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https://www.readbyqxmd.com/read/27931087/metastatic-renal-cell-carcinoma-in-a-renal-allograft-a-sustained-complete-remission-after-stimulated-rejection
#1
L Champion, S Culine, F Desgranchamps, K Benali, J Verine, E Daugas
We report the case of a 40-year-old woman who recovered from a diffuse metastatic renal cell carcinoma that developed from a kidney allograft. She was successfully treated by the induction of tumor rejection. Immunosuppression was discontinued, and transplant nephrectomy was deliberately delayed based on the expectation that the tumor mass would trigger the alloimmune response, which was stimulated with pegylated interferon-α-2a. Three years later, the patient remained in complete remission. Despite this severe context, the present case shows that the poor prognosis of allograft metastatic renal cell carcinoma could be dramatically reversed by taking advantage of the donor tumor origin to actively induce a specific alloimmune rejection of the tumor...
December 8, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27930871/hepatitis-b-virus-infection-status-is-more-prevalent-in-patients-with-type-2-diabetes
#2
Jun Lu, Xuhong Hou, Hong Tu, Zhenghao Tang, Yongbing Xiang, Yuqian Bao, Jianren Gu, Weiping Jia
AIMS/INTRODUCTION: It has not been reported whether chronic hepatitis B virus (HBV) infection (CHB) is associated with a specific type of diabetes. We sought to investigate the prevalence of CHB status in different diabetes subtypes among Chinese population MATERIALS AND METHODS: This is a cross-sectional study. 381 cases with adult-onset autoimmune diabetes,1365 patients with type 2 diabetes, and 1365 non-diabetic controls were recruited from Jun 2005 to Feb 2014.The exclusion criteria included: (1) HCV-antibody positive, (2) hepatic cirrhosis, (3) malignant neoplasm and severe renal dysfunction (serum creatinine > 450 umol/L)...
December 8, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27925350/a-kidney-transplant-recipient-with-renal-medullary-viral-cytopathic-changes
#3
Poornima Ramanan, Elizabeth A Timmerman, Mary E Fidler, Hatem Amer, Bobbi S Pritt, Dale A Schwab, Hollis J Batterman, Matthew J Binnicker
We present a case of JC polyomavirus (JCV)-associated nephropathy (PyVAN) in an asymptomatic deceased-donor kidney transplant recipient. Despite the presence of viral cytopathic effect in the kidney biopsy and positive BK polyomavirus (BKV) in situ hybridization (ISH), BKV real-time polymerase chain reaction (PCR) results of plasma and urine were negative. JCV ISH was performed and was found to be positive. JCV real-time PCR on urine, plasma, and the kidney biopsy tissue was positive. Reduction in immunosuppression resulted in resolution of JCV viremia...
December 7, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27925186/up-regulation-of-transient-receptor-potential-melastatin-6-channel-expression-by-tumor-necrosis-factor-%C3%AE-in-the-presence-of-epidermal-growth-factor-receptor-tyrosine-kinase-inhibitor
#4
Chisa Furukawa, Naoko Fujii, Aya Manabe, Toshiyuki Matsunaga, Satoshi Endo, Hajime Hasegawa, Yoshinori Ito, Masahiko Yamaguchi, Yasuhiro Yamazaki, Akira Ikari
Anti-epidermal growth factor receptor (EGFR) drugs such as erlotinib and gefitinib cause a side effect of hypomagnesemia, but chemotherapy to treat this has not yet been developed. The transient receptor potential melastatin 6 (TRPM6) channel is involved in the reabsorption of Mg(2+) in the renal tubule. We reported previously that the expression of TRPM6 is up-regulated by epidermal growth factor (EGF) in renal tubular epithelial NRK-52E and HEK293 cells. EGF-induced elevation of TRPM6 expression was inhibited by erlotinib, gefitinib, and lapatinib...
December 7, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27914584/outcome-of-poorly-functioning-kidneys-secondary-to-pujo-preserved-by-pyeloplast
#5
Yasir Ahmad Lone, Ram Samujh, Anish Bhattacharya, Ravi Prakash Kanojia
AIMS: To study the intermediate term to long-term functional status of kidneys with split renal function(SRF) <15% secondary to PUJO which are preserved by pyeloplasty and to find out whether these kidneys can recover or eventually need nephrectomy. METHODS: 24 patients with SRF<15% and undergoing pyeloplasty with or without prior percutaneous nephrostomy (PCN) were studied. Those with associated VUR, B/L disease and redo pyeloplasties were excluded. Follow up USG and EC scan were done at 3, 9 and 18months and yearly thereafter to document functional status after surgery...
