipment significantly reduces radiation exposure to personnel during the handling and overpacking efforts. The design system combines existing technologies from the nuclear industry, the materials processing and handling industry and the mining industry. The designed system consists of a modified fork lift truck for the transport of thorium containers, automated equipment for material identification and inventory control, and remote handling and overpacking equipment for material identification and inventory control, and remote handling and overpacking equipment for repackaging of the thorium materials

  14. Energy to the Edge (E2E) Equipment Assessment U.S. Army Rapid Equipping Force

    Science.gov (United States)

    2015-05-01

    84 Contents Energy to the Edge • U.S. Army Rapid Equipping Force U.S. Army Rapid Equipping Force 1.0 Executive Summary Executive Summary U.S. Army... audiovisual equipment. • Once radiant barrier liner is inserted, the process of subsequent setups • Cables for lighting and outlets are located...behind the internal barrier • The shelter comes with organic audiovisual equipment. b. • • This shelter has a different setup and tear down process

  15. Days individual equipment of protection and professional risks; Equipements de protection individuelle et risques professionnelles

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    The personal protection equipment is studied in the legal way (legal liabilities, certification, European texts), technical way (ergonomics, painfulness of ventilated equipment wearing, reliability of a respirable air line, protection gloves against the chemical risk, exposure to nano particulates, working in hot area), human factors (hostile area and emotion management), studies on personal equipment such evaluation, efficiency, conception of new equipment, physiological tolerance, limit of use, and some general safety studies on the working places. (N.C.)

  16. Establishment of nuclear equipment qualification system

    International Nuclear Information System (INIS)

    Joo, Po Kook; Lim, Nam Jin; Lee, Young Gun

    2003-04-01

    This study is carried out by KEARI(Korea Atomic Energy Research Institute) as the lead organization in cooperation with KIMM(Korea Institute of Machinery and Materials), KTL(Korea Testing Laboratory) and KRISS(Korea Research Institute of Standards and Science) to construct a basis of efficient management of nuclear equipment qualification business by expanding test equipment of each of participating organization, and developing qualification technologies. As for KIMM, control system of large scale shaker was replaced with advanced system, and LOCA(Loss of Coolant Accident) test facility was installed. KTL is now capable of conducting seismic tests of nuclear I and C as a result of installation of seismic test equipment during the first two project years. KRISS participated in the Project with a view to have large scale EMI test equipment and related technologies. In parallel with expansion of test equipment, a industrial-educational-research cooperation committee, as an intermediate step toward integrated equipment qualification system to maximize the usage of test equipment, was established and cooperation methods were investigated. As a result, Korea Nuclear Equipment Qualification Association, an corporate juridical person, was established. Research on development of thermal and radiation aging test technology of nuclear materials was carried out by Hanyang University and SECO(Saehan Engineering and Qualification Co., Ltd.). Integrated Equipment Qualification Database was developed which contains material test data, equipment qualification data and other EQ related informations. Standard qualification procedures were developed in order for test laboratories and manufacturers to establish design requirements and to efficiently perform tests

  17. Equipment Reliability Program in NPP Krsko

    International Nuclear Information System (INIS)

    Skaler, F.; Djetelic, N.

    2006-01-01

    Operation that is safe, reliable, effective and acceptable to public is the common message in a mission statement of commercial nuclear power plants (NPPs). To fulfill these goals, nuclear industry, among other areas, has to focus on: 1 Human Performance (HU) and 2 Equipment Reliability (EQ). The performance objective of HU is as follows: The behaviors of all personnel result in safe and reliable station operation. While unwanted human behaviors in operations mostly result directly in the event, the behavior flaws either in the area of maintenance or engineering usually cause decreased equipment reliability. Unsatisfied Human performance leads even the best designed power plants into significant operating events, which can be found as well-known examples in nuclear industry. Equipment reliability is today recognized as the key to success. While the human performance at most NPPs has been improving since the start of WANO / INPO / IAEA evaluations, the open energy market has forced the nuclear plants to reduce production costs and operate more reliably and effectively. The balance between these two (opposite) goals has made equipment reliability even more important for safe, reliable and efficient production. Insisting on on-line operation by ignoring some principles of safety could nowadays in a well-developed safety culture and human performance environment exceed the cost of electricity losses. In last decade the leading USA nuclear companies put a lot of effort to improve equipment reliability primarily based on INPO Equipment Reliability Program AP-913 at their NPP stations. The Equipment Reliability Program is the key program not only for safe and reliable operation, but also for the Life Cycle Management and Aging Management on the way to the nuclear power plant life extension. The purpose of Equipment Reliability process is to identify, organize, integrate and coordinate equipment reliability activities (preventive and predictive maintenance, maintenance

  18. Drawing Evaluation Report for Sampling Equipment Drawings

    International Nuclear Information System (INIS)

    BOGER, R.M.

