History of circumcision: a religious obligation or a medical necessity.

Circumcision is the oldest documented surgical procedure. Practiced for ritual religious and likely medical purposes, it seems to have emerged in Egypt and was adopted by the western Semitic tribes. In biblical times, circumcision became a religious doctrine described in the Covenant between God and Abraham in the book of Genesis.

Sequence of cellular events in pancreatic islets leading to impaired insulin secretion in chronic kidney disease.

Objectives: In chronic renal failure (CRF), a multitude of metabolic derangements occur in the pancreatic islets, resulting in impaired glucose-induced insulin secretion. These abnormalities include a rise in the basal level of cytosolic calcium ([Ca(2+)]i) in the islets, a decrease in their basal and stimulated adenosine triphosphate (ATP) and adenosine diphosphate (ADP) content, a reduction in the V(max) of Ca(2+) ATPase and Na(+)-K(+) ATPase, and an impaired glucose-induced calcium signal. The sequence of events that leads to these derangements and to the impairment in insulin secretion during the evolution of CRF has not been defined.

Intensive blood-pressure control in hypertensive chronic kidney disease.

Background: In observational studies, the relationship between blood pressure and end-stage renal disease (ESRD) is direct and progressive. The burden of hypertension-related chronic kidney disease and ESRD is especially high among black patients. Yet few trials have tested whether intensive blood-pressure control retards the progression of chronic kidney disease among black patients.

Isaac Judaeus Israeli: a Jewish founder of the origins of nephrology.

This paper discusses the Book of Urine in the Opera Omnia Isaci of Isaac Judaeus Israeli. Born in Egypt in the middle of the ninth century, Isaac Judaeus was considered a genius by his peers. The book accepted Galen's ideas and expanded them.

Altered acetylcholine metabolism of brain in uremia: role of secondary hyperparathyroidism.

Objective: Cholinergic system and its neurotransmitter, acetylcholine (ACh), play a major role in both behavior and motor function of the nervous system. Cholinergic neurons synthesize ACh from choline and acetyl-CoA by choline acetyltransferase in the nerve ending. The release of ACh in response to nerve impulses is dependent on the intracellular calcium ([Ca2+]i) concentration and its gradient.

Management of vascular calcification in CKD patients.

Vascular calcification is common in patients with chronic kidney disease (CKD) and it may affect almost every artery. It is associated with a significant increase in morbidity and mortality. Therefore, the detection, prevention and treatment of vascular calcification in CKD patients are critical for the overall approach for the management of these patients.

Clinical practice guidelines for bone metabolism and disease in chronic kidney disease: an overview.

The National Kidney Foundation developed and oversees the Kidney Disease Outcomes Quality Initiative, a process that develops clinical practice guidelines in nephrology. Recent guidelines address the aberrations in bone metabolism and disease that occur as a complication of chronic kidney disease. These guidelines provide, for the first time, a standard approach to the detection and management of alterations in calcium, phosphorus, and parathyroid hormone metabolism.

The relationship between magnitude of proteinuria reduction and risk of end-stage renal disease: results of the African American study of kidney disease and hypertension.

Background: The magnitude of proteinuria is associated with a graded increase in the risk of progression to end-stage renal disease and cardiovascular events. The objective of this study was to relate baseline and early changes in proteinuria and glomerular filtration rate (GFR) to long-term progression of hypertensive nondiabetic kidney disease.

Methods: Post hoc analysis of a randomized 3 x 2 factorial trial.

C-reactive protein is a significant predictor of vascular calcification of both aorta and hand arteries.

Although evidence has accumulated indicating a close relationship between inflammation and atherosclerosis, the relationship between inflammation and vascular calcification in patients with chronic renal failure is unclear. In the present study, the relationship between C-reactive protein (CRP) and vascular calcification in dialysis patients was examined. Vascular calcification of the aorta and hand arteries of 512 hemodialysis patients without significant infection (age 58.

Amlodipine reverses the elevation in [Ca2+]i and the impairment of phagocytosis in PMNLs of NIDDM patients.

Background: Patients with diabetes mellitus display an elevation in the basal levels of [Ca2+]i of polymorphonuclear leukocytes (PMNLs) and impaired phagocytosis. These derangements are due to the hyperglycemia of diabetes. Calcium channel blockers reverse these abnormalities both in in vitro studies and in diabetic rats.

Liver metabolism in CRF.

Alteration in liver function are not typically present in patients with uremic syndrome, but varying degrees of liver dysfunction were observed in animals with experimental uremia and, to a lesser degree, in patients with chronic renal failure. This article summarizes the data obtained during the last 2 decades on protein, carbohydrate, and lipid metabolism by the liver in uremia and molecular aspects of regulation of lipids and protein synthesis. Particular attention is given to the role of cytosolic calcium ([Ca(2+)](i)) regulation and calcium signal transduction in hepatocytes in chronic renal failure.

Fibrinolysis defect in long-term hemodialysis patients with type 2 diabetes mellitus and its relation to metabolic disorders.

Background/aims: Patients with chronic renal failure (CRF) secondary to diabetes mellitus show a high incidence of atherosclerosis with its thrombotic complications. Both CRF and type 2 diabetes mellitus (DM2) results in fibrinolysis defects causally related to atherogenesis and thrombogenesis. It is not well known whether or not and, if so, how fibrinolysis is altered in patients with both CRF and DM2.

Successful blood pressure control in the African American Study of Kidney Disease and Hypertension.

Background: The African American Study of Kidney Disease and Hypertension (AASK) is an ongoing trial to evaluate the effect of blood pressure and choice of antihypertensive drug on the rate of decline of renal function.

Objective: To present the success of the AASK in achieving the trial's rigorous blood pressure goals in an extremely challenging patient population.

Methods: The AASK participants included African American patients with hypertension (n = 1094), aged 18 to 70 years, with glomerular filtration rates between 20 and 65 mL/min per 1.

[The medical school of Padua and its Jewish graduates].

During the period between the 12th and 16th century, most European universities were under Papal control and Jews were restricted. An exception to this was the University of Padua, established in 1222. As "Universa Universis Patavina Liberta", outside of papal control, Jewish students were permitted to study and qualify for academic degrees.

Efficacious response with low-dose indapamide therapy in the treatment of type II diabetic patients with normal renal function or moderate renal insufficiency and moderate hypertension.

We examined the efficacy of low daily dose (1.25 mg/day) of indapamide in the treatment of high blood pressure in patients with diabetes mellitus with normal renal function and those with moderate renal insufficiency (serum creatinine <1.5 mg/dl).