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1.
Peripheral blood dendritic cells increase in kidney-transplant patients without rejection 总被引:2,自引:0,他引:2
Saresella M Marini M Guerini F Ferrante P Della Bella S Chiaramonte S Riva A 《Clinical immunology (Orlando, Fla.)》2004,110(2):191-3; author reply 194
2.
P. Mendogni S. Henchi L.C. Morlacchi D. Tosi M. Nosotti P. Tarsia A.I. Gregorini L. Rosso 《Transplantation proceedings》2019,51(1):194-197
Background
Solid organ transplantation is associated with a higher risk of Epstein-Barr virus (EBV)–related lymphoproliferative disease due to immunosuppressive regimen. Little evidence is currently available on post-transplant lymphoproliferative disorders (PTLDs) in the lung transplant (LuTx) setting, particularly in cystic fibrosis (CF) recipients.Methods
We retrospectively analyzed all the cases of PTLDs that occurred in our LuTx center between January 2015 and December 2017. We reviewed clinical and radiologic data, donor and recipient EBV serostatus, immunosuppressive therapy, histologic data, and follow-up of these patients.Results
A total of 77 LuTxs were performed at our center in the study period; 39 (50.6%) patients had CF; 4 developed EBV-related PTLDs. They were all young (17–26 years) CF patients with high serum EBV DNA load. Disease onset was within the first 3 months after LuTx. In 3 cases presentation was associated with fever and infection-like symptoms, whereas in 1 case radiologic suspicion arose unexpectedly from a CT scan performed for different clinical reasons. Diagnosis was reached through lung biopsy in all cases. All patients received rituximab,?cyclophosphamide, doxorubicin hydrochloride (hydroxydaunomycin), vincristine sulfate (Oncovin), and prednisone with variable response and complications.Conclusion
In our experience, the early development of EBV-related PTLD was a highly aggressive, life-threatening condition, which exclusively affected young CF patients in the early post-transplant period. The rate of this complication was relatively high in our population.Diagnosis with lung biopsy is crucial in all suspected cases and regular monitoring of EBV DNA levels is of utmost importance given the high correlation with PTLDs in patients at increased risk. 相似文献3.
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5.
G Leonetti C Biachini L Terzoli R Gradnik M Tusa E Bramati A Zanchetti 《The American journal of cardiology》1982,49(6):1564-1565
There is no general agreement on the relation between the hypotensive effect of captopril and the pretreatment plasma renin levels of hypertensive patients. To determine whether the hypotensive effect of captopril was directly related to plasma renin, the angiotensin-converting enzyme inhibitor was administered acutely to 10 essential hypertensive patients with normal or suppressed plasma renin activity before and after inhibition of renin secretion with propranolol. Captopril was equally effective in reducing blood pressure both when administered alone (25 mg: -29/-17; 50 mg: -37/-23 mm Hg) and after chronic treatment with propranolol (25 mg: -33/-20; 50 mg: -30/-20 mm Hg). The increase in renin induced by captopril was not decreased by propranolol therapy. The persistence of the hypotensive effect of captopril after renin suppression by propranolol suggests that this drug has some blood pressure decreasing properties independent of plasma renin. 相似文献
6.
Background
Work engagement is a positive, fulfilling affective and motivational state of work-related wellbeing and a protective factor for workers' mental health. The aim of the present study was to examine the association between psychological distress (conceptualised as the target variable), job satisfaction, and work engagement in contexts of low-intensity warfare and political violence. According to the salutogenic perspective, the relationship between job satisfaction and psychological distress is influenced by the level of work engagement.Methods
We selected a convenience sample of 380 Palestinian teachers from Gaza (40%, 152 out of 380) and the West Bank (60%, 228 out of 380). The participants were recruited on-site during morning breaks from the classroom teaching activity. The selection criteria were being in a teaching position, and working in a primary or lower secondary school. The participants completed the Arabic versions of the Teacher Job satisfaction Scale (TJSS-9), the General Health Questionnaire (GHQ-12) and the Utrecht Work Engagement Scale (UWE-SF). The statistical strategy was based on structural equation modelling. The study was approved by the Ethical Board of the University of Milano Bicocca. Informed written consent was obtained from all participants.Findings
The General Health Questionnaire cumulative score revealed a medium to high level of psychological distress (mean 18·68 [SD 4·03]) among teachers, but high job satisfaction (mean 27·18 [SD 5·65]). The structural model showed an excellent fit (χ2 (23)=69·6, p<0·0001, NC=3·021, NFI=0·939, NNFI=0·959, CFI=0·958, RMSEA=0·073). Job satisfaction and psychological distress had a moderate and inverse relationship that was, statistically speaking, fully mediated by the level of work engagement (F=17·05, p<0·001, R2=0·16). The direct effect of job satisfaction on work engagement was positive and medium (according to Cohen, 1988) in strength.Interpretation
The main finding of the study is that work engagement may mediate the impact of job satisfaction on teachers' psychological distress by lessening the effect of difficult working conditions. It further suggests that in order to mediate the effect of low job satisfaction on psychological distress of teachers, organisational policies and practices should focus on improving employees' work engagement. This means that, in developing job programmes for teachers in contexts characterised by difficult working conditions, the main focus must be to increase the level of subjective resources (eg, inner states, emotional activation, personal motivational processes) and workers' engagement rather than focusing primarily on job satisfaction.Funding
None. 相似文献7.
