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https://www.readbyqxmd.com/read/28331803/ivig-a-cure-to-severe-refractory-nap-1-clostridium-difficile-colitis-a-case-of-successful-treatment-of-severe-infection-which-failed-standard-therapy-including-fecal-microbiota-transplants-and-fidaxomicin
#1
Kelley Coffman, Xian Jie Cindy Chen, Charles Okamura, Eddie Louie
The mainstay treatment of Clostridium difficile infections (CDI) is antimicrobials with growing support for fecal microbiota transplants. We report the first case of an elderly man with severe refractory NAP-1 pseudomembranous CDI who failed all medical therapy and two fecal transplants with response only seen after administration of intravenous immunoglobulin.
2017: IDCases
https://www.readbyqxmd.com/read/28331450/pulmonary-thromboendarterectomy-for-pulmonary-hypertension-before-considering-transplant
#2
Hannah Kooperkamp, Inder Mehta, David Fary, Michael Bates
BACKGROUND: In cases of chronic thromboembolic pulmonary hypertension (CTEPH), referral for possible surgical intervention is important because surgery can be curative. Surgery necessitates cardiopulmonary bypass and deep circulatory arrest with pulmonary thrombectomy and bilateral endarterectomy (PTE). If surgery fails, lung transplant is the next best surgical option. Medical treatment is also an important adjunct. CASE REPORT: A 35-year-old female presented 3 months after a pulmonary embolus was found to be completely occluding her left pulmonary artery...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28330901/azacitidine-mitigates-graft-versus-host-disease-via-differential-effects-on-the-proliferation-of-t-effectors-and-natural-regulatory-t-cells-in-vivo
#3
Matthew L Cooper, Jaebok Choi, Darja Karpova, Kiran Vij, Julie Ritchey, Mark A Schroeder, John F DiPersio
Azacitidine (AzaC) mitigates graft-versus-host disease (GvHD) in both murine preclinical transplant models and in human clinical trials while maintaining a robust graft-versus-leukemia effect. Previous studies have failed to investigate the role of natural regulatory T cells (nTregs) on the mitigation of GvHD by AzaC, instead focusing on the generation of suppressive Tregs (CD4(+)CD25(+)FOXP3(+)) through the in vivo conversion of alloreactive donor T effectors (Teffs; CD4(+)CD25(-)FOXP3(-)) and the direct antiproliferative effects of AzaC on allogeneic T cells...
March 22, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28327905/phase-ii-study-of-idelalisib-a-selective-inhibitor-of-pi3k%C3%AE-for-relapsed-refractory-classical-hodgkin-lymphoma
#4
A K Gopal, M A Fanale, C H Moskowitz, A R Shustov, S Mitra, W Ye, A Younes, A J Moskowitz
Background: The phosphatidylinositol-3-kinase delta (PI3Kδ) inhibitor idelalisib has been shown to block downstream intracellular signaling, reduce the production of prosurvival chemokines and induce apoptosis in classical Hodgkin lymphoma (HL) cell lines. It has also been shown to inhibit regulatory T cells and myeloid-derived suppressor cells in other tumor models. We hypothesized that inhibiting PI3Kδ would have both direct and indirect antitumor effects by directly targeting the malignant cells as well as modulating the inflammatory microenvironment...
January 24, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28321984/reciprocity-to-increase-participation-of-compatible-living-donor-and-recipient-pairs-in-kidney-paired-donation
#5
John S Gill, Kathryn Tinckam, Marie Chantal Fortin, Caren Rose, Kara Shick-Makaroff, Kimberly Young, Julie Lesage, Edward H Cole, Maeghan Toews, David N Landsberg, Jagbir Gill
Inclusion of compatible living donor and recipient pairs (CPs) in kidney paired donation (KPD) programs could increase living donor transplantation. We introduce the concept of a reciprocity based strategy in which the recipient of a CP that participates in KPD receives priority for a repeat deceased donor transplant in the event their primary living donor KPD transplant fails, and review the practical and ethical considerations of this strategy. The strategy limits prioritization to CPs already committed to living donation, minimizing the risk of unduly influencing donor behavior...
