bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between the time after transplantation and different immunosuppressive medications with dental and periodontal treatment need in patients after solid organ transplantation
Authors: Schmalz Gerhard , Wendorff Horst , Berisha Lisa , Meisel Anja , Widmer Florian , Marcinkowski Anna , Teschler Helmut , Sommerwerck Urte , Haak Rainer , Kollmar Otto , Ziebolz Dirk 
Published: January 2018

AbstractObjectiveThe aim of this study was to investigate the association of time after transplantation and different immunosuppressive medications with dental and periodontal treatment needs in patients after solid organ transplantation (SOT).MethodsAfter lung, liver, or kidney transplantation, patients were included and divided into subgroups based on the time after SOT (0‐1, 1‐3, 3‐6, 6‐10, and >10 years) and immunosuppression (tacrolimus, cyclosporine, mycophenolate, glucocorticoids, sirolimus, and monotherapy vs combination). Dental treatment need was determined by the presence of carious lesions, while periodontal treatment need was diagnosed based on a Periodontal Screening index score of 3‐4. The overall treatment need included both the dental and/or periodontal treatment needs. Statistical analysis was performed using the Kruskal‐Wallis test and chi‐squared test (P < .05).ResultsA total of 169 patients were included after SOT. A dental treatment need of 44%, a periodontal treatment need of 71%, and an overall treatment need of 84% were detected in the total cohort. Only patients with >10 years after SOT had a lower dental treatment need compared to the other groups (P = .02). All other comparisons of dental, periodontal, and overall treatment needs were comparable between subgroups depending on time since SOT. Furthermore, no statistically significant differences were found in terms of the dental, periodontal, or overall treatment needs following the administration of different immunosuppressive medications.ConclusionThe high treatment need of patients after SOT, irrespective of the time since transplantation, suggests insufficient dental and periodontal treatment before and maintenance after organ transplantation. Furthermore, immunosuppressive medication was not associated with the treatment need.
Early infections in the intensive care unit after liver transplantation‐etiology and risk factors: A single‐center experience
Authors: Laici Cristiana , Gamberini Lorenzo , Bardi Tommaso , Siniscalchi Antonio , Reggiani Maria Letizia Bacchi , Faenza Stefano 
Published: January 2018

AbstractBackgroundInfectious complications represent one of the main causes of perioperative morbidity and mortality of liver transplant recipients. The primary objective of this retrospective observational study was to evaluate incidence and etiology of early (within 1 month from surgery and occurring in the intensive care unit [ICU]) postoperative infections as well as donor‐ and recipient‐related risk factors.MethodsThe data of 280 patients undergoing 299 consecutive liver transplant procedures from January 2012 to December 2015 were extracted from the Italian ICU registry database and hospital registries. Perioperative risk factors, etiology of infections, and antibiotic susceptibility of isolated microorganisms were taken into consideration.ResultsGlobal incidence of postoperative infections was 21%. Pneumonia was the most frequent infection and, globally, gram‐negative bacteria were the most common agents. Septic shock was present in 22% of infection cases and hospital mortality was higher in patients with postoperative infection. Preoperative chronic obstructive pulmonary disease, malnutrition, preoperative ascites, encephalopathy, and early re‐transplantation were significantly associated to post orthotopic LT infections.ConclusionInfections represent a major cause of early postoperative morbidity and mortality. The impact of single risk factors and the results of their preoperative management should be further investigated in order to reduce the incidence and evolution of postoperative infections.
Carbapenem‐resistant Klebsiella pneumoniae vertebral osteomyelitis in a renal transplant recipient treated with ceftazidime‐avibactam
Authors: Cani Eris , Moussavi Farzad , Ocheretyaner Eric , Sharma Roopali , Brown Clinton , Eilertson Brandon 
Published: January 2018

AbstractCeftazidime‐avibactam (CAZ‐AVI) is a novel cephalosporin beta lactamase inhibitor combination that has shown activity against carbapenem‐resistant Enterobactericeae. Data are limited on its utilization in the treatment of carbapenem‐resistant Klebsiella pneumoniae osteomyelitis in solid organ transplant patients. We describe a case report on the use of CAZ‐AVI in the treatment of vertebral osteomyelitis in a renal transplant recipient.
A successful aggressive surgical and medical approach to pulmonary artery obstruction due to Mycobacterium abscessus infection post lung transplantation
Authors: Kotecha Sakhee , Smibert Olivia C. , Doi Atsuo , Gooi Julian , Morrissey Orla , Paraskeva Miranda , Snell Greg I. , McGiffin David 
Published: January 2018

