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diarrhea and transplant

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https://www.readbyqxmd.com/read/29349869/clostridium-difficile-infection-is-associated-with-graft-loss-in-solid-organ-transplant-recipients
#1
A Cusini, C Béguelin, S Stampf, K Boggian, C Garzoni, M Koller, O Manuel, P Meylan, N J Mueller, H Hirsch, M Weisser, C Berger, C van Delden
Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea in solid organ transplant recipients (SOT). We aimed to assess incidence, risk factors and outcome of CDI within the Swiss Transplant Cohort Study (STCS). We performed a case-control study of SOT recipients in the STCS diagnosed with CDI between May 2008 and August 2013. We matched two control subjects per case by age at transplantation, sex and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors and evaluate outcome of CDI...
January 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29344912/capillary-leak-syndrome-as-a-complication-of-antibody-mediated-rejection-treatment-a-case-report
#2
Juan C Ramirez-Sandoval, Ricardo Varela-Jimenez, Luis E Morales-Buenrostro
We report a case of capillary leak that developed during treatment of antibody-mediated rejection in a kidney transplant recipient. A 53-year-old female transplant recipient experienced an increase in serum creatinine from 1.1 to 1.8 mg/dL. Antibody-mediated rejection was diagnosed by graft biopsy. She was treated with five plasmapheresis sessions (on alternate days with albumin replacement), five doses of immunoglobulin (5 g/dose at 100 mg/kg), a single dose of rituximab (500 mg), and four doses of bortezomib on days 1, 4, 7, and 10 (1...
January 17, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29336929/economic-burden-and-cost-effective-management-of-clostridium-difficile-infections
#3
REVIEW
S M Heimann, M R Cruz Aguilar, S Mellinghof, M J G T Vehreschild
Clostridium difficile infection (CDI) is the most important cause of healthcare-associated infectious diarrhea in industrialized countries. We performed a literature review of the overall economic burden of initial and recurrent CDI as well as of the cost-effectiveness of the various treatment strategies applied in these settings. Even though analysis of health economic data is complicated by the limited comparability of results, our review identified several internationally consistent results. Authors from different countries have shown that recurrent CDI disproportionally contributes to the overall economic burden of CDI and therefore offers considerable saving potential...
January 11, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29311077/posaconazole-tablets-in-real-life-lung-transplantation-impact-on-exposure-drug-drug-interactions-and-drug-management-in-lung-transplanted-patients-including-cystic-fibrosis
#4
Manon Launay, Antoine Roux, Laurence Beaumont, Benoit Douvry, Lucien Lecuyer, Emmanuel Douez, Clément Picard, Dominique Grenet, Vincent Jullien, Véronique Boussaud, Romain Guillemain, Eliane M Billaud
Appropriate exposure to Posaconazole (PSZ) was limited since the recent approval of the delayed release oral tablet formulation. Our goal was to determine the exposure obtained by using the standard dose of 300mgx1 in lung transplant patients (LT) including cystic fibrosis (CF) background.PSZ trough concentrations (C0) were determined using LCMS assay. Indicative thresholds of interest were <0.7mg/L (prophylaxis) and 1-3mg/L (curative). Tacrolimus (TRL) and everolimus (ERL) C0 measured during PSZ exposure were collected...
January 8, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29304833/a-phase-i-study-of-selinexor-in-combination-with-high-dose-cytarabine-and-mitoxantrone-for-remission-induction-in-patients-with-acute-myeloid-leukemia
#5
Amy Y Wang, Howard Weiner, Margaret Green, Hua Chang, Noreen Fulton, Richard A Larson, Olatoyosi Odenike, Andrew S Artz, Michael R Bishop, Lucy A Godley, Michael J Thirman, Satyajit Kosuri, Jane E Churpek, Emily Curran, Kristen Pettit, Wendy Stock, Hongtao Liu
BACKGROUND: Novel therapies for patients with acute myeloid leukemia (AML) are imperative, particularly for those with high-risk features. Selinexor, an exportin 1 (XPO1/CRM1) inhibitor, has demonstrated anti-leukemia activity as a single agent, as well as in combination with anthracyclines and/or DNA-damaging agents. METHODS: We report the findings of a phase I dose escalation trial with cohort expansion in 20 patients with newly diagnosed or relapsed/refractory AML that combined selinexor with age-adjusted high-dose cytarabine and mitoxantrone (HiDAC/Mito)...
