Search

Kidney international 103(2), 391-402 (2022). doi:10.1016/j.kint.2022.09.017, Published by Elsevier, New York, NY

Success in treatment with hemodialysis (HD) and kidney transplantation (KTx) requires good adherence. The objective of this study was to evaluate adherence to pharmacotherapy and health recommendations among HD and KTx patients using subjective and objective measures.Two hundred thirty-nine enrolled patients, with 132 KTx (39F, 93M) and 107 HD (48F, 59M) completed a questionnaire regarding over-the-counter (OTC) medications and dietary supplements (DS), adherence to pharmacotherapy, lifestyle recommendations, and self-evaluation of knowledge on them. The surveys were supplemented with objective data from patients' medical records, including interdialytic weight gain and laboratory parameters.About 42.1% HD and 39.4% KTx patients reported using OTC medications without medical consultation (P = .677); 43.9% HD and 31.1% KTx used DS (P = .040); more HD than KTx failed to notify a doctor about it (52.2% vs. 21.4%; P .001). More HD patients skipped medication doses (33.6% vs. 9.7%; P .001). About 40.2% HD and 20.5% KTx patients drank alcohol (P .001), 22.4% HD and 10.5% KTx smoked (P = .013). About 46.7% HD and 66.4% KTx patients limited their caloric intake (P = .002), 73.8% HD and 84.9% KTx limited their salt intake (P = .030). HD patients drank 1.17 ± 0.57 L of fluids daily and KTx drank 2.51 ± 0.67 L (P .001). In HD patients, interdialytic weight gains positively correlated with dialysis vintage (R = 0.26, P = .02) and fluid (R = 0.28, P = .011) but not salt intake (P = .307). The variability of trough levels of calcineurin inhibitors was unrelated to use of DS or OTC medications. KTx rated their knowledge on recommendations higher compared with HD (mean score 4.0 ± 1.0 vs. 3.7 ± 1.0, P = .040).KTx recipients exhibit better adherence and rate their knowledge on recommendations higher than HD patients.

Aim: 2D speckle tracking is a method used in myocardial strain assessment. However, several studies have confirmed the suitability of its application in the assessment of arterial strain (a marker of arterial stiffness). The aims of our study were to evaluate whether 2D speckle tracking can assess the changes in carotid and femoral strain caused by fluid loss during haemodialysis, and to determine the direction and amount of these changes. Material and methods: We examined the distal common carotid and proximal femoral arteries in 74 haemodialysed patients (28 women and 46 men) before and after their haemodialysis sessions. EchoPac software was used to analyse the recorded ultrasound examinations. Circumferential strain values were acquired for further analysis. Results: We found a decrease in carotid circumferential strain values after haemodialysis sessions (5.916 ± 2.632% before haemodialysis and 4.909 ± 2.409% after haemodialysis, p = 0.000022). The amount of fluid lost during haemodialysis sessions correlated (correlation coefficient of 0.434, p = 0.000222) with the decrease of carotid circumferential strain. The correlation coefficients were slightly higher (0.445, p = 0.000146) when a ratio of fluid loss volume to the BMI was used. No statistically significant changes were found in femoral circumferential strain. Conclusions: Our findings suggest that arterial response to body fluid loss may be assessed by 2D speckle tracking. This method enabled us to measure carotid circumferential strain changes caused by fluid volume contraction during haemodialysis sessions. We found an important decrease in the carotid circumferential strain values after the procedure. The amount of this decrease correlated significantly with the decrease in the volume of fluid lost during the haemodialysis session.

Leukocytapheresis, a blood purification therapy, exerts anti-inflammatory effects by removing activated leukocytes from the peripheral blood through extracorporeal circulation. It is a potential option of treatment for patients with inflammatory bowel diseases (IBD), especially those with ulcerative colitis (UC), who do not respond to conventional therapy. Given that it has a favourable safety profile and seems to have steroid sparing effects, its position in the treatment of UC is likely to expand. However, there is inadequate evidence to draw any conclusions about the efficacy of leukocytapheresis in patients with Crohn's disease, and it should only be used in accordance with special arrangements for consent. Considering the current level of knowledge, it is essential to conduct large, well-designed, randomized clinical trials to evaluate the effects of leukocytapheresis in the management of IBD patients.

BACKGROUND The aim of the study was to assess the relationship between body composition and nutritional status with the level of vitamin D metabolites 25(OH)D and 1,25(OH)₂D in patients in the long term after kidney transplantation (KTx). MATERIAL AND METHODS During 2 routine outpatient visits in summer and winter, the anthropometric and body composition measurements and laboratory data from 105 stable KTx patients were taken and the annual averages were analyzed. RESULTS Data of 64 patients (26 F, 38 M) at mean age 49.3±12.2 years and 5.6±2.7 years after KTx with mean BMI 26.9 kg/m² were included for final analysis. Mean annual 25(OH)D concentration was 18.76±6.32 ng/dl and 1,25(OH)₂D 86.65±18.0 pg/ml. A reverse relationship between 25(OH)D level and fat tissue index was observed (r=-0.26; P=0.039). 25(OH)D level increased together with body cell mass (r=0.30, P=0.017) and lean tissue mass values (r=0.30, P=0.015). The body weight and BMI were not associated with 25(OH)D or 1,25(OH)₂D level. A reverse relationship was found between: 25(OH)D and total cholesterol (r=-0.31, P=0.012) and LDL level (r=-0.25, P=0.049), and between 1,25(OH)₂D and HDL level (r=-0.25, P=0.046). No significant correlations between biochemical nutritional parameters, graft function and 25(OH)D or 1,25(OH)2D were noted. CONCLUSIONS Body composition is one of the factors affecting the vitamin D status in KTx patients. Fat tissue index is a negative predictor of 25(OH)D level in patients in the long term after KTx. A low level of 25(OH)D predisposes to lipids disturbances in KTx recipients.

