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Background: Chemokines (chemotactic cytokines) are small proteins which are engaged in many pathophysiological processes, including inflammation and homeostasis. In recent years, application of chemokines in transplant medicine was intensively studied. The aim of this study was to determine the utility of urinary chemokines CCL2 (C‐C motif ligand 2) and CXCL10 (C‐X‐C motif chemokine ligand 10) in prognosis of 5‐year graft failure and mortality post 1‐year protocol biopsy in renal transplant recipients. Methods: Forty patients who had a protocol biopsy 1 year after renal transplantation were included. Concentrations of CCL2 and CXCL10 in urine with reference to urine creatinine were measured. All patients were under the supervision of one transplant center. Long‐term outcomes within 5 years after 1‐year posttransplant biopsy were analyzed. Results: Urinary CCL2:Cr at the time of biopsy was significantly increased in patients who died or had graft failure. CCL2:Cr was proven to be a significant predictor of 5‐year graft failure and mortality (odds ratio [OR]: 1.09, 95% confidence interval [CI]: 1.02–1.19, p =.02; OR: 1.08, 95% CI: 1.02–1.16, p =.04; respectively). Conclusion: Chemokines are easily detected by current methods. In the era of personalized medicine, urinary CCL2:Cr can be considered as a factor providing complementary information regarding risk of graft failure or increased mortality. [ABSTRACT FROM AUTHOR]

Introduction: Gallstones are increasingly common in children. Genetic analyses of adult cohorts demonstrated that the sterol transporter ABCG8 p.D19H and Gilbert UGT1A1*28 variants enhance the odds of developing gallstones. The genetic background of common lithiasis in children remains unknown. Methods: Overall, 214 children with gallstone disease (1 month–17 years, 107 boys) were inclueded. The control cohorts comprised 214 children (age 6–17 years, 115 boys) and 172 adults (age 40–92 years, 70 men) without gallstones. The ABCG8 p.D19H and UGT1A1*28 polymorphisms as well as ABCB4 (c.504C>T rs1202283, c.711A>T rs2109505) and NPC1L1 variants (p.V1296V rs217434, c.−18C>A rs41279633) were genotyped using TaqMan assays. Serum concentrations of plant sterols and cholesterol precursors were measured by gas chromatography/mass spectrometry. Results: The ABCG8 risk allele was associated with an increased risk of stones (OR = 1.82, p =.03). Children carrying the p.19H allele presented with lower serum concentrations of surrogate markers of intestinal cholesterol absorption and decreased ratios of phytosterols to the cholesterol precursor desmosterol. Carriers of the common NPC1L1 rs217434 allele had an increased gallstone risk compared with stone‐free adults (OR 1.90, p <.01). This variant also affected the ratio of phytosterols to cholesterol precursors (p =.03). Other tested variants were not associated with gallstone risk. Conclusions: The p.D19H ABCG8 and, to a lesser extent, NPC1L1 rs217434 variants increase the risk of early‐onset gallstone formation. These results point to the presence of a common lithogenic pathway in children and adults. [ABSTRACT FROM AUTHOR]

Copyright of Review of Medicine / Przeglad Lekarski is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Review of Medicine / Przeglad Lekarski is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Solid organ transplant recipients are specific group due to taken immunosuppressive agents. This can result in side effects including infections caused by rare opportunistic pathogens., A Case Report: A 64-year old woman after orthotopic liver transplantation due to primary biliary cirrhosis and autoimmune hepatitis was admitted to hospital because of several infections. A painful lesion on left lower leg was noticed 3 months after surgery, while the patient was hospitalized with pneumonia. The Doppler ultrasound showed no signs of deep vein thrombosis. In the course of next month, the inflammatory infiltration has increased and the patient was readmitted to the hospital. After another ultrasound and MRI, which revealed solid-cystic character of the lesion, erythema nodosum was suspected. However, no pathogens were detected in blood and tissue cultures. After empiric antibiotic therapy regression of the lesion were observed. Recurrence of inflammation of the skin, the subcutaneous tissue and the knee joint resulted in readmission to the hospital after 3 months. Empiric antimicrobial therapy was administrated again and the dose of immunosuppressive agent was reduced. Since there was no bacterial growth in another routine culture of blood and synovial fluid, samples were cultured for opportunistic bacteria - Nocardia spp, Cryptococcus spp, Nontuberculous mycobacteria. Nocardia abscessus has grown after few weeks. Ceftriaxone, then trimethoprim-sulfamethoxazole (3x960 mg for 6 months) was administered according to antibiogram. Treatment resulted in regression of the lesion, pain alleviation and simultaneous liver function tests elevation., Conclusions: Cutaneous and subcutaneous nocardiosis is a rare infection. Solid organ transplant recipients are at risk of nocardiosis so it should be considered in differential diagnosis, especially when infections are hard to treat., (© 2020 MEDPRESS.)

