scholarly journals Cytomegalovirus Disease in Renal Transplanted Patients: Prevalence, Determining Factors, and Influence on Graft and Patients Outcomes

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 473
Author(s):  
Carlo Maria Alfieri ◽  
Paolo Molinari ◽  
Mariateresa Gandolfo ◽  
Mariarosaria Campise ◽  
Donata Cresseri ◽  
...  
Keyword(s):  
Graft Loss ◽  
Clinical Signs ◽  
Female Gender ◽  
C Protein ◽  
P Loss ◽  
Determining Factors ◽  
Unique Factor ◽  
Cmv Disease ◽  
The Relationship

The prevalence and the factors related to cytomegalovirus (CMV) disease (CMVd) during the 1st year of renal transplantation (RTx) and the relationship between CMVd and early and long-term graft and RTx-patient (RTx-p) survival were evaluated. In 505 RTx-p, followed up for 8(5–11) years, data were recorded after 1-(T1) and 12-(T12) months of RTx. CMVd was defined either by CMV replication without clinical signs of disease (CMVr, 43%), or CMV replication with signs of disease (CMVs, 57%). During the 1st year of RTx, 45% of RTx-p had CMVd (CMVd+). CMVd+ patients were older than CMVd− patients. Female gender and Donor CMV-IgG+ (CMV IgG−D+)/recipient IgG- (CMV IgG−R-) status were more prevalent in CMVd+. At T1, CMVd+ had lower albumin, haemoglobin, and higher uric-acid and reactive C-protein than CMVd− and, at T1 and T12, received more steroids. Albumin-T1 was the unique factor in determining CMVd+, maintaining its significance also after the inclusion of IgG−D+/IgG−R− status to the model. CMVs had higher prevalence of CMV IgG-D+/IgG-R- than CMVr. CMVd, CMVr, and CMVs had no impact on graft loss (11% of RTx-p) and RTx-p death (8% of RTx-p). CMVd is highly prevalent during the 1st year of RTx. Albumin-T1 influences CMVd insurgence. CMVd did not impact on RTx and RTx-p loss.

P1700CYTOMEGALOVIRUS DISEASE IN RENAL TRANSPLANTED PATIENTS: DETERMINING FACTORS AND ITS RELATION WITH GRAFT OUTCOME AND PATIENTS SURVIVAL

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Carlo Maria Alfieri ◽  
Paolo Molinari ◽  
Maria Teresa Gandolfo ◽  
Maria Rosaria Campise ◽  
Donata Cresseri ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Induction Therapy ◽  
Graft Loss ◽  
Clinical Signs ◽  
Female Gender ◽  
First Year ◽  
Number Of Patients ◽  
Dialysis Vintage ◽  
Cmv Disease

