An account of the first hours of the Covid-19 epidemic at the Nephrology Unit in Lodi (Lombardy).

Marco Farina and colleagues give us their account of the first days of the Covid-19 epidemic in the Nephrology Unit of the Ospedale Maggiore in Lodi. From the news trickling through from Codogno on the 20th of February to the hospitalization, the following day, of the first dialytic patient with signs of pneumonia, who later tested positive to the virus. They tell us of how the hospital has been completely restructured in the wake of the epidemic, at remarkable speed and providing an example for others to follow, and the great sense self-sacrifice displayed by all medical personnel. After an overview of the clinical conditions of the 7 patients positive to the virus hospitalised in the following few days, they describe in some detail how symptomatic Covid+ patients are currently managed at the Ospedale Maggiore in Lodi.

Prevalence of influenza vaccination among nurses and ancillary workers in Italy: systematic review and meta analysis.

INTRODUCTION: Italian Ministry of Health, recommends vaccination for seasonal influenza to all healthcare workers (HCW), particularly to nurses who have an important interaction with patients. The aim of this study is to conduct a systematic review in order to estimate the pooled prevalence of influenza vaccinations among nurses and ancillary workers in Italy and analyse the enhancing and hindering factors. RESULTS: The review was performed using 15 articles, six containing the prevalence of vaccination for nurses and ancillary workers, while the others qualitative analysis. In all the selected articles the score calculation has been carried out by using a protocol for observational studies. The nurses and ancillary workers pooled proportion of influenza vaccination was respectively 13.47% (95%CI 9.58-17.90%) and 12.52% (95%CI 9.97-15.31%). DISCUSSION: The Italian mean of influenza vaccination prevalence appear low if compared to other European countries, ranging from 15% to 29% in Countries such as UK, Germany, France. This situation of weakness should be seen as an opportunity to improve the vaccination rate for seasonal influenza significantly This should be done by intervening on the category which affirms caring less. In fact, this category has a priority to receive vaccination, due to their numbers and closer contact to patients. METHODS: Research was conducted using medical database Scopus, PubMed, the search engine Google Scholar and ISI web of knowledge, and was concluded February 1st 2011.

[Cardioprotective effect of vitamin D in nondialyzed patients with stage 3-5 CKD]. / Effetti cardioprotettivi della vitamina D nei pazienti con malattia renale cronica allo stadio 3-5 non in dialisi.

Epidemiological and observational data indicate that there is a close relationship between progressive renal dysfunction in chronic kidney disease (CKD), cardiovascular disease, and mortality. In addition, deficits in vitamin D (25-hydroxyvitamin D) and vitamin D receptor (VDR) activation play a crucial role in adversely affecting cardiovascular health in CKD patients. Even in patients with mild CKD, renal dysfunction is associated with cardiovascular events. Modulation of vitamin D levels results in correlative regulatory effects on mineral homeostasis, hypertension, and vascular calcification. The use of VDR activators such as paricalcitol to treat these and other parameters outside of cardiovascular and renal disease not only results in enhanced patient health but significantly reduces the mortality risk in CKD patients.

[Anticoagulant therapy in patients with atrial fibrillation on dialysis: between the risk of hemorrhage and vascular calcification]. / La terapia anticoagulante nel paziente con fibrillazione atriale in dialisi: tra il rischio emorragico e le calcificazioni vascolari.

Oral anticoagulant therapy (OAT) in patients with atrial fibrillation during dialitic treatment or suffering from severe chronic renal failure is not easy to mange. OAT interferes with the mechanisms of protection and prevention of vascular calcification and increases the risk of bleeding and of the development of vascular calcifications typical of these patients. The aim of this report is to highlight the complexity of the management and therapy in uremic patients, discussing the importance of OAT in order to prevent thrombo-embolic complications during atrial fibrillation episodes.