1,720,971 research outputs found
Analysis of Impact of Post Transplant Neoplastic Disease on Long-Term Follow up Following Heart Transplant
No full textCardiac Allograft Vasculopathy after Heart Transplantation: 25-year Single-Center Experience
No full textImpact of high titre of antiphospholipid antibodies on postoperative outcome following pulmonary endarterectomy.
No full textOBJECTIVES: Antiphospholipid (a-PL) antibodies, especially IgG isotype, have been associated with a variety of neurological manifestations related to thrombotic mechanism and reactivity against nervous tissues. Furthermore, high titre of a-PL antibodies has been also correlated to chronic thromboembolic pulmonary hypertension (CTEPH) and, therefore, is frequently reported in patients undergoing pulmonary endarterectomy (PEA). The impact of a-PL antibodies in postoperative outcome following PEA, however, has not been clearly evaluated yet. In this paper, we investigated the impact of a high a-PL IgG titre (HAPT) on postoperative outcome following PEA. METHODS: From April 1994 to October 2008, out of 204 patients undergoing PEA at our centre, 184 were prospectively screened for a-PL antibodies. According to the preoperative IgG titre, patients were divided into two groups: Group A (high a-PL antibodies titre - HAPT) with a-PL IgG titre >10 U/ml and Group B (low a-PL antibodies titre - LAPT) with a-PL IgG titre <or=10 U/ml. Early outcomes were compared between the two groups. RESULTS: Twenty-eight patients (15%) were included in Group A, whereas 156 (85%) patients were included in Group B. HAPT influenced preoperative parameters as patients of Group A were younger compared to those of Group B (42+/-16 and 52+/-16 for Group A and B, respectively, P=0.001) and presented more frequently a previous history of deep venous thrombosis (DVT) (96% and 62% for Group A and B, respectively, P=0.001). The two groups were homogeneous for all other operative parameters. As far as postoperative outcome, in terms of mortality and major complications, there were no differences between the two groups. Incidence of transient neurological complications, however, was significantly different (32% and 10% for Group A and B, respectively, P=0.023). CONCLUSIONS: The presence of high titre of IgG isotype a-PL antibodies significantly influences preoperative characteristics of patients undergoing PEA. Furthermore, despite that no significant differences were shown in major end points, the presence of high titre of a-PL did interfere with postoperative course as caused by an increased rate of minor and transient neurological impairment (TNI). An accurate monitoring especially during hypothermic circulatory arrest (CA) period seems, therefore, mandatory in this subgroup of patients undergoing PEA
Experience with Cylex Immune Cell Function Assay in Clinical Immune Monitoring of Lung Transplant Recipients
No full textPurpose
The Cylex Immune Cell Function Assay (ImmuKnow; Cylex, Inc., Columbia, MD: IK) was approved by the U.S. Food and Drug Administration (FDA) to measure global immune response in solid-organ transplant patients receiving immunosuppressive treatment. We determined the number of infections arising in our cohort of lung transplant and correlated blood levels of ImmuKnow with blood levels of immunosuppressive drugs.
Methods and Materials
We used 102 determinations of ImmuKnow (IK) from 58 lung recipients (LTR) from October 2008 to September 2011. The values of CD4 + T cell activation (in ng/mL ATP) were categorized as strong (n°13), moderate (n°39) and low (n°50) with >525, 225 to 525, and <225 respectively. IK response was correlated with through blood levels of tacrolimus and with peripheral and BAL cell subsets.
Results
Patients with a low IK had a significantly higher risk of acquiring a graft infection than those who had a normal or high immune response. Total n° of samples associated to an infectious episodes was 51 with a significant number of co-infections (35 bacterial,5 fungal and 25 viral). Thirty-three infectious episodes (including16 co-infections) were observed among low IK samples, while only 18 among strong and moderate IK samples (chi square test 0.0018). Therefore low IK response was associated with a two fold increase in risk of infection. Values of IK response did not correlate with the levels of tacrolimus (p=0.9). A very low correlation coefficient was present with CD3+CD4+ counts (+0.19) while no correlation was found with other analysed peripheral and BAL cell subset. Immunosuppressive regimen was changed according to IK results and was decreased in 86% of low test results.
