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https://www.readbyqxmd.com/read/29225970/dialysis-provision-and-implications-of-health-economics-on-peritoneal-dialysis-utilization-a-review-from-a-malaysian-perspective
#1
REVIEW
Mohd Rizal Abdul Manaf, Naren Kumar Surendra, Abdul Halim Abdul Gafor, Lai Seong Hooi, Sunita Bavanandan
End-stage renal disease (ESRD) is managed by either lifesaving hemodialysis (HD) and peritoneal dialysis (PD) or a kidney transplant. In Malaysia, the prevalence of dialysis-treated ESRD patients has shown an exponential growth from 504 per million population (pmp) in 2005 to 1155 pmp in 2014. There were 1046 pmp patients on HD and 109 pmp patients on PD in 2014. Kidney transplants are limited due to lack of donors. Malaysia adopts public-private financing model for dialysis. Majority of HD patients were treated in the private sector but almost all PD patients were treated in government facilities...
2017: International Journal of Nephrology
https://www.readbyqxmd.com/read/29222306/therapy-of-primary-cns-lymphoma-role-of-intensity-radiation-and-novel-agents
#2
REVIEW
Andrés José María Ferreri
Primary central nervous system (CNS) lymphomas represent a subgroup of malignancies with specific characteristics, an aggressive course, and unsatisfactory outcome in contrast with other lymphomas comparable for tumor burden and histological type. Despite the high sensitivity to conventional chemotherapy and radiotherapy, remissions are frequently short lasting. Treatment efficacy is limited by several factors, including the biology and microenvironment of this malignancy and the "protective" effect of the blood-brain barrier, which limits the access of most drugs to the CNS...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222290/chronic-organ-failure-in-adult-sickle-cell-disease
#3
REVIEW
Elliott Vichinsky
Sickle cell disease is now a chronic adult illness characterized by progressive multiorgan failure, particularly involving the brain and kidney. The etiology is multifactorial; it includes hemolysis and nitric oxide deficiency. As patients age, most experience neurologic insult. Twenty-five percent of older adults have had a clinical stroke and at least half of the population have had a silent infarct, cortical atrophy, and neurocognitive impairment. Periodic screening with neuroimaging and neurocognitive testing is recommended...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221922/pediatric-percutaneous-nephrostomy-a-multicenter-experience
#4
Sphoorti Shellikeri, Robert Daulton, Madeleine Sertic, Bairbre Connolly, Mark Hogan, Francis Marshalleck, Anne Marie Cahill
PURPOSE: To analyze technique, outcomes, and complications of a large series of pediatric percutaneous nephrostomy (PCN) procedures performed at 4 tertiary pediatric centers. MATERIALS AND METHODS: Retrospective multicenter study of PCNs performed during an 11-year period. Six hundred seventy-five PCNs were performed on 441 patients (median age: 4 y, range: 1 d-18 y, median weight: 17 kg, range: 0.7-112 kg); 31% were younger than 1 year. The most frequent indications for PCN procedures included hydronephrosis (57%), calculus (14%), and infection (12%)...
December 5, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29221730/ablation-of-transcription-factor-irf4-promotes-transplant-acceptance-by-driving-allogenic-cd4-t-cell-dysfunction
#5
Jie Wu, Hedong Zhang, Xiaomin Shi, Xiang Xiao, Yihui Fan, Laurie J Minze, Jin Wang, Rafik M Ghobrial, Jiahong Xia, Roger Sciammas, Xian C Li, Wenhao Chen
CD4+ T cells orchestrate immune responses and destruction of allogeneic organ transplants, but how this process is regulated on a transcriptional level remains unclear. Here, we demonstrated that interferon regulatory factor 4 (IRF4) was a key transcriptional determinant controlling T cell responses during transplantation. IRF4 deletion in mice resulted in progressive establishment of CD4+ T cell dysfunction and long-term allograft survival. Mechanistically, IRF4 repressed PD-1, Helios, and other molecules associated with T cell dysfunction...
