Search

Fingerprint powder remains one of the most effective techniques for identifying individuals from their latent fingerprints. Visualizing latent fingerprints requires powder with high color contrast and strong adhesive to be easily applied on various substrates. The utilization of silica gel extracted from local materials of Lapindo volcanic mud can be applied for fluorescent fingerprint powder based on methyl orange. The powder was synthesized by the sol-gel method, followed by the impregnation of methyl orange as a dye with varying loads. The powders exhibit an amorphous structure and nanoparticle size with an average particle diameter of 80.93 nm by spherical morphology interconnected to form agglomerations. The powder contains silanol, siloxane, azo, and carboxylate functional groups derived from its precursors. The dusting method proves the performance of fluorescent fingerprint powder on porous and non-porous substrates hereafter observed under white light and UV light. The powder containing 0.05 gs of methyl orange per gram of silica gel is the most effective in revealing fingerprint patterns on non-porous surfaces. It has mesoporous properties with a specific surface area of 7.95 m2g−1 and a pore diameter of 23.14 nm. SiMO retained its full capability after two years of storage, indicating it is a great choice for forensic investigations.

Community empowerment and household waste processing are two issues that need to be resolved by the government. An independent and educated society is an important pillar to support the development of country. Meanwhile, waste that continues to accumulate without processing has a negative impact on health and the environment. Public education about household waste processing can be a solution to the two problems above. Education was carried out at Junior High School YBPK Surabaya and residents of Dukuh Kupang Surabaya, and other participants who joined in a hibrid meeting with a total of 116 participants. Activities at YBPK Surabaya took place on 25 March and 5 August 2023 and activities at Dukuh Kupang Surabaya took place on 27 May and 26 August 2023. The types of waste processed are organic waste and used cooking oil, which are then converted into eco-enzymes and used cooking oil Activities are divided into 2 stages. there are community education activities and program sustainability monitoring activities. The community education activities includes presentation and workshop were hold in March 2023 at YBPK Surabaya Middle School and May 2023 at Dukuh Kupang Surabaya. The evaluation of sustainability program including individual practice and monitoring of activities was carried out in August 2023 at Dukuh Kupang Surabaya. Methods for implementing activities include presentation, practice accompanied by a mentor, individual practice, and monitoring program sustainability. Based on the analysis of participants' ability, the participant scores before and after the activity was increase. It means that this training succeeded in increasing participants' knowledge and skills in processing waste, especially organic waste and used cooking oil waste. A total of 72 out of 116 participants (62%) had processed household waste either individually or in groups. Activity evaluation data shows that these activities are necessary and on target to create an independent and creative society.

The improvement in the design of mordenite-based catalysts focuses on the present study to fulfill the massive demand for bio-aviation fuel (BAF) as renewable energy. Modification of the mordenite through ionic impregnation of Fe, Cu, and Cr, has supported the mordenite to perform with better efficiency and activity in catalyzing the cracking process of stearic acid. The adjustment on catalytic activity was carried out by simply reacting the catalyst with stearic acid at 190 °C and investigating cracking products with Gas Chromatography-Mass Spectroscopy. The results of the GC-MS test of the cracking product showed the formation of alkane-alkene and aromatic compounds. BAF was selectively obtained (30.27%) when the reaction was catalyzed by FeCuCr/mordenite catalyst. The BAF derived from FeCuCr/mordenite contained hydrocarbons that include xylene, mesitylene, dodecane, tridecane, tetradecane, and pentadecane. However, reduced selectivity was realized (19.85%) when the reaction was catalyzed by nano FeCuCr/mordenite. Its hydrocarbon constituents include benzene, tetradecane, and pentadecane compounds.

Imprinted zeolite modified carbon paste (carbon paste-IZ) electrode had been developed as a sensor to analyze blood glucose content by potentiometry. The used zeolite was Lynde Type A (LTA) that synthesized with a mole ratio of Na2O, Al2O3, SiO2 and H2O of 4:1:1.8:270, respectively while non-imprinted zeolite was prepared with a mole ratio of glucose/Si of 0.0306. Glucose was then extracted from the zeolite framework using hot water (80 °C) to produce imprinted zeolite (IZ). The carbon paste-IZ electrode prepared from activated carbon, paraffin pastilles, and IZ with a mass ratio of 5:4:1 showed the best performance. The modified electrode demonstrated the measurement range of 10–4-10–2 M, the Nernst factor of 29.55 mV/decade, the response time less than 120 s, and the detection limit of 5.62 × 10–5 M. Ascorbic acid, uric acid, urea and creatinine did not interfere on the glucose analysis by potentiometry. Comparison test with spectrophotometry showed an accuracy of (90.7 ± 1.4)% (n = 5), while the application of the electrode to analyze five spiked serum samples showed recovery of (92.2 ± 1.3)% (n = 5). The electrode was stable for up to 9 weeks (168 times usage). Based on its performance, the developed electrode can be applied to analyze glucose in human serum sample and recommended for used in the medical field.