(1) Patients on chronic hemodialysis (HD) experience impaired quality of life (QoL). We analyzed HD’s relationship with physical performance, body composition, and muscle strength; (2) QoL was assessed with the Short Form-36, composed of physical (PCS) and mental (MCS) health dimensions. Physical performance was assessed with the Short Physical Performance Battery (SPPB), body composition (lean tissue mass% (LTM%), fat tissue mass% (FTM%), and skeletal muscle mass% (SMM%)) was assessed with bioelectrical impedance, and lower extremity strength was assessed with a handheld dynamometer; and (3) we enrolled 76 patients (27 F, 49 M), age 62.26 ± 12.81 years, HD vintage 28.45 (8.65–77.49) months. Their QoL score was 53.57 (41.07–70.64); their PCS and MCS scores were 52.14 (38.69–65.95) and 63.39 (44.64–76.79) and strongly correlated (p < 0.0001, R = 0.738). QoL correlated positively with SPPB (R = 0.35, p ≤ 0.001), muscle strength (R from 0.21 to 0.41, p < 0.05), and LTM% (R = 0.38, p < 0.001) and negatively with FTM% (R = −0.32, p = 0.006). PCS correlated positively with SPPB (R = 0.42 p < 0.001), muscle strength (R 0.25–0.44, p < 0.05), and LTM% (R = 0.32, p = 0.006) and negatively with FTM% (R = −0.25, p = 0.031). MCS correlated positively with SPPB (R = 0.23, p = 0.047), SMM% (R = 0.25; p = 0.003), and LTM% (R = 0.39, p < 0.001) and negatively with FTM% (R = −0.34; p = 0.003). QoL was unrelated to sex (p = 0.213), age (p = 0.157), HD vintage (p = 0.156), and BMI (p = 0.202); (4) Better physical performance, leaner body composition, and higher muscle strength are associated with better mental and physical QoL in HD.

Due to the significant socioeconomic burden of kidney diseases, we decided to analyse years of life lost (YLLs) from this cause in Poland between the years 2000 and 2019. The standard expected years of life lost (SEYLL) measure was used to calculate the number of YLLs, the value of which was related to the size of the study population and calculated per 100,000 persons (SEYLLp). A time trend analysis was performed using the Joinpoint regression method. In 2000, the number of YLLs for the entire population was 72,795 (SEYLLp = 190.3 years). After a period of minor changes between 2000 and 2011 (increasing at 0.9% per year), the YLL index rapidly declined between 2011 and 2015 (at −15.4% yearly) and then increased in the last years of the study period (at 12.5% yearly). These changes resulted in a decrease in the number of YLLs to 57,278 in 2019 (SEYLLp = 149.2). The deteriorating health status of Poles after 2015 most likely was caused by the aging of the population, as well as the increasing incidence of risk factors, in particular diabetes and arterial hypertension.

Ilona Kurnatowska and Irena Maniecka-Bryła were not included as authors in the original publication [...]

Background and Objectives: Intradialytic hypotension (IDH) complicates 4 to 39.9% of hemodialysis (HD) sessions. Vessels’ reactivity disturbances may be responsible for this complication. Two-dimensional speckle tracking is used to assess arterial circumferential strain (CS) as a marker of the effectiveness of the cardiovascular response to the reduction of circulating plasma. Materials and Methods: The common carotid artery (CCA) and common iliac artery (CIA) CSs were recorded using ultrasonography in 68 chronically dialyzed patients before and after one HD session. Results: In patients with IDH episodes (n = 26), the CCA-CS was significantly lower both before (6.28 ± 2.34 vs. 4.63 ± 1.74 p = 0.003) and after HD (5.00 (3.53–6.78) vs. 3.79 ± 1.47 p = 0.010) than it was in patients without this complication. No relationship was observed between CIA-CS and IDH. IDH patients had a significantly higher UF rate; however, they did not differ compared to complication-free patients either in anthropometric or laboratory parameters. Conclusions: Patients with IDH were characterized by lower pre- and post-HD circumferential strain of the common carotid artery. The lower CCA-CS showed that impaired vascular reactivity is one of the most important risk factors for this complication’s occurrence.

Background: Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist, has favorable effects on cardiorenal outcomes in patients with predominantly stage 3 or 4 chronic kidney disease (CKD) with severely elevated albuminuria and type 2 diabetes. The use of finerenone in patients with type 2 diabetes and a wider range of CKD is unclear. Methods: In this double-blind trial, we randomly assigned patients with CKD and type 2 diabetes to receive finerenone or placebo. Eligible patients had a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of 30 to less than 300 and an estimated glomerular filtration rate (eGFR) of 25 to 90 ml per minute per 1.73 m2 of body-surface area (stage 2 to 4 CKD) or a urinary albumin-to-creatinine ratio of 300 to 5000 and an eGFR of at least 60 ml per minute per 1.73 m2 (stage 1 or 2 CKD). Patients were treated with renin-angiotensin system blockade that had been adjusted before randomization to the maximum dose on the manufacturer's label that did not cause unacceptable side effects. The primary outcome, assessed in a time-to-event analysis, was a composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. The first secondary outcome was a composite of kidney failure, a sustained decrease from baseline of at least 40% in the eGFR, or death from renal causes. Safety was assessed as investigator-reported adverse events. Results: A total of 7437 patients underwent randomization. Among the patients included in the analysis, during a median follow-up of 3.4 years, a primary outcome event occurred in 458 of 3686 patients (12.4%) in the finerenone group and in 519 of 3666 (14.2%) in the placebo group (hazard ratio, 0.87; 95% confidence interval [CI], 0.76 to 0.98; P = 0.03), with the benefit driven primarily by a lower incidence of hospitalization for heart failure (hazard ratio, 0.71; 95% CI, 0.56 to 0.90). The secondary composite outcome occurred in 350 patients (9.5%) in the finerenone group and in 395 (10.8%) in the placebo group (hazard ratio, 0.87; 95% CI, 0.76 to 1.01). The overall frequency of adverse events did not differ substantially between groups. The incidence of hyperkalemia-related discontinuation of the trial regimen was higher with finerenone (1.2%) than with placebo (0.4%). Conclusions: Among patients with type 2 diabetes and stage 2 to 4 CKD with moderately elevated albuminuria or stage 1 or 2 CKD with severely elevated albuminuria, finerenone therapy improved cardiovascular outcomes as compared with placebo. Bayer; FIGARO-DKD ClinicalTrials.gov (NCT02545049) 176.082 JCR (2021) Q1, 2/172 Medicine, General & Internal 24.907 SJR (2021) Q1, 2/2489 Medicine (miscellaneous) No data IDR 2021 UEM

The doubly and mono doped nanocrystalline mixed oxides Ce1-x-yYbyPdxO2-δ (y up to 0.4, x up to 0.2) were synthesized with the reversed microemulsion method. The morphology, microstructure and composition of the samples were investigated by TEM, EDS, XRD, XAFS, and DFT calculations of XANES spectra. The main aim of the study was the determination of the influence of an additional ytterbium content on structural and electronic properties of the Pd-doped ceria mixed oxide, i.e., the comparative discussion of the results obtained for Ce1-xPdxO2-δ and Ce1-x-yYbyPdxO2-δ. All samples were homogeneous fluorite-type nanocrystallites with very small size (3–5 nm). Reducibility studies revealed strong hydrogen consumption in these systems at low temperatures without any changes of their structure. The XANES and EXAFS spectra for Ce1-x-yYbyPdxO2-δ indicate a partial reduction of palladium at 200 °C and almost complete (90%) at 500 °C in hydrogen. The presence of ytterbium in Ce1-x-yYbyPdxO2-δ prevents the formation of metallic particles in reducing atmosphere (up to 500 °C) and strongly inhibits crystal growth of the mixed oxide.