March 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28319322/an-analysis-of-the-survival-outcomes-of-simultaneous-pancreas-and-kidney-transplantation-compared-to-live-donor-kidney-transplantation-in-patients-with-type-1-diabetes-a-uk-transplant-registry-study
#6
Adam D Barlow, Kourosh Saeb-Parsy, Christopher J E Watson
BACKGROUND: Transplant options for patients with type 1 diabetes and end-stage renal disease (ESRD) include deceased donor kidney, live donor kidney (LDK) and simultaneous pancreas-kidney (SPK) transplantation. The aim of this study was to compare outcomes between LDK and SPK for patients with type 1 diabetes and ESRD in the UK. METHODS: Data on all SPK (n=1739) and LDK (n=385) transplants performed between January 2001 and December 2014 were obtained from the UK Transplant Registry...
March 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28316853/primary-hepatic-neuroendocrine-tumor-with-unusual-thyroid-follicular-like-morphologic-characteristics
#7
Mohd Elmugtaba Ibrahim, Kerolos Abadeer, Qihui Jim Zhai, Aziza Nassar
We describe a primary hepatic neuroendocrine tumor of a 57-year-old Thai woman who presented in 2004 with a suspicious mass in the left hepatic lobe. She underwent left hepatectomy for the 10.5-cm mass, called intermediate grade neuroendocrine carcinoma of unknown origin, likely metastatic. The tumor recurred in 2007, then called recurrent primary hepatic neuroendocrine tumor (PHNET), and the patient underwent liver transplant. Because of similarity between the neuroendocrine tumor and a thyroid tumor-specifically, follicular-like characteristics-immunohistochemical stains for thyroglobulin, TTF1, and calcitonin were performed...
2017: Case Reports in Pathology
https://www.readbyqxmd.com/read/28315911/reproducibility-of-a-semi-quantitative-lobar-pulmonary-ventilation-and-perfusion-technique-using-spet-and-ct
#8
Esber N El-Barhoun, Ghee Chew, Benjamin Crouch, Barry Chatterton
OBJECTIVE: Evaluation of regional lung function is valuable prior to lung surgery in patients with chronic lung disease. Our aim was to evaluate the reproducibility of a locally developed single photon emission tomography/computed tomography (SPET/CT) programme between and within three observers in assessing lobar pulmonary volumes, perfusion and ventilation. SUBJECTS AND METHODS: Twelve lung transplantation candidates had VQ SPET and diagnostic CT to determine lobar pulmonary function and plan surgery...
March 20, 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28302642/pregnancy-and-the-risk-of-spontaneous-coronary-artery-dissection-an-analysis-of-120-contemporary-cases
#9
Ofer Havakuk, Sorel Goland, Anil Mehra, Uri Elkayam
BACKGROUND: Because of the rarity of this condition, information on pregnancy-associated spontaneous coronary artery dissection is limited. We reviewed a large number of contemporary pregnancy-associated spontaneous coronary artery dissection cases in an attempt to define the clinical characteristics and provide management recommendations. METHODS AND RESULTS: A literature search for cases of pregnancy-associated spontaneous coronary artery dissection reported between 2000 and 2015 included 120 cases; 75% presented with ST-segment-elevation myocardial infarction, and 80% had anterior myocardial infarction...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28299615/remote-monitoring-in-heart-failure-the-current-state
#10
REVIEW
Rajeev C Mohan, J Thomas Heywood, Roy S Small
The treatment of congestive heart failure is an expensive undertaking with much of this cost occurring as a result of hospitalization. It is not surprising that many remote monitoring strategies have been developed to help patients maintain clinical stability by avoiding congestion. Most of these have failed. It seems very unlikely that these failures were the result of any one underlying false assumption but rather from the fact that heart failure is a progressive, deadly disease and that human behavior is hard to modify...
March 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28295914/development-of-a-gastric-carcinoid-tumor-following-allogeneic-hematopoietic-stem-cell-transplantation-for-early-t-cell-precursor-acute-lymphoblastic-leukemia
#11
Tsung-Yen Chang, Jin-Yao Lai, Chao-Jan Wang, Shih-Yen Chen, Tang-Her Jaing, Chuen Hsueh, Lee-Yung Shih, Shih-Hsiang Chen
Gastric carcinoid tumor is rarely diagnosed in children. We report a case of gastric carcinoid tumor that occurred after allogeneic HSCT. A 13-year-old girl with ETP acute lymphoblastic leukemia underwent allogeneic HSCT from a 7/8 HLA-matched unrelated donor. She presented with rashes, abdominal pain, and diarrhea, which were suggestive of GVHD, 7 months after HSCT. Immunosuppressive agents failed to resolve these symptoms well. After a series of evaluations, carcinoid syndrome caused by a gastric carcinoid tumor was diagnosed...