December 4, 2017: Immunity
https://www.readbyqxmd.com/read/29218968/the-psychiatry-integrated-nurse-practitioner-role-in-hemodialysis-an-opportunity-to-provide-nurse-practitioner-care-between-the-interface-of-psychiatry-and-hemodialysis
#6
Brock Cooper, Kien Dang, Ann Jones, Alison Thomas
The mental health of patients living with end-stage kidney disease (ESKD) is an important aspect of their care. According to national survey data, depressive disorders affect about 9% of the North American population (Kessler, Chiu, Demler, Merikangas, & Walters, 2005). A review of psychological distress and depression across the spectrum of chronic kidney disease indicates that the prevalence of depression in ESKD is reported to be about four times that of the general population and it is associated with adverse outcomes including low quality-of-life ratings, graft failure, and death after renal transplantation (Zalai, Szeifert, & Novak, 2012)...
January 2017: CANNT Journal, Journal ACITN
https://www.readbyqxmd.com/read/29218696/a-modular-vascular-access-training-program-for-higher-surgical-trainees
#7
Mark Edwards, Alexander D Rodway, Islam G Ahmed, Richard A Harvey, Tamer S Foad, Karim M El Sakka
INTRODUCTION: Access surgery is delivered by vascular/transplant surgeons with a division that is defined by historic practice. This has resulted in an inconsistent training pattern. We aimed to design a focused, modular training program (The Brighton Vascular Access Fellowship) providing trainees with a reproducible level of exposure and competence. METHODS: The programme was 16 days over 8 weeks on a one-to-one basis with candidates expected to be performing procedures as first surgeon with ongoing, formative assessment...
December 4, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29217801/accessible-pediatric-liver-transplantation-in-india-a-long-way-to-go
#8
Mohamed Rela, Naresh P Shanmugham
No abstract text is available yet for this article.
November 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/29217436/endolymphatic-thoracic-duct-stent-graft-reconstruction-for-chylothorax-approach-technical-success-safety-and-short-term-outcomes
#9
Rajiv Srinivasa, Jeffrey Forris Beecham Chick, Anthony Hage, Joseph J Gemmete, Douglas C Murrey, Ravi N Srinivasa
PURPOSE: To report approach, technical success, safety, and short-term outcomes of thoracic duct stent-graft reconstruction for the treatment of chylothorax. MATERIALS AND METHODS: Two patients, one (50%) male and one (50%) female, with mean age of 38 years (range: 16-59 years) underwent endolymphatic thoracic duct stent-grafting between September 2016 and July 2017. Patients had radiographic left-sided chylothoraces (n=2) from idiopathic causes (n=1) and heart transplantation (n=1)...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29215463/variation-in-practice-patterns-for-listing-patients-for-renal-transplantation-in-the-united-kingdom-a-national-survey
#10
Rishi Pruthi, Sarah Tonkin-Crine, Melania Calestani, Geraldine Leydon, Caroline Eyles, Gabriel C Oniscu, Charles Tomson, Andrew Bradley, John L Forsythe, Clare Bradley, John Cairns, Christopher Dudley, Christopher Watson, Heather Draper, Rachel Johnson, Wendy Metcalfe, Damian Fogarty, Rommel Ravanan, Paul J Roderick
INTRODUCTION: Despite the availability of guidelines for the evaluation of candidates for renal transplantation, variation in access to transplantation exists. This national survey investigates whether centre variation exists in the assessment of patients for renal transplantation in the UK. METHODS: An online survey, informed by qualitative interviews, was distributed to all UK renal centres. This survey examined centre approaches to chronic kidney disease service provision, transplant recipient assessment, education provision and wait-listing decision making processes...
