Beliefs and behaviours of radiographers and other health professionals concerning radiation protection safety in a high-volume Greek public hospital. Development of a new measuring instrument.

INTRODUCTION: The use of fluoroscopy-assisted surgical procedures has been increasing recently. The extensive use of fluoroscopy, combined with the lack of knowledge about radiation risks among operating room (OR) personnel (surgeons, anaesthetists, nurses, and radiographers), may lead to misconceptions. The perceptions and beliefs of any health professional concerning radiation protection safety (RPS) may affect their behaviour during surgery, leading to negative outcomes. The aim of this study was to construct a new, original, reliable, and valid instrument to record the beliefs, perceptions, and behaviours of health professionals during surgery, which reflects the established culture of RPS. METHODS: A questionnaire was designed, consisting of 95 questions grouped into six coherent sections. The study was performed at a Greek public hospital with a high workload in terms of fluoroscopically guided surgical operations. RESULTS: It was distributed among 136 people, and 132 completed questionnaires were collected (response rate 97%). Exploratory factor analysis was performed separately for each scale studied and Cronbach's Alpha reliability analysis was also performed. The reliability of the greater part of the new measurement tool ranged from very good to acceptable. CONCLUSION: The questionnaire developed in this study is a valid and reliable option for recording health professionals' perceptions, beliefs, and behaviours concerning the RPS culture. IMPLICATIONS FOR PRACTICE: This study helps clinical radiographers to understand a possible knowledge gap about RPS and locates the specific fields that the OR personnel misunderstand. It also can support and establish local learning organisations with regular targeted staff training for health professionals, thereby leading to a generally improved RPS culture.

Poststroke shoulder pain in subacute patients and its correlation with upper limb recovery after robotic or conventional treatment: A secondary analysis of a multicenter randomized controlled trial.

BACKGROUND AND AIMS: Poststroke shoulder pain is a common complication. We aimed to investigate the prevalence of poststroke shoulder pain, with attention to the neuropathic component, and the relationship between poststroke shoulder pain and upper limb improvement in motor function, strength, disability, and quality of life after upper limb rehabilitation. METHODS: This is a secondary analysis of a multicenter randomized controlled trial to compare upper limb conventional or robotic rehabilitation on 224 patients enrolled in eight rehabilitation centers. We assessed poststroke shoulder pain (using the Numerical Rating Scale and the Douleur Neuropathique 4), and upper limb motor function, strength, disability, and quality of life at baseline (T0), after 30 rehabilitation sessions (T1), and three months after the end of rehabilitation (T2). RESULTS: A moderate/severe poststroke shoulder pain was reported by 28.9% of patients, while 19.6% of them showed a neuropathic component. At T0, the intensity of pain was higher in women and in patients with neglect syndrome, positively correlated with the time since stroke and disability and negatively correlated with motor function, strength, and the physical aspects of the quality of life.Moderate/severe pain and neuropathic component significantly reduced after both treatments and this reduction was maintained at T2. Finally, the intensity of pain at baseline was negatively correlated with the improvement of upper limb motor function. CONCLUSIONS: Poststroke shoulder pain negatively impact on motor performance, strength, disability, and physical aspects of the quality of life as well as on upper limb motor recovery; however, it can be reduced after a robotic or a conventional rehabilitation. Therefore, we suggest considering poststroke shoulder pain when planning the rehabilitation intervention.

FCGR3A-V158F polymorphism is a disease-specific pharmacogenetic marker for the treatment of psoriasis with Fc-containing TNFα inhibitors.

Psoriasis is a multifactorial skin disease affecting ~2% of world's population, causing a dramatic decrease in patients' quality of life and a significant increase in health-care expenses. Biological agents such as the anti-TNFα ones had an enormous impact in patients' therapy; however, a significant proportion of them do not respond well, an outcome attributed mainly to genetic factors. Recently, in a large European cohort of rheumatoid arthritis patients we have shown association with variation in the receptors that correspond to the Fc portion of the biological agents. As both diseases share common immunological fingerprints, we examined the hypothesis that they share common pharmacogenetic markers. Analysis of FCGR2A-H131R and FCGR3A-V158F polymorphisms in 100 psoriasis patients showed association only with respect to FCGR3A-V158F and response to etanercept (P=0.018). Interestingly, no association was found between FCGR2A-H131R and response to anti-TNFα therapy (P=0.882). This study suggests a role for FCGR3A-V158F polymorphism unique for psoriasis.

