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elderly transplant

J Aleksova, S Kurniawan, G J Elder
Fracture risk increases in end-stage kidney disease (ESKD), but bone mineral density (BMD) measurement is less predictive of risk than in the general population. In this study of patients with ESKD, a lower trabecular bone score (TBS), indicative of microarchitectural deterioration, was associated with higher bone turnover markers and prevalent non-vertebral fracture. INTRODUCTION: Declining renal function carries increased fracture risks, but BMD is less predictive of fracture for dialysis patients than the general population...
March 19, 2018: Osteoporosis International
Amro M S El-Ghammaz, Mostafa K El-Razzaz
BACKGROUND: Prognosis of acute leukemia patients who experience relapse after hematopoietic stem-cell transplantation (HSCT) remains poor. Identifying risk factors influencing outcome of these patients is essential. PATIENTS AND METHODS: Follow-up of 234 acute leukemia patients who underwent allogeneic HSCT from matched related donor was performed for occurrence of posttransplantation relapse. Statuses of remission and survival were assessed at 6 months after treatment of relapse...
February 17, 2018: Clinical Lymphoma, Myeloma & Leukemia
L E J Peeters, L M Andrews, D A Hesselink, B C M de Winter, T van Gelder
The number of elderly people has increased considerably over the last decades, due to a rising life expectancy and ageing populations. As a result, an increased number of elderly with end-stage-renal-disease are diagnosed, for which the preferred treatment is renal transplantation. Over the past years the awareness of the elderly as a specific patient population has grown, which increases the importance of research in this group. Elderly patients often receive kidneys from elderly donors while younger donor kidneys are preferentially reserved for younger recipients...
February 28, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
L Ryom, C Boesecke, M Bracchi, J Ambrosioni, A Pozniak, J Arribas, G Behrens, Pgm Mallon, M Puoti, A Rauch, J M Miro, O Kirk, C Marzolini, J D Lundgren, M Battegay
BACKGROUND: The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV-positive persons in geographically diverse areas. GUIDELINE HIGHLIGHTS: Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management...
March 1, 2018: HIV Medicine
Darko Vucicevic, Lily Honoris, Federica Raia, Mario Deng
Heart failure (HF) is a complex clinical syndrome that results from structural or functional cardiovascular disorders causing a mismatch between demand and supply of oxygenated blood and consecutive failure of the body's organs. For those patients with stage D HF, advanced therapies, such as mechanical circulatory support (MCS) or heart transplantation (HTx), are potentially life-saving options. The role of risk stratification of patients with stage D HF in a value-based healthcare framework is to predict which subset might benefit from advanced HF (AdHF) therapies, to improve outcomes related to the individual patient including mortality, morbidity and patient experience as well as to optimize health care delivery system outcomes such as cost-effectiveness...
January 2018: Annals of Cardiothoracic Surgery
Domingo Hernández, Juana Alonso-Titos, Ana María Armas-Padrón, Pedro Ruiz-Esteban, Mercedes Cabello, Verónica López, Laura Fuentes, Cristina Jironda, Silvia Ros, Tamara Jiménez, Elena Gutiérrez, Eugenia Sola, Miguel Angel Frutos, Miguel González-Molina, Armando Torres
The number of elderly patients on the waiting list (WL) for kidney transplantation (KT) has risen significantly in recent years. Because KT offers a better survival than dialysis therapy, even in the elderly, candidates for KT should be selected carefully, particularly in older waitlisted patients. Identification of risk factors for death in WL patients and prediction of both perioperative risk and long-term post-transplant mortality are crucial for the proper allocation of organs and the clinical management of these patients in order to decrease mortality, both while on the WL and after KT...
February 22, 2018: Kidney & Blood Pressure Research
Sung-Yup Cho, Chang Ohk Sung, Jeesoo Chae, Jieun Lee, Deukchae Na, Wonyoung Kang, Jinjoo Kang, Seoyeon Min, Ahra Lee, Eunhye Kwak, Jooyoung Kim, Boram Choi, Hyunsoo Kim, Jeffrey H Chuang, Hyo-Kyung Pak, Chan-Sik Park, Sanghui Park, Young Hyeh Ko, Dakeun Lee, Jin Roh, Min-Sun Cho, Seongyeol Park, Young Seok Ju, Yun-Suhk Suh, Seong-Ho Kong, Hyuk-Joon Lee, James Keck, Jacques Banchereau, Edison T Liu, Woo-Ho Kim, Hansoo Park, Han-Kwang Yang, Jong-Il Kim, Charles Lee
Epstein-Barr virus (EBV)-positive diffuse large B cell lymphomas (EBV+ -DLBLs) tend to occur in immunocompromised patients, such as the elderly or those undergoing solid organ transplantation. The pathogenesis and genomic characteristics of EBV+ -DLBLs are largely unknown because of the limited availability of human samples and lack of experimental animal models. We observed the development of 25 human EBV+ -DLBLs during the engraftment of gastric adenocarcinomas into immunodeficient mice. An integrated genomic analysis of the human-derived EBV+ -DLBLs revealed enrichment of mutations in Rho pathway genes, including RHPN2 , and Rho pathway transcriptomic activation...
