Mycophenolate mofetil use is associated with prolonged graft survival after kidney transplantation.

Background: Mycophenolate mofetil has replaced azathioprine in many transplant centers, but data on hard outcomes such as graft and patient survival are lacking.

Methods: We analyzed graft and patient survival of the 1219 first renal allograft recipients at the Medical University of Vienna who were treated with azathioprine or mycophenolate mofetil over the past decade. Cox's proportional hazards models were used to compute crude and confounder-adjusted hazard ratio estimates of azathioprine versus mycophenolate mofetil.

Mortality in renal transplant recipients given erythropoietins to increase haemoglobin concentration: cohort study.

Objective: To determine the optimal range of increase in haemoglobin concentration with treatment with erythropoietins that is safe and is not associated with mortality.

Design: Retrospective cohort study. The analysis was adjusted for several covariables with Cox regression analysis with spline functions.

Side effects of phytoestrogens: a meta-analysis of randomized trials.

Background: Phytoestrogens are widely used by postmenopausal women for the treatment of the climacteric syndrome. The risk of adverse effects of this treatment, however, is unknown.

Methods: Using a fixed-effects model, we performed a meta-analysis of side effects comparing phytoestrogen treatment with placebo or no treatment in randomized controlled trials.

Association between depressive symptoms and reproductive variables in a group of perimenopausal women attending a menopause clinic in México City.

The aim of this study was to explore the association between depressive symptoms and some variables related to the reproductive life, such as history of premenstrual dysphoric disorder, antecedent of postpartum depression, previous use of hormonal contraceptives, and current hot flushes, in a group of perimenopausal women attending a menopause clinic. Perimenopausal women, 45 to 55 years old, who had not received hormonal replacement therapy and/or psychotropic medication, were invited to participate in this study. 141 perimenopausal women were included; we obtained their psychiatric and gynecological data, and we evaluated their depressive symptomatology using the CES-D scale.

Serum C-reactive protein in the differential diagnosis of ovarian masses.

Objective: A number of serum tumor markers have been investigated to aid clinicians in the differential diagnosis of ovarian masses. Serum C-reactive protein (CRP) is a widely used biomarker of inflammation and has been previously shown to be a promising biomarker in patients with ovarian cancer.

Study Design: In a retrospective single-center study, we evaluated serum CRP in 576 patients with benign and in 242 patients with malignant (ovarian tumors of low malignant potential [LMP]: n=44, epithelial ovarian cancer [EOC]: n=198) ovarian masses.

Calcineurin inhibitor-based immunosuppressive therapy, donor age, and long-term outcome after kidney transplantation.

Background: It is unclear whether the choice of maintenance immunosuppression modulates the negative effect of advanced donor age on outcome after renal transplantation.

Methods: All 1829 patients who received their first transplant between 1990 and 2003 at the Vienna Medical Centre and had a functioning graft after 90 days were studied. At this time point, 1587 received calcineurin inhibitors (CNI+), 242 did not (CNI-).

VITA-D: cholecalciferol substitution in vitamin D deficient kidney transplant recipients: a randomized, placebo-controlled study to evaluate the post-transplant outcome.

Background: Vitamin D does not only regulate calcium homeostasis but also plays an important role as an immune modulator. It influences the immune system through the induction of immune shifts and regulatory cells resulting in immunologic tolerance. As such, vitamin D is thought to exert beneficial effects within the transplant setting, especially in kidney transplant recipients, considering the high prevalence of vitamin D deficiency in kidney transplant recipients.

The estimation of average hazard ratios by weighted Cox regression.

Often the effect of at least one of the prognostic factors in a Cox regression model changes over time, which violates the proportional hazards assumption of this model. As a consequence, the average hazard ratio for such a prognostic factor is under- or overestimated. While there are several methods to appropriately cope with non-proportional hazards, in particular by including parameters for time-dependent effects, weighted estimation in Cox regression is a parsimonious alternative without additional parameters.

Prolonged venoarterial extracorporeal membrane oxygenation after transplantation restores functional integrity of severely injured lung allografts and prevents the development of pulmonary graft failure in a pig model.

Objective: Prolonged venoarterial extracorporeal membrane oxygenation support during transplantation provides reduction of pulmonary artery flow and allows for protective ventilation. This approach might have the potential to restore function of lungs that would be unsuitable for transplantation.

Methods: Left lung transplantation was performed on 16 pigs.

Gene expression signature of chronic lymphocytic leukaemia with Trisomy 12.

Background: The prognosis of chronic lymphocytic leukaemia (CLL) patients is largely determined by the karyotype of the malignant clone. We have investigated the gene expression profile associated with trisomy 12 (+12).

Design: Initially, unselected peripheral blood mononuclear cells of four patients with +12 were compared with 16 CLL controls using microarray analysis.

Fibrinogen plasma levels are an independent prognostic parameter in patients with cervical cancer.

Objective: The purpose of this study was to evaluate the association between fibrinogen plasma levels on disease-free patients and overall survival in patients with cervical cancer.

Study Design: Pretherapeutic fibrinogen plasma levels were examined in 313 patients with cervical cancer who were treated at the Department of Obstetrics and Gynecology, Medical University of Vienna. Fibrinogen plasma levels were correlated with clinical-pathologic findings and patient survival.

The prognostic value of four interleukin-1 gene polymorphisms in Caucasian women with breast cancer: a multicenter study.