Intraoperative use of a tablet computer to aid rhinoplasty.

Open septorhinoplasty enables excellent exposure to the structural components of the nasal tip. Nevertheless, it runs the risk of weakening its support mechanisms, which can lead to notable changes to tip projection and rotation as well as to the nasolabial angle. It is therefore paramount that the surgeon reconstructs the nose to the desired endpoint at the end of the operation. Currently, the gold standard of care in rhinoplasty uses preoperative photographs with the patient sitting or standing. However, this is not a true representation of the face in the operative position as the patient is placed supine and so gravity affects the appearance of the nose in a different way. Other factors such as head drapes and traction on the endotracheal tube can also cause subtle changes. We therefore advocate additional intraoperative profile view photographs to improve the accuracy of nasal tip positioning. In our department, in addition to standard preoperative photographs, immediate preoperative profile photos are taken with the patient supine, intubated and draped. Images are captured using a tablet computer at a distance of 1 meter from the patient. We ensure that the Frankfort plane is perpendicular to the floor. The picture is enlarged so that the image is full scale and the tablet is subsequently placed immediately behind the patient for direct comparison. This is then used during the procedure to check tip projection and rotation as well as at the end of the procedure following closure of the columellar incision to ensure correct placement of the nasal tip.

Anatomical and Functional Results of Lamellar Macular Holes Surgery.

PURPOSE: To determine the long-term surgical findings and outcomes after vitrectomy for symptomatic lamellar macular holes. METHODS: We studied 28 patients with lamellar macular holes and central visual loss or distortion. All interventions were standard 25 G vitrectomy with membranectomy of the internal limiting membrane (ILM), peeling and gas tamponade with SF6 20 %. Operations were performed by a single experienced surgeon within the last 3 years. Best corrected visual acuity and optical coherence tomography appearance were determined preoperatively and postoperatively. RESULTS: Following the surgical procedure, all macular holes were closed; however, in 3 eyes, significant foveal thinning was associated with changes in the retinal pigment epithelium changes. The mean best-corrected visual acuity improved postoperatively in the majority of the patients (n: 21, mean 0.3 logMAR), stabilised in 4 patients and decreased in 3 patients (mean 0.4 logMAR). Spectral Domain-Optical coherence tomography (SD-OCT) showed resolution of the lamellar lesion and improved macular contour in all cases. CONCLUSION: We demonstrated improvement in postoperative vision and the anatomical reconstruction of the anatomical contour of the fovea in most eyes with symptomatic lamellar holes. These findings indicate that vitrectomy, membranectomy and ILM peeling with gas tamponade is a beneficial treatment of symptomatic lamellar macular holes.

Clinical expression and course in patients with late onset systemic lupus erythematosus.

BACKGROUND: To analyze the pattern of clinical expression and the 5-year disease course in Caucasian patients with late onset of systemic lupus erythematosus (SLE) and to compare the findings with an early onset SLE group. METHODS: Medical records of 551 patients who presented with SLE at hospitals of the region of Thessaloniki between 1989 and 2007 were studied. Patients who developed SLE at or after the age of 50 years were classified as the late onset group, while younger patients served as the early onset group. Data on clinical manifestations and damage accrual at disease onset and at 5 years was obtained and compared between the two groups. RESULTS: In 121 patients, the disease started after the age of 50 years. Elderly patients showed less pronounced female predominance and less often presented with malar rash, nephropathy, fever and lymphadenopathy, while lung involvement, pericarditis and sicca syndrome were more frequent. Damage accrual was similar in both groups. The main causes of damage at 5 years differed, with the elderly exhibiting more cardiovascular damage. They also had a higher incidence of hypertension and osteoporosis at 5 years. CONCLUSIONS: Caucasian SLE patients with late onset of the disease present with different clinical manifestations, suggesting that age affects the expression of SLE. Damage accrual at 5 years is similar in the elderly and the younger patients. However, the causes of this damage and the occurrence of other comorbidities follow a different pattern, possibly reflecting the disease process and the effects of aging.

Restless legs syndrome in hemodialysis patients: an epidemiologic survey in Greece.