    1999-01-01

    This document presents the results of a task to update the evaluation of River Protection Project (WP) sampling equipment drawings and updates the assigned drawings category as either essential, support, or general drawings. This report updates the drawing evaluation that was originally done per Engineering Task Plan For Truck 3 and 4 Drawing Compliance and Evaluation. The scope of this report is limited to updating the evaluation and identification of drawing category for drawings of certain tank waste sampling equipment for which the RPP Characterization Project has been assigned custody, including: vapor sampling, grab sampling, auger sampling, all core sampling equipment, and Light Duty Utility Arm (LDUA) (see LMHC contract No. 519, release 10). This report does not address drawings for other waste tank deployed equipment systems having similar assigned custody, such as, Cone Penetrometer system, or Long Length Contaminated Equipment (LLCE). The Cone Penetrometer system, which is depicted on vendor drawings, (not H- series), is not currently turned over to operations for deployment. The LLCE equipment was just recently assigned to Characterization Project and was not included in the original scope for this update and will be addressed in the evaluation update scheduled for later in fiscal year 1999, when equipment ownership is determined

  19. Drawing evaluation report for sampling equipment drawings

    International Nuclear Information System (INIS)

    WILSON, G.W.

    1999-01-01

    This document presents the results of a task to evaluate Tank Waste Remediation System (TWRS) sampling equipment drawings and identifies drawings category as either essential, support, or general drawings. This report completes the drawing evaluation task as outlined in Engineering Task Plan For Truck 3 and 4 Drawing Compliance and Evaluation (Wilson, 1997). The scope of this report is limited to an evaluation and identification of drawing category for drawings of certain tank waste sampling equipment for which the TRWS Characterization Project has been assigned custody, including: vapor sampling, grab sampling, auger sampling, and all core sampling equipment (see LMHC Task Order 304). This report does not address drawings for other waste tank deployed equipment systems having similar assigned custody, such as, Light Duty Utility Arm (LDUA), Cone Penetrometer system, or Long Length Contaminated Equipment (LLCE). The LDUA drawings are addressed in the Characterization Equipment Essential Drawings (HNF 1998). The Cone Penetrometer system drawings which are vendor drawings (not H- series) is not currently turned over to operations for deployment. The LLCE equipment was just recently assigned to Characterization Project and were not included in the original scope for this evaluation and will be addressed in the evaluation update scheduled for fiscal year 1999

  20. Progress on EPRI electrical equipment qualification research

    International Nuclear Information System (INIS)

    Sliter, G.E.

    1983-01-01

    The objective of EPRI's electrical equipment qualification research program is to provide technical assistance to utilities in meeting nuclear plant safety requirements in a manner consistent with the state of the art. This paper reports progress on several research projects including: radiation effects studies, which compile data on degradation of organic materials in electrical equipment exposed to operational and accident radiation doses; the Equipment Qualification Data Bank, which is a remotely accessible computer system for disseminating qualification information on in-plant equipment, seismic data, and materials data; an aging/seismic correlation program, which is providing test data showing that, in many cases, age degradation has a negligibly small effect on the performance of electrical components under seismic excitation; a review of condition monitoring techniques, which has identified surveillance methods for measuring key performance parameters that have the potential for predicting remaining equipment life; and large-scale hydrogen burn equipment response tests, which are providing data to assess the ability of equipment to remain functional during and after hydrogen burning in postulated degraded core accidents

  1. A phase 3, multicentre, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of etelcalcetide (ONO-5163/AMG 416), a novel intravenous calcimimetic, for secondary hyperparathyroidism in Japanese haemodialysis patients.

