High-content phenotypic screening identifies novel chemistries that disrupt mosquito activity and development.

New classes of chemistries are needed to control insecticide resistant populations of mosquitoes and prevent transmission of vector-borne diseases (VBDs). Organismal screens of chemical collections have played an important role in the search for new vector insecticides and the identification of active ingredients (AIs) that cause rapid mortality of mosquitoes. Advances in image-based screening offer an opportunity to identify chemistries that operate via novel biochemical modes and investigate the range of phenotypes exhibited by mosquitoes following exposure to lethal and sub-lethal chemical dose. An automated, high throughput phenotypic screen (HTS) employing high-content imaging of first instar (L1) Aedes aegypti larvae was developed to identify chemistries associated with mortality and atypical morphological phenotypes. A pilot screen of the Library of Pharmacologically Active Compounds (LOPAC1280) identified 92 chemistries that disrupted larval activity and development, including conventional insecticides and chemistries known to modulate G protein-coupled receptors (GPCRs) and other molecular targets in mammalian systems. Secondary assay series were used to evaluate a selection of chemistries for impacts on mosquito activity, survival and development. Ritodrine hydrochloride reduced mobility of larvae but had no observable effect on survival and development of mosquitoes. High doses of metergoline suppressed larval activity and sub-lethal dose resulted in pupal mortality. Assay data support the utility of phenotypic screening and diverse entomological end-points for discovery of novel insecticidal chemical scaffolds. The insecticide discovery process must consider how multi-modal efficacy spectra contribute to vector and VBD control.

Deep muscle-proteomic analysis of freeze-dried human muscle biopsies reveals fiber type-specific adaptations to exercise training.

Skeletal muscle conveys several of the health-promoting effects of exercise; yet the underlying mechanisms are not fully elucidated. Studying skeletal muscle is challenging due to its different fiber types and the presence of non-muscle cells. This can be circumvented by isolation of single muscle fibers. Here, we develop a workflow enabling proteomics analysis of pools of isolated muscle fibers from freeze-dried human muscle biopsies. We identify more than 4000 proteins in slow- and fast-twitch muscle fibers. Exercise training alters expression of 237 and 172 proteins in slow- and fast-twitch muscle fibers, respectively. Interestingly, expression levels of secreted proteins and proteins involved in transcription, mitochondrial metabolism, Ca2+ signaling, and fat and glucose metabolism adapts to training in a fiber type-specific manner. Our data provide a resource to elucidate molecular mechanisms underlying muscle function and health, and our workflow allows fiber type-specific proteomic analyses of snap-frozen non-embedded human muscle biopsies.

Examining Reliability and Validity of the Jebsen-Taylor Hand Function Test Among Children With Cerebral Palsy.

Manual dexterity has strongly predicted functional independence for daily life activities among children with cerebral palsy (CP). The Jebsen-Taylor Hand Function Test (JTHFT) is the most widely used assessment tool for exploring manual dexterity in the CP population, though no research has yet examined its psychometric properties for this use. This cross-sectional study explored the validity and internal consistency of the JTHFT in an Italian sample of inpatient and outpatient children with CP aged between 6-18 years (35 girls and 49 boys). We calculated internal consistency with Cronbach's alpha and tested validity against the Manual Ability Classification System (MACS) using Pearson's correlation coefficient. To better understand how the JTHFT compares with different levels of the MACS, we performed dominant hand timing variability for each test item. Results showed excellent internal consistency with a Cronbach's alpha of .944 and .911, respectively, for nondominant and dominant hands. There was also a statistically significant positive linear Pearson's correlation coefficient between the JTHFT and the MACS (p < .01). We observed high variability in writing performance (Item 1 of the JTHFT) within this sample for each level of the MACS. This study confirms that the JTHFT is a valid assessment tool when used in children with CP aged 6-18 years.

A radio ridge connecting two galaxy clusters in a filament of the cosmic web.

Galaxy clusters are the most massive gravitationally bound structures in the Universe. They grow by accreting smaller structures in a merging process that produces shocks and turbulence in the intracluster gas. We observed a ridge of radio emission connecting the merging galaxy clusters Abell 0399 and Abell 0401 with the Low-Frequency Array (LOFAR) telescope network at 140 megahertz. This emission requires a population of relativistic electrons and a magnetic field located in a filament between the two galaxy clusters. We performed simulations to show that a volume-filling distribution of weak shocks may reaccelerate a preexisting population of relativistic particles, producing emission at radio wavelengths that illuminates the magnetic ridge.