BACKGROUND: Restless legs syndrome (RLS) is a sensorimotor disorder characterized by an uncontrolled need to move extremities accompanied by unpleasant sensations, which frequently leads to sleep disturbances. In hemodialysis (HD) patients, the previously reported RLS prevalence varied enormously, between 6% and 60%. In our study, we investigated the RLS prevalence in HD patients for the first time in Greece. METHODS: A continuous sample of HD patients was studied between January and September of 2010 in six dialysis units in Greece. RLS diagnosis was based on the essential clinical criteria of the International RLS Study Group (IRLSSG). The standardized incidence ratio (SIR) for RLS in HD patients was calculated in comparison to data from a recent survey of the general population in Greece. RESULTS: In our study of 579 HD patients in Greece (236 women; mean age, 65±13years), the prevalence of RLS was elevated in comparison to the general population (26.6% vs 3.9%), with an SIR of 5.4 (95% confidence interval [CI], 4.6-6.3). In the fully adjusted model, the risk for RLS in HD patients was reduced in older age (odds ratio [OR], 0.98 [95% CI, 0.96-0.99]) and increased in women (OR, 1.60 [95% CI, 1.05-2.43]) in cases with elevated levels of ß2 microglobulin (OR, 1.15 [95% CI, 1.01-1.32]) and intact parathormone (iPTH) (OR, 1.30 [95% CI, 1.08-1.56]). CONCLUSION: A high RLS prevalence was recorded in a large HD population in Greece, clearly suggesting the need for enhanced awareness of RLS in nephrology. The RLS risk was increased in women and in younger HD patients as well as in those with elevated ß2 microglobulin and iPTH levels.

Synchronous gastric inflammatory myofibroblastic tumour with gastrointestinal stromal tumour of the stomach and hepatic syringious haemangioma.

Inflammatory myofibroblastic tumour of the stomach is a very rare lesion. A case of a gastric inflammatory myofibroblastic tumour associated with gastrointestinal stromal tumour of the stomach and hepatic syringious haemangioma is described. We report an 80-year-old male who had an exophytic mass in the area of the pylorus and the duodenum, where hepatic cysts were found in the magnetic resonance (MRI) scan on examination of hypochromic microcytic anaemia, and prolapsus and torsion of the bulb of the stomach found during gastroscopy. During surgical excision of the exophytic mass, a gastrointestinal stromal tumour from the gastric fundus and a syringious haemangioma from the superior hepatic surface were resected. All tumours were treated successfully by surgical excision. The patient had an uneventful recovery. Neither recurrence nor metastasis was found after a 12-month follow-up. To our knowledge, this is the first time that such an association is reported in the literature.

Clinical expression and morbidity of systemic lupus erythematosus during a post-diagnostic 5-year follow-up: a male:female comparison.

The aim of this study was to analyse the prevalence of the most relevant clinical features of the diagnosis of systemic lupus erythematosus (SLE) in a sample of male patients with lupus as well as the incidence of the main causes of morbidity in a 5-year period after the diagnosis. A further aim of this study was to investigate the impact of gender on expression and morbidity of SLE. Data were collected from the medical records of 59 male and 535 female patients with SLE who were diagnosed at the hospitals in the region of Thessaloniki. Several differences in the expression and morbidity of the disease were found in relation to the gender of the patient. Male patients had a higher prevalence of thromboses, nephropathy, strokes, gastrointestinal tract symptoms and antiphospholipid syndrome when compared with female patients, but tended to present less often with arthralgia, hair loss, Raynaud's phenomenon and photosensitivity as the initial clinical manifestations. During the 5-year follow-up, positive associations have been found between male gender and the incidence of tendonitis, myositis, nephropathy and infections, particularly of the respiratory tract. In conclusion, this study has provided information regarding the features of clinical expression and morbidity in male patients, and has shown that gender is a possible factor that can influence the clinical expression of SLE.

Intravitreal l-Arginine injection reverses the retinal arteriolar vasoconstriction that occurs after experimental acute branch retinal vein occlusion.