AbstractMycobacterium abscessus infection following lung transplantation has historically been associated with poor outcomes. We report a case of bilateral lung retransplantation complicated by obstruction of the right pulmonary artery secondary to M. abscessus mycotic aneurysm. Aggressive surgical management, including reconstruction of the right pulmonary artery, was undertaken with prolonged antimicrobial therapy. Thirty‐six months later, antibiotics have been discontinued and the patient has stable soft tissue chest wall disease with good graft function. Mortality and morbidity associated with M. abscessus infection is considerable but this case illustrates that with aggressive early management, outcomes may be favorable.
Successful resolution of hyperammonemia following hematopoietic cell transplantation with directed treatment of Ureaplasma parvum infection
Authors: Graetz Riley , Meyer Robyn , Shehab Kareem , Katsanis Emmanuel 
Published: January 2018

AbstractHyperammonemia following hematopoietic cell transplantation (HCT) has been characterized as idiopathic and is associated with a very high mortality. A causal relationship between Ureaplasma infection and hyperammonemia in immunocompromised lung transplant recipients has recently been described. We document the first case of hyperammonemia following HCT associated with Ureaplasma parvum. The initiation of appropriate antibiotics resulted in rapid resolution of hyperammonemic encephalopathy and eradication of the implicating organism.
Long‐term follow‐up of post renal transplantation Epstein‐Barr virus‐associated smooth muscle tumors: Report of two cases and review of the literature
Authors: El Hennawy Hany M. , Habhab Wael , Almutawa Abdulmonem , Shinawi Sumaih , Al Ayad Abdulrahman , Fahmy Ahmed 
Published: January 2018

AbstractEpstein‐Barr virus (EBV)‐associated smooth muscle tumors (SMTs) following solid organ transplantation are very rare slow growing neoplasms. Most tumors present with non‐specific symptoms mainly related to tumor location. Post‐transplant EBV‐associated small muscle tumors have been reported in various anatomical locations. The tumors have a predilection to unusual sites for SMTs and tend to be multifocal. The histologic appearance of these tumors generally does not predict their clinical behavior. Surgery and reduction in immunosuppression are the main stays of management. We herein report two cases of post renal transplant EBV‐associated SMTs with over 6 years of follow‐up. A 33‐year‐old male patient presented with hepatic lesions and a 49‐year‐old female patient presented with multiple mesenteric and gluteal lesions. The tumors were diagnosed 6 and 10 years after renal transplantation, respectively. Surgical resection and reduction/discontinuation of immunosuppression were successful in delaying progression of the disease; however, in both cases, the allografts failed during the course of management.
Hepatitis A, cardiomyopathy, aplastic anemia, and acute liver failure: A devastating scenario
Authors: Botero Verónica , García Víctor H. , Aristizabal Ana M. , Gomez Catalina , Perez Paola , Caicedo Luis A. , Echeverri Gabriel J. 
Published: January 2018

AbstractHepatitis A virus (HAV) causes an acute infection and is usually asymptomatic in children. When clinical manifestations appear, these include choluria, jaundice, and abdominal pain. Although infrequent, extra‐hepatic manifestations related to HAV have been described, affecting the heart, bone marrow, blood vessels, and other tissues.A 10‐year‐old boy from a rural area presented with a 15‐day history of malaise, fever, and jaundice; laboratory examinations were compatible with HAV infection. The patient turned encephalopathic and was remitted to our center, where laboratory examinations showed a medullary aplasia and fulminant hepatitis requiring a liver transplant that was performed 72 hours after admission. At 24 hours post transplant, the patient developed a cardiomyopathy secondary to HAV, and intravenous immunoglobulin was administered. The patient is still alive and attending his medical check‐ups.Although rare, extra‐hepatic manifestations of HAV infection have been described in 14% of cases. The groups of patients affected are usually aged and present with high bilirubin levels. Acquired aplastic anemia and myocarditis caused by HAV are uncommon, and its pathophysiology has not yet been elucidated.HAV infection is usually asymptomatic in children, although extra‐hepatic manifestations can appear requiring early detection and management.
Acanthamoeba endophthalmitis during treatment for cutaneous disease in a renal transplant patient
Authors: Kutner Allison , Aldrich Margaret , Patel Sarju , Kang Joann J. , Amin Bijal , Mann Ranon , Ali Ibne Karim M. , Martines Roosecelis Brasil , Cope Jennifer Rittenhouse , De Boccardo Graciela O. , Puius Yoram A. 
Published: January 2018

