[Nephrological nutritional office: a transversal organization model and access flowchart].

The nutritional aspect has a critical relevance in the educational and care path of nephropathic patients. The Nephrology-Dietology synergy in the Hospital is conditioned by various factors, such as the difficulty for Dietology to provide capillary and personalized follow-up to nephropathic patients. Hence the experience of a transversal II level nephrological clinic, dedicated to nutritional aspects throughout the path of nephropathic patients, from the earliest stages of kidney disease to replacement treatment.

[Left atrial appendage occlusion as replacement of coumarin anticoagulants in calciphylaxis].

Calcific uremic arteriolopathy (CUA), often referred to as calciphylaxis, is a rare condition potentially life-threatening seen in 1-4% of patients with kidney failure on chronic dialysis. Pathogenesis is not clear, but several risk factors have been identified, one of the most known among them is coumarin anticoagulants therapy (tAC). When CUA occurs, tAC is contraindicated: the left atrial appendage occlusion, in dialysed patients affected by non-valvular atrial fibrillation, could be contemplated in replacement of tAC, that should be considered by nephrologist and discussed by a multidisciplinary team including cardiologists.

ddRAD-seq reveals the genetic structure and detects signals of selection in Italian brown trout.

Background: Brown trout is one of the most widespread fresh-water fish species in Europe. The evolutionary history of and phylogenetic relationships between brown trout populations are complex, and this is especially true for Italian populations, which are heavily influenced in different ways by stocking practices. The characterization of the genetic structure of Italian brown trout populations may give information on the risk of losing endemic Italian populations due to lack of genetic diversity or to admixture with stocking populations.

Curcumin Supplementation (Meriva) Modulates Inflammation, Lipid Peroxidation and Gut Microbiota Composition in Chronic Kidney Disease.

Chronic kidney disease (CKD) subjects suffer from high risk of cardiovascular mortality, and any intervention preventing the progression of CKD may have an enormous impact on public health. In the last decade, there has been growing awareness that the gut microbiota (GM) can play a pivotal role in controlling the pathogenesis of systemic inflammatory state and CKD progression. To ameliorate the quality of life in CKD subjects, the use of dietary supplements has increased over time.

Evidence of Phytotoxicity and Genotoxicity in Hordeum vulgare L. Exposed to CeO2 and TiO2 Nanoparticles.

Engineered nanoscale materials (ENMs) are considered emerging contaminants since they are perceived as a potential threat to the environment and the human health. The reactions of living organisms when exposed to metal nanoparticles (NPs) or NPs of different size are not well known. Very few studies on NPs-plant interactions have been published, so far.

Variation in Heavy Metal Accumulation and Genetic Diversity at a Regional Scale Among Metallicolous and Non-Metallicolous Populations of the Facultative Metallophyte Biscutella laevigata subsp. laevigata.

Biscutella laevigata is a facultative metallophyte, with populations on non-metalliferous and metalliferous soils. Some of its metallicolous populations have been shown to hyperaccumulate thallium or lead in nature. Only Tl hyperaccumulation has been experimentally confirmed.

A randomized trial comparing eptifibatide vs. placebo in patients with diffuse coronary artery disease undergoing drug-eluting stent implantation: design of the INtegrilin plus STenting to Avoid myocardial Necrosis Trial.

Background: Despite the availability of several potent antithrombotic agents, the optimal antiplatelet regimen in elective patients undergoing complex percutaneous coronary interventions is still debated. Aim of the INtegrilin plus STenting to Avoid myocardial Necrosis Trial will be to assess the safety and efficacy of routine usage of the glycoprotein IIb/IIIa inhibitor eptifibatide in patients already treated with aspirin and clopidogrel and undergoing implantation of at least two drug-eluting stents in the same lesion, thus identifying a clinically stable but anatomically complex patient subset.

Design: This will be a single-blind, placebo-controlled multicenter randomized trial.

Long-term follow-up of Tako-Tsubo-like syndrome: a retrospective study of 22 cases.

Objectives: To assess the late outcome of the Tako-Tsubo like syndrome in a community hospital in northern Italy.

Methods And Results: We reviewed 2233 patients who were admitted from 2001 to 2006 with diagnosis of acute coronary syndrome. Twenty-two patients (1%) presenting clinical and instrumental characteristics of Tako-Tsubo like syndrome were included in the study and prospectively underwent clinical and echocardiographic follow-up.

A rare case of idiopathic spontaneous coronary artery dissection causing acute myocardial infarction.

Spontaneous coronary artery dissection is a rare clinical event and often a fatal cause of ischaemic heart disease occurring predominantly in young or middle-aged otherwise healthy patients. We present the case of a 59-year-old female patient who was admitted to our coronary care unit with acute anterior myocardial infarction. Coronary angiography showed a long dissection involving the left coronary artery.

Transcranial Doppler monitoring during stenting of the carotid bifurcation: evaluation of two different distal protection devices in preventing embolization.

Purpose: To compare the efficacy of 2 emboli protection devices in preventing embolization during carotid artery stenting (CAS).

Methods: The GuardWire distal occlusion system (n=19) and the distal FilterWire EX (n=12) were compared in 31 consecutive patients (24 men; mean age 71+/-10 years) monitored with transcranial Doppler for microembolic signals before, during, and after CAS. The choice of the protection device was based on availability and on the patency of the contralateral carotid artery.

Modifications of minimal luminal diameter during the 24 hours following percutaneous treatment of in-stent restenosis.