March 11, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28295849/efficacy-safety-and-pharmacokinetics-of-simeprevir-daclatasvir-and-ribavirin-in-patients-with-recurrent-hepatitis-c-virus-genotype-1b-infection-after-orthotopic-liver-transplantation-the-phase-ii-saturn-study
#12
Xavier Forns, Marina Berenguer, Kerstin Herzer, Martina Sterneck, Maria Francesca Donato, Pietro Andreone, Stefano Fagiuoli, Tomasz Cieciura, Magdalena Durlik, Jose Luis Calleja, Zoe Mariño, Umesh Shukla, Thierry Verbinnen, Oliver Lenz, Sivi Ouwerkerk-Mahadevan, Monika Peeters, Katrien Janssen, Ronald Kalmeijer, Wolfgang Jessner
BACKGROUND: Recurrent hepatitis C virus (HCV) infection following liver transplantation is associated with accelerated progression to graft failure and reduced patient survival. METHODS: The Phase II, open-label SATURN study (NCT01938625) investigated the combination of simeprevir (SMV), daclatasvir (DCV), and ribavirin (RBV) administered for 24 weeks in 35 patients with recurrent HCV genotype (GT) 1b infection after orthotopic liver transplantation (OLT). RESULTS: High rates of both on-treatment and sustained virologic response 12 weeks after end of treatment (SVR12) were achieved in patients who were either treatment-naïve or had failed post-OLT treatment with peginterferon and RBV...
March 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28295441/fosfomycin-for-the-treatment-of-cystitis-in-the-abdominal-solid-organ-transplant-population
#13
A A Loethen, L Kerstenetzky, J L Descourouez, G E Leverson, J A Smith, M R Jorgenson
STUDY OBJECTIVES: Evaluate the use of fosfomycin (FOS) at the FDA-approved single-dose regimen as well as off-label multidose regimens for the treatment of cystitis after abdominal solid organ transplant (aSOT). DESIGN: Retrospective study. SETTING: Tertiary academic medical center. PATIENTS: Adult inpatients with history of aSOT receiving FOS between 1/1/2009-4/30/2015 for the treatment of cystitis. MEASUREMENTS AND MAIN RESULTS: Seventy-six courses of FOS were identified in 64 patients...
March 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28295299/oral-findings-and-dental-behaviour-before-and-after-liver-transplantation-a-single-centre-cross-sectional-study
#14
Anne Kauffels, Gerhard Schmalz, Otto Kollmar, Jan E Slotta, Michael Weig, Uwe Groß, Oliver Bader, Dirk Ziebolz
OBJECTIVE: The aim of this single-centre, cross-sectional study was to evaluate dental, periodontal and mycological findings, as well as oral behaviour, in patients before (pre-LTx) and after (post-LTx) liver transplantation. METHODS: A total of 47 patients pre-LTx and 119 patients post-LTx were asked to participate. Oral health behaviour was assessed using a standardised questionnaire. Oral examinations included dental [decayed, missing and filled teeth (DMFT) index] and periodontal [papillary bleeding index (PBI), periodontal probing depth (PPD) and clinical attachment loss (CAL)] findings...
March 10, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28295190/phase-i-study-of-cord-blood-derived-natural-killer-cells-combined-with-autologous-stem-cell-transplantation-in-multiple-myeloma
#15
Nina Shah, Li Li, Jessica McCarty, Indreshpal Kaur, Eric Yvon, Hila Shaim, Muharrem Muftuoglu, Enli Liu, Robert Z Orlowski, Laurence Cooper, Dean Lee, Simrit Parmar, Kai Cao, Catherine Sobieiski, Rima Saliba, Chitra Hosing, Sairah Ahmed, Yago Nieto, Qaiser Bashir, Krina Patel, Catherine Bollard, Muzaffar Qazilbash, Richard Champlin, Katy Rezvani, Elizabeth J Shpall
Multiple myeloma (MM) is a disease with known immune dysregulation. Natural killer (NK) cells have shown preclinical activity in MM. We conducted a first-in-human study of umbilical cord blood-derived (CB) NK cells for MM patients undergoing high dose chemotherapy and autologous haematopoietic stem cell transplantation (auto-HCT). Patients received lenalidomide (10 mg) on days -8 to -2, melphalan 200 mg/m(2) on day -7, CB-NK cells on day -5 and auto-HCT on day 0. Twelve patients were enrolled, three on each of four CB-NK cell dose levels: 5 × 10(6) , 1 × 10(7) , 5 × 10(7) and 1 × 10(8) CB-NK cells/kg...