January 5, 2018: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/29299892/cytomegalovirus-infection-after-renal-transplantation-occurrence-clinical-features-and-the-cutoff-for-antigenemia-in-a-university-hospital-in-brazil
#6
Sócrates Bezerra de Matos, Roberto Meyer, Fernanda Washington de Mendonça Lima
BACKGROUND: Cytomegalovirus (CMV) is the main infectious agent causative of morbidity and mortality in transplant recipients. This study aimed to describe the occurrence and clinical features of CMV infection, and the optimum antigenemia assay cutoff associated with symptomatic infection. MATERIALS AND METHODS: This was a cohort study that investigated 87 patients undergoing renal transplantation. The patients were monitored with the CMV antigenemia assay performed weekly for the first 3 months post-transplantation and subsequently, when CMV infection was suspected clinically...
December 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/29299452/transfer-of-altered-behaviour-and-irritable-bowel-syndrome-with-diarrhea-ibs-d-through-fecal-microbiota-transplant-in-mouse-model-indicates-need-for-stricter-donor-screening-criteria
#7
EDITORIAL
Laura J Craven, Michael Silverman, Jeremy P Burton
No abstract text is available yet for this article.
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29295650/amifostine-reduces-gastro-intestinal-toxicity-after-autologous-transplantation-for-multiple-myeloma
#8
Ehsan Malek, Vinita Gupta, Richard Creger, Paolo Caimi, Anant Vatsayan, Fahrettin Covut, Qaiser Bashir, Richard Champlin, Ruby Delgado, Gabriela Rondon, Brenda Cooper, Marcos de Lima, Hillard M Lazarus, Muzaffar Qazilbash
High-dose melphalan (HDM) followed by autologous hematopoietic cell transplantation (auto-HCT) remains the standard-of-care therapy for multiple myeloma (MM) even with the availability of proteasome inhibitors and immunomodulatory drugs. Gastrointestinal (GI) toxicity is the main cause of morbidity after HDM. Amifostine, a cytoprotective agent, may reduce HDM-associated GI toxicity. We conducted a case control study comparing HDM + auto-HCT with or without amifostine for MM patients. One hundred and seven patients treated at University Hospitals Cleveland Medical Center who received pre-transplant amifostine were compared to 114 patients treated at MD Anderson Cancer Center without use of this agent...
January 2, 2018: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29284356/comparison-of-conditioning-regimen-toxicities-among-autologous-stem-cell-transplantation-eligible-multiple-myeloma-patients-high-dose-melphalan-versus-high-dose-melphalan-and-bortezomib
#9
Eda Aypar, Fikret Vehbi İzzettin, Şahika Zeynep Akı, Mesut Sancar, Zeynep Arzu Yeğin, Gülsan Türköz Sucak
Background Autologous hematopoietic stem cell transplantation (AHSCT) remains the standard of care for younger patients with multiple myeloma (MM). Currently, high-dose melphalan (HDM) is recommended as conditioning regimen before AHSCT. Preclinical data suggest that combining bortezomib and melphalan has synergistic effect against multiple myeloma cells. Bortezomib and HDM (Bor-HDM) combination as conditioning regimen has been investigated by many other investigators. Objective In this retrospective study, we aimed to compare transplant-related toxicities and hematologic recovery of HDM and Bor-HDM conditioning regimens...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29280704/reversible-pneumatosis-cystoides-intestinalis-after-liver-transplantation
#10
M Telegrafo, A A Stabile Ianora, G Angelelli, M Moschetta
Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by the presence of multiple gas-filled cysts within the submucosa or subserosa of the intestinal wall. We report a case of PCI in a 54-yearold man 4 weeks after liver transplantation due to hepatitis B virus (HBV)-associated liver cirrhosis presenting with illness, diarrhea and abdominal pain. CT scans revealed normal shape of the abdominal parenchymal organs and no intra-hepatic complication due to liver transplantation. Main abdominal venous and arterial vessels resulted patent...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29278934/impact-of-oral-and-gastrointestinal-mucositis-on-body-weight-alterations-during-hematopoietic-stem-cell-transplantation
#11
Fernanda de Paula Eduardo, Leticia Mello Bezinelli, Marcella Ferreira Gobbi, Andrea Z Pereira, Cristina Vogel, Nelson Hamerschlak, Luciana Corrêa
The aim of this study was to evaluate whether digestive tract mucositis is a predictive factor for body weight (BW) alterations during hematopoietic stem cell transplantation (HSCT). Data about characteristics of transplantation, initial nutritional conditions and gastrointestinal mucositis were collected from adult patients (n = 105) who underwent autologous and allogeneic HSCT. Oral mucositis (OM) was not a predictive factor for BW loss, but it was an independent factor for BW gain in autologous HSCT (β = 0...