November 26, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27899012/disease-outcomes-and-care-fragmentation-among-patients-with-systemic-lupus-erythematosus
#6
Theresa L Walunas, Kathryn L Jackson, Anh H Chung, Karen A Mancera-Cuevas, Daniel L Erickson, Rosalind Ramsey-Goldman, Abel Kho
OBJECTIVE: To examine the impact of care fragmentation across multiple healthcare institutions on disease outcomes in patients with systemic lupus erythematosus (SLE). METHODS: Using the Chicago HealthLNK Data Repository (HDR), an assembly of electronic health records from six institutions, we identified patients with SLE, using ICD-9 codes, whose care was delivered at more than one organization. We examined whether patients had severe infections or comorbidities (ICD-9 code defined) that indicate SLE-induced damage...
November 29, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27896857/former-smoking-and-early-and-long-term-graft-outcome-in-renal-transplant-recipients-a-retrospective-cohort-study
#7
Steven Van Laecke, Evi Vanessa Nagler, Patrick Peeters, Francis Verbeke, Wim Van Biesen
Smoking is associated with unfavourable outcome in solid organ transplant recipients. Nicotine may predispose to kidney injury by increasing oxidative stress. We hypothesized that former smoking negatively affects graft outcome in kidney transplant recipients and especially those with delayed graft function (DGF). We included adult recipients of a kidney transplant between January 1(st) 2003 and October 1(st) 2015 at Ghent University Hospital and recorded outcomes until October, 31(st) 2015. We used Kaplan-Meier and multivariable Cox proportional hazard analysis to examine the relationship between former smoking at the time of transplantation and the incidence of 10-year graft loss with and without censoring for death in 1013 participants...
November 28, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27893184/ecg-alterations-associated-with-psychotropic-drug-use-and-cacna1c-gene-variants-in-three-independent-samples
#8
Chiara Fabbri, Giuseppe Boriani, Igor Diemberger, Maria Giulia Filippi, Gloria Ravegnini, Patrizia Hrelia, Alessandro Minarini, Diego Albani, Gianluigi Forloni, Sabrina Angelini, Alessandro Serretti
Several antipsychotics and antidepressants have been associated with QTc prolongation or other ECG alterations, but their impact is still debated and other risk factors are known to affect QTc. We investigated the effect of antidepressants and antipsychotics on QTc and other ECG intervals/waves in three samples. Two discovery samples (cross-sectional sample n=145 and prospective sample n=68, naturalistic treatment) and a replication prospective sample (CATIE, n=515, randomized treatment) were analysed. In both prospective samples, baseline/follow-up changes in ECG parameters were analysed in relation to the number of psychotropic drugs stratified according to their known cardiovascular risk...
November 28, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27888584/small-molecule-inhibiting-nf-kb-ameliorates-oxidative-stress-and-suppresses-renal-inflammation-in-early-stage-of-alloxan-induced-diabetic-nephropathy-in-rat
#9
Manash P Borgohain, Mangala Lakhar, Sahabuddin Ahmed, Liakat Chowdhury, Saurabh Kumar, Rajat Pant, Abhinav Choubey
Diabetic nephropathy is one of the major microvascular complications of diabetes mellitus which ultimately gives rise to cardiovascular diseases. Oxidative stress produced by prolonged hyperglycaemia and chronic renal inflammation are the two key players in the development and progression of diabetic nephropathy. NF-kB-mediated inflammatory cascade is a strong contributor to the renovascular inflammation in diabetic nephropathy. Here, we studied the effects of piceatannol, a potent NF-kB inhibitor, on various oxidative stress markers and diabetic renal inflammatory pathway in rat induced by alloxan...