    Science.gov (United States)

    Fukagawa, Masafumi; Yokoyama, Keitaro; Shigematsu, Takashi; Akiba, Takashi; Fujii, Akifumi; Kuramoto, Takuto; Odani, Motoi; Akizawa, Tadao

    2017-10-01

    Secondary hyperparathyroidism (SHPT) is a major complication associated with chronic kidney disease. We evaluated the efficacy and safety of etelcalcetide (ONO-5163/AMG 416), a novel intravenous calcimimetic, in Japanese haemodialysis patients with SHPT. In this phase 3, multicentre, randomized, double-blind, placebo-controlled, parallel-group study, etelcalcetide was administered three times per week at an initial dose of 5 mg, and subsequently adjusted to doses between 2.5 and 15 mg at 4-week intervals for 12 weeks. A total of 155 SHPT patients with serum intact parathyroid hormone (iPTH) levels ≥300 pg/mL were assigned to receive etelcalcetide (n = 78) or placebo (n = 77). The primary endpoint was the proportion of patients with decreased serum iPTH to the target range proposed by the Japanese Society for Dialysis Therapy (60-240 pg/mL). The major secondary endpoint was the proportion of patients with ≥30% reductions in serum iPTH from baseline. The proportion of patients meeting the primary endpoint was significantly higher for etelcalcetide (59.0%) versus placebo (1.3%). Similarly, the proportion of patients meeting the major secondary endpoint was significantly higher for etelcalcetide (76.9%) versus placebo (5.2%). Serum albumin-corrected calcium, phosphorus and intact fibroblast growth factor-23 levels were decreased in the etelcalcetide group. Nausea, vomiting and symptomatic hypocalcaemia were mild with etelcalcetide. Serious adverse events related to etelcalcetide were not observed. This study demonstrated the efficacy and safety of etelcalcetide. As the only available intravenous calcium-sensing receptor agonist, etelcalcetide is likely to provide a new treatment option for SHPT in haemodialysis patients. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

  2. Long Length Contaminated Equipment Maintenance Plan

    International Nuclear Information System (INIS)

    ESVELT, C.A.

    2000-01-01

    The purpose of this document is to provide the maintenance requirements of the Long Length Contaminated Equipment (LLCE) trailers and provide a basis for the maintenance frequencies selected. This document is applicable to the LLCE Receiver trailer and Transport trailer assembled by Mobilized Systems Inc. (MSI). Equipment used in conjunction with, or in support of, these trailers is not included. This document does not provide the maintenance requirements for checkout and startup of the equipment following the extended lay-up status which began in the mid 1990s. These requirements will be specified in other documentation

  3. Remote handling equipment for CANDU retubing

    International Nuclear Information System (INIS)

    Crawford, G.S.; Lowe, H.

    1993-01-01

    Numet Engineering Ltd. has designed and supplied remote handling equipment for Ontario Hydro's retubing operation of its CANDU reactors at the Bruce Nuclear Generating Station. This equipment consists of ''Retubing Tool Carriers'' an'' Worktables'' which operate remotely or manually at the reactor face. Together they function to transport tooling to and from the reactor face, to position and support tooling during retubing operations, and to deliver and retrieve fuel channels and channel components. This paper presents the fundamentals of the process and discusses the equipment supplied in terms of its design, manufacturing, components and controls, to meet the functional and quality requirements of Ontario Hydro's retubing process. (author)

  4. Equipment for x- and gamma ray radiography

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    The following topics related to the equipment for x - and gamma ray radiography are discussed in this chapter. The topics are x-ray source for Industrial Radiography: properties of x-ray, generation of x-ray, mechanism of x-ray production, x-ray equipment, power supply, distribution of x-ray intensity along the tube: gamma ray source for Industrial Radiography: properties of gamma rays, gamma ray sources, gamma ray projectors on cameras, source changing. Care of Radiographic Equipments: Merits and Demerits of x and Gamma Rays

  5. Exposure parameters in fluoroscopy equipment. Quality control

    International Nuclear Information System (INIS)

    Alonso, M.; Castaneda, M.J.; Matorras, P.; Diaz-Caneja, N.; Gutierrez, I.

