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Journal ArticleDOI

Incidence and severity of nausea and vomiting in a group of maintenance hemodialysis patients.

03 Sep 2016-Journal of renal injury prevention (Published by Nickan Research Institute)-Vol. 6, Iss: 1, pp 49-55
TL;DR: The results of the study showed a relatively high incidence of nausea and vomiting in patients undergoing hemodialysis, hence nurses must consider these problems by suitable measures to prevent the occurrence of the these unpleasant feelings in the patients during he modialysis.
Abstract: Introduction: Chronic kidney disease (CKD) is a rising problem across the world, including Iran. Most of the patients will require hemodialysis for survival. Despite the great progress has been made in the hemodialysis equipment, but it is still associated with complications. Nausea and vomiting are common complication of during hemodialysis, which leads to unpleasant feeling in patients. Objectives: This study aimed to determine incidence and severity of nausea and vomiting in a group of maintenance hemodialysis patients. Patients and Methods: This is a descriptive and analytical study on 60 hemodialysis patients of dialysis wards in Semnan University of Medical Sciences. Verbal Numeric Rating Scale (VNRS) and Korttila vomiting severity scale were used to measure the severity of nausea and vomiting during hemodialysis respectively. Results: In this study, the incidence of nausea and vomiting during hemodialysis were 28.3% and 11.7%, respectively. Meanwhile, the mean severity of nausea was 1.15 and the mean rank of vomiting was 2.08. Conclusion: The results of the study showed a relatively high incidence of nausea and vomiting in patients undergoing hemodialysis, hence nurses must consider these problems by suitable measures to prevent the occurrence of the these unpleasant feelings in the patients during hemodialysis.
Citations
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Journal ArticleDOI
TL;DR: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors.
Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

6,968 citations

Journal ArticleDOI
TL;DR: This report provides a well-formulated framework for decision-makers and health service planners to implement strategies for comprehensively managing chronic conditions and describes eight essential elements for improving and creating innovations in the care of chronic conditions.
Abstract: Chronic health conditions have been on the rise across the world. But few health care systems, have proved able to cope with managing this dramatic increase in chronic conditions. This report from the World Health Organization (WHO) provides a comprehensive framework for the prevention framework for the prevention and management of Chronic health conditions around the world. Chronic health conditions were defined in this report as “health problems that persist across time and require some degree of health care management”. This new report addresses how policy makers can take effective and innovative action to tackle these conditions. The report addresses the following issues: Exploring chronic conditions, including how and why they are increasing, what is their economic impact on patients, families, communities, and governments, and how to reduce their prevalence. The deficits in current systems of health to successfully manage chronic conditions because the acute care model dominates health care systems. The acute care model increased health care expenditures without improving populations health status. A new framework for health care systems to improve care for chronic conditions. This framework is comprised of fundamental components within the patient, health care organization and community, and policy levels. These components were described as “building blocks” that can be used to re-design a health care system to manage long-term health problems more effectively. The report describes eight essential elements for improving and creating innovations in the care of chronic conditions. These elements include: Supporting a shift in attitudes, so that decision­ makers, health workers and patients are aware that a shift in resources from the acute, episodic model of care is needed to meet the different of chronic conditions. Building political commitment to the process of preventing and managing chronic conditions. Avoiding fragmentation of services, to ensure that the care for chronic conditions is integrated. To align and analyze policies which affect chronic conditions, such as agricultural regulations, labor laws and health education. To use new, team care models and evidence-based skills for managing chronic conditions, worth more efficient use of health care personnel. To re-oriented Health care for chronic conditions around the patient and family. To support patients within their communities, because communities can fill a crucial gap in health services that are not provided by organized health care. To emphasize prevention, as many of the complications of chronic conditions can be prevented or reduced. This report provides a well-formulated framework for decision-makers and health service planners to implement strategies for comprehensively managing chronic conditions.

506 citations

Journal ArticleDOI
01 Feb 2019-Ndt Plus
TL;DR: Daprodustat produced dose-dependent changes in hemoglobin over the first 4 weeks after switching from a stable dose of rhEPO as well as maintained hemoglobin target levels over 24 weeks, demonstrating an adverse event profile consistent with the HD population.
Abstract: Background This study evaluated the hemoglobin dose response, other efficacy measures and safety of daprodustat, an orally administered, hypoxia-inducible factor prolyl hydroxylase inhibitor in development for anemia of chronic kidney disease.

