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https://www.readbyqxmd.com/read/27888534/early-steroid-withdrawal-results-in-improved-patient-and-graft-survival-and-lower-risk-of-post-transplant-cardiovascular-risk-profiles-a-single-center-10-year-experience
#1
Reynold Lopez-Soler, Ryan Chan, Jessica Martinolich, Lisa Park, Ashar Ata, Nikolaos Chandolias, David Conti
Long term use of steroids results in predictable secondary effects that can lead to increased morbidity and mortality. In this study, we present 10 years' worth of data of early steroid withdrawal (ESW) immunosuppression consisting of Mycophenolate, Sirolimus, and Tacrolimus. From 2003 to 2013, 563 kidney transplant recipients were weaned off steroids prior to discharge. We compared outcomes with that of our 65 historical controls maintained on steroids. We analyzed graft and patient survival and determined the incidence of steroid-related comorbidities such as hypertension, hypercholesterolemia, diabetes, coronary artery disease, and weight gain...
November 26, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27885196/stent-recoil-manifesting-as-early-stent-thrombosis-after-ultimaster-thin-strut-cobalt-chromium-sirolimus-eluting-stent-implantation
#2
Akira Sato, Masafumi Ohtani, Hiroaki Watabe, Daiki Akiyama, Tomoya Hoshi, Kazutaka Aonuma
No abstract text is available yet for this article.
November 22, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27876438/physicochemical-characteristics-of-liposomes-are-decisive-for-their-antirestenosis-efficacy-following-local-delivery
#3
Azadeh Haeri, Saeed Sadeghian, Shahram Rabbani, Shapour Shirani, Maryam Sotoudeh Anvari, Simin Dadashzadeh
AIM: To develop an ameliorated sirolimus (SIR) liposome for intramural delivery, the effects of various carrier physicochemical parameters on the antirestenosis efficacy were evaluated. MATERIALS & METHODS: Different liposomes were prepared, characterized and administered to balloon injured rats (12 animal groups). Their efficacies were investigated using morphometric, immunohistochemical and in vivo computed tomography imaging analyses. RESULTS: The antirestenosis efficacy of SIR liposomes decreased in the following order: cationic 100 nm vesicles ≥ cationic 60 nm vesicles > neutral 100 nm vesicles ≥ stealth 100 nm vesicles > anionic 100 nm vesicles...
November 23, 2016: Nanomedicine
https://www.readbyqxmd.com/read/27875036/drug-loaded-nanoparticle-coating-on-totally-bioresorbable-plla-stents-to-prevent-in-stent-restenosis
#4
Jian Zhao, Zhichao Mo, Fangfang Guo, Donglu Shi, Qian Qian Han, Qing Liu
Biodegradable polymer poly (dl-lactide) (PDLLA) has been used as drug coating material for drug-eluting stents due to its excellent biocompatibility and sustained drug release ability. However, the uniform thin layer drug eluting coating on a stent not only inhibits the blood vessel's smooth muscle cell overgrowth but also delay the endotheliation process which is often associated with the occurrence of acute thrombosis. Therefore, in this study, we developed a novel coating method using PDLLA nanoparticles (NPs) as a coating to overcome this issue...
November 22, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/27866137/clinical-and-multimodality-imaging-results-at-6-months-of-a-bioresorbable-sirolimus-eluting-scaffold-for-patients-with-single-de-novo-coronary-artery-lesions-the-neovas-first-in-man-trial
#5
Yao-Jun Zhang, Xiao-Zeng Wang, Guosheng Fu, Quan-Min Jing, Geng Wang, Chong-Ying Jin, Li-Hua Xie, Jin-Zan Cai, Bo Xu, Ya-Ling Han
AIMS: The study sought to investigate clinical and multimodality imaging assessment of a bioresorbable sirolimus-eluting scaffold (NeoVas, Lepu Medical, Beijing, China) for patients with single de novo coronary artery lesions. METHODS AND RESULTS: The NeoVas first-in-man study was a prospective, open-label study which enrolled 31 patients with single de novo lesions treated with a bioresorbable sirolimus-eluting scaffold. The primary endpoint was target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularisation (TLR)...
