Hospitalization and death after recovery from acute COVID-19 among renal transplant recipients.

INTRODUCTION: Data on post-COVID-19 in renal transplant recipients (RTR) is scarce. We investigated the rate of hospitalizations, reasons for hospital admission, and mortality rate among RTR who survived acute COVID-19. METHODS: A multi-center retrospective observational cohort study measured hospital admission and death to 180 days after acute SARS-CoV-2 infection in 308 adult patients. RESULTS: The median age was 57 years, 64.9% were male. All patients had at least one comorbidity, and 26.3% had diabetes. Data on post-COVID-19 course was available for 267 patients, and 49 of them (15.9%) required hospital treatment after recovery from the acute infection. The most common indications included pneumonia (24.5%) and renal allograft dysfunction (22.4%), 7 (14.3%) had sepsis and 5 (10.2%) had thrombotic events. A median duration of the hospital stay was 12 days. Six patients (2.2%) died due to multiorgan failure, respiratory insufficiency or urosepsis. The strongest predictor for hospitalization after acute COVID-19 was hospitalization for acute SARS-CoV-2 infection, while better allograft function decreased the probability of hospitalization. CONCLUSION: Delayed consequences of acute COVID-19 are highly prevalent and the health care systems should be prepared to respond to the needs of RTR suffering from post-COVID-19 complications.

Stereological analysis of mature human placenta of pregnant women of different age.

The normal placentas, regular pregnancies and deliveries were structurally examined. The aim of this research was to compare the results and to confirm if there were some difference in the structure of placenta related to the age of pregnant women. We examined 30 human placentas. The examined group of women were divided into two groups: 1) pregnant women 20-35 years old; 2) pregnant women over 35 years old. The stereological method was used. The volume density, absolute volume, the surface density and absolute surface of terminal villi of placentas in younger and older pregnant women were not significantly different. The volume density, absolute volume, the surface density and absolute surface of the other placentas villi in younger pregnant women compared to older ones, were significantly increased (p<0.001). The volume density of fibrinoid of placentas in older pregnant women compared to younger ones was significantly increased (p<0.02). The surface density, absolute volume and absolute surface of fibrinoid in these two examined groups of pregnant women were not significantly different. The volume density of intervillous space of placentas in older pregnant women compared to younger ones was significantly increased (p<0.05). Absolute volumes of intervillous space of placentas in these two examined groups of pregnant women are not significantly different.

Glomerular filtration rate in examined population of Bosnian Posavina - region of Balkan Endemic Nephropathy.

Balkan endemic nephropathy (BEN) is chronic tubulointersticial nephritis of unknown aetiology characterized by an insidious onset and gradual progression to end stage renal disease (ESRD). Endemic regions of Bosnia and Herzegovina are Posavina and Semberija, sited at basin of Sava River. In BEN, just like in other chronic renal diseases (CKD), glomerular filtration rate (GFR), is assumed a marker of overall renal function. The aim of this study was to compare GFR in examinees of endemic and non-endemic region for BEN, and between examinees with and without risk factors for BEN within endemic region. Study included 603 inhabitants of Bosnian Posavina, out of whom 386 (65%) from endemic (Domaljevac) and 217 (36%) from non-endemic (Svilaj) village, and it was performed in two phases. The first phase encompassed obtaining anamnestic data (demographic, personal and family history), measurement of arterial blood pressure, and urine dipstick testing (specific gravity, pH, proteins, leukocytes, glucose, ketones, and microalbuminuria). In the second phase, besides repeated urine dipstick test, laboratory blood testing and abdominal ultrasound, with special attention to urinary tract, was also performed. We have compared GFR between examinees of endemic and non-endemic regions for BEN, and between examinees with and without family burden for BEN within endemic region, using MDRD formula for calculating GFR, with cut-off value (5th percentile) based on result of studies performed in European Caucasians in screening for CKD and for establishing stages of CKD in BEN. Medical was used for statistical testing. Out of total number of examined inhabitants (603), 145 examinees were included in the second phase. After exclusion of 17 diabetic patients, 94 (73%) examinees from endemic and 34 (27%) examinees from non-endemic region remained. In the endemic region there were 46 (49%) examinees with and 48 (51%) without family burden for BEN. Overall GFR in examined groups was within physiologic range. There was not statistically significant difference in calculated GFR between examinees of endemic and non-endemic regions for BEN (Mann-Whitney test p=0.104; Fisher's test p=1), neither between examinees with and without family burden for BEN within endemic region (Mann-Whitney test p=0,7393; Fisher's test p=0,263). Overall GFR in examined groups was within physiologic range. There wasn't statistically significant difference in calculated GFR between examinees of endemic and non-endemic regions for BEN, neither between examinees with and without family burden for BEN within endemic region. GFR, no matter how accurately calculated and estimated, does not represent significant biomarker for diagnosis, especially early diagnosis, of BEN, until maybe its overt advanced form.

[Case report of successful treating of refractory form of chronic lymphatic leukemia in Binnet C stage by using anti-CD52 antibodies]. / Uspjesno lijecenje refrakterne forme hronicne limfaticne leukemije u stadiju Binnet C primjenom antiCD52 antitijela.

Chronic lymphatic leukemia (CLL) is the most frequent type of leukemia in western world, and a choice of treatment modality depends on current stage of disease. Clinical condition of patient considered as Binnet C stage, requires treatment. Standard polyhemiotherapy (FC protocol) does not always warrant adequate and satisfactory response. This case report reviews the patient with CLL in Binnet C stage, who did not respond on FC protocol in expected way, meaning, hematological and medullar response was not detected. Twelve weeks therapy of monoclonal antiCD52 antibody (MabCampath) was than applied, resulting in normalization of all parameters of disease activity, which was desired effect of the therapy. Administration of monoclonal antiCD52 antibody is justified in case of resistance on conventional previously applied means of therapy.