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https://www.readbyqxmd.com/read/28433406/results-of-the-implementation-of-a-multidisciplinary-programme-of-faecal-microbiota-transplantation-by-colonoscopy-for-the-treatment-of-recurrent-clostridium-difficile-infection
#1
Antonio López-Sanromán, Enrique Rodríguez de Santiago, Javier Cobo Reinoso, Rosa Del Campo Moreno, José Ramón Foruny Olcina, Sergio García Fernández, Ana García García de Paredes, Lara Aguilera Castro, Carlos Ferre Aracil, Agustín Albillos Martínez
INTRODUCTION: Recurrent Clostridium difficile infection (CDI) is common and often difficult to manage. Faecal microbiota transplant (FMT) is an effective therapeutic tool in these cases, although its applicability and effectiveness in Spain is currently unknown. AIM: To analyse the technical aspects, safety and effectiveness of the first consolidated FMT programme in Spain. METHODS: Retrospective descriptive study of all patients with recurrent CDI treated with FMT performed by colonoscopy in a tertiary centre after the implementation of a multidisciplinary protocol between March 2015 and September 2016...
April 19, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28433104/wilson-disease-symptomatic-liver-therapy
#2
Jan Pfeiffenberger, Karl-Heinz Weiss, Wolfgang Stremmel
Wilson disease leads to symptomatic impairment of liver function or liver cirrhosis. Strict adherence to decoppering agents is essential in these patients. Secondary prevention of additional hepatic damage by avoidance of other toxic substances (e.g., alcohol, drugs) and sufficient calorie intake is recommended. Routine examinations in cirrhotic patients include screening for signs of portal hypertension (esophagus varices), development of ascites, and hepatic encephalopathy. Where varices are present, primary or secondary preventive interventions may include treatment with nonselective beta-blockers or variceal ligation, similar to the approach in patients with liver cirrhosis due to other etiologies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28432714/high-human-cytomegalovirus-dnaemia-early-post-transplantation-associates-with-irreversible-and-progressive-loss-of-renal-function
#3
Wouter T Lollinga, Lilli Rurenga-Gard, Willem van Doesum, Rik van Bergen, Arjan Diepstra, Judith M Vonk, Annelies Riezebos-Brilman, Hgm Niesters, Willem J van Son, Jacob van den Born, Jan-Stephan Sanders
BACKGROUND: Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. METHODS: 264 (age 50.9±13.5; male 55%) Renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL≤536, PVL536-6310 or PVL>6310 International Units/ml (IU/ml)...
April 22, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28432575/liver-transplantation-the-role-of-metabolic-syndrome
#4
REVIEW
Brian C Davis, M Shadab Siddiqui
The long-term survival in liver transplant recipients (LTRs) is currently at an historical high level stemming from improvement in perioperative care, infection control, and immunosuppression medications. However, compared to the general population, LTRs have decreased survival. Metabolic diseases like hypertension, dyslipidemia, type 2 diabetes, and obesity are key determinants of long-term mortality in LTRs. The incidence and prevalence of these metabolic comorbidities is considerably higher in LTRs and likely results from a combination of factors including exposure to chronic immunosuppression, weight gain, and recurrence of chronic liver disease after liver transplantation (LT)...
April 21, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28432506/elective-colectomy-for-diverticulitis-in-transplant-patients-is-it-worth-the-risk
#5
Janet T Lee, Steve Skube, Genevieve B Melton, Mary R Kwaan, Christine C Jensen, Robert D Madoff, Wolfgang B Gaertner
BACKGROUND: The aim of this study was to determine morbidity and mortality for transplant patients undergoing elective colectomy for diverticulitis and determine the impact of recurrent diverticulitis on postoperative complications. METHODS: We identified transplant recipients that underwent elective colectomy for diverticulitis between 2000 and 2015 at a tertiary care institution. Patient and procedure variables, postoperative complications, length of stay, 30-day readmission, and mortality were identified through retrospective chart review...
