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Biomedical subjects

G Botti

Publications and source records attributed to G Botti.

176 records · Page 10Linked to original sources
PubMedDate not supplied

[Polyomavirus BK-associated nephropathy after kidney transplantation].

Polyomavirus BK (BKV) infection has been lately recognized as a major cause of renal allograft dysfunction. BKV-related interstitial nephropathy (PVAN) may affect 1-10% of renal allograft recipients, occurring more frequently in the first 6 months after transplantation. Progression to irreversible allograft failure has been observed in up to 45% of all cases; thanks to increased PVAN awareness and improved diagnostic techniques, the rate of graft loss has lowered, more consistently in centres with active screening and intervention programs. PVAN pathogenesis is characterized by multiple synergizing factors, among which immunodepression plays a key role. PVAN diagnosis requires the evaluation of a renal biopsy showing polyomavirus cytopathic changes and confirming BKV through an ancillary technique such as immunohistochemistry. Given the focal nature of the disease, early diagnosis may be difficult to obtain. Thus, quantification of BKV-DNA in plasma has been suggested as surrogate marker for PVAN. To date, given the lack of controlled trials, there is no consensus on a 'standard' management of PVAN. However, evidence based on reported observations suggests that a step-wise reduction of immunosuppression, preceded by pulsed steroids in case of coexistent acute rejection, may improve outcomes. Additional options may be represented by drugs with antiviral activity, such as cidofovir, leflunomide or quinolones. Application of a preventive treatment based on viremia monitoring has been recently proposed.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Pneumatic dilatation in the treatment of achalasia.

The results of a European survey on pneumatic dilatation in the treatment of achalasia have been compiled from a questionnaire completed by 18 different surgical teams. The total number of patients investigated was 2,161. Surgical treatment was prescribed by 94% of teams, whereas pneumatic dilatation was only prescribed by 56%. The indications for pneumatic dilatation were: inoperability (28%), drug failure (17%), surgical failure (11%). Nine surgeons believe pneumatic dilatation is indicated in all cases (50%), four consider it ineffective and useless (22%), and one expressed no opinion (6%). The arguments in favour of pneumatic dilatation are the fact that the procedure is minor and cost efficient and that it is relatively safe and effective with good long-term results in 75% of cases. Pneumatic dilatation should be used as the initial treatment in achalasia; surgery is only indicated in cases of failure.

Dilatation↗