The development of sensors based on imprinted zeolite X to detect blood glucose through potentiometry was performed. In this study, the sensor was made of a mixture of carbon paste and imprinted zeolite X. Zeolite X was synthesized using a sol–gel-hydrothermal method at a temperature of 100 °C with basic materials of NaAlO2, NaOH, TEOS, and distilled water. The characterization results of XRD showed the presence of specific peaks, which were confirmed with standard zeolite X. Imprinted zeolite X exhibited a 20 times greater adsorption capacity size, and an adsorption efficiency 3 times greater than that of zeolite X. This is thought to be due to the presence of a molecular template within it. The IZ–carbon paste electrode showed optimum performance due to a mass ratio of carbon, paraffin, and imprinted zeolite X of 12:7:1. The electrode performance was expressed by the Nernst factor value of 30 mV/decade, the measuring range of 10−4–10−2 M, the upper detection limit of 1.38 × 10−2 M, and the lower detection limit of 1.28 × 10−4 M, so this electrode can be used for glucose analysis with a normal concentration (70–110 mg/dL or equivalent to 3.8 × 10−3–6.1 × 10−3 M), as well as the glucose concentration of people with diabetes mellitus (>200 mg/dL or about 10−2 M). This electrode showed precision values of 97.14–99.02%, accuracy values of 98.65–99.39%, and electrode response times of 10–13 s. The electrodes showed high stability for more than 5 weeks with 141 uses. The electrodes also showed high selectivity for glucose in the matrix of uric acid, urea, NaCl, and KCl. Therefore, its use as an alternative electrode for routine glucose analysis in the medical field is recommended.

The clean technologies of self-cleaning surfaces are expanding rapidly. Highly hydrophobic coatings with strong adhesion, high durability, and dirt-free surfaces have been prepared via sol-gel deposition of SiO2-TiO2-alkylsilane. The influence of the effects of the alkyl chain length of silane on surface roughness was investigated. This deposition involved a one-layer technique to produce the rough surfaces. The bimetal oxide of SiO2-TiO2 created a high level of surface roughness. As a result, the water contact angle of the coatings increased with the increasing alkyl chain length of silane (up to C=8). However, the water contact angle decreased when the C=16 of alkylsilane was applied. It was predicted that the longer alkyl chain would cause the molecules to collapse. The higher hydrophobicity was produced by SiO2-TiO2-OTMS coatings with a water contact angle of about 140.67 ± 1.23°. The effect of the dip-coating technique (one layer and layer-by-layer) on hydrophobicity was also discussed. The results showed that coatings produced by the one-layer technique had a higher contact angle than coatings made by the layer-by-layer technique. The coatings were stable under outdoor exposure and able to hinder dirt attachment to their surfaces.

A hydrophobic coating for glass substrates was developed using SiO2, TiO2, and methyltrimethoxysilane (MTMS) to achieve low surface energy and a rough surface. The coating process was conducted using a sol–gel method and layer by layer deposition. The effect of SiO2, TiO2, and MTMS on the hydrophobicity and transparency of the coating were evaluated using contact angle and optical transmittance measurements, respectively. The transparency was found to decrease with higher moles of SiO2, TiO2, and MTMS; the water contact angle initially increased with increasing addition of these reagents, but then declined above the optimum conditions. The optimum conditions were determined to be at approximately 0.075, 0.030, and 0.002 mol of SiO2, TiO2, and MTMS, respectively. The resulting water contact angle was 115.56 ± 1.01°. SiO2 and TiO2 provided a synergistic effect to improve the roughness surface, as shown in the AFM data. The glass coated using SiO2–TiO2–MTMS exhibited higher hardness values than bare glass.

In this study water repellent layered glass has been prepared by coating silica (SiO2) combined with a hydrophobic silane compound. SiO2 was extracted from rice hull ash and two silane compounds, namely hexadecyltrimethoxysilane (HDTMS) and trimethylchlorosilane (TMCS) were used. Coating was performed through two deposition techniques, i.e. one step (mono-layer) and layer by layer (LBL, multi-layer). The effect of silane to SiO2 mole ratio, silane type and layer number on the glass characters was evaluated. Characterization included hydrophobicity, transparency, surface roughness and stability of coating. Results showed that increasing the mole ratio of silane to SiO2 and the layer number increased the hydrophobicity of the glass surface. The optimum mole ratio was 5:1 and the significant increase of contact angle occurred at lower mole ratio, but the stability tends to be increased at higher mole ratio. For HDTMS-SiO2 layer, the technique of LBL technique produced a coating with higher hydrophobicity and transparency than single-stage one. The LBL technique produced the highest water contact angle of 103.7° with transmittance of 96%, while for TMCS-SiO2 layer the one stage technique produced hydrophobic layer with higher water contact angle of 108.0° and transparency about 94.52%. The prepared hydrophobic glasses were relatively stable in polar and non-polar solvents, but unstable to ambient conditions.