November 26, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27888555/renal-operational-tolerance-is-associated-with-a-defect-of-blood-tfh-cells-that-exhibit-impaired-b-cell-help
#10
Alexis Chenouard, Mélanie Chesneau, Linh Bui Nguyen, Sabine Le Bot, Marion Cadoux, Emilie Dugast, Chloé Paul, Stéphanie Malard-Castagnet, Simon Ville, Pierrick Guérif, Jean-Paul Soulillou, Nicolas Degauque, Richard Danger, Magali Giral, Sophie Brouard
Renal operationally tolerant patients (TOL) display a defect in B cell differentiation, with a deficiency in plasma cells. Recently described, T follicular helper cells (Tfh) play a critical role in B cell differentiation. We analyzed blood Tfh subsets in TOL and transplanted patients with stable graft function under immunosuppression (STA). We observed a reduced proportion of blood activated and highly functional Tfh subsets in TOL, without affecting Tfh absolute numbers. Functionally, Tfh from TOL displayed a modified gene expression profile, failed to produce IL-21 and were unable to induce IgG production by naive B cells...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888551/selective-targeting-of-high-affinity-lfa-1-does-not-augment-costimulation-blockade-in-a-nonhuman-primate-renal-transplantation-model
#11
K P Samy, D A Anderson, D J Lo, M S Mulvihill, M Song, A B Farris, B S Parker, A L MacDonald, C Lu, T A Springer, S C Kachlany, K A Reimann, T How, F V Leopardi, K S Franke, K D Williams, B H Collins, A D Kirk
Costimulation blockade (CoB) via belatacept is a lower morbidity alternative to calcineurin inhibitor (CNI)-based immunosuppression. However, it has higher rates of early acute rejection. These early rejections are mediated in part by memory T cells, which have reduced dependence on the pathway targeted by belatacept, and increased adhesion molecule expression. One such molecule is Leukocyte Function Associated Antigen (LFA)-1. LFA-1 exists in two forms, a commonly expressed, low-affinity form, and a transient, high-affinity form, expressed only during activation...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27888550/mesenchymal-stem-stromal-cells-biology-and-preclinical-evidence-for-therapeutic-potential-for-organ-dysfunction-following-trauma-or-sepsis
#12
Michael A Matthay, Shibani Pati, Jae-Woo Lee
Several experimental studies have provided evidence that bone-marrow derived mesenchymal stem (stromal) cells (MSC) may be effective in treating critically ill surgical patients who develop traumatic brain injury, acute renal failure, or the acute respiratory distress syndrome. There is also preclinical evidence that MSC may be effective in treating sepsis-induced organ failure, including evidence that MSC have anti-microbial properties. This review considers preclinical studies with direct relevance to organ failure following trauma, sepsis or major infections that apply to critically ill patients...
November 26, 2016: Stem Cells
https://www.readbyqxmd.com/read/27888534/early-steroid-withdrawal-results-in-improved-patient-and-graft-survival-and-lower-risk-of-post-transplant-cardiovascular-risk-profiles-a-single-center-10-year-experience
#13
Reynold Lopez-Soler, Ryan Chan, Jessica Martinolich, Lisa Park, Ashar Ata, Nikolaos Chandolias, David Conti
Long term use of steroids results in predictable secondary effects that can lead to increased morbidity and mortality. In this study, we present 10 years' worth of data of early steroid withdrawal (ESW) immunosuppression consisting of Mycophenolate, Sirolimus, and Tacrolimus. From 2003 to 2013, 563 kidney transplant recipients were weaned off steroids prior to discharge. We compared outcomes with that of our 65 historical controls maintained on steroids. We analyzed graft and patient survival and determined the incidence of steroid-related comorbidities such as hypertension, hypercholesterolemia, diabetes, coronary artery disease, and weight gain...
November 26, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27885762/esophageal-tuberculosis-with-coexisting-opportunistic-infections-in-a-renal-allograft-transplant-recipient
#14
Sunil Kumar, Mukut Minz, Saroj K Sinha, Kim Vaiphei, Ashish Sharma, Sarbpreet Singh, Deepesh B Kenwar
We report a renal allograft transplant recipient with esophageal tuberculosis (TB) coinfected with herpes simplex virus (HSV) and Candida. The patient presented with oropharyngeal candidiasis and was started on fluconazole. Upper gastrointestinal endoscopy showed whitish patches with mucosal ulcers in the esophagus. Histopathological examination confirmed TB and HSV infection. The patient recovered after antiviral, antifungal, and anti-tubercular therapy with reduction in immunosuppression. In a TB-endemic zone, TB can coexist with opportunistic infections in an immunocompromised host...
