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961.
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963.
Epidemiology,risk factors,and impact of bacterial infections on outcomes for pancreatic grafts
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Marta Bodro Joana Ferrer María José Ricart Gemma Sanclemente Laura Linares Carlos Cervera Frederic Cofan Pedro Ventura‐Aguiar Miguel Ángel Lopez‐Boado Francesc Marco Josep Fuster Juan Carlos García‐Valdecasas Asunción Moreno 《Clinical transplantation》2018,32(8)
We aimed to determine the epidemiology, risk factors, and impact of bacterial infection on pancreatic function after pancreas transplantation. Data for pancreas transplant recipients were retrospectively reviewed between 2000 and 2014 for at least 1 year. We collected and analyzed post‐transplant data for bacterial infection, morbidity, and mortality. During the study period, 312 pancreas transplants were performed. In total, 509 episodes of bacterial infection were diagnosed in 191 patients (61%). Multidrug‐resistant (MDR) organisms were present in 173 of the 513 isolated microorganisms (33%). Risk factors independently associated with bacterial infection were acute allograft rejection (OR 1.7, 95%CI 1.1‐3), the need for post‐transplant hemodialysis, (OR 5.3, 95%CI 1.8‐15.7) and surgical re‐intervention (OR 2.8, 95%CI 1.5‐5.1), which was also considered a risk factor for infections caused by MDR bacteria. Graft survival was associated with the occurrence of one or more episodes of bacterial infection (log‐rank test = 0.009). Surgical re‐intervention was independently associated with graft loss (OR 2.5, 95%CI 1.3‐4.7). To conclude, pancreas recipients frequently experienced bacterial infections associated with the need for hemodialysis or surgical re‐intervention. Infection by MDR organisms is a growing concern in these patients and was related to graft survival. Graft loss was independently associated with surgical re‐intervention. 相似文献
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M.R. Igreja J.C. Wiederkehr B.A. Wiederkehr A. Maykon Massutti H. de Aguiar Wiederkehr 《Transplantation proceedings》2018,50(3):702-704
Background
Graft preservation continues to be one of the main pillars of pancreas transplantation (PT). Surgical complications, possibly caused or facilitated by organ damage during preservation, continue to occur more frequently after PT than for any other abdominal organ. During the past few years, the Georges Lopez Institute preservation solution IGL-1 has been introduced with satisfactory results for the perfusion and cold storage of abdominal grafts such as kidney and liver.Methods
Aspects related to 47 PTs with the use of IGL-1 as the only preservation solution performed from January 2012 to September 2017 at Hospital Santa Isabel, Blumenau, Brazil, were retrospectively analyzed.Results
Considering the 46 transplanted patients (1 patient underwent 2 PTs), graft loss followed by death occurred in 2 patients: 1 due to pancreatic thrombosis, and 1 due to sepsis. In addition, a 3rd patient died with a functioning graft due to sepsis of an infected hematoma. In 1 patient, graft loss occurred due to pancreatic thrombosis and was later retransplanted. One patient presented post-transplantation pancreatitis. The overall survival of patients in 1 month after transplantation was 95.7%, and graft survival in the 1st month was 93.6%.Conclusions
In all patients transplanted with the use of IGL-1, normalization of pancreatic function occurred early after reperfusion, there was no delayed graft function, and all transplanted patients maintained a non–insulin-dependent status after transplantation. The use of IGL-1 as preservation solution for PT is safe and effective. 相似文献966.