Abstrak Sintesis ZSM-5 dilakukan dari metakaolin terdealuminasi tanpa penambahan templat organik. Sintesis dilakukan melalui pengaturan suhu hidrotermal mulai suhu 120oC, 150o, dan 170oC. Hasil sintesis dikarakterisasi dengan difraktometer sinar-X , spektrometer FTIR, dan adsorpsi/desorpsi nitrogen. Pengaturan suhu hidrotermal pada 120oC selama 24 jam belum menghasilkan ZSM-5, sedangkan sintesis pada suhu 150oC selama 24 jam diperoleh hasil ZSM-5 dengan kristal yang cukup baik. Hidrotermal pada 170o tetap dapat membentuk ZSM-5 dengan pengotor mordenit dan kurang kristalin dibandingkan sintesis pada 150oC. Kata kunci: Abstrak Sintesis ZSM-5 dilakukan dari metakaolin terdealuminasi tanpa penambahan templat organik. Sintesis dilakukan melalui pengaturan suhu hidrotermal mulai suhu 120oC, 150o, dan 170oC. Hasil sintesis dikarakterisasi dengan difraktometer sinar-X , spektrometer FTIR, dan adsorpsi/desorpsi nitrogen. Pengaturan suhu hidrotermal pada 120oC selama 24 jam belum menghasilkan ZSM-5, sedangkan sintesis pada suhu 150oC selama 24 jam diperoleh hasil ZSM-5 dengan kristal yang cukup baik. Hidrotermal pada 170o tetap dapat membentuk ZSM-5 dengan pengotor mordenit dan kurang kristalin dibandingkan sintesis pada 150oC. Kata kunci: ZSM-5, metakaolin, terdealuminasi, tanpa templat, pengaturan suhu dan waktu Abstract Synthesis of ZSM-5 is carried out from dealuminated metakaolin without the addition of organic template. The synthesis is done by setting the hydrothermal temperature from 120oC, 150oC, and 170oC. The results were characterized by an X-ray diffractometer, FTIR spectrometer, and nitrogen adsorption / desorption. Hydrothermal temperature setting at 120oC for 24 hours has not produced ZSM-5, while the synthesis at 150oC for 24 hours was obtained ZSM-5 with good crystals. Hydrothermal at 170 °C can still form ZSM-5 with mordenite impurities and less crystalline than synthesis at 150 °C. Keywords: ZSM-5, dealuminated metakaolin, without organic templates, temperature and time settings Abstract Synthesis of ZSM-5 is carried out from dealuminated metakaolin without the addition of organic template. The synthesis is done by setting the hydrothermal temperature from 120oC, 150oC, and 170oC. The results were characterized by an X-ray diffractometer, FTIR spectrometer, and nitrogen adsorption / desorption. Hydrothermal temperature setting at 120oC for 24 hours has not produced ZSM-5, while the synthesis at 150oC for 24 hours was obtained ZSM-5 with good crystals. Hydrothermal at 170 °C can still form ZSM-5 with mordenite impurities and less crystalline than synthesis at 150 °C. Keywords: ZSM-5, dealuminated metakaolin, without organic templates, temperature and time settings

Peritoneal dialysis-associated peritonitis from such resistant organisms as vancomycin-resistant enterococci increasingly is occurring and is challenging to treat. We describe 2 cases of vancomycin-resistant entercoccus peritonitis successfully treated with intraperitoneal daptomycin. Both patients were on automated peritoneal dialysis therapy with culture-positive vancomycin-resistant Enterococcus faecium peritonitis and were treated with 10 to 14 days of intraperitoneal daptomycin given every 4 hours through manual peritoneal dialysate exchanges. Despite the known degradation in dextrose solutions, intraperitoneal daptomycin was effective in clearing both infections. Neither patient experienced a relapse or repeated peritonitis. Additional studies of dosing and pharmacokinetics of intraperitoneal daptomycin in the treatment of patients with vancomycin-resistant enterococcus peritonitis are needed. Copyright © 2009 National Kidney Foundation, Inc. [ABSTRACT FROM AUTHOR]

Direct synthesis of ZSM-5 from Indonesian kaolin without calcination for the formation of metakaolin was done through the addition of an alkaline solution (sodium fluoride and sodium hydroxide) and the fusion using sodium hydroxide. Crystallization was conducted through hydrothermal method at 80 °C for four days. XRD diffractogram and FTIR spectra showed that the addition of sodium fluoride solution in the ratio Si/Al = 100 could produce highly crystalline ZSM-5, whereas the use of a sodium hydroxide solution and fusion process did not produce the crystalline ZSM-5.

Abstrak Telah dilakukan hidrolisis minyak jarak pagar (Jatropha curcas oil: JO) menggunakan katalis CaO. Reaksi ini dimaksudkan untuk meningkatkan nilai ekonomis minyak jarak pagar selain biodiesel. Katalis CaO dikalsinasi terlebih dahulu pada suhu 800ᵒC untuk menghindari terjadinya deaktivasi katalis oleh terbentuknya CaCO3. Pada penelitian ini dilakukan karakterisasi katalis CaO meliputi struktur kristal CaO, luas permukaan, jumlah situs basa dan kekuatan kebasaan serta aktivitas katalitiknya. Hasil penelitian menunjukkan, katalis CaO memiliki luas permukaan 26,451 m2/g, kekuatan situs basa (pKB) pada daerah 7,2 < pKBH CaO < 15,0. Hasil uji aktivitas katalis CaO pada reaksi hidrolisis CJO diperoleh konversi CJO menjadi asam lemak bebas (free fatty acid: FFA) sebesar 77,58% pada waktu 60 menit. Kata kunci: hidrolisis, minyak jarak pagar (JO), free fatty acid (FFA), CaO dan situs basa Abstract Hydrolysis of Jatropha curcas oil has been carried out using CaO as a catalyst. This reaction is intended to increase the economic value besides biodiesel. CaO catalyst was calcined at a temperature of 800 oC to avoid catalyst deactivation by formation of CaCO3. In this research include the characterization of catalysts CaO crystal structure, surface area, the number of base sites and the strength of basicity and catalytic activity. The results of the analysis showed that CaO catalyst has a surface area of 26.451 m2/g, the number of base sites of 221.77 mmol/g and the strength of base sites (pKBH) in the range of 7.2 < pKBH CaO < 15.0. From catalytic activity test showed that that the use of the catalytic activity of CaO catalyst in the hydrolysis reaction CJO into free fatty acids (FFA) as much as 77.58% for 60 minutes. Keywords: hydrolysis, Jatropha curcas oil (JO), free fatty acid (FFA), CaO and base site

Development of the uric acid sensor through coating of glassy carbon (GC) electrode with imprinting zeolite (IZ) was carried out. Zeolite was synthesized by mixing TEOS, TBOT, TPAOH, and water followed by hydrothermal process. Zeolite was molded together with uric acid to produce IZ. The deposition potential of IZ and uric acid to the GC surface was -0.6 V during 150 sec with addition of KNO3 0.02 M as supporting electrolyte. The method gives linearity of 0.9834 (concentration 5.6x10-9M - 2.8x10-8 M), precision 1.89 - 7.65%, sensitivity 0.33 µA/nM/cm2, limit of detection 5.9x10-9 M, and accuracy 96.26 ± 0.55% (n = 5). The developed sensor showed a high selectivity toward uric acid. The presence of ascorbic acid, creatine, and creatinine with an equal concentration with uric acid did not interfere on the uric acid analysis.

