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Progressive renal failure is one of the main complications in HbS/beta-thalassemia (HbS/beta-thal). Early identification of patients at high risk of developing renal failure is of great importance as it may allow specific measures to delay the progression of renal damage and thus reduce the incidence of end-stage renal failure and mortality. Early predictors of renal impairment in HbS/beta-thal remain to explore. Within this context, we studied 87 compound HbS/beta-thal patients (36 males/51 females; median age 39 years) and 30 healthy controls. In addition to conventional renal biochemistries we measured serum cystatin-C (Cys-C), urine N-acetyl-beta-D-glucosaminidase (NAG) excretion and serum and urinary beta(2)-microglobulin (beta(2)-M). Cystatin-C, NAG and serum beta(2)-M levels were higher in patients than controls. The incidence of patients with high levels of Cys-C, NAG, and beta(2)-M was 32.1, 74.7, and 70.1% respectively, while only 6.8% of patients had increased serum creatinine levels. Cystatin-C and serum beta(2)-M showed a strong correlation with creatinine clearance and age, while NAG positively correlated with proteinuria. An inverse correlation was also shown between hemoglobin and beta(2)-M, NAG, and Cys-C levels. Seven patients with proteinuria received therapy with angiotensin-converting enzyme (ACE) inhibitors. Changes of poteinuria positively correlated with NAG levels. These results indicate that Cys-C is an accurate marker of renal dysfunction, and urinary NAG excretion can be considered as a reliable index of the tubular toxicity, and possible predictor of proteinuria and eventual renal impairment in HbS/beta-thal patients. Furthermore, NAG measurement may be used for monitoring ACE-inhibitors therapy in HbS/beta-thal patients with proteinuria.

BackgroundPirfenidone is an antifibrotic compound able to slow down disease progression in patients with idiopathic pulmonary fibrosis (IPF).ObjectiveTo investigate the safety and efficacy of pirfenidone in patients with IPF in a real-life setting.MethodsThis was a multicenter, retrospective, real-life, observational study for patients with IPF receiving pirfenidone.ResultsWe identified 92 patients with IPF receiving pirfenidone. Eighty patients (70 males and 10 females, mean age ± SD: 68.1 + 7.5, mean %FVC ± SD = 74.9 ± 17.2, mean %DLCO ± SD = 48.1 ± 16.9) were included in the analysis. Skin-related (25%) and gastrointestinal (17.5%) adverse events were the most common and led to drug discontinuation in 22.5% of cases. The majority (87%) of patients experienced side effects during the first 6 months of treatment. At 36 months, changes in %FVC and %DLCO were −9.25 ± 16.34 and −9.26 ± 15.26, respectively. At 6, 12, and 24 months after treatment initiation (n = 80, 60, and 26), 18, 15, and 5 patients (22.5, 25, and 19.2%) experienced significant (>10%) and 11, 3, and 3 patients (13.8, 5, and 11.5%) experienced marginal (5–10%) %FVC improvement; and 13, 6, and 1 patient (16.2, 10, and 3.9%) experienced marginal (−5 to −10%) and 20, 21, and 8 patients (25, 35, and 30.8%) experienced significant decline (<−10%) in %FVCpred. Median survival was 851 days, and 41 patients died during the study period.ConclusionPirfenidone demonstrated an acceptable safety and therapeutic profile in patients with IPF on a longitudinal basis. Prospective observational registries are urgently needed to provide a real-world view of outcomes of pirfenidone in clinical practice.

In this photo-essay we present and discuss an experiment with digital photography as part of our archaeological ethnography within the Kalaureia Research Programme, on the island of Poros, Greece. We contextualize this attempt by reviewing, briefl y but critically, the collateral development of photography and modernist archaeology, and the links between photography and anthropology, especially with regard to the fi eld of visual anthropology. Our contention is that at the core of the uses of photographs made by both disciplines is the assumption that photographs are faithful, disembodied representations of reality. We instead discuss photographs, including digital photographs, as material artefacts that work by evocation rather than representation, and as material memories of the things they have witnessed; as such they are multi-sensorially experienced. While in archaeology photographs are seen as either offi cial records or informal snapshots, we offer instead a third kind of photographic production, which occupies the space between artwork and ethnographic commentary or intervention. It is our contention that it is within the emerging fi eld of archaeological ethnography that such interventions acquire their full poignancy and potential, and are protected from the risk of colonial objectifi cation.keywords Photography, Archaeology, Archaeological ethnography, Social anthropology, Senses, Materiality, Kalaureia, Greece IntroductionIn one of Aris's visits to a neighbour of the sanctuary of Poseidon, a ship mechanic by trade, the latter pulled out a hefty tome on horses. It was an 'Encyclopaedia of public archaeology : archaeological ethnographies, Vol. 8 No. 2-3, 2009, 283-309 284 YANNIS HAMILAKIS et al. Horses' published by DK publishers in Britain. Aris thought he meant to demonstrate his passion for horses, which was already known to him. 'No,' he insisted, 'I bought this book in one of my trips abroad, because I love horses. But it kept a surprise for me in store. Look at this.' He turned to a page with a picture of an old man on a horse. The caption to the photograph said something about the 'Pindos horse', which apparently was fi gured here, but not much else. 'This is my father', the neighbour insisted. It turned out that, ages ago, a gentleman had arrived at the farmstead kept by his father near the sanctuary of Poseidon, and taken some pictures of him riding the horse. That same person had written the book. Aris asked whether the neighbour's father had received anything for this. 'He did not understand, he was an illiterate man', the son told him. What about himself, Aris insisted, but he waved the question away and changed the subject. It was probably too late for all this, Aris thought back then, too late to press for claims on memory as property. To discover a picture of your long-dead father inside a book on horses in some European capital is surely to marvel at the unexpected trajectories photographs can take. It is also to feel a sense of awe at your own inability to control photographic ...