April 21, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28431983/comparison-of-extracorporeal-photopheresis-and-alemtuzumab-for-the-treatment-of-chronic-lung-allograft-dysfunction
#6
Anna Moniodis, Keri Townsend, Alexander Rabin, Obadah Aloum, Jessica Stempel, Patrick Burkett, Phillip Camp, Miguel Divo, Souheil El-Chemaly, Hari Mallidi, Ivan Rosas, Anne Fuhlbrigge, Sophia Koo, Hilary J Goldberg
BACKGROUND: Survival after lung transplantation is limited by chronic lung allograft dysfunction (CLAD). Immunomodulatory therapies such as extracorporeal photopheresis (ECP) and alemtuzumab (AL) have been described for refractory CLAD, but comparative outcomes are not well defined. METHODS: We retrospectively reviewed spirometric values and clinical outcomes after therapy with ECP, AL, or no treatment (NT) in patients with CLAD who underwent transplant between January 2005 and December 2014...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28430300/left-ventricular-assist-pump-pocket-infection-conservative-treatment-strategy-for-destination-therapy-candidates
#7
Elie Haddad, François-Xavier Lescure, Walid Ghodhbane, Laurent Lepage, Camille D'humieres, William Vindrios, Yazdan Yazdanpanah, Patrick Nataf, Matthias Kirsch
BACKGROUND: Heart failure is a major cause of mortality and morbidity, particularly among patients with advanced disease and no access to cardiac transplantation. LVAD implantation is not only a bridge-to-transplantation option for patients awaiting a heart donor, but is often used as bridge-to-destination therapy in patients unsuited for transplantation for various reasons. LVAD infection is considered the second-most common cause of death in patients who survive the initial 6 months on LVAD support...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28430065/ethical-issues-in-fecal-microbiota-transplantation-in-practice
#8
Yonghui Ma, Jiayu Liu, Catherine Rhodes, Yongzhan Nie, Faming Zhang
Fecal microbiota transplantation (FMT) has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent Clostridium difficile infection. Despite a lack of high-quality trials to provide more information on the long-term effects of FMT, there has been great enthusiasm about the potential for expanding its applications. However, FMT presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. In this article, we draw on a sample of the scientific and bioethics literatures to examine clusters of ethical and social issues arising in five main areas: (1) informed consent and the vulnerability of patients; (2) determining what a "suitable healthy donor" is; (3) safety and risk; (4) commercialization and potential exploitation of vulnerable patients; and (5) public health implications...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28429866/successful-multiple-organ-donation-after-donor-brain-death-due-to-actinomyces-israelii-meningitis
#9
Leonel Lagunes, Oscar Len, Alberto Sandiumenge, Elena Martínez-Saez, Tomás Pumarola, Marta Bodro, Antonio Macías, Jose T Silva, F Xavier Nuvials, Ramon Charco, Francesc Moreso, Teresa Pont
The increasing gap between availability of solid organs for transplantation and the demand has led to the inclusion of donors which according to current guidelines may be discarded, some of them because of the possibility for transmission of infection to their recipients. We present the first report, to the best of our knowledge, of a case of a brain-dead donor with a localized and treated Actinomyces israelii central nervous system infection who, after a thorough evaluation, led to successful transplant procedures in four recipients...
April 21, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28429862/epidemiology-of-invasive-fungal-diseases-in-children-with-solid-tumours-undergoing-autologous-haematopoietic-stem-cell-transplantation-a-10-year-experience-in-a-tertiary-italian-centre
#10
Paola Tatarelli, Maura Faraci, Ilaria Caviglia, Roberto Bandettini, Giuliana Cangemi, Gian Michele Magnano, Alberto Garaventa, Claudio Viscoli, Elio Castagnola
The objective of the study was to determine the incidence of invasive fungal disease (IFD) in children undergoing autologous haematopoietic stem cell transplantation (auHSCT) for solid tumours (ST). Retrospective study on auHSCT was performed in children with ST (January 2006-December 2015). Data on the number of patient-days at risk (pdr) during the first 30 and 90 days after auHSCT and cases of proven/probable IFDs were collected. Infection rate (IR, episodes/1000 pdr) and proportions and cumulative risk (CR) of IFD were evaluated...