Ahmed Fathi Elkeraie,1 Saeed Al-Ghamdi,2 Ali K Abu-Alfa,3 Torki Alotaibi,4 Ali Jasim AlSaedi,5 Abdulkareem AlSuwaida,6 Mustafa Arici,7 Tevfik Ecder,8 Mohammad Ghnaimat,9 Mohamed Hany Hafez,10 Mohamed H Hassan,11 Tarik Sqalli12 1Department of Internal Medicine and Nephrology, Alexandria University, Alexandria, Egypt; 2Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Internal Medicine, Division of Nephrology and Hypertension, American University of Beirut, Beirut, Lebanon; 4Transplant Nephrology, Hamed Al-Essa Organ Transplant Center, Sabah Health Region, Kuwait City, Kuwait; 5Department of Nephrology, College of Medicine, University of Baghdad, Nephrology and Transplantation Center, Medical City Complex, Baghdad, Iraq; 6Department of Medicine, King Saud University, Riyadh, Saudi Arabia; 7Department of Nephrology, Faculty of Medicine, Hacettepe University, Alt&inodot;nda&gbreve;, Ankara, Turkey; 8Department of Medicine, Istinye University; Division of Nephrology, Topkap&inodot;, Istanbul, Turkey; 9Department of Nephrology, Specialty Hospital, Jaber Ibn Hayyan St. Shmeisani, Amman, Jordan; 10Department of Nephrology and Medicine, Cairo University, Cairo, Egypt; 11Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; 12Department of Nephrology, Moroccan Society of Nephrology, Casablanca, MoroccoCorrespondence: Ahmed Fathi Elkeraie, Department of Internal Medicine and Nephrology Alexandria University, Alexandria, Egypt, Email drahmed@hotmail.comAbstract: Chronic kidney disease (CKD) is a major public health concern in the Middle East and Africa (MEA) region and a leading cause of death in patients with type 2 diabetes mellitus (T2DM) and hypertension. Early initiation of sodium-glucose cotransporter - 2 inhibitors (SGLT-2i) and proper sequencing with renin-angiotensin-aldosterone system inhibitors (RAASi) in these patients may result in better clinical outcomes due to their cardioprotective properties and complementary mechanisms of action. In this review, we present guideline-based consensus recommendations by experts from the MEA region, as practical algorithms for screening, early detection, nephrology referral, and treatment pathways for CKD management in patients with hypertension and diabetes mellitus. This study will help physicians take timely and appropriate actions to provide better care to patients with CKD or those at high risk of CKD.Keywords: chronic kidney disease, nephrology referral, screening, sodium-glucose cotransporter-2 inhibitors

Purpose of Review: Disasters, natural and man-made, are rising in frequency and pose significant challenges to the provision of renal care worldwide. Patients with kidney disease, particularly those on dialysis, are extremely vulnerable during disasters. This timely review summarizes the potential roles international renal disaster preparedness working groups have in addressing these challenges., Recent Findings: The vulnerability of kidney patients has galvanized the evolution of global response mechanisms and the contemporary efforts of various organizations. In this review, the importance of preparedness, networking, and collaborations at all levels are highlighted, citing recent crises. It will also note key areas for improvement, including an enhanced engagement with global health organizations. Finally, it is imperative to urge the international community to recognize that individuals with kidney disease are often among the first patient groups to suffer in disaster zones. These messages are intended to persuade global stakeholders that kidney patients, including pediatric ones, should be prioritized as requiring immediate support during disasters., Summary: The unique and life-threatening challenges faced by individuals with kidney disease in natural disaster- or war-torn areas demand special consideration in humanitarian efforts and international crisis response strategies. International organizations can play a major role in this regard., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Lanthanum carbonate (LC) is a phosphate binder used in end-stage renal disease (ESRD) with few adverse effects due to poor systemic absorption. Gastrointestinal deposition is likely due to alterations in epithelial permeability from inflammation in ESRD. It is challenging to detect in cases with minimal deposition and may be missed on endoscopy and biopsy. A 36-year-old with ESRD who was evaluated for gastrectomy was found to have LC deposition histologically. Years later, the excised portion had similar findings. This case allows for evaluation of LC gastropathy in a resection specimen, providing the opportunity to showcase its unique pathology features.