The treatment of femoral fractures in children with cerebral palsy.

OBJECTIVE: The purpose of this study is to retrospectively evaluate a group of children affected by cerebral palsy with a recent femoral fracture, and to analyse the results and complications in relation to the treatment used. MATERIALS AND METHODS: The analysis was performed on 36 children (21 M, 15 F, 8-14 years old) with cerebral palsy (7 diplegia, 28 tetraparesis, 1 hemiplegia) with a metaphyseal or a diaphyseal femoral fracture. The patients were subdivided into two groups according to their Gross Motor Function Classification System (GMFCS) level: level 2-3 (9 patients) and level 4-5 (27 patients), evaluating the presence of complications and malunions for each group at the end of each follow up. RESULTS: The fractures were displaced in 24 patients and nondisplaced in 12 patients. In 26 cases the treatment involved a closed reduction and immobilisation in a long leg hip spica cast for 7 weeks, while in 10 cases the treatment involved an open reduction-internal fixation (ORIF) followed by a 3-week period in a plaster coated fracture bandage. CONCLUSIONS: Taking into consideration the maximum possible recovery of function, an ORIF is preferable to prevent malunion, particularly in distal metaphysis and distal shaft fractures. In the GMFCS level 2-3 patients, surgery has allowed to recover, or at least maintain, the pre-fracture functional level, while in patients with GMFCS level 4-5, it has allowed to reduce the immobilisation times and prevent the development of decubitus lesions.

Inter- and intra-interviewer reliability of Italian version of Pediatric Evaluation of Disability Inventory (I-PEDI).

BACKGROUND: Childhood disabilities determine a range of immediate and long-term economic costs that have important implications for the well-being of the child, the family and the society. The Pediatric Evaluation of Disability Inventory (PEDI) measures capability and performance in children aged between 6 months and 7.5 years. It contains three scales: Functional Skills Scales (FSS), Caregiver Assistance Scale (CAS) and Modifications Scale (MS). The present study evaluated the measurement properties of the Italian version of the PEDI (PEDI-I) in patients with spastic cerebral palsy (CP). STUDY DESIGN: Reliability study. METHODS: The original PEDI was translated - including a cross-cultural adaptation - into Italian. Internal consistency and test-retest reliability were evaluated. RESULTS: Fifty-eight children with CP were recruited. According to inter-interviewer reproducibility, the FSS domain revealed intraclass correlation coefficient (ICC) values ranging between 0.94 and 1.00. CAS domain revealed ICC values ranging between 0.94 and 1.00. The SEM values ranged between 3.25 (SDD=8.98) for SF and 5.24 for SC (SDD=14.5). According to intra-interviewer reproducibility, the FSS domain revealed ICC values ranging between 0.99 and 1.00. CAS domain revealed ICC values ranging between 0.92 and 0.99. The SEM values ranged between 3.44 (SDD=9.5) for SF and 3.75 for SC (SDD=10.36). The inter-interviewer and intra-interviewer reproducibility results showed very high ICC values for both FFS and CAS domains. Cronbach's α ranged between 0.94 and 0.99, indicating excellent internal consistency within each domain of the PEDI-I. CONCLUSION: The inter-interviewer and intra-interviewer reproducibility results of PEDI-I showed very high ICC values for FFS and CAS domains. Therefore, we recommend its application to evaluate the effect of treatment in children with CP.

Spatial genetic structure in wild cardoon, the ancestor of cultivated globe artichoke: Limited gene flow, fragmentation and population history.

Nuclear and chloroplast markers and phenotypic characters were integrated to analyse the population genetic structure of wild cardoon, Cynara cardunculus var. sylvestris, the ancestor of cultivated globe artichoke, Cynara cardunculus var. scolymus on the island of Sardinia, Italy. The spatial scale ranged from a few metres to ∼200km. Wild cardoon appears to be genetically fragmented, with significant genetic divergence at various scales, indicating that gene flow is insufficient to counterbalance the effects of genetic drift or founder effects. Divergence between populations was higher for chloroplast (40%) than for nuclear markers (15%), suggesting that gene flow via seed was lower than via pollen. Two main genetic groups were detected; these correlated with differences in flowering time, capitula size, glossiness, and anthocyanin pigmentation. A complex population structure of wild cardoon emerged over small spatial scales, likely resulting from the interplay between gene dispersal, colonisation history and selective forces. Indeed, Sardinia appears to be a 'hybrid zone' of different gene pools. The island has unique diverse germplasm that has originated from hybridisation among different gene pools. The sampling of seeds from a few plants but from many sites is suggested as the best strategy to harvest the genetic diversity of wild cardoon.