81 citations


Cites background from "Incidence and severity of nausea an..."

  • ...Nausea is common in patients on dialysis [30]....

    [...]

Journal ArticleDOI
TL;DR: Clinicians need to be cognizant that nonsynthetic cannabinoid preparations, particularly smoked cannabis, can pose significant health risks and these must be cautiously weighed against the limited substantiated therapeutic benefits of cannabis in patients with CKD.
Abstract: Purpose of Review:Physical and psychological symptom burden in patients with advanced chronic kidney disease (CKD) is significantly debilitating; yet, it is often inadequately treated. Legalization...

32 citations

Journal ArticleDOI
TL;DR: Evidence is provided that mirtazapine can be an effective therapy for UP in patients who are on maintenance HD and side effects such as drowsiness and dry mouth more reported in the mirtzapine treatment period, while overall higher percentage of the study patients preferred mirtZapine over gabapentin for the treatment of their pruritus symptoms.
Abstract: Uremic pruritus (UP) is a highly prevalent and disturbing problem in patients with advanced chronic kidney disease (CKD); however, treatment of UP is largely unsatisfactory. The present study was designed to investigate the effectiveness of mirtazapine, an atypical antidepressant agent with potent antagonistic activity against serotonin (5HT2, 5HT3) and histamine (H1) receptors, in the treatment of pruritus in hemodialysis (HD) patients. An 8-week long, prospective, open-label, and cross-over randomized clinical trial study was conducted on 77 HD patients with chronic pruritus. After a 2-week washout period, eligible patients were randomly assigned either to the mirtazapine (15 mg per day) or gabapentin (100 per day) for 2 weeks. Following 2 weeks washout period, subjects crossed over to the other treatment arm for 2 more weeks. The severity of pruritus was measured seven times during each treatment period using the visual analogue scale (VAS). Furthermore, at the end of the study, patients also were blindly asked which treatment (first or last in the sequential course of the study) they preferred. Sixty-one patients completed two treatment periods of the study. Although, compared to baseline, both gabapentin and mirtazapine treatment resulting in significant improvement in VAS scores, decreasing in pruritus severity was significantly greater in the mirtazapine treatment period compared with the gabapentin treatment period (P < 0.001). Furthermore, although side effects such as drowsiness and dry mouth more reported in the mirtazapine treatment period, overall higher percentage of the study patients preferred mirtazapine over gabapentin for the treatment of their pruritus symptoms. Although preliminary, our study provides evidence that mirtazapine can be an effective therapy for UP in patients who are on maintenance HD. However, further studies would be necessary to confirm effectiveness as well as the safety of mirtazapine in the long-term management of chronic pruritus.

13 citations

References
More filters
Journal ArticleDOI
TL;DR: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors.
Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

6,968 citations


"Incidence and severity of nausea an..." refers background in this paper

  • ...Given that in the final stage of CKD, the kidney function is no longer adequate to sustain life, the patient develops a permanent need for renal replacement therapies at this stage, including dialysis or kidney transplantation (8)....

    [...]

Book
01 Jan 1996
TL;DR: Unit 1: Basic Concepts in Nursing Practice Unit 2: Biophysical and Psychosocial concepts in Nursing practice Unit 3: Concepts and Challenges in Patient Management Unit 4: Perioperative Concepts and Nursing Management Unit 5: Gas Exchange and Respiratory Function Unit 6: Cardiovascular, Circulatory, and Hematologic Function Unit 7: Digestive and Gastrointestinal Function Unit 8: Metabolic and Endocrine Function Unit 9: Urinary and Renal Function Unit 10: Reproductive Function Unit
Abstract: Unit 1. Basic Concepts in Nursing Unit 2. Biophysical & Psychosocial Concepts in Nursing Practice Unit 3. Concepts & Challenges in Patient Management Unit 4. Perioperative Concepts & Nursing Management Unit 5. Gas Exchange & Respiratory Function Unit 6. Cardiovascular, Circulatory and Hematologic Function Unit 7. Digestive & Gastrointestinal Function Unit 8. Metabolic and Endocrine Function Unit 9. Renal and Urinary Tract Function Unit 10. Reproductive Function Unit 11. Immunologic Function Unit 12. Integumentary Function Unit 13. Sensorineural Function Unit 14. Neurologic Function Unit 15. Musculoskeletal Function Unit 16. Other Acute Problem