The highest financial and symptom burdens and the lowest health-related quality-of-life scores are seen in people with kidney failure. A total of 11 countries in the International Society of Nephrology (ISN) Middle East region responded to the ISN-Global Kidney Health Atlas. The prevalence of chronic kidney disease (CKD) in the region ranged from 4.9% in Yemen to 12.2% in Lebanon, whereas prevalence of kidney failure treated with dialysis or transplantation ranged from 152 per million population (pmp) in the United Arab Emirates to 869 pmp in Kuwait. Overall, the incidence of kidney transplantation was highest in Saudi Arabia (20.2 pmp) and was lowest in Oman (2.2 pmp). Chronic hemodialysis (HD) and peritoneal dialysis (PD) services were available in all countries, whereas kidney transplantation was available in most countries of the region. Public government funding that makes acute dialysis, chronic HD, chronic PD, and kidney transplantation medications free at the point of delivery was available in 54.5%, 72.7%, 54.5%, and 54.5% of countries, respectively. Conservative kidney management was available in 45% of countries. Only Oman had a CKD registry; 7 countries (64%) had dialysis registries, and 8 (73%) had kidney transplantation registries. The ISN Middle East region has a high burden of kidney disease and multiple challenges to overcome. Prevention and detection of kidney disease can be improved by the design of tailored guidelines, allocation of additional resources, improvement of early detection at all levels of care, and implementation of sustainable health information systems., (© 2024 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Objective: To describe the clinical, endoscopic, histologic, and treatment outcomes of Helicobacter heilmannii (H. heilmannii) associated gastritis in children in the New England region of the United States., Methods: Retrospective study of children (1-18 years) with H. heilmannii identified on gastric mucosal biopsies from two pediatric centers over a 21-year period, January 2000-December 2021. Cases were identified by querying pathology databases at each institution. Demographic and clinical data were obtained from the medical record. Endoscopic and histologic findings were extracted from endoscopy and pathology reports, respectively., Results: Thirty-eight children were diagnosed with H. heilmannii-associated gastritis during the study period. The mean age at diagnosis was 10.1 ± 5.3 years, and 25/38 (66%) cases were male. Abdominal pain (32%) and nausea with or without vomiting (26%) were the most common symptoms. Thirty-two children (84%) had endoscopic findings including gastric nodularity (55%) and erythema (26%). All children had histologic signs of chronic gastritis, including those with normal endoscopic exams. Antibiotic regimens used for treating Helicobacter pylori were frequently prescribed. Of the 17 children who underwent a follow-up endoscopy (range 2-68 months), 15 (88%) did not have H. heilmannii identified on gastric biopsies., Conclusion: H. heilmannii was an infrequent but potential cause of epigastric abdominal pain and nausea in our cohort of New England children. While morphologically distinct from H. pylori, the bacteria can result in similar endoscopic and histologic findings of nodularity and chronic gastritis, respectively. The rate of eradication, as assessed by histology following treatment with H. pylori therapies, was below the 90% recommended goal for antimicrobial therapies., (© 2023 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Purpose: Biobanking helps source tissue and blood for studying cancer genomics. Access to biorepository resources in low- and middle-income countries is lacking. Memorial Sloan Kettering Cancer Center (MSK) and the American University of Beirut (AUB) established a joint tissue biorepository at AUB in Beirut, Lebanon. The undertaking encountered key challenges that were unanticipated., Materials and Methods: Patients age 18 years or older were eligible for enrollment at AUB. After consent, biospecimens were obtained at the time of routine diagnostic and/or therapeutic interventions. Both normal and abnormal tissue and solid and/or liquid specimens were collected from varied body sites. Early on, declining consent was frequently observed, and this was highlighted for investigation to understand potential participants reasoning., Results: Of 850 patients approached, 704 (70.8%) elected to consent and 293 (29.5%) declined participation. The number of declined consents led to an amendment permitting the documentation of reasons for same. Of 100 potential participants who declined to consent and to whom outreach was undertaken, 63% indicated lack of research awareness and 27% deferral to their primary physician or family member. A financial gain for AUB was cited as concern by 5%, cultural boundaries in 4%, and 1% expressed concern about confidentiality. Of the patients who elected to consent, 682 biospecimens were procured., Conclusion: The AUB-MSK biospecimen repository has provided a unique resource for interrogation. Patient participation rate was high, and analyses of those who elected not to consent (29%) provide important insights into educational need and the local and cultural awareness and norms.

Background: The Food and Drug Administration (FDA)-approved submucosal injection of lifting agents such as ORISE ® has become a widespread, routine and standard practice in endoscopic mucosal resection and endoscopic submucosal dissection of gastrointestinal lesions. Lifting agent granulomas result from transformation of injected material into a mass-forming amorphous hyaline-like material eliciting a strong foreign body giant cell reaction. This report of three cases shows how lifting agent granulomas can act as potential clinical and gross mimickers of invasive adenocarcinoma., Cases Description: Three cases were identified in a six-month span based on the histological presence of a lifting agent granuloma in a colonic/colorectal resection specimen with associated clinical, imaging and gross concern for invasive malignancy. Each case resulted in an escalation of clinical and surgical management due to the suspicion of an unresectable neoplastic process that was at least partially involved by an exuberant granulomatous reaction due to the utilization of a lifting agent. Colonic transmural involvement and sub-serosal vascular infiltration by the granulomas are described., Conclusions: Lifting agent granulomas have become a routine endoscopic technique to help achieve full resection of flat/sessile colorectal polyps and early-stage cancers. This report confirms that these granulomas exhibit colonic transmural involvement. Sub-serosal blood vessel involvement is reported for the first time. It is important to recognize the unique characteristics of these new synthetic lifting agents. Their propensity to develop a mass-forming granulomatous reaction has the potential to mimic invasive adenocarcinoma clinically, radiologically and pathologically. This can significantly impact patient care and management both clinically and surgically., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://acr.amegroups.com/article/view/10.21037/acr-22-59/coif). The authors have no conflicts of interest to declare., (2023 AME Case Reports. All rights reserved.)

