Surface Fraction Dependence of Contact Angles Induced by Kinks in the Triple Line.

On periodic superhydrophobic surfaces the receding contact angle often scales with the surface fraction, as expected from a simple rule of mixture, the Cassie relation. However, it has been argued that energy averaging breaks down owing to line pinning, and that line fraction scaling should apply instead. From experiments and simulations we show that proper inclusion of triple line defects introduce surface fraction scaling in the line depinning threshold. In contrast to the Cassie relation and in agreement with the data, this dependence is strongly nonlinear due to triple line elasticity.

Compliance with automated peritoneal dialysis.

Compliance in peritoneal dialysis is reported as being a significant problem. In CAPD, the percentage of non-compliant patients varies between 10 and 40%. In APD the phenomenon seems to be more limited, at 15% - 20%. We considered 23 patients who had been on APD for more than 3 months.The dialytic treatment was performed using the Home Choice Pro device to record all the parameters of the dialysis session. The last 30 days of treatment were considered in the assessment of compliance, evaluating differences in daytime and night-time volumes between the prescription and the actual treatment,the length of the night-time session, and the days of treatment. As regards volume and duration, no differences were found compared to the dialytic prescriptions. For the days of treatment, a differencewas onlyfound in 3 patients: 2 self-administered patients missed day of therapy out of 30, and in both cases the missed tretment was ageed with the Centre; non-compliance was only found in 1 patient (4,3%), whose treatment was performed by the family, and who missed 4 days out of 30.

Communication as a teamwork tool in peritoneal dialysis.

The growing complexity of the problems which have to be faced in providing a peritoneal dialysis service, such as giving assistance over a territory, consideration of the needs of the individual and the greater emphasis on the prevention of complications, makes multidisciplinary teamwork necessary, with the interaction of various skills. In order to succeed, teamwork requires the identification of clear objectives which are shared by all the members of the team. The various skills can best be exploited by defining roles and agreeing common aims and objectives so that the team can provide the patient with holistic treatment, which recognises the needs of the individual rather than the needs of the illness. Active cohesion between the various components is only possible through a defined communication strategy and an on-going transfer of knowledge.

Exit-site infection prevention and treatment protocol.

Infections are universally known as one of the main causes of drop-out in peritoneal dialysis. Exit-site infections are often a problem, as they are difficult to treat, tend to become chronic and may lead to the development of continuity peritonitis, resulting in the need for removal of the peritoneal catheter. The purpose of this paper is to describe the application of an exit-site infection prevention and treatment protocol.

Information technology in a dialysis department.

The use of information technology in a peritoneal dialysis service, as in any facility, poses the problem of the choice of the data to be stored. It is important to define the whole range of information which may be of use and to assess the costs and benefits involved. These will depend on how complete and reliable the stored information is, how well the management process (filing and processing) is integrated with its day to day use by the Department. It is essential to both safeguard work efficiency and guarantee processing which will be useful in routine operations, including checking the quality of work carried out, and in study and research.

APD: selection criteria and training methods.

The growing use of automated night-time dialysis (APD) in peritoneal dialysis over the last few years shows that this method represents a valid alternative to continuous ambulatory peritoneal dialysis (CAPD). APD unquestionably offers a wide range of treatments which are able to cover the diverse dialytic needs of patients from both clinical and social points of view.

Coronary reactive hyperaemia after two periods of coronary occlusion in the anaesthetized goat.

In the coronary circulation an ischaemic preconditioning obtained with two periods of 2.5 min each of occlusion of the left circumflex coronary artery alters the pattern of a coronary reactive hyperaemia which follows 15 s only of occlusion of the studied artery. The most remarkable change consists of a reduction of 40-45% of the time required by the flow to reach the maximum hyperaemic peak (time to peak) after the brief occlusion. The present investigation was planned to study whether the time to peak of the hyperaemia following the second 2.5 min preconditioning occlusion was shorter than the hyperaemia following the first occlusion. Experiments performed in the anaesthetized goat, in which coronary flow was measured with an electromagnetic flow-probe placed around the left circumflex coronary artery showed that in the hyperaemia occurring after the second preconditioning occlusion the time to peak was reduced by 18% only. The moderate effect of the second preconditioning occlusion in reducing the time to peak is attributed to the fact that the heart was already partially preconditioned after the first occlusion and that after relatively long periods (2.5 min) of occlusion the metabolic component of the hyperaemic response was so predominant to partially mask the role of the vascular mechanisms presumably responsible for the reduction of the time to peak.