Purpose Pentraxin 3 (PTX-3) is an acute phase protein that belongs to the pentraxin superfamily. It is synthesized locally at the site of inflammation and its levels are related to the damage of blood vessels. There are only a few studies examining the relationship between PTX-3 and chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the serum levels of PTX-3 and relative PTX-3 gene expression in COPD patients and their correlations with cigarette smoking history and lung function. Materials/methods A total number of 34 participants were enrolled into this study. Only stable patients without comorbidities were recruited. After obtaining written informed consent all planned procedures were performed (pre- and post-bronchodilator spirometry, blood samples for PTX-3 serum levels and PTX-3 gene expression measurements, demographical data, medical history, COPD patients were also asked for CAT and MMRC questionnaires). Results PTX-3 serum levels were significantly higher in the COPD group (29.22 (5.47) ng/ml vs. 14.64 (3.64) ng/ml). PTX-3 gene relative quantification (RQ) values were also significantly higher in the COPD group (0.15 (1.33) vs. -2.80 (1.99)). No differences in CRP serum levels were found between the control group and the COPD group. Conclusions Our study demonstrates that serum levels of PTX-3 and the relative expression values of its gene are elevated in COPD, and can be related to cigarette smoking history.

A forty-seven-year-old recipient in late period after kidney transplantation with chronic estimated glomerular filtration rate (eGFR) 30 mL/min/1.73 m2, fully vaccinated against COVID-19 was diagnosed with SARS-CoV-2 infection in November 2021. After an initially mild course of the disease, he developed multiorgan failure requiring periodic respiratory and dialysis therapy. Covid-19 disease was complicated by multiple infections such Clostridioides difficile infection, Streptococcus epidermidis bacteriemia, Klebsiella pneumoniae and Candida glabrata urinary tract disease, cytomegalovirus infection and oral candidiasis. In a short period, he was readmitted to the hospital twice with recurrent Klebsiella pneumoniae urosepsis. One of those hospitalizations was also complicated by another COVID-19 infection that was confirmed with non-reactive neutralizing antibody. Due to severe infections the patient required individualized modification of immunotherapy; however, due to their recurrence it was finally decided to be discontinued. The patient was also reintroduced to hemodialysis therapy and no infections occurred since then.

The purpose of this in vitro study was to determine the effects of 13 mouth rinses on one hundred Candida strains isolated from the oral cavity of patients. Five of the rinses had no antifungal activity. Chlorhexidine, Colgate and Dentosept acted on all isolated strains; Corsodyl did not act on C. glabrata (2 strains), Octenidol on C. glabrata and C. guilliermondii (1 each), Sylveco on C. tropicalis (2), Oral B on C. parapsilosis, Curasept did not affect 17 strains, including on C. albicans (5), C. guilliermondii (4), C. dubliniensis (3), C. humicola and C. parapsilosis (2 each) and C. glabrata (1). The lowest MIC (the strongest potential activity), was observed for chlorhexidine, followed by Sylveco, Corsodryl and Colgate; in contrast, the highest MIC (the lowest activity) was calculated for Octenidol and Curasept. Eight of the mouthrinses inhibited the in vitro growth of potentially pathogenic fungal strains isolated from the oral cavity at varying dilutions of up to 1:16, depending on the rinse. Chlorhexidine demonstrated strong antifungal efficiency. The antifungal effect of a mouthrinse depends on its composition and the species of fungus. Mouthrinse use is an important complement to procedures ensuring proper oral hygiene and preventing certain oral diseases.

An amendment to this paper has been published and can be accessed via the original article.

Background Ankylosing spondylitis (AS) is an insidiously progressive and debilitating form of arthritis involving the axial skeleton, characterized by chronic back pain and progressive spinal stiffness, and lessening of pain and stiffness with exercise. Due to subsequent manifestation in different organs, AS causes reduction in life expectancy, so early diagnosis and treatment are of great importance. No AS cases have been reported in solid-organ transplant recipients yet. Case presentation A 58-year-old woman with end-stage renal disease due to chronic glomerulonephritis, after allogenic kidney transplantation 25 years earlier, with stable, good graft function, treated with chronic immunosuppressive therapy based on cyclosporine A, mycophenolate mofetil, and prednisone, with no previous history of a connective tissue disease presented fever up to 39 °C accompanied by pain localized in sacroiliac region radiating to the left lower limb. Detailed diagnostic procedures and x-rays of the lumbar spine and of the targeted sacroiliac joints revealed lesions characteristic of AS. Sulphasalazine was added to standard immunosuppression regimen with good clinical results. Conclusions We report an adult kidney transplant recipient with a new onset of AS. The risk of relapse or new onset of inflammatory disease in transplant recipients is extremely low due to immunosuppressive therapy following transplantation. However, when it occurs, the clinical presentation is commonly atypical, often leading to delayed diagnosis.