To investigate the effect of l-Arginine on the retinal arteriolar diameter following acute branch retinal vein occlusion (BRVO) in minipigs. Under general anesthesia, 10 eyes of 10 minipigs were evaluated. Two hours after BRVO, an intravitreal juxta-arteriolar micro-injection of 30 microl l-Arginine 1 mM (pH = 7.4) was performed in 7 eyes. Three eyes received a micro-injection of 30 microl of the solvent (pH = 7.4) that was used to prepare the solution of l-Arginine and served as controls. Retinal arteriolar diameter changes were measured using a Retinal Vessel Analyzer. Overall (n = 10), 2 h after BRVO there was a 10.5 +/- 1.9% decrease in the retinal arteriolar diameter in the affected territories compared to baseline (p < 0.001). An increase of 16.0 +/- 3.0% (p = 0.001) and 21.0 +/- 7.0% (p = 0.013) of the arteriolar diameter was evidenced 10 and 15 min respectively after l-Arginine injection (n = 7) compared to the diameter prior to l-Arginine injection. Thereafter, the vasodilatory effect of l-Arginine started to decrease but persisted and remained significant at the end of the study period (5.0 +/- 1.5% at 30 min, p = 0.007). Micro-injection of the solvent alone (n = 3) did not produce any significant effect on the retinal arterioles, which remained constricted at all time-points (p > 0.1). These findings demonstrate a significant arteriolar vasodilation after intravitreal juxta-arteriolar l-Arginine micro-injection in eyes with experimental BRVO in the affected territories. l-Arginine micro-injection can reverse the arteriolar vasoconstriction that occurs in acute experimental BRVO by stimulating nitric oxide production.

Acute hepatitis C in patients receiving hemodialysis.

Hepatitis C virus (HCV) infection is frequent in patients with end-stage renal disease treated by chronic dialysis, with a prevalence varying from 10-65% according to the geographical data. The prevalence is significantly associated with the duration of dialysis and the number of transfused blood products[1,2] and has dramatically declined with efficient blood screening.[3] We studied patients with acute HCV infection in a dialysis unit. The diagnosis was based on both anti-HCV detection and HCV-RNA detection. Other virological tools including HCV genotype determination was also used to tailor treatment to the individual patient and determine its efficacy for a one-year follow-up period. Seventeen patients (7 male and 10 female, mean age: 63.7 +/- 11.6 SD) with acute hepatitis C were enrolled to our study. All of them were followed up for a period of one year after the diagnosis was established. Phylogenetic analysis distinguished two separate HCV subtypes 1b, which were both responsible for this acute infection (see Figure 1). These types did not differ in their behavior on the clinical situation of our patients, as confirmed by the fact that in both groups of patients, there was only one patient who presented with acute illness. Six patients of our study group, three months after the acute infection, received pegylated interferon (Peg-IFNa2a) 135 mug for a six-month period. Four of them responded very well to therapy and at the first determination HCV RNA was below the cutoff point. One of our patients with very high HCV levels (HCV RNA > 50,000,000 IU/mL), despite receiving the same therapy, did not respond well and developed cirrhosis. In conclusion, it is clear from our experience that better information is needed about the current incidence, prevalence, and risk factors for HCV infection in dialysis patients. Algorithms for the diagnosis and management of hepatitis C should be developed by academic societies. Routine screening for hepatitis C also would allow for better definition of the natural history of hepatitis C in patients with end stage renal disease. [image omitted]Figure 1. NS 5B gene phylogenetic tree analysis of the acute hepatitis C epidemic.

Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study.

Seeking to assess the radiation risk associated with radiological examinations in neonatal intensive care units, thermo-luminescence dosimetry was used for the measurement of entrance surface dose (ESD) in 44 AP chest and 28 AP combined chest-abdominal exposures of a sample of 60 neonates. The mean values of ESD were found to be equal to 44 +/- 16 microGy and 43 +/- 19 microGy, respectively. The MCNP-4C2 code with a mathematical phantom simulating a neonate and appropriate x-ray energy spectra were employed for the simulation of the AP chest and AP combined chest-abdominal exposures. Equivalent organ dose per unit ESD and energy imparted per unit ESD calculations are presented in tabular form. Combined with ESD measurements, these calculations yield an effective dose of 10.2 +/- 3.7 microSv, regardless of sex, and an imparted energy of 18.5 +/- 6.7 microJ for the chest radiograph. The corresponding results for the combined chest-abdominal examination are 14.7 +/- 7.6 microSv (males)/17.2 +/- 7.6 microSv (females) and 29.7 +/- 13.2 microJ. The calculated total risk per radiograph was low, ranging between 1.7 and 2.9 per million neonates, per film, and being slightly higher for females. Results of this study are in good agreement with previous studies, especially in view of the diversity met in the calculation methods.

Development and optimisation of a portable micro-XRF method for in situ multi-element analysis of ancient ceramics.

