scholarly journals MO203ALTERATIONS IN T REGULATORY CELLS IN CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HEMODIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Erasmia Sampani ◽  
Asimina Fylaktou ◽  
Maria Stangou ◽  
Xaralampos Vagiotas ◽  
Efstratios Kasimatis ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Lymphocyte Count ◽  
T Regulatory Cells ◽  
Absolute Number ◽  
Regulatory Cells ◽  
Cell Immunity ◽  
Treg Population ◽  
Group A ◽  
Group B

Abstract Background and Aims Disturbances in T cell immunity are frequently seen in patients with end stage renal disease (ESRD), and the effect of long term hemodialysis (HD) is still obscure, though extremely important, especially regarding T regulatory cells (Tregs, CD4+CD25+FoxP3+) which seem to have a central role in immune response and tolerance after renal transplantation. In the present study, we assessed the possible effect of HD vintage on Treg population. Method Cytometric analysis was performed in 66 patients with ESRD on HD, in order to estimate CD4+ and CD4+CD25+FoxP3+ subtypes. According to HD vintage, patients were classified into two groups, group A: recently commenced on HD, and group B: on long term HD (≤12months and >12months, respectively). Results In all 66 patients there was a negative correlation between time on HD and lymphocyte count, both percentage (r=-0.34 p=0.005) and absolute lymphocyte number (r=-0.42 p<0.001) as well as CD4+ cells frequencies (r=-0.25 p=0.042) and total numbers (r=-0.41 p=0.001). Twenty eight patients (42%) were included in group A (HD vintage 9±3 months) and 38 (58%) in group B, (HD vintage 99±41 months). Compared to group A, patients in group B, showed a significant reduction in percentage of Tregs on total lymphocytes (2.6±1.3% vs 1.9±0.9%, respectively, p<0.019) as well as absolute number of Tregs (34±14 μ/L vs. 21±11 μ/L, respectively, p<0.001). Conclusion Long term HD may act as an additional factor reducing lymphocyte count, especially Tregs in ESRD patients. This result, apart from direct affecting immunity of patients, is mostly important for those preparing for renal transplantation, or being on the waiting list.

Presenting Features Predictive of Long-Term Stability in Chronic Lymphocytic Leukemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4982-4982
Author(s):  
Kortney L. Hillier ◽  
Sarah S. Fung ◽  
Linda M. Vickars ◽  
Chantal S. Leger ◽  
Paul F. Galbraith ◽  
...  
Keyword(s):  
B Cell ◽  
Lymphocyte Count ◽  
Lymphocytic Leukemia ◽  
Cell Group ◽  
Term Stability ◽  
Long Term Stability ◽  
Group A ◽  
Group B

Abstract Prognostic factors to predict an aggressive clinical course in chronic lymphocytic leukemia (CLL) such as CD38, ZAP-70 and IgH mutation status have been well described, however, readily available presenting features predictive of long-term stability are less well defined. We performed a retrospective analysis of 335 consecutive patients with CLL seen at St. Paul’s Hospital from January 1969 to July 2005. Patients were identified from the practice data-base and clinical and pathological data abstracted by chart review. Long-term stability was defined as no requirement for treatment for at least 6 years (n=66, group A). Characteristics of group A were compared to all other pts (group B, n=269), and, to avoid follow-up bias, to pts followed for ≥6 y who required treatment (group C, n=62). 65 pts in group A were B-cell in phenotype and 1 was T-cell; group B 268 pts B-cell, 1 T-cell; group C all 62 B-cell. Median age at diagnosis for groups A, B and C were 59.5 (range 33–80) y; 68 (30–94) y; and 60 (30–82) y, respectively (p<0.0001 for A vs. B and p<0.42 for A vs. C). Male pts comprised 52%, 54.3% and 53% of groups A, B and C respectively (p<0.85). Rai stages were: stage 0, 1, 2, 3, and 4; 111, 48, 47, 3 and 6 respectively. ECOG Performance Status was 0 in 307 pts and was not analyzed further. Lymphocyte count at diagnosis (LCD) for groups A, B and C were 9 (4–50 X 109/L), 10 (3–394) and 12 (3–155; p<0.0001 for A vs. B and p< 0.01 for A vs. C); in group A, 25 (38%) of pts had a LCD ≤10, as did 81 (30%) in group B and 10 (16%) in group C. In groups A, B and C, 9 (13.6%), 21 (11.5%), and 7 (11.3%) pts, respectively, had a lymphocyte doubling time (LDT) ≤12mo (to an absolute value ≥50X109/L; p<0.65). Immunophenotyping was available in 202 pts; 173 were CD5+ CD19+, 2 were CD5- and 29 CD19-. Analysis for CD38 was available in 50 pts; in groups A, B and C, 5 of 36 (14.3%), 2 of 14 (16.7%) and 0 of 7, respectively, were CD38+ (defined as ≥30% of cells; p<0.84). Median follow-up for groups A, B and C was 110.5 (76–369) mo, 43 (0–309) mo, and 134.5 (72–309 mo; p<0.0001 for A vs. B and p<0.67 for A vs. C). Pts in group A did not require treatment by definition; time to treatment (TTT) for group B was median 35 (0–243) mo and group C 66 (0–243) mo (p<0.0001). Median OS for all pts was 191 (0–369) mo. Two deaths occurred in group A; 1 of Richter’s transformation at 77 mo and 1 of unknown causes at 78 mo; median OS for groups B and C was 189 (0–311) mo and 127 (69–311) mo respectively (p<0.025). In group A, 1 pt (1.5%) transformed, as did 15 (5.6%) in group B (8 Richter’s and 7 PLL) and 4 (6%) in group C (1 Richter’s, 3 PLL, p<0.46). At a cutoff in LCD of 10 and 20 the difference in OS between groups was maintained (see Table). Characteristic OS @ 120 mo (%) Lymphocyte count at Dx (X109/L) Group A (stable ≥ 72 mo, n=66) Group B (all others, n=269) Group C (not stable, ≥72 f/u mo, n=62) All pts 93 64 64 ≤10 100 100 100 >10 91 64 64 ≤20 93 38 38 >20 0 of 2 0 of 5 0 of 5 p (log rank) A vs. B p<0.023 A vs. C p<0.025 In conclusion, in this series of 335 patients with CLL, lower lymphocyte count at diagnosis predicted for long-term stability, decreased requirement for treatment and improved OS.

