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https://www.readbyqxmd.com/read/28230643/mtor-inhibition-clinical-transplantation-pancreas-islet
#1
Thierry Berney, Axel Andres, Christian Toso, Pietro Majno, Jean-Paul Squifflet
This brief overview discusses the beneficial and deleterious effects of mTOR inhibitors on beta-cells, and how sirolimus- and everolimus-based immunosuppression have impacted on practices and outcomes of pancreas and islet transplantation. Sirolimus was the cornerstone of immunosuppressive regimens in islet transplantation at the turn of the millenium, but utilization of mTOR inhibitors has progressively decreased from >80% to <50% of islet transplant recipients in more recent years. For whole pancreas transplantation, mTOR inhibitors were used in approximately 20% of patients in the early 2000s, but this dropped over the years to <10% currently...
February 23, 2017: Transplantation
https://www.readbyqxmd.com/read/28220461/new-generation-coronary-stents-current-data-and-future-directions
#2
REVIEW
Ankur Kalra, Hasan Rehman, Sahil Khera, Braghadheeswar Thyagarajan, Deepak L Bhatt, Neal S Kleiman, Robert W Yeh
PURPOSE OF REVIEW: Drug-eluting stents are the mainstay in the treatment of coronary artery disease using percutaneous coronary intervention. Innovations developed to overcome the limitations of prior generations of stents include biodegradable polymer stents, drug-eluting stents without a polymer, and bioabsorbable scaffolds. Our review briefly discusses the clinical profiles of first- and second-generation coronary stents, and provides an up-to-date overview of design, technology, and clinical safety and efficacy profiles of newer generation coronary stents discussing the relevant clinical trials in this rapidly evolving area of interventional cardiology...
March 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28217909/successful-use-of-sirolimus-for-refractory-atrial-ectopic-tachycardia-in-a-child-with-cardiac-rhabdomyoma
#3
Sanja Ninic, Marija Kalaba, Bosiljka Jovicic, Vladislav Vukomanovic, Sergej Prijic, Biljana Vucetic, Ruzica Kravljanac, Ana Vujic, Jovan Kosutic
Cardiac rhabdomyomas are common in tuberous sclerosis. We report a child who developed rhabdomyoma related arrhythmia refractory to antiarrhythmic drug therapy. Reversion of the atrial ectopic tachycardia was achieved with mammalian target of rapamycin pathway (mTOR) inhibitor sirolimus. As per our knowledge, this is the first time that sirolimus has been successfully used in this setting.
February 19, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28205445/severe-hypertriglyceridemia-induced-by-sirolimus-treated-with-medical-management-without-plasmapheresis
#4
Kazuhiko Kido, Rickey A Evans, Anil Gopinath, Jeremy D Flynn
: Hypertriglyceridemia and hyperlipidemia are the most remarkable metabolic complications seen with long-term sirolimus therapy. We report the case of a 36-year-old woman status post bilateral lung transplantation on a maintenance immunosuppression regimen of sirolimus, tacrolimus, and prednisone who presented with status migrainosus, chest pain, abdominal discomfort, and triglyceride levels greater than 4425 mg/dL. In previously reported cases of severe hypertriglyceridemia that developed on maintenance sirolimus therapy, plasmapheresis has been utilized as an early strategy to rapidly lower triglycerides in order to minimize the risk of acute complications such as pancreatitis, but our case was managed medically without plasmapheresis...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28205374/developmental-pharmacokinetics-of-sirolimus-implications-for-precision-dosing-in-neonates-and-infants-with-complicated-vascular-anomalies
#5
Tomoyuki Mizuno, Tsuyoshi Fukuda, Chie Emoto, Paula S Mobberley-Schuman, Adrienne M Hammill, Denise M Adams, Alexander A Vinks
BACKGROUND: Sirolimus has recently been shown to be efficacious and tolerable in pediatric patients with complicated vascular anomalies. Nevertheless, dosing information remains very limited especially for neonates and infants. The purpose of this study was to develop an age-appropriate sirolimus starting dosing regimen based on the developmental changes in drug elimination capacity using data collected in neonates and infants. PROCEDURE: A recently developed sirolimus maturation model [Emoto et al...