April 21, 2017: Mycoses
https://www.readbyqxmd.com/read/28429575/recovery-from-talaromyces-marneffei-involving-the-kidney-in-a-renal-transplant-recipient-a-case-report-and-literature-review
#11
Juan Peng, Zhiyong Chen, Ruiming Cai, Xianen Huang, Liying Lin, Weixiang Liang, Zhongtang Xiong, Juan Chen, Hui Chen, Yuexin Yang, Shaoyan Liu, Qingping Jiang
Talaromyces marneffei is an emerging opportunistic infection among immunocompromised patients. We observe the first native case of disseminated T. marneffei involving the kidney in a renal transplant recipient in mainland China. We describe the comprehensive clinical course, and ultrasound imaging of renal transplant biopsy, pathologic images, and electron microscopy observation of the biopsy specimen, highlighting the relevance of biopsy findings and the blood culture. We also focus on the treatment and good outcome of the patient...
April 21, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28429246/comparison-of-efficacy-and-safety-of-caspofungin-versus-micafungin-in-pediatric-allogeneic-stem-cell-transplant-recipients-a-retrospective-analysis
#12
Natalia Maximova, Giulia Schillani, Roberto Simeone, Alessandra Maestro, Davide Zanon
INTRODUCTION: The high morbidity and mortality associated with invasive fungal infections (IFIs) provide the rationale for antifungal prophylaxis in immuno-compromised pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Caspofungin and micafungin are antifungal agents of interest for prophylaxis of IFIs because of their potency against Candida and minimal toxicity or interactions with other drugs. Few studies have demonstrated the safety and efficacy of such echinocandins as prophylaxis for IFIs in patients undergoing HSCT...
April 20, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28429083/intravenous-treprostinil-infusion-via-a-fully-implantable-pump-for-pulmonary-arterial-hypertension
#13
Ralf Ewert, Manuel J Richter, Regina Steringer-Mascherbauer, Ekkehard Grünig, Tobias J Lange, Christian F Opitz, Christian Warnke, Hossein-Ardeschir Ghofrani
OBJECTIVES: Parenteral prostanoids infused via external pumps are well-established pulmonary arterial hypertension (PAH) treatments. However, local side-effects and systemic infections restrict their use. The purpose of this study was to investigate the safety of a fully implantable treprostinil infusion pump (LENUS Pro(®)) in patients with PAH. METHODS: Thirty patients with PAH undergoing pump implantation (with stable PAH therapy for ≥3 weeks pre-implantation) were included in this prospective, multicenter, observational study (NCT01979822)...
April 20, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28428898/severe-acute-hepatitis-b-in-hbv-vaccinated-partner-of-a-patient-with-multiple-myeloma-treated-with-cyclophosphamide-bortezomib-and-dexamethasone-and-autologous-stem-cell-transplant
#14
Majed M Almaghrabi, Kyle J Fortinsky, David Wong
Hepatitis B reactivation can occur with various forms of immunosuppression. Cyclophosphamide, Bortezomib, and Dexamethasone (CYBOR-D) chemotherapy is commonly used for the treatment of multiple myeloma and has not been noted in guidelines to be causative in HBV reactivation. Indeed, current guidelines do not recommend providing antiviral prophylaxis to patients with prior HBV infection. We present a case of HBV reactivation as a result of CYBOR-D and autologous stem cell transplant which is complicated by the patient's partner who developed acute hepatitis B...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28428345/proliferation-of-primary-human-hepatocytes-and-prevention-of-hepatitis-b-virus-reinfection-efficiently-deplete-nuclear-cccdna-in-vivo
#15
Lena Allweiss, Tassilo Volz, Katja Giersch, Janine Kah, Giuseppina Raffa, Joerg Petersen, Ansgar W Lohse, Concetta Beninati, Teresa Pollicino, Stephan Urban, Marc Lütgehetmann, Maura Dandri
OBJECTIVE: The stability of the covalently closed circular DNA (cccDNA) in nuclei of non-dividing hepatocytes represents a key determinant of HBV persistence. Contrarily, studies with animal hepadnaviruses indicated that hepatocyte turnover can reduce cccDNA loads but knowledge on the proliferative capacity of HBV-infected primary human hepatocytes (PHHs) in vivo and the fate of cccDNA in dividing PHHs is still lacking. This study aimed to determine the impact of human hepatocyte division on cccDNA stability in vivo...