Oral Protein-Energy Supplements in Peritoneal Dialysis: A Multicenter Study

2005 ◽  
Vol 25 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Josep Teixidó–Planas ◽  
Alberto Ortíz ◽  
Francisco Coronel ◽  
Jesús Montenegro ◽  
Ramón López-Menchero ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Lymphocyte Count ◽  
Mixed Model ◽  
Residual Renal Function ◽  
High Rate ◽  
Protein Energy ◽  
Group A ◽  
Group B

Background Protein-energy malnutrition is prevalent in peritoneal dialysis (PD) patients and is associated with increased morbidity and mortality. Objective To evaluate the impact of prophylactic treatment with an oral protein-energy supplement (Protenplus; Fresenius AG, Bad Homburg, Germany) on nutritional parameters in patients starting PD. Design Prospective, multicenter, randomized study of group A patients (Protenplus, n = 35) and group B (controls, n = 30), with evaluations at baseline and at 6 and 12 months. Statistical Methods: Efficacy of factors by linear mixed model analysis for repeated measurements, chi-square, t-test, and Mann–Whitney test. Outcome Parameters Patient compliance, serum albumin, and other nutritional parameters. Results No significant differences were found at baseline evaluation. During follow-up, a significant number of group A patients abandoned intake of the supplement due to noncompliance ( n = 7) or side effects ( n = 8) (χ2 p < 0.01). Patients with lower residual renal function were less likely to comply. The mixed model in the “intention to treat” analysis showed a significant increase related to supplement intake only in total lymphocyte count in group A. The “as treated” analysis of the 29 patients who fulfilled the study (9 in group A, 20 in group B) disclosed that belonging to group A constituted an independent factor for increased lymphocyte count ( p < 0.001), body weight ( p < 0.03), tricipital skinfold thickness ( p < 0.01), middle-arm muscle circumference ( p < 0.025), lean body mass (LBM) ( p < 0.002), creatinine LBM related to body surface area ( p < 0.001), and creatinine generation rate ( p < 0.002). However, these data may have been biased by the high rate of noncompliance in group A. Conclusions Protenplus proved to be unsuitable as a long term, oral protein-energy supplement in PD patients due to a high rate of noncompliance and intolerance, primarily among patients with lower residual renal function. The question of whether other products, better-tolerated as nutritional supplements, could compensate for daily protein peritoneal losses in long-term PD remains open.