Background and Aims Chronic hemodialysis (HD) is associated with prolonged immobilization, chronic inflammation, and protein-energy wasting, which can decrease muscle mass and impair their function. HD also contributes to excessive fatigue, decreased functional capacity and exercise tolerance, which influence HD patients’ everyday lives in multiple areas - personal and professional life as well as everyday activities. The study aimed to analyze the relationship between HD patients’ body composition, muscle mass, strength and physical performance, and their reported quality of life (QoL). Method We enrolled adult, stable patients chronically HD for at least 3 months. Patients’ height and weight were measured; their overhydration (calculated as a percentage of dry weight) and body composition (lean tissue mass - LTM, fat tissue mass - FTM) were assessed using an electrical bioimpedance analyzer (BCM Fresenius™). Skeletal muscle mass (SMM) was calculated. The maximal voluntary force of five muscle groups of both lower extremities was assessed with a handheld dynamometer (microFET®2). Physical performance was evaluated with the Short Physical Performance Battery (SPPB), a tool assessing gait speed, chair stand, and balance. All measurements were performed by trained personnel before the same midweek dialysis session. The Short Form-36 (SF-36), EQ-5D and EQ-VAS questionnaires were utilized in self-assessment of QoL and functional capacity. The SF-36 questionnaire consists of two primary components: physical health (PHC) and mental health (MHC). EQ-5D and EQ-VAS assess patients’ health status across five dimensions and their overall health perception. Coexisting conditions were assessed using the Charlson Comorbidity Index (CCI). Laboratory data (red blood cell and iron metabolism parameters, calcium, phosphate, and PTH) from 3 routine monthly assessments preceding the study were collected from medical records. Results We enrolled 60 HD patients (20F, 40M) with a mean age of 61.9±13.5 years and median time of HD of 34.5 (10-81.8) months. Mean LTM% was 48.3±13.2%, FTM% 35.6±9.9% and median overhydration was 0.8 (-0.4-2.7) %. Median SPPB score was 9 (6-11) points; 4 patients presented with severe, 12 with moderate and 44 with mild or no functional limitations. The mean score of CCI was 6.1±2.6 points. The mean SF-36 QoL score was 59.5±17; the score was unrelated to sex (P=.649), age (P=.165) and HD vintage (P=.349). Median values of the PHC and MHC were 54.2 (41.1-69.1) and 67.9 (77.7-17.3), respectively. Both components correlated with each other (R=.67, p SF-36 QoL correlated positively with SMM (R=.36, P=.005), LTM% (R=.39, P=.002) and SPPB scores (R=.28, P=.030), but negatively with FTM% (R=-.36, P=.004). PHC correlated positively with lower extremity muscle strength (R from .29 to .44, every P No significant correlations between laboratory results and other parameters were found. Conclusion Better physical performance, higher lean tissue percentage, higher muscle mass and strength, as well as lower fat percentage and lesser comorbidity burden are associated with better self-perceived quality of life in HD patients - both physical and mental health.

Introduction Recurrent urinary tract infections (UTIs) are a frequent health problem and a common reason for treatment resistance. Objectives The purpose of the study was to evaluate the etiology of community‑ acquired lower recurrent UTI and bacterial antibiotic susceptibility. Patients and methods A total of 796 microbiological urine cultures from 332 patients (280 women and 52 men) treated in a single nephrology outpatient department in central Poland in years 2016 to 2018 were analyzed. The most frequent species responsible for recurrent lower UTI were identified and the susceptibility of all the microbes to specific antibiotics was assessed. The patients' kidney function and inflammation parameters were evaluated. Results The median (interquartile range [IQR]) age of the patients was 65 (59-77) years (women, 69 [57-78] years; men, 67 [62-77] years), median (IQR) glomerular filtration rate was 56.6 (40.2-81.3) ml/min/1.73 m2 with median (IQR) C‑ reactive protein concentration of 3.2 (1.5-7.0) mg/l. There were 43 bacterial species identified: 24 gram‑positive and 19 gram-negative. The analyzed urine cultures contained 977 microbial samples (563 gram‑negative bacteria, 408 gram-positive, 6 fungi). The most common bacteria was Escherichia coli (39.6%) which showed 100% susceptibility to carbapenems, 98.9% to amikacin, 96.5% to piperacillin / tazobactam, and 94.3% to gentamicin. With regard to oral antibiotics, its highest susceptibility was to fosfomycin 95.5%, nitrofurantoin 85.5%, and cefuroxime 82.3%. In 39.9% of cases, E. coli was resistant to fluoroquinolones and in 46.6% to trimethoprim / sulfamethoxazole. Conclusions The most frequently occurring bacteria causing recurrent lower UTI are characterized by significant resistance to the antimicrobial therapy recommended as the first‑ line treatment: fluoroquinolones and trimethoprim / sulfamethoxazole. It seems that the first choice in the treatment of lower UTIs should be: fosfomycin, nitrofurantoin, or cefuroxime.

Electronic properties of pure and Rh/Pd-doped CeO2 materials are studied with the density functional theory (DFT) methods. Although the MBJLDA approach yields a reasonable band gap of CeO2, the position of the Ce 4 f bands inside a gap of such a material may require further correction in the MBJLDA + U manner. The presence of additional transition metal d states in Ce1-xRhxO2 and Ce1-xPdxO2 materials results in their metallic character, which may be diminished due to an oxygen vacancy neighboring to the transition metal atom. The correspondence between the electronic structures of Rh- and Pd-doped CeO2 is discussed based on the density of states plots and X-ray absorption spectra.

Aim: The study aimed to evaluate the usefulness of contrast-enhanced ultrasonography in renal perfusion disorders caused by obstructive uropathy. Case description: We present a case of a patient with a horseshoe kidney, in which the urine outflow from the right part of the kidney was blocked due to the presence of a bladder tumour infiltrating the ureter. Perfusion disorders in both parts of the kidney, visible in computed tomography, were partially reflected in the ultrasound image. Conclusions: Doppler ultrasound and contrast-enhanced ultrasound may be useful for monitoring perfusion disorders in the course of obstructive uropathy, provided that appropriate methodology is developed to compare blood flow in both kidneys.

Background There is little information about circannual rhythm of vitamin D level in kidney transplantation (KTx) patients. Material and Methods In 71 patients (27 females; 44 males) in the long term after KTx (5.5 ± 2.6 years) during the winter and summer months plasma concentration of 25-hydroxyvitamin D (25(OH)D), 1,25-hydroxyvitamin D, parathormone (PTH), fibroblast growth factor 23 (FGF-23), calcium, and phosphorus were assessed. Vitamin D status was classified according to 25(OH)D level (ie, insufficiency, ≤30 ng/mL; deficiency, Results In this study, 96% of KTx patients had vitamin D insufficiency including 37% deficiency during winter and 89% of KTx patients had vitamin D insufficiency and 24% had vitamin D deficiency, respectively, during summer. Mean 25(OH)D level during winter was lower than in summer (17.4 ± 7.1 vs 20.2 ± 7.2 ng/mL; P = .02), similar to calcitriol (163.6 ± 37.4 vs 284.5 ± 77.8 pmol/L; P = .001). There were no significant differences in winter and summer levels of calcium, phosphorus, and PTH. The 25(OH)D level was significantly higher in patients with estimated glomerular filtration rate (eGFR) ≥45 mL/min/1.73 m2 compared with those with lower eGFR (21.6 ± 7.5 vs 17.6 ± 6.0; P = .02) only in the summer time. Conclusions Most of the KTx patients have vitamin D insufficiency during both winter and summer with higher concentration of vitamin D metabolites in summer. Other factors than graft function may have an impact on vitamin D levels in KTx patients.

