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https://www.readbyqxmd.com/read/27913989/cost-effectiveness-analysis-of-isavuconazole-vs-voriconazole-as-first-line-treatment-for-invasive-aspergillosis
#1
Rachel Harrington, Edward Lee, Hongbo Yang, Jin Wei, Andrew Messali, Nkechi Azie, Eric Q Wu, James Spalding
INTRODUCTION: Invasive aspergillosis (IA) is associated with a significant clinical and economic burden. The phase III SECURE trial demonstrated non-inferiority in clinical efficacy between isavuconazole and voriconazole. No studies have evaluated the cost-effectiveness of isavuconazole compared to voriconazole. The objective of this study was to evaluate the costs and cost-effectiveness of isavuconazole vs. voriconazole for the first-line treatment of IA from the US hospital perspective...
December 2, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27906775/improving-liver-allocation-using-optimized-neighborhoods
#2
Vikram Kilambi, Sanjay Mehrotra
BACKGROUND: Geographic disparities persist in access to liver transplantation. Candidates with similar urgency experience varying opportunities for transplants across the US. Policymakers are poised to act and 1 proposal entails reorganizing the current OPTN of 11 regions into 8 districts. However, redistricting has the shortcomings that OPOs are disconnected from their immediate neighbors by district borders and that it is not easily responsive to uncertainty resulting from variability in donor and listing rates...
October 7, 2016: Transplantation
https://www.readbyqxmd.com/read/27903923/stent-assisted-coil-embolization-of-a-recurrent-posterior-cerebral-artery-aneurysm-following-surgical-clipping
#3
Tomonori Takeshita, Tomoaki Nagamine, Kohei Ishihara, Yasuhiko Kaku
Posterior cerebral artery (PCA) aneurysms are rare, and direct surgery of these is considered difficult. Coil embolization of PCA aneurysms is becoming popular. However, it is difficult to completely obliterate the aneurysm while preserving the flow of the parent artery in large or giant PCA aneurysms with a wide neck with this technique. We report a case of a large and wide-necked PCA aneurysm with multiple recurrences following successful surgical clipping and coil embolization.A 77-year-old man with a large unruptured right PCA (P2) aneurysm was successfully treated by surgical clipping...
November 30, 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27903345/-application-of-low-dose-ct-angiography-with-70-kv-in-patients-with-peripheral-arterial-diseases
#4
Y H Duan, G M Lu, J Wu, X C Yang, D D Wu, Z P Cheng, X M Wang
Objective: To assess the image quality, radiation dose and diagnostic efficiency of peripheral arterial CT angiography (CTA) performed at tube voltage of 70 and 120 kV. Methods: Between January 2014 and December 2015, a total of 200 consecutive patients with known or suspected lower extremity arteriosclerosis obliterans (LEASO) underwent CTA.Patients were randomly divided into 2 groups by different scanning protocols.Group A (n=100): 70 kV and 0.8 ml/kg contrast agent, group B (n=100): 120 kV and 100 ml contrast agent...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27898462/recent-advances-in-allograft-vasculopathy
#5
Jonathan Merola, Daniel D Jane-Wit, Jordan S Pober
PURPOSE OF REVIEW: Despite considerable advances in controlling acute rejection, the longevity of cardiac and renal allografts remains significantly limited by chronic rejection in the form of allograft vasculopathy. This review discusses recently reported mechanistic insights of allograft vasculopathy pathogenesis as well as recent clinical evaluations of new therapeutic approaches. RECENT FINDINGS: Although adaptive immunity is the major driver of allograft vasculopathy, natural killer cells mediate vasculopathic changes in a transplanted mouse heart following treatment with donor-specific antibody (DSA)...
November 24, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27894836/use-of-complement-binding-assays-to-assess-the-efficacy-of-antibody-mediated-rejection-therapy-and-prediction-of-graft-survival-in-kidney-transplantation
#6
Daniel S Ramon, Yihung Huang, Lili Zhao, TrisAnn Rendulic, Jeong M Park, Randall S Sung, Milagros Samaniego
BACKGROUND: The Luminex(®) single antigen bead assay (SAB) is the method of choice for monitoring the treatment for antibody-mediated rejection (AMR). A ⩾50% reduction of the dominant donor-specific antibody (IgG-DSA) mean fluorescence intensity (MFI) has been associated with improved kidney allograft survival, and C1q-fixing DSA activity is associated with poor outcomes in patients with AMR. We aimed to investigate if C1q-DSA can be used as a reliable predictor of response to therapy and allograft survival in patients with biopsy-proven AMR...