Mitochondrial specialization revealed by single muscle fiber proteomics: focus on the Krebs cycle.

We have developed a highly sensitive mass spectrometry-based proteomic workflow to examine the proteome of single muscle fibers. This study revealed significant differences in the mitochondrial proteome of the four major fiber types present in mouse skeletal muscle. Here, we focus on Krebs cycle enzymes and in particular on the differential distribution of the two mitochondrial isocitrate dehydrogenases, IDH2 and IDH3. Type 1/slow fibers contain high levels of IDH2 and relatively low levels of IDH3, whereas fast 2X and 2B fibers show an opposite expression pattern. The findings suggest that in skeletal muscle, IDH2 functions in the forward direction of the Krebs cycle and that substrate flux along the cycle occurs predominantly via IDH2 in type 1 fibers and via IDH3 in 2X and 2B fibers. IDH2-mediated conversion of isocitrate to α-ketoglutarate leads to the generation of NADPH, which is critical to buffering the H2O2 produced by the respiratory chain. Nicotinamide nucleotide transhydrogenase (NNT), the other major mitochondrial enzyme involved in NADPH generation, is also more abundant in type 1 fibers. We suggest that the continuously active type 1 fibers are endowed with a more efficient H2O2 scavenging capacity to cope with the higher levels of reactive oxygen species production.

Trichinella britovi from domestic to wild animals of Sardinia, Italy.

The zoonotic nematode Trichinella britovi has been documented in animals and/or humans of the Mediterranean islands of Corsica and Sardinia since 2004. From 2005 to 2007 in the Sardinia island, several surveys had shown that T. britovi was circulating among backyard and free-ranging pigs reared in the Orgosolo municipality but all attempts had failed to detect this parasite in wild susceptible animals. The aim of the present work was to investigate the circulation of T. britovi in pigs and wildlife of the Orgosolo municipality, and of surrounding municipalities and provinces in the 2010-2014 slaughtering/hunting seasons. The results show that the T. britovi circulation was still restricted to the Orgosolo municipality with a prevalence of 2.6% in free-ranging pigs and 0.2% in backyard pigs but, for the first time, this parasite was detected also in 0.4% of wild boar, and 27.6% of red foxes. No infection was detected in backyard pigs, wild boar, and red foxes of the other municipalities and provinces. Since 1978, African swine fever is endemic in Sardinia and foci of this virus are still active in the investigated areas favoring cannibalism and, consequently, the T. britovi transmission, due to the high mortality rate caused by this virus. This is the first documented report on the transmission of T. britovi between the domestic and the sylvatic cycle. The health authority of the island must provide a service to dispose animal carcasses and offal, stamping out illegal free-ranging pigs, and train hunters and pig owners to manage waste and by-products according to the EU regulations.

[The patient on hemodialysis: psychological and management difficulties]. / Il paziente emodializzato: difficoltà psicologiche e gestionali.

OBJECTIVES: Chronic renal failure is a public health problem of great relevance for significant mortality and high socio-economic impact. This study purposed to assess the psychological status in patients on hemodialysis; moreover other purpose is to investigate the possible differences among the first 3 months of hemodialysis treatment replacement. MATERIALS AND METHODS: The study was carried out on 12 hemodialysis patients, aged 71.6 years (range: 34-87). Mood was measured by using the Profile of Mood States (POMS) developed in 1971 by Douglas M. McNair. RESULTS: The overall score of mood disorders shows a total negative state in the initial phases of dialysis treatment [F (2,22) = 10.17; p <0.01] and a progressive improvement of the same, with a linear trend [F (1,11) = 12.65; p <0.05]. CONCLUSIONS: The model of hemodialysis patients is particularly interesting for several reasons, but especially for the possibility of crosssectional and longitudinal assessments. The aim of future studies will be to characterize and investigate the complex psycho-social variables in this category of patients, to improve their quality of life.

