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Is Chronic Kidney Disease Reversible?

(2000) Glomerular hypertension, abnormal glomerular growth, and progression of renal diseases. Kidney Int Suppl 75: S1521 8.Klahr S, (1990) Progression of chronic renal disease; Nutrition., 6(3):207-212. 9.Shankland SJ. 2006 The podocyte’s response to injury: role in proteinuria and glomerulosclerosis. Kidney Int. 69(12):2131-47. 10.Nagata M. 2016 Podocyte injury and its consequences. Kidney Int. 89(6):1221-30 11.Lee HS, 2012 Mechanisms and consequences of TGF-ß overexpression by podocytes in progressive podocyte disease. Cell Tissue Res. 347

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Acute Coronary Syndrome Following Long-Term Erlotinib Treatment


Introduction. The treatment of neoplasia has advanced due to targeted molecular therapies. Erlotinib, a tyrosine kinase inhibitor that acts by blocking epidermal growth factor receptor (EGFR), is used to treat advanced or metastatic chemotherapy-resistant non-small cell lung cancers (NSCLC).

Erlotinib is a safe and well tolerated medication. Although the most common adverse effects are cutaneous or gastrointestinal, its cardiotoxicity is an important topic in the treatment and follow-up of neoplastic patients.

Clinical case. A 76-year-old male patient with 40 Pack Year history of smoking that has quitted 20 years ago, was admitted in 2009 for night sweats, dry cough and weight loss. He is diagnosed with lung cancer in the right upper lobe (T4N2M1), with the histopathological diagnosis of clear cell adenocarcinoma. The patient performs radiotherapy and chemotherapy with 6 series of Gemcitabine and Cisplatin with partial response, followed by Erlotinib treatment with favorable progression with regression of tumor size.

In December 2017, he presents recurrent episodes of atypical angina lasting about 2 weeks. The electrocardiographic examination reveals ST segment elevation, with tall T waves and Q waves are present in the lower branches, associated with the increase of myocardial necrosis enzymes. Echocardiography highlights inferior hypokinesia with left ventricle ejection rate estimated at 45%. The patient has a favorable evolution during admission without recurrence of pain. Coronary angiography is performed at distance with evidence of vascular atherosclerotic lesions and the installation of active pharmacodynamic stents.

Discussions. Tyrosine kinase inhibitors may be the cause of acute coronary events both by affecting myocardiocytes following EGFR inhibition, but also by increasing atheromatic plaque instability and by prolonging theQT segment.

In conclusion a systemic cardiologic assessment of Erlotinib-treated patients may be recommended throughout the course of therapy.

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Pulmonary tuberculosis with atypical presentation because of unknown previous HIV infection – case report


Background: People coinfected with tuberculosis (TB) and human immunodeficiency virus (HIV) are 20–37 times more likely to develop active TB disease than non-HIV-infected people. Syndemic interaction between HIV and TB epidemics has made testing for TB a must for HIV-infected people and vice versa. We present the case of a young male diagnosed with HIV infection, due to mandatory HIV testing for all TB cases in Romania.

Case presentation: A 30-year-old man was hospitalized for fever, chills and productive cough not influenced by previous antibiotic home treatment. He was admitted with tachycardia and bilateral presence of coarse crackles in lower pulmonary areas. Chest X-ray suggested bilateral bronchopneumonia; the results from blood tests showed inflammation, leukocytosis and anaemia. Hemocultures were negative. Under wide-spectrum antibiotic treatment, his general condition partially improved, but on the seventh day, chest X-ray revealed abscess in the left inferior lobe and the progression of previous lesions. Chest computed tomography revealed multiple large consolidation areas in both lung areas, a 13 cm diameter abscess and multiple mediastinal adenopathy of 2–4 cm in diameter. Acid fast bacilli smear from sputum was positive. After the diagnosis of pulmonary TB, anti-TB treatment was started; the patient was subsequently diagnosed with HIV infection. He received specific anti-TB treatment, and 3 weeks later, retroviral treatment was initiated. Clinical evolution was favourable and radiological appearance improved. In addition, he did not present any adverse effects of therapy.

