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Post-transplantation diabetes

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https://www.readbyqxmd.com/read/28736056/variability-of-glycated-hemoglobin-levels-in-the-first-year-post-renal-transplantation-in-patients-without-diabetes
#1
Ana Laura Pimentel, Joíza Lins Camargo
BACKGROUND: Glycated hemoglobin (HbA1c) is an alternative test used for the diagnosis and monitoring of diabetes in kidney transplant recipients. Immunosuppressive drugs are the most important risk factors related with changes in the glucose metabolism after transplant. It is still unknown if they impact on the variability of HbA1c. We assessed the variability of HbA1c levels in a group of renal transplant recipients without diabetes during the first year after transplant. METHODS: We estimated the variability of HbA1c in a group of 95 Brazilian kidney transplant recipients...
July 20, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28728478/psychosocial-response-to-new-onset-diabetes-as-a-long-term-effect-of-allogeneic-hematopoietic-stem-cell-transplantation
#2
Jill M Olausson, Lauren Clark, Janice M Morse, Marilyn Hammer, Nancy Allen, Marcia Grant
Currently, little information is available to guide health care practitioners on how to facilitate positive outcomes in individuals who develop new-onset diabetes after allogeneic hematopoietic stem cell transplantation (allo HSCT) for treatment of hematological cancers. Results from this constructivist grounded theory study provide a theoretical framework explaining the psychosocial process of change that middle-age and older adults experience when developing new-onset diabetes in this context. Two predominant factors influenced this change: treatment burden and perception of diabetes...
July 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28727287/weighing-the-risks-morbid-obesity-and-diabetes-are-associated-with-increased-risk-of-death-on-the-liver-transplant-waiting-list
#3
Ani A Kardashian, Jennifer L Dodge, John Roberts, Danielle Brandman
Obesity is a growing problem in liver transplant (LT) candidates, paralleling the U.S. obesity epidemic and increase in LT for nonalcoholic steatohepatitis (NASH). While post-LT survival appears to be similar in obese and non-obese patients, data is scarce regarding risk of waitlist dropout in patients with morbid obesity (BMI≥40 kg/m(2) ). We examined the impact of obesity on waitlist mortality and evaluated predictors of dropout in LT candidates with morbid obesity or NASH METHODS: Competing risk analyses were performed in candidates listed between 3/2002-12/2013 to evaluate predictors of waitlist removal or death...
July 20, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28720321/no-evidence-for-progressive-deterioration-in-stimulated-insulin-secretion-in-renal-transplant-recipients-after-12years-tacrolimus-exposure
#4
Mariëlle A C J Gelens, Johannes P van Hooff, Len Usvyat, Maarten H Christiaans
AIMS: Tacrolimus (Tac) inhibits insulin secretion in a Tac-trough blood level dependent way early post-transplant in renal transplant recipients (Rtx). It is unknown whether long-term exposure results into a progressive beta cells dysfunction. METHODS: Two independent cohorts of Tac-treated non-diabetic Rtx, previously participating in glucose metabolism studies using intravenous Glucose Tolerance Test (ivGTT) were included: Fifty-eight Rtx were tested by ivGTT cross-sectional between 0...
July 4, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28720103/an-information-and-communication-technology-based-centralized-clinical-trial-to-determine-the-efficacy-and-safety-of-insulin-dose-adjustment-education-based-on-a-smartphone-personal-health-record-application-a-randomized-controlled-trial
#5
Gyuri Kim, Ji Cheol Bae, Byoung Kee Yi, Kyu Yeon Hur, Dong Kyung Chang, Moon-Kyu Lee, Jae Hyeon Kim, Sang-Man Jin
BACKGROUND: A Personal Health Record (PHR) is an online application that allows patients to access, manage, and share their health data. PHRs not only enhance shared decision making with healthcare providers, but also enable remote monitoring and at-home-collection of detailed data. The benefits of PHRs can be maximized in insulin dose adjustment for patients starting or intensifying insulin regimens, as frequent self-monitoring of glucose, self-adjustment of insulin dose, and precise at-home data collection during the visit-to-visit period are important for glycemic control...