Non-destructive analysis of cultural objects by micro-XRF spectrometry is an advantageous multi-element technique that has rapidly developed during the past few years. Portable instruments contribute significantly to the in situ analysis of valuable cultural objects, which cannot be transported to the laboratory. Ancient ceramics are the most common archaeological findings and they carry a significant historical content. Their analysis often presents certain particularities due to surface irregularities and heterogeneity problems. In the present work, the analytical characteristics (beam spot size, geometry effect and detection limits) of a compact and portable micro-XRF instrument with a monocapillary lens are presented in details. The standard reference materials SARM 69, SRM 620, NCS DC 73332 and the reference materials AWI-1 and PRI-1 were analysed for the determination of the detection limits (DL's) and the evaluation of the accuracy of the micro-XRF. Emphasis is given on the critical parameters, which should be monitored during measurements and influence the final results in the analysis of ancient ceramics. A quantitative analysis of ancient ceramic samples from Abdera (North Greece) is also presented.

Relevance of procalcitonin levels in comparison to other markers of inflammation in hemodialysis patients.

PURPOSE: The objective of this study was to evaluate the diagnostic value of serum procalcitonin (PCT) in hemodialysis (HD) patients and its correlation to other traditional inflammatory markers. METHODS: We measured plasma PCT levels in 120 patients on maintenance HD. PCT levels were compared with C-reactive protein (CRP), interleukin-6 (IL-6), prealbumin, and albumin. We also examined the above parameters subgroups, especially in diabetics and the elderly. Relations between parameters were studied by Spearman's correlation. RESULTS: PCT concentrations were higher than the upper normal limit of 0.5 ng/ mL in 38% of the patients. All patients with increased CRP had PCT concentrations higher than the upper normal limit. Plasma CRP concentrations were positively correlated to IL-6 (r = 0.304). Prealbumin was negatively correlated with CRP (r = 0.259) and with IL-6 (r = 0.388). CONCLUSIONS: The combination of elevated IL-6 and CRP levels was associated with an altered nutritional status. The concomitant elevations in PCT, CRP, and IL-6 could be more sensitive in the evaluation of inflammation.

Cellular immunity and levels of parathyroid hormone in uremic patients receiving hemodialysis.

OBJECTIVE: The clinical relevance of altered lymphocyte function and the possible relation with uremic toxins, such as parathyroid hormone (PTH) is not well understood. We studied the changes in cellular immunity in patients in hemodialysis (HD) therapy and examined the relationship between T-lymphocyte function and plasma levels of PTH. PATIENTS AND METHODS: Thirty-four patients (14 male) were enrolled in this study (mean age: 63.20 +/- 10.01 years, M +/- SD, 12 h/week HD). Our study population was divided into two groups: 18 patients with increased levels of PTH and 16 patients with normal levels of PTH. Lymphocyte subsets (CD2+, CD3+, CD3+/4+, CD3+/8+, CD19+, CD3-/16+56+, CD4/CD8 ratio) were quantitated in both groups using monoclonal antibodies (Immunotech, Coulter) and flow cytometric analysis. Following analysis of variance (ANOVA) testing was performed to test differences between groups (SPSS version 10). RESULTS: A significant increase of CD2 was noticed in patients with increased levels of PTH (84.8 +/- 5.5 vs. 79.8 +/- 4, p<0.05). The CD3 population was also increased in patients with elevated PTH (72 +/- 8.6 vs. 68 +/- 9.2, p=NS). This group of patients had also significantly increased levels of CD3/8 (44.8 +/- 9.8 vs. 37.1 +/- 5.8, p<0.05). The CD4/CD8 ratio levels were higher in patients with elevated PTH compared with those who had normal PTH (2.2 +/- 1.5 vs. 1.5 +/- 0.8, p=NS). CONCLUSIONS: The elevated level of PTH seems to affect the lymphocyte function and is associated with changes in cellular immunity in the hemodialysis population. Our study is in progress in order to enlarge our study population and collect more data, which will lead us to more solid conclusions.

Investigation of occupational radiation exposure during interventional cardiac catheterisations performed via radial artery.

The purpose of this study was to determine the thyroid, sternum and hand radiation doses of radiologists who perform angiographies and angioplasties via the radial artery. Staff radiation dose was estimated for 21 cardiac interventional catheterisations. Thermoluminescence dosemeters (TLDs) were used to determine radiation dose for each procedure at the right and left wrist, at the sternum and the thyroid. A dose area product (DAP) meter was also attached to give a direct value in Gy cm2 for each procedure. Staff radiation doses varied between 34 and 235 microGy per procedure at the left wrist, 28 and 172 microGy at the right wrist, 16 and 106 microGy at the level of the thyroid and 16 and 154 microGy at the level of the sternum. The DAP values varied between 25 and 167 Gy cm2. Radiation doses in this study are comparable to those reported in previous studies. Moreover, good correlation was found between the DAP values and the occupational dose measured with TLDs.