AbstractAcanthamoeba infections are difficult to diagnose and treat. We present a renal transplant patient who developed Acanthamoeba endophthalmitis on therapy with posaconazole and miltefosine for cutaneous acanthamobiasis. The patient was maintained on intracameral voriconazole injections, and oral azithromycin, fluconazole, and flucytosine. This case highlights novel presentations and treatments for acanthamoebic infection.
Comparative effectiveness of aerosolized versus oral ribavirin for the treatment of respiratory syncytial virus infections: A single‐center retrospective cohort study and review of the literature
Authors: Trang Tracy P. , Whalen Meghan , Hilts‐Horeczko Alexandra , Doernberg Sarah B. , Liu Catherine 
Published: January 2018

AbstractBackgroundRespiratory syncytial virus (RSV) is a leading cause of viral infections in immunocompromised hosts and is associated with significant morbidity and mortality. In January 2015, our institution switched from aerosolized to oral ribavirin (RBV) for primary treatment of RSV infection among high‐risk immunocompromised adult patients. The objective of the study was to evaluate the clinical and economic outcomes associated with this switch.MethodsRetrospective cohort analysis of adult patients diagnosed with RSV infection and treated with RBV between January 1, 2013, and May 31, 2016.ResultsOf 46 patients, 20 (43%) patients received oral RBV and 26 (57%) received aerosolized RBV. Underlying conditions included lung transplant (n = 22), hematopoietic cell transplant (n = 16), hematological malignancy (n = 5), and structural lung diseases (n = 4). At the time of RSV diagnosis, 42 (91%) were hospitalized, 36 (78%) had clinical and radiographic evidence of lower respiratory tract infection (RTI), 9 (20%) were admitted to the ICU, and 4 (9%) required intubation. There were no differences in clinical outcomes between the 2 groups with regard to adverse events, progression from upper to lower RTI, escalation of care, or 30‐day mortality. Three (15%) in the oral group and 1 (4%) in the aerosolized group died within 30 days (P = .33). The cost avoidance attributable to the switch in therapy over 1 year is $1.2 million.ConclusionOral RBV appears to be a safe and cost‐effective alternative to aerosolized RBV for the management of RSV infection in immunocompromised patients. Larger studies are needed to validate the safety and efficacy of this approach.
Tuberculosis after liver transplantation in a large center in New York City: QuantiFERON®‐TB Gold‐based pre‐transplant screening performance and active tuberculosis post‐transplant
Authors: Hand Jonathan , Sigel Keith , Huprikar Shirish , Hamula Camille , Rana Meena 
Published: January 2018

AbstractIntroductionPre‐transplant screening for latent tuberculosis infection (LTBI) is a complex consideration that varies by institution. Inconsistent performance of interferon‐gamma release assay (IGRA) further complicates screening. Data regarding LTBI screening outcomes and test characteristics in a large, foreign‐born pre‐transplant population within the United States are limited.MethodsIn this retrospective study, patients who received QuantiFERON®‐TB Gold (QFT) prior to liver transplantation (LT) were included. Characteristics of patients were compared by QFT result, and predictors of indeterminate results were evaluated. Similar comparisons were performed between patients who developed active TB and those who did not.ResultsOf 148 patients screened, the rate of positive, indeterminate, and negative testing was 13.5% (20/148), 27% (40/148), and 59% (88/148), respectively. An indeterminate QFT result was more than 16 times more likely in patients with a Model for End‐stage Liver Disease score >25 (odds ratio [OR] 16.7; 95% confidence interval [CI], 2.1‐132.0; P = .008) and more than 4 times when performed in our institution's lab compared with commercial lab (OR 4.1; 95% CI, 1.34‐12.44; P = .013). The overall TB incidence was 1102/100 000 transplant cases. No patient who developed active TB had a positive QFT. All were born outside of the United States (P = .06) and had pre‐transplantation chest imaging demonstrating granulomatous disease (P = .006).ConclusionOur experience further highlights the challenges of LTBI screening prior to LT and suggests that QFT may be a poor predictor of active TB in higher risk pre‐transplant populations. Candidates should be screened as early as possible to optimize QFT performance, and local epidemiological data should be used to create institution‐specific screening protocols in areas with large populations from TB‐endemic regions. Management should consider TB risk factors, QFT, and imaging instead of reliance on QFT testing alone.
Progressive multifocal leukoencephalopathy after T‐cell replete HLA‐haploidentical transplantation with post‐transplantation cyclophosphamide graft‐versus‐host disease prophylaxis
Authors: Ikegawa Shuntaro , Fujii Nobuharu , Tadokoro Koh , Sato Kota , Iwamoto Miki , Matsuda Masayuki , Inomata Tomoko , Sugiura Hiroyuki , Asano Takeru , Yoshida Shohei , Nishimori Hisakazu , Matsuoka Ken‐ichi , Maeda Yoshinobu 
Published: January 2018

