Everolimus-based immunosuppression therapy for BK virus nephropathy.

BACKGROUND: Mammalian target of rapamycin inhibitors (mTOR-i) have been proposed as possible immunosuppressants of choice in BK virus nephropathy (BKN) because of their antiviral capacity. On this basis, in 2007, our Service proposed a conversion to everolimus (EVE)-based therapy from calcineurin inhibitors with an anti-calcineurin-free therapy protocol in those patients diagnosed of BKN. METHODS: A prospective, single-center case series study was performed. Fifteen cases of BKN were diagnosed from 2007 to the end of 2010. According to our protocol, immunosuppressant treatment was modified in 9 of these patients with suspension of mycophenolate and conversion from tacrolimus to EVE. RESULTS: The renal function achieved by our patients after the transplantation was excellent. Mean serum creatinine (sCr) achieved was 1.16 ± 0.2 mg/dL. Evolution of the renal function after BKN diagnosis and conversion to mTOR-i was positive in all the patients. sCr on diagnosis was 1.85 ± 0.22 mg/dL, sCr at the point in time of conversion to EVE was 2 ± 0.21 mg/dL, and final sCr of the follow-up was 1.6 ± 0.39 mg/dL (P = .05). BK viremia became negative in 5 of our patients and decreased more than 95% in the remaining 4. None of the patients had an acute rejection episode after the change of immunosuppressant. CONCLUSIONS: Conversion to mTOR-i-based therapy could provide an added benefit in BKN and could be an effective strategy for the decrease of the viremia and increase of graft survival in selected patients.

[The fetal development curves of newborn infants in the Hospital de Cruces (Vizcaya). I. Weight]. / Curvas de desarrollo fetal de los recién nacidos en el Hospital de Cruces (Vizcaya). I. Peso.

Taking a 33,753 live birth sample, without congenital or genetical malformations and from single pregnancies, delivered at Cruces Hospital (Vizcaya) from January 1st. 1987 to December 31st. 1992. Fetal growth curves of weight, have been developed. For every gestational week, percentile distribution, mean and standard deviation and 95% confidence interval of the mean have been calculated. The later calculation allowed us to compare our means with those of national and international studies, finding significance differences with the great majority of them. Since the sample used was of large size, we believe that the resulting norms adjusted to our population. Being useful clinical, public health and investigational purposes.

[The fetal development curves of newborn infants in the Hospital de Cruces (Vizcaya). II. Length, head circumference and ponderal index]. / Curvas de desarrollo fetal de los recién nacidos en el Hospital de Cruces (Vizcaya). II. Longitud, perímetro cefálico e indice ponderal.

Taking a 27,641 live birth sample, without congenital or genetical malformations and from single pregnancies, delivered at Cruces Hospital (Vizcaya) from February 17 1987 to December 31st 1992, fetal growth curves of length, head circumference and ponderal index, have been developed. For every variable and in every gestational week, percentile distribution, mean and standard deviation and 95% confidence interval of the mean have been calculated. Charts of intrauterine growth in length, head circumference and weight-length ratio must be use in conjunction with intrauterine weight charts allowing the identification of infants with unusual prenatal growth patterns.