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

scholarly journals Multiple sclerosis patients have reduced resting and increased activated CD4+CD25+FOXP3+T regulatory cells

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nirupama D. Verma ◽  
Andrew D. Lam ◽  
Christopher Chiu ◽  
Giang T. Tran ◽  
Bruce M. Hall ◽  
...  
Keyword(s):  
T Cells ◽  
T Regulatory Cells ◽  
Mononuclear Cells ◽  
Effector Memory ◽  
Regulatory Cells ◽  
Peripheral Blood Mononuclear ◽  
Healthy Donors ◽  
Treg Population ◽  
Multiple Sclerosis Patients ◽  
Population Iii

AbstractResting and activated subpopulations of CD4+CD25+CD127loT regulatory cells (Treg) and CD4+CD25+CD127+ effector T cells in MS patients and in healthy individuals were compared. Peripheral blood mononuclear cells isolated using Ficoll Hypaque were stained with monoclonal antibodies and analysed by flow cytometer. CD45RA and Foxp3 expression within CD4+ cells and in CD4+CD25+CD127loT cells identified Population I; CD45RA+Foxp3+, Population II; CD45RA−Foxp3hi and Population III; CD45RA−Foxp3+ cells. Effector CD4+CD127+ T cells were subdivided into Population IV; memory /effector CD45RA− CD25−Foxp3− and Population V; effector naïve CD45RA+CD25−Foxp3−CCR7+ and terminally differentiated RA+ (TEMRA) effector memory cells. Chemokine receptor staining identified CXCR3+Th1-like Treg, CCR6+Th17-like Treg and CCR7+ resting Treg. Resting Treg (Population I) were reduced in MS patients, both in untreated and treated MS compared to healthy donors. Activated/memory Treg (Population II) were significantly increased in MS patients compared to healthy donors. Activated effector CD4+ (Population IV) were increased and the naïve/ TEMRA CD4+ (Population V) were decreased in MS compared to HD. Expression of CCR7 was mainly in Population I, whereas expression of CCR6 and CXCR3 was greatest in Populations II and intermediate in Population III. In MS, CCR6+Treg were lower in Population III. This study found MS is associated with significant shifts in CD4+T cells subpopulations. MS patients had lower resting CD4+CD25+CD45RA+CCR7+ Treg than healthy donors while activated CD4+CD25hiCD45RA−Foxp3hiTreg were increased in MS patients even before treatment. Some MS patients had reduced CCR6+Th17-like Treg, which may contribute to the activity of MS.

scholarly journals Reconstructive Approaches in Surgical Management of Congenital Pseudarthrosis of the Tibia

2020 ◽  
Vol 9 (12) ◽  
pp. 4132
Author(s):  
Andrea Laufer ◽  
Adrien Frommer ◽  
Georg Gosheger ◽  
Robert Roedl ◽  
Frank Schiedel ◽  
...  
Keyword(s):  
External Fixation ◽  
Bone Transport ◽  
Bone Union ◽  
Complication Rates ◽  
Union Rate ◽  
Bone Fusion ◽  
Group A ◽  
Primary Bone ◽  
Group B

Treatment of congenital pseudarthrosis of the tibia remains a major challenge in pediatric orthopedics. Ideal timing and preference of surgical procedures are discussed controversially. A variety of reconstructive treatment strategies have been described in literature, but so far none has proven its superiority. The aim of treatment is to obtain long-term bone union, to prevent refracture, and to correct angular deformities and leg length discrepancies. This study retrospectively evaluates the outcome of different reconstructive strategies. Sixty-nine patients were identified who presented to our outpatient department between 1997 and 2019. Twenty-six of these patients underwent reconstructive surgical treatment and were included in this study. The study cohort was divided into three groups. Excision of the pseudarthrosis was performed in all patients in Group A and B, and in two patients of Group C. Group A (six/26 patients) received subsequent bone transport through external fixation maintaining original length. In Group B (15/26 patients), patients underwent either previous, simultaneous, or subsequent extrafocal lengthening through external fixation to reconstitute length. In Group C (five/26 patients), internal fixation with intramedullary nails was applied. Radiological and clinical evaluation was performed to assess bone union and complication rates. Results varied considerably between the study groups. Overall, the primary bone fusion rate was 69.2%. There were four refractures, all occurring in Group B. The long-term bone union rate without refracture was 53.8%. The overall complication rate was 53.8% and 23.1% showed persistent pseudarthrosis. Two secondary amputations were performed due to failed bone fusion. In conclusion, excision of the pseudarthrosis and extrafocal lengthening achieves a satisfying bone union rate and limb reconstruction, while bone transport does not offer significant advantages but shows higher complication rates. Intramedullary stabilization should be applied to maintain bone union, but shows lower bone union rates when used as a stand-alone treatment regimen. Regardless of the primary bone fusion rates, the probability of long-term bone union remains unpredictable.