AbstractA 52‐year‐old man suffered from progressive multifocal leukoencephalopathy (PML) after human leukocyte antigen (HLA)‐haploidentical transplantation with post‐transplantation cyclophosphamide (PTCY). Mirtazapine, mefloquine, and cytarabine failed to improve his symptoms, and he finally died 4.5 months after PML onset. This is the first case report of a patient with PML after HLA‐haploidentical transplantation with PTCY. Although T‐cell replete HLA‐haploidentical transplantation with PTCY has enabled early immune reconstitution, PML should be considered if a patient's mental condition deteriorates.
Macroeconomic policy cooperation and the G20
Authors: Triggs Adam 
Published: January 2018

AbstractHas the G20 achieved its goals in macroeconomic cooperation since 2008? The paper organises the G20's efforts under five themes: macroeconomic stimulus, fiscal consolidation, monetary policy, the global financial safety net and global imbalances. The G20 was initially successful in each of these areas, but this success was short‐lived. While the G20 met its goals on macroeconomic stimulus, it has been less successful in reducing deficits and debt. While it was successful in increasing its resources, the global financial safety net remains too small, too fragmented and institutional reform is incomplete. While the G20 succeeded in moving to more market‐determined exchange rates and avoiding competitive devaluations, it struggled to avoid negative spillovers. Despite years of effort, the G20 has made limited progress in reducing global imbalances. Current account imbalances are creeping back to pre‐crisis levels. Public debt remains high and most economies are moving in the wrong direction in correcting imbalances in household savings and debt. The paper concludes that the G20 has done better in some areas than others. But to suggest the G20 is a forum in decline ignores its shift from reactive crisis response to longer‐term structural challenges outside of the pressing need of an immediate crisis.
Capnocytophaga keratitis in dogs: clinical, histopathologic, and microbiologic features of seven cases
Authors: Ledbetter Eric C. , Franklin‐Guild Rebecca J. , Edelmann Michele L. 
Published: January 2018

AbstractObjectiveTo describe the clinical, microbiologic, and histopathologic features of Capnocytophaga keratitis in dogs.Animals studiedSeven dogs with naturally acquired Capnocytophaga keratitis.ProceduresMedical records of dogs with a clinical diagnosis of keratitis and corneal cultures positive for Capnocytophaga spp. were reviewed. Dog signalment, medical history, clinical findings, and diagnostic assay results were recorded.ResultsBreeds included Boston terrier (n = 3 dogs), Rat terrier (n = 2), and single cases of mixed breed and Pug. All dogs examined had expansive corneal ulceration involving the majority of the corneal surface. Marked corneal infiltrates, keratomalacia, and hypopyon were present. Progression of corneal disease was rapid with extensive dissolution of the corneal stroma. Corneal lesions progressed to catastrophic perforations within 24 h of the initial examination in three dogs, requiring enucleation. One globe was enucleated after failure to resolve with long‐term medical therapy. Globes and vision were retained in three dogs following aggressive medical therapy (two dogs) or 360° conjunctival graft surgery (one dog). Capnocytophaga cynodegmi, Capnocytophaga canimorsus, or unspeciated Capnocytophaga spp. were cultured from corneal samples of all dogs. Long, thin, gram‐negative rods were present during cytological evaluation of the cornea in some dogs. Histopathologic evaluation of enucleated globes revealed severe and diffuse neutrophilic and collagenolytic keratitis.ConclusionsCapnocytophaga keratitis is a severe, rapidly progressive corneal infection in dogs that is associated with diffuse corneal involvement, extensive keratomalacia, and a relatively poor prognosis. Clinical features of canine Capnocytophaga keratitis are similar to human cases of this infection.
P‐ and E‐selectin receptor antagonism prevents human leukocyte adhesion to activated porcine endothelial monolayers and attenuates porcine endothelial damage
Authors: Laird Christopher T. , Hassanein Wessam , O'Neill Natalie A. , French Beth M. , Cheng Xiangfei , Fogler William E. , Magnani John L. , Parsell Dawn , Cimeno Arielle , Phelps Carol J. , Ayares David , Burdorf Lars , Azimzadeh Agnes M. , Pierson Richard N. 
Published: January 2018

