Evaluation of Renal Function in Patients Undergoing Lung Transplantation

Background

Acute kidney injury and chronic kidney failure are serious complications after lung transplantation. Glomerular filtration rate (GFR) is the primary indicator of renal function. Several equations have been proposed to evaluate the estimated GFR (eGFR). We compared three different equations to determine which has the better correlation with the development of acute and chronic renal failure in lung recipients.

Comparison between small renal masses 0-2 cm vs. 2.1-4 cm in size: A population-based study

BackgroundThe NCCN guidelines recommend active surveillance (AS) as an option for the initial management of cT1a 0-2 cm renal lesions. However, data about comparison between renal cell carcinoma (RCC) 0-2 cm vs. 2.1-4 cm are scarce.MethodsWithin the Surveillance, Epidemiology, and End Results database (2002–2016), 46,630 T1a N_anyM_any stage patients treated with nephrectomy were identified. Data were tabulated according to histological subtype, tumor grade (low [LG] vs. high [HG]), as well as age category and gender. Additionally, rates of synchronous metastases were quantified.ResultsOverall, 69.3 vs. 74.1% clear cell, 21.4 vs. 17.6% papillary, 6.9 vs. 6.8% chromophobe, 2.0 vs. 1.1% sarcomatoid dedifferentiation, 0.2 vs. 0.2% collecting duct histological subtype were identified for respectively 0-2 cm and 2.1-4 cm RCCs. In both groups, advanced age was associated with higher rate of HG clear cell and HG papillary histological subtype. In 0-2 cm vs. 2.1-4 cm RCCs, 13.8% vs. 20.2% individuals operated on harbored HG tumors and were more prevalent in males. Lower synchronous metastases rates were recorded in 0-2 cm RCC and ranged from 0 in respectively multilocular cystic to 0.9% in HG papillary histological subtype. The highest synchronous metastases rates were recorded in sarcomatoid dedifferentiation histological subtype (13.8% and 9.7%) in both groups.ConclusionsRelative to 2.1-4 cm RCCs, 0-2 cm RCCs harbored lower rates of HG tumors, lower rates of aggressive variant histology and lower rates of synchronous metastases. The indications and demographics of patients selected for AS may be expanded in the future to include younger and healthier patients.     

Modulatory effects of 1 Hz rTMS over the cerebellum on motor cortex excitability

Clinical observations and data from animal experiments point to a physiological facilitatory influence of the deep cerebellar structures on the motor system through the cerebello-thalamo-cortical pathways. The aim of the present study was to explore the long-term effects of low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) over the cerebellum on short intracortical inhibition (SICI) and facilitation (ICF) of the motor cortex in normal subjects. Eight healthy subjects (mean age 26.9 ± 3.1) underwent 1 Hz frequency rTMS delivered on the right cerebellar hemisphere. Before and after cerebellar rTMS, SICI and ICF were assessed in the motor cortex contralateral to the stimulated cerebellar hemisphere by means of a paired pulse paradigm with a conditioning subthreshold stimulus set to 80% of the motor threshold (MT) followed by a testing stimulus at 120% of MT intensity. Five different interstimulus intervals (ISIs) were used to assess SICI (2 and 4 ms) and ICF (7, 10 and 15 ms). Amplitude of the responses was expressed as the percentage of motor evoked potential (MEP) to test stimulus alone. Results showed a significant decrease of ICF at 10 ms ISI that persisted up to 20 min after cerebellar rTMS. This was the only significant modulatory effect of cerebellar stimulation on intracortical motor excitability A suppressive effect of the low-frequency TMS on Purkinje cells could be supposed, even if, the lack of effects on other facilitatory ISIs, stands for more complex modulatory effects of rTMS over cerebellum. The study is a further demonstration that rTMS over the cerebellum induces a long-lasting modulatory effect on the excitability of the interconnected motor area.     