    1992-01-01

    Within the quality control program in Diagnostic Radiology currently being undertaken at the 'Marques de Valdecilla' University Hospital, the corresponding specification and procedure prototypes for the control of conventional radioscopy equipment have been elaborated and applied. This paper presents the values proposed in the specifications and those obtained for the following radioscopy equipment parameters: reference kerma, and its reproducibility, kerma linearity, maximum kerma at the skin, and total filtration. The results obtained indicate that the equipment studied could comply with specified requirements if a Maintenance Program were to be implemented in coordination with the Quality Control Program. (author)

  6. LMZ experience in refurbishment of hydroturbine equipment

    Energy Technology Data Exchange (ETDEWEB)

    Sotnikov, Anatoly A. [LMZ, St. Petersburg (Russian Federation). Div. of Hydraulic Machine

    2000-07-01

    AO LMZ experience in refurbishment of hydroturbine equipment is generalized. Hydraulic turbines of many power stations having been in service of more than 30 years need rehabilitation and modernization. As a rule, the following problems are solved in the process of refurbishment works: increase of turbine efficiency and output, ensuring of reliable operation of the equipment during the next length of life, ensuring the environmental safety of the equipment, furnishing of the power station with up to date automatic control systems. The process of refurbishment used by LMZ is described. The examples of refurbishment are given. (author)

  7. Incidents of chemical reactions in cell equipment

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, N.M.; Barlow, C.R. [Uranium Enrichment Organization, Oak Ridge, TN (United States)

    1991-12-31

    Strongly exothermic reactions can occur between equipment structural components and process gases under certain accident conditions in the diffusion enrichment cascades. This paper describes the conditions required for initiation of these reactions, and describes the range of such reactions experienced over nearly 50 years of equipment operation in the US uranium enrichment program. Factors are cited which can promote or limit the destructive extent of these reactions, and process operations are described which are designed to control the reactions to minimize equipment damage, downtime, and the possibility of material releases.

  8. [Development of Hospital Equipment Maintenance Information System].

    Science.gov (United States)

    Zhou, Zhixin

    2015-11-01

    Hospital equipment maintenance information system plays an important role in improving medical treatment quality and efficiency. By requirement analysis of hospital equipment maintenance, the system function diagram is drawed. According to analysis of input and output data, tables and reports in connection with equipment maintenance process, relationships between entity and attribute is found out, and E-R diagram is drawed and relational database table is established. Software development should meet actual process requirement of maintenance and have a friendly user interface and flexible operation. The software can analyze failure cause by statistical analysis.

  9. Automatic dose-rate controlling equipment

    International Nuclear Information System (INIS)

    Szasz, T.; Nagy Czirok, Cs.; Batki, L.; Antal, S.

    1977-01-01

    The patent of a dose-rate controlling equipment that can be attached to X-ray image-amplifiers is presented. In the new equipment the current of the photocatode of the image-amplifier is led into the regulating unit, which controls the X-ray generator automatically. The advantages of the equipment are the following: it can be simply attached to any type of X-ray image-amplifier, it accomplishes fast and sensitive regulation, it makes possible the control of both the mA and the kV values, it is attached to the most reliable point of the image-transmission chain. (L.E.)

  10. Maintenance and fabrication of nuclear electronic equipment

    International Nuclear Information System (INIS)

    Hong, Seok Boong; Chung, Chong Eun; Hwang, In Koo; Koo, In Soo; Park, Bum; Kim, Soo Hee; Lee, Seong Joo; Kim, Min Seok; Choi, Wha Lim

    2011-12-01

    - process equipment at PIEF, Chemical Analysis Team and RWFTF have been calibrated. - The electronic equipment and radiation equipment at RWTF and PIEF have been prepared. - Development and installation of integrated RMS software for Hanaro Cold Neutron Laboratory Building(CNLB) RMS, and development and performance upgrade of a portal monitor for CNLB. - Performance test of the Hardware/Software of digital unit controller has been performed, and functional upgrade of the Hardware/Software of stimulator for SMART MMIS performance test facility has also been performed. - A controller of high voltage power supply for a small electron beam generator and a controller for razer pinning and a remote monitoring apparatus of cathode power supply for a 0.2 Mev. small electron beam generator have been designed and fabricated. - Database construction for effective maintenance for the process equipment and radiation instruments are designed and constructed

  11. 18 CFR 367.57 - Equipment.

    Science.gov (United States)

    2010-04-01

    ... piers and foundations that are designed to be as permanent as the buildings that house the equipment, or... walls, ceilings or floors or without in some way impairing the building, must be included in the...

