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Nephrocalcinosis in phosphate nephropathy following oral phosphate purgative: a role for underlying subclinical primary hyperparathyroidism?
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To the Editor:
We have 2 questions for Dr Beyea, who described a patient with acute phosphate nephropathy after consumption of oral sodium phosphate solution (OSPS) for colonoscopy. Acute phosphate nephropathy following oral sodium phosphate soution to cleanse the bowel for colonoscopy. Their report belongs to a small group of recently published cases describing coincidence of acute renal failure after bowel cleansing with OSPS and renal heavy deposition of calcium phosphate concretions.First, the authors wrote that phosphate nephropathy differs from nephrocalcinosis by virtue of “distinct histopathologic findings.We question the accuracy of the distinction between nephrocalcinosis and phosphate nephropathy. Nephrocalcinosis refers to intrarenal deposits of calcium, regardless of whether these deposits occur in the form of phosphate or oxalate salts. In our view, phosphate nephropathy represents an acute nephrocalcinosis.Second, the authors wrote that the patient “has required management for anemia and secondary hyperparathyroidism,but they did not mention the time of follow-up of the chronic renal disease. Is there any possibility that the patient’s hyperparathyroidism was primary? Underlying subclinical primary hyperthyroidism might be a very appealing factor to explain the intriguing puzzle of why only very few patients develop this ominous complication among all the people using OSPS. Primary hyperparathyroidism has been described in one case may be undiagnosed when acute hyperphosphatemia lowers serum calcium levels, and offers the best conditions for nephrocalcinosis in the presence of an oral charge of phosphate, as it is demonstrated in experimental setting
Ciprofloxacin crystal nephropathy
No full textCiprofloxacin is a widely used fluoroquinolone for the treatment of patients with complicated and uncomplicated infections. With rare exceptions, only immune-mediated interstitial nephritis was described, with direct renal damage reported only in case of overdose. Experimental studies indicated that crystalluria may be associated with the administration of this drug, but the likelihood that ciprofloxacin crystal nephropathy would occur in humans was believed to be very low on the basis of previous data showing that ciprofloxacin crystalluria depended on a urine pH greater than 6.8. However, we report 2 cases of ciprofloxacin crystal-induced nephropathy with a clinical pattern of acute reversible tubular damage and intratubular crystals identical to that previously described in elderly patients treated with ciprofloxacin dosages within therapeutic schedules. Crystals in the tubules were negative for both the von Kossa stain for phosphates and alizarin red stain for calcium
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
How can we be sure that renal dysfunction after coronary angiography is just explained by contrast nephropathy?
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