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https://www.readbyqxmd.com/read/28318212/multiple-myeloma-diagnosis-and-treatment
#1
Thomas C Michels, Keith E Petersen
Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. In 2015, an estimated 28,850 new cases of multiple myeloma were diagnosed in the United States, and the disease caused more than 11,000 deaths. Patients older than 65 years account for 85% of those diagnosed with multiple myeloma, and there is a twofold increased incidence in blacks compared with whites. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea, vomiting, malaise, weakness, recurrent infections, and weight loss...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28317077/de-novo-cancer-in-patients-on-dialysis-and-after-renal-transplantation-north-western-italy-1997-2012
#2
Valentina Mazzucotelli, Pierluca Piselli, Diana Verdirosi, Claudia Cimaglia, Giovanni Cancarini, Diego Serraino, Silvio Sandrini
BACKGROUND: Kidney transplant recipients (KTR) are known to have a higher risk of cancer than the general population, especially of malignancies related to oncogenic viral infections. This study assessed the incidence of de novo malignancies (DNMs) in patients receiving kidney transplantation and in dialysis patients (DP) on the waiting list for transplantation at the same centre. The aim was to quantify the contribution of post-transplant immunosuppression to the underlying risk of developing a DNM in dialysis patients on the waiting list for kidney transplant...
March 19, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28315744/cardiac-implantable-electronic-device-infections-who-is-at-greatest-risk
#3
Parijat Saurav Joy, Gagan Kumar, Jeanne E Poole, Barry London, Brian Olshansky
BACKGROUND: Cardiac Implantable Electronic Device (CIED) infections are associated with hospitalization, mortality, increased costs and adverse outcomes. OBJECTIVE: Determine the burden of infections for CIEDs based on device type, associated comorbidities and clinical characteristics over a 12-year period. METHODS: Utilizing the National Inpatient Sample database from 2000-2012, procedures for device related infection (DRI) were identified using ICD-9-CM code for CIED removal with diagnosis codes for device-related infection or systemic infection...
March 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28298471/bk-polyomavirus-clinical-aspects-immune-regulation-and-emerging-therapies
#4
REVIEW
George R Ambalathingal, Ross S Francis, Mark J Smyth, Corey Smith, Rajiv Khanna
BK polyomavirus (BKV) causes frequent infections during childhood and establishes persistent infections within renal tubular cells and the uroepithelium, with minimal clinical implications. However, reactivation of BKV in immunocompromised individuals following renal or hematopoietic stem cell transplantation may cause serious complications, including BKV-associated nephropathy (BKVAN), ureteric stenosis, or hemorrhagic cystitis. Implementation of more potent immunosuppression and increased posttransplant surveillance has resulted in a higher incidence of BKVAN...
April 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/28296195/evaluation-of-the-infection-risk-in-dialysis-and-chronic-kidney-disease-patients-using-an-atp-monitoring-assay
#5
Junichi Kusano, Rei Kato, Hiroto Matsuda, Yoshikazu Hara, Yoshiaki Fujii, Shinya Suzuki, Masao Sekiyama, Eiki Ando, Kentaro Sugiyama, Toshihiko Hirano
The ATP monitoring assay is a useful biomarker for risk monitoring to detect infection and rejection episodes in transplant recipients. Hemodialysis patients have a higher rate of infectious mortality. Infections in hemodialysis patients are mainly caused by venous catheters, uremia, malnutrition and inflammation. However, the risk of infection episodes has not been evaluated using a lymphocyte ATP monitoring assay in hemodialysis and chronic kidney disease (CKD) patients. We measured the ATP amounts in the peripheral CD4+ cells of CKD (N = 85) and dialysis patients (N = 17) using an "Immuknow" assay kit...
March 13, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#6
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T-cells were measured using an interferon-γ Elispot-assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28295968/nosocomial-bk-polyomavirus-infection-causing-hemorrhagic-cystitis-among-patients-with-hematological-malignancies-after-hematopoietic-stem-cell-transplantation
#7
Jun Kato, Takehiko Mori, Tetsuro Suzuki, Masahiko Ito, Tian-Cheng Li, Masatoshi Sakurai, Yusuke Yamane, Rie Yamazaki, Yuya Koda, Takaaki Toyama, Naoki Hasegwa, Shinichiro Okamoto
BK polyomavirus (BKPyV) is recognized as a pathogen that causes diseases such as hemorrhagic cystitis and nephritis after allogeneic hematopoietic stem cell transplantation (HSCT) or renal transplantation. BKPYV-associated disease is thought to occur through reactivation under immunosuppression. However, the possibility of its nosocomial transmission and the clinical significance of such transmission have not been elucidated. During a 6-month period, 9 adult patients (median age: 47 years) with hematological disorders who were treated with HSCT (N=7) or chemotherapy (N=2) in a single hematology department developed hemorrhagic cystitis due to BKPYV infection...