December 5, 2017: Transplantation
https://www.readbyqxmd.com/read/29214956/wickedness-moral-responsibility-and-access-to-transplantable-livers
#11
Ryan Tonkens
Under the current conditions of scarcity of transplantable livers, difficult decisions need to be made about access. There is a growing consensus that it is morally justified to give people with ARESLD lower priority than those whose need is not self-caused. The purpose of this article is to critically examine the conditions under which such prioritization is morally justified, by challenging arguments put forth by Walter Glannon and Daniel Brudney. There are serious theoretical and practical problems with these views, which have to do with the nature and scope of the (putative) moral duty not to contribute to the competition for scarce transplantable livers, and the difficulty in determining whether people are responsible for their weakness or even wickedness of character...
January 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/29210975/multi-center-evaluation-of-a-new-electrochemiluminescence-immunoassay-eclia-for-everolimus-concentrations-in-whole-blood
#12
Alain G Verstraete, Raül Rigo-Bonnin, Pierre Wallemacq, Michael Vogeser, Andre Schuetzenmeister, Christian Schmiedel, Maria Shipkova
BACKGROUND: The precise monitoring of everolimus, an immunosuppressant drug, is vital for transplant recipients due to its narrow therapeutic range. This study evaluated the analytical performance of a new electrochemiluminescence immunoassay (ECLIA) for everolimus concentrations in whole blood. METHODS: Accuracy, imprecision, and sensitivity studies for the Roche Elecsys everolimus ECLIA were performed at five European laboratories. The ECLIA was compared with liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods, as well as the Quantitative Microsphere System (QMS) everolimus assay...
November 28, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29210164/relative-risk-of-home-hemodialysis-attrition-in-patients-using-a-telehealth-platform
#13
Eric D Weinhandl, Allan J Collins
INTRODUCTION: Home hemodialysis (HHD) facilitates increased treatment frequency, which may improve patient outcomes. However, attrition due to technique failure limits the clinical effectiveness of the modality. Nx2me Connected Health is a telehealth platform that enables ongoing assessment of HHD patients using NxStage equipment, and that may reduce patient burden. We aimed to assess whether use of Nx2me was associated with risk of HHD attrition. METHODS: We compared risks of all-cause attrition, dialysis cessation (i...
December 6, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29208489/relaxing-access-to-liver-transplantation-with-living-donation-a-foolish-move-or-a-time-to-change
#14
EDITORIAL
John G O'Grady
No abstract text is available yet for this article.
December 2, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29206486/the-method-of-chicken-whole-embryo-culture-using-the-eggshell-windowing-surrogate-eggshell-and-ex-ovo-culture-system
#15
M Farzaneh, F Attari, S E Khoshnam, P E Mozdziak
1. The unique accessibility of the avian embryo have made them an ideal model for the study of development and genome editing. Chicken whole embryo culture has provided important insights into toxicity tests, gene manipulation, clarifying gene functions, cell transplantation, and cell tracking. 2. A simple technique for chicken manipulation is eggshell windowing, without or with seal, the latter having demonstrated some improvement in hatching rates. 3. Likewise, a surrogate eggshell system provides an accessible model for manipulation during chicken and quail development, with a higher hatchability compared to the simple windowing method...
December 5, 2017: British Poultry Science
https://www.readbyqxmd.com/read/29205755/short-term-outcomes-of-pediatric-liver-transplant-recipients-after-transition-to-adult-healthcare-service
#16
Alberto Ferrarese, Giacomo Germani, Silvia Lazzaro, Mara Cananzi, Francesco Paolo Russo, Marco Senzolo, Martina Gambato, Alberto Zanetto, Umberto Cillo, Enrico Gringeri, Giorgio Perilongo, Patrizia Burra
BACKGROUND AND AIMS: Survival rates after liver transplantation (LT) in pediatric recipients has significantly improved overtime. However, data regarding outcomes after transition from Pediatric to Adult Healthcare Service (AHS) are still lacking. Therefore, we aimed to prospectively evaluate the outcome of LT recipients after transition; to access patients' non-adherence and identify potential risk factors for non-adherence. METHODS: All consecutive adolescent LT recipients moving to the AHS at Padua University Hospital were evaluated between 2010-2015...