November 25, 2016: Human Immunology
https://www.readbyqxmd.com/read/27893614/the-presence-of-pretransplant-hla-antibodies-does-not-impact-the-development-of-chronic-lung-allograft-dysfunction-or-clad-related-death
#7
Oscar E Zazueta, Sara E Preston, Anna Moniodis, Sabrina Fried, Miae Kim, Keri Townsend, Isabelle Wood, Steve Boukedes, Indira Guleria, Phillip Camp, Souheil El-Chemaly, Ivan O Rosas, Anil Chandraker, Edgar Milford, Hilary J Goldberg
BACKGROUND: Development of Donor-specific Antibodies (DSA) after lung transplantation is associated with antibody mediated rejection (AMR), acute cellular rejection, and bronchiolitis obliterans syndrome (BOS); however, the significance of circulating antibodies before transplant remains unclear. METHODS: We performed a retrospective cohort study including recipients of primary lung transplants between 2008 and 2012.We assessed the impact of circulating human leukocyte (HLA) and noncytotoxic Donor Specific antibodies (DSA) detected before transplant on development of Chronic Lung Allograft Dysfunction (CLAD) or CLAD related death...
November 23, 2016: Transplantation
https://www.readbyqxmd.com/read/27891269/unruptured-basilar-tip-aneurysm-with-internal-septation-coiling-implications
#8
Ayman Khalil, Hong Kuan Kok, Mark Schembri, Paul Brennan, Mohsen Javadpour, John Thornton, Alan O'Hare, Hamed Asadi
An internal septum within a basilar artery aneurysm is an infrequent anomaly and is very rarely reported in the literature. We report a 62-year-old lady that was incidentally diagnosed with basilar tip aneurysm. Further imaging with magnetic resonance imaging (MRI) revealed internal septation within this aneurysm which was later confirmed with digital subtraction angiography (DSA). She underwent coil embolisation, which involved technical manipulation of the microcatheter and the balloon to enable coiling of each separate aneurysm compartment...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27890764/spontaneous-spinal-epidural-hematoma-a-study-of-55-cases-focused-on-the-etiology-and-treatment-strategy
#9
Jiaxing Yu, Jiang Liu, Chuan He, Liyong Sun, Sishi Xiang, Yongjie Ma, Lisong Bian, Tao Hong, Jian Ren, Pengyu Tao, Jingwei Li, Guilin Li, Feng Ling, Hongqi Zhang
BACKGROUND: Spontaneous spinal epidural hematoma (SSEH) is a rare neurological emergency of the spinal cord. Its etiology and treatment strategy remain controversial. This study aimed to evaluate a significant cause of SSEH and to discuss the treatment strategy according to the clinical outcomes of patients in two institutions. METHODS: Fifty-five cases of SSEH treated at our institutions between February 2002 and February 2016 were retrospectively analyzed. RESULT: The mean age of the first SSEH onset was 31...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27888573/b-cell-activating-factor-baff-a-predictor-of-antibody-mediated-rejection-in-kidney-transplantation-recipients
#10
Wannarat Pongpirul, Wiwat Chancharoenthana, Krit Pongpirul, Asada Leelahavanichakul, Wipawee Kittikowit, Kamonwan Jutivorakool, Bunthoon Nonthasoot, Yingyos Avihingsanon, Somchai Eiam-Ong, Kearkiat Praditpornsilpa, Natavudh Townamchai
BACKGROUND: Donor-specific antibody (DSA) is a widely-used biomarker for antibody-mediated rejection (ABMR) but correctly indicates only 30-40% of patients with ABMR. Additional biomarkers of ABMR in kidney transplant recipients are needed. METHODS: All 68 kidney transplanted-recipients enrolled in this study were negative for graft rejection as determined by surveillance-biopsy ELISA at day 7 post-transplantation. Allograft biopsy was then performed at 6 months post-transplantation for subclinical-ABMR detection...
