bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of angiotensin I‐converting enzyme polymorphism on development of post‐transplant erythrocytosis in renal graft recipients
Authors: Kędzierska Karolina , Kabat‐Koperska Joanna , Safranow Krzysztof , Domański Maciej , Gołembiewska Edyta , Bober Joanna , Bohatyrewicz Romuald , Ciechanowski Kazimierz 
Published: August 2010

Abstract: Background: Post‐transplant erythrocytosis (PTE) is estimated at 5–20%. Angiotensin II generated by angiotensin I‐converting enzyme (ACE) stimulates erythropoiesis. The highest activity of ACE is observed in DD genotype. The question arises if ACE gene polymorphism influences PTE.Methods: One‐year prospective study included 89 kidney recipients (28 women and 61 men).Results: Thirty‐four (38%) recipients proved to be DD genotype, 36 (40%) ID, and 19 (22%) II genotype. Absolute PTE [hematocrit level (HCT) >50% and RBC > 5.5 mln/mm3] was found in 14 (19%) patients. PTE developed 6–12 months after kidney Tx. There were no significant differences in genotype distribution between patients with and without PTE. ANOVA showed that the most significant predictor of PTE development was the time since kidney Tx (p < 0.0001). Analysis of logistic regression showed that male sex was the most important factor in PTE development 12 months after kidney Tx (OR = 13.6: 95% CI 1.2–150.9, p < 0.05). D allele increased the PTE risk (OR = 3.3 for each allele: 95% CI 1.1–10.4, p < 0.05), the use of angiotensin‐converting enzyme inhibitors (ACEI) decreased the PTE risk (OR = 0.15: 95% CI 0.03–0.85, p < 0.05). In patients with DD genotype, there was a correlation between hemoglobin, RBC and HCT concentration, 12 months after Tx and panel of reactive antibody value before Tx (Rs = +0.43, p < 0.05).Conclusions: Male sex and D allele presence increase the risk of PTE development, especially in highly immunized patients. The use of ACEI decreases the risk of PTE development.
Emergence of drug‐resistant cytomegalovirus in the era of valganciclovir prophylaxis: therapeutic implications and outcomes
Authors: Eid Albert J , Arthurs Supha K , Deziel Paul J , Wilhelm Mark P , Razonable Raymund R 
Published: August 2010

Abstract:  Background:  Valganciclovir prophylaxis is reportedly associated with a low incidence of ganciclovir‐resistant cytomegalovirus (CMV). We assessed the incidence, clinical features, and outcome of drug‐resistant CMV among solid organ transplant patients who received valganciclovir prophylaxis.Methods:  The medical records of all CMV D+/R− kidney, pancreas, liver, and heart recipients were screened for CMV disease, and the clinical course and outcomes of patients with drug‐resistant CMV were reviewed.Results:  During a four‐yr‐study period, a total of 225 CMV D+/R− transplant patients received valganciclovir prophylaxis for a median of 92 d. Sixty‐five (29%) of the 225 patients developed delayed‐onset primary CMV disease, including nine (14%) suspected to have drug‐resistant virus. Four (6.2%) had confirmed UL97 or UL54 mutations. All except one patient manifested gastrointestinal tissue‐invasive disease. Together with reduction in immunosuppression, intravenous foscarnet with or without CMV hyperimmunoglobulin was the most common treatment. Drug‐associated nephrotoxicity was commonly observed and resulted in allograft loss in two patients. During the mean follow‐up of 2.2 yr, allograft loss and mortality occurred in two of four patients with proven and in three of five patients with clinically suspected drug‐resistant CMV.Conclusions:  Cytomegalovirus disease because of clinically suspected or genotypically confirmed drug‐resistant CMV is not uncommon in CMV D+/R− solid organ transplant patients who received valganciclovir prophylaxis. Because of its significant morbidity and mortality, an optimized strategy of CMV prevention is warranted to reduce the negative impact of drug‐resistant CMV on the successful outcome of organ transplantation.
Pharmacokinetics of mycophenolic acid, tacrolimus and sirolimus after gastric bypass surgery in end‐stage renal disease and transplant patients: a pilot study
Authors: Rogers Christin C , Alloway Rita R , Alexander J. Wesley , Cardi Michael , Trofe Jennifer , Vinks Alexander A 
Published: August 2010