Entrance radiation doses during paediatric cardiac catheterisations performed for diagnosis or the treatment of congenital heart disease.

The purpose of this study was to estimate the radiation exposure of children, during cardiac catheterisations for the diagnosis or treatment of congenital heart disease. Radiation doses were estimated for 45 children aged from 1 d to 13 y old. Thermoluminescent dosemeters (TLDs) were used to estimate the posterior entrance dose (DP), the lateral entrance dose (DLAT), the thyroid dose and the gonads dose. A dose-area product (DAP) meter was also attached externally to the tube of the angiographic system and gave a direct value in mGy cm2 for each procedure. Posterior and lateral entrance dose values during cardiac catheterisations ranged from 1 to 197 mGy and from 1.1 to 250.3 mGy, respectively. Radiation exposure to the thyroid and the gonads ranged from 0.3 to 8.4 mGy to 0.1 and 0.7 mGy, respectively. Finally, the DAP meter values ranged between 360 and 33,200 mGy cm2. Radiation doses measured in this study are comparable with those reported to previous studies. Moreover, strong correlation was found between the DAP values and the entrance radiation dose measured with TLDs.

Lymphocytes subsets in the course of continuous ambulatory peritoneal dialysis (CAPD).

BACKGROUND: We studied lymphocyte subset counts in comparison with normal subjects in order to clarify the abnormalities of cellular immune responses in uremic patients undergoing continuous ambulatory peritoneal dialysis (CAPD). METHODS: The study included 37 CAPD patients and 45 normal individuals, as the control group. For the study, CAPD patients were divided into four groups depending on duration of replacement therapy. Group I consisted of patients treated for 0-6 months (n=6), group II for 6-12 months (n=6), group III for 13-24 months (n=16), and group IV for more than 25 months (n=9). Flow cytometry was used for estimation of lymphocyte subsets (determination of CD2, CD3, CD3+/CD4+, CD3+/CD8+, CD3-/16+56+, CD19, CD4/CD8). RESULTS: Our patients started CAPD with decreased lymphocyte subset counts, slightly above the normal range (excluding CD3 -/16+56+, CD2). After 6 months of CAPD therapy, an increase in CD4/CD8 ratio was observed and all examined lymphocyte subset counts decreased (excluding CD2). In patients on CAPD for more than 25 months, CD3+/CD4+, CD19 counts were below the normal range, CD3 -/16+56+ exceeded the upper limit of normal range and at the same time mean total lymphocyte count (TLC) was maintained in the normal range. CONCLUSIONS: We recommend lymphocyte subset determinations for detection of immune abnormalities in the course of CAPD treatment.

Glomerular filtration rate estimation in renal transplant patients based on serum cystatin-C levels: comparison with other markers of glomerular filtration rate.

PURPOSE: The assessment of glomerular filtration rate (GFR) is the most commonly used test of renal function. Cystatin-C, a cysteine protease inhibitor, which can be measured by light-scattering immunoassay, possesses many of the attributes required of the ideal GFR marker. Conversely, many endogenous markers that are widely used for the estimation of GFR such as serum creatinine (SCr) are not ideal. The present study was undertaken to evaluate the clinical application of serum cystatin-C (CysC) as a new marker of GFR in renal transplant patients. METHODS: Eighteen patients (9 men) were enrolled in the study (mean age: 46.35, range: 31-67 years) to measure serum CysC levels and compare them, with SCr, creatinine clearance (CCr), as well as the Cockcroft-Gault equation (CG) or the MDRD as indicator of GFR. Spearman's correlation coefficient was used to determine the relationship between CysC and other markers. RESULTS: There was a significant negative correlation between serum CysC and CCr (r = -0.768). Moreover, the CysC level was negatively correlated with CG (r = -0.854), positively correlated with SCr (r = 0.629), and negatively correlated with MDRD (r = -0.604). CONCLUSIONS: These results indicate that measurement of serum cystatin-C was useful and accurate to estimate GFR in renal transplant patients. The recent literature confirms our data although there are concerns about nonrenal influence on this test. Although serum CysC can generally be recommended as a marker for GFR, our study is still in progress seeking to validate the conclusions in a larger number of patients.