Type 2 diabetes (T2D) is a global health problem accompanied by an elevated risk of complications, the most common being cardiac and renal diseases. In Lebanon, the prevalence of T2D is estimated at 8-13%. Local medical practice generally suffers from clinical inertia, with gaps in the yearly assessment of clinical manifestations and suboptimal screening for major complications. The joint statement presented here, endorsed by five Lebanese scientific medical societies, aims at providing physicians in Lebanon with a tool for early, effective, and comprehensive care of patients with T2D. Findings from major randomized clinical trials of antidiabetic medications with cardio-renal benefits are presented, together with recommendations from international medical societies. Optimal care should be multidisciplinary and should include a multifactorial risk assessment, lifestyle modifications, and a regular evaluation of risks, including the risks for cardiovascular (CV) and renal complications. With international guidelines supporting a shift in T2D management from glucose-lowering agents to disease-modifying drugs, the present statement recommends treatment initiation with metformin, followed by the addition of sodium-glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists due to their CV and renal protection properties, whenever possible. In addition to the selection of the most appropriate pharmacological therapy, efforts should be made to provide continuous education to patients about their disease, with the aim to achieve a patient-centered approach and to foster self-management and adherence to the medical plan. Increasing the level of patient engagement is expected to be associated with favorable health outcomes. Finally, this statement recommends setting an achievable individualized management plan and conducting regular follow-ups to monitor the patients' glycemic status and assess their risks every 3-6 months., (© 2022. The Author(s).)

Collagenofibrotic glomerulopathy (CG) is a rare disease characterized by the deposition of collagen type 3 fibrils in the glomeruli. Patients may have proteinuria, hematuria, and/or renal dysfunction. CG is considered a progressive disease with variable rates of progression. The definitive diagnosis is made by electron microscopy with the presence of characteristic subendothelial and mesangial curved, comma-like, banded collagen type 3 fibers of 40-65 nm periodicity. We are reporting the first case of CG in a kidney transplant recipient with kidney disease of unknown cause., (© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)

Kidney failure is the permanent impairment of kidney function associated with increased morbidity, hospitalization, and requirement for kidney replacement therapy. A total of 11 countries in the Middle East region (84.6%) responded to the survey. The prevalence of chronic kidney disease in the region ranged from 5.2% to 10.6%, whereas prevalence of treated kidney failure ranged from 152 to 826 per million population. Overall, the incidence of kidney transplantation was highest in Iran (30.9 per million population) and lowest in Oman and the United Arab Emirates (2.2 and 3.0 per million population, respectively). Long-term hemodialysis services were available in all countries, long-term peritoneal dialysis services were available in 9 (69.2%) countries, and transplantation services were available in most countries of the region. Public funding covered the costs of nondialysis chronic kidney disease care in two-thirds of countries, and kidney replacement therapy in nearly all countries. More than half of the countries had dialysis registries; however, national noncommunicable disease strategies were lacking in most countries. The Middle East is a region with high burden of kidney disease and needs cost-effective measures through effective health care funding to be available to improve kidney care in the region. Furthermore, well-designed and sustainable health information systems are needed in the region to address current gaps in kidney care in the region., (© 2021 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Competing Interests: The author has nothing to disclose.

Achievement of equity in health requires development of a health system in which everyone has a fair opportunity to attain their full health potential. The current, large country-level variation in the reported incidence and prevalence of treated end-stage kidney disease indicates the existence of system-level inequities. Equitable implementation of kidney replacement therapy (KRT) programs must address issues of availability, affordability, and acceptability. The major structural factors that impact equity in KRT in different countries are the organization of health systems, overall health care spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or peritoneal dialysis, and conservative care). Implementation of KRT programs has the potential to exacerbate inequity unless equity is deliberately addressed. In this review, we summarize discussions on equitable provision of KRT in low- and middle-income countries and suggest areas for future research., (© 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Secular increases in the burden of kidney failure is a major challenge for health systems worldwide, especially in low- and middle-income countries (LMICs) due to growing demand for expensive kidney replacement therapies. In LMICs with limited resources, the priority of providing kidney replacement therapies must be weighed against the prevention and treatment of chronic kidney disease, other kidney disorders such as acute kidney injury, and other noncommunicable diseases, as well as other urgent public health needs. Kidney failure is potentially preventable-not just through primary prevention of risk factors for kidney disease such as hypertension and diabetes, but also by timely management of established chronic kidney disease. Among people with established or incipient kidney failure, there are 3 key treatment strategies-conservative care, kidney transplantation, and dialysis-each of which has its own benefits. Joining up preventive care for people with or at risk for milder forms of chronic kidney disease with all 3 therapies for kidney failure (and developing synergistic links between the different treatment options) is termed "integrated kidney care" and has potential benefits for patients, families, and providers. In addition, because integrated kidney care implicitly considers resource use, it should facilitate a more sustainable approach to managing kidney failure than providing one or more of its components separately. There is currently no agreed framework that LMIC governments can use to establish and/or scale up programs to prevent and treat kidney failure or join up these programs to provide integrated kidney care. This review presents a suggested framework for establishing integrated kidney care programs, focusing on the anticipated needs of policy makers in LMICs., (© 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Cinacalcet is an effective and safe alternative to parathyroidectomy in end stage renal disease (ESRD) patients with secondary hyperparathyroidism. Hypocalcemia is a known complication of treatment that is usually readily reversible upon discontinuation of the drug. It rarely manifests severely and symptomatically requiring hospital admission. We present the case of a 55 year old man with severe, symptomatic and prolonged hypocalcemia that occurred 2 weeks after starting cinacalcet. Cinacalcet induced a state of pharmacological parathyroidectomy with subsequent hungry bone syndrome. Serum calcium returned to normal range after 4 weeks of stopping the drug while receiving high doses of elemental calcium and vitamin D receptor activation therapy (VDRA).