Abstract Background CMV disease (CMVd) is a frequent complication in renal transplanted patients (RTxp), especially during the first year of transplantation (RTx). CMVd impacts on long term graft and patients outcomes is still debated. Our observational retrospective study aims to evaluate: 1) the prevalence of CMVd during the first year of RTx; 2) the factors related to CMVd; 3) the relationship between CMVd and early and long term graft and patients survival. Method In 505 RTxp (age: 50[41;58]yrs – 292 males), up to the 616 transplanted in our unit between 2004 and 2016, clinical, blood and urinary parameters were recorded after 1 (T1) and 12 (T12) months of RTx. eGFR was estimated by MDRD formula. Donor (D) and Recipient (R) CMV serology was tested at the moment of RTx. CMV IgG-D+/IgG-R- RTxp (12%) and high risk patients (second or more RTx, ATG induction therapy), received prophylaxis therapy until the 3rd month of RTx. CMVd, was defined by the presence either of CMVr (CMV replication without clinical signs of CMV disease) or CMVs (CMV replication with signs of disease and/or need of antiviral therapy/reduction of immunosuppressive therapy). Median follow up (FU) was 8[5-11]yrs. The following outcomes were investigated: 1) graft: reduction of eGFR >20% between T1 and T12; reduction of eGFR >50% between T1 and end of FU (eGFRr>50%); graft loss (GL); eGFRr>50% + GL.; 2) RTxp survival at the end of FU. Results Ninty percent of RTxp had a kidney from a deceased D; 73% and 21% received haemodialysis (HD+) and peritoneal dialysis before RTx. Dialysis vintage was 50[33-75] months. In 12% of RTxp, induction therapy included ATG. Cumulative steroids dose was 880[840-105]mg and 2272[2598-3223]mg at T1 and T12 respectively. During the first year of RTx, 45% of patients had CMVd (CMVd+). CMVd+ were older than CMV free RTxp (CMVd-). Female gender, HD+ and CMV IgG-D+/IgG-R- were more prevalent in CMVd+. In addition, at T1, CMVd+ had lower albumin, haemoglobin and higher PTH, uric acid and reactive C protein levels than CMVd- and, both at T1 and T12, received higher steroid dose. In multivariate analysis, albumin-T1 was the most significant modifiable factor in determining CMVd+ (p=0.009 OR 0.50 – IC 0.29-0.84). Albumin-T1 maintained its significance also after the addiction of CMV serology IgG-D+/IgG-R- to the model (albumin T1: p=0.008 OR 0.48 – IC 0.29-0.84; CMV serology IgG-D+/IgG-R-: p=0.01 OR 2.16 – IC 1,18 -3,95). Among CMVd, 19% and 25% had respectively CMVr and CMVs. CMVs were characterized by lower dialysis vintage and higher prevalence of CMV IgG-D+/IgG-R- than CMVr. GL and death were observed in 11% and 8% of RTxp respectively. In univariate and survival analyses, CMVd, CMVr and CMVs didn’t show any impact on the graft and patients outcomes examined. Conclusion Our retrospective study confirms the high prevalence of CMVd during the first year of RTx, and identifies albumin at T1 as the most impacting parameter in influence CMVd insurgence. This might reflect the importance of the pre-RTx status in CMVd development after RTx. Nevertheless, CMVd seems not impact significantly on early and long term outcomes, experienced however in a small part of the cohort studied. Future studies, possibly prospective and including higher number of patients might better elucidate this issue.

scholarly journals A májfunkció romlásának rizikófaktorai sikeres vesetranszplantációt követően

2019 ◽  
Vol 160 (5) ◽  
pp. 186-190
Author(s):  
Bernadett Borda ◽  
Attila Nemes ◽  
Csaba Lengyel ◽  
Tamás Várkonyi ◽  
Ferenc Rárosi ◽  
...  
Keyword(s):  
Liver Function ◽  
Immunosuppressive Therapy ◽  
Liver Enzymes ◽  
Graft Loss ◽  
Study Results ◽  
Allograft Function ◽  
The Difference ◽  
The Impact ◽  
The Relationship

Abstract: Introduction: Increase of liver function is one of the most common complications after kidney transplantation due to the use of immunosuppressive therapy and hyperlipidemia in addition to hepatitis C virus (HCV) infection. Method: Following the selection criteria (n = 59), the study is based on applied immunosuppressive therapy, baseline data of patients, further correlation between HCV and liver function deterioration. Patients were subjected to fasting laboratory examination to monitor serum electrolytes, uric acid and albumin levels. We looked at the effects of immunosuppressive therapy on the lipids (TG, TC, HDL, LDL) and liver enzymes (GOT, GPT, ALP, GGT). The analysis of the relationship between lipids and liver enzymes was also included in our study. Results: The data basics were not significantly different between the tacrolimus and the cyclosporine groups. In the laboratory results, Mg levels were significantly different between the two groups (p = 0.044). The impact of HCV on the liver function was significantly different on GGT (p = 0.008). We examed the lipids and liver function level between the tacrolimus and the patients receiving cyclosporine-based immunosuppression and the total cholesterol (p = 0.005) and GOT (p = 0.05) were significantly different between the two groups. Hyperlipidemia was associated with 26% of patients taking tacrolimus-based immunosuppression, and 89% of those receiving cyclosporine; the difference was significant (p = 0.002). Regarding the effect of hyperlipidemia on liver enzymes, ALP (p = 0.006) and GGT (p = 0.0001) were significantly higher. Conclusion: Increases in hepatic enzymes, ALT and GGT indicate the damage to hepatocytes. Beside the increase of liver function, which is the main risk factor in hepatitis on HCV soil, the applied immunosuppressive therapy and hyperlipidemia lead to degradation of allograft function and long-term graft loss. Orv hetil. 2019; 160(5): 186–190.