  12. Capitalization of Defense Technology Security Administration Equipment

    National Research Council Canada - National Science Library

    Gimble, Thomas

    1996-01-01

    ... $5.2 million in the Equipment in Use account on its trial balance. Starting with FY 1996, Defense Technology Security Administration financial data will be included in consolidated DoD financial statements...

  13. Hot conditioning equipment conceptual design report

    Energy Technology Data Exchange (ETDEWEB)

    Bradshaw, F.W., Westinghouse Hanford

    1996-08-06

    This report documents the conceptual design of the Hot Conditioning System Equipment. The Hot conditioning System will consist of two separate designs: the Hot Conditioning System Equipment; and the Hot Conditioning System Annex. The Hot Conditioning System Equipment Design includes the equipment such as ovens, vacuum pumps, inert gas delivery systems, etc.necessary to condition spent nuclear fuel currently in storage in the K Basins of the Hanford Site. The Hot Conditioning System Annex consists of the facility of house the Hot Conditioning System. The Hot Conditioning System will be housed in an annex to the Canister Storage Building. The Hot Conditioning System will consist of pits in the floor which contain ovens in which the spent nuclear will be conditioned prior to interim storage.

  14. Hot conditioning equipment conceptual design report

    International Nuclear Information System (INIS)

    Bradshaw, F.W.

    1996-01-01

    This report documents the conceptual design of the Hot Conditioning System Equipment. The Hot conditioning System will consist of two separate designs: the Hot Conditioning System Equipment; and the Hot Conditioning System Annex. The Hot Conditioning System Equipment Design includes the equipment such as ovens, vacuum pumps, inert gas delivery systems, etc.necessary to condition spent nuclear fuel currently in storage in the K Basins of the Hanford Site. The Hot Conditioning System Annex consists of the facility of house the Hot Conditioning System. The Hot Conditioning System will be housed in an annex to the Canister Storage Building. The Hot Conditioning System will consist of pits in the floor which contain ovens in which the spent nuclear will be conditioned prior to interim storage

  15. ENERGY STAR Certified Electric Vehicle Supply Equipment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Electric Vehicle Supply Equipment that are...

  16. Study Of Robotic Replacement Of Equipment Modules

    Science.gov (United States)

    Backes, Paul G.; Tso, Kam S.

    1992-01-01

    Report discusses issues pertaining to control of single-arm robotic manipulator to remove and install interchangeable equipment modules. Presents preliminary control strategy intended to guide development of control algorithms, along with analyses of problems arising in implementing strategy.

  17. Market survey of level measurement equipment

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    In a market survey of level measurement equipment from 42 manufacturers, which is based on different principles of measurement and which is used for different applications, the data of the various manufacturers is compiled. (orig./HP) [de

  18. 77 FR 13173 - Best Equipped Best Served

    Science.gov (United States)

    2012-03-05

    ... on the best equipped, best performing, best served concept for implementation in the 2012-2014... Advisory Committee (NAC). FAA is seeking stakeholder input on the technical and operational feasibility of...

  19. Methods and equipments used in power reactors

    International Nuclear Information System (INIS)

    Beraha, R.; Delevallee, A.

    1976-01-01

    The various reactor γ fuel scanning facilities presently operating around the world are reviewed. Both equipments proposed by FRAMATOME are described: one is intended for scanning removable fuel pencils, and the other one for fuel assembly scanning [fr

  20. AX Tank Farm ancillary equipment study

    International Nuclear Information System (INIS)

    SKELLY, W.A.

    1999-01-01

    This report examines the feasibility of remediating ancillary equipment associated with the 241-AX Tank Farm at the Hanford Site. Ancillary equipment includes surface structures and equipment, process waste piping, ventilation components, wells, and pits, boxes, sumps, and tanks used to make waste transfers to/from the AX tanks and adjoining tank farms. Two remedial alternatives are considered: (1) excavation and removal of all ancillary equipment items, and (2) in-situ stabilization by grout filling, the 241-AX Tank Farm is being employed as a strawman in engineering studies evaluating clean and landfill closure options for Hanford single-shell tanks. This is one of several reports being prepared for use by the Hanford Tanks Initiative Project to explore potential closure options and to develop retrieval performance evaluation criteria for tank farms

  1. VIRTUAL ELECTRONIC COMPONENTS OF THE ELECTRONIC EQUIPMENT

    Directory of Open Access Journals (Sweden)