Evaluation of photorefractive keratectomy retreatments after regressed myopic laser in situ keratomileusis 总被引:4,自引:0,他引:4
PURPOSE: To evaluate the results of photorefractive keratectomy (PRK) enhancements in eyes previously treated by myopic laser in situ keratomileusis (LASIK) showing an undercorrection due to either a refractive regression or a primary undercorrection, when an in-the-bed enhancement was not advisable because of residual stromal thickness limitations. DESIGN: Noncomparative, prospective, interventional case series. PARTICIPANTS: Seventeen eyes of 17 patients previously treated by LASIK for a spherical equivalent (SE) correction of -8.125 to -12.50 diopters (D; mean, -9.45 +/- 1.01 D), that after a follow-up of 6 to 14 months ended up with a refraction of -1.50 to -3.75 D (SE; mean, -2.48 +/- 0.74 D). Intended flap thickness was 160 microm for all eyes. In all cases, the residual stromal bed under the flap was considered too thin (255-305 microm) to allow an in-the-bed enhancement without exceeding an assumed safety thickness limit (250 microm). INTERVENTION: Eyes were treated by PRK at least 6 months after LASIK. The PRK ablation parameters (diameter, attempted correction) were selected to avoid theoretical flap perforation. The deepest ablation was 60 microm, for a -3.75-D correction. We used a Bausch & Lomb 217 C excimer laser (Bausch & Lomb, Rochester, New York). MAIN OUTCOME MEASURES: Refraction, uncorrected and best-corrected visual acuity (BCVA), slit-lamp evidence of corneal opacity or other visible complications, and corneal topography. RESULTS: Although the initial postoperative period was characterized by very satisfactory refractive results (mean SE error at 1 month, -0.04 +/- 0.37 D; range, +0.75 to -0.625 D), during follow-up, a dense haze (grade 3 and 4) developed in 14 eyes (82.3%) that induced a further myopic regression (SE, -1.725 to -5.50 D; mean, -3.11 D) and BCVA loss (two to six lines). These 14 eyes underwent a further surgical treatment to remove the severe haze at 3 to 10 months after PRK. CONCLUSIONS: Based on these results, we strongly advise against PRK as a possible option to correct eyes previously treated by myopic LASIK that resulted in an undercorrection. 相似文献
8.
U. Maggi M. Iavarone M. Fabbi D. Yiu G. Fornoni E. Melada D. Dondossola P. Cantù G. Rossi 《Transplantation proceedings》2018,50(10):3105-3110
Background and aim
Liver grafts from donors with chronic and active history of alcohol abuse are usually immediately ruled out for use in liver transplantation (LT). The aim of our study is to evaluate the use of those grafts.Methods
From 2011 to 2016, a study group (Group 1) composed of 5 adult LT patients transplanted with livers from donors with alcohol abuse, was compared with a control group (Group 2) of 10 randomly matched patients who received liver transplants. Preoperative, intraoperative, and postoperative data were compared.Results
Among donors, serum gamma-glutamyl transferase values were significantly higher in Group 1. In recipients, post-LT laboratory exams showed significantly higher peak values of aspartate transaminase and alanine transaminase in Group 1; higher values of aspartate aminotransferase, alanine aminotransferase, and total bilirubin in Group 1 were also recorded on day 0. Early allograft dysfunction occurred at higher rates in Group 1 (80% vs 20%, P = .025), with no differences in early rejection episodes or early surgical repeat interventions. All patients from both groups were alive after 20 ± 10 (range 6–35) months from LT.Conclusion
Despite higher rates of early allograft dysfunction, selected liver grafts from donors with alcohol abuse can be accepted for LT with good clinical results. 相似文献9.