Comparison of observer reliability in assessing alveolar bone height on direct digital and conventional radiographs

OBJECTIVES: Radiographs are an important adjunct in the assessment of periodontal disease in clinical practice and research. The purpose of this study is to compare intraexaminer and interexaminer reproducibility in assessing alveolar bone height on direct digital and conventional radiographs. MATERIALS AND METHODS: Matched sets of conventional radiographs and digital radiographs were taken on 23 subjects. Bone levels were measured on radiographs as the distance from the cementoenamel junction to the alveolar crest in millimetres at the mesial and distal surfaces of all available teeth excluding third molars. Two examiners measured bone levels twice on each type of imaging system independent of one another. Correlations and paired t-test values were computed. RESULTS: Intraexaminer relative agreement (r-value) on both digital and conventional radiographs ranged from 0.73 to 0.98, P<0.05; however, differences between measurements (absolute agreement) for each examiner were non-significant, P>0.05. Interexaminer relative agreement on both digital and conventional radiographs ranged from 0.70 to 0.95, P<0.05, and measurement differences between the two examiners were also significant, P<0.05. One examiner tended to score higher measurements than the other, P<0.05. CONCLUSIONS: Alveolar bone measurements are reproducible on both digital and conventional radiographs. Intraexaminer reproducibility is superior to interexaminer reproducibility. Direct digital radiographs did not enhance examiner agreement over conventional radiographs.     

Risk factors for poor renal prognosis in children with hemolytic uremic syndrome

Many factors have been proposed as predictors of poor renal prognosis in children with hemolytic uremic syndrome (HUS), but their role is still controversial. Our aim was to detect the most reliable early predictors of poor renal prognosis to promptly identify children at major risk of bad outcome who could eventually benefit from early specific treatments, such as plasmapheresis. Prognostic factors identifiable at onset of HUS were evaluated by survival analysis and a proportional hazard model. These included age at onset, prodromal diarrhea (D), leukocyte count, central nervous system (CNS) involvement, and evidence of Shiga toxin-producing Escherichia coli (STEC) infection. Three hundred and eighty-seven HUS cases were reported; 276 were investigated for STEC infection and 189 (68%) proved positive. Age at onset, leukocyte count, and CNS involvement were not associated with the time to recovery. Absence of prodromal D and lack of evidence of STEC infection were independently associated with a poor renal prognosis; only 34% of patients D^–STEC^– recovered normal renal function compared with 65%–76% of D⁺STEC⁺, D⁺STEC^– and D^–STEC⁺ patients. In conclusion, absence of both D and evidence of STEC infection are needed to identify patients with HUS and worst prognosis, while D^– but STEC⁺ patients have a significantly better prognosis.     

Spermatogenesis before and after renal transplant

Studies on the relationship of fertility and renal transplantation are relatively recent. Data related to the sexual aspects of uremic patients before and after renal transplantation are available. Information about spermatogenesis, as offered by testicular biopsy, is scarce. The present study has as its objective the quantitative analysis of testicular biopsies obtained pre- and postoperatively from the renal transplant patients after normalization of the renal function.     

Isolation, sequence and expression of a cDNA encoding the alpha-chain of the feline CD8.

We have cloned, sequenced and expressed a cDNA encoding the alpha-chain of feline CD8. This clone, named FT8-10, has an open reading frame with 720 nucleotides in length encoding a protein with 239 amino acid residues. Sequence analysis has revealed that the feline CD8 alpha-chain (CD8 alpha) shares significant homology with human (T8/Leu-2), bovine (BoCD8), rat (MRC OX8) and mouse (Lyt-2) CD8 alpha subunits. Cysteine residues as well as the tyrosine kinase p56lck binding site are well conserved. Besides, no putative N-linked glycosylation site was found. Interestingly, immunofluorescence analysis of COS-7 cells transfected with feline CD8 alpha expression plasmid driven by SR alpha promoter showed that the expressed feline CD8 alpha cross-reacted with an anti-human CD8 alpha monoclonal antibody OKT8, but did not react with an anti-feline monoclonal antibody, FT-2, which is thought to recognize the feline analogue of the human T8/Leu-2 and murine Lyt-2 molecules expressed on cytotoxic/suppressor T cells.