Water-gated organic field effect transistors - opportunities for biochemical sensing and extracellular signal transduction.

There is a quest for electronic biosensors operated in water for biomedical applications and environmental monitoring. Water is an aggressive medium for standard electronics materials and devices due to its strong polarizability and electrochemical activity. Thick dielectric encapsulation provides necessary stability while it damps the sensitivity of the device to sensing events occurring in the aqueous environment. Organic electronics provides materials that exhibit stable electronic conduction in direct contact with water combined with other desirable properties like mechanical softness, biocompatibility and processability onto flexible substrates. In this review, we introduce an emerging class of organic transistors, in which the current across the organic film is gated by the electric field of the Debye-Helmholtz layer. We discuss the device physics, the sensing mechanism and the relevant electrochemical processes. Applications of water-gated transistors range from the sensing of biologically relevant molecules like DNA, proteins or hormones to non-invasive recording and stimulation of electrical activity of neurons. Materials chemistry is crucial to control properties of electrically active films and to allow the introduction of specific chemical functionalities and receptors at sensing interfaces of the device.

Ultrasound-guided aspiration and corticosteroid injection compared to horizontal therapy for treatment of knee osteoarthritis complicated with Baker's cyst: a randomized, controlled trial.

BACKGROUND: Combining different therapies, physical therapy agents, pharmacological and physical therapies, generally produces better outcomes for symptoms of knee osteoarthritis (OA) than do isolated therapies. AIM: To demonstrate if horizontal therapy (HT) and aspiration alone and corticosteroid injection alone or in combination determine pain relief and functional improvement in a group of patients with knee OA complicated with Baker's cyst (BC). DESIGN: We designed a randomized controlled trial (RCT). SETTING: Outpatients. POPULATION: Sixty patients with a knee OA and diagnosis of BC confirmed by means of standard ultrasound (US) evaluation. METHODS: The trial was conducted as a randomized, controlled trial. Patients who satisfied the inclusion criteria were randomized to either the US-guided (Ultrasound Guided BC aspiration and corticosteroid injection group (Group A), the Horizontal Therapy group (Group B) or the US-guided BC aspiration and corticosteroid injection plus Horizontal therapy group (Group C). Outcome measures included: 1) pain reduction as measured by visual analogue scale (VAS); 2) functional improvement, as measured by WOMAC; and 3) US evaluation at baseline (T0), at one (T1) and four (T2) weeks follow-up. RESULTS: A total of 60 patients were randomized into group A (N.=20), group B (N.=20) or Group C (N.=20). Patients in group A and in group C, but not those in group B maintained lower pain level at T2 than at baseline, with significant lower VAS values in Group C. As regards US measurements, the maximum axial area did not change as a consequence of the treatment in any of the three groups (P=0.259). Contrarily, sagittal area measurements were influenced by time (P<0.01). CONCLUSION: Our results show that the group with the best performance for pain, functionality and dimension of BC was that in which combined use was made of horizontal and corticosteroid injection therapies. CLINICAL REHABILITATION IMPACT: In this study we want to demonstrate the effectiveness of Horizontal Therapy in the treatment of knee OA complicated by BC.

Prevalence of parvoviruses in commercial turkey flocks.

Turkey parvovirus belongs to the family Parvoviridae, subfamily Parvovirinae, Genus parvovirus. Since the initial report on turkey parvovirus in the United States appeared in 1983, there had been no further reports of parvovirus in turkeys until 2008. The aims of our study were to determine the prevalence of parvovirus in commercial turkey flocks using PCR; to determine their genetic relationship to previous strains identified in North America and Europe; and to test samples for enteric viruses by transmission electron microscopy (TEM). A total of 169 fecal samples collected from 42 turkey farms in four different states within the United States between 2000 and 2010 were examined. We found that the most frequently detected viruses by TEM were small round viruses, accounting for 52% of the examined samples; however, the PCR detected parvoviruses in 71% of the samples. The phylogenetic analysis of partial nonstructural gene sequences showed a certain degree of variability among the turkey samples tested in the study. Moreover, there was a clear dichotomy in the phylogenetic tree between chicken and turkey samples, with the exception of one turkey isolate from 2000, which clustered together with the chicken group.

Efficient second harmonic generation from thin films of V-shaped benzo[b]thiophene based molecules.