February 16, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28198567/sirolimus-for-vincristine-resistant-kasabach-merritt-phenomenon-report-of-eight-patients
#6
Huaijie Wang, Yitao Duan, Ya Gao, Xinkui Guo
BACKGROUND: The use of sirolimus for patients with multidrug-resistant Kasabach-Merritt phenomenon (KMP) has been reported in recent years. We present the experience of a single center in treating vincristine-resistant KMP using sirolimus alone. METHODS: Children with vincristine-resistant KMP who were treated with oral sirolimus alone were eligible for inclusion in the study. We evaluated responses according to graded response criteria and acute toxicities according to the National Cancer Institute Common Toxicity Criteria...
February 15, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28197826/safety-and-efficacy-of-a-novel-abluminal-groove-filled-biodegradable-polymer-sirolimus-eluting-stent
#7
Jinzhou Zhu, Huizhu Liu, Haipo Cui, Zhirong Tang, Chengli Song, Ruiyan Zhang
Late stent thrombosis (LST) following drug-eluting stent (DES) implantation in patients with coronary artery disease (CAD) is often associated with delayed vascular healing, resulting from vascular inflammation and hypersensitivity to durable polymers and drugs. Therefore, DES design, materials, and coatings have been technologically revolutionized. Herein, we designed a novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent (AGF-BP-SES), with a sirolimus content of only about one-third of traditional DES...
March 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28192114/sirolimus-and-autophagy-inhibition-in-lam-results-of-a-phase-i-clinical-trial
#8
Souheil El-Chemaly, Angelo Taveira-Dasilva, Hilary J Goldberg, Elizabeth Peters, Mary Haughey, Don Bienfang, Amanda M Jones, Patricia Julien-Williams, Ye Cui, Julian A Villalba, Shefali Bagwe, Rie Maurer, Ivan O Rosas, Joel Moss, Elizabeth P Henske
BACKGROUND: Animal and cellular studies support the importance of autophagy inhibition in lymphangioleiomyomatosis (LAM). In a cohort of subjects with LAM, we tested the hypothesis that treatment with sirolimus and hydroxycholoroquine (an autophagy inhibitor) at 2 different dose levels is safe and well tolerated. Secondary endpoints included changes in lung function. METHODS: This 48-week, two-center Phase I trial evaluated the safety of escalating oral hydroxychloroquine doses (100-200 mg) given twice a day in combination with sirolimus to eligible patients ≥18 years old with LAM...
February 10, 2017: Chest
https://www.readbyqxmd.com/read/28186963/an-oral-quinoline-derivative-mpt0b392-causes-leukemic-cells-mitotic-arrest-and-overcomes-drug-resistant-cancer-cells
#9
Min-Wu Chao, Han-Li Huang, Wei-Chun HuangFu, Kai-Cheng Hsu, Yi-Min Liu, Yi-Wen Wu, Chao-Feng Lin, Yi-Lin Chen, Mei-Jung Lai, Hsueh-Yun Lee, Jing-Ping Liou, Che-Ming Teng, Chia-Ron Yang
Despite great advances in the treatment of acute leukemia, a renaissance of current chemotherapy needs to be improved. The present study elucidates the underlying mechanism of a new synthetic quinoline derivative, MPT0B392 (B392) against acute leukemia and its potential anticancer effect in drug resistant cells. B392 caused mitotic arrest and ultimately led to apoptosis. It was further demonstrated to be a novel microtubule-depolymerizing agent. The effects of oral administration of B392 showed relative potent anti-leukemia activity in an in vivo xenograft model...