    E. Lazarevich

    2013-01-01

    Full Text Available The article is present new idea of the creation, developments and improvements of the electronic equipment of complex systems by means of the virtual electronic components. The idea of the virtual electronic components is a presentation and perception of the creation and developments of the equipment on two forming: real – in the manner of standard marketed block of the intellectual property and image – in the manner of virtual component. The real component in most cases slows the development of the electronic equipment. The imaginary component is the «locomotive» of development of the electronic equipment. The Imaginary component contains the scientific has brushed against developer. The scientific has brushed against developer reveals of itself in the manner of virtual component on the modern level of the design rates of microelectronics.

  2. 7 CFR 58.626 - Packaging equipment.

    Science.gov (United States)

    2010-01-01

    ... containers with frozen desserts shall be constructed so that all product contact surfaces shall be of... Standards for Equipment for Packaging Frozen Desserts and Cottage Cheese. Quality Specifications for Raw...

  3. ENERGY STAR Certified Small Network Equipment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Small Networking Equipment that are effective as...

  4. Ethical home medical equipment business practices.

    Science.gov (United States)

    Parver, C

    1991-11-01

    National uniform standards as a condition for receipt of a Medicare provider number would help rid the home medical equipment industry of those unethical and unscrupulous suppliers who have tarnished the industry's reputation.

  5. Experience with rotating equipment in FBTR

    International Nuclear Information System (INIS)

    Babu, A.; Subramanian, K.G.; Selvam, B.

    2006-01-01

    Fast breeder test reactor (FBTR) is a 40MWth sodium cooled PuC-UC fuelled fast breeder reactor located at Kalpakkam, Tamilnadu. FBTR has a variety of mechanical and electrical equipment comprising of single stage and multi stage water pumps, sodium pumps, compressors, Chiller units, Diesel Generator sets, vacuum pumps, ventilation fans, Turbo generator etc. The degree and extent of maintenance on these equipment are decided based on nuclear safety, station technical specification requirements, design criteria and operating philosophy. The variety and complexity of the equipment in FBTR demands various maintenance strategies (preventive, predictive, proactive etc.) for their upkeep. This paper discusses the performance of all mechanical and electrical equipment in FBTR, measures taken for their upkeep, major modifications done to prevent recurring failures, condition monitoring programme implemented, Maintenance Management and Information System developed for data acquisition and dissemination, etc. (author)

  6. Radiation therapy sources, equipment and installations

    International Nuclear Information System (INIS)

    2011-03-01

    The safety code for Telegamma Therapy Equipment and Installations, (AERB/SC/MED-1) and safety code for Brachytherapy Sources, Equipment and Installations, (AERB/SC/MED-3) were issued by AERB in 1986 and 1988 respectively. These codes specified mandatory requirements for radiation therapy facilities, covering the entire spectrum of operations ranging from the setting up of a facility to its ultimate decommissioning, including procedures to be followed during emergency situations. The codes also stipulated requirements of personnel and their responsibilities. With the advent of new techniques and equipment such as 3D-conformal radiation therapy, intensity modulated radiation therapy, image guided radiation therapy, treatment planning system, stereotactic radiosurgery, stereotactic radiotherapy, portal imaging, integrated brachytherapy and endovascular brachytherapy during the last two decades, AERB desires that these codes be revised and merged into a single code titled Radiation Therapy Sources, Equipment, and Installations

  7. Equipment for oral surgery in small animals.

    Science.gov (United States)

    Reiter, Alexander M

    2013-05-01

    This article provides an overview of equipment used for oral surgery. Specific instruments and materials used when performing relevant operative procedures are also mentioned in other articles in this issue. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Manufacture and maintenance of laboratory equipment

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Chang Kyu; Hwang, Bong Ha; Lee, Jong Wha; Kim, Jong Kyun; Yeum, Ki Eon; Park, Myung Ku; Hong, Soon Eon; Choi, Ho Young; An, Dae Kyu; An, Choon; Park, In Won; Kim, Kyung Sik; Lee, Won Jae; Yoon, Ki Byung; Kim, Heung Woo; Lee, In Bae; Yeom, Jeong Hyun; Lee, Chul Ku; Sin, Keon Ju; Oh, Wan Ho; Seo, Yong Chil; Yang, Song Yeul; Lee, Young Soon; Choi, Byung Kwon; Chang, Kyung Duk [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1993-12-01

    This report on the manufacture and maintenance of laboratory equipment contains working contents, scope and contents of request working to the machine shop, also records the principal production design, manufacture contents and a relevant working drawing. The working content and scope of the machine shop is to support the successful and convenient performance of the R and D by manufacture and maintenance of all sorts of laboratory equipment. 11 tabs., 3 figs. (Author) .new.