December 26, 2017: Nutrition and Cancer
https://www.readbyqxmd.com/read/29277954/cryptosporidiosis-in-a-transplant-recipient-with-severe-intractable-diarrhea-detection-of-cryptosporidium-oocysts-by-intestinal-biopsies
#12
Kumiko Kagawa, Hikaru Fujino, Hirokazu Miki, Kimiko Sogabe, Mamiko Takahashi, Tomoko Maruhashi, Kengo Udaka, Masami Iwasa, Shiro Fujii, Shingen Nakamura, Masahiro Abe
Disseminated Cryptosporidium infection results in manifestations similar to those of graft versus host disease (GVHD), which hampers the detection of Cryptosporidium infection after allogeneic hematopoietic stem cell transplantation. Surveillance of oocysts on the surface of intestinal epithelial cells is needed for early and appropriate detection of Cryptosporidium infection in transplant recipients on immunosuppressants with severe intractable diarrhea. We present the first case of Cryptosporidium meleagridis infection in Japan after allogeneic cord blood transplantation...
December 26, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29259832/gain-of-function-mutations-in-stat1-a-recently-defined-cause-for-chronic-mucocutaneous-candidiasis-disease-mimicking-combined-immunodeficiencies
#13
Sanem Eren Akarcan, Ezgi Ulusoy Severcan, Neslihan Edeer Karaca, Esra Isik, Guzide Aksu, Mélanie Migaud, Ferda Evin Gurkan, Elif Azarsiz, Anne Puel, Jean-Laurent Casanova, Necil Kutukculer
Chronic Mucocutaneous Candidiasis (CMC) is the chronic, recurrent, noninvasive Candida infections of the skin, mucous membranes, and nails. A 26-month-old girl was admitted with the complaints of recurrent oral Candidiasis, diarrhea, and respiratory infections. Candida albicans grew in oral mucosa swab. CMV and EBV DNA titers were elevated. She had hypergammaglobulinemia; IgE level, percentages of lymphocyte subgroups, and in vitro T-cell proliferation responses were normal. She had parenchymal nodules within the lungs and a calcific nodule in the liver...
2017: Case Reports in Immunology
https://www.readbyqxmd.com/read/29246821/late-gastrointestinal-complications-of-allogeneic-hematopoietic-stem-cell-transplantation-in-adults
#14
Anthony D Sung, Syed Hassan, Diana M Cardona, Daniel Wild, Krista Rowe Nichols, Hossein Mehdikhani, Bryan Balmadrid, Claire J Detweiler, Michael Shealy, Constance Cirrincione, Zhiguo Li, Martin Poleski, Tara E Dalton, Sharareh Siamakpour-Reihani, Nelson J Chao, Keith M Sullivan
INTRODUCTION: Gastrointestinal (GI) complications including graft versus host disease (GVHD) are a major cause of morbidity and mortality in allogenic stem transplant recipients. While several studies have previously looked into the acute gastrointestinal complications, fewer smaller studies have reported late complications. In this large study, we focus on the late (100 days post-transplant) gastrointestinal complications in allogenic stem transplant recipients METHODS: This is a single center, retrospective study, of all of the adult allogenic stem cell transplant recipients who had their transplant at Duke University over a six year period...
December 12, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29239198/faecal-microbiota-transplantation-for-clostridium-difficile-infection-using-a-lyophilized-inoculum-from-non-related-donors-a-case-series-involving-19-patients
#15
Szabolcs Vigvári, Dávid Sipos, Jenő Solt, Áron Vincze, Béla Kocsis, Zsuzsanna Nemes, Ágnes Kappéter, Zsófia Feiszt, Beáta Kovács, Zoltán Péterfi
Faecal microbiota transplantation (FMT) has been reported to be effective in treating relapsing of refractory Clostridium difficile infections, although some practical barriers are limiting its widespread use. In this study, our objective was to evaluate the rate of resolution of diarrhea following administration of lyophilized and resolved FMT via a nasogastric (NG) tube. We recruited 19 patients suffered from laboratory-confirmed C. difficile infection. Each of them was treated by lyophilized and resolved inoculum through a NG tube...