The concentration dependent up-conversion luminescence of 0.1; 0.2; 0.5; 1; 1.5; 2; 3; 4 and 5% Ho3+ and 20% Yb3+ co-doped β-NaYF4 colloidal nanocrystals have been studied. The obtained nanocrystals were homogenous in size and shape, as well as the crystallographic structure was pure. The absorption spectra, upconversion lifetimes, up-conversion emission and Quantum Yield power dependence have been measured to estimate the optimum doping concentration of Ho3+ ions. The experimental results were supported by the calculations based on Judd-Ofelt theory, in order to quantify the oscillator strengths in absorption and luminescence, excited-state radiative lifetimes, energy-transfer probabilities, and to estimate the quantum efficiencies of this interesting material. We have observed evident trend in rise- and luminescence decay profiles with rising Ho3+ activator concentration, and the 1–2% Ho3+ ions doping was found to be the most efficient nanophosphors.

Objectives Nutritional behaviors may exert important influence on morbidity and graft function in patients after kidney transplantation (KT). Nutritional status is closely related to potential risk factors of developing posttransplant complications, including diabetes mellitus, weight gain, and negative effects on immunosuppressive therapy. The aim of this study was to assess the dietary intake in patients after KT. Design and methods Nutritional intake of 154 (61 women and 93 men) patients was assessed based on a questionnaire regarding food intake (proteins, fats, carbohydrates, cholesterol, sugar, phosphorus, calorific value) within 3 working days preceding the routine outpatient posttransplant visit. Patient medical history, concomitant medications, and estimated glomerular filtration rate (eGFR) was obtained from medical charts. Results The mean age (years) ± SD of patients was 51.9 ± 14.1. The patients were evaluated 94 ± 67 months after KT, with a median eGFR of 53 (range, 41.2-64.1) mL/min/1.73 m2. Sixty-two percent of patients had increased body mass index values. The mean total energy intake was 2159.4 ± 551.9 kcal/day. The patients reported elevated salt (8.5 ± 2.4 g per day) and fat intake (99.4 ± 3.2 g per day) including 57% saturated fatty acids. The patients consumed products containing high amounts of sugars (108.2 ± 107.0 g per day), carbohydrates (238.3 ± 64.3 g per day), and cholesterol (303.6 ± 11.1 mg per day). The diet among kidney recipients consisted predominantly of fats, meat, cured meat, and sweets. Conclusions The nutritional behaviors of patients after KT are in most cases poor. Improvement of eating habits in these patients seems to be a simple method to preserve kidney function over the long term.

Protozoa, such as Trichomonas tenax, Entamoeba gingivalis and Leishmania braziliensis, may be present in the mouth but their role in the pathophysiology of oral diseases is not clear yet. The use of various types of mouthrinses plays an important role in maintaining proper oral hygiene and in removing some of the microbial components from the oral cavity. The purpose of this study was to investigate the effects of selected mouthrinses on the reference strains of Trichomonas tenax and Entamoeba gingivalis which can be a part of the oral cavity microbiota. Two standard strains Trichomonas tenax (ATCC 30207) and Entamoeba gingivalis (ATCC 30927) were used and metronidazole as a drug used in the treatment of infections caused by protozoa as well as fourteen agents used as mouthwashes were tested, with two pure compounds acting as mouthrinse ingredients, i.e. 20% benzocaine and 0.2% chlorhexidine, as well as 12 commercially-available formulas: Azulan, Colgate Plax Complete Care Sensitive, Corsodyl 0.2%, Curasept ADS 205, Dentosept, Dentosept A, Eludril Classic, Listerine Total Care, Octenidol, Oral-B Pro-Expert Clinic Line, Sylveco and Tinctura salviae. The protozoonicidal activity of the preparations was evaluated on the basis of the ratio of dead to living ratios after incubation in an incubator (37°C) for 1, 10 and 30 min. Protozoa were counted in the Bürker chamber in each case up to 100 cells in an optical microscope (over 400×). The criterion for the death of protozoa was the lack of movement and changes in the shape and characteristics of cell disintegration. The curves of activity were obtained after experiments conducted for 5–7 different solutions of each preparation. On the basis of the curves, the solution killing 50% of the population (CL50) was calculated. All mouthrinses tested in this work in their undiluted form acted lethally on both protozoa. Benzocaine, used as a local anesthetic, has etiotropic properties which can be useful for supporting antiprotozoal treatment. Chlorhexidine confirmed its high efficiency in the eradication of potentially pathogenic protozoa. The use of mouthrinses is an important complement for other procedures intended to maintain correct oral hygiene.

Introduction: Tacrolimus (TAC) metabolism rate has the potential to impact graft function after kidney transplantation (KTx). We aimed to analyze the relationship between the early post-KTx TAC C/D ratio (blood trough concentration normalized by total daily dose) and kidney graft function in a 2-year follow-up. Methods: We retrospectively analyzed data from 101 post-KTx patients at 3, 6, 12, and 24 months after KTx to identify the C/D ratio cutoff value optimal for dividing patients into fast and slow TAC metabolizers. We investigated the relationship between their TAC metabolism rate and graft function. Results: Patients were divided based on the TAC C/D ratio at 6 months after KTx of 1.47 ng/mL * 1 mg. Fast metabolizers (C/D ratio p < 0.05 at each timepoint) and were significantly less likely to develop good graft function (estimated glomerular filtration rate ≥45 mL/min/1.73 m2) than slow metabolizers. Our model based on donor and recipient age, recipient sex and slow/fast metabolism status allowed for identification of patients with compromised graft function in 2-year follow-up with 66.7% sensitivity and 94.6% specificity. Conclusion: Estimating TAC C/D ratio at 6 months post-KTx might help identify patients at risk of developing deteriorated graft function in a 2-year follow-up.

Background: Among diabetics, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality, and progression of their underlying disease. Finerenone is a novel, non-steroidal, selective mineralocorticoid-receptor antagonist which has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD), while revealing only a low risk of hyperkalemia. However, the effect of finerenone on renal and CV outcomes has not been investigated in long-term trials yet. Methods: The Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease ­(FIDELIO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important renal and CV outcomes in T2D patients with CKD. FIDELIO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 5.5 years. FIDELIO-DKD randomized 5,734 patients with an estimated glomerular filtration rate (eGFR) ≥25–2 and albuminuria (urinary albumin-to-creatinine ratio ≥30–≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of kidney failure, a sustained decrease of eGFR ≥40% from baseline over at least 4 weeks, or renal death. Conclusion: FIDELIO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of renal and CV events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen.

