Indexes for the assessment of bacterial pollution in bathing waters from point sources: The northern Adriatic Sea CADEAU service.

This paper presents a novel set of water quality indexes to identify the area potentially affected by point sources of bacterial pollution in coastal bathing waters. The indexes, developed in the framework of the CADEAU service, are evaluated on the results of a modelling system based on the integration of a high-resolution ocean model, remote sensing observations and in situ monitoring data for the northern Adriatic Sea. In particular, the system is a downscaling of the Mediterranean Copernicus Marine Environment Monitoring Service and exploits data produced within the Bathing Waters Directive, the Water Framework Directive and the Urban Waste Water Treatment Directive to create added value products.

The first assessment of marine debris in a Site of Community Importance in the north-western Adriatic Sea (Mediterranean Sea).

At present, few studies have investigated the marine litter abundance, composition and distribution on rocky bottoms due to sampling constraints. We surveyed by means of the ROV imaging technique a system of biogenic rocky outcrops classified as a Site of Community Importance in the Adriatic Sea. A mean density of 3.

Hydrodynamic properties of San Quintin Bay, Baja California: Merging models and observations.

We investigated the physical dynamics of San Quintin Bay, a coastal lagoon located on the Pacific coast of northern Baja California, Mexico. We implemented, validated and used a finite element 2-D hydrodynamic model to characterize the spatial and temporal variability of the hydrodynamic of the bay in response to variability in the tidal regime and in meteorological forcing patterns. Our analysis of general circulation, residual currents, residence times, and tidal propagation delays allowed us to characterize spatial variability in the hydrodynamic basin features.

Calcareous Bio-Concretions in the Northern Adriatic Sea: Habitat Types, Environmental Factors that Influence Habitat Distributions, and Predictive Modeling.

Habitat classifications provide guidelines for mapping and comparing marine resources across geographic regions. Calcareous bio-concretions and their associated biota have not been exhaustively categorized. Furthermore, for management and conservation purposes, species and habitat mapping is critical.

[Physician-patient communication in nephrology].

Training the nephrologist-to-be to physician-patient communication (PPC) has several objectives: to guide his/her history taking in order to make a diagnosis, of course, but also to help him/her establish a long-lasting relationship, inform and motivate the patient, and prepare him/her to break bad news and to deal with end-of-life issues. PPC rests on specific strategies and on the ethical grounds of a human encounter, the success of which expresses itself in care. An effective PPC offers many benefits to the patient, but also to the clinician.

Measurement of the international normalized ratio (INR) in hemodialysis patients with heparin-locked central venous catheters: evaluation of a novel blood sampling method.

Background: Accurate measurement of the international normalized ratio (INR) may be difficult in hemodialysis (HD) patients with heparin-locked central catheters. Blood contamination with locking solutions may interfere with INR measurement when samples are collected directly from the catheter.

Methods: The aim of our study was to evaluate a novel sampling method for the measurement of INR in HD patients with heparin-locked central catheters.

FSGS permeability factor-associated nephrotic syndrome: remission after oral galactose therapy.

Some cases of nephrotic syndrome in focal and segmental glomerulosclerosis (FSGS) are associated with a circulating factor, the FSGS permeability factor (FSPF). Galactose has a high affinity for FSPF, and experimental data suggest that it could reduce its activity. We describe the case of a 48-year-old male with a nephrotic syndrome found to be resistant to corticosteroids, immunosuppression and plasmaphaeresis.

Pediatric salivary gland obstructive swelling: sialendoscopic approach.

Objective: To assess the efficacy of sialendoscopy as a diagnostic and interventional procedure for salivary ductal pathologies of children.

Design: Prospective case series study.

Setting: Tertiary care teaching hospitals.

[Nephrogenic systemic fibrosis: more hard times for renal failure patients].

To date, more than 200 cases of nephrogenic systemic fibrosis have been documented worldwide. All patients have had renal failure, most of them requiring dialysis. We herein describe the course of a hemodialyzed patient who developed nephrogenic systemic fibrosis in the months following magnetic resonance angiography of the lower extremities.

