Atheroembolic renal disease

Atheroembolic renal disease develops when atheromatous aortic plaques rupture, releasing cholesterol crystals into the small renal arteries. Embolisation often affects other organs, such as the skin, gastrointestinal system, and brain. Although the disease can develop spontaneously, it usually develops after vascular surgery, catheterisation, or anticoagulation. The systemic nature of atheroembolism makes diagnosis difficult. The classic triad of a precipitating event, acute or subacute renal failure, and skin lesions, are strongly suggestive of the disorder. Eosinophilia further supports the diagnosis, usually confirmed by biopsy of an affected organ or by the fundoscopic finding of cholesterol crystals in the retinal circulation. Renal and patient prognosis are poor. Treatment is mostly preventive, based on avoidance of further precipitating factors, and symptomatic, aimed to the optimum treatment of hypertension and cardiac and renal failure. Statins, which stabilise atherosclerotic plaques, should be offered to all patients. Steroids might have a role in acute or subacute progressive forms with systemic inflammation

Optimizing the dialysate calcium concentration in bicarbonate haemodialysis

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Psychological impact and health-related quality-of-life outcomes of Mayer-Rokitansky-Küster-Hauser syndrome : A systematic review and narrative synthesis

Mayer-Rokitansky-K\ufcster-Hauser syndrome causes absence or underdevelopment of uterus and vagina, but women's subjective experience remains understudied. This systematic review was conducted to examine the psychological and health-related quality-of-life outcomes of Mayer-Rokitansky-K\ufcster-Hauser syndrome. In total, 22 articles identified through electronic search matched the inclusion criteria and were included in our review. Mayer-Rokitansky-K\ufcster-Hauser syndrome may be associated with psychological symptoms and impaired quality of life, but especially with poor sexual esteem and genital image. Women may experience difficulties managing intimacy and disclosing to partners. Mothers may be perceived as overinvolved, with consequent negative emotions in women with the disease

La sequenza archeologica di Barbiano – Caserma dei vigili del fuoco (Bolzano) : evidenze di sistemazioni dei versanti durante il neolitico

Il sito di Barbiano \ue8 stato occupato in varie fasi dalla Preistoria all\u2019Et\ue0 Romana Le prime evidenze insediative risalgono all\u2019inizio del Neolitico medio, circa 7000 anni BP. L\u2019occupazione venne preceduta dalla creazione di una ampia piattaforma, un terrazzo, realizzato asportando i depositi fluvioglaciali e la sovrastante copertura pedologica. La piattaforma venne completata con il riporto su tutta la superficie di alcuni decimetri di sabbia. Si tratta di una delle pi\uf9 antiche evidenze di significative modificazioni antropiche del paesaggio in area alpina. Questi importanti lavori suggeriscono inoltre che l\u2019ampia area insediativa fosse abitata per la maggior parte dell\u2019anno. L\u2019insediamento marca dunque la transizione dalle pi\uf9 antiche attivit\ue0 agricole basate sulla pratica dello "slash and burn" a quelle stanziali. I livelli neolitici vennero coperti da sedimenti alluvionali e colluviali deposti come conseguenza dell\u2019attivazione di processi di degradazione dei versanti innescati dalla deforestazione. Durante l\u2019Et\ue0 Romana il torrente locale era delimitato da argini artificiali ed una serie di strutture murarie vennero edificate per delimitare e proteggere aree insediative che per\uf2 si sviluppano al di fuori dell\u2019area scavata. I sedimenti grossolani all\u2019interno del canale suggeriscono che limitati processi erosivi ancora interessavano il versante. I livelli romani sono stati successivamente sepolti da una sottile coltre colluviale che suggeriscono come i versanti sovrastanti, oggigiorno largamente terrazzati, non sono pi\uf9 stati interessati da processi erosivi che sono invece noti in altre aree della regione.The archaeological succession of Barbiano-Firehouse (Bozen): evidence of slope terracing during the Neolithic Barbiano archaeological site was occupied at various stages from the Prehistory to the Roman era. The earliest occupation of the area, seems to have occurred at the beginning of the Middle Neolithic, around 7 ka bP. It was preceded by the excavation of a large almost flat platform, a terrace, realised with the stripping of fluvioglacial deposits and the overlying soil cover. The platform was later covered with a few decimetre-thick layer of sand. This is one of the earliest evidence of important anthropogenic topographic and landscape modification in the Alps. These important works suggest that the large occupation surface was probably settled for most of the year following the transition from the nomadic agriculture and the "slash and burn" practices usually associated with the Neolithic . The Neolithic settlement was lately buried under colluvial and alluvial sediments that indicate slope degradation processes most probably triggered by deforestation. In Roman Times the local stream was delimited by artificial levee and a series of walls were built to delimitate and protect larger structures that extended beyond the excavated area. The coarse sediments that fill the channel bear witness that limited erosional processes still affected on the slope. The Roman structures were buried under shallow colluvial deposits suggesting that the overlying slope, nowadays largely terraced, did not experienced anymore erosive processes that are known to have occurred in nearby areas

Osteopontin plasma levels and accelerated atherosclerosis in patients with CAD undergoing PCI: a prospective clinical study.

OBJECTIVES: Growing evidence supports the role played by inflammation in atherosclerosis. Identifying sensitive biomarkers is useful in predicting accelerated atherosclerosis. We investigated prospectively the relationship between plasma levels of inflammatory biomarkers [osteopontin, C-reactive protein (CRP), interleukin-6 (IL-6)] and instent restenosis, and rapid coronary plaque progression in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). METHODS: We studied 77 patients with CAD: 45 affected by unstable angina/non-ST elevation myocardial infarction [acute coronary syndrome (ACS)], and 32 by chronic coronary syndrome (CCS). Plasma osteopontin, IL-6, and CRP levels were measured before intervention in all patients; measurements were carried out on the basis of the following time course at 1,15, 30, 90, and 180 days follow-up in a subgroup of 39 consenting patients. Clinical and biohumoral data were correlated with baseline and 6-month PCI follow-up angiography. RESULTS: Osteopontin, IL-6, and CRP were higher in patients with ACS than in those with CCS (analysis of variance: P<0.001, 0.05, and 0.05, respectively). Baseline osteopontin levels proved to be associated with rapid coronary plaque progression (P=0.005) and instent restenosis (P=0.05). The highest osteopontin levels were found in patients with CAD with both rapid plaque progression and instent restenosis (P=0.003). PCI increased inflammatory markers acutely, and osteopontin remained elevated in patients with ACS. Patients with ACS showed a higher percentage (74%) of rapid plaque progression than those with CCS (26%) (P<0.05). CONCLUSION: The study prospectively shows the link between inflammatory status and accelerated atherosclerosis in patients with CAD undergoing PCI. The baseline and persistent rise of osteopontin is an expression of its contribution to the accelerated plaque progression, and therefore osteopontin may be a useful prognostic biomarker

Renal outcome in patients with congenital anomalies of the kidney and urinary tract.

15openopenSanna-Cherchi S; Ravani P; Corbani V; Parodi S; Haupt R; Piaggio G; Innocenti ML; Somenzi D; Trivelli A; Caridi G; Izzi C; Scolari F; Mattioli G; Allegri L; Ghiggeri GM.Sanna Cherchi, S; Ravani, P; Corbani, V; Parodi, S; Haupt, R; Piaggio, G; Innocenti, Ml; Somenzi, D; Trivelli, A; Caridi, G; Izzi, C; Scolari, Francesco; Mattioli, G; Allegri, L; Ghiggeri, G. M