March 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28295622/low-vitamin-d-exposure-is-associated-with-higher-risk-of-infection-in-renal-transplant-recipients
#8
Hari V Kalluri, Lauren M Sacha, Amanda I Ingemi, Michael A Shullo, Heather J Johnson, Puneet Sood, Amit D Tevar, Abhinav Humar, Raman Venkataramanan
BACKGROUND: Vitamin-D is a steroid hormone with multiple vital roles within the immune system. Various studies evaluated the influence of vitamin-D on infections post-renal transplantation and found contrasting results. This study aims to assess the relationship between vitamin-D status and the incidence of infection in renal transplant recipients. METHODS: This is a retrospective cohort study of adult renal transplant recipients at the University of Pittsburgh Medical Center between 2005 and 2012...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295601/idiopathic-hyperammonemia-after-solid-organ-transplantation-primarily-a-lung-problem-a-single-center-experience-and-systematic-review
#9
Dustin Krutsinger, Alejandro Pezzulo, Amy E Blevins, Robert M Reed, Michael Voigt, Michael Eberlein
BACKGROUND: Idiopathic hyperammonemia syndrome (IHS) is an uncommon, often deadly complication of solid organ transplantation. IHS cases in solid organ transplantation seem to occur predominantly in lung transplant (LTx) recipients. However to the best of our knowledge the occurrence of IHS has not been systematically evaluated. We set out to identify all reported cases of IHS following non-liver solid organ transplantations. METHODS: Retrospective review of our institutional experience and systematic review of the literature...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28288014/the-times-they-are-a-changing-hope-for-hiv-to-hiv-organ-transplantation
#10
Ghady Haidar, Nina Singh
HIV-infected persons who achieve undetectable viral loads on antiretroviral therapy currently have near-normal lifespans. Liver disease is a major cause of non-AIDS-related deaths, and as a result of longer survival, the prevalence of end-stage renal disease in HIV is increasing. HIV-infected persons undergoing organ transplantation generally achieve comparable patient and graft survival rates compared to their HIV-uninfected counterparts, despite a nearly threefold increased risk of acute rejection. However, the ongoing shortage of suitable organs can limit transplantation as an option, and patients with HIV have higher waitlist mortality than others...
March 1, 2017: Transplantation
https://www.readbyqxmd.com/read/28285802/long-term-prognosis-and-cost-effectiveness-of-left-ventricular-assist-device-as-bridge-to-transplantation-a-systematic-review
#11
Michael Seco, Dong Fang Zhao, Michael J Byrom, Michael K Wilson, Michael P Vallely, John F Fraser, Paul G Bannon
BACKGROUND: This systematic review aimed to evaluate the clinical outcomes and cost-effectiveness of left ventricular assist devices (LVADs) used as bridge to transplantation (BTT), compared to orthotopic heart transplantation (OHT) without a bridge. METHOD: Systematic searches were performed in electronic databases with available data extracted from text and digitized figures. Meta-analysis of short and long-term term post-transplantation outcomes was performed with summation of cost-effectiveness analyses...
March 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28281085/efficacy-and-safety-of-sofosbuvir-based-regimens-in-chronic-hepatitis-c-patients-on-dialysis
#12
Narendra S Choudhary, Amit Kumar, Vijay Bodh, Shyam Bihari Bansal, Reetesh Sharma, Manish Jain, Sanjiv Saigal, Neeraj Saraf
INTRODUCTION: Patients with end-stage renal disease (ESRD) have poor treatment tolerance and outcome to interferon-based regimens. Sofosbuvir-based regimens have improved treatment success in chronic hepatitis C. There is limited data in ESRD patients as sofosbuvir is excreted by the kidney. Several small studies have shown good results. METHODS: Sixteen consecutive patients of ESRD (on dialysis) and chronic hepatitis C were treated with sofosbuvir-based regimens as they were prospective kidney transplantation recipients, at a tertiary care center in north India...
March 9, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28280938/viral-load-of-ebv-dnaemia-is-a-predictor-of-ebv-related-post-transplant-lymphoproliferative-disorders-in-pediatric-renal-transplant-recipients
#13
Elisa Colombini, Isabella Guzzo, Federica Morolli, Germana Longo, Cristina Russo, Alessandra Lombardi, Pietro Merli, Luisa Barzon, Luisa Murer, Simone Piga, Marta Luisa Ciofi Degli Atti, Franco Locatelli, Luca Dello Strologo
BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is a severe complication of solid organ transplantation that can be classified into two major subtypes, namely, early lesions and non-early lesions, based on histopathological findings. In the vast majority of cases, proliferating cells are B lymphocytes and, most frequently, proliferation is induced by Epstein-Barr virus (EBV) infection. METHODS: The aim of our study was to evaluate the natural history of EBV infection and its possible evolution toward PTLD in a pediatric cohort of patients who received a renal transplant between January 2000 and December 2013...