November 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27862340/everolimus-with-early-withdrawal-or-reduced-dose-calcineurin-inhibitors-improves-renal-function-in-liver-transplant-recipients-a-systematic-review-and-meta-analysis
#6
Michael Lin, Sahil Mittal, Farhad Sahebjam, Abbas Rana, Gagan K Sood
Calcineurin inhibitors (CNI) are the mainstay of immunosuppression after liver transplantation (LT), but CNIs are associated with significant nephrotoxicity. Recently, mTOR inhibitors such as sirolimus and everolimus (EVR) have been used with or without CNIs in LT recipients for their renal-sparing effect. We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) that examined the effect of EVR with CNI minimization or withdrawal on renal function in LT recipients. RCT of primary adult LT recipients with baseline GFR >30 mL/min who received EVR with CNI minimization or withdrawal were included...
November 16, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27855235/sirolimus-therapy-in-a-child-with-partially-diazoxide-responsive-hyperinsulinaemic-hypoglycaemia
#7
Kah-Yin Loke, Andrew Sng Anjian, Yvonne Lim Yijuan, Cindy Ho Wei Li, Maria Güemes, Khalid Hussain
: Hyperinsulinaemic hypoglycaemia (HH), which causes persistent neonatal hypoglycaemia, can result in neurological damage and it's management is challenging. Diazoxide is the first-line treatment, albeit not all patients will fully respond to it, as episodes of hypoglycaemia may persist and it entails unpleasant adverse effects. Sirolimus, an mTOR inhibitor, has reportedly been successful in treating children with severe diffuse HH, thus obviating the need for pancreatectomy. We report a girl with HH, with a novel heterozygous ABCC8 gene missense mutation (c...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27837201/efficacy-and-safety-of-topical-sirolimus-therapy-for-facial-angiofibromas-in-the-tuberous-sclerosis-complex-a-randomized-clinical-trial
#8
Mari Wataya-Kaneda, Ayumi Nakamura, Mari Tanaka, Misa Hayashi, Shoji Matsumoto, Koji Yamamoto, Ichiro Katayama
Importance: Inhibitors of mammalian target of rapamycin complex 1, such as sirolimus, effectively target skin lesions in tuberous sclerosis complex (TSC). However, systemic treatment causes adverse effects, and topical sirolimus has shown promise in the treatment of facial angiofibromas. Objective: To evaluate the efficacy, safety, and optimal concentration of a topical sirolimus gel vs placebo for treatment of facial angiofibromas in TSC. Design, Setting, and Participants: A double-blind, placebo-controlled, parallel-group, dose-escalation, phase 2 randomized clinical trial using 3 sirolimus gel concentrations was performed at Osaka University Hospital, Osaka, Japan...
November 12, 2016: JAMA Dermatology
https://www.readbyqxmd.com/read/27833825/epidemiology-pathogenesis-and-diagnosis-of-lymphangioleiomyomatosis
#9
Angelo M Taveira-DaSilva, Joel Moss
INTRODUCTION: Lymphangioleiomyomatosis (LAM) is a disease of women characterized by cystic lung destruction, lymphatic involvement, and renal angiomyolipomas. AREAS COVERED: LAM is caused by proliferation of abnormal smooth muscle-like LAM cells containing mutations and perhaps epigenetic modifications of the TSC1 or TSC2 genes, which encode, respectively, hamartin and tuberin, two proteins controlling the mechanistic target of rapamycin (mTOR) signaling pathway...
2016: Expert Opinion on Orphan Drugs
https://www.readbyqxmd.com/read/27827824/plasma-biomarkers-of-risk-for-death-in-a-multicenter-phase-3-trial-with-uniform-transplant-characteristics-post-allogeneic-hct
#10
Mohammad Abu Zaid, Juan Wu, Cindy Wu, Brent R Logan, Jeffrey Yu, Corey Cutler, Joseph H Antin, Sophie Paczesny, Sung Won Choi
A phase 3 clinical trial (BMT CTN 0402) comparing tacrolimus/sirolimus (Tac/Sir) versus tacrolimus/methotrexate (Tac/Mtx) as graft-versus-host disease (GVHD) prophylaxis after matched-related allogeneic hematopoietic cell transplantation (HCT) recently showed no difference between study arms in acute GVHD-free survival. Within this setting of a prospective, multicenter study with uniform GVHD prophylaxis, conditioning regimen, and donor source, we explored the correlation of 10 previously identified biomarkers with clinical outcomes after allogeneic HCT...