November 26, 2016: Nephrology
https://www.readbyqxmd.com/read/27888555/renal-operational-tolerance-is-associated-with-a-defect-of-blood-tfh-cells-that-exhibit-impaired-b-cell-help
#11
Alexis Chenouard, Mélanie Chesneau, Linh Bui Nguyen, Sabine Le Bot, Marion Cadoux, Emilie Dugast, Chloé Paul, Stéphanie Malard-Castagnet, Simon Ville, Pierrick Guérif, Jean-Paul Soulillou, Nicolas Degauque, Richard Danger, Magali Giral, Sophie Brouard
Renal operationally tolerant patients (TOL) display a defect in B cell differentiation, with a deficiency in plasma cells. Recently described, T follicular helper cells (Tfh) play a critical role in B cell differentiation. We analyzed blood Tfh subsets in TOL and transplanted patients with stable graft function under immunosuppression (STA). We observed a reduced proportion of blood activated and highly functional Tfh subsets in TOL, without affecting Tfh absolute numbers. Functionally, Tfh from TOL displayed a modified gene expression profile, failed to produce IL-21 and were unable to induce IgG production by naive B cells...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27884880/first-pass-contrast-enhanced-mra-for-pretherapeutic-diagnosis-of-spinal-epidural-arteriovenous-fistulas-with-intradural-venous-reflux
#12
S Mathur, S P Symons, T J Huynh, P Muthusami, W Montanera, A Bharatha
BACKGROUND AND PURPOSE: Spinal epidural AVFs are rare spinal vascular malformations. When there is associated intradural venous reflux, they may mimic the more common spinal dural AVFs. Correct diagnosis and localization before conventional angiography is beneficial to facilitate treatment. We hypothesize that first-pass contrast-enhanced MRA can diagnose and localize spinal epidural AVFs with intradural venous reflux and distinguish them from other spinal AVFs. MATERIALS AND METHODS: Forty-two consecutive patients with a clinical and/or radiologic suspicion of spinal AVF underwent MR imaging, first-pass contrast-enhanced MRA, and DSA at a single institute (2000-2015)...
November 24, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27882440/hemodynamic-changes-in-a-middle-cerebral-artery-aneurysm-at-follow-up-times-before-and-after-its-rupture-a-case-report-and-a-review-of-the-literature
#13
A Sejkorová, K D Dennis, H Švihlová, O Petr, G Lanzino, A Hejčl, D Dragomir-Daescu
Hemodynamic parameters play a significant role in the development of cerebral aneurysms. Parameters such as wall shear stress (WSS) or velocity could change in time and may contribute to aneurysm growth and rupture. However, the hemodynamic changes at the rupture location remain unclear because it is difficult to obtain data prior to rupture. We analyzed a case of a ruptured middle cerebral artery (MCA) aneurysm for which we acquired imaging data at three time points, including at rupture. A patient with an observed MCA aneurysm was admitted to the emergency department with clinical symptoms of a subarachnoid hemorrhage...
November 24, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27881343/-surgical-management-of-proximal-anterior-cerebral-artery-a1-aneurysms
#14
Hua-Wei Wang, Zhe Xue, Yu-Dong Ma, Wen-Xin Wang, Chen Wu, Zheng-Hui Sun
OBJECTIVE: To review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients. METHODS: Between January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded...
November 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27870633/dsa-of-perimesencephalic-hemorrhage
#15
Ajay Malhotra, Xiao Wu, David Durand, Vivek B Kalra, Howard P Forman
No abstract text is available yet for this article.
December 2016: Radiology
https://www.readbyqxmd.com/read/27870356/clinical-and-immunological-relevance-of-antibodies-in-solid-organ-transplantation
#16
REVIEW
N K Mehra, A K Baranwal
The two important issues affecting recipients of solid organ transplants and of importance to immunologists are (i) sensitization of the recipient to HLA antigens and the resultant humoral immune response leading to the development of anti-HLA antibodies; and ii) development of robust assays for early detection of humoral rejection post-transplant. Evidence from several studies clearly indicates that presence of circulating anti-HLA antibodies especially donor specific leads to early graft loss and high titres of DSA may even lead to hyperacute or accelerated acute rejection...
