92 research outputs found
Bifosfonati e disfunzione renale
Disphosphonates and renal impairmentOsteoporosis and chronic kidney disease (CKD) are two frequent pathological conditions in the adult and geriatric population and often coexist. These conditions ..
Ultrafiltrazione peritoneale e sindrome cardiorenale: gestione del sovraccarico di fluidi e ruolo del sodio
Congestion represents a crucial clinical component of both heart failure and cardiorenal syndrome and it has been postulated to modulate heart and kidney cross-link. Diuretic therapy is a corner stone in the treatment patients with heart failure, and renal replacement therapies are mainly used for patients with refractory heart failure who have not reached the worst stages of renal disfunction. Peritoneal dialysis is a home-based therapeutic modality providing both solute clearance and ultrafiltration, together with relief from congestion in decompensated heart failure patients. The following review will focus on sodium removal in refractory decompensated heart failure patients undergoing peritoneal dialysis. (Cardionephrology
Kidney Disease in HIV Infection
Antiretroviral therapy (ART) has significantly improved life expectancy of infected subjects, generating a new epidemiological setting of people aging withHuman Immunodeficiency Virus (HIV). People living with HIV (PLWH), having longer life expectancy, now face several age-related conditions as well as side effects of long-term exposure of ART. Chronic kidney disease (CKD) is a common comorbidity in this population. CKD is a relentlessly progressive disease that may evolve toward end-stage renal disease (ESRD) and significantly affect quality of life and risk of death. Herein, we review current understanding of renal involvement in PLWH, mechanisms and risk factors for CKD as well as strategies for early recognition of renal dysfunction and best care of CKD
Osteoma del mascellare associato a cisti odontogena omolaterale: approccio chirurgico combinato.
L’osteoma osteoide è una lesione osteogenica benigna la cui localizzazione nel seno mascellare è piuttosto rara, appena 7 casi descritti negli ultimi 15 anni. Di più frequente riscontro, sono le cisti odontogene del mascellare. Il riscontro contestuale delle due patologie è un evento piuttosto raro. Descriviamo il caso di osteoma del mascellare associato a voluminosa cisti odontogena omolaterale a partenza dalla radice dell’11mo. La paziente (42a), giungeva alla nostra osservazione per ostruzione respiratoria nasale, cacosmia, rinorrea mucopurulenta ed epifora monolaterali. L’imaging evidenziava la presenza di entrambe le lesioni che occupavano interamente il seno mascellare destro. La paziente veniva indirizzata a chirurgia e si optava per un approccio endoscopico combinato con doppio accesso transorale e transnasale con exeresi delle lesioni e ricostruzione del pavimento del mascellare con ausilio di membrana con PRGF (plasma ricco di fattori di crescita). Nessuna complicanza peri e post-operatoria è stata osservata. Il caso in esame pone l’attenzione sull’approccio multidisciplinare alla patologia e sulla scelta di una tecnica chirurgica conservativa con utilizzo di PRGF
Identification of a novel non-desmoglein autoantigen in Pemphigus Vulgaris
Pemphigus vulgaris (PV) is an autoimmune bullous disease of the skin and mucous membranes characterized by the presence of circulating and tissue-bound autoantibodies against keratinocyte cell surface antigens, specifically desmoglein (Dsg) 1 and 3. The pathogenic role of anti-Dsg antibodies is well-established, while the mechanism of blister formation is only partly defined. We have applied a previously developed method for the efficient immortalization of IgG+ memory B cells to identify novel target antigens in PV. A human monoclonal antibody reactive with a hitherto unreported non-Dsg antigen was isolated. Immunoprecipitation and immunoblotting studies with keratinocyte extracts indicated α-catenin as the putative antigen, then confirmed by immunoblotting on the recombinant protein. Four of ten PV sera reacted with recombinant α- catenin. Although the isolated human monoclonal antibody was per se unable to dissociate keratinocyte monolayers and also to synergize with a pathogenic antibody in vitro, further studies are warranted to assess its possible in vivo contribution in the multifactorial pathogenesis and heterogeneous manifestations of PV disease
Predictive Value ofMeasures of Vascular Calcification Burden and Progression for Risk of Death in Incident to Dialysis Patients
Abstract: Background: Vascular calcification (VC) is a marker of cardiovascular (CV) disease
and various methods allow for presence and extension assessment in different arterial districts.
Nevertheless, it is currently unclear which one of these methods for VC evaluation best predict
outcome and if this piece of information adds to the predictive value of traditional CV risk factors
in patients receiving hemodialysis (HD). Methods: data of 184 of the 466 patients followed in the
Independent study (NCT00710788) were post hoc examined to assess the association three concurrent
measures of vascular calcification and all-cause survival. Specifically, coronary artery calcification
(CAC) was determined by the Agatston and the volume score while abdominal aorta calcification was
determined by plain X-ray of the lumbar spine (Kauppila score (KS)). Survival and regression models
as well as metrics of risk recalculation were used to test the association of VC and outcome beyond the
Framingham risk score. Results: Middle-age (62.6(15.8) years) men (51%) and women (49%) starting
HD were analyzed. Over 36 (median 36; interquartile range: 8–36) months of follow-up 69 patients
expired. Each measure of VC (CAC or KS) predicted all-cause mortality independently factors
commonly associated with all-cause survival (p < 0.001). Far more importantly, each measurement of
VC significantly improved risk prediction and patient reclassification (p < 0.001) beyond traditional
cardiovascular risk factors. Conclusions: Overall, presence and extension of VC, irrespective of the
arterial site, predict risk of all-cause of death in patients starting hemodialysis. Of note, both CAC
and KS increase risk stratification beyond traditional CV risk factors. However, future efforts are
needed to assess whether a risk-based approach encompassing VC screening to guide HD patient
management improves survival
Does Systematic Preliminar Colour Doppler Study Reduce Kidney Biopsy Complication Incidence?
While ultrasonography is widely performed prior to biopsy, colour Doppler examination is often used only to discover post-biopsy complications. Aim of this paper was to evaluate the usefulness of colour Doppler examination in planning the optimal site of puncture for renal biopsy. Present analysis includes 561 consecutive percutaneous renal biopsies performed from the same operator. Until August 2000 332 biopsies were performed after a preliminary ultrasonography (Group A). From September 2000, 229 patients underwent even a preliminary colour Doppler study (Group B). Postbioptic bleeding were categorized as minor (gross hematuria or subcapsular perinephric hematoma < 4 cmq of greater diameter) or major (hematoma >4 cmq of greater diameter; requiring blood transfusion or invasive procedures; leading to acute renal failure, urine tract obstruction, septicaemia, or death). Major complications were seen in 2.1% in Group A while in Group B only one case was reported (0.43%). Minor clinically significant complications occur in 7.8% in Group A and in 3.4% of cases of Group B. Colour Doppler reduced drastically the incidence of complications observed before the introduction of routine colour Doppler examination prior to biopsy. In our opinion, these data support the use of preliminary colour Doppler study when a biopsy is planned
Ivabradina, insufficienza cardiaca e malattia renale cronica
Abstract non disponibile (Cardionephrology
L'ecocardiografia e il nefrologo: seconda e ultima puntata della "pocket guide"
Abstract non disponibile (Cardionephrology
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