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Jose M. Morales Jose Angel Martinez-Flores Manuel Serrano Maria José Castro Francisco Javier Alfaro Florencio García Miguel Angel Martínez Amado Andrés Esther González Manuel Praga Estela Paz-Artal Antonio Serrano 《Journal of the American Society of Nephrology : JASN》2015,26(3):735-745
In the current immunosuppressive therapy era, vessel thrombosis is the most common cause of early graft loss after renal transplantation. The prevalence of IgA anti–β2-glycoprotein I antibodies (IgA-aB2GPI-ab) in patients on dialysis is elevated (>30%), and these antibodies correlate with mortality and cardiovascular morbidity. To evaluate the effect of IgA-aB2GPI-ab in patients with transplants, we followed all patients transplanted from 2000 to 2002 in the Hospital 12 de Octubre prospectively for 10 years. Presence of IgA-aB2GPI-ab in pretransplant serum was examined retrospectively. Of 269 patients, 89 patients were positive for IgA-aB2GPI-ab (33%; group 1), and the remaining patients were negative (67%; group 2). Graft loss at 6 months post-transplant was significantly higher in group 1 (10 of 89 versus 3 of 180 patients in group 2; P=0.002). The most frequent cause of graft loss was thrombosis of the vessels, which was observed only in group 1 (8 of 10 versus 0 of 3 patients in group 2; P=0.04). Multivariate analysis showed that the presence of IgA-aB2GPI-ab was an independent risk factor for early graft loss (P=0.04) and delayed graft function (P=0.04). There were no significant differences regarding patient survival between the two groups. Graft survival was similar in both groups after 6 months. In conclusion, patients with pretransplant IgA-aB2GPI-ab have a high risk of early graft loss caused by thrombosis and a high risk of delayed graft function. Therefore, pretransplant IgA-aB2GPI-ab may have a detrimental effect on early clinical outcomes after renal transplantation. 相似文献
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Zaida Araujo Sietze Brandes Elena Pinelli María A. Bochichio Andrea Palacios Albina Wide Bruno Rivas-Santiago Juan Carlos Jiménez 《Revista do Instituto de Medicina Tropical de S?o Paulo》2015,57(1):47-55
The present study aimed at measuring seropositivities for infection by
Ascaris suum and Toxocara canis using the
excretory/secretory (E/S) antigens from Ascaris suum (AES) and
Toxocara canis (TES) within an indigenous population. In
addition, quantification of cytokine expressions in peripheral blood cells was
determined. A total of 50 Warao indigenous were included; of which 43 were adults and
seven children. In adults, 44.1% were seropositive for both parasites; whereas
children had only seropositivity to one or the other helminth. For ascariosis, the
percentage of AES seropositivity in adults and children was high; 23.3% and 57.1%,
respectively. While that for toxocariosis, the percentage of TES seropositivity in
adults and children was low; 9.3% and 14.3%, respectively. The percentage of
seronegativity was comparable for AES and TES antigens in adults (27.9%) and children
(28.6%). When positive sera were analyzed by Western blotting technique using AES
antigens; three bands of 97.2, 193.6 and 200.2 kDas were mostly recognized. When the
TES antigens were used, nine major bands were mostly identified; 47.4, 52.2, 84.9,
98.2, 119.1, 131.3, 175.6, 184.4 and 193.6 kDas. Stool examinations showed that
Blastocystis hominis, Hymenolepis nana and
Entamoeba coli were the most commonly observed intestinal
parasites. Quantification of cytokines IFN-γ, IL-2, IL-6, TGF-β, TNF-α, IL-10 and
IL-4 expressions showed that there was only a significant increased expression of
IL-4 in indigenous with TES seropositivity (p < 0.002).
Ascaris and Toxocara seropositivity was
prevalent among Warao indigenous. 相似文献
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Alejandra Gordillo Hernández Eduardo Dominguez-Adame Lanuza Auxiliadora Cano Matias Rosario Perez Huertas Katherine Maria Gallardo Rodriguez Purificacion Gallinato Perez Fernando Oliva Mompean 《World journal of gastrointestinal surgery》2015,7(8):170-173
Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. In the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence. 相似文献
8.
Marta Rozanski Valentin Neuhaus Emily Thornton Stéphanie J. E. Becker James P. Rathmell David Ring 《Journal of hand and microsurgery》2015,7(1):30-35
This study used the National Survey of Ambulatory Surgery (NSAS) database to measure the incidence of and risk factors for symptoms in the ambulatory surgery center and problems within 24 h after isolated carpal tunnel release (CTR). The NSAS contained records on 400,000 adult patients with carpal tunnel syndrome who were treated with CTR in 2006, based on ICD-9 codes. The type of anesthesia used and factors associated with symptoms and problems were sought in bivariate and multivariable statistical analyses. The mean duration of the procedure was 16 ± 8.8 min. Only 5 % were performed under local anesthesia without sedation, 45 % with IV sedation, 28 % regional anesthesia, and 19 % general anesthesia. Symptoms in the ambulatory surgery center or a problem within 24 h after discharge were recorded in 10 % of patients, all of them minor and transient, including difficulties with pain and its treatment. The strongest risk factors were male sex, age of 45 years and older, and participation of an anesthesiologist. Local anesthesia and regional anesthesia were associated with more perioperative symptoms and postoperative problems. Most CTR are performed with some sedation in the United States. CTR is a safe procedure: one in 10 patients will experience a minor issue in the perioperative or immediate postoperative period. 相似文献
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