[Population genetic structure of Bemisia tabaci (Hemiptera: Aleyrodidae) utilizing microsatellite markers]. / Estrutura genética populacional de Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) utilizando marcadores microssatélites.

We aimed to characterize the population genetic structure within and among five Bemisia tabaci (Gennadius) populations collected from different host plants and geographic regions by using microssatelites as a molecular marker. Each population was represented by 19 specimens. The host plants and geographic origins of these populations were described as follows: Pop 1: Squash Barreiras (BA); Pop 2: Cotton Barreiras (BA); Pop 3: Soybean Campinas (SP); Pop 4: Tomato Cruz das Almas (BA); and Pop 5: Soybean Rondonópolis (MT). Six polymorphic loci were observed, which discriminated 31 different alleles in the studied populations, with a mean number of alleles per population of 3.30 (2.67 - 4.00). Using Fisher's Exact test, it was observed that at least three populations were in Hardy-Weinberg equilibrium for most of the studied loci (six). The dendrogram (UPGMA) separated populations into groups mainly related to the geographic origin of the samples. Only population 5 differed from the others at a 0.15 distance (74.5% group consistency). The most similar populations were 1 and 2, with a 0.01 distance (65.3%). This is in agreement with their geographic origins and it was not consistent with host specificity. The results suggest considerable gene flow (7.3%) among all whitefly populations and indicate that a better understanding of the gene flow in populations of B. tabaci associated with different hosts is required for the management of this insect.

[Unexpected cause of acute renal failure in an 85-year-old woman]. / Una inaspettata causa di insufficienza renale acuta in una 85-enne.

Acute postinfectious glomerulonephritis (APIGN) is usually diagnosed in young people, while in elderly people rapidly progressive forms appear to be the most important glomerular disease causing acute renal failure. We report on a 85-year-old woman with acute renal failure due to APIGN. An 85-year-old woman with a history of hypertension and cerebrovascular disease was hospitalized because of diarrhea and syncope associated with atrial fibrillation. She was found to have left lower lobe pneumonia. Serum creatinine was over 2 mg/dL. Fluids were given, without improvement in renal function but leading to volume overload instead. Within a few days serum creatinine reached a level of 5.4 mg/dL with reduction of urine output despite administration of diuretics. The patient developed hematuria and purpura of the feet. Serum IgA was high and the urine sediment showed casts. Methylprednisolone 125 mg i.v. was given for three days followed by prednisone 50 mg daily. The patient's clinical condition gradually improved and serum creatinine decreased to 1.9 mg/dL. Renal biopsy showed APIGN. During hospitalization, three major complications occurred: hemodynamic instability due to atrial fibrillation, Clostridium difficile colitis and urinary tract infections due to Enterococcus faecalis and Candida tropicans, all successfully treated. APIGN should be taken into account as a cause of acute renal failure in hospitalized elderly patients with many comorbidities.

Clinical features of sarcomatoid renal cell carcinoma causing bilateral urinary tract obstruction.

We report on a 52-year-old female patient hospitalized because of uremia due to bilateral urinary tract obstruction caused by bilateral sarcomatoid renal cell carcinoma (SRCC). Abdominal computed tomography with contrast showed a large mass on the left side, infiltrating the left kidney, while the right kidney was described as enlarged. The latter was investigated with sonographic angiography using contrast and selective arteriography of the renal arteries, demonstrating a pseudonodular area at the inferior pole of the right kidney. The patient underwent bilateral nephrectomy and chronic hemodialysis treatment; unfortunately, after one month she died from cachexia. To the best of our knowledge this is the first case to be reported on bilateral SRCC causing bilateral urinary tract obstruction.

Role of B-type natriuretic peptide in cardiovascular state monitoring in a hemodialysis patient with primary amyloidosis.