The relationship between relapse, impairment and disability in multiple sclerosis

2011 ◽  
Vol 17 (10) ◽  
pp. 1218-1224 ◽  
Author(s):  
L Bennetto ◽  
J Burrow ◽  
H Sakai ◽  
J Cobby ◽  
NP Robertson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Signs ◽  
Spatial Relationship ◽  
Afferent Pathways ◽  
Motor Pathways ◽  
Disability Status ◽  
Natural History Studies ◽  
History Of ◽  
The Relationship

Objective: To describe the spatial relationship between relapse and disability in multiple sclerosis (MS). Methods: 141 relapse onset MS patients were studied. For each patient an examination was performed and a relapse history obtained. Multivariate logistic regression examined whether there was an association between localizing clinical signs and a history of relevant relapse in order to explore the spatial relationship between relapse and subsequent disability. Results: The presence of impaired vision or sensation was independently associated with a history of one or more anatomically related relapses. The presence of weakness or cerebellar ataxia in a limb was not associated with a single relevant relapse but was associated with multiple relevant relapses. A history of multiple episodes of weakness or ataxia in the same limb was uncommon. Conclusions: Our data suggest that motor pathways are relatively resistant to chronic impairment from acute relapse, whereas afferent pathways are more susceptible. This, in combination with prominent usage of the Expanded Disability Status Scale, which is dependent on mobility and motor function at higher scores, may explain the paradox between natural history studies that suggest relapses are irrelevant to long-term disability and shorter studies at lower disability levels suggesting relapses are responsible for disability accumulation.

Patient disability and treatment variation among older adults with kidney cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 573-573
Author(s):  
Hung-Jui Tan ◽  
Karim Chamie ◽  
Mark S. Litwin ◽  
Jim Hu
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
Kidney Cancer ◽  
Metastatic Cancer ◽  
Female Gender ◽  
Cancer Stage ◽  
Term Survival ◽  
Long Term Survival ◽  
The Relationship

573 Background: Beyond age and comorbidity, functional status shapes the long-term survival potential of patients with cancer. Accordingly, we explored the relationship between preexisting disability and surgery among older adults with kidney cancer. Methods: Using SEER-Medicare data from 2000–2009, we sampled 28,326 patients ≥66 years old diagnosed with primary kidney cancer. Disability was quantified using function-related indicators (FRI)—claims indicative of patient dysfunction (e.g., mobility-assist devices, falls). We used competing risk regression to assess the relationship between FRI score and non-cancer-related mortality and generalized estimating equations to estimate the probability of surgery according to FRI score, adjusting for patient and tumor stage. Results: We identified 13,619 (48.1%) adults with ≥1 FRI. Disability was associated with older age, greater comorbidity, female gender, unmarried status, lower socioeconomic status, and higher cancer stage (p<0.001). Patients with a FRI score of 1 (SHR 1.10, 95% CI 1.04–1.16) and ≥2 (SHR 1.52, 95% CI 1.44–1.60) had higher likelihoods of non-cancer-related death compared with those with a FRI score of 0. Predicted 10-year incidence of non-cancer-related death was 35, 38, and 48% while the incidence of kidney cancer-related death was 26, 28, and 29% for patients with FRI score of 0, 1, and ≥2, respectively. Patients with FRI of ≥2 received surgical treatment less often than those without disability (OR 0.61, 95% 0.56–0.66), though treatment probabilities remained high for patients with loco-regional disease and low for adults with metastatic cancer (Table). Conclusions: Among older adults with kidney cancer, functional status stands as a significant predictor of long-term survival. Although preexisting disability modulates treatment use to some degree, receipt of cancer-directed surgery appears largely determined by cancer stage. Patient functionality should be considered more heavily when deciding treatment for kidney cancer. [Table: see text]

