Low serum 25(OH)-D levels were inversely and independently associated with BP. Supplemental measures to prevent hypovitaminosis D in this population would be important, not only to protect the skeletal system but also for the possible beneficial effects on the cardiovascular system and the BP regulation.

The relevance of eosinophilia in the physiopathology of transplant rejection has yet to be established. The appearance of eosinophilia has been occasionally associated with an adverse prognosis on graft rejection episodes. The aim of the present study was to evaluate the role and prognostic implications of blood and graft eosinophilia in kidney transplant rejection. We have examined the intrarenal infiltrate in 173 fine-needle aspiration biopsies from 36 consecutively transplant patients, and blood samples obtained simultaneously with fine-needle aspirations. Two different immunosuppressive regimens were administered: triple therapy (azathioprine + prednisone + antilymphocytic globulin) in patients with posttransplant acute tubular necrosis and cyclosporine A monotherapy in the rest of the patients. Comparing the two immunosuppressive groups, more elevated eosinophil values were observed in the monotherapy group during stable graft and also at the rejection episode. In the monotherapy group, a significant increase in the eosinophil values, in peripheral blood samples and in the intragraft infiltrates were noted at the rejection episode with respect to the stable situation. Following pulsed-steroid treatment an immediate disappearance of the eosinophils was evident. In contrast, no differences could be demonstrated between these two clinical situations in the TT group. Higher rates of eosinophils in the intrarenal infiltrate with respect to peripheral blood samples were observed during rejection episodes, suggesting some role of the eosinophils in the physiopathology of graft rejection. Higher values of eosinophils in graft infiltrates at rejection episode and a rapid reappearance of eosinophils in the infiltrate following pulsed-steroid treatment, were correlated with an unfavorable prognosis of graft rejection. In conclusion, the eosinophil counts (blood and graft) could be adopted as an additional criteria of immunoactivation in transplant patients treated with cyclosporine A monotherapy, and the rapid reappearance of eosinophils following pulsed-steroid treatment represents a useful negative prognostic predictor in acute rejection management.

Fifty-three consecutive subclavian or jugular hemodialysis catheters inserted into 41 patients were prospectively studied over a period of 8 months in order to determine the incidence of infection and its mechanisms. The intravascular, intradermal and the Y catheter segments as well as both connections were cultured using a quantitative technique for the intraluminal surface. In addition, the intravascular and intradermal portions of the catheter were cultured using a semiquantitative technique for the external surface. Skin smears of the catheter entry site were also cultured, and blood cultures were similarly obtained if fewer developed. Twenty-nine of the 53 catheters (55%) were significantly colonized by one (19 cases) or more (10 cases) microorganisms. The source of the colonizing microorganisms was the skin in 17 cases (58 %), intraluminal in 5 (17 %), both routes in 5 (17 %) and others in 2 (6.8%). Staphylococcus epidermidis (22 cases) and Staphylococcus aureus (4 cases) were the bacteria most frequently isolated. Nine of the 53 catheterizations (17%) were complicated by catheter-related septicemia due to S. aureus in 4 cases, S. epidermidis in 3 cases, Streptococcus faecalis in 1 and Proteus vulgaris in 1. Catheter-related bacteremia contributed to a patient’s death in 1 case. Suppurative local infections of the catheter entry site developed in 3 cases, 2 of them with septicemia. We conclude that the rate of infection due to subclavian or jugular hemodialysis catheters is very high and that the skin is the most frequent origin of the microorganisms.

During CO2 rebreathing in sitting position seven of nine conscious men showed a progressive fall in expiratory reserve volume, most of it due to a decrease in abdominal volume. Diaphragm length at end expiration was thus increased, and some elastic recoil pressure became available to drive inspiration. In four out of six subjects, when CO2 tension was greater than 55 Torr, there was a dip in abdominal pressure at the beginning of inspiration, and the change in transdiaphragmatic pressure during the first 100 ms of an occluded inspiration was smaller than the simultaneous change in mouth pressure (P0.1). In the subjects who showed the smallest diaphragmatic pressure in this 100 ms, electromyogram recordings showed that abdominal activity ceased before the onset of inspiration, and diaphragm activity did not appear until later than 100 ms into inspiration. We conclude that, in four our of our six subjects in the sitting posture, P0.1 can be generated in whole or in part by release of chest wall elastic recoil or in intercostal muscle contraction. In the supine posture, there was no change by end-expiratory chest wall configuration, and onset of diaphragm contraction coincided with beginning of inspiration in the two subjects in whom diaphragm electromyogram was recorded.

The progression of hyperparathyroidism is slower in predialysis patients with BB genotypes than in the other genotypes. Also, calcitriol levels are less reduced in the BB genotype, which may act to lessen the severity of secondary hyperparathyroidism.