AbstractBackgroundAlongside the need to develop more effective and less toxic immunosuppression, the shortage of human organs available for organ transplantation is one of the major hurdles facing the field. Research into xenotransplantation, as an alternative source of organs, has unveiled formidable challenges. Porcine lungs perfused with human blood rapidly sequester the majority of circulating neutrophils and platelets, which leads to inflammation and organ failure within hours, and is not significantly attenuated by genetic modifications to the pig targeted to diminish antibody binding and complement and coagulation cascade activation.MethodsHere, we model the interaction of freshly isolated human leukocytes with xenotransplanted vasculature under physiologic flow conditions using microfluidic channels coated with porcine endothelial cells. Both isolated human neutrophils and whole human blood were perfused over transgenic pig aortic endothelial cells that had been activated with rhTNF‐α or rhIL‐4 using the BioFlux system. Novel compounds GMI‐1271 and rPSGL1.Fc were tested as E‐ and P‐ selectin antagonists, respectively. Cellular adhesion and rolling events were tracked using FIJI (imageJ).ResultsPorcine endothelium activated with either rhTNF‐α or rhIL‐4 expressed high amounts of selectins, to which isolated human neutrophils readily rolled and tethered. Both E‐and P‐selectin antagonism significantly reduced the number of neutrophils rolling and rolling distance in a dose‐dependent manner, with near total inhibition at higher doses (P < .001). Similarly, with whole human blood, selectin blocking compounds exhibited dose‐dependent inhibition of prevalent leukocyte adhesion and severe endothelial injury (Untreated: 394 ± 97 PMNs/hpf, 57 ± 6% loss EC; GMI1271+rPSGL1.Fc: 23 ± 9 PMNs/hpf, 8 ± 6% loss EC P < .01).ConclusionsSelectin blockade may be useful as part of an integrated strategy to prevent neutrophil‐mediated organ xenograft injury, especially during the early time points following reperfusion.
Strong xenoprotective function by single‐copy transgenes placed sequentially at a permissive locus
Authors: Rieblinger Beate , Fischer Konrad , Kind Alexander , Saller Benedikt S. , Baars Wiebke , Schuster Marion , Wolf‐van Buerck Lelia , Schäffler Andrea , Flisikowska Tatiana , Kurome Mayuko , Zakhartchenko Valeri , Kessler Barbara , Flisikowski Krzysztof , Wolf Eckhard , Seissler Jochen , Schwinzer Reinhard , Schnieke Angelika 
Published: January 2018

AbstractBackgroundMultiple xenoprotective transgenes are best grouped at a single locus to avoid segregation during breeding and simplify production of donor animals.MethodsWe used transgene stacking to place a human CD55 transgene adjacent to a human heme oxygenase 1 construct at the porcine ROSA26 locus. A transgenic pig was analyzed by PCR, RT‐PCR, droplet digital PCR, immunohistochemistry, immunofluorescence, and flow cytometry. Resistance to complement‐mediated cell lysis and caspase 3/7 activation were determined in vitro.ResultsThe ROSA26 locus was retargeted efficiently, and animals were generated by nuclear transfer. RNA and protein analyses revealed abundant expression in all organs analyzed, including pancreatic beta cells. Transgenic porcine kidney fibroblasts were almost completely protected against complement‐mediated lysis and showed reduced caspase 3/7 activation.ConclusionStep‐by‐step placement enables highly expressed single‐copy xenoprotective transgenes to be grouped at porcine ROSA26.