December 5, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29203125/vascular-access-outcomes-reported-in-maintenance-hemodialysis-trials-a-systematic-review
#17
Andrea K Viecelli, Emma O'Lone, Benedicte Sautenet, Jonathan C Craig, Allison Tong, Eric Chemla, Lai-Seong Hooi, Timmy Lee, Charmaine Lok, Kevan R Polkinghorne, Robert R Quinn, Tushar Vachharajani, Raymond Vanholder, Li Zuo, Ashley B Irish, Trevor A Mori, Elaine M Pascoe, David W Johnson, Carmel M Hawley
BACKGROUND: Many randomized controlled trials have been performed with the goal of improving outcomes related to hemodialysis vascular access. If the reported outcomes are relevant and measured consistently to allow comparison of interventions across trials, such trials can inform decision making. This study aimed to assess the scope and consistency of vascular access outcomes reported in contemporary hemodialysis trials. STUDY DESIGN: Systematic review. SETTING & POPULATION: Adults requiring maintenance hemodialysis...
December 1, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29202467/endothelial-chimerism-and-vascular-sequestration-protect-pancreatic-islet-grafts-from-antibody-mediated-rejection
#18
Chien-Chia Chen, Eric Pouliquen, Alexis Broisat, Francesco Andreata, Maud Racapé, Patrick Bruneval, Laurence Kessler, Mitra Ahmadi, Sandrine Bacot, Carole Saison-Delaplace, Marina Marcaud, Jean-Paul Duong Van Huyen, Alexandre Loupy, Jean Villard, Sandrine Demuylder-Mischler, Thierry Berney, Emmanuel Morelon, Meng-Kun Tsai, Marie-Nathalie Kolopp-Sarda, Alice Koenig, Virginie Mathias, Stéphanie Ducreux, Catherine Ghezzi, Valerie Dubois, Antonino Nicoletti, Thierry Defrance, Olivier Thaunat
Humoral rejection is the most common cause of solid organ transplant failure. Here, we evaluated a cohort of 49 patients who were successfully grafted with allogenic islets and determined that the appearance of donor-specific anti-HLA antibodies (DSAs) did not accelerate the rate of islet graft attrition, suggesting resistance to humoral rejection. Murine DSAs bound to allogeneic targets expressed by islet cells and induced their destruction in vitro; however, passive transfer of the same DSAs did not affect islet graft survival in murine models...
November 20, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29198669/broadened-allocation-of-pancreas-transplants-across-compatible-abo-blood-types
#19
J A Fridell, S K Gustafson, B W Thompson, A C Fox, M A Prentice, M A Curry, J S Odorico
BACKGROUND: Current Organ Procurement and Transplantation Network (OPTN) policy restricts certain blood type-compatible simultaneous pancreas and kidney (SPK) transplants. Using the Kidney Pancreas Simulated Allocation Model, we examined the effects of 5 alternative allocation sequences that allowed all clinically compatible ABO transplants. METHODS: The study cohort included kidney (KI), SPK, and pancreas alone (PA) candidates waiting for transplant for at least 1 day between January 1, 2010, and December 31, 2010 (full cohort), and kidneys and pancreata recovered for transplant during the same period...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198642/caring-for-undocumented-immigrants-with-kidney-disease
#20
Rajeev Raghavan
The care of dialysis-dependent undocumented immigrants exemplifies a problem at the crux of 2 US national agendas: immigration and health care reform. Undocumented immigrants represent 3% of the US population and 27% of the uninsured, and an estimated 6,500 individuals are dialysis dependent. With no uniform national policy, an estimated 30% to 50% of these individuals receive treatment only in life-threatening situations (emergent dialysis). Since 2005, about 400 undocumented immigrants have received a kidney transplant (>70% living)...
November 30, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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