March 14, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28294481/mycoplasma-hominis-periaortic-abscess-following-heart-lung-transplantation
#16
Hideharu Hagiya, Hisao Yoshida, Norihisa Yamamoto, Keigo Kimura, Akiko Ueda, Isao Nishi, Yukihiro Akeda, Kazunori Tomono
We report the first case of Mycoplasma hominis periaortic abscess after heart-lung transplantation, to our knowledge. The absence of sternal wound infection delayed the diagnosis, but the patient successfully recovered with debridement surgeries and long-term antibiotic therapy. Owing to the difficulty in detection and the intrinsic resistance to beta-lactams, M. hominis infections are prone to being misdiagnosed and undertreated. M. hominis should be suspected in cases where conventional microbiological identification and treatment approaches fail...
March 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28289144/staphylococcus-aureus-survives-in-cystic-fibrosis-macrophages-forming-a-reservoir-for-chronic-pneumonia
#17
Cao Li, Yuqing Wu, Andrea Riehle, Jie Ma, Markus Kamler, Erich Gulbins, Heike Grassmé
Staphylococcus aureus (S. aureus) plays an important role in sepsis, pneumonia, wound infections and cystic fibrosis (CF), which is caused by mutations of the cystic fibrosis transmembrane conductance regulator (Cftr). Pulmonary S. aureus infections in CF often occur very early and prior to colonization with other pathogens, in particular Pseudomonas aeruginosa Here, we demonstrate that CF mice are highly susceptible to pulmonary infections with S. aureus and fail to clear the pathogen during infection. S. aureus is internalized by Cftr-deficient macrophages in the lung, but these macrophages are unable to kill intracellular bacteria...
March 13, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28280701/renoportal-anastomosis-in-living-donor-liver-transplantation-with-prior-proximal-splenorenal-shunt
#18
Fatih Ozdemir, Koray Kutluturk, Bora Barut, Perviz Abbasov, Ramazan Kutlu, Cuneyt Kayaalp, Sezai Yılmaz
For transplant surgeons, end-stage liver disease with portal venous thrombosis and a previous splenorenal shunt (SRS) is a significant challenge during liver transplantation. Thrombosis of the portal vein can be corrected by surgical interventions, such as portal venous thrombectomy or surgical removal of the thrombosed portal vein. Even also placement of a graft between the mesenteric vein and the graft portal vein can be performed. If these maneuvers fail, a renoportal anastomosis (RPA) can be performed to achieve adequate graft inflow...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28280700/allograft-loss-from-acute-page-kidney-secondary-to-trauma-after-kidney-transplantation
#19
Kazuhiro Takahashi, Rohini Prashar, Krishna G Putchakayala, William J Kane, Jason E Denny, Dean Y Kim, Lauren E Malinzak
We report a rare case of allograft loss from acute Page kidney secondary to trauma that occurred 12 years after kidney transplantation. A 67-year-old Caucasian male with a past surgical history of kidney transplant presented to the emergency department at a local hospital with left lower abdominal tenderness. He recalled that his cat, which weighs 15 lbs, jumped on his abdomen 7 d prior. On physical examination, a small tender mass was noticed at the incisional site of the kidney transplant. He was producing a normal amount of urine without hematuria...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28275389/cd19-cd56-myeloma-arising-in-a-patient-who-failed-two-courses-of-immunosupressive-therapy-for-aplastic-anaemia
#20
Nigel P Murray, M Amparo Ruiz, G Maximiliano Miranda
Patients diagnosed with severe aplastic anaemia and without a compatible bone marrow transplant donor are treated with immunosuppressive therapy. These patients are found with time to develop a clonal disease such as myelodysplasia or paroxysmal nocturnal haemoglobinuria. However, the development of plasma cell dyscrasias is rare. We report the case here of a patient treated with immunosuppressive therapy who went on to develop myeloma 11 months after being diagnosed with severe aplastic anaemia. We include here a review of the literature...
2017: Ecancermedicalscience
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