Obesity modulates the association between systolic blood pressure and albuminuria.

Background: Obesity is associated with albuminuria and incident kidney disease. Increased vulnerability of the glomerular microcirculation to elevated systemic blood pressure is postulated to contribute to adverse effects of obesity on the kidney. We therefore hypothesized that obesity would modulate the association between systolic blood pressure (sBP) and albuminuria.

Interleukin (IL)-6 modulates transforming growth factor-β receptor I and II (TGF-βRI and II) function in epidermal keratinocytes.

It been shown that IL-6 modulates TGF-β1 expression in fibroblasts, however, what role IL-6 plays concerning TGF-βR expression and function in skin is unknown. Therefore, the aim of this study was to investigate the mechanism by which IL-6 might modulates TGF-β receptors in skin. Skin from WT, IL-6 over-expressing mice and IL-6 treated keratinocyte cultures was analysed for TGF-βRI and TGF-βRII expression via histology, PCR and flow cytometry.

The body composition and excretory burden of lean, obese, and severely obese individuals has implications for the assessment of chronic kidney disease.

Obesity could affect associations between creatinine generation, estimated body surface area, and excretory burden, with effects on chronic kidney disease assessment. We therefore examined the impact of obesity on the performances of estimated glomerular filtration rate (eGFR), the urine albumin:creatinine ratio (ACR), and excretory burden in 3611 participants of the Chronic Renal Insufficiency Cohort. Urine creatinine excretion significantly increased with body mass index (BMI) (34 and 31% greater at 40 kg/m(2) or more versus the normal of 18.

Differential scaling of glomerular filtration rate and ingested metabolic burden: implications for gender differences in chronic kidney disease outcomes.

Background: Men commence dialysis with a higher estimated glomerular filtration rate (eGFR) than women and are more likely to transition from chronic kidney disease (CKD) to end-stage renal disease. We hypothesized that for a given estimated body surface area (BSA) men have a greater metabolic burden, and that consequently, the practice of indexing GFR to BSA results in gender differences in the degree of biochemical uraemia.

Methods: Metabolic burden was assessed as estimated dietary protein, calorie, phosphorus, sodium and potassium intakes and urinary urea nitrogen excretion in the Chronic Renal Insufficiency Cohort, Modification of Diet in Renal Disease study, and National Health and Nutrition Examinations Surveys (NHANES) 1999-2010.

Cosegregation of focal segmental glomerulosclerosis in a family with familial partial lipodystrophy due to a mutation in LMNA.

Background And Aim: Focal segmental glomerulosclerosis (FSGS) is a common cause of idiopathic nephrotic syndrome in adults (35%). A number of genetic and familial forms of FSGS have been recognized. Here, we report a large pedigree with a pathogenic mutation in LMNA (R349W) in which four members were found to have biopsy-proven FSGS.

Pulmonary hypertension in renal disease: epidemiology, potential mechanisms and implications.

Pulmonary hypertension (PH) is highly prevalent in end-stage renal disease. Several observational studies, based on an echocardiographic diagnosis of PH, have suggested a prevalence of 30-60% and an association with increased mortality and poorer outcome following renal transplantation. The pathogenesis of PH in this population remains poorly understood.

Early histological changes in the kidney of people with morbid obesity.

Background: Morbid obesity represents a major health problem with increasing incidence worldwide. The clinical manifestation of renal involvement in obesity is proteinuria, and the histological feature is glomerulomegaly with or without focal and segmental glomerulosclerosis (FSGS). In this study, we have investigated the very early histological changes in kidneys of people with morbid obesity and no proteinuria.

Influence of obesity on progression of non-diabetic chronic kidney disease: a retrospective cohort study.

Background: There is increasing awareness of the impact of obesity on chronic diseases including chronic kidney disease (CKD). Until recently, a limited number of epidemiologic studies have examined the association between obesity and CKD. We conducted a retrospective cohort study to evaluate whether obesity impacts on the rate of non-diabetic CKD progression.

High prevalence of microalbuminuria in the overweight and obese population: data from a UK population screening programme.

Background: Microalbuminuria (MA) is associated with increased risk of cardiovascular and possibly chronic kidney disease (CKD). Obesity has been linked to MA, though the prevalence of MA in overweight groups is not well documented. This population study with an overrepresentation of individuals with BMI >25 (calculated as kg/m2) investigates the prevalence of MA in different BMI categories, and the relationship between MA and BMI.

