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排序方式: 共有7664条查询结果,搜索用时 93 毫秒
71.
Rania El Fekih James Hurley Vasisht Tadigotla Areej Alghamdi Anand Srivastava Christine Coticchia John Choi Hazim Allos Karim Yatim Juliano Alhaddad Siawosh Eskandari Philip Chu Albana B. Mihali Isadora T. Lape Mauricio P. Lima Filho Bruno T. Aoyama Anil Chandraker Kassem Safa James F. Markmann Leonardo V. Riella Richard N. Formica Johan Skog Jamil R. Azzi 《Journal of the American Society of Nephrology : JASN》2021,32(4):994
BackgroundDeveloping a noninvasive clinical test to accurately diagnose kidney allograft rejection is critical to improve allograft outcomes. Urinary exosomes, tiny vesicles released into the urine that carry parent cells’ proteins and nucleic acids, reflect the biologic function of the parent cells within the kidney, including immune cells. Their stability in urine makes them a potentially powerful tool for liquid biopsy and a noninvasive diagnostic biomarker for kidney-transplant rejection.MethodsUsing 192 of 220 urine samples with matched biopsy samples from 175 patients who underwent a clinically indicated kidney-transplant biopsy, we isolated urinary exosomal mRNAs and developed rejection signatures on the basis of differential gene expression. We used crossvalidation to assess the performance of the signatures on multiple data subsets.ResultsAn exosomal mRNA signature discriminated between biopsy samples from patients with all-cause rejection and those with no rejection, yielding an area under the curve (AUC) of 0.93 (95% CI, 0.87 to 0.98), which is significantly better than the current standard of care (increase in eGFR AUC of 0.57; 95% CI, 0.49 to 0.65). The exosome-based signature’s negative predictive value was 93.3% and its positive predictive value was 86.2%. Using the same approach, we identified an additional gene signature that discriminated patients with T cell–mediated rejection from those with antibody-mediated rejection (with an AUC of 0.87; 95% CI, 0.76 to 0.97). This signature’s negative predictive value was 90.6% and its positive predictive value was 77.8%.ConclusionsOur findings show that mRNA signatures derived from urinary exosomes represent a powerful and noninvasive tool to screen for kidney allograft rejection. This finding has the potential to assist clinicians in therapeutic decision making. 相似文献
72.
Rohit R. Badia Solomon Woldu Hiten D. Patel Nirmish Singla Arnav Srivastava Joseph G. Cheaib Phillip M. Pierorazio Aditya Bagrodia 《Urologic oncology》2021,39(2):136.e19-136.e25
BackgroundThe American Joint Committee on Cancer 8th edition staging guidelines for testicular cancer established a 3 cm cutoff to subclassify stage T1 seminomas (<3 cm = pT1a and ≥3 cm = pT1b). The efficacy of this cutoff in predicting metastatic disease and impact on treatment patterns have not been studied.MethodsWe retrospectively reviewed patients with pT1 testicular seminoma in the National Cancer Database from 2004 to 2016. Receiver operating curves were used to determine the efficacy of the 3 cm tumor cutoff in identifying metastatic disease, and multivariable regression was used to compute the effect of tumor size on the rate of adjuvant therapy among Stage I patients.ResultsA total of 10,134 patients with pT1 seminoma were evaluated. The current size cutoff of 3 cm for subclassification did not exhibit high discrimination in identifying metastatic disease (area under receiver operating curve: 0.546). Surveillance has grown as the preferred treatment after orchiectomy ?32.1% in 2004 to 81.2% in 2015. However, the rate of adjuvant therapy for pT1, Stage I seminomas associated positively with tumor size even with adjustment for year of diagnosis. For tumors above 3 cm, the odds ratio stabilized around 1.9. By using the 3 cm cutoff to guide adjuvant therapy, up to 85% of T1b patients may be overtreated.ConclusionThe 3 cm cutoff for subclassification of Stage I seminoma does not predict metastatic recurrence but is associated with increased receipt of adjuvant therapy. A 3 cm cutoff and the pT1a/b classification may therefore contribute to overtreatment in many young patients with a long life expectancy for whom minimizing adverse effects should be prioritized. 相似文献
73.
Notfall + Rettungsmedizin - Die Entlassung aus der Notfallstation in die ambulante Weiterbehandlung stellt den größten Teil des „outflow“ aus den Notfallstationen dar. Um die... 相似文献
74.
Jo-Lynn S. Tan Niranjan Sathianathen Marcus Cumberbatch Prokar Dasgupta Alexandre Mottrie Ronney Abaza Koon Ho Rha Thyavihally B. Yuvaraja Dipen J. Parekh Umberto Capitanio Rajesh Ahlawat Sudhir Rawal Nicolò M. Buffi Ananthakrishnan Sivaraman Kris K. Maes Gagan Gautam Francesco Porpiglia Levent Turkeri Mahendra Bhandari Benjamin Challacombe James Roscoe Porter Craig R. Rogers Daniel A. Moon 《BJU international》2021,128(Z3):30-35
75.