BACKGROUND: Cardiac involvement occurs in up to 50% of patients with primary or A amyloidosis (ALA) and is associated with very poor prognosis. B-type natriuretic peptide (BNP) has been proposed as a guide for treatment of heart failure patients and as an index of myocardial dysfunction in patients with ALA. Data about BNP dosage for cardiovascular monitoring of patients with ALA on renal replacement therapy are lacking. CASE: A 64 year old Caucasian man was admitted because of nephrotic syndrome in July 2003. Renal diagnosis was ALA. Melphalan and prednisolone were given but renal function worsened and in April 2004 standard bicarbonate hemodialysis was started. In March 2004 thalidomide was added to his therapy. During the follow-up ejection fraction was stable and was 65% on the contrary E/A ratio gradually increased and overtook 1. BNP plasma levels were increased and the values recorded during the follow-up were: 2505 pg/mL in October 2003 (normal reference values<100), 1827 in April 2004, 4006 in June 2004, 5000 in September 2004, 3750 in January 2005 and 1920 in April 2005. In September 2005 BNP was 3380 pg/mL. The patient was still alive after a follow-up longer than two years. CONCLUSION: In ALA patients a powerful prognostic role of BNP has been reported whose expression is increased in ventricular myocytes of patients with cardiac involvement. BNP level monitoring does not appear to be superior to standard echocardiography in evaluating cardiovascular status of uremic patients with ALA.

Tubulo-interstitial nephritis and uveitis syndrome associated with mastitis: a case report.

UNLABELLED: A new case of tubulo-interstitial nephritis and uveitis (TINU) syndrome in a 14-y-old girl is described. In this patient unilateral mastitis was an associated feature. The aetiology of this rare syndrome, the prognosis for which is usually good, is still unknown. The most common theory supports a cell-mediated immune response induced by infectious/antigenic stimuli. CONCLUSION: The presence of acute unilateral mastitis in this patient may represent an additional localization in TINU syndrome.

[Renal atheroembolic disease: evaluation of the efficacy of corticosteroid therapy]. / Malattia ateroembolica: valutazione dell'efficacia della terapia steroidea.

BACKGROUND: Even though many organs may be involved and clinical manifestations are extremely variable, a sudden worsening of renal function after vascular surgery or invasive angiographic manoeuvres is a clue for the diagnosis of renal cholesterol crystal embolization. In rare cases the disease may also occur spontaneously during anticoagulant or thrombolytic therapy. Renal atheroembolism is becoming increasingly recognized as an important cause of renal failure particularly in elderly men, and is often associated with a bad outcome. To date there is no specific and proven useful treatment apart from a few anecdotal reports on the benefits of corticosteroids. PATIENTS AND METHODS: We report a group of seven patients with cholesterol atheroembolic disease presenting acute renal failure; in six patients the disease appeared after coronary arteriography and PTCA performed in the last four months, and in one patient in an apparently spontaneous form. All the patients presented cutaneous lesions, livedo reticularis, purpuric rush, necrosis of the toes; laboratory data showed an increase of acute phase proteins and eosinophilia. Results. Treatment with prednisolone was begun at a dose of 40 mg/day i.v. for four days; the dose was reduced to prednisone 0.4-0.5 mg/kg/day for 1 week, than gradually reduced further and stopped within a month. Following therapy renal function rapidly improved; clinical symptoms of malaise and abdominal discomfort subsided, with amelioration of skin lesions and cyanosis of toes. CONCLUSIONS: Despite the small number of patients studied, our experience suggests that corticosteroid treatment is an effective therapeutic option in cholesterol renal atheroembolic disease, especially in the more severe cases of acute renal failure.

One case of immunotactoid glomerulopathy: morphological-ultrastructural aspects.

Starting from a group of 736 renal biopsy patients, evaluated by ultrastructural studies over a period of 22 years, the authors present a rare case of immunotactoid glomerulopathy, suggesting that these forms, until a few years ago considered in the same group as fibrillary glomerulonephritis, are in fact a separate entity; moreover, they may represent a very early manifestation of plasmacellular dyscrasia still at the initial stage.

Fatal sepsis from Vibrio vulnificus in a hemodialyzed patient.