The early renarrowing after percutaneous coronary interventions (PCI) for in-stent restenosis (ISR) is a phenomenon that has received little investigation. Therefore, we assessed the angiographic minimal luminal diameter (MLD) before, immediately after, and 24 hours after the procedure in 30 ISR's treated with balloon angioplasty (BA) or rotational atherectomy (RA). The MLD was 0.

Distal protection with a filter device during coronary stenting in patients with stable and unstable angina.

Background: Filter protection after percutaneous coronary intervention (PCI) is now available to prevent distal embolization. The aims of this study were (1) to evaluate the microembolization phenomenon during procedures of stent implantation in native coronary arteries of patients with stable and unstable angina, (2) to assess the amount and characteristics of the debris captured by the Angioguard, and (3) to investigate the relation between clinical and angiographic variables and pathological data.

Methods And Results: Elective coronary stenting with the use of a protective filter was attempted in 39 consecutive coronary artery lesions with >60% stenosis (mean, 67.

Karyotype of Norway spruce by multicolor FISH.

The chromosomes (2n = 2 x = 24) of Norway spruce are very large since their size reflects the huge amount of genomic DNA (2C = 30 x 10(9) bp). However, the identification of homologous pairs is hampered by their high degree of similarity at the morphological level. Data so far presented in the literature were not sufficient to solve all the ambiguities in chromosome identification.

Patients on renal replacement therapy for 20 or more years: a clinical profile.

Background: Long-term survivors are living evidence of the goals and limits of renal replacement therapy (RRT).

Methods: A cross-sectional study was performed on all cases (188 patients) with RRT follow-up >/=20 years in Piemonte, northern Italy (4 350 000 inhabitants, 22 dialysis centres). Study included revision of clinical charts and assessment of functional (Karnofsky scale, Ks) and nutritional status (subjective global assessment, SGA).

[Daily dialysis: evaluation of the first year of experience at home and in a limited care center].

Background: Among self dialysis treatments, daily dialysis is encountering a growing interest. Aim of this study was to evaluate results of the first year of daily dialysis in our Center.

Methods: Since November 1998, twelve patients started daily dialysis.

Henoch-Schönlein purpura after 20 years of renal replacement therapy.

While the clinical impact of the impaired immune response, commonly described in chronic dialysis patients, is still a matter of discussion, it is usually considered that immunological diseases tend to become progressively less active after the start of regular renal replacement therapy (RRT). We reported a case of Henoch-Schonlein Purpura in a 51-year-old male, on RRT for 20 years, 8 on dialysis and 12 with renal graft, because of ESRD of unknown origin (chronic glomerulonephritis?). The acute onset of the syndrome, presenting purpuric rash, abdominal discomfort and asymmetric joint pain with edema and local signs of acute inflammation, was followed by several relapses over a 2 years period.

Daily dialysis Kt/V and flexible schedules: is it possible to control efficiency, when and how?

Background: Daily hemodialysis is a promising treatment schedule but uniform criteria for defining efficiency are lacking.

Methods: On our daily dialysis (DD) schedule, duration is flexible (2-3 hours, patients are free to add up to 30 min/session), Qb 250-350 mL/min; dialyser 1.6-1.

Modelling the "ideal" self care--limited care dialysis center.

Limited care dialysis is an interesting option, which has gained attention in several settings because of the aging of the uremic cohort. The aim of this study was to assess its potential in the Piedmont region in northern Italy, evaluating patients' and care-givers' preferences and testing them in a mathematical model of organisation. The study was conducted in the satellite unit of a university hospital (200-210 dialysis patients), following 35 patients (15 at home, 20 in the center, 10 on daily dialysis).

Identification of wild and cultivated sunflower for breeding purposes by AFLP markers.

Amplified fragment length polymorphisms (AFLPs) represent one of the most powerful polymerase chain reaction (PCR)-based markers which enables one to discriminate single plants by DNA analysis. To date this technique has only been applied in cultivated sunflower to detect genetic diversity among oilseed inbred lines. In this article we report the use of AFLP markers to investigate the level of diversity within and between populations of Helianthus argophyllus collected in the Maputo area, Mozambique, both for taxonomic and breeding purposes.

Daily Dialysis: Toward a New Standard in Well-Being.

Daily hemodialysis (DHD) is a promising option; however, logistic obstacles and clinical perplexities limit its dissemination. Understanding the mechanisms of, and the time until, the onset of improved well-being may help to quantify clinical advantages and to define the minimum length of a "trial" of daily dialysis. By following 30 patients treated in 4 centers, this study aimed to determine how long a period of time is needed until a patient experiences subjective improvement.

Education as a clinical tool for self-dialysis.

Therapeutic compliance and patient education are presently considered crucial parts of end-stage renal disease (ESRD) therapy. In the center where Italian home and self-care dialysis treatment started, an education program was designed as multi-step pathway--following patients from chronic renal failure to dialysis and eventual graft--employing lessons, booklets, and books. Each step was validated in various subsets of patients.

Why Our Patients Like Daily Hemodialysis.

The option of daily hemodialysis (HD) was discussed in November 1998 with a group of 35 HD patients on home or self-care/limited-care HD in a single, freestanding unit. After the meeting, 3 patients on home HD chose to switch to daily HD. The clinical success of the first patient and the immediate followers was one of the main reasons for further extension of this experience.

Stent implantation in a left anterior descending coronary artery through an internal mammary artery graft.

We describe a case of balloon angioplasty of a totally occluded left anterior descending coronary artery through a tortuous left internal mammary artery graft. Because of early recurrence of the lesion, we implanted a short Palmaz-Schatz stent with good angiographic and clinical results.