Advances in methods for surveillance of rejection

2004 ◽  
Vol 14 (S1) ◽  
pp. 93-96 ◽  
Author(s):  
Robert J. Boucek Jr ◽  
Mark M. Boucek ◽  
Alfred Asante-Korang
Keyword(s):  
Acute Rejection ◽  
Newborn Infants ◽  
Major Complication ◽  
High Specificity ◽  
Clinical Findings ◽  
Short Term ◽  
Effective Treatment Modality ◽  
High Negative Predictive Value ◽  
End Stage ◽  
The Ideal

Transplantation is an effective treatment modality for infants1 and children2 with end-stage cardiac diseases. Rejection remains a major complication (Figure 1), even in newborn infants.3 Acute rejection can best be operationally defined by clinical findings, histopathology, and/or abnormalities of ventricular function of new origin that require, and respond to, intensified immunosuppression. Mechanistically, the ability to detect acute rejection is critically dependent on the detection of significant new myocytic injury, damage, and/or death. Surveillance for rejection is critically important in determining both long and short-term outcomes following cardiac transplantation. The ideal strategy for surveillance should have a high negative predictive value, correctly identifying the absence of myocytic injury, with high specificity, such that it does not falsely predict such injury.4

scholarly journals Clinical, Laboratory, and Short-Term Outcomes in Neonatal Nonketotic Hyperglycinemia

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Muhittin Celik ◽  
Osman Akdeniz
Keyword(s):  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Newborn Infants ◽  
Clinical Findings ◽  
Resonance Spectroscopy ◽  
Short Term ◽  
Laboratory Findings ◽  
Respiratory Problems ◽  
Metabolism Disorder ◽  
Nonketotic Hyperglycinemia

Background: Nonketotic hyperglycinemia (NKH) is a rare metabolism disorder with autosomal recessive transmission. Newborn infants characteristically present with hypotonia, lethargy, convulsions, and apnea and are generally lost within the first year of life. Objectives: The aim of this study was to evaluate the clinical characteristics, laboratory findings, and short-term results of infants diagnosed with NKH. Methods: The retrospective study included 10 infants diagnosed with NKH between August 2013 and July 2020. The clinical characteristics, laboratory findings, treatment methods, and short-term outcomes of the patients were evaluated. Results: The age range of patients (50% males vs. 50% females) was 2 - 8 days on presentation. The complaints on presentation were decreased breastfeeding, lethargy, convulsions, hiccups, apnea, and respiratory problems. In the physical examination, significant hypotonia and reduced or absence of newborn reflexes were predominant. Mechanical ventilation (MV) was required for nine patients. The cerebral spinal fluid/serum glycine ratio was > 0.08 in all patients, with median value of 0.19 (range: 0.12 - 0.30). The presence of a burst suppression pattern on electroencephalography and an increase in the glycine peak in magnetic resonance spectroscopy were the supportive diagnostic findings. Mutation analysis was performed on one patient. Seizures resistant to treatment were controlled with levetiracetam in three patients and dextromethorphan in one patient. Conclusions: According to the results, the most common clinical findings in NKH were severe hypotonia, seizure, and encephalopathy. In some cases, with resistant seizures, levetiracetam was found to be effective.

Introduction

2017 ◽  
Author(s):  
Frances Harris
Keyword(s):  
Cultural Influences ◽  
Short Term ◽  
Historical Figures ◽  
Platonic Love ◽  
Close Friendship ◽  
The Ideal ◽  
At Home

This introduces the Marlborough-Godolphin partnership as not just a political alliance, but a close friendship founded on ideals of platonic love and heroic virtue. It reviews the various discourses of friendship, noting the cultural influences (the essayists Montaigne, Sir William Temple, Saint-Évremond, as well as heroic drama and opera) which carried the ideal forward, but with the growing sense that it must prove itself in actual human transactions. It suggests that studying the Marlborough-Godolphin friendship as it proved itself in war abroad and party conflict at home is revealing of two historical figures whom historians have often found enigmatic, though in the end their commitment to it contributed to their short-term failure as well as their longer-term success. The distinction between friendship and royal favour is also touched on.

