Circulating genotypes of Toxoplasma gondii in Northwestern Italy.

Toxoplasma gondii is an apicomplexan parasite that in Europe is genetically characterized by three main clonal genotypes, with a lesser prevalence of atypical patterns. Data on the genotypes of T. gondii circulating both in wildlife and livestock in Northern Italy are scarce.

Computed tomography evaluation of autosomal dominant polycystic kidney disease progression: a progress report.

At the moment, there are no effective therapies to prevent or slow the progression of autosomal dominant polycystic kidney disease (ADPKD). Radiologic evaluations are used to monitor volume of renal cysts and parenchyma during disease evolution. Volumetric quantifications based on computed tomography were used to investigate the relation between structural and functional changes in patients with advanced-stage ADPKD.

Vascular access-related thrombotic complications: research hypotheses and therapeutic strategies.

The most common complication of permanent vascular access is thrombosis, which accounts for 80 to 85% of AV access loss. Treatment of venous stenosis by percutaneous angioplasty, endovascular stents and surgical revision is clinically important but many strategies to prevent thrombosis have been employed, such as antiplatelet agents, systemic anticoagulation, and experimental therapies as fish oils, heparinoids, clopidogrel, renin-angiotensin system antagonists, calcium channel blockers, alpha adrenergic antagonists, homocysteine-lowering agents and beta-hydroxybetamethyglutaryl coenzyme-A reductase inhibitors. Future but promising approaches are endovascular radiation and gene therapy.

Emerging drugs for diabetic nephropathy.

There is an increasing number of patients with diabetes mellitus in many countries. Diabetic kidney disease, one of its microvascular complications, is also increasing markedly and has become a major cause of end stage renal disease worldwide. Intervention for preventing and delaying the development and progression of diabetic kidney disease is not only a medical concern, but also a social issue.

Preventing microalbuminuria in type 2 diabetes.

Background: The multicenter double-blind, randomized Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) was designed to assess whether angiotensin-converting-enzyme inhibitors and non-dihydropyridine calcium-channel blockers, alone or in combination, prevent microalbuminuria in subjects with hypertension, type 2 diabetes mellitus, and normal urinary albumin excretion.

Methods: We studied 1204 subjects, who were randomly assigned to receive at least three years of treatment with trandolapril (at a dose of 2 mg per day) plus verapamil (sustained-release formulation, 180 mg per day), trandolapril alone (2 mg per day), verapamil alone (sustained-release formulation, 240 mg per day), or placebo. The target blood pressure was 120/80 mm Hg.

Transplant renal artery stenosis.

Transplant renal artery stenosis (TRAS) is a recognized, potentially curable cause of posttransplant arterial hypertension, allograft dysfunction, and graft loss. It usually occurs 3 mo to 2 yr after transplantation, but early or later presentations are not uncommon. The prevalence ranges widely from 1 to 23% in different series, reflecting the heterogeneous criteria used to establish the diagnosis, the different manner of preservation of the graft, and surgical expertise.

Doppler ultrasonography in posttransplant renal artery stenosis: a reliable tool for assessing effectiveness of revascularization?

Background: Renal artery stenosis is usually treated by angioplasty and stenting, but the effectiveness of graft perfusion is difficult to establish on clinical grounds.

Methods: We compared changes in Doppler ultrasound parameters such as resistive index and peak systolic velocity with concomitant changes in renal vascular resistances, renal blood velocity, and wall shear stress measured before and 1 month after percutaneous transluminal angioplasty and stenting in 12 renal transplant patients with renal artery stenosis.

Results: After revascularization, peak systolic velocity and resistive index normalized in all patients.

Radial artery remodeling in response to shear stress increase within arteriovenous fistula for hemodialysis access.

It is known that changes in blood flow induce vascular remodeling and that shear stress, the tractive force acting on the vessel wall due to blood flowing, influences endothelial cell function. The aim of the present study was to investigate the relation between changes in pulsatile shear forces and arterial remodeling in response to chronic elevation in blood flow within the radial artery. The authors studied vessel diameter, flow rate, and shear stress in the radial artery of uremic patients before and after surgical creation of a native arteriovenous fistula for hemodialysis access.

Radial artery wall shear stress evaluation in patients with arteriovenous fistula for hemodialysis access.

It has been extensively documented that changes in blood flow induce vascular remodeling and this phenomenon seems to be correlated to the shear forces imposed on the vessel wall by motion of blood. Wall shear stress, the tractive force that acts on the endothelium, has been shown to influence endothelial cell function. To study changes in wall shear stress that develop on the vessel wall upon changes of blood flow, we set up a technique that allows estimation of shear stress in the radial artery of patients on chronic hemodialysis therapy.