  9. Manufacture and maintenance of laboratory equipment

    International Nuclear Information System (INIS)

    Hwang, Chang Kyu; Hwang, Bong Ha; Lee, Jong Wha; Kim, Jong Kyun; Yeum, Ki Eon; Park, Myung Ku; Hong, Soon Eon; Choi, Ho Young; An, Dae Kyu; An, Choon; Park, In Won; Kim, Kyung Sik; Lee, Won Jae; Yoon, Ki Byung; Kim, Heung Woo; Lee, In Bae; Yeom, Jeong Hyun; Lee, Chul Ku; Sin, Keon Ju; Oh, Wan Ho; Seo, Yong Chil; Yang, Song Yeul; Lee, Young Soon; Choi, Byung Kwon; Chang, Kyung Duk

    1993-12-01

    This report on the manufacture and maintenance of laboratory equipment contains working contents, scope and contents of request working to the machine shop, also records the principal production design, manufacture contents and a relevant working drawing. The working content and scope of the machine shop is to support the successful and convenient performance of the R and D by manufacture and maintenance of all sorts of laboratory equipment. 11 tabs., 3 figs. (Author) .new

  10. Ion beam stabilization in ion implantation equipment

    International Nuclear Information System (INIS)

    Pina, L.

    1973-01-01

    The results are presented of experimental efforts aimed at ion beam current stabilization in an equipment for ion implantation in solids. The related problems of power supplies are discussed. Measured characteristics of laboratory equipment served the determination of the parameters to be required of the supplies as well as the design and the construction of the supplies. The respective wiring diagram is presented. (J.K.)

  11. Manufacture and maintenance of laboratory equipment

    International Nuclear Information System (INIS)

    Kim, Jong Kyun; Hwang, Chang Kyu; Hwang, Bong Ha; Lee, Jong Wha; Yeom, Ki Eon; Park, Myung Ku; Hong, Soon Hyeon; Choi, Ho Young; An, Dae Kyu; An, Choon; Park, In Won; Kim, Kyeong Sik; Lee, In Bae; Yeom, Jeong Heon; Lee, Chul Ku; Sin, Keon Ju; Oh, Wan Ho; Choi, Byung Kwon; Chang, Kyeong Duk; Lee, Young Soon

    1995-12-01

    This report on the manufacture and maintenance of laboratory equipment contains working contents, scope and contents of a request working to the Machine Shop, also records the principal production design, manufacture contents and a relevant working drawing. The working content and scope of the Machine Shop is to support the successful and convenient performance of the Research and development by manufacture and maintenance of all sorts of laboratory equipment. 12 tabs., 5 figs. (Author) .new

  12. Regulatory process for material handling equipment

    International Nuclear Information System (INIS)

    Rajendran, S.; Agarwal, Kailash

    2017-01-01

    Atomic Energy (Factories) Rules (AEFR) 1996, Rule 35 states, 'Thorough inspection and load testing of a Crane shall be done by a Competent Person at least once every 12 months'. To adhere to this rule, BARC Safety Council constituted 'Material Handling Equipment Committee (MHEC)' under the aegis of Conventional Fire and Safety Review Committee (CFSRC) to carry out periodical inspection and certification of Material Handling Equipment (MHE), tools and tackles used in BARC Facilities at Trombay, Tarapur and Kalpakkam

  13. Manufacture and maintenance of laboratory equipment

    International Nuclear Information System (INIS)

    Kim, J. K.; Whang, C. K.; Lee, J. H.; Youm, K. Y.; Hong, S. H.; Choi, H. Y.; An, C.; Park, I. W.; Kim, K. S.; Lee, W. J.; Yoon, K. B.; Kim, H. W.; Lee, I. B.; Lee, C. K.; Youm, J. H.; Oho, W. H.; Choi, B. K.; Jang, K. D.