Conclusions: HIV testing for all TB cases is a must because HIV-TB coinfection raises important diagnostic and treatment problems.

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Clinical Ankle Involvement and Ultrasound Synovial Hypertrophy are Significant Predictors of DAS28-Defined Rheumatoid Arthritis Disease Activity

Remission Induced by Synthetic and Biological Modifying Disease Drugs. Reumatol Clin. 2017. 24. Sewerin P, Vordenbaeumen S, Hoyer A, Brinks R, Buchbender C, Miese F, et al. Silent progression in patients with rheumatoid arthritis: is DAS28 remission an insufficient goal in RA? Results from the German Remission-plus cohort. BMC Musculoskelet Disord. 2017;18(1):163. 25. Schoels M, Aletaha D, Funovits J, Kavanaugh A, Baker D, Smolen JS. Application of the DAREA/DAPSA score for assessment of disease activity in psoriatic arthritis. Ann Rheum Dis. 2010

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Present and Future in Treatment of Hodgkin Lymphoma

: 0732-183X) 5. Moskowitz CH, Nademanee A, Masszi T, et al. - Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin's lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebocontrolled, phase 3 trial; Lancet. 2015; 385(9980):1853-62 (ISSN: 1474-547X) 6. Younes A, Bartlett NL, Leonard JP, et al. - Brentuximab vedotin (SGN-35) for relapsed CD30-positive lymphomas, N Engl JMed. 2010; 363(19):1812-21 (ISSN: 1533-4406) 7. Ansell SM, Lesokhin AM, Borrello I, et al

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NGAL – Urinary Biomarker With Pathologic Significance in Nephrology Practice

antibody-negative pauci-immune crescentic glomerulonephritis. J Nephrol. 2009 Jul-Aug;22(4):491-6. 24. Torres-Salido MT et all Neutrophil gelatinase-associated lipocalin as a biomarker for lupus nephritis Nephrology Dialysis Transplantation, Volume 29,Issue 9, 1 September 2014, Pages 17401749, 25. Rhee H et all, High serum and urine neutrophil gelatinase associated lipocalin levels are independent predictors of renal progression in patients with immunoglobulin A nephropathy Korean J Intern Med. 2015 May; 30(3): 354361

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Endoscopic Mucosal Phenotypes in the Helicobacter Pylori Infection

pylori evolution during progression from chronic atrophic gastritis to gastric cancer and its impact on gastric stem cells. Proc Natl Acad Sci U S A. Mar 2008;105(11):4358-63. [Medline]. 17. Luther J, Dave M, Higgins PD, Kao JY. Association between Helicobacter pylori infection and inflammatory bowel disease: A meta-analysis and systematic review of the literature. Inflamm Bowel Dis. Sep 16 2009;epub ahead of print. [Medline]. 18. Jackson L, Britton J, Lewis SA, et al. A populationbased epidemiologic study of Helicobacter pylori infection and i t s

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How Epstein-Barr Virus “Manipulates” The Tumoral Microenvironment in Hodgkin Lymphoma?

in pediatric classical Hodgkin lymphoma: association with Epstein-Barr virus, lymphocyte subsets, and prognostic impact, 2012, Clin Cancer Res 18:3762–3771 37. Tan KL, Scott DW, Hong F, et al. – Tumor associated macrophages predict inferior outcomes in classic Hodgkin lymphoma: a correlative study from the E2496 intergroup trial, 2012, Blood 120:3280–3287 38. Mantovani A, Schioppa T, Porta C, et al. - Role of tumor associated macrophages in tumor progression and invasion, 2006, Cancer Metastasis Rev 25:315–322 39. Murdoch C, Muthana M, Coffelt SB

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