Expanded Hemodialysis Translating Innovation To Clinical Outcomes

Despite constant significant advances, cardiovascular as well as more general outcomes of hemodialysis treatment remain unsatisfactory. The introduction of innovative 'high retention onset' membranes has led to the development of a new treatment modality called 'expanded hemodialysis' (HDx), which is the focus of this book. This new therapy is likely to benefit end-stage kidney disease patients, thanks to enhanced removal of molecules retained by current dialysis techniques. HDx is simple to set up and application does not require special hardware or specific nursing skills. This book contains emerging evidence and fascinating new hypotheses on HDx. It is highly recommended for all physicians and healthcare professionals who are caring for dialysis patients and are seeking innovation and improved care solutions. It will also be of considerable interest to students and fellows.

This publication is a collection of the papers presented at the 'First International Course on Hemodialysis Technology', Vicenza, June 2002: It covers a wide range of topics, including aspects of vascular access and new forms of monitoring access function. Moreover, anticoagulation strategies and antimicrobial treatment are debated, with special emphasis on temporary catheters and prosthetic devices.Membrane composition and structure, their methods of sterilization and performance are discussed by experts and manufacturers, bringing together in a unique way science, theory and manufacturing procedures. The same synthesis is achieved with respect to hemodialyzers, adsorbent devices, dialysis techniques and machines. A new issue is the possibility of computer-assisted data collection and management: This subject is discussed by experts in electronic data management, together with managers of large dialysis networks, concentrating on matters of quality assurance and continuous quality improvement programs.Special attention is given to dialysate and water purity since this is the starting point for newer dialytic techniques such as online hemodiafiltration. Moreover, the results obtained from the IDOPPS study are incorporated into the discussion of different practice patterns and anemia management. Finally, future trends are explored including automatic sensors and biofeedback monitors.Covering various aspects of hemodialysis technology, this book will be a helpful tool for physicians and nurses, both for education and information.

This study has emerged from an ongoing program of trilateral cooperation between WHO, WTO and WIPO. It responds to an increasing demand, particularly in developing countries, for strengthened capacity for informed policy-making in areas of intersection between health, trade and IP, focusing on access to and innovation of medicines and other medical technologies.

The very rapid pace of advances in biomedical research promises us a wide range of new drugs, medical devices, and clinical procedures. The extent to which these discoveries will benefit the public, however, depends in large part on the methods we choose for developing and testing them. Modern Methods of Clinical Investigation focuses on strategies for clinical evaluation and their role in uncovering the actual benefits and risks of medical innovation. Essays explore differences in our current systems for evaluating drugs, medical devices, and clinical procedures; health insurance databases as a tool for assessing treatment outcomes; the role of the medical profession, the Food and Drug Administration, and industry in stimulating the use of evaluative methods; and more. This book will be of special interest to policymakers, regulators, executives in the medical industry, clinical researchers, and physicians.

A few years ago, as the editor of Kidney International, I was ap proached by Drs. Cohen, Kassirer, and Harrington who suggested that a new feature should be included in each monthly issue of the journal. They suggested that it should employ a case discussion format such as that used frequently at specialty rounds in teaching hospitals, and that the discussion should place a special emphasis on the relationship between basic science and important problems in clinical nephrology. The summary of an actual patient history would first be presented to exemplify a particular clinical problem, a seasoned person of proven expertise would be invited to deliver a well-documented analysis of the relevant issues, and perhaps most ambitiously of all, a critical audience would be assembled to challenge the principal discussant in an open ended, question-and-answer period. The entire affair would be recorded at the time of the live conference and transcribed subse quently in preparation for publication as a "Nephrology Forum. " I must confess that I was somewhat hesitant at first to endorse their proposal because, at the time, Kidney International had just begun to establish a solid reputation for the publication of high quality, peer reviewed manuscripts dealing with the clinical and laboratory research interests of the international nephrological community.

Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance for the management of critically ill patients with acute renal failure, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.