How histopathological diagnosis interacts with kidney ultrasound parameters and glomerular filtration rate.

The evaluation of estimated GFR (eGFR) is a pivotal staging step in patients with chronic kidney disease (CKD), and renal ultrasound plays an important role in diagnosis, prognosis and progression of CKD. The interaction between histopathological diagnosis and ultrasound parameters in eGFR determination has not been fully investigated yet. The study examined the results of native kidney biopsies performed in 48 Italian centers between 2012 and 2020. The primary goal was if and how the histopathological diagnosis influences the relationship between ultrasound parameters and eGFR. After exclusion of children, patients with acute kidney injury and patients without measure of kidney length or parenchymal thickness, 2795 patients have been selected for analysis. The median values were 52 years for patient age, 11 cm for bipolar kidney diameter, 16 mm for parenchymal thickness, 2.5 g/day for proteinuria and 70 ml/min/1.73 m2 for eGFR. The bipolar kidney diameter and the parenchymal thickness were directly related with eGFR values (R square 0.064). Diabetes and proteinuria were associated with a consistent reduction of eGFR, improving the adjusted R square up to 0.100. Addition of histopathological diagnosis in the model increased the adjusted R square to 0.216. There is a significant interaction between histopathological diagnosis and longitudinal kidney diameter (P 0.006). Renal bipolar length and parenchymal thickness are directly related with eGFR. The magnitude of proteinuria and histopathological kidney diagnosis are associated with eGFR. The relationship between kidney length and the level of eGFR depends on the nature of the kidney disease.

Microbiological Analysis of Surfaces of Leonardo Da Vinci's Atlantic Codex: Biodeterioration Risk.

Following the discovery of discoloration on some pages of the Atlantic Codex (AC) of Leonardo da Vinci kept in the Biblioteca Ambrosiana in Milan, some investigations have been carried out to verify the presence of microorganisms, such as bacteria and fungi. To verify the presence of microorganisms a noninvasive method of sampling has been used that was efficient and allowed us to highlight the microbial facies of the material that was examined using conventional microbiological techniques. The microclimatic conditions in the storage room as well as the water content of the volume were also assessed. The combined observations allowed the conclusion that the discoloration of suspected biological origin on some pages of AC is not related to the presence or current attack of microbial agents.

Proposal for a biological environmental monitoring approach to be used in libraries and archives.

In cultural-heritage-related indoor environments, biological particles represent a hazard not only for cultural property, but also for operators and visitors. Reliable environmental monitoring methods are essential for examining each situation and assessing the effectiveness of preventive measures. We propose an integrated approach to the study of biological pollution in indoor environments such as libraries and archives. This approach includes microbial air and surface sampling, as well as an investigation of allergens and pollens. Part of this monitoring plan has been applied at the Palatina Library in Parma, Italy. However, wider collections of data are needed to fully understand the phenomena related with biological contamination, define reliable contamination threshold values, and implement appropriate preventive measures.

Lipoprotein glomerulopathy: first report of 2 not consanguineous Italian men from the same town.

It is well known that the abnormal accumulation of lipids can occur in kidneys of patients affected by some metabolic disorders due either to inherited enzymatic deficiency or to an acquired lipid alteration as in nephrotic syndrome. Lipoprotein glomerulopathy (LG), briefly described in a patient of Koitabashi in 1987 in a review on renal lipidoses authored by Faraggiana and Churg, represents an emerging novel storage renal disease. This rare and unique nephropathy is characterized by the presence of lipoprotein thrombi in dilated glomerular capillary lumina associated with type III hyperlipoproteinemia, and high serum levels of apolipoprotein E (apo E). Several specific studies conducted by Saito et al on his patients from 1989, revealed that it was an hereditary disease with an autosomal recessive pattern that predominantly affects patients of Asian ancestry, mainly the Japanese population, but which very seldom, can also occur in white subjects. The disorder is probably due to an inherited altered lipid metabolism due to a mutation of the apo E genetic code. Clinically, LG is characterized by proteinuria generally associated with nephrotic syndrome and progressive renal insufficiency. We describe the cases of 2 Italian adult white male patients affected by LG, admitted in our nephrology unit in 2004 and in 2009, respectively.

Scripta manent? Assessing microbial risk to paper heritage.

Paper, like all other cultural heritage materials, degrades over time, but conservation slows down the rate of its deterioration. There is a long history of cooperation between microbiologists and conservators of libraries and archival materials, but current approaches addressing paper deterioration need urgent reassessment to take full advantage of modern microbiological methodologies. The present article discusses what we believe are the current priority research areas in assessing microbial risk to paper heritage, and reports studies on a 13th century Italian manuscript and on Leonardo da Vinci's Atlantic Codex which illustrate the problems and challenges encountered when dealing with microbial investigations of paper artworks. The potential of using a more advanced microbiological approach is highlighted.

Theoretical calculation of optimal depth in the percutaneous native kidney biopsy to drastically reduce bleeding complications and sample inadequacy for histopathological diagnosis.

BACKGROUND: In recent years percutaneous native kidney biopsy (PNKB) has become of very common use and safe enough for the patient if performed by skilled physicians; nevertheless, haemorrhagic complications or inadequate tissue sample for the diagnosis may occur. We report here the type and the adequacy rate of specimens for diagnosis and complication rate associated with PNKB performed in a single centre from May 2003 to December 2005 using a mathematical formula to determine the depth in centimetre where pushing the trigger. METHODS: In this prospective study we analysed data from 126 consecutive PNKB performed by the same two skilled nephrologists with the free hand technique using the 14-gauge automated biopsy gun under continuous sonographic control (Group I). The trigger was pushed exactly at the depth previously calculated by a mathematical formula: BW/H (body weight expressed in hectograms divided by patient height expressed in centimetres) less 0.5 (BW/H - 0.5). The type and the adequacy rate of specimens for diagnosis and the associated complication rate were retrospectively compared with data obtained from 123 consecutive PNKB performed from January 2001 to April 2003 by the same operators before using the mathematical formula described earlier (Group II). RESULTS: Of our series of 126 consecutive PNKD using the mathematical formula (Group I), only four subjects presented post-biopsy gross haematuria (3.2%) and three experienced symptomatic small subcapsular haematoma (2.4%). All biopsy specimens proved to be adequate for diagnosis (100%) with a mean of 22 glomeruli (range 5-60) per specimen. The previous series of 123 consecutive PNKB (Group II) showed gross haematuria (8.4%; P < 0.01 vs Group I) and symptomatic subcapsular haematoma (3.7%) with an adequate sampling of 94.8% (P < 0.01 vs Group I) and a mean glomerular count of 17 (range 4-47) per specimen (P < 0.01 vs Group I). Conclusions. PNKB is an invasive procedure that in spite of progress made in safety, diagnostic adequacy and performing techniques, still involves minor or major risks. The results obtained show that our method is extremely useful to reduce significantly the incidence of bleeding complications and permits us to take enough renal tissue for diagnostic evaluation in all cases.