February 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28185978/long-term-serial-changes-in-platelet-activation-indices-following-sirolimus-eluting-and-bare-metal-stents-implantation-in-patients-with-stable-coronary-artery-disease
#10
Maria Marketou, George E Kochiadakis, Aikaterini Giaouzaki, Katerini Sfiridaki, Stelios Petousis, Fragiskos Maragoudakis, Konstantinos Roufas, Despoina Vougia, John Logakis, Gregory Chlouverakis, Panos E Vardas
BACKGROUND: Platelet activation is crucial in the development of stent thrombosis following percutaneous coronary intervention (PCI). We carried out a long-term assessment of multiple factors implicated in the thrombotic process and markers of platelet activation, after implantation of sirolimus-eluting stents (SES) in patients with stable coronary artery disease (CAD), and we compared the results with those after bare-metal stent (BMS) implantation. METHODS: Forty-seven consecutive patients, aged <70 years, with severe stenosis (>70% narrowing of the lumen) of one major epicardial coronary artery and stable CAD, underwent successful elective PCI and were randomly allocated to SES (n=25) or BMS (n=22)...
February 6, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28183505/10-year-clinical-outcome-after-randomization-to-treatment-by-sirolimus-%C3%A2-or-paclitaxel-eluting-coronary%C3%A2-stents
#11
Anders M Galløe, Henning Kelbæk, Leif Thuesen, Henrik S Hansen, Jan Ravkilde, Peter R Hansen, Evald H Christiansen, Ulrik Abildgaard, Ghita Stephansen, Jens F Lassen, Thomas Engstrøm, Jan Skov Jensen, Jørgen L Jeppesen, Niels Bligaard
BACKGROUND: First-generation drug-eluting coronary stents (DES) were introduced in 2003 to 2004, and their use resulted in a considerable reduction in the development of in-stent restenosis at the cost of an increased risk of late stent thromboses. OBJECTIVES: This study followed clinical outcomes of patients included in a large randomized trial for 10 years to enable detection of late changes in annual event rates that could necessitate medical attention. METHODS: A total of 2,098 unselected all-comer patients (50% with acute coronary syndrome) were randomly assigned to have a first-generation DES implanted...
February 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28182044/efficacy-and-safety-of-early-tacrolimus-conversion-to-sirolimus-after-kidney-transplantation-long-term-results-of-a-prospective-randomized-study
#12
A E El-Agroudy, S M Alarrayed, S M Al-Ghareeb, E Farid, H Alhelow, S Abdulla
We report a prospective, open-label, randomized study to evaluate the safety and efficacy of converting patients with a stable renal function from tacrolimus (Tac)-based regimen to a sirolimus (SRL)-based regimen after kidney transplantation. Fifty-eight low-risk renal allograft recipients who receiving Tac 6 months posttransplant, were randomly assigned to continue Tac (n = 29) or convert to SRL (n = 29). We evaluated the 3-year outcomes including patient and graft survival, graft function, and safety profile...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28181585/single-or-dual-antiplatelet-therapy-after-pci
#13
REVIEW
Yosuke Miyazaki, Pannipa Suwannasom, Yohei Sotomi, Mohammad Abdelghani, Karthik Tummala, Yuki Katagiri, Taku Asano, Erhan Tenekecioglu, Yaping Zeng, Rafael Cavalcante, Carlos Collet, Yoshinobu Onuma, Patrick W Serruys
The optimal duration and type of antiplatelet therapy after implantation of a drug-eluting stent (DES) remains uncertain. At the time of the first-in-man implantation of the sirolimus DES in 1999, the protocol-defined dual antiplatelet therapy (DAPT) duration was only 2 months. Subsequently, DAPT duration was extended to 1 year on the basis of anecdotal historical data, and this practice was then incorporated into clinical guidelines. For >1 decade, trialists have sought to compare the safety and efficacy of abbreviated (<6 months) and prolonged (>12 months) DAPT regimens...
February 9, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28177188/management-of-hepatic-angiomyolipoma-a-systematic-review
#14
Anne J Klompenhouwer, Danielle Verver, Shiromani Janki, Wichor M Bramer, Michail Doukas, Roy S Dwarkasing, Robert A de Man, Jan N M IJzermans
BACKGROUND & AIMS: Hepatic Angiomyolipoma (HAML) is a rare mesenchymal liver tumor assumed to be predominantly benign, although incidental cases with malignant behavior such as invasive growth, recurrence after resection and metastases have been reported. The aim of this systematic review was to assess the biological behavior, estimate the risk of HAML related mortality and recommend on a justifiable management strategy. METHODS: We performed a systematic literature search in Embase, Medline, Web-of-Science, Scopus, Pubmed Publisher, Cochrane and Google Scholar...
