Infectious complications in renal transplant recipients.

Renal transplantation has become a well-established therapeutic option for end-stage renal disease, but infectious diseases remain a significant cause of morbidity and mortality. Although a wide variety of pathogens may cause infection, viral ones must be regarded as the single most important class of infections. Progress has been made both in the prevention and the early recognition treatment of infections that are closely linked to rejection.

Survival and prognostic factors of women with advanced ovarian cancer and complete response after a carboplatin-paclitaxel chemotherapy.

Objective: We evaluated the characteristics and determinants of 5-year survival in ovarian cancer patients with complete response after first line treatment who entered a randomised study comparing two different chemotherapeutic schedules.

Methods: This analysis included 232 ovarian cancer patients with complete response after first line surgery and chemotherapy coming from a large randomised trial comparing the effect of different doses of paclitaxel combined with fixed doses of carboplatin.

Results: The 5-year overall survival in patients was 57.

ATP extracellular concentrations are increased in the rat striatum during in vivo ischemia.

Interest is growing in the role of adenosine triphosphate (ATP) on P2 receptors during hypoxic/ischemic events in the brain. However, there is no direct evidence of an increase in extracellular ATP levels during cerebral ischemia in vivo. The aim of the present study was to evaluate ATP outflow from the rat striatum by the microdialysis technique associated with focal cerebral ischemia in vivo by intraluminal occlusion of the right middle cerebral artery (MCA).

[Long-term clinical experience in post-dilution HFR].

Purpose: Hemodiafiltration reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as replacement fluid. We devised a new technique, post-dilution HFR, aimed at increasing the purification efficiency, treatment tolerability and at reducing inflammatory state.

Methods: We performed post-dilution HFR in six uremic patients during 18 months.

Hemodiafiltration with post-dilution reinfusion of the regenerated ultrafiltrate: a new on-line technique.

Aims: All convective hemodiafiltration techniques require a replacement fluid, which must have an adequate electrolytic composition and must be sterile and pyrogen-free. Using an integrated adsorption cartridge, the ultrafiltrate can be "regenerated" and used as a replacement fluid (hemo-filtrate reinfusion; HFR). The aim of this study was to evaluate whether the HFR technique as suggested in its original configuration could be improved by inverting the purification sequence (post-dilution HFR; PDHFR) in order to increase the purification efficiency of the whole system.

A case report of plasma exchange therapy in non-paraneoplastic cerebellar ataxia associated with anti-Yo antibody.

A 71-year-old-woman was admitted to the S. Eugenio Hospital for a history of progressively impaired standing and gait. Anamnesis revealed systemic hypertension, gastric polyposis and juvenile pulmonary tuberculosis.

One year of clinical experience in postdilution hemofiltration with online reinfusion of regenerated ultrafiltrate.

Background/aims: Hemofiltrate reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as replacement fluid. We set up a new technique, postdilution HFR (PD-HFR), aiming at increasing purification efficiency, treatment tolerance and at reducing inflammatory states.

Methods: We performed PD-HFR in 6 uremic patients during 1 year.

Adequate protein dietary restriction in diabetic and nondiabetic patients with chronic renal failure.

Objective: To evaluate whether a dietary protein restriction is useful for slowing the progression of chronic renal failure (CRF) in diabetic and nondiabetic patients and to analyze the possible risk of malnutrition after such a dietary regimen.

Design: Prospective, randomized case-control clinical trial.

Setting: Nephrology outpatients.

Maternal coffee drinking in pregnancy and risk of small for gestational age birth.

Objective: We have analysed the association between coffee drinking before and during the three trimesters of pregnancy and risk of small for gestational age (SGA) birth.

Methods: Cases were 555 women who delivered SGA births (ie <10th percentile according Italian standard). The controls included 1966 women who gave birth at term (>/=37 weeks of gestation) to healthy infants of normal weight.

The first human renal transplant and the first xenotransplant in Italy.

The authors describe the first human renal transplantation and the first renal xenotransplant in Italy and the atmosphere at the University of Rome where these transplants were performed. Just a few months after those events, a state law was approved which allowed kidney donation.

Selected food intake and risk of endometriosis.

Background: To offer data on the relationship between diet and risk of pelvic endometriosis, we analysed data collected in the framework of two case-control studies.

Methods: Data from two case-control studies conducted in Northern Italy between 1984 and 1999 were combined. Cases were 504 women aged < 65 years (median age 33 years, range 20-65) with a laparoscopically confirmed diagnosis of endometriosis, admitted to a network of obstetrics and gynaecology departments in Milan, Brescia and Pavia.

Polyoma virus BK and renal dysfunction in a transplanted population.

Introduction: Reactivation of polyoma virus BK (BKV) is increasingly recognized as a cause of severe renal-allograft dysfunction. The aim of the present study was to evaluate prevalence of BKV infection and activity in a population of kidney (KT) and liver (LT) transplant patients and search for a possible correlation with renal dysfunction.

Methods: We studied 118 patients for BKV viruria and, when present, for BKV viremia.

Living donor transplant: wider selection criteria.

The availability of cadaveric donor organs is insufficient for actual needs. The organ demand increases by 20% per year. Living donor transplant (LDT) may be a valid therapeutical alternative provided one uses proper criteria.

Paclitaxel 175 or 225 mg per meters squared with carboplatin in advanced ovarian cancer: a randomized trial.

Purpose: To analyze the effect of different doses of paclitaxel with fixed doses of carboplatin in the treatment of ovarian cancer.