Abstract: Background: Promising data regarding the safety and efficacy of gastric bypass surgery (GBS) as an option to address obesity in the transplant population are emerging. The data lack on how GBS may alter the pharmacokinetics (PK) of modern immunosuppression. The objective of this study was to describe the alterations in the PK of modern immunosuppressants and the GBS population.Methods: Data are presented on six subjects who participated in this trial – four were on dialysis and two were renal transplant recipients. Dialysis‐dependent bypass subjects received a single dose of 6 mg of sirolimus, two 4‐mg doses of tacrolimus and two 1000‐mg doses of mycophenolate mofetil (MMF) over the 24‐h study period. Transplant recipients continued their current regimen. Maximum plasma concentration (Cmax), time to reach the maximum plasma concentration (Tmax) and the area under the plasma concentration vs. time curve (AUC0–12and AUC0–∞where appropriate) were calculated for tacrolimus, sirolimus, mycophenolic acid (MPA) and mycophenolic acid glucuronide (MPAG).Results: Significant inter‐patient variability in theCmax,Tmaxand AUC of tacrolimus, sirolimus MPA and MPAG was observed. A notable difference in the AUC:dose ratio for tacrolimus was seen when comparing data with published data in the non‐bypass population. Similar differences in PK were seen with sirolimus, MPA and MPAG.Conclusions: When comparing the PK of sirolimus, tacrolimus, MPA and MPAG to published PK data in the non‐bypass population, significant differences are observed. It is likely that transplant recipients with GBS would need higher doses of tacrolimus, sirolimus and MMF to provide similar exposure to a non‐bypass patient.
Protein levels of heme oxygenase‐1 during reperfusion in human kidney transplants with delayed graft function
Authors: Öllinger Robert , Kogler Pamela , Biebl Matthias , Sieb Michael , Sucher Robert , Bösmüller Claudia , Troppmair Jakob , Mark Walter , Weiss Helmut , Margreiter Raimund 
Published: August 2010

Abstract: Introduction:  Delayed graft function (DGF) as a consequence of ischemia reperfusion injury (IRI) is associated with a decrease in long‐term allograft survival. Heme oxygenase‐1 (HO‐1) is a stress responsive gene that is highly expressed in multiple pathological processes. The aim of our study was to analyze whether HO‐1 protein levels in human kidney transplants during IRI correlate with the incidence of DGF.Methods:  Kidney biopsies were obtained from 27 kidney allografts at two time points: at the end of cold storage and shortly after reperfusion. Samples were analyzed for HO‐1 protein levels by Western blot.Results:  Heme oxygenase‐1 protein levels were significantly higher in post‐reperfusion biopsies (39.4 vs. 13.7 arbitrary units, p = 0.001). In pre‐reperfusion biopsies no association was observed between HO‐1 protein levels and DGF. In post‐reperfusion biopsies, higher levels of HO‐1 protein were measured in kidneys with DGF (53.7 vs. 36.2 arbitrary units, p = 0.064). DGF kidneys showed a significantly higher increase from pre‐ to post‐reperfusion in HO‐1 protein (42.0 vs. 18.7 arbitrary units, p = 0.025).Conclusion:  Heme oxygenase‐1 protein levels shortly after allograft reperfusion are closely related with initial graft function. Assessment thereof may be considered a valuable tool to predict DGF.
Pharmacodynamic immune monitoring of NFAT‐regulated genes predicts skin cancer in elderly long‐term renal transplant recipients
Authors: Sommerer Claudia , Hartschuh Wolfgang , Enk Alexander , Meuer Stefan , Zeier Martin , Giese Thomas 
Published: August 2010

Abstract:  Introduction:  Among elderly allograft recipients non‐melanoma skin cancer (NMSC) is the most common malignancy. We have previously shown that malignancies are associated with a higher intensity of ciclosporin A (CsA)‐induced immunosuppression.Method:  Fifty‐five long‐term elderly renal transplant patients with a stable transplant function had regular skin examinations. The expression of the nuclear factor of activated T cells (NFAT)‐regulated genes (interleukin‐2, granulocyte‐macrophage colony stimulating‐factor, interferon‐γ) was determined by real‐time PCR at CsA trough levels and two h after oral intake.Results:  The CsA dose was 2.0 mg/kg (0.95–3.50), with CsA trough level (C0) level 97 μg/L (33–157) and CsA two‐h level (C2) 538 μg/L (350–1228). NMSC was diagnosed in 14/55 patients (25.4%). A total of 85.7% of allograft recipients with NMSC were male (p < 0.005). Age, time after transplantation, CsA dose, CsA C0 and C2 level were comparable in both groups. NFAT‐regulated gene expression was signficantly lower in patients with skin cancer compared with patients without skin cancer [4.94% (0.91–13.4) vs. 11.6% (3.3–40.8), p < 0.001).Conclusion:  The unproportional high incidence of NMSC in elderly long‐term kidney‐transplanted patients correlates with a lower NFAT‐regulated gene expression which is a surrogate biomarker for a higher degree of functional immunosuppression. Further studies are required to determine whether the reduction of CsA with an increased NFAT‐regulated gene expression is associated with a lower NMSC incidence.
Excellent outcome using “impaired” standard criteria donors with elevated serum creatinine
Authors: Greenstein Stuart M , Moore Norman , McDonough Patricia , Schechner Richard , Tellis Vivian 
Published: August 2010