Maurizio Domanin Daniele Bissacco Davide Le Van Christian Vergara 《Journal of vascular surgery》2018,67(3):887-897
Objective
The aim of the study was to provide, by means of computational fluid dynamics, a comparative analysis after carotid endarterectomy (CEA) between patch graft (PG) and primary closure (PC) techniques performed in real carotid geometries to identify disturbed flow conditions potentially involved in the development of restenosis.Methods
Eight carotid geometries in seven asymptomatic patients who underwent CEA were analyzed. In six cases (A-F), CEA was performed using PG closure; in two cases (G and H), PC was performed. Three-dimensional carotid geometries, derived from postoperative magnetic resonance angiography, were reconstructed, and a computational fluid dynamics analysis was performed. A virtual scenario with PC closure was designed in patients in whom PG was originally inserted and vice versa. This allowed us to compare for each patient hemodynamic effects in the PG and PC scenarios in terms of oscillatory shear index (OSI) and relative residence time (RRT), considered indicators of disturbed flow.Results
For the six original PG cases, the mean averaged-in-space OSI was 0.07 ± 0.01 for PG and 0.03 ± 0.02 for virtual-PC (difference, 0.04 ± 0.01; P = .0016). The mean of the percentage of area (%A) with OSI >0.2 resulted in 10.08% ± 3.38% for PG and 3.80% ± 3.22% for virtual-PC (difference, 6.28 ± 1.91; P = .008). For the same cases, the mean of the averaged-in-space RRT resulted in 5.48 ± 3.40 1/Pa for PG and 2.62 ± 1.12 1/Pa for virtual-PC (difference, 2.87 ± 1.46; P = .097). The mean of %A RRT >4.0 1/Pa resulted in 26.53% ± 12.98% for PG and 9.95% ± 6.53% for virtual-PC (difference, 16.58 ± 5.93; P = .025). For the two original PC cases, the averaged-in-space OSIs were 0.02 and 0.04 for PC and 0.03 and 0.02 for virtual-PG; the %A OSIs >0.2 were 0.9% and 7.6% for PC and 3.0% and 2.2% for virtual-PG; the averaged-in-space RRTs were 1.8 and 2.0 1/Pa for PC and 2.9 and 1.9 1/Pa for virtual-PG; the %A RRTs >4.0 1/Pa were 6.8% and 9.8% for PC and 9.4% and 6.2% for virtual-PG. These results revealed generally higher disturbed flows in the PG configurations with respect to the PC ones.Conclusions
OSI and RRT values were generally higher in PG cases with respect to PC, especially for high carotids or when the arteriotomy is mainly at the bulb region. Thus, an elective use of patch should be considered to prevent disturbed flows. 相似文献10.
V Saibene L Brembilla A Bertoletti L Bolognani G Pozza 《Clinica chimica acta; international journal of clinical chemistry》1979,93(2):199-205
The measurement of glycosylated hemoglobins in diabetic patients represents a new approach to the problem of the long-term glycemie control.Chromatographic procedures are usually employed to separate the glycosylated components of hemoglobin; we performed a comparative analysis of two different methods: Chromatographic and colorimetric. Chromatographic separation on small ion-exchange resin columns gives high precision (coefficient of variation = 1.7%) over the whole range of normal and diabetic values of percentage of glycosylated hemoglobin (3.2–15.9%).An alternative technique is the measurement of 5-hydroxymethylfurfural released by oxalic acid hydrolysis of the hexoses bound to hemoglobin, as proposed by Fluckiger and Winterhalter (Fluckiger, R. and Winterhalter, K.H. (1976) FEES Lett. 71, 356–360). Normal values, expressed as 5-hydroxymethylfurfural absorbance per 10 g of total hemoglobin, range from 133 to 235, with mean ± S.D. = 189 ± 26; while diabetic patients show a range from 220 to 443 and mean ± S.D. = 318 ± 65.This last method gives satisfactory precision over the entire range of values examined (coefficient of variation = 4.2%) and has proved simple and inexpensive.The correlation between the two methods is very high (n = 20; r = 0.98; p < 0.001) with a regression line, y = 25. Ix + 40.3.The storage of the hemolysates at ?20°C for up to 70 days for the colorimetric method and up to 260 for the Chromatographic procedure does not decrease the precision of either technique. 相似文献