July 18, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28718192/cardiometabolic-risks-vary-by-weight-status-in-pediatric-kidney-and-liver-transplant-recipients-a-cross-sectional-single-center-study-in-the-usa
#6
S He, N A Le, J K Frediani, P D Winterberg, R Jin, R Liverman, A Hernandez, R L Cleeton, M B Vos
There is an increasing need to understand long-term metabolic changes and resultant comorbidities because life expectancy is increasing after pediatric kidney and liver transplants. We evaluated differences in classic and novel cardiometabolic biomarkers among obese and normal weight adolescent transplant recipients. We enrolled a total of 80 adolescent (mean±SD, 14.8 years ±3.0) transplant recipients (63 kidney, 17 liver) with mean duration from transplantation of 6.0 (±4.1) years. Among kidney transplant recipients, overweight and obese individuals had higher leptin (16...
July 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28718072/diabetes-mellitus-following-renal-transplantation-clinical-and-pharmacological-considerations-for-the-elderly-patient
#7
REVIEW
David Langsford, Adam Steinberg, Karen M Dwyer
Post-transplant diabetes mellitus occurs in 30-50% of cases during the first year post-renal transplantation. It is associated with increased morbidity, mortality and healthcare costs. Risk factors include age and specific immunosuppression regimens. At the same time, renal transplantation is increasingly indicated in elderly (aged >65 years) patients as this proportion of older patients in the prevalent dialysis population has increased. The immune system and β cells undergo senescence and this impacts on the risk for developing post-transplant diabetes and our ability to prevent such development...
July 17, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28688150/national-assessment-of-early-hospitalization-after-liver-transplantation-risk-factors-and-association-with-patient-survival
#8
Pratima Sharma, Nathan P Goodrich, Douglas E Schaubel, Abigail R Smith, Robert M Merion
Hospitalization is known to occur frequently in the first 6 months following liver transplantation (LT). Using a novel data linkage between the Scientific Registry of Transplant Recipients and Centers for Medicare and Medicaid Services, our study has two objectives: (i) determine risk factors for "early" hospitalization (i.e., within 6 months of LT) (ii) quantify the importance of hospitalization history in the first 6 months with respect to subsequent patient survival (i.e., survival, conditional on surviving 6 months post-LT)...
July 7, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28666883/a-macroporous-heparin-releasing-silk-fibroin-scaffold-improves-islet-transplantation-outcome-by-promoting-islet-revascularisation-and-survival
#9
Duo Mao, Meifeng Zhu, Xiuyuan Zhang, Rong Ma, Xiaoqing Yang, Tingyu Ke, Lianyong Wang, Zongjin Li, Deling Kong, Chen Li
Islet transplantation is considered the most promising therapeutic option with the potential to cure diabetes. However, efficacy of current clinical islet transplantation is limited by long-term graft dysfunction and attrition. We have investigated the therapeutic potential of a silk fibroin macroporous (SF) scaffold for syngeneic islet transplantation in diabetic mice. The SF scaffold was prepared via lyophilisation, which enables incorporation of active compounds including cytokines, peptide and growth factors without compromising their biological activity...
June 27, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28662293/retrospective-evaluation-of-the-efficacy-and-safety-of-belatacept-with-thymoglobulin-induction-and-maintenance-everolimus-a-single-center-clinical-experience
#10
D Wojciechowski, S Chandran, J Yang, M Sarwal, F Vincenti
Belatacept use has been constrained by higher rates of acute rejection. We hypothesized that belatacept with low dose rATG and initial mycophenolate maintenance with conversion to everolimus at 1 month post-transplant ± corticosteroids would improve efficacy and maintain safety. Retrospective single center analysis of the first 44 low immunologic risk kidney transplant recipients treated with this regimen. The cohort was 59% male, mean age at transplant of 57 years. Diabetes was the most common cause of ESRD (39%)...