February 8, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28176536/kinase-targets-in-cns-drug-discovery
#15
Hendra Gunosewoyo, Lifang Yu, Lenka Munoz, Michael Kassiou
Originally thought to be nondruggable, kinases represent attractive drug targets for pharmaceutical companies and academia. To date, there are over 40 kinase inhibitors approved by the US FDA, with 32 of these being small molecules, in addition to the three mammalian target of rapamycin inhibitor macrolides (sirolimus, temsirolimus and everolimus). Despite the rapid development of kinase inhibitors for cancer, presently none of these agents are approved for CNS indications. This mini perspective highlights selected kinase targets for CNS disorders, of which brain-permeable small-molecule inhibitors are reported, with demonstrated preclinical proof-of-concept efficacy...
February 8, 2017: Future Medicinal Chemistry
https://www.readbyqxmd.com/read/28169477/localised-intravascular-coagulation-complicating-venous-malformations-in-children-associations-and-therapeutic-options
#16
REVIEW
Kevin Y Zhuo, Susan Russell, Orli Wargon, Susan Adams
Venous malformations are slow-flow congenital vascular malformations that enlarge as the child ages and may be associated with localised intravascular coagulation, a consumptive coagulopathy characterised by elevated D-dimer and decreased fibrinogen levels. The authors review the known correlations between localised intravascular coagulation and venous malformation number, size and planes involved, and call attention to the concept of the progression of localised intravascular coagulopathy as the child ages and their venous malformations enlarge...
February 7, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28154268/heterogeneous-intravascular-ultrasound-findings-of-stent-thrombosis
#17
Toru Morofuji, Shinji Inaba, Hiroe Aisu, Kayo Takahashi, Makoto Saito, Haruhiko Higashi, Toyofumi Yoshii, Takumi Sumimoto
Objective The underlying mechanisms of stent thrombosis are not completely understood. Methods We experienced 12 definite stent thrombosis cases (1 early, 1 late, and 10 very late) at our hospital from July 2011 to April 2016 and evaluated the possible causes of stent thrombosis by intravascular ultrasound (IVUS). Results Five different potential morphological causes of stent thrombosis (neoatherosclerosis, stent malapposition, stent fracture, edge dissection, and stent underexpansion) were detected by IVUS in 10 cases (83...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28149546/localization-of-in-stent-neoatherosclerosis-in-relation-to-curvatures-and-bifurcations-after-stenting
#18
Yongpeng Zou, Xingtao Huang, Linxing Feng, Jingbo Hou, Lei Xing, Bo Yu
BACKGROUND: In-stent neoatherosclerosis (ISNA) is a final common pathway of late-stent failure. However, distribution of ISNA has been little reported. This study was to evaluate the localization of ISNA in relation to curvatures and bifurcations after stent implantation using optical coherence tomography (OCT). METHODS: We retrospectively selected patients who underwent OCT examination ≥12 months after stent (sirolimus-eluting stents, SES) implantation. A stent curvature was defined if the angulation of the stent segment was >29°...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28149155/therapeutic-drug-monitoring-on-the-safety-of-sirolimus-in-transplant-patients
#19
COMMENT
Edibe Minareci
No abstract text is available yet for this article.
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28146142/comparative-efficacy-of-sirolimus-eluting-stents-and-paclitaxel-eluting-stents-in-east-asian-versus-non-east-asian-patients-a-systematic-review-and-meta-analysis
#20
Rui Zhao, Qianwei Lu, Rui Yang, Jianlin DU, Songbo Deng, Qiang She
INTRODUCTION: First-generation drug-eluting stents - such as the sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) - have become attractive options for percutaneous coronary intervention (PCI) and are still widely used in Asia. However, the effect of East Asian ethnicity on their efficacy remains unclear. EVIDENCE ACQUISITION: Pubmed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials comparing the efficacy of the Cypher SES and Taxus PES...
January 31, 2017: Minerva Cardioangiologica
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