Objective: To compare and contrast three databases, that is, The International Centre for Nephrogenic Systemic Fibrosis Registry (ICNSFR), the Food and Drug Administration Adverse Event Reporting System (FAERS) and a legal data set, through pharmacovigilance and to evaluate international nephrogenic systemic fibrosis (NSF) safety efforts., Methods: The Research on Adverse Drug events And Reports methodology was used for assessment-the FAERS (through June 2009), ICNSFR and the legal data set (January 2002 to December 2010). Safety information was obtained from the European Medicines Agency, the Danish Medicine Agency and the Food and Drug Administration., Results: The FAERS encompassed the largest number (n = 1395) of NSF reports. The ICNSFR contained the most complete (n = 335, 100%) histopathological data. A total of 382 individual biopsy-proven, product-specific NSF cases were analysed from the legal data set. 76.2% (291/382) identified exposure to gadodiamide, of which 67.7% (197/291) were unconfounded. Additionally, 40.1% (153/382) of cases involved gadopentetate dimeglumine, of which 48.4% (74/153) were unconfounded, while gadoversetamide was identified in 7.3% (28/382) of which 28.6% (8/28) were unconfounded. Some cases involved gadobenate dimeglumine or gadoteridol, 5.8% (22/382), all of which were confounded. The mean number of exposures to gadolinium-based contrast agents (GBCAs) was gadodiamide (3), gadopentetate dimeglumine (5) and gadoversetamide (2). Of the 279 unconfounded cases, all involved a linear-structured GBCA. 205 (73.5%) were a non-ionic GBCA while 74 (26.5%) were an ionic GBCA., Conclusion: Clinical and legal databases exhibit unique characteristics that prove complementary in safety evaluations. Use of the legal data set allowed the identification of the most commonly implicated GBCA., Advances in Knowledge: This article is the first to demonstrate explicitly the utility of a legal data set to pharmacovigilance research.

Background: Nephrogenic systemic fibrosis is a fibrosing disorder associated with exposure to gadolinium-based contrast agents in people with severely compromised renal function., Objective: The purpose of this study was to determine the reported number of cases of nephrogenic systemic fibrosis in children using three distinct publicly available data sources., Materials and Methods: We conducted systematic searches of the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS), the International Center for Nephrogenic Systemic Fibrosis Research (ICNSFR) registry and published literature from January 1997 through September 2012. We contacted authors of individual published cases to obtain follow-up data. Data sets were cross-referenced to eliminate duplicate reporting., Results: We identified 23 children with nephrogenic systemic fibrosis. Seventeen had documented exposure to gadolinium-based contrast agents. Six children had been reported in both the FAERS and the literature, four in the FAERS and the ICNSFR registry and five in all three data sources., Conclusion: Nephrogenic systemic fibrosis has been rarely reported in children. Although rules related to confidentiality limit the ability to reconcile reports, active pharmaco-vigilance using RADAR (Research on Adverse Drug events And Reports) methodology helped in establishing the number of individual pediatric cases within the three major data sources.

Lichen planus (LP) affects mucocutaneous surfaces and is characterized by intraepithelial and lamina propria lymphocytosis and squamous cell apoptosis (Civatte bodies). Lichen planus esophagitis (LPE) is underrecognized; concurrent cutaneous disease is present in some patients, but LPE alone is more common. We diagnose patients with characteristic pathologic findings of LPE and known correlation with skin disease or immunofluorescence (IF) results as LPE but use descriptive terminology ("lichenoid esophagitis pattern" [LEP]) when confirmation is unavailable. We reviewed clinicopathologic features of patients diagnosed at our institution with LPE or LEP. There were 88 specimens with LPE or LEP from 65 patients. Most patients were female. Seventeen patients had LPE confirmed by IF. Five patients had both esophageal (1 with IF) and skin LP. Strictures were a prominent presenting feature in LPE patients, with disease distribution more frequent in the upper and lower esophagus. Dysphagia was a common reason for endoscopy in LEP patients. Rheumatologic diseases are more common in patients with LPE compared with LEP. Viral hepatitides and human immunodeficiency virus (HIV) infections are associated with LEP. We defined polypharmacy as patients taking >3 medications; this finding was present in both LPE and LEP cohorts; however, this is a prominent feature in those with established LPE. Progression to dysplasia was noted in both cohorts. About 5% of LPE patients have tandem skin manifestations. LPE is more likely than LEP to arise in women, result in stricture formation, and be associated with rheumatologic disorders and polypharmacy, whereas LEP is associated with viral hepatitis and HIV. Both can progress to neoplasia. As the risk of stricture formation is high in patients with LPE, it is worth performing pertinent IF studies to confirm LPE, although knowledge of the clinical association of LEP with viral hepatitis, HIV, and use of multiple medications is of value in daily practice.

Increasing evidence nowadays is showing that obesity by itself, independent of other comorbidities like diabetes and hypertension, is associated with renal functional changes and structural damage. Intentional weight loss demonstrates beneficial reduction in proteinuria and albuminuria in patients with mild to moderate chronic kidney disease, particularly those whose renal damage is likely induced by obesity. The safety of some weight loss interventions, particularly the use of high-protein diets and/or medications, is questionable in this population due to the lack of well-designed randomized controlled studies reporting on their efficacy or harm. Bariatric surgery showed the most promising results with regards to ameliorating glomerular hyperfiltration and albuminuria albeit with a modest risk of increased perioperative complications with advanced stages of chronic kidney disease (CKD).

