Publications by authors named "Lidia Ghezzi"

Background: Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome (STEC-HUS) is a severe condition mainly affecting children. It is one of the leading causes of acute kidney injury in the pediatric population. There is no established therapy for this disease.

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In Argentina, hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC-HUS) infection is endemic, and reliable data about prevalence and risk factors have been available since 2000. However, information about STEC-associated bloody diarrhea (BD) is limited. A prospective study was performed during the period October 2018-June 2019 in seven tertiary-hospitals and 18 referral units from different regions, aiming to determine (i) the frequency of STEC-positive BD cases in 714 children aged 1-9 years of age and (ii) the rate of progression of bloody diarrhea to HUS.

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Introduction: Health-related quality of life (HRQoL) is a measure of health outcomes. It assesses the subjective and overall impact of diseases on daily life. It also provides multidimensional data about physical wellbeing, family and peers relations.

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Studies are increasingly recognizing health-related quality of life (HRQOL) as a key pediatric outcome in both clinical and research settings and an essential health outcome measure to assess the effectiveness of medical treatment. However, it has not yet been studied among the healthy siblings of kidney transplant recipients. The aim of this study, therefore, is to examine HRQOL among this population.

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Article Synopsis
  • Vitamin D deficiency (25(OH)D) is common in children with chronic kidney disease (CKD), with a significant correlation found between 25(OH)D levels and parathormone.
  • A study involving 167 patients showed that 32% of CKD patients had 25(OH)D deficiency, with particularly high rates (51%) in those on dialysis (stage 5 CKD).
  • Key factors associated with deficiency included low albumin levels, more advanced stages of CKD, and being from the Northwest region of Argentina.
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  • This study investigates how the CYP3A5 enzyme affects tacrolimus (TAC) dosing in pediatric kidney transplant patients, focusing on the differences between genetic polymorphisms of CYP3A5.
  • The researchers found that 79% of the participants had the non-expressing CYP3A5*3/*3 allele, requiring higher daily doses of TAC, while those with the CYP3A5*1/*3 allele had lower TAC levels for similar doses.
  • Additionally, the study highlights that prepubertal patients tend to need higher TAC doses and experience different pharmacological interactions with steroids compared to pubertal patients, suggesting the need for personalized TAC therapy based on genetic testing.
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Allograft function and metabolic effects of four treatment regimens, namely, methylprednisone (MP) standard dose (MP-STD), deflazacort (DFZ), MP-late steroid withdrawal (MP-LSW), and MP-very low dose (MP-VLD), were evaluated in prepubertal patients. MP was decreased by month 4 post-transplantation to 0.2 mg/kg/day in MP-STD and DFZ patients and to <0.

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While 24-h ambulatory blood pressure monitoring (ABPM) is an established tool for monitoring antihypertensive therapy in adults, data in children are scarce. We retrospectively analysed whether office blood pressure (BP) is reliable for the diagnosis of BP control in 26 treated hypertensive paediatric renal transplants. Controlled office BP was defined as the mean of three replicate systolic and diastolic BP recordings less than or equal to the 95th age-, sex- and height-matched percentile on the three-outpatient visits closest to ABPM.

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  • Cyclosporin (CsA) therapy leads to side effects like hypertension, hyperlipidemia, and nephrotoxicity, while tacrolimus (Tac) shows better outcomes in these areas for kidney transplant patients.
  • A study involving 70 renal transplant recipients compared the effects of CsA (38 patients) and Tac (32 patients) on blood pressure, cholesterol, glucose levels, and graft function over 2 years.
  • Results showed that the Tac group had significantly lower blood pressure and better graft function compared to the CsA group, with no increase in diabetes risk despite slightly higher glucose levels with Tac.
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MMF has been shown to decrease the incidence of acute rejection in children and adults at 1 and 3 yr. Other beneficial effects of MMF have been more difficult to demonstrate. Our open-labeled study presents a 5-yr data for patients and graft survival, allograft function, and growth in MMF-treated patients.

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Five characteristics of neonate renal physiology, namely glomerular hypofiltration, low renal blood flow and alterations in water, sodium and potassium management, disappear during the first year of life but reoccur during senescence. However, the underlying mechanisms are different during the two periods.

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