Background: Lynch syndrome (HNPCC, hereditary non-polyposis colorectal cancer) is a syndrome of predisposition to cancer inherited in an autosomal dominant fashion. A person with Lynch syndrome has a considerably increased risk of colorectal cancer in comparison with the general population., Case Report: We present a case of a 24-year-old man with Lynch syndrome (carrying an MLH1 gene mutation) who had colorectal adenocarcinoma diagnosed at 16 years of age. During this time, he had a colectomy performed and chemotherapy was administered (5-FU, CDDP, Leucovorin). Due to hepatic metastases, a decision was made to change chemotherapy to IF with ADM, as a result of which complete remission was obtained. However, kidney failure developed. Its cause was not fully elucidated. The patient was treated by hemodialyses. After six years of complete remission of cancer, kidney transplantation started to be considered. Before the patient was found eligible for transplantation, extended diagnostic tests were performed: whole body PET scan, tumour marker tests and intestinal endoscopy, which did not reveal any abnormalities. The patient had a family donor (mother) who had no contraindications to kidney donation. Kidney transplantation was performed on 15/10/2012. Induction with basiliximab was used, along with steroids, tacrolimus, and mycophenolate mofetil was also administered. Three months after the procedure CNI/mTOR conversion was performed. The maintenance treatment includes prednisone, everolimus and mycophenolate mofetil. One year after transplantation, renal function is normal. The patient is subjected to close oncological surveillance., Conclusions: The risk of recurrence or new development of cancer related to immunosuppressive treatment should be considered on a case-by-case basis. In patients with a history or high risk of cancer, immunosuppression protocols based on the m-TOR pathway inhibitors should be used, if possible. Oncological surveillance and early detection of new cancer lesions are also important.

Unlabelled: Some of living kidney donors have medical conditions associated with future risk of cardiovascular diseases. It seems justified to identify risk factors and cardiological disorders prior to the donation., Aim: To determine the cardiological status of persons qualified as a living kidney donor., Material and Methods: We analyzed the data of 109 potential living kidney donors, aged 25-70 (mean 45.7 ± 10.9) years. They underwent clinical and biochemical examination. In some of them extended diagnostics was performed. The presence of risk factors of coronary artery disease were registered., Results: Only 46 (42%) persons were qualified for kidney donation. As many as 40 of them had 21 risk factor. In 75 (68.8%) patients without hypertension, 24-hours ambulatory blood pressure monitoring was done. The masked hypertension was found in 6 persons. In 22 candidates aged > 50 years the exercise test was performed (positive or inconclusive in 3 persons). Coronarography was done in 5 individuals (in no any significant atherosclerotic lesions were found). 63 (58%) person were disqualified. In 15 (23.8%) person the reasons were cardiological. In 2 patient the abdominal aneurysms were found. Both men smoked and had severe dyslipidaemias. In 3rd patient we observed persistent atrial fibrillation. The next 2 men had the peripheral occlusive arterial disease. In 9 patients ≥ 2 risk factors and in the last one morbid obesity were present., Conclusion: In Poland candidates for living kidney donation have very often risk factors of cardiovascular disease. Among the persons proceeded for kidney donation cardiovascular problems are an important cause of disqualification.

Background: The living kidney donor is exposed to the renal function impairment as a result of kidney donation, which may increase the risk of cardiovascular diseases. It seems justified to identify cardiovascular risk factors prior to kidney donation., Material and Methods: We analyzed data of 50 consecutive potential kidney donors. All individuals underwent clinical examination and lipid profile. For each subject we calculated atherogenic index. To calculate the 10-year risk of cardiovascular death, the HeartScore calculator was used., Results: The most frequent risk factors were obesity, lipid disorders, and smoking. In 72% of subjects, at least 1 of the risk factors was detected. Atherogenic index values considered to indicate high risk of atherosclerosis were found in 16% of subjects. More than 40% of subjects had more than 1 coronary risk factor, and most had 2. In 58% of subjects, the calculated HeartScore risk value was consistent with risk estimated for age, and in 26% it exceeded this value by 1-9% (mean, 3.1%)., Conclusions: The prevalence of coronary risk factors is high in potential kidney donors. HeartScore seems to be a useful method to evaluate the risk of cardiovascular mortality in these individuals, and is a simple tool to use in controlling the influence of the modification of risk factors on the global risk in follow-up. Comparison with the value of risk acceptable according to age and sex may oblige the physician to take action to reduce it.