Validity and reliability of Greek versions of two scales assessing family and friend support for exercise behaviour.

This study examined the validity and reliability of Greek versions of two scales assessing family and friend support for exercise behaviour. Exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs) were performed in a sample of 360 students. Additionally, CFAs were applied in a second sample of 726 physically active adults. Finally, associations were examined among scales and physical activity, exercise self-efficacy, and socio-demographic variables. Results indicated (a) a two-factor model for the Family Support for Exercise Behaviour Scale, (b) a one-factor solution for the Friend Support for Exercise Behaviour Scale, (c) satisfactory reliability coefficients, and (d) associations among the scales and physical activity, self-efficacy and socio-demographic variables. Conclusively, the social support scales were valid and reliable.

Impact of donor and recipient age difference on long-term allograft survival after living donor renal transplantation: analysis of 478 cases.

INTRODUCTION: Either deceased or living-related renal transplantation constitutes the best therapeutic option for patients with end-stage renal disease. In this retrospective study, an attempt to identify parameters that affect allograft survival in living donor renal transplantation was made. METHODS: Between January 2000 and July 2012, 478 adult patients received a renal transplant from a living-related donor in our center and their records were retrospectively reviewed in November 2012. Data concerning donor age, recipient age, donor/recipient age difference, donor/recipient gender, and ABO compatibility/incompatibility were recorded and associated with renal allograft survival rate. RESULTS: Renal allograft survival rate was 96%, 89.5%, and 77.7% in the first, fifth, and 10th yr after transplantation, respectively. Only the difference between donor and recipient age was statistically significant in relation to graft survival. In cases with age difference >13 yr, graft survival rate was lower from the third yr onward. CONCLUSIONS: Only the age difference between donor and recipient exerts an adverse impact on graft outcome after living donor renal transplantation, whereas donor age, recipient age, donor/recipient gender, and ABO incompatibility do not significantly influence renal allograft survival.

Immune Checkpoint Inhibitors' Associated Renal Toxicity: A Series of 12 Cases.

We present a series of twelve patients, bearing a wide range of solid malignancies, who received either PD-L1 or a combination of PD-L1 and CTLA-4 inhibitors. Following immunotherapy administration, they exhibited the clinical signs indicative of renal toxicity, including increased serum creatinine levels, proteinuria, nephrotic syndrome and/or hematuria. All patients underwent renal biopsy. Results: All cases demonstrated some degree of interstitial inflammation and tubular injury, while in five patients, glomerular alterations consistent with a specific glomerulopathy were also observed: secondary "lupus-like" membranous glomerulopathy in two cases and membranoproliferative glomerulonephritis, IgA glomerulonephritis and secondary AA amyloidosis in each of the remaining three patients. The two patients with "lupus-like" nephritis and the one with amyloidosis experienced nephrotic syndrome, while their creatinine was within normal range. In the remaining nine cases, deterioration of renal function was the main manifestation. Conclusion: Our findings harmonize with bibliographical data that identify tubulointerstitial nephritis as the most frequent histological lesion related to ICIs administration. The preferential involvement of tubulointerstitial tissue could be associated with the reported higher expression levels of PD-L1 on tubular epithelial cells, compared to glomeruli. On the other hand, glomerular involvement is probably a consequence of a systemic immune system reconstruction, induced by immune-checkpoints inhibition.

Neighborhood environment, physical activity, and quality of life in adults: Intermediary effects of personal and psychosocial factors.

BACKGROUND: Studies have indicated that there is a positive and indirect relationship between physical activity (PA) and quality of life (QoL). The current study examined this relationship through a social cognitive model with consideration to the intermediary effects of exercise self-efficacy, and physical (PCS, physical component summary) and psychological (MCS, mental component summary) health. Additionally, this model was widened to include concepts from the ecological theory, and any causal associations among neighborhood environment, PA, and QoL. METHODS: Six hundred and eighty-four physically active adults (39.16 ± 13.52 years, mean ± SD), living in Athens, Greece, completed a series of questionnaires measuring PA, QoL, exercise self-efficacy, PCS, MCS, neighborhood environment, and family and friend support for PA. The examined models were analyzed using structural equation modeling. RESULTS: The social cognitive and ecological models proved to be of appropriate fit. Within the social cognitive model, PA positively affected QoL through the mediating effects of exercise self-efficacy, PCS, and MCS. With regards to the ecological model, neighborhood environment positively influenced QoL through the intermediary effects of family support for PA, exercise self-efficacy, PA, PCS, and MCS. CONCLUSION: Results indicated that the most important mediators in the examined models were exercise self-efficacy and health. Further, findings demonstrated the role of neighborhood environment in enhancing PA and QoL. Future studies should be carried out applying longitudinal data for a better understanding of these associations over time.

Clinical correlation of nitric oxide levels with acute rejection in renal transplantation.

BACKGROUND: The objective of this study was to examine whether there was an association between acute rejection (AR) and nitric oxide (NO) levels and also to evaluate the clinical impact of NO measurement as a noninvasive marker for early detection of AR. METHODS: Fifty consecutive patients aged 17-62 years old received a living-related kidney graft. Serum levels of total nitrite and nitrate (NOx) were measured 30 min after graft reperfusion (NOx 1) and on days 1 (NOx 2), 5 (NOx 3), and 10 (NOx 4) post-transplantation (Tx). If clinically indicated, graft biopsy was performed. RESULTS: Acute humoral rejection was diagnosed by biopsy on 3rd post-Tx day in one patient. His serum NOx 2 levels were remarkably higher (380%) compared with his NOx 1 measurement. At the same time, NOx 1-2 measurements in uncomplicated group showed lower levels (-12%). Additionally, during the first month post-Tx, 5 cases of acute cellular rejection (ACR) were diagnosed. The mean percent change of NOx 3-4 levels in ACR group was 180.7 versus 16.1 in uncomplicated patients (P < 0.01). In addition, >70 µmol/L change in NOx levels in consecutive samples had a sensitivity of 100% and a specificity of 97.7% in predicting AR episodes. CONCLUSION: Our study reports significant increase in serum NOx levels in episodes of AR. NOx might be an useful noninvasive marker for early diagnosis of AR.

Nonmelanoma skin cancer after renal transplantation: a single-center experience in 1736 transplantations.

BACKGROUND: Renal transplantation is associated with an increased incidence of nonmela-noma skin cancer (NMSC) caused by immunosuppression. Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), the two major histological types of NMSC, exhibit more aggressive biological and clinical courses in renal transplant recipients (RTRs), with higher rates of recurrence and mortality than in the general population. METHODS: We retrospectively analyzed our experience of NMSC in 1736 renal transplantations performed over a 25-year period. All cases of skin cancer after renal transplantation were included except those of skin cancer resulting from melanoma and mesenchymal skin tumors. RESULTS: In our series, the overall incidence of NMSC after transplantation was 2.2% (n = 39), and SCC represented the most frequent skin malignancy (64.1%), followed by BCC (17.9%), Bowen's disease (10.2%), basosquamous carcinoma (5.1%), and a rare case of invasive sebaceous carcinoma (2.6%). A shift to newer immunosuppressive regimens after the initial diagnosis of NMSC had been implemented in eight cases (20.5%). The recurrence rate after initial treatment was 41% (n = 16), and distant metastatic disease was diagnosed in 15.4% (n = 6) of NMSC patients. The NMSC-specific mortality rate was 25.6% (n = 10). CONCLUSIONS: Nonmelanoma skin cancer remains a significant source of morbidity and mortality in RTRs, and post-transplant surveillance should be increased.