Multi-Center Calibration of the Second Reference Material for Thromboplastin, Rabbit, Plain, Coded CRM 149R

1991 ◽  
Vol 65 (03) ◽  
pp. 263-267 ◽  
Author(s):  
A M H P van den Besselaar ◽  
R M Bertina
Keyword(s):  
Reference Material ◽  
Standard Error ◽  
Standard Errors ◽  
Sensitivity Index ◽  
Long Term Stability ◽  
Significant Bias ◽  
The Mean ◽  
The Relationship ◽  
International Sensitivity Index

SummaryIn a collaborative trial of eleven laboratories which was performed mainly within the framework of the European Community Bureau of Reference (BCR), a second reference material for thromboplastin, rabbit, plain, was calibrated against its predecessor RBT/79. This second reference material (coded CRM 149R) has a mean International Sensitivity Index (ISI) of 1.343 with a standard error of the mean of 0.035. The standard error of the ISI was determined by combination of the standard errors of the ISI of RBT/79 and the slope of the calibration line in this trial.The BCR reference material for thromboplastin, human, plain (coded BCT/099) was also included in this trial for assessment of the long-term stability of the relationship with RBT/79. The results indicated that this relationship has not changed over a period of 8 years. The interlaboratory variation of the slope of the relationship between CRM 149R and RBT/79 was significantly lower than the variation of the slope of the relationship between BCT/099 and RBT/79. In addition to the manual technique, a semi-automatic coagulometer according to Schnitger & Gross was used to determine prothrombin times with CRM 149R. The mean ISI of CRM 149R was not affected by replacement of the manual technique by this particular coagulometer.Two lyophilized plasmas were included in this trial. The mean slope of relationship between RBT/79 and CRM 149R based on the two lyophilized plasmas was the same as the corresponding slope based on fresh plasmas. Tlowever, the mean slope of relationship between RBT/79 and BCT/099 based on the two lyophilized plasmas was 4.9% higher than the mean slope based on fresh plasmas. Thus, the use of these lyophilized plasmas induced a small but significant bias in the slope of relationship between these thromboplastins of different species.

Risk Attitude and Corporate Investment under Output Market Uncertainty: Evidence from The Mekong River Delta, Vietnam

2016 ◽  
pp. 59-70
Author(s):  
Ninh Le Khuong ◽  
Nghiem Le Tan ◽  
Tho Huynh Huu
Keyword(s):  
Negative Relationship ◽  
Risk Attitude ◽  
Business Strategies ◽  
Risk Averse ◽  
Market Uncertainty ◽  
Firm Investment ◽  
Output Market ◽  
The Impact ◽  
The Relationship

This paper aims to detect the impact of firm managers’ risk attitude on the relationship between the degree of output market uncertainty and firm investment. The findings show that there is a negative relationship between these two aspects for risk-averse managers while there is a positive relationship for risk-loving ones, since they have different utility functions. Based on the findings, this paper proposes recommendations for firm managers to take into account when making investment decisions and long-term business strategies as well.

Financial Folly and Spain’s Black Legend

2017 ◽  
Author(s):  
Mauricio Drelichman ◽  
Hans-Joachim Voth
Keyword(s):  
Seventeenth Century ◽  
Economic History ◽  
Military Power ◽  
Great Flexibility ◽  
Loan Contracts ◽  
Historical Tradition ◽  
Black Legend ◽  
Contractual Obligations ◽  
The Relationship

This epilogue argues that Castile was solvent throughout Philip II's reign. A complex web of contractual obligations designed to ensure repayment governed the relationship between the king and his bankers. The same contracts allowed great flexibility for both the Crown and bankers when liquidity was tight. The risk of potential defaults was not a surprise; their likelihood was priced into the loan contracts. As a consequence, virtually every banking family turned a profit over the long term, while the king benefited from their services to run the largest empire that had yet existed. The epilogue then looks at the economic history version of Spain's Black Legend. The economic history version of the Black Legend emerged from a combination of two narratives: a rich historical tradition analyzing the decline of Spain as an economic and military power from the seventeenth century onward, combined with new institutional analysis highlighting the unconstrained power of the monarch.