João Paulo Lemos da Silveira Santos Carla Jorge Machado Eduardo Paulino Junior João Bernardo Sancio Rocha Rodrigues Paula Teixeira Vidigal Vivian Resende 《Journal of gastrointestinal surgery》2018,22(7):1171-1178
Objectives
To investigate immunohistochemical predictors for intestinal and pancreatobiliary types of adenocarcinoma of ampulla of Vater and identify clinicopathological characteristics associated with the histological types and patient survival.Methods
Immunohistochemical markers included MUC1, MUC2, MUC5AC, CDX2, CK7, and CK20. The data were analyzed by univariate and multivariate methods. The two-step cluster method was used to determine the best immunohistochemical markers to discriminate the intestinal from the pancreatobiliary type.Results
This study identified 9 (33.3%) intestinal and 21 (66.7%) pancreatobiliary tumors. CK7 and CDX2 achieved the highest value (=?1) as predictor markers, while CK20, MUC1, and MUC2 showed degrees of importance equal to 0.77, 0.71, and 0.68, respectively. MUC5AC did not reach 0.50 of importance. In the univariate analysis, lymph node involvement, staging (TNM), and angiolymphatic and perineural invasions were associated with histological types. The independent clinicopathological variable in the multivariate model to predict the histological type was angiolymphatic invasion (p?=?0.005), OR?=?17 (95% CI 2.33 to 123.83). The final model showed positive nodes (N1) associated with shorter survival (HR?=?9.5; p?=?0.006). Overall survival at 12, 36, and 60 months was 88.5, 67.0, and 47.6%, respectively.Conclusions
CDX2 and CK7 were the immunohistochemical markers that best discriminated the intestinal from the pancreatobiliary type. Lymph node involvement had a high impact on survival and proved to be more frequent in the pancreatobiliary type.967.
Aline Bobato Lara Gongora Leandro Jonata Carvalho Oliveira 《Expert review of molecular diagnostics》2020,20(6):611-618
ABSTRACT
Introduction
Recently, new oncology therapies were developed using a biomarker for patient selection. In the era of cancer genomics, this paradigm is expected to increase. Most cytotoxic chemotherapies and other oncological treatments were historically approved without a biomarker. However, this strategy seems to be less efficient. We reviewed the biomarker-based strategy and its impact in cancer drug development. 相似文献968.
Women with epilepsy are more likely to have maternal and fetal complications during pregnancy. Risks can be minimized with preconception planning, careful obstetric care, and close postpartum follow-up. 相似文献
969.
Luquetti AO Ponce C Ponce E Esfandiari J Schijman A Revollo S Añez N Zingales B Ramgel-Aldao R Gonzalez A Levin MJ Umezawa ES Franco da Silveira J 《Diagnostic microbiology and infectious disease》2003,46(4):265-271
A rapid serologic test for diagnosis of T. cruzi infection (Chagas Stat Pak) was developed using recombinant proteins in an immunochromatographic assay. This cassette format test was evaluated first in blind with a panel of 393 coded serum samples. The Chagas Stat-Pak identified 197 infected (98.5% sensitivity) and 183 non-infected individuals (94.8% specificity). A second evaluation was performed with 352 sera from four Latin America countries tested independently in each country, showing a sensitivity of 100% and specificity of 98.6%. A third set of tests comparing sera with plasma and eluates from filter paper as well as serum preserved in 50% glycerol did show identical results as those obtained with serum. This rapid test (15 min) uses one device per sample, does not require refrigeration nor a laboratory structure or specialized skills to be performed, accepts different types of samples and may be stored for long periods of time for result checking and documentation. These attributes together with the high sensitivity and specificity demonstrated herein, make this test a suitable tool for field studies, small laboratories and emergencies at blood banks in the countryside of endemic areas. 相似文献
970.
Silveira DT 《Revista gaúcha de enfermagem / EENFUFRGS》2001,22(1):6-19
The construction of this article reflects our attempt to demarcate knowledge as a bracket for the actions and interventions of nursing in the area of the worker's health. We believe that the proposals of the educative and caring actions in the field of the worker's health become appropriate and effective when engaged to the relation work-health-sickness, allowing the joint action nurse-worker in the inquiry, recognition and resolution of identified problems. So, the Consulta-a??o, by means of a method of joint action, rescues for nursing basic elements of the preventive intervention and the promotion of the worker's health. 相似文献