Aims: Microcarcinoids refer to microscopic nests of monotonous cells with endocrine and squamoid features. Their peculiar morphology can appear infiltrative with a desmoplastic-like background, raising concerns for an infiltrating adenocarcinoma. To further characterise microcarcinoids, we undertook a prospective clinicopathological study., Methods: 11 specimens originating from five men and six women (average age=58.9 years) were prospectively collected from December 2004 to December 2011., Results: Microcarcinoids were most commonly identified in high-risk adenomas (size ≥10 mm (n=10), villous components (n=8) and/or high-grade dysplasia (n=4)). All polyps had mucosal prolapse and four displayed background fibrosis reminiscent of desmoplasia. The microcarcinoid component was most often multifocal (n=7) within the individual polyp and extended over an average length of 3.9 mm. The individual microcarcinoid cells were cuboidal with abundant eosinophilic cytoplasm. All cases had monotonous nuclei which lacked pleomorphism, hyperchromasia and mitotic activity. All available microcarcinoids were β-catenin and synaptophysin reactive and non-reactive for chromogranin and p53 with a negligible Ki-67 proliferation index (<2%). In addition, the microcarcinoids were variably reactive for p63 and/or CK 5/6, thereby demonstrating focal squamoid features. Two of the study cases were submitted with a concern for invasive carcinoma. Clinical information was available in 10 patients with up to 24 months of follow-up: all patients are alive and well and no subsequent malignancy has been reported., Conclusions: Awareness of this unique morphology is important to avoid overdiagnosing microcarcinoids as invasive adenocarcinoma. Moreover, this immunohistochemical panel can be helpful in discriminating microcarcinoids from its malignant mimic in challenging cases.

Objective: Gynecologic and mammary cancers occupy a prominent place in female tumor pathology. The purpose of this report is to describe aspects of these cancers in Togo., Material and Methods: This retrospective and descriptive study includes all gynecologic and mammary cancers diagnosed between 1987 and 2006 in the pathology laboratory of Tokoin University Hospital in Lomé, Togo., Results: During the study period, 882 gynecologic and mammary cancers were diagnosed. Breast cancer accounted for 440 cases (49.88%). The most common gynecologic cancer locations were the cervix in 212 cases (24.03%) and uterine corpus in 108 cases (12.25%). Mean patient age was 48.3 years overall, 48,6 years for breast cancer and 49 years for cervical cancer. In almost all cases, cancer was diagnosed at an invasive stage., Conclusion: Gynecologic and mammary cancers are common in Togo and most cases are diagnosed at a late stage. An epidemiological monitoring program is needed.

The strong association between nephrogenic systemic fibrosis (NSF) and exposure to gadolinium-based contrast agents (GBCAs) has greatly affected the care of patients with kidney disease. NSF has been reported in patients with ESRD, CKD, and acute kidney injury (AKI). The majority of cases have occurred in patients with ESRD, but about 20% have been reported in patients with AKI or CKD stages 4 and 5. There is also a risk difference among GBCAs, with the Food and Drug Administration contraindicating 3 linear agents in patients at risk. Given the significant morbidity and mortality of NSF, it is imperative to identify individuals at risk. Although there are no data to support a role for hemodialysis (HD) in reducing the risk for NSF after administration of GBCAs, immediate HD is still recommended within 2 hours. Patients maintained on peritoneal dialysis seem to be at high risk and immediate HD is also recommended. However, this is not the current recommendation for CKD stages 4 and 5, especially with suspected lower risk of noncontraindicated agents. Individualized assessment is important and especially in those patients close to dialysis initiation. Instituting policies is important to address the imaging needs of patients with CKD and AKI while ensuring a balance between benefits and risks., (Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Nephrogenic systemic fibrosis (NSF) is a rare fibrosing disorder described among patients with renal disease. Currently, no standard therapy exists, although therapeutic modalities have included plasmapheresis, extracorporeal photopheresis, sodium thiosulphate, imatinib and renal transplantation. We describe a patient with NSF who was physically debilitated and underwent renal transplantation. After transplantation, the patient's lesions improved clinically, and the patient was ambulatory. Despite developing worsening renal function, her lesions remained unchanged. We conclude that renal transplantation improves symptoms of NSF, and believe that in patients with NSF, careful consideration should be made for early renal transplantation.

Native kidney biopsy is still performed primarily with hospital inpatient observation period. Experience with outpatient Computed Tomographic (CT)-guided renal biopsy at Yale New Haven Medical Center was studied to assess efficacy and safety. A total of 146 outpatient native kidney biopsies were identified between 1995 and 2001. Records were reviewed for demographics, clinical, and laboratory data and details of the procedure. Time of admission to the outpatient unit, duration of procedure and post-biopsy observation period were recorded. Complications such as bleeding, infection, admission to the hospital, transfusion, or intervention for continued bleeding were noted. Mean age was 43.9 ± 14.9 years and mean serum creatinine was 1.8 ± 1.4 mg/dl. Renal size averaged 11.4 cm. Post-procedure observation time of 4 - 6 h appeared to be adequate. Diagnostic tissue was successfully sampled in 98.6% of cases. Procedure was well tolerated with no hemodynamically significant changes. Hematocrit and hemoglobin concentration changes averaged 3.6 ± 2.5% and 1.0 ± 0.9 mg/dl, respectively (p < 0.001). There were no instances of death or need for intervention. Transfusion was required in 1 patient while 6 patients had detectable bleeding and were hospitalized for observation. Outpatient CT-guided kidney biopsy provides adequate tissue and appears to be safe with very low complication rates.

Tumor lysis syndrome (TLS) describes a constellation of biochemical and clinical abnormalities resulting from rapid and massive tumor cell death. TLS is frequently associated with hyperuricemia, hyperkalemia, hyperphosphatemia, and secondary hypocalcemia that may lead to serious clinical complications, including acute kidney injury and cardiac arrest. Identification of tumor- and patient-specific risk factors for TLS and early recognition of laboratory and clinical TLS based on established criteria are essential for preventing TLS and forestalling acute kidney injury. Early collaboration between oncologists and nephrologists will help improve assessment of patients' kidney function and risk factors, paving the way for timely and efficacious interventions., (Copyright 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)