    1996-12-01

    This report on the manufacture and maintenance of laboratory equipment contains working contents, scope and contents of a request working to the Machine Shop, also records the principal production design, manufacture contents and a relevant working drawing. The working content and scope of the Machine Shop is to support the successful and convenient performance of the R and D by manufacture and maintenance of all sorts of laboratory equipment. (author). 9 tabs., 12 figs

  14. Stud bolt handling equipment for reactor vessel

    International Nuclear Information System (INIS)

    Bunyan, T.W.

    1989-01-01

    Reactor vessel stud bolt handling equipment includes means for transferring a stud bolt to a carrier from a parking station, or vice versa. Preferably a number of stud bolts are handled simultaneously. The transfer means may include cross arms rotatable about extendable columns, and the equipment is mounted on a mobile base for movement into and out of position. Each carrier comprises a tubular socket and an expandable sleeve to grip a stud bolt. (author)

  15. Protecting electrical equipment against dust explosions

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, J

    1981-07-01

    The new ordinance on electrical equipment in hazardous areas and the new VDE 0165/6.80 have brought about significant changes in the field of electrical equipment in areas with a explosion hazard due inflammable dust. There are no constructional regulations yet in this field, and producers, planners, and users are uncertain about what measures to take. The article attempts to clear up a few points.

  16. Manufacture and maintenance of laboratory equipment

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Kyun; Hwang, Chang Kyu; Hwang, Bong Ha; Lee, Jong Wha; Yeom, Ki Eon; Park, Myung Ku; Hong, Soon Hyeon; Choi, Ho Young; An, Dae Kyu; An, Choon; Park, In Won; Kim, Kyeong Sik; Lee, In Bae; Yeom, Jeong Heon; Lee, Chul Ku; Sin, Keon Ju; Oh, Wan Ho; Choi, Byung Kwon; Chang, Kyeong Duk; Lee, Young Soon [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1995-12-01

    This report on the manufacture and maintenance of laboratory equipment contains working contents, scope and contents of a request working to the Machine Shop, also records the principal production design, manufacture contents and a relevant working drawing. The working content and scope of the Machine Shop is to support the successful and convenient performance of the Research and development by manufacture and maintenance of all sorts of laboratory equipment. 12 tabs., 5 figs. (Author) .new.

  17. Profit ability versus construction equipment maintenance

    OpenAIRE

    Clutts, Craig A.

    2010-01-01

    CIVINS (Civilian Institutions) Thesis document Approved for public release ; distribution is unlimited Construction equipment is a high cost of capital investment necessary for the successful existence of a private construction company and essential to the mission success of the Naval Construction Force (NCF). The highest impact cost factor other than the initial purchase investment is the expenses related to maintenance and repair. As the equipment ages, the ownership costs decrease an...

  18. Electronic equipment for spectrometric data processing

    International Nuclear Information System (INIS)

    Antonov, L.J.; Trenev, A.M.; Todorova, E.I.; Dimitrov, V.D.

    1978-01-01

    Electronic equipment carrying out logical operations and a full set of the arithmetic operations was developed for spectrometric data processing. The flowsheet of the computing part of the device, made on the basis of a specialized integral circuit, is given. The device includes input registers, multiplexor, matrix commutator, arithmetic unit and indication unit. The equipment is rated to carry out calculations according to comparatively complex formulae in several seconds

  19. Physical protection equipment study. Final report

    International Nuclear Information System (INIS)

    Haberman, W.

    1977-06-01

    This report summarizes the work performed by MITRE for the U.S. Nuclear Regulatory Commission. The major products of this effort are a Catalog of Physical Protection Equipment, a Guide for Evaluation of Physical Protection Equipment, a book of Reference Materials, and a set of guidelines for use in the development of a methodology for measuring levels of security system effectiveness. A summary of recommendations resulting from this study is also presented

  20. Industrial Employment, Investment Equipment and Economic Growth

    OpenAIRE

    Dellas, Harris

    2000-01-01

    The industrialization of labour is the main engine of growth during the early stages of economic development. In less developed countries, equipment investment has played a less important role than non-equipment investment; and it has only proved growth enhancing when it either encountered a substantial industrial labour force or fostered a large increase in the share of industrial employment. These findings draw attention to the effects of investment on the composition of the labour force; a...