The early introduction of percutaneous renal biopsy in Italy

The early introduction of percutaneous renal biopsy in Italy.BackgroundPercutaneous renal biopsy, based on the use of an aspiration needle and the patient in the sitting position, was first described by Iversen and Brun in 1951. In 1954, Kark and Muehrcke described the use of the cutting Vim-Silverman needle on patients in the prone position, with a substantial improvement in the rate of success. The 1961 CIBA Foundation Symposium on renal biopsy marked the coming of age of this technique. During the 1950s in Italy, several individuals played a part in promoting and developing percutaneous renal biopsy. Because this pioneer work has received insufficient attention, we describe the contributions of Italians to the early introduction of this technique.MethodsThe Italian and international literature about percutaneous renal biopsy of the period 1951 through 1965 was reviewed. In addition, structured interviews with surviving members of the Italian researchers who first used renal biopsy were conducted.ResultsThe first renal biopsies in Italy were performed in 1951 in Pisa by the group of Ernico Fiaschi (1913–1989). In their hands, renal biopsy became a tool to investigate the pathogenesis of renal diseases in particular, while simultaneously using the early application of immunofluorescence and electron microscopy. In 1954, Pietro Leonardi (1914–1991) and Arturo Ruol (born 1924) introduced renal biopsy in Padova; they used this technique extensively and published one of the first monographs on the subject. In 1957, Vittorio Bonomini (born 1928) introduced renal biopsy in Bologna, and in subsequent years used this technique to focus on the study of pyelonephritis.ConclusionsOur historical research shows that Italian groups were among the first to use and develop percutaneous renal biopsy both as a clinical tool and an investigative tool. This article gives international credit to their work

Waxy casts in the urinary sediment of patients with different types of glomerular diseases: Results of a prospective study

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Aplicação mobile para visualização de grandes quantidades de objetos 3D em realidade aumentada

Existe um problema com a quantidade de lixo produzida no mundo e nos propomos a criar uma peça de "software" que ajudasse as pessoas a terem consciência do lixo que elas produzem. Para a realização deste estudo foi criado o núcleo de um "software" capaz de facilitar a conscientização do lixo produzido. Este núcleo consiste em usar realidade aumentada para instanciar modelos 3D e, com um simulador de física, fazer uma pilha de objetos comuns encontrados no lixo, como sacos de lixo, latas e caixas de leite. Para a criação de tal "software" utilizamos a "Game Engine Unity" para o sistema operacional "An droid" e "Ios", fizemos uso do interpretador de modelos 3D e de seu simulador de física e adquirimos métricas sobre este núcleo. Estas métricas foram números de "colliders", números de triângulos, memória alocada, FPS(frames por segundo) e "frame time" (tempo de processamento do "frame"). Com estas informações em mão, poderemos definir gargalos no aplicativo, e, deste modo, em implementações futuras sabermos que tipos de configurações o aplicativo pode suportar.There is a problem with the amount of garbage produced in the world and we propose to create a piece of "software" that would help people to be aware of the garbage they produce. In order to carry out this study, the core of a "software" capable of facilitating the awareness of the waste produced was created. This core consists of using augmented reality to instantiate 3D models and, with a physics simulator, making a pile of common objects found in the garbage, such as garbage bags, cans and milk cartons. For the cre ation of such "software" we used the "Game Engine Unity" for the "Android" and "Ios" operating systems, we made use of the 3D model interpreter and its physics simulator and we acquired metrics about this core. These metrics were collider numbers, triangle num bers, allocated memory, FPS(frames per second) and frame time. With this information in hand, we will be able to define bottlenecks in the application, and in this way, in future implementations, we will know what types of configurations the application can support

A nephrological program in Benin and Togo (West Africa)

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Video Call Educational Program for Cystic Fibrosis Adolescents