PELAKSANAAN PROMOSI GUNA MENINGKATKAN VOLUME PENJUALAN

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Wahyuni Sri Astutik
Keyword(s):  
Marketing Strategy ◽  
Marketing Strategies ◽  
Sales Volume ◽  
Price Promotion ◽  
Product Strategy ◽  
The Public ◽  
Maximum Profit ◽  
Advertising Effort ◽  
Determining Factors ◽  
The Relationship

In the implementation of promotions in order to increase sales volume at the Pangkat - Kediri tile company, an analysis result of 6.00 was obtained which states that the relationship between promotion and sales volume is strong. Because promotion is one of the determining factors for the success of every company in producing to selling their products to consumers.Because the promotion includes many things starting from product strategy to product marketing / sales. However, companies certainly cannot only focus on promotional activities, because the four elements of marketing strategy (price, promotion, distribution and production) cannot be separated. So companies should be able to combine marketing strategies appropriately, so that the company is able to achieve the desired targets, namely achieving maximum profit. In order to introduce its company products to the public with advertising media is very important. Because with this advertising effort, society knows advantages that accompanied these products, so that the company's expectations for sales to increase will be even greater and its profits will also increase.Keywords:Promotion, sale, Marketing strategy and profit.

Evaluación Cognitiva Montreal y consumo de alcohol: Un diagnóstico descriptivo del deterioro cognitivo en estudiantes universitarios de Durango, México

2019 ◽  
pp. 28-38
Author(s):  
Karla Liliana Pérez-Sosa ◽  
Edgar Felipe Lares-Bayona
Keyword(s):  
Cognitive Impairment ◽  
Alcohol Consumption ◽  
Cognitive Functions ◽  
Toxic Substance ◽  
Female Gender ◽  
Diagnostic Tools ◽  
Cross Sectional ◽  
Probabilistic Study ◽  
The Central Nervous System ◽  
The Relationship

Alcohol is a toxic substance associated with acute and chronic disorders affecting the Central Nervous System and significantly altering brain function. Objective: To determine the relationship between cognitive impairment and alcohol consumption in university students of the Juárez University of the State of Durango. Methodology: It is a cross-sectional, descriptive, comparative, non-probabilistic study, for convenience. A database was designed on the results obtained in a clinical interview on alcohol consumption and the application of the Montreal Cognitive Assessment (MoCA) test. Contribution: The evaluation of cognitive functions show similar results, the male sex presented a better score in Attention and the female one in Orientation. More involvement was identified in the Deferred Memory functions in both groups. In relation to alcohol consumption, the cognitive functions evaluated show lower levels. The female gender was more evident cognitive impairment in relation to alcohol consumption being statistically significant (p <0.025). Alcohol consumption is a risky behavior that deserves to be recognized by the main actors about neurocognitive effects. Alcohol consumption prevention programs and cognitive diagnostic tools are appropriate strategies to reduce risk behaviors in mental health.

QUALITY OF LIFE PROBLEMS OF GYNECOLOGICAL CANCER PATIENTS

2017 ◽  
Vol 63 (3) ◽  
pp. 368-374
Author(s):  
Olga Churuksaeva ◽  
Larisa Kolomiets
Keyword(s):  
Quality Of Life ◽  
Gynecological Cancer ◽  
Social Aspects ◽  
Cancer Data ◽  
Life Problems ◽  
Anticancer Treatment ◽  
Short And Long Term ◽  
The Relationship

Due to improvements in short- and long-term clinical outcomes a study of quality of life is one of the most promising trends in oncology today. This review analyzes the published literature on problems dealing with quality of life of patients with gynecological cancer. Data on quality of life with respect to the extent of anticancer treatment as well as psychological and social aspects are presented. The relationship between quality of life and survival has been estimated.

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