February 23, 2018: Blood
Jill A Bell, Aaron Galaznik, Rachel Huelin, Michael Stokes, Yelan Guo, Robert J Fram, Douglas V Faller
High-dose chemotherapy with allogeneic hematopoietic stem cell transplantation (allo-HSCT) can produce long-term remission in patients with higher-risk myelodysplastic syndromes (HR-MDS) and chronic myelomonocytic leukemia (CMML). However, this treatment regimen is not appropriate for elderly and/or comorbid patients; in these cases, azacitidine is a standard treatment. This systematic review was conducted to evaluate real-world evidence of treatment options for patients with HR-MDS/CMML. Medline and Embase (January 2006 to May 2016) were searched, in addition to conference proceedings and treatment guideline reviews...
February 8, 2018: Clinical Lymphoma, Myeloma & Leukemia
Maja Rothenberg-Thurley, Susanne Amler, Dennis Goerlich, Thomas Köhnke, Nikola P Konstandin, Stephanie Schneider, Maria C Sauerland, Tobias Herold, Max Hubmann, Bianka Ksienzyk, Evelyn Zellmeier, Stefan K Bohlander, Marion Subklewe, Andreas Faldum, Wolfgang Hiddemann, Jan Braess, Karsten Spiekermann, Klaus H Metzeler
Some patients with acute myeloid leukemia (AML) who are in complete remission after induction chemotherapy harbor persisting pre-leukemic clones, carrying a subset of leukemia-associated somatic mutations. There is conflicting evidence on the prognostic relevance of these clones for AML relapse. Here, we characterized paired pre-treatment and remission samples from 126 AML patients for mutations in 68 leukemia-associated genes. Fifty patients (40%) retained ≥1 mutation during remission at a VAF of ≥2%. Mutation persistence was most frequent in DNMT3A (65% of patients with mutations at diagnosis), SRSF2 (64%), TET2 (55%), and ASXL1 (46%), and significantly associated with older age (p < 0...
February 23, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Shunan Wang, Xingtong Wang, Mingsuo Liu, Ou Bai
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematopoietic malignancy mainly affecting elderly patients. Most patients present with asymptomatic skin lesions as the first symptom and has a high frequency of bone marrow involvement. BPDCN is typically characterized by CD4+ and CD 56+ co-expression without common lymphoid or myeloid lineage markers. There is no consensus on the optimal therapeutic strategy for BPDCN. It is highly responsive to chemotherapy but the median event-free survival is very short...
April 2018: Annals of Hematology
Kristian Heldal, Karsten Midtvedt, Anders Hartmann, Anna Varberg Reisaeter, Torbjørn Fossum Heldal, Stein Bergan, Cathrin Lytomt Salvador, Anders Åsberg
Several equations have been developed for estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease (CKD), but none were developed based on data from elderly kidney transplant recipients (KTR). The primary aim of this study was to evaluate different creatinine based equations in stable elderly KTR. A national cross-sectional study was performed using data from 263 consecutive kidney transplant recipients 60 years or older who performed a routine GFR measurement one year after engraftment...
February 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Raynier Devillier, Faezeh Legrand, Jérôme Rey, Luca Castagna, Sabine Fürst, Angela Granata, Aude Charbonnier, Samia Harbi, Evelyne d'Incan, Thomas Pagliardini, Catherine Faucher, Claude Lemarie, Colombe Saillard, Boris Calmels, Bilal Mohty, Valerio Maisano, Pierre-Jean Weiller, Christian Chabannon, Norbert Vey, Didier Blaise
Haploidentical related donor (HRD) allogeneic hematopoietic stem cell transplantation (Allo-HSCT) was developed as a valid option for the treatment of acute myeloid leukemia (AML) in the absence of a matched donor. However, many investigators are reluctant to consider the use of this alternative in elderly patients, anticipating high morbidity. Here, we report a single-center comparison of HRD vs. matched sibling donor (MSD) and unrelated donor (UD) Allo-HSCT for patients with AML aged ≥60 years. Ninety-four patients (MSD: n = 31; UD: n = 30; HRD: n = 33) were analyzed...
February 12, 2018: Biology of Blood and Marrow Transplantation
Daniel R Richardson, Ying Huang, Heather L McGinty, Patrick Elder, Joanna Newlin, Cyndi Kirkendall, Leslie Andritsos, Don Benson, William Blum, Yvonne Efebera, Sam Penza, Craig Hofmeister, Samantha Jaglowski, Rebecca Klisovic, Sumithira Vasu, Basem William, Steven Devine, Ashley E Rosko
Hematopoietic cell transplantation (HCT) is an intensive treatment resulting in disease control however subsequent psychosocial distress is common. Screening for psychosocial risk factors that contribute to morbidity is underutilized; moreover, the value in screening is uncertain. We performed a retrospective study of 395 HCT patients who were screened for psychosocial risk using the Transplant Evaluation Rating Scale (TERS). Patients were classified by psychosocial risk as no-risk (TERS = 26.5, 52%) vs. at-risk (TERS > 26...
