The relationship between blood pressure and pain.

The relationship between pain and hypertension is potentially of great pathophysiological and clinical interest, but is poorly understood. The perception of acute pain initially plays an adaptive role, which results in the prevention of tissue damage. The consequence of ascending nociception is the recruitment of segmental spinal reflexes through the physiological neuronal connections.

[Loop diuretics: facts and fallacies].

Refractory edema is a clinical condition which recognises different etiologies and is characterized by decreased or absent diuretic response before the therapeutic goal is reached. Several pharmacokinetic and pharmacodynamic strategies are used in this setting, and further research is needed in order to optimize drug effectiveness.

Ultrafiltration in heart failure.

Fluid overload is a key pathophysiologic mechanism underlying both the acute decompensation episodes of heart failure and the progression of the syndrome. Moreover, it represents the most important factor responsible for the high readmission rates observed in these patients and is often associated with renal function worsening, which by itself increases mortality risk. In this clinical context, ultrafiltration (UF) has been proposed as an alternative to diuretics to obtain a quicker relief of pulmonary/systemic congestion.

[Ultrafiltration and hemofiltration in the cardiology unit].

The utilization of renal replacement therapies in cardiac patients has received increasing attention in recent years. In fact, isolated ultrafiltration has been proposed in patients with heart failure as a means for rapidly relieving fluid overload while preserving renal function; moreover, periprocedural hemofiltration (HF) has been suggested for radiocontrast-induced nephropathy (RCIN) prophylaxis. As a matter of fact fluid overload, with the ensuing systemic and pulmonary congestion, remains a major problem in patients with heart failure, and diuretic resistance is not an uncommon feature in the more advanced stages of the syndrome.

[Contrast-induced nephropathy. Current concepts and propositions for Italian guidelines].

Contrast-induced nephropathy is an impairment in renal function following intravascular exposure to radiographic contrast media (CM). Kidney damage may be limited to an asymptomatic increase in serum creatinine or reveal itself as acute renal failure, which can require renal replacement therapy. The aim of the present review is to describe the most recent knowledge concerning this matter.

Contrast medium induced nephropathy in urological practice.

Purpose: Contrast medium induced nephropathy is the third cause of in-hospital acute renal failure. The first studies in this area were done with reference to urological practice only. Although various guidelines on the management of contrast medium induced nephropathy were provided by the European Society of Urogenital Radiology, more recently many investigators have focused their attention on contrast medium use in interventional vascular radiology and cardiology.

Contrast medium administration in the elderly patient: is advancing age an independent risk factor for contrast nephropathy after angiographic procedures?

Contrast medium-induced nephropathy (CMIN) is the third leading cause of hospital-acquired acute renal dysfunction. Even if the number of patients over 75 years of age undergoing diagnostic and/or interventional procedures and requiring administration of contrast medium (CM) is growing constantly, at present there is no definitive consensus regarding the role of advancing age and related morphologic or functional renal changes as an independent risk factor for CMIN. The authors review the evidence from recent medical literature on the definition, pathophysiology, and clinical presentation of CMIN as well as therapeutic approaches to its prophylaxis.

Facts and fallacies concerning the prevention of contrast medium-induced nephropathy.

Objective: The aim of this article is to extract from recent medical literature and nephrologic practice the facts and fallacies concerning the possible prophylaxis of contrast medium-induced nephropathy.

Data Sources, Study Selection, And Data Extraction: A MEDLINE/PubMed search (1985 to January 2006) was conducted, including all relevant articles investigating the pathogenesis and prevention of contrast medium-induced nephropathy from a nephrologic critical point of view.

Data Synthesis: Considerable efforts have been made to develop pharmacologic therapy for the prevention of contrast medium-induced nephropathy, especially in patients at risk, such as elderly subjects and those with preexisting renal impairment, hypovolemia, or dehydration.

[Serum concentration of some tumor markers in renal failure].

This study was undertaken to define the relationship between renal function and the blood level of some tumor markers. In order to evaluate the specificity of tumor markers in cronic renal failure the following alphaFP, CEA, NSE, SCC and beta2 microglobulin were studied in 40 adult patients, with cronic renal failure of different degrees (27 p.), in hemodialyzed patients (6 p.

[Differential diagnosis in hypokalemia. A case of Liddle syndrome].

A case of Liddle's syndrome showing weakness, hypertension, metabolic alkalosis and hypokalemia, identifiable as Liddle's syndrome, allows us to face the differential diagnosis among ionic dysfunctions, as primitive and secondary hyperaldosteronism, hypercorticism and pseudohyperaldosteronism. We discuss hypokalemia due to reduced potassium pool, or referable to altered ionic redistribution without losses. Concerning the treatment of important hypokalemia, we face manners and times of intravenous administration of potassium salts, potassium-sparing diuretics and supplementation per os; besides, we stress the dietetic contribution of rich in potassium foods, for the correction of the light hypokalemia and against deficit of pool referable to the long-term diuretic therapy.