We have designed an original approach for efficient Second Harmonic Generation of tailored V-shape benzo[b]thiophene molecular systems enabling versatile and flexible one-step, dry and technologically friendly thin film processing. The designed moieties show chi((2)) values at least as high as the reference LiNbO(3) single crystal, without poling processing and matching the constrains of integrated optical configuration for nonlinear optical devices. This may open the way to a new class of organic materials exploitable for photonic applications.

Prevalence and Antibiotic-Resistance of Salmonella Isolated from Food in Morocco

Background: Salmonellosis remains one of the most frequent food-borne diseases worldwide; especially in developing countries. The emergence of antimicrobial resistance in Salmonella isolates from food can potentially compromise the treatment of these infections. This investigation was conducted for the first time in Morocco both to detect the occurrence of Salmonella in foods as well as to determine the antibiotic resistance profile of the Salmonella isolates. Methodology: In total; 11;516 food samples collected from 2002 to 2005 were investigated. Isolated Salmonella were characterized by serotyping and susceptibilities were determined for 15 antimicrobial drugs using the disc diffusion assay. Results: The overall percentage of Salmonella prevalence (n=105) was 0.91with rates of 71for slaughterhouses and 9for seafood. Sixteen different serotypes were identified among 104 Salmonella enterica isolates including serotypes Infantis (n=25); Bredeney (n=13); Blokley (n=11); Typhimurium (n=9); Mbandaka (n=8); Branderup II (n=7); and Kiambu (n=6); 1 isolate of Salmonella enterica belonged to subspecies II salamae. Twenty-nine percent of isolates (n=30/105) were resistant to at least one antimicrobial. Resistance to tetracycline was the most common finding (21); followed by resistance to ampicillin (13); amoxicillin+clavulanic acid (9); streptomycin (7); chloramphenicol (4) and nalidixic acid (3;8). None of the isolates was resistant to 3rd-cephalosporin and fluoroquinolones (i.e. ciprofloxacin). Multidrug resistance (MDR) was seen in 9.5of the isolates; mainly in S. Typhimurium DT104 with R-type ACSSuT and S. Hadar. Conclusions: Despite a low frequency of Salmonella isolation; S. Typhimurium DT104 was identified in the first step of the food chain. The study points out the need control antibiotic resistance in Salmonella isolated from food in Morocco to avoid the spread of MDR

Prevalence and Antibiotic-Resistance of Salmonella Isolated from Food in Morocco

Background: Salmonellosis remains one of the most frequent food-borne diseases worldwide; especially in developing countries. The emergence of antimicrobial resistance in Salmonella isolates from food can potentially compromise the treatment of these infections. This investigation was conducted for the first time in Morocco both to detect the occurrence of Salmonella in foods as well as to determine the antibiotic resistance profile of the Salmonella isolates. Methodology: In total; 11;516 food samples collected from 2002 to 2005 were investigated. Isolated Salmonella were characterized by serotyping and susceptibilities were determined for 15 antimicrobial drugs using the disc diffusion assay. Results: The overall percentage of Salmonella prevalence (n=105) was 0.91with rates of 71for slaughterhouses and 9for seafood. Sixteen different serotypes were identified among 104 Salmonella enterica isolates including serotypes Infantis (n=25); Bredeney (n=13); Blokley (n=11); Typhimurium (n=9); Mbandaka (n=8); Branderup II (n=7); and Kiambu (n=6); 1 isolate of Salmonella enterica belonged to subspecies II salamae. Twenty-nine percent of isolates (n=30/105) were resistant to at least one antimicrobial. Resistance to tetracycline was the most common finding (21); followed by resistance to ampicillin (13); amoxicillin+clavulanic acid (9); streptomycin (7); chloramphenicol (4) and nalidixic acid (3;8). None of the isolates was resistant to 3rd-cephalosporin and fluoroquinolones (i.e. ciprofloxacin). Multidrug resistance (MDR) was seen in 9.5of the isolates; mainly in S.. Typhimurium DT104 with R-type ACSSuT and S. Hadar. Conclusions: Despite a low frequency of Salmonella isolation; S. Typhimurium DT104 was identified in the first step of the food chain. The study points out the need control antibiotic resistance in Salmonella isolated from food in Morocco to avoid the spread of MDR

Molecular characterization of ciprofloxacin-resistant Salmonella enterica serovar Typhi and Paratyphi A causing enteric fever in India.

