Search

Abstract: The incidence of kidney tumors in USA and Europe (in particular, Central Europe and Italy) has been dramatically increasing since the 1970s, possibly as a consequence of ongoing environmental pollution. Environmental factors have been considered responsible for at least 80% of the incidence of neoplastic diseases. To shed some light on this issue, the amounts of Cd and Pb were measured in neoplastic tissue and adjacent normal part of kidney excised for carcinoma and compared with those in renal tissues of fetuses, newborns and subjects that died of non-neoplastic diseases. Cd and Pb were determined by Inductively Coupled Plasma Atomic Emission Spectrometry and Atomic Absorption Spectrometry with Electrothermal Atomization. Metallothionein immunoperoxidase staining technique was used to localize the accumulation of Cd and Zn in the nephrons. Content of Cd and Pb in kidneys of fetuses and newborns was extremely low. However, it was significantly increased in adjacent-normal tissues of kidneys with carcinomas, and significantly higher compared to kidneys of individuals that died of non-neoplastic diseases. In tumoral tissues of the excised kidneys, Cd content was very low, while that of Pb significantly elevated. High amounts of Cd and Pb in the adjacent-normal parts of kidneys with carcinomas are suggestive of possible, individual or synergistic, effects of these pollutants on enzymatic systems, priming an oncogenic pathway. Detection of metallothioneins, primary ligands of Cd, exclusively in the cells of proximal tubuli, i.e. wherein renal carcinoma develops in over 80% of cases, strongly supports the assumption that Cd exerts a carcinogenic effect. [Copyright &y& Elsevier]

Presents information on a study which validated a pain scale for the Minimum Data Set (MDS) assessment instrument and examined the prevalence of pain in nursing homes in the United States. Explanations on the National Resident Assessment Instrument and MDS; Methodology and results; Limitations and strengths of the study.

Purpose: The potential of renal MRI biomarkers has been increasingly recognised, but clinical translation requires more standardisation. The PARENCHIMA consensus project aims to develop and apply a process for generating technical recommendations on renal MRI., Methods: A task force was formed in July 2018 focused on five methods. A draft process for attaining consensus was distributed publicly for consultation and finalised at an open meeting (Prague, October 2018). Four expert panels completed surveys between October 2018 and March 2019, discussed results and refined the surveys at a face-to-face meeting (Aarhus, March 2019) and completed a second round (May 2019)., Results: A seven-stage process was defined: (1) formation of expert panels; (2) definition of the context of use; (3) literature review; (4) collection and comparison of MRI protocols; (5) consensus generation by an approximate Delphi method; (6) reporting of results in vendor-neutral and vendor-specific terms; (7) ongoing review and updating. Application of the process resulted in 166 consensus statements., Conclusion: The process generated meaningful technical recommendations across very different MRI methods, while allowing for improvement and refinement as open issues are resolved. The results are likely to be widely supported by the renal MRI community and thereby promote more harmonisation.