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51.
52.
Wagner de Castro Andrade Manoel Carlos Prieto VelhoteAli Ahman Ayoub Marcos Marques SilvaNelson Elias M. Gibelli Ana Cristina A. TannuriMaria Merces Santos Maria Lucia Pinho-ApezzatoFabio de Barros Daniel Rangel MoreiraHelena T. Miyatani Raimundo Renato PereiraUenis Tannuri 《Journal of pediatric surgery》2014
Background/Purpose
Living donor liver transplantation has become a cornerstone for the treatment of children with end-stage hepatic dysfunction, especially within populations or countries with low rates of organ utilization from deceased donors. The objective is to report our experience with 185 living donors operated on by a team pediatric surgeons in a tertiary center for pediatric liver transplantation.Methods
Retrospective analysis of medical records of donors of hepatic grafts for transplant undergoing surgery between June 1998 and March 2013.Results
Over the last 14 years, 185 liver transplants were performed in pediatric recipients of grafts from living donors. Among the donors, 166 left lateral segments (89.7%), 18 left lobes without the caudate lobe (9.7%) and 1 right lobe (0.5%) were harvested. The donor age ranged from 16 to 53 years, and the weight ranged from 47 to 106 kg. In 10 donors, an additional graft of the donor inferior mesenteric vein was harvested to substitute for a hypoplastic recipient portal vein. The transfusion of blood products was required in 15 donors (8.1%). The mean hospital stay was 5 days. No deaths occurred, but complications were identified in 23 patients (12.4%): 9 patients experienced abdominal pain and severe gastrointestinal symptoms and 3 patients required reoperations. Eight donors presented with minor bile leaks that were treated conservatively, and 3 patients developed extra-peritoneal infections (1 wound collection, 1 phlebitis and 1 pneumonia). Eight grafts (4.3%) showed primary dysfunction resulting in recipient death (3 cases of fulminant hepatitis, 1 patient with metabolic disease, 1 patient with Alagille syndrome and 3 cases of biliary atresia in infants under 1 year old). There was no relation between donor complications and primary graft dysfunction (P = 0.6).Conclusions
Living donor transplantation is safe for the donor and presents a low morbidity. The donor surgery may be performed by a team of trained pediatric surgeons. 相似文献53.
Frank Jacobi Michael Höfler Jens Siegert Simon Mack Anja Gerschler Lucie Scholl Markus A. Busch Ulfert Hapke Ulrike Maske Ingeburg Seiffert Wolfgang Gaebel Wolfgang Maier Michael Wagner Jürgen Zielasek Hans‐Ulrich Wittchen 《International journal of methods in psychiatric research》2014,23(3):304-319
This paper provides up to date prevalence estimates of mental disorders in Germany derived from a national survey (German Health Interview and Examination Survey for Adults, Mental Health Module [DEGS1‐MH]). A nationally representative sample (N = 5318) of the adult (18–79) population was examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview (DEGS‐CIDI) to assess symptoms, syndromes and diagnoses according to DSM‐IV‐TR (25 diagnoses covered). Of the participants 27.7% met criteria for at least one mental disorder during the past 12 months, among them 44% with more than one disorder and 22% with three or more diagnoses. Most frequent were anxiety (15.3%), mood (9.3%) and substance use disorders (5.7%). Overall rates for mental disorders were substantially higher in women (33% versus 22% in men), younger age group (18–34: 37% versus 20% in age group 65–79), when living without a partner (37% versus 26% with partnership) or with low (38%) versus high socio‐economic status (22%). High degree of urbanization (> 500,000 inhabitants versus < 20,000) was associated with elevated rates of psychotic (5.2% versus 2.5%) and mood disorders (13.9% versus 7.8%). The findings confirm that almost one third of the general population is affected by mental disorders and inform about subsets in the population who are particularly affected. Copyright © 2014 John Wiley & Sons, Ltd. 相似文献
54.
55.
Glenn J. Wagner Ph.D. Bonnie Ghosh-Dastidar Ph.D. Mary Ellen Slaughter M.S. Dickens Akena M.B.Ch.B. Noeline Nakasujja M.B.Ch.B. Seggane Musisi M.B.Ch.B. 《Annals of behavioral medicine》2014,48(2):175-183
Purpose
We examined the effect of antiretroviral therapy (ART), and the predictive role of depression, on condom use with primary partners.Methods
Data from three studies in Uganda were combined into a sample of 750 patients with a primary sex partner, with 502 starting ART and 248 entering HIV care, and followed for 12 months. Random-effects logistic regression models were used to examine the impact of ART, and the influence of baseline level and change in depression, on condom use with primary partners.Results
At month 12, 61 % ART and 67 % non-ART patients were consistent condom users, compared to 44 and 41 % at baseline, respectively. Multivariate analysis revealed that consistent condom use increased similarly for ART and non-ART patients, and that minor depression at baseline and increased depression over time predicted inconsistent condom use.Conclusions
Improved depression diagnosis and treatment could benefit HIV prevention. 相似文献56.
Reply to: Cognitive dysfunction in spinocerebellar ataxia type 3: Variable topographies and patterns
57.