OBJECTIVES: To define the genetic characteristics and resistance mechanisms of clinical isolates of Salmonella enterica serovar Typhi (S. Typhi) and S. enterica serovar Paratyphi A (S. Paratyphi A) exhibiting high-level fluoroquinolones resistance. METHODS: Three S. Typhi and two S. Paratyphi A ciprofloxacin-resistant isolates (MICs > 4 mg/L) were compared with isolates with reduced susceptibility to ciprofloxacin (MICs 0.125-1 mg/L) by PFGE, plasmid analysis, presence of integrons and nucleotide changes in topoisomerase genes. RESULTS: In S. Typhi and Paratyphi A, a single gyrA mutation (Ser-83-->Phe or Ser-83-->Tyr) was associated with reduced susceptibility to ciprofloxacin (MICs 0.125-1 mg/L); an additional mutation in parC (Ser-80-->Ile, Ser-80-->Arg, Asp-69-->Glu or Gly-78-->Asp) was accompanied by an increase in ciprofloxacin MIC (> or = 0.5 mg/L). Three mutations conferred ciprofloxacin resistance: two in gyrA (Ser-83-->Phe and Asp-87-->Asn or Asp-87-->Gly) and one in parC. This is the first report of parC mutations in S. Typhi. Ciprofloxacin-resistant S. Typhi and S. Paratyphi A differed in their MICs and mutations in gyrA and parC. Moreover S. Typhi harboured a 50 kb transferable plasmid carrying a class 1 integron (dfrA15/aadA1) that confers resistance to co-trimoxazole and tetracycline but not to ciprofloxacin. PFGE revealed undistinguishable XbaI fragment patterns in ciprofloxacin-resistant S. Typhi as well as in S. Paratyphi A isolates and showed that ciprofloxacin-resistant S. Typhi have emerged from a clonally related isolate with reduced susceptibility to ciprofloxacin after sequential acquisition of a second mutation in gyrA. CONCLUSIONS: To our knowledge this is the first report of molecular characterization of S. Typhi with full resistance to ciprofloxacin. Notably, the presence of a plasmid-borne integron in ciprofloxacin-resistant S. Typhi may lead to a situation of untreatable enteric fever.

Pathogenicity of turkey astroviruses in turkey embryos and poults.

The pathogenicity of turkey astrovirus 2001 (TAstV2001) and turkey astrovirus 1987 (TAstV1987) in specific-pathogen-free (SPF) turkey embryos and commercial poults was investigated. The virus shedding in poults was monitored using electron microscopy (EM) and reverse transcription-polymerase chain reaction (RT-PCR) during the 14-day experimental period. Both viruses caused enteritis and growth depression in SPF turkey embryos and poults. The TAstV2001 did not induce macroscopic or microscopic lesions in thymuses and bursas of embryos or poults. No macroscopic changes were observed in thymuses and bursas of embryos and poults inoculated with TAstV1987, and no statistically significant differences in bursa weight/ body weight ratios (P > 0.05) were detected. However, TAstV1987 infection resulted in microscopic lesions in bursas but not in thymuses of infected embryos and poults. Both TAstV2001 and TAstV1987 were shed during the whole 14-day experimental period as detected by EM and RT-PCR. These findings indicated that both TAstV1987 and TAstV2001 are etiologic agents of turkey enteritis. In addition, TAstV1987 might cause impairment of the immune system of infected poults. The pathogenicity of TAstV1987 is somewhat different from TAstV2001.

[Clinical results of the various replacement therapies for chronic renal failure: haemodialysis and renal transplantation]. / Risultati clinici delle diverse terapie sostitutive dell'insufficienza renale cronica: emodialisi e trapianto renale.

Results from recent studies have demonstrated that kidney-transplanted patients have better expectation and quality of life than dialysis patients on a waiting list for kidney transplant. Moreover, the scientific literature has conclusively shown that the survival of the patient and of the kidney graft are better in patients who received a kidney from a living donor, than in patients who received a cadaveric kidney. The main factors that may have a negative influence on the kidney transplant are: the recipient's age, diabetes mellitus, smoking and the time spent on dialysis before the transplant. The shortage of cadaveric kidneys and the small number of living kidney transplant are the main obstacles to a more widespread use of kidney transplantation. Kidney transplant from living donors needs to be implemented because it represents the best treatment for patients with kidney failure and it can decrease or even avoid the need for dialysis before kidney transplantation.