Patients And Methods: Patients with histologically confirmed epithelial ovarian cancer, International Federation of Gynecology and Obstetrics stages IIB to IV, were eligible for this randomized, multicenter study. Women were randomly assigned to treatment with (1) carboplatin at the dose (in milligrams) corresponding to the following formula: target area under the free carboplatin plasma concentration versus time curve (AUC) = 6 x (glomerular filtration rate + 25) mg/m(2) (AUC6) plus paclitaxel 175 mg/m(2) for six cycles every 21 days or (2) carboplatin AUC6 plus paclitaxel 225 mg/m(2) for six cycles every 21 days.

Acute rectal obstruction after PPH stapled haemorrhoidectomy.

An unusual case of acute intestinal obstruction following a PPH stapled haemorrhoidectomy is reported: the complication was due to an almost complete interruption of the rectal lumen tightened by a purse-string suture anchored by staples. The stricture was dilated and the suture released thus restoring intestinal continuity. Surgeons should be aware that such troublesome complication may occur and can be treated successfully by a transanal approach.

Artificial organs and transplantation.

Nowadays artificial devices are not able to totally and undefinitely replace the loss of function of all vital organs and artificial organs can be used only to bridge the time to transplantation, which must be considered the first choice in the therapeutical approach for many chronic diseases. Since general population aging process is leading to an increase of organ demand, the gap between performed and requested transplantation is hard to fill. Xenotransplantation is nowadays only an experimental alternative solution and we have to do our best using available artificial organs to increase and improve the survival of patients waiting for transplantation.

Cardiac troponin I (2nd generation assay) in chronic haemodialysis patients: prevalence and prognostic value.

Background: Elevated serum cardiac troponin T (cTnT) levels are frequently observed in chronic dialysis patients and have been shown to be associated with increased morbidity and mortality. The aim of this study was to determine whether cardiac troponin I (cTnI), which is less frequently elevated, has similar clinical significance.

Methods: We studied 101 asymptomatic patients with no clinical evidence of coronary artery disease who were undergoing chronic dialytic treatment.

Plasmaperfusion on triptophan columns can improve the clinical outcome of patients affected with myasthenia gravis.

Unlabelled: Myasthenia Gravis (MG) is a neuromuscular disease often associated with thymic pathology due to neuromuscular transmission impairment by circulating antibodies directed against the cholinergic postsynaptic receptor on the neuromuscular junction (Anti-AchR-Ab). The treatment of MG includes cholinesterase inhibitors, steroids and thymectomy. Plasmapheresis can remove Anti-AchR-Ab but more recently plasma-perfusion (PP), a more specific apheresis for selective removal of noxious plasma components, has been developed.

Developmental assessment of preterm and term children at 18 months: reproducibility and validity of a postal questionnaire to parents.

Aim: To examine the degree of agreement between the paediatrician's assessment and parental reporting of infants' development using a postal questionnaire.

Methods: The developmental status of 241 infants in the charge of 9 community paediatricians or discharged from one Neonatal Intensive Care Unit (NICU) was assessed by their parents 18 mo after delivery, using a postal questionnaire regarding child's height, weight. respiratory, hearing and vision problems, and items taken mainly from the Griffiths' Developmental Scales.

[Clinical experience in treatment of Amanita phalloides poisoning].

Background: The management of patients suffering from Amanita Phalloides poisoning (APP) may be very challenging. Furthermore, the treatment often includes depurative techniques and Orthotopic Liver Transplantation (OLTx) must be started timely to be effective. We report our experience in severe APP treatment.

Oral contraceptives and risk of gestational trophoblastic disease.

Clinical reports suggested that the use of oral contraceptives (OC) after a molar pregnancy may increase the risk of persistent throphoblastic disease. However, few epidemiologic studies have analyzed the effect of OC use on the risk of developing gestational trophoblastic disease (GTD). To give further information, we have analyzed data from a case-control study on risk factors for GTD.

Adherence to HIV treatment: results from a 1-year follow-up study.

We evaluated adherence to HIV treatments every 4 months during one year in 63 HIV-infected subjects using combination therapies including a protease inhibitor. A total of 18 subjects reported a high level of adherence, 14 in two evaluations, and eight a low level of adherence in all the three evaluations. The remaining 23 subjects (36.

Is there a future for clinical laboratories? Experience in the Marche Region, Italy.

The government of the Marche Region has approved an Act called the "Regional Health Plan" establishing rules for the organization and development of healthcare. The main aim of the general plan is to rationalize the activities of medical laboratories first by making up an inventory of existing facilities and tests performed, and by classifying laboratories on the basis of their specialization and the complexity of tests that they perform.Moreover, the possible role of point-of-care testing and the need for clinical advice by laboratory professionals has also been debated.

[Urinary incontinence: frequency and diagnostic and therapeutic approach in general practice in Italy].

Objective: A large observational study was conducted to assess the frequency of urinary incontinence (UI) and overactive bladder (OAB) and to describe the diagnostic and therapeutic approach in General Medical Practice in Italy.

Materials And Methods: Subjects eligible for the study were men aged > 50 years and women aged > 40 years, observed consecutively by their own General Practitioner (GP) for a check-up or medical prescription examination during the recruitment period, who agreed to participate in the study. All the subjects included in the study were interviewed by their GP using a common questionnaire that included information about their general characteristics and a specific medical history.

Continuous renal replacement therapy: our experience in intensive care unit.

Continuous Renal Replacement Therapy (CRRT) indication is still discussed. We report our experience on 98 patients affected with Multiple Organ System Failure (MOSF) and renal failure (acute or chronic) requiring dialysis and timely treated by CRRT. Mortality after 5 days of ICU permanence was 60.