[Disinfection is prevention]. / Disinfezione è prevenzione.

Prevention of outbreaks is very important in haemodialysis units because of the high risk of infectious complications caused by contaminated water or equipment. Our aim was to evaluate the efficiency of a chloride based disinfectant for haemodialysis machines. Five different machines were tested for infection by culturing water drawn from both inlet (point A) and outlet (point B) of the dialyser and from the waste site (point C). Six series of tests were analysed during a 3-week period. In the first week water was drawn from point A before and after disinfection on two different days; during the second and third weeks the same procedure was performed at points B and C, respectively. Three non-contaminated samples of 2 mL each were sent to the microbiology department for cultures. Samples from point B grew a number of bacteria even after the disinfectant for the water system was changed. We conclude that machine contamination is due to patients and, therefore, a very accurate cleaning and disinfection of system components is essential. This procedure can avoid isolation of infected patients. Prevention of infection is a complex procedure and should engage water systems, machines, as well as environment and nurses.

99mTc-Ca-gluconate renal scintigraphy in patients with chronic renal failure.

From use of 99mTc-Ca-Sn-gluconate in patients with various degrees of renal failure the following conclusions were drawn: 1. a good relationship exists between the parenchymal and vascular patterns in scintigraphy and the functional renal impairment; 2. the morphological definition is good, since in most cases a differential diagnosis can be made between diffuse parenchymal disease and space-occupying lesions even very low glomerular filtration rate values; 3. this technique is supplementary to i.v. pyelography in patients with relatively good glomerular filtration rate values and is a reliable alternative to i.v. pyelography in those with low creatinine clearance values.

125I-iothalamate and creatinine clearances in patients with chronic renal diseases.

In 196 adult patients with chronic renal disease or primary hypertension, the evaluation of glomerular filtration rate (GFR) by means of creatinine clearance, 'predicted' creatinine clearance and [125I]-iothalamate clearance was performed. Iothalamate clearance was evaluated after subcutaneous injection of the substance . In patients with normal or upper borderline plasma creatinine values, the iothalamate clearance ranged from 44 to 117 ml/min/1.73 m2 and the overestimation of GFR from creatinine clearance was negligible. In patients with mild or advanced renal failure, the overestimation of GFR from creatinine clearance increased up to 18 and 32%, respectively. The clinical usefulness of iothalamate clearance is evident especially in patients with mild renal failure, in whom an accurate evaluation of GFR is often important for a correct dietary and therapeutic approach.