Wagner F. Gattaz Leda L. Talib Evelin L. Schaeffer Breno S. Diniz Orestes V. Forlenza 《Journal of neural transmission (Vienna, Austria : 1996)》2014,121(2):193-200
Reduced phospholipase A2 (PLA2) activity has been reported in the brain and in blood cells of patients with Alzheimer’s disease (AD). Individuals with mild cognitive impairment (MCI) are at increased risk of developing AD. In the present study, we determined the activity of distinct PLA2 subgroups (iPLA2, sPLA2 and cPLA2) in older adults with MCI as compared to patients with mild dementia due to AD and to cognitively healthy controls. We investigated whether decreased PLA2 activity at baseline is associated with the progression of MCI to AD upon follow-up during a period of 4 years. The activity of PLA2 subgroups was determined in platelets from 169 elderly adults. Progression of MCI to AD was ascertained by standard clinical criteria for AD upon follow-up. At baseline, iPLA2 activity was significantly decreased (p = 0.001) in patients with AD and MCI as compared to controls. Patients with MCI who progressed to AD during follow-up showed significantly lower iPLA2 activity at baseline as compared to patients with MCI who did not progress to AD (p = 0.009). Moreover, subjects from the control group at baseline who progressed to MCI during follow-up had lower sPLA2 and cPLA2 (p = 0.014 and p = 0.009, respectively). Our findings suggest that low platelet iPLA2 activity may be a risk marker for AD in subjects with MCI. Moreover, low sPLA2 and cPLA2 were related to cognitive decline in healthy controls, suggesting a relationship with the very early stages of the disease. 相似文献
58.
Sergio Sánchez-García Carmen García-Peña Catalina González-Forteza Alberto Jiménez-Tapia Joseph J. Gallo Fernando A. Wagner 《Social psychiatry and psychiatric epidemiology》2014,49(6):953-960
Purpose
Determine the structure of depressive symptoms among adolescents and older adults through the person-centered approach of latent class analysis (LCA).Methods
The study is based on data from two independent samples collected in Mexico City (2,444 adolescents and 2,223 older adults) which included the revised version of the CES-D. The presence or absence of depressed mood (dysphoria), diminished pleasure (anhedonia), drastic change in weight, sleep problems, thinking and concentration difficulties, excessive or inappropriate guilt, fatigue, psychomotor agitation/retardation, and suicide ideation were used in LCA to determine the structure of depressive symptoms for adolescents and older adults.Results
Adolescents reported higher excessive or inappropriate guilt compared to older adults, while older adults had higher proportions of anhedonia, sleep problems, fatigue, and psychomotor agitation/retardation. Similar proportions were found in other symptoms. The LCA analysis showed the best fit with four latent classes (LC): LC 1, “symptoms suggestive of major depressive episode (MDE)” with prevalence of 5.9 % (n = 144) and 10.3 % (n = 230) among adolescents and older adults, respectively; LC 2, “probable MDE symptoms” 18.2 % (n = 446) and 23.0 % (n = 512); LC 3, “possible MDE” 27.7 % (n = 676) and 21.8 % (n = 485); LC 4, “without significant depressive symptoms” 48.2 % (n = 1,178) and 44.8 % (n = 996). The differences in item thresholds between the two groups (adolescents vs. older adults) were statistically significant (Wald test = 255.684, df = 1, p < 0.001).Conclusions
This study documented important similarities and differences in the structure of depressive symptoms between adolescents and older adults that merit acknowledgment, further study, and consideration of their potential clinical and public health implications. 相似文献59.
Stefan Steurer Julius Magnus Singer Michael Rink Felix Chun Roland Dahlem Ronald Simon Eike Burandt Phillip Stahl Luigi Terracciano Thorsten Schlomm Walter Wagner Wolfgang Höppner Maryam Omidi Olga Kraus Marcel Kwiatkowski Ousman Doh Margit Fisch Armin Soave Sarah Minner 《Urologic oncology》2014,32(8):1225-1233
ObjectiveAlthough most patients with urinary bladder cancer present with noninvasive and low-malignant stages of the disease, about 20% eventually develop life-threatening metastatic tumors. This study was designed to evaluate the potential of matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MSI) to identify molecular markers predicting the clinical course of bladder cancer.Materials and methodsWe employed MALDI-MSI to a bladder cancer tissue microarray including paraffin-embedded tissue samples from 697 patients with clinical follow-up data to search for prognostically relevant associations.ResultsAnalysis of our MALDI imaging data revealed 40 signals in the mass spectra (m/z signals) associated with epithelial structures. The presence of numerous m/z signals was statistically related to one or several phenotypical findings including tumor aggressiveness (stage, grade, or nodal status; 30 signals), solid (5 signals) or papillary (3 signals) growth patterns, and increased (6 signals) or decreased (12 signals) cell proliferation, as determined by Ki-67 immunohistochemistry. Two signals were linked with tumor recurrence in noninvasive (pTa category) tumors, of which one was also related to progression from pTa-category to pT1-category disease. The absence of one m/z signal was linked with decreased survival in the subset of 102 muscle-invasive cancers.ConclusionOur data demonstrate the suitability of combining MSI and large-scale tissue microarrays to simultaneously identify and validate clinically useful molecular markers in urinary bladder cancer. 相似文献
60.