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https://www.readbyqxmd.com/read/28435278/genetic-factors-in-pathogenesis-of-diabetes-mellitus-after-kidney-transplantation
#1
REVIEW
Maciej Tarnowski, Sylwia Słuczanowska-Głabowska, Andrzej Pawlik, Małgorzata Mazurek-Mochol, Elżbieta Dembowska
Posttransplant diabetes mellitus (PTDM) is one of the major metabolic complications after transplantation of solid organs including the kidney. This type of diabetes mellitus affects allograft survival, cardiovascular complications and overall patient survival. The modifiable risk factors that contribute to PTDM include obesity, some viral infections (eg, hepatitis C virus, cytomegalovirus) and especially immunosuppressive drugs including corticosteroids, tacrolimus, cyclosporine and sirolimus. Currently, predisposing genetic factors have been considered important in PTDM development...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#2
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429866/successful-multiple-organ-donation-after-donor-brain-death-due-to-actinomyces-israelii-meningitis
#3
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/28425766/update-in-the-treatment-of-non-influenza-respiratory-virus-infection-in-solid-organ-transplant-recipients
#4
Shellee A Grim, Gail E Reid, Nina M Clark
Despite the improved outcomes in solid organ transplantation with regard to prevention of rejection and increased patient and graft survival, infection remains a common cause of morbidity and mortality. Respiratory viruses are a frequent and potentially serious cause of infection after solid organ transplantation. Furthermore, clinical manifestations of respiratory virus infection (RVI) may be more severe and unusual in solid organ transplant recipients (SOTRs) compared with the non-immunocompromised population...
April 20, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28423464/high-clinical-suspicion-of-donor-derived-disease-leads-to-timely-recognition-and-early-intervention-to-treat-solid-organ-transplant-transmitted-lymphocytic-choriomeningitis-virus
#5
Gagan Mathur, Kunal Yadav, Bradley Ford, Ilana J Schafer, Shridhar V Basavaraju, Barbara Knust, Wun-Ju Shieh, Sam Hill, Garret D Locke, Patricia Quinlisk, Shelley Brown, Ardith Gibbons, Deborah Cannon, Matthew Kuehnert, Stuart T Nichol, Pierre E Rollin, Ute Ströher, Rachel Miller
Despite careful donor screening, unexpected donor-derived infections continue to occur in organ transplant recipients (OTRs). Lymphocytic choriomeningitis virus (LCMV) is one such transplant-transmitted infection that in previous reports has resulted in a high mortality among the affected OTRs. We report a LCMV case cluster that occurred 3 weeks post-transplant in three OTRs who received allografts from a common organ donor in March 2013. Following confirmation of LCMV infection at Centers for Disease Control and Prevention, immunosuppression was promptly reduced and ribavirin and/or intravenous immunoglobulin therapy were initiated in OTRs...
April 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28423227/a-national-survey-of-screening-and-management-of-hypogammaglobulinemia-in-canadian-transplantation-centers
#6
Samuel Bourassa-Blanchette, Greg Knoll, Jason Tay, Christopher Bredeson, Donald W Cameron, Juthaporn Cowan
BACKGROUND: Infection remains one of the most common transplant-related causes of death in patients undergoing transplantation. Secondary hypogammaglobulinemia (HGG) as a component of immune suppression and deficiency is associated with both solid organ (SOT) and hematopoietic cell transplantation (HCT). Available data and clinical experience for the supplementation of immunoglobulin (Ig) in these patients is conflicting, and clinical equipoise accounts for non-uniform practice in the use of Ig treatment...
April 18, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28421185/changes-in-composition-of-the-gut-bacterial-microbiome-after-fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-in-a-pediatric-heart-transplant-patient
#7
Kyle L Flannigan, Taylor Rajbar, Andrew Moffat, Leanna S McKenzie, Frank Dicke, Kevin Rioux, Matthew L Workentine, Thomas J Louie, Simon A Hirota, Steven C Greenway
The microbiome is increasingly recognized as an important influence on human health and many of the comorbidities that affect patients after solid organ transplantation (SOT) have been shown to involve changes in gut bacterial populations. Thus, microbiome changes in an individual patient may have important health implications after SOT but this area remains understudied. We describe changes in the composition of the fecal microbiome from a pediatric heart transplant recipient before and >2.5 years after he underwent repeated fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection (CDI)...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28419938/direct-acting-antivirals-the-endgame-for-hepatitis-c
#8
REVIEW
Roberta D'Ambrosio, Elisabetta Degasperi, Massimo Colombo, Alessio Aghemo
Directly-acting antivirals (DAA) have finally allowed all patients to be potentially cured from chronic hepatitis C (HCV) infection. All-oral, Interferon (IFN)-free regimens are based upon the combination of molecules targeting different sites of the HCV replication process. Three classes of DAA exist: protease inhibitors (anti-NS3/4A), RNA-dependent polymerase inhibitors (anti-NS5B) and anti-NS5A inhibitors, which are characterized by different antiviral potency and barrier to resistance and therefore are usually combined in different treatment schedules...