Vibrio vulnificus, a particularly virulent halophilic vibrio, has been isolated from the blood and skin necrotic lesion of a hemodialyzed patient with sepsis. The patient has had exposure of the skin to seawater. Various chronic conditions including renal failure have a great risk for developing septicemia due to V vulnificus. It is necessary to inform persons with liver diseases or immunocompromising conditions of hazards associated with the consumption of undercooked seafood and seawater exposure.

Familial interstitial nephropathy without hyperuricemia.

Progressive hereditary nephropathy is described in 6 members of a single family. Renal biopsies, performed in 3 patients, revealed tubular atrophy, interstitial fibrosis, and lymphomonocytic infiltration associated with severe vascular lesions. These features were disproportionately serious when related to age, arterial pressure, and renal function. Similar familial nephropathy has been reported in the literature, generally in association with gout or asymptomatic hyperuricemia. The patients described here had normal blood concentrations of uric acid. It is proposed that the members of the present group of patients are suffering from the same interstitial nephropathy as that described in the literature and that the hyperuricemia found by other investigators is coincidental and does not play a pathogenetic role.

Lipoprotein abnormalities in hypertriglyceridaemic patients on long-term haemodialysis.

OBJECTIVES: To analyse by ultracentrifugation in a zonal rotor the plasma lipoproteins in hypertriglyceridaemic patients on long-term haemodialysis. DESIGN: Case-control study. SETTING: Tertiary referred care centre. SUBJECTS: Ten consecutive hypertriglyceridaemic patients on haemodialysis and 12 consecutive healthy controls. MAIN OUTCOME MEASURES: Plasma lipid and lipoprotein cholesterol concentrations, lipoprotein physical properties and compositions, apolipoprotein concentrations. RESULTS: Hypertriglyceridaemia in patients undergoing haemodialysis is characterized by an increased amount of small and slow floating very-low density lipoproteins (VLDL), higher concentrations of intermediate density lipoproteins (IDL) and small and dense low-density lipoprotein (LDL) particles; reduced levels of high-density lipoproteins (HDL), in particular of HDL2. The lipoprotein composition of such patients indicates reduced cholesterol ester and increased triglyceride content. Compared to controls, they have lower levels of plasma apolipoprotein A-I and A-II and higher B, C-II, C-III and E values. CONCLUSIONS: The lipoprotein abnormalities observed in hypertriglyceridaemic patients undergoing haemodialysis have recently been associated with an increased incidence of vascular complications and may in part explain the high incidence of vascular disease reported in these subjects.

Histological features of non-A, non-B hepatitis in hemodialysis patients.

In 12 hemodialysis (HD) patients with persistently raised serum alanine amino-transferase concentrations, 6 of which with anti-HCV antibodies, a liver biopsy was performed. The histological examination showed chronic persistent hepatitis or less significant changes in 11 patients and mild chronic active hepatitis in only 1. Non-A, non-B hepatitis seems to demonstrate in HD patients a low tendency to induce an active and progressive liver disease.

Henoch-Schönlein purpura after Salmonella hirschfeldii infection.

The authors present a case of Henoch-Schönlein purpura in a young soldier (19 years old) which they consider important for its etiology and the length of its oligoanuric phase. The syndrome followed a Salmonella hirschfeldii infection, and a protracted oligoanuric phase was followed by nephrotic syndrome and selective glomerular proteinuria which lasted for 1 year. The young man recovered after the eradication of the Salmonella. It seems possible that there was an overall anomalous regulation of the 'lymphoid system of the mucosa', perhaps dependent on a genetic predisposition.

Effect on leukocyte locomotion and superoxide production by uremic toxins and polyamines.

We have isolated peak II, which is the peak of the middle molecules containing polyamines, from dialysate of uremic patients in recirculating dialysis. We investigated the effect of total dialysate, chromatographic peaks, I, II, III, IV and commercial polyamines on polymorphonuclear leukocyte chemotaxis and superoxide production (i.e. phagocytic activity) in healthy and uremic patients. Polymorphonuclear chemotaxis was inhibited by total dialysate and peak II but not by polyamines; polyamines, total dialysate and peak II had no activity on polymorphonuclear phagocytosis.