February 14, 2018: Bone Marrow Transplantation
Caiqin Hu, Ying Huang, Juwei Su, Mengyan Wang, Qihui Zhou, Biao Zhu
BK polyomavirus (BKPyV) is an opportunistic infectious pathogen that is associated with hemorrhagic cystitis and nephropathy, mainly in transplant recipients and human immunodeficiency virus 1 (HIV-1) infected patients. However, molecular characterization studies of BKPyV in China are rare. This study was designed to elucidate the prevalence and to determine the main subtypes of BKPyV among HIV-1-infected patients in southeastern China. In addition, the increased incidences for BKPyV reactivation were analyzed...
February 12, 2018: Archives of Virology
Elisabeth Tamara Strässler, Katriina Aalto-Setälä, Mostafa Kiamehr, Ulf Landmesser, Nicolle Kränkel
Induced pluripotent stem cells (iPSCs) avoid many of the restrictions that hamper the application of human embryonic stem cells: limited availability of source material due to legal restrictions in some countries, immunogenic rejection and ethical concerns. Also, the donor's clinical phenotype is often known when working with iPSCs. Therefore, iPSCs seem ideal to tackle the two biggest tasks of regenerative medicine: degenerative diseases with genetic cause (e.g., Duchenne's muscular dystrophy) and organ replacement in age-related diseases (e...
2018: Frontiers in Cardiovascular Medicine
L Gajate Martín, A Martín Grande, D Parise Roux, C González Cibrián, C Fernández Martín, M A Rodríguez Gandía, A López Buenadicha
BACKGROUND: There are increasingly more patients awaiting liver transplantation while the number of donors has remained stable. It has been proven that grafts from donors older than 60 years have comparable results with those from younger donors. It is unclear whether this is so with donors older than 80 years old. MATERIAL AND METHODS: This was a retrospective study of all adult liver transplantations at our institution between March 2011 and December 2015. We compared 1-, 3-, 6-, and 12-month graft survival rates from donors <80 years and ≥80 years...
January 2018: Transplantation Proceedings
Alessio Rotini, Ester Martínez-Sarrà, Robin Duelen, Domiziana Costamagna, Ester Sara Di Filippo, Giorgia Giacomazzi, Hanne Grosemans, Stefania Fulle, Maurilio Sampaolesi
Sarcopenia is the age-related loss of muscle mass, strength, and function. Although the role of human satellite cells (SCs) as adult skeletal muscle stem cells has been deeply investigated, little is known about the impact of aging on muscle interstitial stem cells. Here, we isolated the non-SC CD56- fraction from human muscle biopsies of young and elderly subjects. The elderly interstitial cell population contained a higher number of CD15+ and PDGFRα+ cells when compared to young samples. In addition, we found that the CD56- /ALP+ cells were well represented as a multipotent stem cell population inside the CD56- fraction...
February 4, 2018: Aging Cell
Henrique Cortes Meira, Bruna Mascarenhas De Oliveira, Igor Figueiredo Pereira, Marcelo Drumond Naves, Ricardo Alves Mesquita, Vagner Rodrigues Santos
Background: Although oral candidiasis (OC) is a very common fungal infection of oral cavity, clinical features of affected patients and their demographic profile are not well documented. Objective: The objective of the study was to assess the demographic profile of patients diagnosed with OC and its clinical features in an import Brazilian center of oral and maxillofacial pathology. Materials and Methods: A retrospective study consisted of 276 patients diagnosed with OC by cytopathology Periodic Acid-Schiff (PAS) staining, during the period of 20 years...
September 2017: Journal of Oral and Maxillofacial Pathology: JOMFP
Linsheng Huang, Qi Zhu, Xiao Qu, Huanlong Qin
Chronic functional constipation is a kind of common intestinal disease that occurs in children, adults and elderly people. This disease not only causes great influence to physiological function, but also results in varying degrees of psychological barriers. At present, constipation treatments continue to rely on traditional methods such as purgative therapy and surgery. However, these approaches can disrupt intestinal function. Recent research between intestinal diseases and gut microbiota has gradually revealed a connection between constipation and intestinal flora disturbance, providing a theoretical basis for microbial treatment in chronic constipation...
January 23, 2018: Science China. Life Sciences
Matthew Ettleson, Kale S Bongers, Kaitlyn Vitale, Anthony J Perissinotti, Tycel Phillips, Bernard L Marini
Mantle cell lymphoma is a mature B-cell non-Hodgkin lymphoma characterized by the hallmark (11;14) chromosomal translocation, which often presents with lymphadenopathy and extra-nodal involvement. Young, fit patients are generally treated with chemotherapy approaches that incorporate high-dose cytarabine (e.g. the Nordic regimen) followed by autologous hematopoietic cell transplantation. Because of the significant activity of cytarabine in mantle cell lymphoma, increasingly, high- and intermediate-dose cytarabine are being used in the treatment of elderly mantle cell lymphoma patients...
January 1, 2018: Journal of Oncology Pharmacy Practice
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