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Cristina Dopazo Itxarone Bilbao Sonia García Concepcin GmezGavara Mireia Caralt Isabel CamposVarela Lluis Castells Ernest Hidalgo Francisco Moreso Bruno Montoro Ramn Charco 《CTS Clinical and Translational Science》2022,15(6):1544
Tacrolimus (TAC) is a dose‐dependent immunosuppressor with considerable intrapatient variability (IPV) in its pharmacokinetics. The aim of this work is to ascertain the association between TAC IPV at 6 months after liver transplantation (LT) and patient outcome. This single‐center cohort study retrospectively analyzed adult patients who underwent transplantation from 2015 to 2019 who survived the first 6 months with a functioning graft. The primary end point was the patient’s probability of death and the secondary outcome was the loss of renal function between month 6 and the last follow‐up. TAC IPV was estimated by calculating the coefficient of variation (CV) of the dose‐corrected concentration (C0/D) between the third and sixth months post‐LT. Of the 140 patients who underwent LT included in the study, the low‐variability group (C0/D CV < 27%) comprised 105 patients and the high‐variability group (C0/D CV ≥ 27%) 35 patients. One‐, 3‐, and 5‐year patient survival rates were 100%, 82%, and 72% in the high‐variability group versus 100%, 97%, and 93% in the low‐variability group, respectively (p = 0.005). Moreover, significant impaired renal function was observed in the high‐variability group at 1 year (69 ± 16 ml/min/1.73 m2 vs. 78 ± 16 ml/min/1.73 m2, p = 0.004) and at 2 years post‐LT (69 ± 17 ml/min/1.73 m2 vs. 77 ± 15 ml/min/1.73 m2, p = 0.03). High C0/D CV 3–6 months remained independently associated with worse survival (hazard ratio = 3.57, 95% CI = 1.32–9.67, p = 0.012) and loss of renal function (odds ratio = 3.47, 95% CI = 1.30–9.20, p = 0.01). Therefore, high IPV between the third and sixth months appears to be an early and independent predictor of patients with poorer liver transplant outcomes.
Abbreviations
- BPAR
- Biopsy proven acute rejection
- BMI
- Body mass index
- CKD‐EPI
- chronic kidney disease epidemiology collaboration
- CV
- coefficient of variation
- C0/D
- dose‐corrected concentration
- CMV
- cytomegalovirus
- eGFR
- estimated glomerular filtration rate
- HR
- hazard ratio
- HCC
- hepatocellular carcinoma
- ICU
- intensive care unit
- IPV
- intrapatient variability
- i.v.
- intravenously
- LC–MS/MS
- liquid chromatography‐ tandem mass spectrometry
- LT
- liver transplantation
- MELD
- model for end‐stage liver disease
- MMF
- mycophenolate mofetil
- NASH
- Non‐Alcoholic Steatohepatitis
- OR
- odds ratio
- PCR
- polymerase chain reaction
- SD
- Standard Deviation
- TAC
- tacrolimus
- 3–6 M
- three–six months
- WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?
- WHAT QUESTION DID THIS STUDY ADDRESS?
- WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?
- HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?
84.
Sonia Sarfraz Pilvi-helin Mntynen Marisa Laurila Juho Suojanen Juha Saarnio Sami Rossi Jani Horelli Mika Kaakinen Junnu Leikola Justus Reunanen 《Materials》2022,15(9)
The aim of this study was to assess the biofilm formation of Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and Escherichia coli on titanium implants with CAD-CAM tooling techniques. Twenty specimens of titanium were studied: Titanium grade 2 tooled with a Planmeca CAD-CAM milling device (TiGrade 2), Ti6Al4V grade 5 as it comes from CAD-DMLS device (computer aided design-direct metal laser sintering device) (TiGrade 5), Ti6Al4V grade 23 as it comes from a CAD-CAM milling device (TiGrade 23), and CAD-DMLS TiGrade 5 polished with an abrasive disc (TiGrade 5 polished). Bacterial adhesion on the implants was completed with and without saliva treatment to mimic both extraoral and intraoral surgical methods of implant placement. Five specimens/implant types were used in the bacterial adhesion experiments. Autoclaved implant specimens were placed in petri plates and immersed in saliva solution for 30 min at room temperature and then washed 3× with 1× PBS. Bacterial suspensions of each strain were made and added to the specimens after saliva treatment. Biofilm was allowed to form for 24 h at 37 °C and the adhered bacteria was calculated. Tooling techniques had an insignificant effect on the bacterial adhesion by all the bacterial strains studied. However, there was a significant difference in biofilm formation between the saliva-treated and non-saliva-treated implants. Saliva contamination enhanced S. mutans, S. aureus, and E. faecalis adhesion in all material types studied. S. aureus was found to be the most adherent strain in the saliva-treated group, whereas E. coli was the most adherent strain in the non-saliva-treated group. In conclusion, CAD-CAM tooling techniques have little effect on bacterial adhesion. Saliva coating enhances the biofilm formation; therefore, saliva contamination of the implant must be minimized during implant placement. Further extensive studies are needed to evaluate the effects of surface treatments of the titanium implant on soft tissue response and to prevent the factors causing implant infection and failure. 相似文献
85.