The short-term prognostic value of serum platelet to hemoglobin in patients with type A acute aortic dissection

Perfusion ◽  
2020 ◽  
pp. 026765912098222
Author(s):  
Yu Wang ◽  
Tengfei Qiao ◽  
Jun Zhou
Keyword(s):  
Aortic Dissection ◽  
Hospital Mortality ◽  
Acute Aortic Dissection ◽  
Independent Predictor ◽  
Type A ◽  
Short Term ◽  
Survivor Group ◽  
Mortality Hazard ◽  
Mortality Hazard Ratio ◽  
The Ideal

Purpose: Type A acute aortic dissection (AAD) is an uncommon catastrophic cardiovascular disease with high pre-hospital mortality rate without timely and effectively treated. The aim of this study was to assess the value of serum platelet to hemoglobin (PHR) in predicting in-hospital mortality in type A AAD patients. Methods: A total of 183 type A AAD patients were included in this retrospective investigation from January 2017 to December 2019. Admission blood routine parameters were gathered and PHR was computed. The outcome was all-cause in-hospital mortality within 30 days. Results The average levels of serum PHR were significant higher in survivor group than those in non-survivor group (1.14 ± 0.57 vs 0.87 ± 0.47, p = 0.006) and serum PHR was an independent factor associated with in-hospital mortality (hazard ratio (HR): 2.831; 95% confidence interval (CI): 1.108–7.231; p = 0.030). ROC noted that 0.8723 was chosen as the ideal cutoff value with a sensitivity of 64.3% and specificity of 72.5%. In addition, the area under the ROC curve (AUC) was 0.693 (95% CI 0.599–0.787, p < 0.001). Conclusion: Admission serum PHR can be used as an independent predictor of in-hospital mortality in patients with type A AAD.

Principles of pediatric lupus nephritis in a prospective contemporary multi-center cohort

Lupus ◽  
2021 ◽  
pp. 096120332110286
Author(s):  
Kathleen M Vazzana ◽  
Ankana Daga ◽  
Beatrice Goilav ◽  
Ekemini A Ogbu ◽  
Daryl M Okamura ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Kidney Function ◽  
Lupus Erythematosus ◽  
Extensive Literature ◽  
Short Term ◽  
Renal Outcomes ◽  
Childhood Arthritis ◽  
Black Patients ◽  
End Stage

Lupus nephritis (LN) is a life-threatening manifestation of systemic lupus erythematosus (SLE) and is more common in children than adults. The epidemiology and management of childhood-onset SLE (cSLE) have changed over time, prompting the need to reassess expected outcomes. The purpose of this study is to use the Childhood Arthritis and Rheumatology Research Alliance (CARRA) prospective registry to validate historical principles of LN in a contemporary, real-world cohort. After an extensive literature review, six principles of LN in cSLE were identified. The CARRA registry was queried to evaluate these principles in determining the rate of LN in cSLE, median time from cSLE diagnosis to LN, short-term renal outcomes, and frequency of rituximab as an induction therapy. Of the 677 cSLE patients in the CARRA registry, 32% had documented LN. Decline in kidney function was more common in Black cSLE patients than non-Black patients ( p = 0.04). Black race was associated with worse short-term renal outcomes. In short-term follow up, most children with LN had unchanged or improved kidney function, and end stage kidney disease (ESKD) was rare. Ongoing follow-up of cSLE patients in the CARRA registry will be necessary to evaluate long-term outcomes to inform risk, management, and prognosis of LN in cSLE.

Alkaline phosphatase isoforms in serum after liver allograft surgery

1994 ◽  
Vol 40 (7) ◽  
pp. 1272-1277 ◽  
Author(s):  
J Randolph-Habecker ◽  
J A Lott ◽  
R J Tesi
Keyword(s):  
Liver Transplantation ◽  
Alkaline Phosphatase ◽  
Liver Function Tests ◽  
Clinical Findings ◽  
High Molecular Mass ◽  
Reference Ranges ◽  
Liver Allograft ◽  
Postoperative Course ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Orthotopic liver transplantation (OLT) is now the only available treatment for end-stage liver disease; the major postoperative complications of OLT are rejection and infection. Fractionation of alkaline phosphatase (ALP) isoforms in serum by isoelectric focusing can be used to identify patients with complications. Reference ranges for liver-function tests (LFT) and liver ALP isoforms were established for post-OLT patients with stable postoperative courses and compared with those of patients with complications. We found canalicular, hepatocyte, and high-molecular-mass ALP to be statistically higher in nearly all patients with complications as compared with patients who had a stable postoperative course; these tests may identify patients requiring a liver biopsy. When used in conjunction with LFT and other clinical findings, ALP isoforms could aid in the monitoring of complications and treatment and in the adjustment of immunosuppressive therapy in stable OLT cases.