April 20, 2017: Gut
https://www.readbyqxmd.com/read/28427505/toxicity-of-iron-overload-and-iron-overload-reduction-in-the-setting-of-hematopoietic-stem-cell-transplantation-for-hematologic-malignancies
#16
REVIEW
Heather A Leitch, Eitan Fibach, Eliezer Rachmilewitz
Iron is an essential element for key cellular metabolic processes. However, transfusional iron overload (IOL) may result in significant cellular toxicity. IOL occurs in transfusion dependent hematologic malignancies (HM), may lead to pathological clinical outcomes, and IOL reduction may improve outcomes. In hematopoietic stem cell transplantation (SCT) for HM, IOL may have clinical importance; endpoints examined regarding an impact of IOL and IOL reduction include transplant-related mortality, organ function, infection, relapse risk, and survival...
May 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28427382/splenectomy-before-adult-liver-transplantation-a-retrospective-study
#17
LingXiang Kong, Ming Li, Lei Li, Li Jiang, Jiayin Yang, Lvnan Yan
BACKGROUND: A considerable number of patients with portal hypertension (PHT) have to undergo splenectomy because they do not meet the requirements for liver transplantation (LT) or cannot find a suitable liver donor. However, it is not known whether pre-transplantation splenectomy may create occult difficulties for patients who require LT in future. METHODS: We analyzed 1059 consecutive patients who underwent adult liver transplantation (ADLT). Patients with pre-transplantation splenectomy Sp(+) and without splenectomy Sp(-) were compared using a propensity score analysis to create the best match between groups...
April 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28427354/unique-case-report-of-a-chromomycosis-and-listeria-in-soft-tissue-and-cerebellar-abscesses-after-kidney-transplantation
#18
J Tourret, N Benabdellah, S Drouin, F Charlotte, J Rottembourg, N Arzouk, A Fekkar, B Barrou
BACKGROUND: Chromomycosis is a rare mycotic infection encountered in tropical and subtropical regions. The disease presents as a slowly-evolving nodule that can become infected with bacteria. Here, we describe a unique association of abscesses caused by a chromomycosis and Listeria monocytogenes in a kidney transplant recipient, and didactically expose how the appropriate diagnosis was reached. CASE PRESENTATION: A 49-year old male originating from the Caribbean presented a scalp lesion which was surgically removed in his hometown where it was misdiagnosed as a sporotrichosis on histology, 3 years after he received a kidney transplant...
April 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28426901/a-case-of-toxic-epidermal-necrolysis-and-vanishing-bile-duct-syndrome-requiring-liver-transplantation
#19
Sophie Momen, Carol Dangiosse, Emma Wedgeworth, Sarah Walsh, Daniel Creamer
A 52-year-old woman presented with a five-day history of headache, fevers and a diffuse, macular erythematous rash. Ten days prior she received cephalexin for a urinary-tract infection. She had a history of gastro-oesophageal reflux disorder and took omeprazole. This article is protected by copyright. All rights reserved.
April 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28426468/indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax
#20
Kevin P Haas, Alexander C Chen
PURPOSE OF REVIEW: Hepatic hydrothorax is a complication of end-stage liver disease that may have significant associated morbidity. Sodium restriction and diuretic therapy are the mainstays of treatment, though up to a quarter of patients will become refractory to this and will require a pleural drainage procedure. Thoracentesis, transjugular intrahepatic portosystemic shunt, and chemical pleurodesis all have variable success rates and associated complications in the management of hepatic hydrothorax...
April 19, 2017: Current Opinion in Pulmonary Medicine
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