April 15, 2017: Current Opinion in Virology
https://www.readbyqxmd.com/read/28419684/should-organs-from-hepatitis-c-virus-infected-donors-be-used-for-transplantation-in-the-era-of-daas
#9
Hideki Ohdan
Hepatitis C virus (HCV) infection has been demonstrated to deleteriously impact both patient and graft survival following non-hepatic organ transplantation [1, 2]. Interferon (IFN)-based therapies prior to non-hepatic transplant in HCV-infected patients improved their survival, however, tolerability and low cure rates practically limited those therapies [3]. In addition, due to the risk of allograft rejection, IFN-based therapy following non-hepatic solid organ transplant is not generally recommended. This article is protected by copyright...
April 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28412164/diagnosis-and-management-of-oropharyngeal-dysphagia-among-older-persons-state-of-the-art
#10
REVIEW
Omar Ortega, Alberto Martín, Pere Clavé
Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization and defined as the difficulty or inability to move a bolus safely and effectively from the oral cavity to the esophagus, and can include aspirations, choking, and residue. OD is pandemic among different phenotypes of older people, affecting between 27% and 91% of the population 70 years or older. Although OD can be diagnosed by well-defined clinical methods and complementary explorations, in the clinical setting OD is seldom systematically screened and treated, and awareness among the medical/geriatric community is scarce...
April 12, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28407197/autologous-hematopoietic-stem-cell-transplantation-following-high-dose-chemotherapy-for-nonrhabdomyosarcoma-soft-tissue-sarcomas
#11
REVIEW
Frank Peinemann, Heike Enk, Lesley A Smith
BACKGROUND: Soft tissue sarcomas (STS) are a highly heterogeneous group of rare malignant solid tumors. Nonrhabdomyosarcoma soft tissue sarcomas (NRSTS) comprise all STS except rhabdomyosarcoma. In people with advanced local or metastatic disease, autologous hematopoietic stem cell transplantation (HSCT) applied after high-dose chemotherapy (HDCT) is a planned rescue therapy for HDCT-related severe hematologic toxicity. The rationale for this update is to determine whether any randomized controlled trials (RCTs) have been conducted and to clarify whether HDCT followed by autologous HSCT has a survival advantage...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28406982/novel-decay-dynamics-revealed-for-virus-mediated-drug-activation-in-cytomegalovirus-infection
#12
Jessica Rose, Vincent C Emery, Deepali Kumar, Anders Asberg, Anders Hartmann, Alan G Jardine, Angelo A Bignamini, Atul Humar, Avidan U Neumann
Human cytomegalovirus (CMV) infection is a substantial cause of morbidity and mortality in immunocompromised hosts and globally is one of the most important congenital infections. The nucleoside analogue ganciclovir (GCV), which requires initial phosphorylation by the viral UL97 kinase, is the mainstay for treatment. To date, CMV decay kinetics during GCV therapy have not been extensively investigated and its clinical implications not fully appreciated. We measured CMV DNA levels in the blood of 92 solid organ transplant recipients with CMV disease over the initial 21 days of ganciclovir therapy and identified four distinct decay patterns, including a new pattern exhibiting a transient viral rebound (Hump) following initial decline...
April 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28401625/fatal-case-of-cutaneous-sparing-oro-laryngeal-zoster-in-a-renal-transplant-recipient
#13
Elie Helou, Matthew Grant, Marie Landry, Xinyu Wu, Jon S Morrow, Maricar F Malinis
Herpesvirus infections in solid organ transplant (SOT) recipients are a significant cause of morbidity and mortality. We report a case of herpes zoster (HZ) in a kidney transplant recipient while receiving belatacept, a CTLA-4 inhibitor that prevents acute rejection. The patient presented with oropharyngolaryngeal mucosal lesions that subsequently disseminated resulting in pneumonitis and meningo-encephalitis. Very late-onset HZ can occur and can present atypically in SOT recipients. Delayed recognition and treatment may result in poor outcomes, as illustrated by this case...