Abstract:  Introduction:  To maximize organ utilization, the United Network for Organ Sharing (UNOS) encourages use of Expanded Criteria Donors (ECD). However, Standard Criteria Donors (SCD) may also be under‐utilized, some centers discarding kidneys with serum creatinine (S.Cr) >2.0 at nephrectomy. Our experience with the use of such ``impaired’’ kidneys was reviewed retrospectively.Results:  From January 1, 2003 to October 1, 2006, of 130 DD kidneys transplanted at our center, 26 were ECD. Also, 22 kidneys were from Impaired SCD (ISCD), with mean S.Cr 3.2 (2.1–4.4) at nephrectomy; eight of these had S.Cr >4.0. For these 22 ISCD, mean age was 22 yrs (11–42), sex: 16 Males; race:12 Caucasians/10 African‐Americans; All had evidence of rhabdomyolysis (Mean peak CPK 11,924 u/l). Thirty‐seven percent came from outside OPOs. Recipient demographics: age 45 years; sex 50% male, 45% African‐American. Mean HLA match was 1; dialysis was required in 28% within the first week. Mean length of stay was 10.7 days. Average discharge S.Cr was 4.2. All kidneys are currently functioning (S.Cr at 3 months, 6 months and 1 year 1.6, 1.7 and 1.7 respectively).Conclusion:  An elevated creatinine should not be the only cause for discarding deceased donor kidneys.
Addition of a total pancreatectomy and pancreas transplantation in a liver transplant recipient with intraductal papillary mucinous neoplasm of the pancreas
Authors: Fridell Jonathan A , Vianna Rodrigo , Mangus Richard S , Kazimi Marwan , Hollinger Edward , Joseph Tector A 
Published: August 2010

Abstract:  Background:  Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are increasingly recognized in clinical practice. There are no published data suggesting a management approach for the potential organ transplant recipient with the incidental finding of this pre‐malignant lesion.Methods:  The recipient was a 65‐yr‐old man with hepatocellular carcinoma in a background of Laennec’s cirrhosis. During evaluation for transplant, he was found to have diffuse IPMN. This patient underwent liver transplantation with a planned simultaneous total native pancreatectomy and pancreas transplant from the same donor.Results:  The patient has had normal liver function and has been free of diabetes and exocrine insufficiency at 18 months post‐transplant.Conclusion:  IPMN in the potential transplant recipient should be managed more aggressively than in the general population because these patients will be committed to life‐long immunosuppression. If a total pancreatectomy is contemplated, this is a unique opportunity to replace the pancreas with an allograft at the time of transplantation.
An Investigation of the Susceptibility of Arabidopsis thaliana to Isolates of Two Species of Verticillium
Authors: Steventon L. A. , Okori P. , Dixelius C. 
Published: August 2010

AbstractEight isolates of Verticillium longisporum and seven of Verticillium dahliae were examined for their pathogenicity to Arabidopsis thaliana. Two‐week‐old seedlings of two A. thaliana ecotypes were inoculated with conidial suspensions (1.6 × 104 conidia/ml) and maintained in sterile conditions on microtitre plates for 25 days. The seedlings were assessed daily for flowering time, height at flowering and mortality. From this data the proportion of plants flowering was calculated and the susceptibility of each ecotype to individual isolate was quantified. The A. thaliana ecotypes were inoculated by several isolates of V. dahliae and V. longisporum with the disease symptoms observed being similar to those characteristic of Verticillium‐infected Brassica napus. Responses to Verticillium isolates varied and for both ecotypes significant dierences (P ≤ 0.05) were recorded in days to flowering between the V. longisporum isolates VD6 and VD12 and the V. dahliae isolate INRA617 and all other isolates. There were no other significant effects correlated with isolate origin or Verticillium species.
Quantification of transgene expression in maize (Zea mays L.) throughout the vegetation period
Authors: Bakó A. , Gell G. , Balázs E. 
Published: August 2010