June 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28653161/the-post-sir-spheres-surgery-study-p4s-retrospective-analysis-of-safety-following-hepatic-resection-or-transplantation-in-patients-previously-treated-with-selective-internal-radiation-therapy-with-yttrium-90-resin-microspheres
#11
Fernando Pardo, Bruno Sangro, Rheun-Chuan Lee, Derek Manas, Rohan Jeyarajah, Vincent Donckier, Geert Maleux, Antonio D Pinna, Lourens Bester, David L Morris, David Iannitti, Pierce K Chow, Richard Stubbs, Paul J Gow, Gianluca Masi, Kevin T Fisher, Wan Y Lau, Konstantinos Kouladouros, Georgios Katsanos, Giorgio Ercolani, Fernando Rotellar, José I Bilbao, Michael Schoen
BACKGROUND: Reports show that selective internal radiation therapy (SIRT) may downsize inoperable liver tumors to resection or transplantation, or enable a bridge-to-transplant. A small-cohort study found that long-term survival in patients undergoing resection following SIRT appears possible but no robust studies on postsurgical safety outcomes exist. The Post-SIR-Spheres Surgery Study was an international, multicenter, retrospective study to assess safety outcomes of liver resection or transplantation following SIRT with yttrium-90 (Y-90) resin microspheres (SIR-Spheres(®); Sirtex)...
June 26, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28640504/sustained-post-transplant-diabetes-is-associated-with-long-term-major-cardiovascular-events-following-liver-transplantation
#12
Giorgio A Roccaro, David S Goldberg, Wei-Ting Hwang, Renae Judy, Arwin Thomasson, Stephen E Kimmel, Kimberly A Forde, James D Lewis, Yu-Xiao Yang
Cardiovascular disease is a leading cause of death among liver transplant (LT) recipients. With a rising burden of post-transplant metabolic disease, increases in cardiovascular-related morbidity and mortality may reduce life expectancy following liver transplantation. It is unknown if the risk of long-term major cardiovascular events (MCE) differs among LT recipients with varying diabetic states. We performed a retrospective cohort study of LT recipients from 2003 to 2013, to compare the incidence of MCE among patients 1) without diabetes, 2) with pre-transplant diabetes 3) with de novo transient post-transplant diabetes, and 4) with de novo sustained post-transplant diabetes...
June 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28640481/using-analytic-morphomics-to-describe-body-composition-associated-with-post-kidney-transplantation-diabetes-mellitus
#13
David C Cron, Kelly A Noon, Devan R Cote, Michael N Terjimanian, Joshua J Augustine, Stewart C Wang, Michael J Englesbe, Kenneth J Woodside
BACKGROUND: Better risk assessment tools are needed to predict post-transplantation diabetes mellitus (PTDM). Using analytic morphomic measurements from computed tomography (CT) scans, we aimed to identify specific measures of body composition associated with PTDM. METHODS: We retrospectively reviewed 99 non-diabetic kidney transplant recipients who received pre-transplant CT scans at a single institution between 1/2005 and 5/2014. Analytic morphomic techniques were used to measure abdominal adiposity, abdominal size, and psoas muscle area and density, standardized by gender...
June 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28636760/successful-management-of-refractory-diabetic-gastroparesis-with-long-term-aprepitant-treatment
#14
N Fountoulakis, J Dunn, S Thomas, J Karalliedde
BACKGROUND: People with gastroparesis who develop treatment-resistant (refractory) disease pose a difficult challenge, especially in the setting of end-stage renal disease (ESRD) or post pancreas transplant. Aprepitant (a neurokinin-receptor antagonist) is licensed for the short-term treatment of chemotherapy-induced nausea. There is lack of information on its long-term efficacy and safety in people with diabetic gastroparesis. CASE REPORT: Case 1 was 73-year-old man with Type 2 diabetes of 25 years' duration and ESRD requiring dialysis...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28632962/a-novel-minimally-invasive-wireless-technology-for-neuromodulation-via-percutaneous-intercostal-nerve-stimulation-pns-for-post-herpetic-neuralgia-a-case-report-with-short-term-follow-up
#15
Bart Billet, Roel Wynendaele, Niek E Vanquathem
BACKGROUND: Peripheral nerve stimulation (PNS) of primary afferent neurons provides control of localized chronic pain. This technique applies permanent electrical stimulation at the target area via a minimally invasive, subcutaneous placement of an electrode. OBJECTIVE: To assess analgesic effects of a minimally invasive wireless neuromodulation in the treatment of chronic intractable pain secondary to post-herpetic neuralgia. CASE SUMMARY: A 78-year-old man presented with severe intractable post herpetic neuralgic pain...