November 8, 2016: Blood
https://www.readbyqxmd.com/read/27825633/survival-analysis-of-sirolimus-based-immunosuppression-in-liver-transplantation-in-patients-with-hepatocellular-carcinoma
#11
Shi-Lei Xu, Ying-Cai Zhang, Guo-Ying Wang, Qin Yang, Bo Liu, Jian Zhang, Hua Li, Gen-Shu Wang, Yang Yang, Gui-Hua Chen
AIM: To investigate the effect of a sirolimus-based immunosuppressive protocol on tumor recurrence and survival after liver transplantation (LT) in hepatocellular carcinoma (HCC) patients. METHODS: We retrospectively analyzed 142 HCC patients who underwent LT in our hospital from January 2006 to January 2012. The patients were divided into the sirolimus (SRL) group (62 cases) and non-sirolimus (control) group (80 cases). Disease-free survival (DFS) and tumor-bearing survival after tumor recurrence were compared using the Kaplan-Meier method...
December 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/27820137/favorable-response-to-sirolimus-in-a-child-with-blue-rubber-bleb-nevus-syndrome-in-the-gastrointestinal-tract
#12
Aysel Ünlüsoy Aksu, Sinan Sari, Ödül Eğritaş Gürkan, Buket Dalgiç
Recently, sirolimus was demonstrated to be effective in treating vascular lesions and lessening the frequency of bleeding and secondary iron deficiency anemia. We present a child with blue rubber bleb nevus syndrome who had prolonged history of iron deficiency anemia secondary to unrecognized gastrointestinal bleeding. Treatment with propranolol, omeprazole and iron had failed. After 2.5 months of sirolimus therapy (trough levels 1 to 5 ng/mL), his hemoglobin concentration improved into the normal range and remained stable...
November 4, 2016: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27820120/successful-treatment-of-a-complex-vascular-malformation-with-sirolimus-and-surgical-resection
#13
Dov C Goldenberg, Marcelo Carvas, Denise Adams, Marcelo Giannotti, Rolf Gemperli
Management of complex vascular malformation represents a challenge as it may include a wide variety of options such as embolization, laser therapy, sclerotherapy, and surgical resection but may lead to significant morbidity and is associated with high recurrence rates. In extreme and/or recurrent cases, successful use of sirolimus has been described. We report a case of large unresectable complex venous malformation treated with oral sirolimus for 24 months. Therapy was well tolerated. Patient had substantial improvement in symptoms and shrinkage of the lesion...
November 4, 2016: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27819684/tacrolimus-plus-sirolimus-with-or-without-atg-as-gvhd-prophylaxis-in-hla-mismatched-unrelated-donor-allogeneic-stem-cell-transplantation
#14
M A Kharfan-Dabaja, R Parody, J Perkins, O Lopez-Godino, L Lopez-Corral, L Vazquez, D Caballero, J Falantes, J Shapiro, G Ortí, P Barba, D Valcárcel, A Esquirol, R Martino, J L Piñana, C Solano, A Tsalatsanis, J Pidala, C Anasetti, J A Perez-Simón
HLA-matched related or unrelated donors are not universally available. Consequently, patients can be offered hematopoietic stem cell transplantation (HSCT) from alternative donors, including mismatched unrelated donors (MMURD), known to cause a higher incidence of acute GVHD (aGVHD) and chronic GVHD. In vivo T-cell-depletion strategies, such as antithymocyte globulin (ATG) therapy, significantly decrease the risk of GVHD. We performed a multicenter, retrospective study comparing tacrolimus (TAC) and sirolimus (SIR) with or without ATG in 104 patients (TAC-SIR=45, TAC-SIR-ATG=59) who underwent MMURD HSCT...
November 7, 2016: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27814621/drug-release-kinetics-from-a-drug-eluting-stent-with-asymmetrical-coat
#15
Haijun Zhang, Xiaodong Li, Wei Deng, Xiangfei Wang, Shenguo Wang, Junbo Ge, Egon Toft
The aim of this study was to investigate the drug release profiles of biodegradable polymer sirolimus- or paclitaxel-eluting stents with asymmetrical coating (BPSES-A or BPPES-A) both in vitro and in vivo. In vitro, the drug release profile was characterized by measuring the drug concentration by HPLC over a time-course. In vivo, a porcine aorta stenting model was employed. The results showed that the drug release rates of BPSES-A and BPPES-A were slower, more stable and less burst releasing than those of conventionally coated stents (BPSES-C and BPPES-C respectively), both in vitro and in vivo...