Conclusions
The Immuknow assay reliably reflects the cellular immune function of LTx patients in relationship with the risk of developing infections, thus can be used as an additional tool in the immune monitoring and management of lung recipients
Efficacy of tacrolimus rescue therapy in refractory acute rejection after lung transplantation
No full textBACKGROUND: Encouraging results in transplantation of other solid organs led to investigation of the use of tacrolimus in lung transplantation as a salvage immunosuppressant in persistent acute rejection.
METHODS: The incidence and severity of acute rejection and the number of steroid pulses were analyzed in 20 lung recipients who were converted from a cyclosporine- to a tacrolimus-based immunosuppressive regimen because of refractory biopsy-proven acute rejection.
RESULTS: Tacrolimus was started 12.0 +/- 13.0 months after transplantation, and the mean follow-up was 25.0 +/- 13.7 months. After shifting to tacrolimus, a significant decline was observed in both the number of acute rejections per patient (3.0 +/- 1.56 to 0.85 +/- 1.14, p < 0.0001), and the incidence of acute rejection per 100 patient-days (1.52 +/- 0.99 to 0.14 +/- 0.21, p < 0.0001). Furthermore, the average histologic grade of rejection decreased from 1.9 +/- 0.8 to 0.4 +/- 0.5 (p < 0.0001). Methylprednisolone pulses similarly decreased from 1.9 +/- 1.3/patient to 0.3 +/- 0.7/patient (p < 0.0001). During cyclosporine immunosuppression, the mean forced expiratory volume in 1 second decreased to 84.4% +/- 13.3% of individual best value. The average lung function parameters were stable 3 months after the change of medication, and then began to improve. After an average follow-up of 36.5 +/- 19.2 months, 2 patients have developed bronchiolitis obliterans syndrome (one has Stage 1 and one has Stage 3).
CONCLUSION: Conversion to a tacrolimus-based immunosuppressive regimen for refractory acute lung rejection is associated with reduced incidence and severity of acute rejection episodes, steroid sparing, and stabilization or improvement of pulmonary function
Experience with Cylex Immune Cell Function Assay in Clinical Immune Monitoring of Lung Transplant Recipients
No full textPurpose
The Cylex Immune Cell Function Assay (ImmuKnow; Cylex, Inc., Columbia, MD: IK) was approved by the U.S. Food and Drug Administration (FDA) to measure global immune response in solid-organ transplant patients receiving immunosuppressive treatment. We determined the number of infections arising in our cohort of lung transplant and correlated blood levels of ImmuKnow with blood levels of immunosuppressive drugs.
Methods and Materials
We used 102 determinations of ImmuKnow (IK) from 58 lung recipients (LTR) from October 2008 to September 2011. The values of CD4 + T cell activation (in ng/mL ATP) were categorized as strong (n°13), moderate (n°39) and low (n°50) with >525, 225 to 525, and <225 respectively. IK response was correlated with through blood levels of tacrolimus and with peripheral and BAL cell subsets.
Results
Patients with a low IK had a significantly higher risk of acquiring a graft infection than those who had a normal or high immune response. Total n° of samples associated to an infectious episodes was 51 with a significant number of co-infections (35 bacterial,5 fungal and 25 viral). Thirty-three infectious episodes (including16 co-infections) were observed among low IK samples, while only 18 among strong and moderate IK samples (chi square test 0.0018). Therefore low IK response was associated with a two fold increase in risk of infection. Values of IK response did not correlate with the levels of tacrolimus (p=0.9). A very low correlation coefficient was present with CD3+CD4+ counts (+0.19) while no correlation was found with other analysed peripheral and BAL cell subset. Immunosuppressive regimen was changed according to IK results and was decreased in 86% of low test results.
Conclusions
The Immuknow assay reliably reflects the cellular immune function of LTx patients in relationship with the risk of developing infections, thus can be used as an additional tool in the immune monitoring and management of lung recipients
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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