1,721,149 research outputs found
Comparative effects of arginine and other amino acid deprivation on in vitro expression of lymphocyte activation markers
No full textRecovery of renal function in liver transplant alone versus combined liver kidney transplantation: analysis from the NHSBT UK registry
Full text linkIntroduction and Aims: Recovery of renal function after liver transplantation is strongly influenced by pretransplant degree and duration of renal insufficiency, despite imprecise methods for measuring renal dysfunction. Indications for combined liver-kidney transplantation (CLKT) have been defined, but these are still under debate and hepatorenal syndrome (HRS) is a particularly challenging condition given the hardly predictable spontaneous improvement with liver transplant alone (LTA). Methods: We analysed data of 6035 patients (Jan 2001-Dec 2012) from NHSBT UK Transplant Registry. Renal function at 1 years after transplantation was compared between CLKT and LTA with stratification on the basis of glomerular filtration rate (eGFR) at transplant (KDIGO Guidelines) and treatment with renal replacement therapy (RRT). Renal function post-transplantation was classified as eGFR >60, between 59-30 and <30 ml/min/1.73m2, the latter identified as non recovery of renal function. Univariate and multivariable analysis were performed.
Results: 5912 patients (98.0%) underwent liver transplant alone (LTA) and 123 (2.0%) patients received a CLKT. 305 (5.2%) of the LTA group were on RRT at time of transplantation, compared to 72 (58.5%) of the CKLT group. No patient with a MELD score <20 received RRT before transplant. No patients with eGFR ≥60 mL/min/1.73m2 received CLKT. 27% of patients receiving CLKT were diagnosed with pre-transplant glomerular/tubular kidney disease, 39% with polycystic disease and 34% were not specified. LTA patients on RRT were more frequently presenting ascites ( p<0.001), variceal bleeding ( p=0.002), higher MELD score ( p<0.001), higher INR ( p<0.001) and bilirubin at transplant ( p<0.001), suggesting the occurrence of HRS (data not available). Patients on RRT experience a significant difference of renal function recovery at 1 year post-transplant when receiving LTA versus CLKT, with the latter group experiencing a higher percentage of non-recovery ( p=0.001; table 1). This difference was not detected for other eGFR stratifications.The univariate analysis identified recipient age >50 years, female gender, RRT in patients with MELD >20, polycystic disease and diabetes as predictive factors for non-recovery of renal function in patients undergoing LTA. In a multivariable model including all clinically relevant variables simultaneously, the independent predictors of renal function non-recovery were female gender (HR 2.76; 95% CI 1.52-4.99, p=0.001), RRT in patients with MELD >20 (HR 3.62; 95% CI 1.44-9.08, p=0.006) and diabetes (HR 2.55; 95% CI 1.38-4.73, p=0.003).
Conclusions: Recovery of renal function post-LTA is acceptable for patients with different stratifications of eGFR pre-transplant. RRT, female gender and diabetes may suggest to perform CLKT
Acute kidney injury as delayed graft function in donation after circulatory death kidney transplantation: uk single centre study
No full textIntroduction and Aims: Delayed graft function (DGF) is a manifestation of acute kidney injury (AKI) traditionally related to cold ischaemia time, with characteristics unique to the kidney transplant (KT) process. It is defined as the need for dialysis within 7 days of the transplant and is associated with higher incidence of rejection, chronic graft dysfunction and premature graft loss after KT. Kidney transplantation from Donation after Circulatory Death (DCD) is a model with increased occurrence of DGF compared to Donation after Brain Death (DBD) and living donation (LD). This is likely to be related to the warm ischaemia sustained by the graft. Since the diagnostic criterion of DGF has shortfalls as dialysis is subjective and is a clinician-dependent decision, aim of the study is to assess the whole incidence of AKI, including DGF after KT in different models of ischaemia of the graft (DCD vs. DBD vs. LD) and to evaluate their impact on outcome.