December 2016: International Journal of Immunogenetics
https://www.readbyqxmd.com/read/27867168/clinical-experience-of-dual-phase-cone-beam-computed-tomography-during-hepatic-arteriography-to-apply-3d-dsa
#17
Yoshinori Takao, Akihiko Kakimi, Yutaka Katayama, Shohei Sasaki, Toshiyo Norimasa, Shinichiro Izuta, Daisuke Himoto, Takao Ichida
We report on the methods and experiences of the dual-phase cone beam computed tomography during hepatic arteriography (CBCTHA) to apply the 3D-DSA. A total of 32 ml contrast medium (150 mgI/ml) was injected at the rate of 2.0 ml/s for 16 s. The early phase scan was initiated 10 s after the start of contrast media injection. The delayed phase scan was started 40 s after that (24 s after the end of CM injection). When using the dual phase CBCTHA, it was able to obtain the classical hepatocellular carcinoma (HCC) images same as computed tomography during hepatic arteriography (CTHA)...
2016: Nihon Hoshasen Gijutsu Gakkai Zasshi
https://www.readbyqxmd.com/read/27867122/resolution-of-trigeminal-neuralgia-after-transvenous-embolization-of-a-cavernous-sinus-dural-arteriovenous-fistula
#18
Kenji Fukutome, Ichiro Nakagawa, Hun Soo Park, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
A rare case of cavernous sinus dural arteriovenous fistula (CSDAVF) in a patient with trigeminal neuralgia (TN) that resolved immediately after transvenous embolization (TVE) is described. A 75-year-old woman presented with continuous facial pain. On time-of-flight magnetic resonance angiography (MRA), a CSDAVF was suspected, and digital subtraction angiography (DSA) showed a CSDAVF. The TN completely resolved immediately after TVE, with no recurrence. Follow-up MRA showed complete obliteration of the fistula 13 months after TVE...
November 17, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27862923/reduction-of-extended-release-tacrolimus-dose-in-low-immunological-risk-kidney-transplant-recipients-increases-risk-of-rejection-and-appearance-of-dsa-a-randomized-study
#19
Philippe Gatault, Nassim Kamar, Matthias Büchler, Charlotte Colosio, Dominique Bertrand, Antoine Durrbach, Laeticia Albano, Joseph Rivalan, Yannick Le Meur, Marie Essig, Nicolas Bouvier, Christophe Legendre, Bruno Moulin, Anne-Elisabeth Heng, Pierre-François Weestel, Johnny Sayegh, Bernard Charpentier, Lionel Rostaing, Eric Thervet, Yvon Lebranchu
The aim of this study (NCT01744470) was to determine the efficacy and safety of two different doses of extended-release tacrolimus (TacER) in kidney transplant recipients (KTR) between 4 and 12 months post-transplantation. Stable steroid-free KTR were randomized (1:1) after 4 months: Group A 50%-reduction in TacER dose with targeted TacERC0>3μg/L; Group B no change in TacER dose (TacERC0=7-12μg/L). The primary outcome was eGFR at 1 year. Of 300 patients, intent-to-treat analysis included 186 patients (Group A 87, Group B 99)...
November 9, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27862900/long-term-renal-allograft-survival-after-sequential-liver-kidney-transplantation-from-a-single-living-donor
#20
Kumiko Kitajima, Yuichi Ogawa, Katsuyuki Miki, Kotaro Kai, Akihito Sannomiya, Kazuhiro Iwadoh, Toru Murakami, Ichiro Koyama, Ichiro Nakajima, Shohei Fuchinoue
Background Combined liver-kidney transplantation (CLKT) is well-established as a definitive therapy with the potential to provide complete recovery for certain liver-kidney diseases, although the results might be contingent on the cause of transplantation. The purposes of the present study were to review the long-term outcome of renal allografts in CLKT patients from single living donors and to investigate the beneficial factors, compared with solitary renal transplantation. Materials and Methods Thirteen patients underwent sequential liver (LTx) and kidney (KTx) transplantations from single living donors...
November 10, 2016: Liver Transplantation
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