133 The Impact of Vaccination on Allosensitization in Candidates on the Lung Transplant Wait List

2011 ◽  
Vol 30 (4) ◽  
pp. S51
Author(s):  
G. Smith ◽  
J. Chu ◽  
L. Danziger-Isakov ◽  
R. Avery ◽  
D. Van Duin ◽  
...  
Keyword(s):  
2020 ◽  
Vol 48 ◽  
pp. 151564
Author(s):  
Sarah Hackman ◽  
Gabriela Gonzalez ◽  
Cynthia A. Forker ◽  
Daniel D. Mais
Keyword(s):  

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Laura Seese ◽  
Arman Kilic ◽  
Harma K. Turbendian ◽  
Pablo G. Sanchez ◽  
Carlos E. Diaz-Castrillon ◽  
...  

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S636-S636
Author(s):  
Anooj Shah ◽  
Carly D’Agostino ◽  
Kathleen Cunningham ◽  
Clare Kane ◽  
Michael G Ison ◽  
...  

Abstract Background The utility and clinical impact of therapeutic drug monitoring (TDM) of prophylactic azole antifungals in lung transplant recipients is not well described. The objective of this study was to investigate the impact of TDM of azole prophylaxis in lung transplant recipients on the development of positive fungal events. Methods A retrospective analysis was performed on 47 lung transplant recipients between 2013 and 2018 at Northwestern Memorial Hospital. A positive fungal event was defined as fungal species on BAL culture and/or positive BAL Aspergillus galactomannan (GM) with an index value ≥1.0. Study groups were defined based on attainment of therapeutic trough levels after initiation of oral therapy (therapeutic if posaconazole level ≥0.7 μg/mL or voriconazole ≥1–5.5 μg/mL, subtherapeutic if ≥2 consecutive levels of posaconazole <0.7 μg/mL or voriconazole <1 μg/mL after initial dose increase). Results There were no differences in baseline characteristics (Figure 1). There were a total of 11 fungal events with 3 (12.0%) occurring in the therapeutic cohort and 8 (36.4%) in those subtherapeutic (P = 0.08). In the 5 patients with a positive GM, the mean index was 2.02 ± 0.95. 7/30 (23.3%) of patients on posaconazole had a fungal event, with 2/7 (28.6%) requiring treatment at the time of event. For patients on voriconazole, 4/17 (23.5%) had a fungal event, with 1/4 (25.0%) requiring treatment. Mean time to fungal event was 164.5 ± 8.9 days vs. 135.9 ± 13.7 days in the therapeutic and subtherapeutic group, respectively (P = 0.05). All patients on posaconazole suspension who experienced a fungal event were subtherapeutic (3/3, 100%) compared with the majority of patients on posaconazole delayed release (DR) tablets who achieved therapeutic levels (17/22, 77.3%). Mean posaconazole trough level observed in the patients receiving DR tablet was 2.15 ± 0.95 μg/mL. Conclusion There was an association between two consecutive subtherapeutic azole prophylaxis levels and positive fungal events indicating a role for TDM in lung transplant recipients. Time to fungal event post-transplant was shorter in subtherapeutic patients. As anticipated, the use of posaconazole suspension resulted in subtherapeutic levels. This study presents an opportunity for further research of the impact of TDM on clinical outcomes to optimize patient care. Disclosures All authors: No reported disclosures.


SLEEP ◽  
2020 ◽  
Vol 43 (9) ◽  
Author(s):  
Simon D Kyle ◽  
Madeleine E D Hurry ◽  
Richard Emsley ◽  
Antonia Marsden ◽  
Ximena Omlin ◽  
...  

Abstract Study Objectives We sought to examine the impact of digital cognitive behavioral therapy (dCBT) for insomnia on both self-reported cognitive impairment and objective cognitive performance. Methods The Defining the Impact of Sleep improvement on Cognitive Outcomes (DISCO) trial was an online, two-arm, single-blind, randomized clinical trial of dCBT versus wait-list control. Participants were aged 25 years and older, met DSM-5 diagnostic criteria for insomnia disorder, and reported difficulties with concentration or memory. Assessments were carried out online at baseline, and 10 and 24 weeks post-randomization. The primary outcome measure was self-reported cognitive impairment, assessed with the British Columbia Cognitive Complaints Inventory (BC-CCI). Secondary outcomes included tests of cognitive performance, insomnia symptoms, cognitive failures, fatigue, sleepiness, depression, and anxiety. Results Four hundred and ten participants with insomnia were recruited and assigned to dCBT (N = 205) or wait-list control (N = 205). At 10 weeks post-randomization the estimated adjusted mean difference for the BC-CCI was −3.03 (95% CI: −3.60, −2.47; p &lt; 0.0001, d = −0.86), indicating that participants in the dCBT group reported less cognitive impairment than the control group. These effects were maintained at 24 weeks (d = −0.96) and were mediated, in part, via reductions in insomnia severity and increased sleep efficiency. Treatment effects in favor of dCBT, at both 10 and 24 weeks, were found for insomnia severity, sleep efficiency, cognitive failures, fatigue, sleepiness, depression, and anxiety. We found no between-group differences in objective tests of cognitive performance. Conclusions Our study shows that dCBT robustly decreases self-reported cognitive impairment at post-treatment and these effects are maintained at 6 months.


2011 ◽  
Vol 11 (3) ◽  
pp. 568-574 ◽  
Author(s):  
B. J. H. Ng ◽  
A. R. Glanville ◽  
G. Snell ◽  
M. Musk ◽  
M. Holmes ◽  
...  

2014 ◽  
Vol 28 (5) ◽  
pp. 590-597 ◽  
Author(s):  
Kelly E. Schoeppler ◽  
Christina L. Aquilante ◽  
Tyree H. Kiser ◽  
Douglas N. Fish ◽  
Martin R. Zamora

Author(s):  
Shahrzad M. Lari ◽  
Michael Y Shino ◽  
Ariss Derhovanessian ◽  
David M Sayah ◽  
Joseph P Lynch ◽  
...  

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