[Parathyroidectomy in end-stage renal disease: perioperative management of calcium-phosphorus balance].

The management of metabolic problems following parathyroidectomy in end stage renal disease remains poorly defined. Hypocalcemia is a common and serious complication in the post-operative period. The objective of the present study was to develop a protocol for the management of patients during the immediate perioperative period based on the best available data from the literature, and to verify its effectiveness and safety in three patients on chronic hemodialysis.

Systemic anticoagulation and prevention of hemodialysis catheter malfunction.

Although chronic anticoagulation is commonly prescribed to prevent thrombosis and malfunction of hemodialysis tunneled cuffed catheters (TCC), there are only limited data regarding its efficacy. The aim of this prospective study was to evaluate whether anticoagulation with adjusted-dose warfarin targeting an international normalized ratio (INR) of 1.5-2.

Measurement of blood volume during hemodialysis is a useful tool to achieve safely adequate dry weight by enhanced ultrafiltration.

Chronic fluid overload and hypertension are highly prevalent in the dialysis population. Measurement of blood volume (BV) during hemodialysis (HD) may prove useful to achieve dry weight (DW). Twelve (12) chronic hemodynamically stable dialysis patients were randomly selected to participate in a pilot study.

Veno-venous continuous renal replacement therapy for burned patients with acute renal failure.

From 1995 to 1998, 12 burned patients with acute renal failure (ARF) were treated by veno-venous continuous renal replacement therapy (CRRT) at the Burn Unit of Hôtel-Dieu de Montréal. Their mean (+/-SD) age was 51+/-12 years, and the mean burned surface covered 48.6+/-15.

Continuous haemofiltration and haemodiafiltration for acute renal failure in severely burned patients.

Among 970 burned patients admitted between April 1987 and September 1994, 16 (1.6 per cent) presented acute renal failure requiring dialytic support and were treated by continuous renal replacement therapy as first-line modality. Their mean burned surface area was 58.

Treatment of renal angioplasty failure by percutaneous renal artery stenting with Palmaz stents: midterm technical and clinical results.

Objective: Renal artery stenting has recently been used to treat failures or complications of renal angioplasty. Although technical results and complication rates have been reported, clinical follow-up and long-term data are limited. The purpose of this study was to evaluate the midterm clinical efficacy and safety of Palmaz stents in rescuing renal artery angioplasty failures.

Radionuclide captopril renography in postpartum renal artery aneurysms.

We report the case of a young woman with three left renal artery aneurysms, diagnosed immediately postpartum, associated with a de novo high blood pressure. To assess anatomical and functional characteristics of renal artery aneurysms, renal angiogram, MRI, intravenous pyelography, ultrasonography and radionuclide renography were performed. Two patent saccular renal artery aneurysms were demonstrated in the left kidney by renal angiogram.

Familial hemolytic-uremic syndrome and homozygous factor H deficiency.

Inherited hemolytic-uremic syndrome (HUS) is unusual. We report the occurrence of HUS in two siblings; one died at an early age while the other (the proband) has presented with three episodes of HUS since the age of 19 years. The finding of a persistently low serum C3 level in this patient led to a thorough evaluation of her complement cascade and a family investigation.

Pharmacokinetics and pharmacodynamics of trandolapril after repeated administration of 2 mg to patients with chronic renal failure and healthy control subjects.

A new, long-acting angiotensin-converting enzyme (ACE) inhibitor, trandolapril, was administered daily for 10 days to 13 patients with chronic renal failure [CRF; creatinine clearance (CLCR) 7-55 ml/min/1.73 m2) and 8 healthy volunteers (CLCR > 80 ml/min/1.73 m2)].

Early experience with laparoscopic approach for adrenalectomy.

Background: Adrenalectomy performed by a posterior or transabdominal approach causes substantial postoperative pain. The purpose of this study was to evaluate laparoscopy as a potential approach for adrenalectomy.

Methods: We performed 25 consecutive laparoscopic adrenalectomies on 22 patients from April 1, 1992, to March 30, 1993.