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.

scholarly journals The Role of Quantic Molecular Resonance (QMR) in the Treatment of Inferior Turbinate Hypertrophy (ITH): Our Experience With Long-Term Follow-Up in Allergic and Nonallergic Rhinitis Refractory to Medical Therapy. Preliminary Results

2021 ◽  
pp. 014556132110015
Author(s):  
Filippo Ricciardiello ◽  
Davide Pisani ◽  
Pasquale Viola ◽  
Raul Pellini ◽  
Giuseppe Russo ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Nonallergic Rhinitis ◽  
Turbinate Hypertrophy ◽  
Group A ◽  
Group B ◽  
Inferior Turbinate Hypertrophy ◽  
Molecular Resonance

Objective: The aim of this study was to assess the long-term effectiveness of quantic molecular resonance (QMR) in the treatment of inferior turbinate hypertrophy (ITH) in allergic and nonallergic rhinitis refractory to medical therapy. Methods: This study enrolled 281 patients, 160 males (56.9%) and 121 females (43.1%), mean age 37.8 ± 4.1 years, range 18 to 71. Fifty-four patients have been lost to follow up and have been therefore excluded from the final analysis. Based on skin prick test results, 69 patients were considered allergic (group A) and 158 nonallergic (group B). All subjects underwent before surgery (T0) and 3 (T1), 12 (T2), 24 (T3), and 36 months (T4) after QMR treatment to: 4-phase rhinomanometric examination, nasal endoscopy evaluation, and visual analogue scale to quantify the subjective feelings about nasal obstruction. Results: Subjective and objective parameters showed statistically significant improvement in both groups. Group B parameters not changed during follow-up, while group A showed significant worsening between T1 and subsequent assessments. T4 outcome indicates a better result in nonallergic patients. Conclusions: In accordance with the literature, our preliminary data validate QMR treatment as a successful therapeutic option for nasal obstruction due to ITH. Nonallergic patients had a very good T4 outcome. Allergic patients showed a worsening trend after 1 year probably due to other causes.

scholarly journals Long-Term Engraftment of Human Natural T Regulatory Cells in NOD/SCID IL2rγcnull Mice by Expression of Human IL-2

PLoS ONE ◽  
2012 ◽  
Vol 7 (12) ◽  
pp. e51832 ◽  
Author(s):  
Sojan Abraham ◽  
Rajendra Pahwa ◽  
Chunting Ye ◽  
Jang-gi Choi ◽  
Savita Pahwa ◽  
...  
Keyword(s):  
T Regulatory Cells ◽  
Regulatory Cells

Management of fresh odontoid fractures using posterior C1–2 fixation without fusion: a long-term clinical follow-up study

2021 ◽  
pp. 1-11
Keyword(s):  
Scale Score ◽  
Neck Disability Index ◽  
Implant Removal ◽  
Odontoid Fractures ◽  
Significant Difference ◽  
Flexion Extension ◽  
Group A ◽  
Group B

OBJECTIVE Posterior C1–2 fixation without fusion makes it possible to restore atlantoaxial motion after removing the implant, and it has been used as an alternative technique for odontoid fractures; however, the long-term efficacy of this technique remains uncertain. The purpose of the present study was to explore the long-term follow-up outcomes of patients with odontoid fractures who underwent posterior C1–2 fixation without fusion. METHODS A retrospective study was performed on 62 patients with type II/III fresh odontoid fractures who underwent posterior C1–2 fixation without fusion and were followed up for more than 5 years. The patients were divided into group A (23 patients with implant removal) and group B (39 patients without implant removal) based on whether they underwent a second surgery to remove the implant. The clinical outcomes were recorded and compared between the two groups. In group A, the range of motion (ROM) of C1–2 was calculated, and correlation analysis was performed to explore the factors that influence the ROM of C1–2. RESULTS A solid fracture fusion was found in all patients. At the final follow-up, no significant difference was found in visual analog scale score or American Spinal Injury Association Impairment Scale score between the two groups (p > 0.05), but patients in group A had a lower Neck Disability Index score and milder neck stiffness than did patients in group B (p < 0.05). In group A, 87.0% (20/23) of the patients had atlantoodontoid joint osteoarthritis at the final follow-up. In group A, the C1–2 ROM in rotation was 6.1° ± 4.5° at the final follow-up, whereas the C1–2 ROM in flexion-extension was 1.8° ± 1.2°. A negative correlation was found between the C1–2 ROM in rotation and the severity of tissue injury in the atlantoaxial region (r = –0.403, p = 0.024) and the degeneration of the atlantoodontoid joint (r = –0.586, p = 0.001). CONCLUSIONS Posterior C1–2 fixation without fusion can be used effectively for the management of fresh odontoid fractures. The removal of the implant can further improve the clinical efficacy, but satisfactory atlantoaxial motion cannot be maintained for a long time after implant removal. A surgeon should reconsider the contribution of posterior C1–2 fixation without fusion and secondary implant removal in preserving atlantoaxial mobility for patients with fresh odontoid fractures.

Sign in / Sign up

Export Citation Format

Share Document