Cerium mixed oxides are interesting materials for the oxygen storage capacity due to the Ce ability to valence state changes and oxygen vacancy formation. The mixed-valence state Ce4+/Ce3+ in Ce0.7Yb0.2Pd0.1O2-δ has been studied by in situ Ce L3 X-ray Absorption Near Edge Structure (XANES) spectroscopy during the reduction from room temperature to a 500 °C. The cerium ions start to reduce in the mixed oxide lattice at a temperature of 70 °C. 13% of Ce3+ has been detected in the studied sample during the reduction at a temperature of 70 °C. 26% of Ce4+ were reduced to Ce3+ at a temperature of 200 °C. No other changes were found in the Ce valence state up to the temperature of 500 °C. The most interesting result is that the reduction of Ce4+ to Ce3+ starts clearly before the reduction of the noble metal. The redox activity temperature range of Ce in mixed oxides is significantly lower than reported by other authors. The total density of states (DOS) of Ce0.7Yb0.2Pd0.1O2-δ is very similar to that of Ce0.875Pd0.125O2. The theoretical calculations using the Density Functional Theory method supported the experimental Ce L3 XANES spectra. It was shown that the presence of Yb and Pd ions could enhance the formation of oxygen vacancies in cerium mixed oxides.

Within this paper the simultaneous local structural analysis of the highly reducible mixed oxides catalysts Ce0.9Pd0.1O2-δ and Ce0.7Yb0.2Pd0.1O2-δ is presented under reduction and oxidation conditions at elevated temperatures up to 500 °C. In situ X-ray Absorption Fine Structure characterization shows that during the reduction up to 80 °C no changes are observed in both of the exemplarily studied samples. The oxidation of the Ce1-xPdxO2-δ sample continuously introduces changes in the structure over the whole temperature range while for the Ce0.7Yb0.2Pd0.1O2-δ sample oxidation is completed already at 200 °C. The metallic palladium cluster formation in both studied samples was followed by Extended X-ray Absorption Fine Structure (EXAFS) studies. The presence of the Yb atoms affects the formation time and the Pd cluster size. It was found that during the reduction process the palladium cluster creation is initiated at higher temperatures for the Ce0.9Pd0.1O2-δ sample than for the Ce0.7Yb0.2Pd0.1O2-δ sample. The higher percentage of Pd atoms creates metallic palladium clusters in the Ce0.9Pd0.1O2-δ sample.

Diabetes is a heterogenous group of diseases with chronic hyperglycemia, which is associated with the risk of many complications, including diabetic kidney disease. Micro- and macroangiopathy in hyperglycemic environment leads to organ failure, including end-stage renal disease, requiring dialysis or kidney transplantation. However, diabetes is not the only cause leading to kidney dysfunction in this patient population. A patient with diabetes should be monitored regularly for proteinuria and glomerular filtration rate and depending on advancement of kidney disease or suspicion other than diabetes cause of kidney damage, should also be covered by nephrological care. Appropriately selected hypoglycemic drugs and their doses, in combination with appropriate non-pharmacological treatment, in the patients with different stages of kidney disease, not only reduces the risk of drug-induced side effects but, above all, may slow the progression of kidney damage and reduce the risk of other complications in this group of patients. Recently, there have been many new groups of hypoglycemic agents that can be used in the treatment of patients with kidney disease. The aim of this study is to present the current possibilities of hypoglycemic therapy in patients with different stages of chronic kidney disease. In addition, the relationship between individual groups of hypoglycemic agents and the renal benefits and risk was analyzed.

INTRODUCTION Observational studies have shown that high dietary intake of vitamin K-2 is associated with reduced risk of coronary vascular disease and vascular calcification. OBJECTIVES We assessed the effect of vitamin K-2 substitution on the progression of atherosclerosis and calcification in nondialyzed patients with CKD stages 3-5. PATIENTS AND METHODS The study included 42 nondialyzed patients with CKD. The following measurements were taken at baseline and after 270 +/- 12 days of supplementation with vitamin K-2 at a dose of 90 mu g (menaquinone, MK-7) together with 10 mu g of cholecalciferol (K+D group) or 10 mu g of cholecalciferol (group D): common carotid intima-media thickness (CCA-IMT), coronary artery calcification score (CACS), basic biochemical parameters, lipids, and calcification modulators: matrix Gla protein (MGP), desphosphorylated-uncarboxylated MGP (dp-ucMGP), osteoprotegerin (OPG), fetuin A, osteocalcin (OC), and fibroblast growth factor 23. RESULTS The increase of CCA-IMT was significantly lower in the K+D group compared with the D group: from 0.95 +/- 0.2 mm to 1.01 +/- 0.3, P = 0.003 vs from 1.02 +/- 0.2 mm to 1.16 +/- 0.3, P = 0.003 (Delta CCA-IMT, 0.06 +/- 0.08 vs 0.136 +/- 0.05 mm, P = 0.005, respectively). The increase in CACS was slightly lower in the K+D group than in the D group (Delta CACS, 58.1 +/- 106.5 AU vs 74.4 +/- 127.1 AU, P = 0.7). In the K+D group, a significant decrease in the level of dp-ucMGP and total OC was observed. CONCLUSIONS A 270-day course of vitamin K-2 administration in patients with CKD stages 3-5 may reduce the progression of atherosclerosis, but does not significantly affect the progression of calcification. Vitamin K-2 significantly changes the levels of calcification promoters and inhibitors: dp-ucMGP, OC, and OPG.

This work highlights the importance of in situ experiments for an improved understanding of graphene growth on copper via metal-catalyzed chemical vapor deposition (CVD). Graphene growth inside the chamber of a modified environmental scanning electron microscope under relevant low-pressure CVD conditions allows visualizing structural dynamics of the active catalyst simultaneously with graphene nucleation and growth in an unparalleled way. It enables the observation of a complete CVD process from substrate annealing through graphene nucleation and growth and, finally, substrate cooling in real time and nanometer- scale resolution without the need of sample transfer. A strong dependence of surface dynamics such as sublimation and surface premelting on grain orientation is demonstrated, and the influence of substrate dynamics on graphene nucleation and growth is presented. Insights on the growth mechanism are provided by a simultaneous observation of the growth front propagation and nucleation rate. Furthermore, the role of trace amounts of oxygen during growth is discussed and related to graphene-induced surface reconstructions during cooling. Above all, this work demonstrates the potential of the method for in situ studies of surface dynamics on active metal catalysts.