November 25, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27884046/effect-of-lycopene-and-rosmarinic-acid-on-gentamicin-induced-renal-cortical-oxidative-stress-apoptosis-and-autophagy-in-adult-male-albino-rat
#15
Naglaa A Bayomy, Reda H Elbakary, Marwa A A Ibrahim, Eman Z Abdelaziz
Gentamicin nephrotoxicity accounts for 10-15% of all cases of acute renal failure. Several natural antioxidants were found to be effective against drug-induced toxicity. The possible protective effects of lycopene (Lyc) and rosmarinic acid (RA) alone or combined on gentamicin (Gen) induced renal cortical oxidative stress, apoptosis and autophagy were evaluated. Sixty three rats were randomly divided into seven groups named: control, group II received RA 50 mg/kg/day, group III received Lyc 4 mg/kg/day, group IV received Gen 100 mg/kg/day, group V (RA + Gen), group VI (Lyc + Gen) and group VII (RA + Lyc + Gen)...
November 24, 2016: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/27878526/intravenous-vancomycin-dosing-in-the-elderly-a-focus-on-clinical-issues-and-practical-application
#16
Katie E Barber, Allison M Bell, Kayla R Stover, Jamie L Wagner
The elderly population can be divided into three distinct age groups: 65-74 years (young-old), 75-84 years (middle-old), and 85+ years (old-old). Despite evidence of a shift in leading causes for mortality in the elderly from infectious diseases to chronic conditions, infections are still a serious cause of death in this population. These patients are at increased risk due to weakened immune systems, an increased prevalence of underlying comorbidities, and decreased physiologic reserves to fight infection. Additionally, elderly patients, especially adults in institutional settings, are at an increased risk of colonization and subsequent infection with methicillin-resistant Staphylococcus aureus at a rate that is five times higher than in younger individuals, causing an increase in empiric and definitive vancomycin use...
December 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#17
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27875832/remediating-hiv-associated-neurocognitive-disorders-via-cognitive-training-a-perspective-on-neurocognitive-aging
#18
David E Vance, Shameka L Cody, Linda Moneyham
Over 50% of adults with HIV exhibit some form of HIV-associated neurocognitive disorder, ranging from mild asymptomatic neurocognitive impairment to HIV-associated dementia. As adults age with HIV and become susceptible to cardiovascular and metabolic comorbidities, the prevalence and severity of such neurocognitive disorders are likely to increase. With compromised renal and hepatic functioning often accompanying HIV, pharmaceutical interventions to address such neurocognitive disorders may not be the best strategy and are not without risks...
2017: Interdisciplinary Topics in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27875016/cryptococcal-infections-in-solid-organ-transplant-recipients-over-a-15-year-period-at-a-state-transplant-center
#19
Ian Gassiep, David McDougall, Joel Douglas, Ross Francis, Elliott G Playford
BACKGROUND: The aim of this research paper is to determine the incidence, risk factors and clinical outcome of solid organ transplant (SOT) recipients diagnosed and treated for cryptococcosis at our institution. METHODS: Retrospective analysis of all patients with SOT diagnosed and treated for cryptococcal infection occurring between January 2001 and December 2015. RESULTS: Of 102 patients diagnosed with cryptococcal infection, 23 were SOT recipients...
November 22, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27874173/identification-and-validation-of-an-8-gene-expression-signature-for-predicting-high-fuhrman-grade-renal-cell-carcinoma
#20
Fangning Wan, Yao Zhu, Chengtao Han, Qinghua Xu, Junlong Wu, Bo Dai, Hailiang Zhang, Guohai Shi, Weijie Gu, Dingwei Ye
Clear cell renal cell carcinoma (ccRCC) is a malignancy with heterogeneous outcomes. Currently, renal mass biopsies are commonly employed to extract disease characteristics and aid prognosis. Although the pathological diagnosis of malignant disease is accurate in contemporary reports, the classification of Fuhrman grade using biopsy specimens is still far from promising. To generate a gene signature to distinguish high-grade ccRCC, we used the Cancer Genome Atlas (TCGA) database to develop a gene expression signature for distinguishing high-grade (G3/4) from low-grade (G1/2) disease...
November 22, 2016: International Journal of Cancer. Journal International du Cancer
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