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Variability of aseptic peritonitis rates in the RDPLF RDPLF地区无菌性腹膜炎发病率的变异性

Bulletin de la Dialyse à Domicile Pub Date : 2018-06-13 DOI: 10.25796/bdd.v1i1.30

C. Verger, G. Veniez, M. Dratwa

{"title":"Variability of aseptic peritonitis rates in the RDPLF","authors":"C. Verger, G. Veniez, M. Dratwa","doi":"10.25796/bdd.v1i1.30","DOIUrl":"https://doi.org/10.25796/bdd.v1i1.30","url":null,"abstract":"Aim : Peritonitis rate in the French Language Peritoneal Dialysis Registry (RDPLF) is one episode per 32 patient-months. The purpose of the present study is to evaluate the percentage of germ-free, or aseptic, peritonitis in all centers, and also by center.Methods : a first group representing all patients treated in metropolitan France in 2017 was selected to identify the rate of peritonitis and the percentage of aseptic peritonitis. Some centers have very low rates and the percentages of aseptic peritonitis would have had little value on small numbers, so we selected a second group of patients treated between 2010 and 2017 and retained centers that had at least 20 peritonitis. The rate of aseptic peritonitis in these centers was calculated individually per center. An additional survey was also carried out at the centers to find out their conditions for collecting and culturing effluent peritoneal dialysis fluid.Results : In 2017, out of 1071 peritonitis, 17.2% had no germ identified. During the period from January 2010 to December 2017, 6068 episodes of peritonitis were reported, including 954 without any germ identified (15.7%). One hundred and one centers had more than 20 episodes of peritonitis during this period. In these centers, the percentage of aseptic peritonitis has varied from less than 6% to more than 50%. The additional survey revealed that the sampling conditions varied considerably from one center to another and sometimes they even were not known to all members of the same team.Conclusion : the peritonitis rates in France and the percentage of aseptic peritonitis are in line with international recommendations. However, there is considerable inter-center variability which would require defining the best sampling conditions and the application of good bacteriological practices. It also highlights the interest of taking into account the center effect in statistical models used in studies. \u0000 ","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127110723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Efficacy of peritoneal dialysis in the treatment of refractory heart failure 腹膜透析治疗难治性心力衰竭的疗效观察

Bulletin de la Dialyse à Domicile Pub Date : 2018-06-13 DOI: 10.25796/bdd.v1i1.32

Jérôme Sanchez, Carmen Rodríguez, Elena Astudillo, J. Bande

{"title":"Efficacy of peritoneal dialysis in the treatment of refractory heart failure","authors":"Jérôme Sanchez, Carmen Rodríguez, Elena Astudillo, J. Bande","doi":"10.25796/bdd.v1i1.32","DOIUrl":"https://doi.org/10.25796/bdd.v1i1.32","url":null,"abstract":"Heart failure (HF) is a progressive disorder even with adequate treatment. Fluid removal may aid in the management of these patients. We evaluated the efficacy of peritoneal dialysis (PD) in the treatment of refractory HF.Patients and Methods : Prospective, non-randomized study involving patients with congestive HF refractory to maximun tolerable drug treatment. All of them were treated with PD. We analysed clinical data and functional status. To determine efficacy we compared the perceived state of health to PD patients respect to those reported with conservative therapies. Finally, we carried out a cost-utility evaluation.Results : Seventy-eight patients (68% men, 66±10 years) were included and 14 were still undergoing PD at the end of the follow-up period (22±9 months). Seventy patients underwent only one daily nocturnal exchange; the rest, 2 or 3 exchanges according to different degrees of renal failure. All of them improved their NYHA functional status, (4% three classes, 63% two, 33% one; p<0.001), with a reduction in their pulmonary artery systolic pressure (48±13 vs 28±10 mmHg; p=0.007). Hospitalization rates underwent a dramatic reduction (from 63±16 to 9±7 days/patient/year; p=0.002). Life expectancy on PD was 88% after 12 months of treatment, and 72% and 54% after 18 and 24 months. PD was associated with a perceived state of health higher than with conservative therapy, (0,416±0,218 vs 0, 658±0,114, p <0.02 ). PD is cost-effective compared with the diuretic regimens.Conclusions : PD is a good option for patients with refractory HF; it improves the functional status and quality of life, reduces morbidity, mortality and health care costs.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122040134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prescriptions (!!) pour maîtriser la prise de parole en public 掌握公共演讲的处方(!!)

Bulletin de la Dialyse à Domicile Pub Date : 2018-06-13 DOI: 10.25796/BDD.V1I1.37

Gérard Gaiddon

{"title":"Prescriptions (!!) pour maîtriser la prise de parole en public","authors":"Gérard Gaiddon","doi":"10.25796/BDD.V1I1.37","DOIUrl":"https://doi.org/10.25796/BDD.V1I1.37","url":null,"abstract":"A défaut de pouvoir bénéficier d’un entraînement et de conseils personnalisés – ce qui est bien entendu le plus souhaitable – le lecteur trouvera ici quelques-unes des notions les plus importantes pour réussir sa prise de parole en public.Il s’agit pour lui de maîtriser rapidement l’essentiel : se familiariser avec les différentes méthodes de préparation, mentale comme émotionnelle, apprendre à gérer au mieux son intervention grâce à une prise de contact adaptée, maîtriser sa communication avec le public, capter son attention, puis la retenir en mobilisant toujours son intérêt.Dans ce but, nous proposons une approche la plus pragmatique possible : une manière de « check-list » que le lecteur pourra aisément mémoriser.Chacun des points abordés ici pourra naturellement être approfondi, complété, enrichi au gré de vos propres expériences, car on n’apprend jamais mieux que par soi-même. \u0000Abstract \u0000Without being able to benefit from training and personalized advice - which is of course the most suitable - the reader will find here some of the most important concepts for delivering successful lectures.It is a matter of quickly mastering the essential: to become familiar with the various methods of preparation, mental as well as emotional, to learn how to manage his / her intervention as best as possible through appropriate contact, to master his/her) communication with the public, to capture his attention, then retain it by always mobilizing its interest.For this purpose, we propose the most pragmatic approach possible: a «checklist» that the reader can easily memorize.Each of the points discussed here can of course be deepened, completed, enriched according to the reader/future speaker’s own experiences, as we never learn better than by ourselves.","PeriodicalId":366938,"journal":{"name":"Bulletin de la Dialyse à Domicile","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126839114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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