December 14, 2017: Acta Microbiologica et Immunologica Hungarica
https://www.readbyqxmd.com/read/29238988/plerixafor-and-granulocyte-colony-stimulating-factor-for-mobilization-of-hematopoietic-stem-cells-for-autologous-transplantation-in-chinese-patients-with-non-hodgkin-s-lymphoma-a-randomized-phase-3-study
#16
Jun Zhu, Huiqiang Huang, Huan Chen, Xi Zhang, Zengjun Li, Depei Wu, Daobin Zhou, Yongping Song, Yu Hu, Yingmin Liang, Hanyun Ren, He Huang, Nainong Li, Hu Chen, Jiong Hu, Jianyong Li, Robin Meng, Junlong Wu, Dong Yu, Xiaojun Huang
BACKGROUND: This Phase 3 randomized, double-blind study evaluated the efficacy and safety of plerixafor plus granulocyte-colony-stimulating factor for the mobilization of hematopoietic stem cells in Chinese patients with non-Hodgkin's lymphoma. STUDY DESIGN AND METHODS: Adults (ages 18-75 years) with non-Hodgkin's lymphoma in first or second complete or partial remission, without previous hematopoietic stem cell mobilization or autologous transplant, were included...
December 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29233098/intractable-ascites-associated-with-mycophenolate-in-a-simultaneous-kidney-pancreas-transplant-patient-a-case-report
#17
Nina T Weber, Ali Sigaroudi, Alexander Ritter, Andreas Boss, Kuno Lehmann, David Goodman, Stefan Farese, Stefan Weiler, Thomas F Mueller
BACKGROUND: Mycophenolic acid (MPA), either given as an ester pro-drug or as an enteric-coated sodium salt, is the most commonly prescribed anti-proliferative immunosuppressive agent used following organ transplantation and widely applied in immune-mediated diseases. Clinicians are well aware of common adverse reactions related to MPA treatment, in particular diarrhea, leukopenia and infections. Here we report a case of severe, persistent ascites associated with MPA treatment. The otherwise unexplained and intractable ascites, requiring repeated paracenteses for more than 8 months, rapidly ceased with stopping the MPA treatment...
December 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29226141/evaluation-of-immunosuppressive-therapy-use-for-tracheal-transplantation-with-trachea-mimetic-bellows-scaffolds-in-a-rabbit-model
#18
Jae Yeon Lee, Jeong Hun Park, Soo Jin Son, Mina Han, Gonhyung Kim, Seong Soo Kang, Seok Hwa Choi, Dong-Woo Cho
The objective of this study was to evaluate the use of immunosuppressive therapy with high-dose cyclosporine, high-dose azathioprine, and a combination of low-dose cyclosporine and azathioprine after tracheal reconstruction by using a trachea-mimetic graft of polycaprolactone (PCL) bellows-type scaffold in a rabbit model. Twenty-four healthy New Zealand white rabbits were used in the study. All underwent circumferential tracheal replacement using tissue-engineered tracheal graft, prepared from PCL bellows scaffold reinforced with silicone ring, collagen hydrogel, and human turbinate mesenchymal stromal cell (hTMSC) sheets...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29220082/benefits-of-multimodal-enhanced-recovery-pathway-in-patients-undergoing-kidney-transplantation
#19
Kevin A Espino, J Reinier F Narvaez, Michael C Ott, Liise K Kayler
BACKGROUND: Use of enhanced recovery after surgery (ERAS) pathways to accelerate functional recovery and reduce length of stay (LOS) has rarely been investigated in kidney transplantation (KTX). MATERIALS AND METHODS: Consecutive adult isolated KTXs between July 2015 and July 2016 (ERAS, n = 139) were compared with a historical cohort between January 2014 and July 2015 (HISTORIC, n = 95). RESULTS: Enhanced recovery after surgery recipients were significantly more likely to receive kidneys that were non-local (56...
December 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29218832/necrotizing-enterocolitis-in-the-setting-of-milk-allergy-after-pediatric-living-donor-liver-transplantation
#20
Soichi Narumoto, Seisuke Sakamoto, Hajime Uchida, Kengo Sasaki, Takanobu Shigeta, Akinari Fukuda, Shunsuke Nosaka, Rie Irie, Takako Yoshioka, Mureo Kasahara
NEC is an idiopathic intestinal mucosal injury that may progress to transmural bowel necrosis without mesenteric ischemia. NEC usually affects 7- to 10-day-old neonates following enteral feeding. A 10-month-old girl with no history of laparotomy underwent LDLT for acute liver failure. After starting enteral feeding on postoperative day 5, she developed abdominal distention. Diffuse PVG and PI were detected by radiologic modalities. Exploratory laparotomy revealed patchy necrosis of the intestine without perforation...
December 7, 2017: Pediatric Transplantation
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