Methods: Retrospective single-centre study of 1042 patients who underwent KT (2007-2014). We considered: renal function pre-KT, daily within one week post-operatively, at 1, 4, 6, 9 months and 1, 3, 5, 8 years post-KT, characteristics of recipient, donor and graft, patient survival. AKI and DGF were defined on the basis of KDIGO Guidelines.
Results: We considered 1042 KT patients (132 DCD, 414 DBD and 496 living). Analysis of the demographic and clinical characteristics showed no significant differences between DCD and DBD recipients, whereas there were significant differences between both DCD and DBD compared to LD in median age, race, HBV, HCV (only DBD), serum sodium, serum creatinine, GFR and dialysis. Preliminary analysis showed that DCD recipients had a significantly lower cold ischaemia time (CIT; p=0.0120) and higher incidence of AKI and DGF than DBD ( p<0.001), but in DBD the CIT had a positive association with the occurrence of DGF ( p=0.072). All results about incidence of AKI and DGF are reported in Table. No significant differences in patient’s survival were found between DCD vs. DBD vs. LD. AKI and DGF had no significant impact on survival.
Conclusions: We demonstrate a higher incidence of post-KT DGF in DCD, despite similar baseline characteristics and a lower CIT, compared to DBD. For the first time we note that DCD recipients suffer a higher incidence of AKI stage 2-3 than DBD and LD. Further analysis should look at the incidence of chronic graft dysfunction and the association between AKI and DGF
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Antibodies to anionic phospholipids and anti-beta2-GPI: association with thrombosis and thrombocytopenia in systemic lupus erythematosus
No full textDifferent injury of common bile ducts in donation after circulatory vs brain death: histological and immunohistochemical evaluation
Full text linkWithin the model of donation after circulatory death (DCD), a more severe degree of ischaemia-reperfusion injury occurs, that seems to play a role on the pathogenesis of biliary complications. Aim of the study was to assess the bile duct injury in two different models of ischaemia, DCD and donation after brain death (DBD), in liver transplantation. Histological samples of common bile duct retrieved after liver graft reperfusion, before biliary anastomosis, were evaluated. Severity of donor bile duct injury was assessed on the basis of Bili- ary epithelial cell loss, Mural stroma necrosis, Inflammation, Peribili- ary vascular plexus damage, Arteriolonecrosis, Thrombosis, Perilumi- nal and deep peribiliary glands (PBG) damage. Cholangiocyte apoptosis and proliferation in periluminal and deep PBG were evaluated by quantitative TUNEL analysis and PCNA immu- nohistochemical expression. Sixty-two bile duct sample were available for evaluation (2014-2015). A significantly higher number of DCD patients presented necrosis >50% of the bile duct wall [DCD 14/28 (50%), DBD 9/34 (26.5%) p=0.056], peribiliary vascular plexus damage [DCD 8/28 (29%), DBD 3/34 (9%); p=0.053] and periluminal PBG damage [DCD 20/28 (71%), DBD 14/34 (41%); p=0.016], defining the occurrence of severe histological injury, that was significantly more frequent in DCD liver transplant patients [15/28 (53.6%)] compared to DBD [7/34 (20.6%)] (p=0.007). A significant increased apoptosis and decreased proliferation was evidenced in both periluminal (Tunel p=0.029; PCNA p=0.029) and deep PBGs (Tunel p=0.002; PCNA p=0.006) from bile duct sample with severe histolog- ical injury. Bile duct samples from DCD grafts expressed more severe injury at the histological level, defining the new feature of severe histological injury. Bile ducts with severe histological injury showed increased apoptosis and reduced proliferation both on periluminal and deep PBG. This study raises the hypothesis of a correlation between the occurrence of microscopic damage and the development of isch- aemic biliary complications. Study supported by ESOT Grant 201
Variations on the Author
Full text link“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
Full text linkWe 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
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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