Congenital midline cervical skin bridge: a case report.

A skin bridge extending from the hyoid region to the sternal notch in a 3-month-old baby is reported as another form of congenital midline neck anomaly that has never been described before. Congenital midline neck anomalies are residual embryonic structures that had failed to completely disappear or mature. They can be classified into masses, clefts, and fistulas.

[Open versus laparoscopic appendectomy in children in a regional hospital in Israel].

Unlabelled: Although laparoscopic appendectomy (LA) has already been found to be associated with greater diagnostic accuracy, less post-operative pain and shorter hospital stay as compared to open appendectomy (OA), questions remain regarding the advantages of this approach and it is still not widely practiced in children, especially in regional hospitals.

Aim: This study aims to evaluate Ha'emek Medical Center's initial experience with pediatric OA and LA between July 2002 and October 2003.

Methods: This study is a retrospective outcome analysis of pediatric OA and LA.

Unusual presentation of McKusick-Kaufman syndrome in a female Bedouin Arab baby.

McKusick-Kaufman syndrome is a rare, autosomal, recessive disorder characterized by hydrometrocolpos, post-axial polydactyly, and congenital heart disease. Less than one hundred cases have been reported in the English literature to date, mainly in the Amish population; sporadic cases have also been described. We present a case of an Arab Bedouin girl who presented with features resembling this syndrome.

Encysted peritoneal hydatidosis in a child -- the effectiveness of pre-operative therapy with a combination of praziquantel and albendazole.

A child with encysted peritoneal hydatidosis was found to be completely cured after 3 months of combined therapy with praziquantel and albendazole followed by resection of a huge peritoneal cyst and the removal of numerous, dead, daughter cysts.

Solitary liver abscess in a healthy child presenting with fever of unknown origin.

Pyogenic liver abscess is rarely encountered in normal children. We report a case of solitary pyogenic liver abscess in a healthy child aged 8 months. He presented with fever of unknown origin and mild hepatomegaly.

Abdominal compartment syndrome in children: the dilemma of treatment.

The Abdominal Compartment Syndrome (ACS) is a clinical entity, which can be defined as the adverse physiologic consequences that occur as a result of a severe increase in intra-abdominal pressure (IAP), and is characterized by cardiovascular, pulmonary, renal, splanchnic, and intra-cranial disturbances regardless of the cause. The level of IAP at which ACS occurs is not known in children, therefore we suggest that the clinical signs of tensely distended abdomen, inability to palpate the femoral pulses, cyanosis of the lower extremities, progressive oliguria and hypoxia due to increasing airway pressures are sufficient to justify abdominal decompression. We report three cases of ACS and review the management of this condition.

Acute perforated neonatal appendicitis associated with chorioamnionitis.

Perforation of the appendix is rare in term neonates and even more rare in prematures. In most of the reported cases it is a complication of necrotizing enterocolitis (NEC) but can also complicate Hirschsprung's disease (HD), cystic fibrosis (CF) or acute appendicitis (AA). We present a pre-term newborn, born to a mother who had bacteriaemia associated with chorioamnionitis.

Use of N-butyl-2-cyanoacrylate in elective surgical incisions--longterm outcomes.

Background: Histoacryl Blue (N-butyl-2-cyanoacrylate) is a tissue adhesive that has been used clinically for more than 20 years. In the last decade, N-butyl-2-cyanoacrylate has been used for cutaneous closure of low-tension lacerations in children and adults and has become a preferred method for closure of pediatric facial lacerations in many emergency rooms outside the United States. Many pediatric elective surgical procedures are performed in tension-free areas and may be suitable for closure with a tissue adhesive.

Changes in the management of pediatric blunt splenic and hepatic injuries.

Background/purpose: Intensive care monitoring, blood replacement, and nonoperative treatment of splenic and hepatic injuries in stable patients is the standard practice in pediatric surgery with a success rate of 90% in children's trauma centers.

Methods: During the past 5 years, 55 children under 14 years of age have been treated for laceration of spleen, liver, or both, proven by computed tomography.

Results: In 34 (62%), other injuries were identified, and only 21 (38%) presented with isolated injuries.