Airway clearance technique (ACT) and inhalation therapy (IT) are essential in cystic fibrosis (CF) lung disease management. We here present our experience with a video-call educational program, which could maintain or improve adherence in adolescents. A 6-month program was offered to adolescents: a physiotherapist would monitor their ACT and IT home program via scheduled video-calls. A structured form evaluating patients’ independence and awareness during a session would be filled in at the start and after 6 months. After informed consent was obtained, subjects filled in a questionnaire about their expectations and a satisfaction questionnaire at the end of the program. Student\u27s t-test for paired data was performed for quantitative evaluation of the variables considered in forms filled during video calls. Eleven CF subjects were enrolled; most of them adhered spontaneously, as they expected to improve technique and receive helpful advice. About 301 educational video-calls were performed, 75% being the scheduled calls. Two patients dropped out. In the end, better awareness and self-management in ACT and IT was evident, and patients showed better performances (P < 0.01), reporting they received helpful advice. Video-call education is a simple and feasible tool which could be useful to support adherence to ACT and IT in CF adolescents

Reversible acute renal failure from gross haematuria due to glomerulonephritis: not only in IgA nephropathy and not associated with intratubular obstruction

Seven patients with acute renal failure due to gross haematuria caused by glomerulonephritis are described. Gross haematuria lasting 4-40 days led to acute impairment of renal function of variable severity (peak plasma creatinine 1.3-12 mg/dl) and duration. While partial recovery of renal function occurred in all patients within few days, complete remission was observed only some months later. Three patients had IgA nephropathy (2 the primary form and 1 nephritis secondary to Schönlein-Henoch purpura), two patients had acute postinfectious glomerulonephritis, andtwo others had focal necrotizing (pauci-immune) glomerulonephritis. The glomerular changes seen in renal biopsy were not enough to explain per se the renal function impairment. Tubular changes, however, were severe and consisted of tubular necrosis, erythrocyte casts, erythrocyte phagocytosis by tubular cells, accompanied by interstitial damage (oedema, red-cell extravasation, and inflammatory infiltrates). Study of the renal biopsies by immunofluorescence revealed retrodiffusion of Tamm-Horsfall protein into the glomerular Bowman's space, a sign of obstructed tubular flow in any case. It is concluded that acute renal failure due to gross haematuria in glomerulonephritic patients may not occur only in IgA nephropathy, as reported so far, and is not associated with intratubular obstructio

18q deletion in a cystic fibrosis infant, increased morbidity and challenge for correct treatment choices: a case report

Cystic Fibrosis (CF) is the most frequent recessive disease of Caucasian patients. Association with other diseases or syndromes has previously been reported. Co-morbidity may be a challenge for clinicians, who have to face more severe problems

Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Background/Aims: Interferon treatment of malignant or viral diseases can be accompanied by various side-effects including nephro-toxicity. Methods: We report on a 68-year-old Caucasian male who received dual therapy with pegylated interferon 2a plus ribavirin for chronic hepatitis C. Results: After three months of antiviral therapy, the patient developed acute kidney failure (serum creatinine up to 6 mg/dL) with mild proteinuria (500 mg daily) and haematuria. Immediate immunosuppressive therapy with high-dose intravenous steroids did not improve kidney function. Kidney biopsy was consistent with acute tubular necrosis without glomerular abnormalities. He started long-term peritoneal dialysis (four regular exchanges) to provide both dialysis adequacy and ascites removal. Kidney function gradually improved over the following months (serum creatinine around 2 mg/dL) and peritoneal dialysis was continued with two exchanges daily. The temporal relationship between the administration of the drug and the occurrence of nephro-toxicity, and the absence of other obvious reasons for acute tubular necrosis support a causative role for pegylated interferon; benefit on kidney disease was noted after withdrawal of antiviral agents. An extensive review of the literature on acute tubular necrosis associated with interferon-based therapy, based on in vitro data and earlier case-reports, has been made. The proposed pathogenic mechanisms are reviewed. Conclusions: Our case emphasizes the importance of monitoring renal function during treatment of chronic hepatitis C with antiviral combination therapy as treatment may precipitate kidney damage at tubular level