June 20, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28616377/blue-after-splenectomy
#16
Taaran Cariappa Ballachanda Subbaiah, Jeremy P Feldman
INTRODUCTION: We present a 51 year old, African American, female who presented with persistent hypoxemia. She had been taking dapsone for many years for prophylaxis against Pneumocystic Jiroveci with no symptoms but eventually developed methemoglobinemia only after a splenectomy. From our literature review there are no documented cases that have demonstrated this relationship between dapsone, splenic function and methemoglobin and we hope to share our perplexing case and shed light on the interaction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28599901/esrd-after-heart-failure-myocardial-infarction-or-stroke-in-type%C3%A2-2-diabetic-patients-with-ckd
#17
David M Charytan, Scott D Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E Cooper, Janet B McGill, Hans-Henrik Parving, Patrick Parfrey, Ajay K Singh, Emmanuel A Burdmann, Andrew S Levey, Dick de Zeeuw, Kai-Uwe Eckardt, John J V McMurray, Brian Claggett, Eldrin F Lewis, Marc A Pfeffer
BACKGROUND: How cardiovascular (CV) events affect progression to end-stage renal disease (ESRD), particularly in the setting of type 2 diabetes, remains uncertain. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: 4,022 patients with type 2 diabetes, anemia, and chronic kidney disease from the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). PREDICTOR: Postrandomization CV events. OUTCOMES: ESRD (defined as initiation of dialysis for >30 days, kidney transplantation, or refusal or nonavailability of renal replacement therapy) and post-ESRD mortality within 30 days and during overall follow-up after an intercurrent CV event...
June 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28591651/transplantation-of-human-pancreatic-endoderm-cells-reverses-diabetes-post-transplantation-in-a-prevascularized-subcutaneous-site
#18
Andrew R Pepper, Rena Pawlick, Antonio Bruni, John Wink, Yasmin Rafiei, Doug O'Gorman, Richard Yan-Do, Boris Gala-Lopez, Tatsuya Kin, Patrick E MacDonald, A M James Shapiro
Beta-cell replacement therapy is an effective means to restore glucose homeostasis in select humans with autoimmune diabetes. The scarcity of "healthy" human donor pancreata restricts the broader application of this effective curative therapy. "β-Like" cells derived from human embryonic stem cells (hESC), with the capacity to secrete insulin in a glucose-regulated manner, have been developed in vitro, with limitless capacity for expansion. Here we report long-term diabetes correction in mice transplanted with hESC-derived pancreatic endoderm cells (PECs) in a prevascularized subcutaneous site...
June 6, 2017: Stem Cell Reports
https://www.readbyqxmd.com/read/28581202/switch-to-an-everolimus-facilitated-cyclosporine-a-sparing-immunosuppression-improves-glycemic-control-in-selected-kidney-transplant-recipients
#19
Florian Kälble, Jörg Seckinger, Matthias Schaier, Christian Morath, Vedat Schwenger, Martin Zeier, Claudia Sommerer
BACKGROUND: Mammalian target of rapamycin inhibitors (mToRi) allow calcineurin inhibitor (CNI) sparing therapy in renal transplant recipients with possible beneficial effects on the long-term allograft function and cardiovascular risk. The influence of mToRi on glucose metabolism is still under discussion. METHODS: In a retrospective analysis, renal allograft recipients switched from a cyclosporine A (CsA) to an everolimus (EVR) based immunosuppression in the first year after transplantation were compared with patients on continued CsA treatment...
June 5, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28577736/-post-transplantation-diabetes-mellitus-in-kidney-recipients
#20
Danièle Dubois-Laforgue
Post-transplantation diabetes mellitus is defined as diabetes that is diagnosed in grafted patients. It affects 20 to 30 % of kidney transplant recipients, with a high incidence in the first year. The increasing age at transplantation and the rising incidence of obesity may increase its prevalence in the next years. Post-transplantation diabetes mellitus is associated with poor outcomes, such as mortality, cardiovascular events or graft dysfunction. Its occurrence is mainly related to immunosuppressive agents, affecting both insulin secretion and sensibility...
April 2017: Néphrologie & Thérapeutique
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