Short-Term Clinical Outcome of Hemiarthroplasty Versus Arthrodesis for End-Stage Hallux Rigidus

2015 ◽  
Vol 54 (5) ◽  
pp. 848-851 ◽  
Author(s):  
Karin H. Simons ◽  
Pieter van der Woude ◽  
Frank W.M. Faber ◽  
Paulien M. van Kampen ◽  
Bregje J.W. Thomassen
Keyword(s):  
Clinical Outcome ◽  
Hallux Rigidus ◽  
Short Term ◽  
End Stage

scholarly journals Cerebrospinal fluid approach on neuro-oncology

2013 ◽  
Vol 71 (9B) ◽  
pp. 677-680 ◽  
Author(s):  
Helio Rodrigues Gomes
Keyword(s):  
Cerebrospinal Fluid ◽  
Gold Standard ◽  
New Technologies ◽  
Major Complication ◽  
High Specificity ◽  
Csf Cytology ◽  
Cns Involvement ◽  
Effective Prophylaxis ◽  
Diagnostic Sensitivity And Specificity ◽  
Standard Marker

Central nervous system (CNS) involvement is a major complication of haematological and solid tumors with an incidence that ranges from 10% in solid malignances up to 25% in specific leukaemia or lymphoma subtypes. Cerebrospinal fluid (CSF) patterns are unspecific. Though CSF cytology has a high specificity (up to 95%), its sensitivity is generally less than 50% and no diagnostic gold standard marker is available, yet. New technologies such as flow cytometry, molecular genetics and newer biomarkers may improve diagnostic sensitivity and specificity, leading to the CNS involvement diagnosis, and consequently, to an effective prophylaxis and successful treatment.

scholarly journals Korelasi antara Letak Ujung Kateter Lumen Ganda Femoralis Jangka Pendek Non-tunneling dengan Laju Aliran darah pada Saat Hemodialisis di RSUP Prof Dr. R. D. Kandou

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Fery Purba ◽  
Richard Sumangkut ◽  
Djoni E. Tjandra
Keyword(s):  
Renal Failure ◽  
Positive Relationship ◽  
Scatter Plot ◽  
Short Term ◽  
Double Lumen ◽  
End Stage Renal Failure ◽  
Double Lumen Catheter ◽  
Lumen Catheter ◽  
Tip Position ◽  
End Stage

Abstract: Patients with end-stage renal failure are unable to survive without dialysis or renal transplantation. To achieve effective dialysis using a double lumen catheter, placement of the catheter tip plays an important role because it may affect blood flow/Quick of Blood (QB). The selection of femoral vein access is more favorable in critical patients. This study was aimed to obtain the correlation between the tip position of the non-tunneling short-term femoral double lumen catheter (DLC) and QB at the time of hemodialysis. This was an analytical correlative and prospective study with a cross-sectional design in patients with end-stage renal failure undergoing hemodialysis using a non-tunneling short-term femoral DLC. This study was conducted at the Hemodialysis Installation of Prof. Dr. R. D. Kandou Hospital Manado. Data were analyzed by using the Pearson's r test. The results showed that there were 31 patients enrolled in this study. The Pearson’s r test obtained an r of 0.147 (statistically weak) and Sig (2-tailed) of 0.430 which showed no correlation but the scatter plot showed a tendency of a weak positive relationship. Conclusion: There was no significant correlation between Qb and the tip position of DLC, albeit, there was a tendency of a weak positive relationship. Increasing the number of samples will more accurately predict the presence or absence of the correlation between Qb and the tip position of the DLC.Keywords: DLC, QB, hemodialysisAbstrak: Pasien dengan penyakit ginjal stadium akhir tidak dapat mempertahankan hidup tanpa dukungan terapi pengganti ginjal yaitu dialisis atau transplantasi ginjal. Untuk mencapai dialisis yang efektif dengan menggunakan kateter lumen ganda, penempatan kateter berperan penting karena dapat memengaruhi aliran darah/Quick of Blood (QB). Pemilihan akses vena femoralis lebih menguntungkan pada pasien kritis. Penelitian ini bertujuan untuk mengetahui korelasi letak ujung kateter lumen ganda femoralis jangka pendek (DLC) dengan QB pada saat hemodialisis. Jenis penelitian ialah analitik korelatif dan prospektif dengan desain potong lintang. Subyek penelitian ialah pasien dengan gagal ginjal tahap akhir yang menjalani hemodialisis menggunakan kateter lumen ganda femoralis jangka pendek non-tunneling. Penelitian dilakukan di Instalasi Hemodialisis RSUP Prof. Dr. R. D. Kandou, Manado. Data dianalisis menggunakan koefisien korelasi Pearson. Hasil penelitian mendapatkan 31 pasien sebagai subyek. Hasil analisis koefisien Pearson terhadap korelasi antara letak ujung DLC dan QB memperlihatkan hubungan statistik lemah (r = 0,147) dengan Sig (2-tailed) 0,430 yang menunjukkan tidak terdapat hubungan bermakna tetapi pada scatter plot terlihat adanya kecenderungan hubungan positif lemah. Simpulan: Tidak terdapat korelasi bermakna antara Qb dan letak ujung DLC tetapi terdapat kecenderungan hubungan positif lemah. Menambah jumlah sampel akan lebih akurat untuk memrediksi ada tidaknya hubungan antara Qb dan letak ujung DLC. Kata kunci: DLC, laju aliran dara (QB), hemodialisis

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