Maria Alenita Oliveira Ana Luisa Godoy Fernandes Lucia Ande Santos Maria Amélia dos Santos Carvalho Sonia Maria Faresin Ilka Lopes Santoro 《The Journal of asthma》2013,50(5):407-410
Aim. To study any discriminative properties of SF-36 and QQL-EPM in stable and non-controlled moderate asthmatic patients. Methods. A total of 63 asthmatic patients were assessed regarding asthma symptoms, FEV1 % predicted value, PEF, ED visits and hospitalizations, QQL-EPM and SF-36 questionnaires. Results. QQL-EPM highlighted significance in all domains to distinguish stable from non-controlled patients (p = 0.0001) while SF-36 was only significant in 3 of its 7 domains (p = 0.009). Conclusion. The study showed that the specific quality of life questionnaire for asthma (QQL-EPM) demonstrates better discriminative properties that characterize asthma control when compared with the more generic SF-36 questionnaire. 相似文献
86.
Marine Gaudry Pierre-Antoine Barral Arnaud Blanchard Sylvie Palazzolo Sonia Bolomey Virgile Omnes Mariangela De Masi Magali Carcopino-Tusoli Olivier Meyrignac Hervé Rousseau Alexis Jacquier Reda Hassen-Khodja Alessandra Bura-Rivière Jean-Michel Bartoli Stéphanie Gentile Philippe Piquet Laurence Bal 《European journal of vascular and endovascular surgery》2021,61(6):930-937
87.
Ana Rachel Oliveira de Andrade Maria Elizabeth Moraes Cavalheiros Dorva Sonia Maria Oliveira de Andrade Alisson Marques Baldomero Antonio Kato da Silva Renato Andreotti 《亚太热带病杂志(英文版)》2012,2(5):362-366
ObjectiveTo identify the urban phlebotomine sandfly fauna in Ponta Porã, Mato Grosso do Sul State, Brazil.MethodsThe captures were undertaken from April 2009 to March 2010 with CDC light traps in 14 ecotopes (intra and peridomicile) in different areas of the city, Shannon traps being used in areas with abundant vegetation.ResultsA total of 707 specimens were captured with CDC light traps (565 males and 142 females) and 155 specimens (112 males and 43 females) with Shannon traps, a total of 862 phlebotomines. The specimens captured belonged to eight species: Lutzomyia longipalpis (Lutz & Neiva, 1912), Evandromyia cortelezzii (Brethes, 1923), Sciopemyia sordelli (Shannon & Del Ponte, 1927), Pintomyia pessoai (Coutinho & Barretto, 1940); Pintomyia monticola (Costa Lima, 1932); Brumptomyia brumpti (Larousse, 1920); Nyssomyia whitmani (Antunes & Coutinho, 1939) and Psathyromyia shannoni (Dyar, 1929). Lutzomyia longipalpis, the main vector of Leishmania (Leishmania) chagasi, was the species most frequently captured (97.03%) and also the most abundant according to the standardized abundance index (SAI)=0.86.ConclusionsThe highest species richness was captured, with CDC light traps, inside the domiciles and the species diversity and evenness in the peridomicile, clearly indicating a preference for anthropic environments. 相似文献
88.
89.
Obesity is on the rise in the pediatric population. Obese individuals are at risk for insulin resistance and this, in combination with impaired β-cell function, can result in type 2 diabetes. The diagnosis of insulin resistance is made in clinical practice by using estimates of insulin sensitivity. Scientific evidence regarding the evaluation of insulin resistance in children has revealed conflicting conclusions. 相似文献
90.
Nangel M. Lindberg Victor J. Stevens Sonia Vega-López Tia L. Kauffman Mariana Rosales Calderón María Antonieta Cervantes 《Journal of immigrant and minority health / Center for Minority Public Health》2012,14(6):1030-1039
This study assessed the feasibility of a culturally-appropriate weight-loss intervention targeting obese Spanish-speaking Mexican women. This 12-month weight-loss program was based on behavioral interventions previously used successfully with English-speaking participants. Cultural adaptations included: female interventionists, minimal written materials, emphasis on group activities, focus on Mexican traditions and beliefs, and skill-building approach to food measurement. All sessions were conducted in Spanish. The study had few exclusionary criteria, which allowed participation of women with a wide range of literacy levels. Recruitment exceeded expectations, with 47 participants enrolling in the program. Not counting participants who became pregnant during the study, attendance at 6 and 12?months was 62 and 50?% respectively. Mean weight loss at 6 and 12?months was 5.3 and 7.2?kg, respectively, with a mean reduction in BMI of 4.0 and 5.5?kg/m2 from baseline to 6 and 12?months, respectively. This pilot study shows that it is feasible to develop and implement culturally-appropriate behavioral lifestyle interventions for obesity treatment in Mexican–American women. 相似文献