April 12, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28400993/criteria-to-screen-molecular-tests-for-the-diagnosis-of-herpes-simplex-virus-in-the-central-nervous-system-have-no-propensity-to-harm
#14
Ronald George Hauser, Cynthia A Brandt, Richard A Martinello
OBJECTIVES: Investigators have ruled out herpes simplex virus (HSV) infection without the detection of herpes simplex deoxyribonucleic acid in cerebrospinal fluid (CSF) (i.e., HSV polymerase chain reaction [PCR]) by laboratory (normal CSF white blood cell count and protein) and clinical criteria (age ≥2 years, no history of human immunodeficiency virus or solid-organ transplant). Compared to HSV PCR of all samples, the algorithm saves money in test costs and may decrease exposure to acyclovir by illustrating the low probability that the patient has HSV...
2017: Journal of Pathology Informatics
https://www.readbyqxmd.com/read/28396194/the-use-of-kinase-inhibitors-in-solid-organ-transplantation
#15
REVIEW
S Dholakia, J E Fildes, P J Friend
INTRODUCTION: Despite the efficacy of current immunosuppression regimes used in solid organ transplantation, graft dysfunction, graft lost and antibody-mediated rejection continue to be problematic. As a result, clear attraction in exploiting key potential targets controlled by kinase phosphorylation has led to a number of studies exploring the use of these drugs in transplantation. Aim In this review, we consider the role of tyrosine kinase as a target in transplantation and summarize the relevant studies on kinase inhibitors that have been reported to date...
March 25, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28394486/chemotherapy-and-transplantation-the-role-of-immunosuppression-in-malignancy-and-a-review-of-antineoplastic-agents-in-solid-organ-transplant-recipients
#16
REVIEW
J C Krisl, V P Doan
It is estimated that solid organ transplant recipients have a two- to fourfold greater overall risk of malignancy than the general population. Some of the most common malignancies after transplant include skin cancers and posttransplant lymphoproliferative disorder. In addition to known risk factors such as environmental exposures, genetics, and infection with oncogenic viruses, immunosuppression plays a large role in the development of cancer through the loss of the immunosurveillance process. The purpose of this article is to explain the role of immunosuppression in cancer and to review the classes of chemotherapeutics...
April 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28392824/posttransplantation-lymphoproliferative-disorder-after-pediatric-solid-organ-transplantation-experiences-of-20-years-in-a-single-center
#17
Hyung Joo Jeong, Yo Han Ahn, Eujin Park, Youngrok Choi, Nam-Joon Yi, Jae Sung Ko, Sang Il Min, Jong Won Ha, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
PURPOSE: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. METHODS: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. RESULTS: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4...
March 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28391862/chemical-and-canine-analysis-as-complimentary-techniques-for-the-identification-of-active-odors-of-the-invasive-fungus-raffaelea-lauricola
#18
Alison G Simon, DeEtta K Mills, Kenneth G Furton
Raffaelea lauricola, a fungus causing a vascular wilt (laurel wilt) in Lauraceae trees, was introduced into the United States in the early 2000s. It has devastated forests in the Southeast and has now moved into the commercial avocado groves in southern Florida. Trained detection canines are currently one of the few successful methods for early detection of pre-symptomatic diseased trees. In order to achieve the universal and frequent training required to have successful detection canines, it is desirable to create accessible, safe, and long-lasting training aids...
June 1, 2017: Talanta
https://www.readbyqxmd.com/read/28389891/a-unique-clinicopathological-manifestation-of-fungal-infection-a-case-series-of-deep-dermatophytosis-in-immunosuppressed-patients
#19
Ruben Kershenovich, Shany Sherman, Ofer Reiter, Shiran Reiss Huss, Elena Didkovsky, Daniel Mimouni, Emmilia Hodak, Rina Segal
BACKGROUND: Dermatophytes are the most common cause of superficial fungal infections in humans. Deep dermatophytosis, however, is rare, described to date only in isolated case reports, usually in the setting of systemic immunosuppression. OBJECTIVE: To present the 15-year experience of a tertiary dermato-mycology clinic with the diagnosis and treatment of deep dermatophytosis. METHODS: Patients were identified by database search. Clinical, mycological, histological, and treatment data were collected from the medical files...
April 8, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28388307/cytomegalovirus-infection-in-lung-transplant-recipients
#20
Reem S Almaghrabi, Ali S Omrani, Ziad A Memish
Cytomegalovirus (CMV) infection is a major cause of morbidity and mortality in solid organ transplant (SOT) patients. Lung transplant recipients are particularly at risk given the intense immunosuppression required. Areas covered: The Detailed review of the literature related to CMV infection, its direct and indirect effect on lung allograft function, as well as diagnosis, immune monitoring, treatment options and prevention strategies. Expert commentary: In lung transplant recipients, CMV infection is associated with pro-inflammatory and immune inhibitory effects that increase the risk of graft dysfunction and loss...
May 2017: Expert Review of Respiratory Medicine
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