January 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/27806902/very-thin-strut-biodegradable-polymer-everolimus-eluting-and-sirolimus-eluting-stents-versus-durable-polymer-zotarolimus-eluting-stents-in-allcomers-with-coronary-artery-disease-bio-resort-a-three-arm-randomised-non-inferiority-trial
#16
Clemens von Birgelen, Marlies M Kok, Liefke C van der Heijden, Peter W Danse, Carl E Schotborgh, Martijn Scholte, R Melvyn Tjon Joe Gin, Samer Somi, K G van Houwelingen, M G Stoel, Frits H A F de Man, J Hans W Louwerenburg, Marc Hartmann, Paolo Zocca, Gerard C M Linssen, Job van der Palen, Carine J M Doggen, Marije M Löwik
BACKGROUND: In patients with coronary artery disease, treated with durable polymer-coated drug-eluting stents, the life-long presence of the polymer might delay arterial healing. Novel very thin strut biodegradable polymer stents, which leave only a bare metal stent after polymer resorption, might improve long-term outcome. We investigated in allcomers the safety and efficacy of three stents eluting either everolimus, sirolimus, or zotarolimus, often clinically used but never compared, of which the biodegradable polymer everolimus-eluting stent was never before assessed in allcomers...
November 26, 2016: Lancet
https://www.readbyqxmd.com/read/27806175/sirolimus-associated-rapid-progression-of-leg-ulcers-in-a-renal-transplant-recipient
#17
Mariam B Totonchy, Oscar R Colegio, Sean R Christensen
No abstract text is available yet for this article.
November 2, 2016: JAMA Dermatology
https://www.readbyqxmd.com/read/27795990/early-kidney-allograft-dysfunction-threatened-allograft-comparative-effectiveness-of-continuing-versus-discontinuation-of-tacrolimus-and-use-of-sirolimus-to-prevent-graft-failure-a-retrospective-patient-centered-outcome-study
#18
Ravinder K Wali, Heather A Prentice, Venkata Reddivari, Geroge Baffoe-Bonnie, Cinthia I Drachenberg, John C Pappadimitriou, Emilio Ramos, Matthew Cooper, Johann Jonsson, Stephen Bartlett, Matthew R Weir
BACKGROUND: Due to lack of treatment options for early acute allograft dysfunction in the presence of tubular-interstitial injury without histological features of rejection, kidney transplant recipients are often treated with sirolimus-based therapy to prevent cumulative calcineurin inhibitor exposure and to prevent premature graft failure. METHODS: We analyzed transplant recipients treated with sirolimus-based (n = 220) compared with continued tacrolimus-based (n = 276) immunosuppression in recipients of early-onset graft dysfunction (threatened allograft) with the use of propensity score-based inverse probability treatment weighted models to balance for potential confounding by indication between 2 nonrandomized groups...
September 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27795987/outcomes-of-pancreatic-islet-allotransplantation-using-the-edmonton-protocol-at-the-university-of-chicago
#19
Zehra Tekin, Marc R Garfinkel, W James Chon, Lindsay Schenck, Karolina Golab, Omid Savari, J Richard Thistlethwaite, Louis H Philipson, Colleen Majewski, Silvana Pannain, Sabarinathan Ramachandran, Kourosh Rezania, Seenu M Hariprasad, J Michael Millis, Piotr Witkowski
OBJECTIVE: The aim of this study was to assess short-term and long-term results of the pancreatic islet transplantation using the Edmonton protocol at the University of Chicago. MATERIALS AND METHODS: Nine patients underwent pancreatic islet cell transplantation using the Edmonton Protocol; they were followed up for 10 years after initial islet transplant with up to 3 separate islet infusions. They were given induction treatment using an IL-2R antibody and their maintenance immunosuppression regimen consisted of sirolimus and tacrolimus...
October 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27793021/phase-1-study-of-sirolimus-in-combination-with-oral-cyclophosphamide-and-topotecan-in-children-and-young-adults-with-relapsed-and-refractory-solid-tumors
#20
Kieuhoa T Vo, Erin E Karski, Nicole M Nasholm, Shelly Allen, Fabienne Hollinger, W Clay Gustafson, Janel R Long-Boyle, Stephen Shiboski, Katherine K Matthay, Steven G DuBois
PURPOSE: To determine the maximum tolerated dose (MTD), toxicities, and pharmacodynamics effects of sirolimus combined with oral metronomic topotecan and cyclophosphamide in a pediatric population. MATERIALS AND METHODS: Patients who were 1 to 30 years of age with relapsed/refractory solid tumors (including CNS) were eligible. Patients received daily oral sirolimus and cyclophosphamide (25-50 mg/m2/dose) on days 1-21 and oral topotecan (0.8 mg/m2/dose) on days 1-14 in 28-day cycles...
October 25, 2016: Oncotarget
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