With 3 figures and 1 table AbstractEvaluation of transgenic plants during their development is of major importance for breeders. To facilitate this evaluation, we applied a real‐time, reverse transcription polymerase chain reaction method to maize tissues that allows quantitative expression profiling of transgenes. To obtain consistent results, sampling, transport, storage and extraction protocols were standardized for a wide range of samples (leaves, stems, roots, pollen and kernels) and phenological stages (from the 4–6 leaves stage to physiological maturity). RNA integrity was monitored by Agilent 2100 Bioanalyzer to ensure that decomposed RNA samples were excluded from further study. A simple and effective SYBR Green methodology was applied for relative quantification of transgene expression. Several endogenous controls were tested to achieve the best possible results. Quantitave results presented illustrate the application of our protocol to the quantification of cry3Bb1 (encoding corn root worm resistance) expression in MON88017 event derived transgenic maize lines. The methodology described here can be routinely performed for the quantification of gene expression in maize.
OPINIONS OF HEALTHCARE PROFESSIONALS REGARDING THE MATERNITY EXPERIENCES OF INDIGENOUS WOMEN IN AN ACUTE CARE SETTING
Authors: Watson Jennifer , Hodson Katrina , Johnson Rhona , Kemp Kath , May Jessica 
Published: August 2010

ABSTRACT: This is the report of stage three of a three stage project. The aims of the overall project were to seek advice from expert Indigenous women on how to gather information from birthing Indigenous women while in hospital. Information was gathered from Indigenous women who gave birth in hospital or were admitted after the birth of their baby. The opinions of healthcare professionals on the care of these women were investigated. This paper describes the opinions and concerns of healthcare professionals regarding identified cultural, social and economical issues for Indigenous women at a large acute care hospital in the Northern Territory, Australia. The opinions of healthcare professionals are vital if the needs and concerns of Indigenous women are to be considered within the hospital setting.Stages one and two of this project have been presented previously. Stage three, reported here, describes a survey of 18 non‐Indigenous and one Indigenous healthcare professionals regarding their opinions of the maternity experiences of Indigenous women admitted to an acute care setting. The consultative process for designing the questionnaire and reflections on issues raised by Indigenous women during their interviews in the previous two stages is presented. The methodology of the survey, demographics and perceptions of healthcare professionals who participated in the project are examined and the similarities and differences between the issues raised by the healthcare professionals and the Indigenous women in stage two of the project are discussed. Suggestions made by the healthcare professionals regarding improving quality of care for Indigenous women when admitted to an acute healthcare setting are presented.
PATIENT VIEWS ON THE MANAGEMENT OF RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE IN THE KIMBERLEY: A QUALITATIVE STUDY
Authors: Mincham Christine M. , Toussaint Sandy , Mak Donna B. , Plant Aileen J. 
Published: August 2010

ABSTRACT Objective: To describe, from a patient perspective, factors leading to suboptimal management of individuals with rheumatic fever (RF) and rheumatic heart disease (RHD) among members of the Kimberley population. Method: Qualitative in‐depth semistructured and repeated interviews of seven Kimberley patients, or parents of children, with rheumatic fever and/or rheumatic heart disease, during 1998. Results: Participants showed variable levels of understanding about RF/RHD, often relating to the need for secondary prophylaxis. Compliance with medication was closely linked with positive patient–staff interactions. From the perspective of health care, living in a remote location was frequently described as a negative influence. Participants desire more accessible and culturally appropriate opportunities for learning about their disease. Conclusions: Participants focused on issues closely related to effective and ineffective management of RF/RHD. The lessons learned are indicators for health staff attempting to improve the quality of management that people receive.
IS RURAL MEDICINE A SEPARATE DISCIPLINE?
Authors: Smith Janie , Hays Richard 
Published: August 2010

Background: The Australian College of Rural and Remote Medicine was established in 1997 to meet what rural doctors perceived as their unmet educational and professional needs. However, the issue of just how different rural practice is from urban practice remains a topic of debate. Methods: This paper explores the scope of rural medical practice, through the use of clinical scenarios and a synthesis of the research literature, to determine if rural medical practice is emerging as a distinct discipline in Australia. Conclusion: Rural and remote medical practice is different, and additional, to urban practice, in the context, content and process of care. Three of the four criteria for determining rural medical practice as a distinct discipline exist in Australia. The fourth criteria: sufficient external recognition of rural medicine as a distinct discipline, awaits resolution.
Rural temperament and character: A new perspective on retention of rural doctors
Authors: Eley Diann , Young Louise , Shrapnel Marilyn 
Published: August 2010