[Care of skin infections in patients in peritoneal dialysis]. / Indagine descrittiva sulla cura dell'emergenza cutanea nel paziente in dialisi peritoneale.

The incidence of exit-site infections among peritoneal home-dialysis patients was quantified following for 1 year all home dialysis patients of 23 dialysis centres. The exit site conditions were observed and classified according to Twardowsky. When an infection occurred data on its treatment were collected. 393 patients were observed. The infection occurred in 40 patients (10.1%). 82.2% of patients wear a Tenckoff catheter, 3% do not protect the exit site with any kind of dressing. The strategies adopted by different centres vary for the choice of antiseptics, the suggested frequency of changes dressing and the routine use of nasal swabs. Due to the limited number of patients with infection no association was found between tunnel direction or frequency of dressing changes and infections occurrence. Discussion on controversial aspects and the definition of common guidelines for instance for frequency of dressing changes, use of antiseptics is warranted.

Patients' group experiences.

In 11 years of experience with dialysis, we have tried to supply a kind of treatment in our center that takes the patient's physical, psychological, and social needs into account. We have been able to observe how important it is to share the common problems connected with a chronic illness in order to make them appear less dramatic. This led to the idea of organizing a group holiday in which the patients and their families would be able to spend some time together. As a result of this positive experience, we decided to organize group encounters in which all the problems could be freely discussed. The group is open to all the patients on dialysis or who have undergone transplants and their families. The group, which has been meeting once every 3 weeks for the last 2 years, is coordinated by a psychologist. This has proved to be important both for the operators, who have been able to expand their own knowledge, and for the patients and their families for whom these gatherings represent a way of helping themselves face up to and accept the limits imposed by chronic illness.

[Enteral nutrition in the elderly]. / La nutrizione enterale dell'anziano.

Elderly is particularly at risk of malnutrition: he is not able to feed himself adequately, it is then important to attain correct intakes using also artificial enteral nutritional techniques (nasogastric tube, gastrostomy, etc.). These techniques may lead to complications (ab ingestis pneumonia, metabolic complications, alvus disorders): the use of artificially nutrition in the elderly must be carefully evaluated. 257 patients (M = 180, F = 77) aged 65 or more, mainly affected by neoplastic diseases (n 195) and by neurological and vascular diseases (n 62). The feeding route were evaluated in this study: 74% by nasogastric tube, 13% by gastrostomy, 11% by jejunostomy. In a group of 55 patients similar concerning clinical and nutritional conditions we evaluated at the beginning of enteral feeding and four months later, caloric/protein intake, body weight and plasmatic albumin. In patients fed by nasogastric tube a mean intake of 1300 +/- 365 Kcal n.p./die, with a protein rate of 58.5 +/- 16.9 g/die was attained; by gastrostomy 1450 +/- 324 Kcal n.p./die and 65.5 +/- 16 g/die; by jejunostomy 1219 +/- 398 Kcal n.p./die and 53.3 +/- 21 g/die. The compliance to enteral nutrition was well in 37% of patients night administration was performed. Clinical complications: nausea and vomiting were observed in 9 patients with nasogastric tube, in 1 patient with gastrostomy and in 3 patients with jejunostomy; diarrhea has been noticed in 6 patients with nasogastric tube and in 1 patient with jejunostomy. Mechanical complications; nasogastric tube (n 189): 35 displacements, 7 breakages, 4 obstructions; pharyngostomy (n 6): 2 displacements and 1 obstruction; gastrostomy (n 33): 3 displacements; jejunostomy (n 29): 2 misplacements.(ABSTRACT TRUNCATED AT 250 WORDS)

Can we obtain a further reduction of peritonitis episodes in CAPD patients already using a Y-set with disinfectant?

A protocol of patient selection and more frequent home visits have significantly reduced peritonitis episodes in CAPD patients using Y-set with Amuchina. However, no change in dropout rates were observed.

[Scleroderma: oral manifestations]. / Sclerodermia: manifestazioni orali.

Oral signs of sclerodermia and dental implications are described. The disease can be classified among the collagenopathies and its onset often involves dermatological signs prior to involving other organs and systems.