Rabea Asleh Hilmi Alnsasra Amir Lerman Alexandros Briasoulis Naveen L. Pereira Brooks S. Edwards Takumi Toya John M. Stulak Alfredo L. Clavell Richard C. Daly Sudhir S. Kushwaha 《American journal of transplantation》2021,21(2):626-635
We have previously described the use of sirolimus (SRL) as primary immunosuppression following heart transplantation (HT). The advantages of this approach include attenuation of cardiac allograft vasculopathy (CAV), improvement in glomerular filtration rate (GFR), and reduced malignancy. However, in some patients SRL may cause significant proteinuria. We sought to investigate the prognostic value of proteinuria after conversion to SRL. CAV progression and adverse clinical events were studied. CAV progression was assessed by measuring the Δ change in plaque volume (PV) and plaque index (PI) per year using coronary intravascular ultrasound. Proteinuria was defined as Δ urine protein ≥300 mg/24 h at 1 year after conversion to SRL. Overall, 137 patients were analyzed (26% with proteinuria). Patients with proteinuria had significantly lower GFR (P = .005) but similar GFR during follow-up. Delta PV (P < .001) and Δ PI (P = .001) were significantly higher among patients with proteinuria after adjustment for baseline characteristics. Multivariate Cox regression analysis showed higher all-cause mortality (hazard ratio 3.8; P = .01) with proteinuria but similar risk of CAV-related events (P = .61). Our results indicate that proteinuria is a marker of baseline renal dysfunction, and that HT recipients who develop proteinuria after conversion to SRL have less attenuation of CAV progression and higher mortality risk. 相似文献
76.
77.
Wen MC Wei CH Hu ZQ Srivastava K Ko J Xi ST Mu DZ Du JB Li GH Wallenstein S Sampson H Kattan M Li XM 《The Journal of allergy and clinical immunology》2005,116(3):517-524
BACKGROUND: Chinese herbal medicine has a long history of human use. A novel herbal formula, anti-asthma herbal medicine intervention (ASHMI), has been shown to be an effective therapy in a murine model of allergic asthma. OBJECTIVE: This study was undertaken to compare the efficacy, safety, and immunomodulatory effects of ASHMI treatment in patients with moderate-severe, persistent asthma with prednisone therapy. METHODS: In a double-blind trial, 91 subjects underwent randomization. Forty-five subjects received oral ASHMI capsules and prednisone placebo tablets (ASHMI group) and 46 subjects received oral prednisone tablets and ASHMI placebo capsules (prednisone group) for 4 weeks. Spirometry measurements; symptom scores; side effects; and serum cortisol, cytokine, and IgE levels were evaluated before and after treatment. RESULTS: Posttreatment lung function was significantly improved in both groups as shown by increased FEV(1) and peak expiratory flow findings (P<.001). The improvement was slightly but significantly greater in the prednisone group (P<.05). Clinical symptom scores, use of beta(2)-bronchodilators, and serum IgE levels were reduced significantly, and to a similar degree in both groups (P<.001). T(H)2 cytokine levels were significantly reduced in both treated groups (P<.001) and were lower in the prednisone-treated group (P<.05). Serum IFN-gamma and cortisol levels were significantly decreased in the prednisone group (P<.001) but significantly increased in the ASHMI group (P<.001). No severe side effects were observed in either group. CONCLUSION: Anti-asthma herbal medicine intervention appears to be a safe and effective alternative medicine for treating asthma. In contrast with prednisone, ASHMI had no adverse effect on adrenal function and had a beneficial effect on T(H)1 and T(H)2 balance. 相似文献
78.
Abhinit Kumar Sudhir Bahadur Suberendra Kumar Sima Mukhopadhyay Meera Mathur 《Indian journal of otolaryngology and head and neck surgery》2000,52(3):230-234
Twelve patients undergoing surgery between May 1995 and March 1999 for malignant tumours of the paranasal sinuses abutting
or invading the orbital walls were studied for the need to remove orbital contents. Alt patients were evaluated clinically,
radiologically (CT Scan) and per-operatively to delineate the extent of orbital invasion. Combined regimen (Surgery + Radiotherapy)
were used in all patients. A biopsy from periorbita was taken when eye was spared. It was found that per-operative evaluation
of the orbit is equally specific in comparision to clinical and CT Scan combined and eye may be preserved in selected patients
with involvement of orbital periosteum provided there is no frank soft tissue mass in the orbit. 相似文献
79.
Sanjeev Gupta Sudhir Bahadur M. Mathur Aloke Thakar 《Indian journal of otolaryngology and head and neck surgery》2000,52(3):253-256
Radical neck dissection is a standard procedure carried out for the teatment of palpable nodes in the neck but if carried
out electively in cases where there are no palpable nodes in the neck it is considered to be an overtreatment with its associated
morbity. Lateral neck dissection was carried out on twenty patients who had T31 T4 lesion of the larynx and hypophar-vnx with
NO neck. The dissection entails removal of Level II. III and IV nodes. Occult metastasis 80% and 85% respectively. The mean
follow up was 13 monts. It appears from our study that elective lateral neck dissection is a promising and safe procedure
and may be useful as an important prognostic tool in sampling the lymph nodes and predicting recurrences in the neck. 相似文献
80.
Sangeeta Varty Dinesh Vaidya Kamal Parasram Divya Prabhat Sudhir Joshi 《Indian journal of otolaryngology and head and neck surgery》2000,52(2):143-146
Tuberculosis of the middle ear it a rare disease. Due to change in the typical clinical pattern and decrease in incidence,
there is a delayed or missed diagnosis and can lead to increased morbidity. We pretent 5 cases of Tuberculous Otitis Media
treated over a period of 2 years, highlighting the fact that it must be considered as a differential diagnosis of persistent
suppurative otitis media. 相似文献