Purpose The aim of the study was to compare the susceptibility of Candida species to caspofungin and itraconazole. Material and methods 118 strains of Candida species were used in the study: 8 pattern strains and 110 strains isolated from different ontocenoses. The susceptibility of fungi strains to drugs was determined by diffusion in agar gel. The minimal inhibitory concentration (MIC) was calculated from the linear regression equation with the use of the method by Kadlubowski. Results The MIC value for caspofungin for the pattern strains ranged from 0.321 mg/L to 0.552 mg/L and for itraconazole from 0.019 mg/L to 0.11 mg/L. All the analyzed strains isolated from patients exhibited susceptibility to caspofungin; 5 strains of Candida albicans (8.06%) proved to be resistant to itraconazole. The MIC values for caspofungin ranged from 0.114 mg/L to 1.26 mg/L and for itraconazole from 0.012 mg/L to 16.1 mg/L. Conclusions 1. All the studied pattern strains are susceptible to the examined drugs; all those isolated from patients show susceptibility to caspofungin; some Candida albicans strains (8.06%) are resistant to itraconazole. 2. The mean MIC values calculated from the activity curves are 0.426 mg/L for caspofungin and 1.0245 mg/L for itraconazole. 3. The mean MIC values calculated for caspofungin are lower than for itraconazole in the case of Candida albicans, C. glabrata and C. tropicalis. Having compared the influence of the drugs on C. famata, C. lusitaniae, C. parapsilosis and C. ciferri we proved there are statistically significant differences (0.0046>p

T-wave changes in electrocardiogram frequently accompany conditions related to myocardial ischemia. A variety of other events are also known to result in giant T-wave inversion (GTWI). The advanced stages of chronic kidney disease carries a cluster of several traditional and uremia-specific cardiovascular risk factors and is associated with risk for electrolyte imbalance and venous thromboembolism, all being the possible reasons for GTWI. GTWI presents a diagnostic challenge for physicians. Medicine specialists should beware of overly one-sided clinical attention and consider diverse and complex basis of the observed signs and symptoms.

At the core of luminescence color and lifetime tuning of rare earth doped upconverting nanoparticles (UCNPs), is the understanding of the impact of the particle architecture for commonly used sensitizer (S) and activator (A) ions. In this respect, a series of core@shell NaYF

Nanocrystalline (4–5 nm) Ce 1− x Ru x O 2 mixed oxides ( x = 0.03–0.16) were synthesized using water in oil microemulsion method. Morphology, microstructure and a phase composition of the samples subjected to heat treatment in oxidizing and reducing atmosphere were investigated by TEM, SEM-EDS-EBSD, XRD and XPS. Oxide with x = 0.11 was structurally stable in oxidizing atmosphere up to 550 °C but above this temperature it decomposed into Ru deficient, nanosized Ce 1− x Ru x O 2 and large (few μm) RuO 2 crystals. No phase separation was observed for Ce 0.97 Ru 0.03 O 2 even after heating at 800 °C. Doping with Ru decreases the size of ceria particles and strongly hinders their sintering at high temperatures. In hydrogen atmosphere a segregation of small (∼1 nm) Ru crystallites occurred at the surface of the Ce 0.89 Ru 0.11 O 2 mixed oxide. Only small increase of the mean crystallite size of Ru (to 2 nm) occurred after reduction at 1000 °C. The unique resistance of Ru to sintering is assigned to a special epitaxial orientation Ru (0 0 2)∥CeO 2 (1 1 1), which persisted up to the highest temperature of reduction, due to very strong surface bonding. Contrary to a situation in oxidizing atmosphere, doping with Ru had no significant effect on the sintering of ceria in hydrogen. Partial substitution of Ru for Ce strongly enhances the reducibility of ceria at low temperatures and its activity in catalytic combustion of CO and soot.

Purpose: Graft parenchyma perfusion disturbances (GPPD) in transplanted kidneys are common in the early postoperative period. Rapid and accurate diagnosis can guide proper treatment, preventing graft dysfunction. Methods: One hundred and eighty patients, who underwent kidney transplantation (KTx), were examined in the immediate postoperative period using real-time ultrasonography (B-mode) with color and power Doppler (US-CD/PD) and B-flow ultrasound, as well as with an additional protocol of contrast-enhanced ultrasonography (CE-US). Regions of GPPD were localized and measured. The number and size of these areas were compared between the two acquisition techniques. Follow-up examinations were carried out 6 months postoperatively. Results: CE-US revealed more GPPDs and showed them more precisely than the B+US-CD/PD/B-flow technique. Moreover, in the CE-US examination, ischemic foci had statistically significant higher echogenicity in comparison to normal parenchyma, were larger and better visualized (better circumscribed) than in B+US-CD/PD/B-flow. Conclusion: CE-US allows the visualization of GPPD caused by occlusion of small arteries. It is a noninvasive, safe, real-time method, which has many advantages over standard B+US-CD/PD/B-flow examinations, and we recommend it as a routine diagnostic procedure in the early postoperative period following KTx.

Background Routine B-mode ultrasound examination (rB-US) is a current standard for the assessment of the transplanted kidney(KTx) in the early post-operative period. The alteration of perirenal hematoma (PH) echostructure over time limits their detectability and size assessment with rB-US. The aim of this study was to evaluate the diagnostic value of contrast-enhanced ultrasound (CE-US) in diagnosing PH of KTx in the early post-operative period. Method Routine B-US and CE-US of KTx, performed in 102 patients in the early post-operative period, were analyzed. CE-US was performed after intravenous administration of 2.4 mL of sulfur hexafluoride solution. The data were analyzed with respect to the occurrence and thickness of PH. Result The difference in echogenicity between PH and kidney parenchyma was modest in rB-US (mean of 5.7 dB). However, in CE-US, the difference in echogenicity was significantly increased (mean of 31.4 dB). Routine B-US did not allow PH to be recognized in 18 patients. The application of CE-US results in a twofold increase in PH detection when compared with rB-US (33.3% vs. 15.7%). Conclusion US-CE examination is a valuable method for detection and assessment of PH size. Compared with rB-US, this technique may substantially increase the detectability of hemorrhagic complications in the direct post-operative period.

Nanoparticles of cobalt(II) chromite, CoCr2O4, have been prepared by hydrothermal synthesis at 230 °C and firing of the obtained nanosized sample at various temperatures. The effect of particle size on the structure and properties of CoCr2O4 nanoparticles has been investigated using the XRD, TEM, diffuse reflectivity, Raman and infrared spectroscopy. The results show that simple hydrothermal synthesis yields material composed of very small crystalline particles with the average size of about 7 nm. Annealing of this sample allows obtaining particles with different sizes. Raman and IR studies show that in addition to the bands characteristic for normal spinel structure, a few additional broad bands appear due to the cation redistribution among the tetrahedral and octahedral sites. Intensity of these bands significantly increases for the samples annealed at lower temperatures. This result shows that with decreasing particle size the cation redistribution is tending towards more inverse spinel configuration compared to bulk, which is predominantly normal spinel. This conclusion is supported by the optical spectra of the obtained samples. Raman and IR spectra also indicate weak phonon confinement effect in CoCr2O4. Significantly larger phonon confinement effect is observed only for the 379 cm−1 IR-active mode involving motions of Cr(III) atoms located at the octahedral sites.