AbstractObjective:  This exploratory study serves as a starting point to establish a psychobiological profile for rural GPs. The overall aim is to describe how individual levels and combinations of temperament (mildly heritable) and character (influenced by sociocultural learning) traits allow GPs to flourish or fail in rural medicine. Design:  In a mixed‐method study, 13 rural GPs (rural and remote metropolitan areas 5–7, minimum 7 years of experience) from Central/Southern Queensland, Australia completed the Temperament and Character Inventory‐R140 to identify the intensity of the seven basic dimensions of temperament and character. These are novelty seeking, harm avoidance, reward dependence, persistence, self‐directedness, cooperativenes and self‐transcendence. Semistructured interviews provided in‐depth information on what brought them to and kept them in rural practice.Results:  Preliminary results show that our sample of rural GPs are highly self directed, caring, cooperative, objective and persistent. Individual variations occur in the temperament dimensions of harm avoidance, novelty seeking and reward dependence. In particular, GPs who intended to leave rural practice due to dissatisfaction had significantly higher harm avoidance (F = 23.74; P < 0.01) than those GPs intent on staying.Conclusion:  Although preliminary, triangulation of the data sources provides insight into individual GP profiles regarding which particular combination of traits is most conducive to maintaining a rural career, and might provide a greater understanding of rural doctors. This information could provide a basis for counselling of students with an interest in rural medicine and for informing policy on appropriate initiatives for rural GPs and the communities they serve.
DOES NITRIC OXIDE MODULATE TRANSMITTER RELEASE AT THE MAMMALIAN NEUROMUSCULAR JUNCTION?
Authors: Nickels Travis J , Reed Grant W , Drummond Justin T , Blevins Dustin E , Lutz Megan C , Wilson David F 
Published: August 2010

SUMMARYApplication of the nitric oxide (NO) donor, sodium nitrite and the NO synthase substratel‐arginine had no effect on nerve‐evoked transmitter release in the rat isolated phrenic nerve/hemidiaphragm preparation; however, when adenosine A1receptors were blocked with the adenosine A1receptor antagonist 1,3‐dipropyl‐8‐cyclopentylxanthine (DPCPX) prior to application of sodium nitrate orl‐arginine, a significant increase in transmitter release was observed. In addition, the NO donors‐nitroso‐N‐acetylpenicillamine (SNAP) significantly increased transmitter release in the presence of DPCPX. In the present study, we have made the assumption that these NO donors elevate the level of NO in the tissue. Future studies should test other NO‐donating compounds and also monitor the NO concentrations in the tissue to ensure that these effects are, in fact, NO induced.Elevation of cGMP in this preparation with the guanylyl cyclase activator 3‐(5′‐hydroxymethyl‐2′‐furyl)‐1‐benzyl indazole (YC‐1) significantly enhanced transmitter release. In the presence of DPCPX and the selective guanylyl cyclase inhibitor 1H‐[1,2,4]oxadiazolo[4,3‐a]quinoxalin‐1‐one (ODQ), which blocks the production of cGMP, the excitatory effects of sodium nitrite andl‐arginine were abolished.These results suggest that NO serves to enhance transmitter release at the rat neuromuscular junction (NMJ) via a cGMP pathway and this facilitation of transmitter release can be blocked with adenosine. Previously, we demonstrated that adenosine inhibits N‐type calcium channels. Because NO only affects transmitter release when adenosine A1receptors are blocked, we suggest that NO enhances transmitter release by enhancing calcium influx via N‐type calcium channels. Further studies are needed to confirm that NO alters transmitter release via cGMP and that this action involves the N‐type calcium channel.The results of the present study are consistent with a model of NO neuromodulation that has been proposed for the mammalian vagal–atrial junction. This model suggests that NO acts on NO‐sensitive guanylyl cyclase to increase the intracellular levels of cGMP. In turn, cGMP inhibits phosphodiesterase‐3, increasing levels of cAMP, which then acts on the N‐type calcium channels to enhance calcium influx, leading to an increase in transmitter release. Our only modification to this model for the NMJ is that adenosine serves to block the modulation of transmitter release by NO.