987 citations

Journal ArticleDOI
TL;DR: This report provides a well-formulated framework for decision-makers and health service planners to implement strategies for comprehensively managing chronic conditions and describes eight essential elements for improving and creating innovations in the care of chronic conditions.
Abstract: Chronic health conditions have been on the rise across the world. But few health care systems, have proved able to cope with managing this dramatic increase in chronic conditions. This report from the World Health Organization (WHO) provides a comprehensive framework for the prevention framework for the prevention and management of Chronic health conditions around the world. Chronic health conditions were defined in this report as “health problems that persist across time and require some degree of health care management”. This new report addresses how policy makers can take effective and innovative action to tackle these conditions. The report addresses the following issues: Exploring chronic conditions, including how and why they are increasing, what is their economic impact on patients, families, communities, and governments, and how to reduce their prevalence. The deficits in current systems of health to successfully manage chronic conditions because the acute care model dominates health care systems. The acute care model increased health care expenditures without improving populations health status. A new framework for health care systems to improve care for chronic conditions. This framework is comprised of fundamental components within the patient, health care organization and community, and policy levels. These components were described as “building blocks” that can be used to re-design a health care system to manage long-term health problems more effectively. The report describes eight essential elements for improving and creating innovations in the care of chronic conditions. These elements include: Supporting a shift in attitudes, so that decision­ makers, health workers and patients are aware that a shift in resources from the acute, episodic model of care is needed to meet the different of chronic conditions. Building political commitment to the process of preventing and managing chronic conditions. Avoiding fragmentation of services, to ensure that the care for chronic conditions is integrated. To align and analyze policies which affect chronic conditions, such as agricultural regulations, labor laws and health education. To use new, team care models and evidence-based skills for managing chronic conditions, worth more efficient use of health care personnel. To re-oriented Health care for chronic conditions around the patient and family. To support patients within their communities, because communities can fill a crucial gap in health services that are not provided by organized health care. To emphasize prevention, as many of the complications of chronic conditions can be prevented or reduced. This report provides a well-formulated framework for decision-makers and health service planners to implement strategies for comprehensively managing chronic conditions.

506 citations

Journal ArticleDOI
TL;DR: This paper should provide essential information for the design, conduct, and presentation of these studies of postoperative nausea and vomiting (PONV) to increase comparability among future studies and help clinicians in assessing and reading the literature on PONV.
Abstract: Anesthesiological journals are flooded by innumerable studies of postoperative nausea and vomiting (PONV). Nevertheless, PONV remains a continuing problem with an average incidence of 20–30%. This paper should provide essential information for the design, conduct, and presentation of these studies. It should also increase comparability among future studies and help clinicians in assessing and reading the literature on PONV. First, future studies should address new and relevant questions instead of repeatedly investigating prophylactically given antiemetics whose main results are predictable (e.g. already proven by meta-analysis). Second, group comparability should be based on well-proven risk factors and a simplified risk score for predicting PONV. Endless listings of doubtful risk factors should be avoided. Third, a realistic sample size estimation should be performed, i.e. in most cases at least 100 patients per group are necessary. Fourth, nausea, vomiting and rescue medication should be recorded and reported separately with the corresponding incidences (and number of patients with these separate symptoms), and the main end-point should be PONV. The entire observation period should cover 24 h. Additional reporting of the early (0–2 h) and delayed (2–24 h) postoperative period is desirable and should consider single and cumulative incidences. Lastly, interpretation of results should take into account the study hypothesis, sources of potential bias or imprecision, and the difficulties associated with multiplicity of analysis and outcomes.

254 citations


"Incidence and severity of nausea an..." refers background in this paper

  • ...In this scale, non-retching is taken as the lack of vomiting, retching less than three times with or without gastric emptying as mild vomiting, 3-5 times of retching with or without gastric emptying as moderate vomiting, and more than 5 times of retching with or without gastric emptying as severe vomiting (16)....

    [...]