Nanocrystalline (4–5 nm) Ce 1− x Rh x O 2− y mixed oxides ( x = 0.03–0.21) were synthesized using water in oil microemulsion method. Morphology, microstructure and phase composition of the samples subjected to heat treatment in oxidizing and reducing atmosphere were investigated by TEM, SEM-EDS, XRD, Raman and IR spectroscopy. Samples with x ≤ 0.16 were structurally stable in oxidizing atmosphere up to 850 °C. Above this temperature the samples decomposed into Rh deficient, nanosized Ce 1− x Rh x O 2− y and large (few μm) Rh 2 O 3 crystals. In hydrogen atmosphere segregation of small (1–2 nm) Rh crystallites in special epitaxial orientation Rh (1 1 1)||CeO 2 (1 1 1) started at 500 °C. The epitaxial orientation of small Rh crystallites was preserved up to 1000 °C indicating their strong bonding to the ceria surface. Partial substitution of Rh for Ce strongly enhanced reducibility of ceria at low temperatures (below 200 °C) and hindered the sintering of ceria at high temperatures. Ce 0.89 Rh 0.11 O 2− y shows an interesting property of reversible extraction–dissolution of Rh upon reduction–oxidation cycles at 500 °C which is important for potential catalytic applications.

BACKGROUND Transplant renal artery stenosis (TRAS) is a serious vascular complication due to non-specific clinical manifestations, causing serious diagnostic difficulties. Contrast-enhanced ultrasound (CE-US) can complement standard sonographic examination in evaluation of TRAS. MATERIAL AND METHODS Standard ultrasound B presentation, extended with color Doppler assessment of the flow spectrum and CE-US, was carried out in the early postoperative period in a group of 180 patients who underwent kidney transplantation. In CE-US analysis, the maximum contrast agent perfusion to the cortex and renal pyramids was evaluated. In 15 patients with sonographically diagnosed TRAS, magnetic resonance angiography and computer tomography angiography were performed to confirm the diagnosis. RESULTS In patients with TRAS, significantly longer time of contrast agent (CE) inflow was observed in comparison to patients without perfusion disturbances (3.47 s vs. 1.5 s, p

BACKGROUND Both adiposity and underweight are negatively associated with graft and patient survival after kidney transplantation (KTx). The aim of this longitudinal study was to evaluate the changes in body mass index (BMI) after KTx and their relations with graft damage markers. MATERIAL AND METHODS The anthropometric measurements of body mass and height were performed in 92 consecutive deceased donor kidney transplant recipients (37 F; 55 M) from a single transplant center. Patient medical history, estimated glomerular filtration rate (eGFR), serum lipids, and ACR (urine albumin-to-creatinine ratio) was obtained from medical charts. RESULTS KTx recipients were on average 3.4±2.5 years after transplantation. Mean body BMI before KTx were 25.3±4.3 kg/m2 and increased after transplantation to 27.0±4.6 kg/m² (p=0.01). BMI increase after KTx was noted in 65% of recipients, most often in patients with normal pre-KTx BMI. Kidney function was better in patients with normal post-KTx BMI (55.2±15.8 ml/min/1.73 m²) than in obese patients (48.0±20.3 ml/min/1.73 m², p

Pure and chromium(III) doped nanosized Al 2 (WO 4 ) 3 was prepared by co-precipitation method. X-ray, transmission electron microscopy, vibrational, absorption and luminescence studies of the obtained nanoparticles are reported. The particle size of the obtained samples ranged from about 20 nm to a few hundreds of nm. Raman and IR studies showed that vibrational properties have been modified in comparison with the bulk material, indicating that with decreasing particle size some weak structural changes are induced in Al 2 (WO 4 ) 3 . The luminescence revealed that the prepared materials have similar properties as the bulk material and chromium(III) ions occupy sites of intermediate crystal field strength. Nevertheless, the obtained results indicate that the electron–phonon coupling slightly decreases with decreasing particle size.

Nanocrystalline (4–8 nm) Ce 1− x Pd x O 2 − y mixed oxide (0 x x 2 (1 1 1) orientation, preserved even after reduction at 800 °C. Ce 0.89 Pd 0.11 O 2− y oxide showed reversible extraction–dissolution of Pd upon successive reduction–oxidation cycles at 500 °C, which is an example of “self-regenerative” property important for potential catalytic applications. Doping with Pd strongly hinders the sintering of ceria at high temperatures and enhances its reducibility at low temperatures (below 500 °C). “As prepared”, oxidized Ce 0.89 Pd 0.11 O 2− y sample demonstrates moderate activity in CO oxidation (reaching 85% conversion at ∼250 °C) similar to that of 3% Pd/CeO 2 prepared by impregnation. The activity improves dramatically (measurable CO conversion below room temperature and 100% conversion at ∼120 °C) after pre-reduction at 400 °C in H 2 . It appears that partially reduced Pd species, or extremely small particles (

Summary Background: During routine ultrasonographic examination in B presentation, performed as a standard diagnostic procedure during the early post-operative period, the most important problem with the interpretation of the images of perirenal haematoma is their ability to change in time. The aim of this work was to assess the echogenicity and the size of perirenal haematomas in patients after kidney transplant during routine examinations in B presentation and during examinations enhanced with a contrast medium (CE-US). Material/Methods: Thirty-seven patients after kidney transplant were examined using standard examination in B presentation. Sixteen patients (7 women and 9 men) with isoechogenic and hypoechogenic areas visualized within the renal parenchyma, who were suspected of perirenal haematoma, underwent a CE-US examination after intravenous administration of sculpture hexafluoride (dose: 2.4 ml/ examination). Using time-intensity curves (TIC), changes in the values were analysed for two areas of interest (ROI): in the renal parenchyma and in the areas identified during standard US as haematomas. Identical examination protocols and dynamic data loops allowed the acquisition of identical kidney cross-sections and enabled measuring the echogenicity and thickness of the abnormalities at the same location. Results: During the routine B presentation examination, the average difference between haematoma and the renal cortex was 5 dB. When performing US-CE examination, a significantly greater difference in echogenicity was observed and reached 31 dB. In six patients, the size of haematomas was comparable using both techniques, whereas in ten patients lesions visualized in B presentation were smaller than in the US-CE examination. Conclusions: The US-CE examination demonstrated a greater, statistically significant, difference in the echogenicity of perirenal haematomas compared to the routine examination in B presentation. This method enabled a more detailed assessment of the size of haematomas in the perirenal space that appeared during early post-operative period.