March 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28280696/dengue-in-renal-transplant-recipients-clinical-course-and-impact-on-renal-function
#14
Paula Frassinetti Castelo Branco Camurça Fernandes, Reed André Siqueira, Evelyne Santana Girão, Rainne André Siqueira, Márcia Uchoa Mota, Leyla Castelo Branco Fernandes Marques, Silvana Cristina Albuquerque Andrade, Wilson Mendes Barroso, Sônia Leite Silva, Bruno Gomes Rodrigues Dos Santos, Claúdia Maria Costa de Oliveira
AIM: To present clinical characteristics from renal transplant recipients with dengue fever and its impact on graft function. METHODS: We retrospectively evaluated 11 renal transplant recipients (RTR) with dengue infection confirmed by laboratory test, between January 2007 and July 2012, transplanted in the Renal Transplant Center of Walter Cantídio University Hospital from Federal University of Ceará. RESULTS: Positive dengue serology (IgM) was found in all patients...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28280694/effectiveness-and-versatility-of-biological-prosthesis-in-transplanted-patients
#15
Giovanni Vennarecci, Gianluca Mascianà, Edoardo De Werra, Giovanni Battista Levi Sandri, Daniele Ferraro, Mirco Burocchi, Giovanni Tortorelli, Nicola Guglielmo, Giuseppe Maria Ettorre
AIM: To emphasize the effectiveness and versatility of prosthesis, and good tolerance by patients with incisional hernia (IH). METHODS: From December 2001 to February 2016, 270 liver transplantations were performed at San Camillo Hospital. IH occurred in 78 patients (28.8%). IH usually appeared early within the first year post-orthotopic liver transplantation. In the first era, fascial defect was repaired by primary closure for defects smaller than 2.5 cm or with synthetic mesh for greater defects...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28280692/influence-of-tacrolimus-metabolism-rate-on-renal-function-after-solid-organ-transplantation
#16
REVIEW
Gerold Thölking, Hans Ulrich Gerth, Katharina Schuette-Nuetgen, Stefan Reuter
The calcineurin inhibitor (CNI) tacrolimus (TAC) is an integral part of the immunosuppressive regimen after solid organ transplantation. Although TAC is very effective in prevention of acute rejection episodes, its highly variable pharmacokinetic and narrow therapeutic window require frequent monitoring of drug levels and dose adjustments. TAC can cause CNI nephrotoxicity even at low blood trough levels (4-6 ng/mL). Thus, other factors besides the TAC trough level might contribute to CNI-related kidney injury...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28272067/prompt-diagnosis-of-scedosporium-apiospermum-soft-tissue-infection-life-saving-in-a-renal-transplant-recipient
#17
R Ghosh, P Mishra, P K Maiti, A Debnandi
Scedosporium apiospermum, an ubiquitous filamentous fungus, a known cause of mycetoma, is emerging as an opportunistic pathogen in immunocompromised individuals. We report a case of painful foot abscess in a renal allograft recipient on immunosuppressive therapy, which was clinically diagnosed as a suppurative bacterial abscess. Pus was aspirated, which showed septate, branching hyphal elements and culture on Sabouraud's dextrose agar yielded S. apiospermum, which was identified based on its macroscopic and microscopic features...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28267882/early-conversion-to-belatacept-after-renal-transplantation
#18
V Nair, L Liriano-Ward, R Kent, Shirish Huprikar, M Rana, S Florman, V Delaney, M Menon, V Sehgal, L Miko, R Khaim, A Benvenisty, S Lerner, A Arvelakis, V Wadhera, S Ames, R Shapiro
Belatacept is a non-nephrotoxic immunosuppressive agent, which may make it the ideal agent for patients with delayed or slow graft function on calcineurin inhibitors. There are limited data on conversion of patients to belatacept within 6 months of transplantation. Between 1/2012 and 12/2015 sixteen patients were converted to belatacept for delayed or poor graft function (eGFR <30 ml/min/1.73m, MDRD); three were HIV+. Conversion protocols were analyzed in patients < 4 months and 4-6 months post transplantation...
March 7, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28266942/personalized-treatment-in-heart-transplantation
#19
Kiran K Khush
PURPOSE OF REVIEW: We are entering the era of personalized medicine, in which pharmacogenomics and biomarker-based assays can be used to tailor diagnostic tests and drug therapies to individual patients. This new approach to patient-specific care offers the potential to maximize the efficacy of available medical treatments while reducing the incidence of adverse side effects. Here, we present approaches to personalize the care of heart transplant recipients. RECENT FINDINGS: Four strategies for personalized posttransplant care are described, including use of pharmacogenomic data to individualize the use of immunosuppressive drugs, immune monitoring to prevent acute rejection while reducing the long-term consequences of over immunosuppression, noninvasive surveillance for acute rejection, and targeted prophylaxis against opportunistic infections...
March 6, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28262440/telomere-length-in-patients-with-pulmonary-fibrosis-associated-with-chronic-lung-allograft-dysfunction-and-post-lung-transplantation-survival
#20
Chad A Newton, Julia Kozlitina, Jefferson R Lines, Vaidehi Kaza, Fernando Torres, Christine Kim Garcia
BACKGROUND: Prior studies have shown that patients with pulmonary fibrosis with mutations in the telomerase genes have a high rate of certain complications after lung transplantation. However, few studies have investigated clinical outcomes based on leukocyte telomere length. METHODS: We conducted an observational cohort study of all patients with pulmonary fibrosis who underwent lung transplantation at a single center between January 1, 2007, and December 31, 2014...
February 4, 2017: Journal of Heart and Lung Transplantation
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