Background: The proinflammatory cytokine interleukin-1 (IL-1) is known to play an important role in the carcinogenesis of breast cancer. Although IL-1 gene polymorphisms were reported to be associated with increased risk of breast cancer, their influence on survival of Caucasian breast cancer patients remains to be shown.

Methods: We studied the influence of four common gene polymorphisms (IL1A -889C/T, IL1B -511C/T, IL1B +3953E1/E2, and IL1RN long/2) of the IL-1 family on survival in 262 Caucasian patients with breast cancer by univariate and multivariate survival analysis.

Influence of blue-light-filtering intraocular lenses on color perception and contrast acuity.

Purpose: To compare contrast acuity at different illumination levels and color vision and the subjective impression in patients after bilateral cataract surgery with a mixed implantation of a blue-light-filtering and an ultraviolet (UV)-filtering intraocular lens (IOL).

Design: Randomized, controlled, double-masked, and bilateral study with intraindividual comparison.

Participants: This study included 48 eyes of 24 consecutive patients with age-related cataract.

NT-proBNP is increased in healthy pregnancies compared to non-pregnant controls.

Serum concentrations of the amino-terminal pro-B-type natriuretic peptide (NT-proBNP) may be used to monitor cardiac function during pregnancy but normal values are not established for this purpose. Therefore, we investigated NT-proBNP in normotensive healthy pregnancies compared to a non-pregnant control group. Serum NT-proBNP was measured in 94 normotensive, healthy pregnant women (32+/-6 years) every five weeks beginning from 12th gestational week (GW) in a longitudinal study and compared to a non-pregnant control group of 521 women (32+/-7 years).

Morphometric signature differences in nuclei of Gleason pattern 4 areas in Gleason 7 prostate cancer with differing primary grades on needle biopsy.

Purpose: Since clinically significant upgrading of the biopsy Gleason score has an adverse clinical impact, ancillary tools besides the visual determination of primary Gleason pattern are essential to aid in better risk stratification.

Materials And Methods: A total of 61 prostate biopsies were selected in patients with a diagnosis of Gleason score 7 prostatic adenocarcinoma, including 41 with primary Gleason pattern 3 and 20 with primary Gleason pattern 4. Slides from these tissues were stained using Feulgen stain, a nuclear DNA stain.

Forced coughing versus local anesthesia and pain associated with cervical biopsy: a randomized trial.

Objective: Cervical biopsy often causes discomfort and pain. To compare local anesthesia (1% lidocaine) with forced coughing as pain relief, we quantified the actual pain experienced during cervical punch biopsies.

Study Design: For a prospective trial conducted at the Medical University of Vienna, 68 women undergoing cervical punch biopsies for assessment of abnormal cervical smears were randomized in 2 pain relief treatment groups.

Avoiding infinite estimates of time-dependent effects in small-sample survival studies.

We address the phenomenon of monotone likelihood in Cox regression with time-dependent effects. Monotone likelihood occurs in the fitting process of a Cox model if at least one parameter estimate diverges to +/- infinity. We show that the probability of monotone likelihood is increased by the inclusion of time-dependent effects, particularly in small samples with several unbalanced and highly predictive covariates, and with a high percentage of censoring.

Overweight, obesity, and the risk of recurrent venous thromboembolism.

Background: Excess body weight is a risk factor for a first venous thromboembolism. The impact of excess body weight on risk of recurrent venous thrombosis is uncertain.

Methods: We studied 1107 patients for an average of 46 months after a first unprovoked venous thromboembolism and withdrawal of anticoagulant therapy.

Statin use is associated with prolonged survival of renal transplant recipients.

The efficacy of statins for the prevention of cardiovascular events is well established in the general population but remains unknown in renal transplant recipients. In this study, the association of statin use with patient and graft survival was investigated in a cohort of 2041 first-time recipients of renal allografts between 1990 and 2003. Multivariable Cox regression demonstrated that statin use was independently associated with lower mortality rates.

Bone marrow-derived endothelial cells contribute to angiogenesis in murine WEHI and JC tumors.

The goal of this study was to determine the contribution of bone marrow-derived circulating endothelial progenitor cells to the formation of endothelial cell linings of tumor vessel walls. The proportion of male endothelial cells in female JC and WEHI tumors was measured in male BALB/c mice and in female mice displaying complete marrow chimerism, after receiving male bone marrow cells. The gender origin of the perivascular endothelial cells was determined by fluorescent in situ hybridization (FISH) analysis of adjacent cuts of the tumors, using CD31 and Y-chromosomes as markers.

Myocardial protection via the coronary sinus.

Background: Recent reports on facilitated reperfusion therapy re-address interests in coronary sinus interventions (CSI). Patients in whom short time results have been reported earlier were re-evaluated, with the aim of gathering the long-term results of pressure-controlled intermittent coronary sinus occlusion (PICSO) generated in patients with acute myocardial infarction (MI) and revascularization.

Methods And Results: Thirty-four patients with ST elevated MI, in whom complete revascularization was achieved, underwent primary thrombolysis with or without PICSO.

ACE-inhibitor or AT2-antagonist therapy of renal transplant recipients is associated with an increase in serum potassium concentrations.

Background: Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II type 1 receptor blockers (ARB) are frequently prescribed to renal transplant recipients with a reduced glomerular filtration rate (GFR). The aim of this study was to investigate the association of ACEI/ARB use and serum potassium levels in renal graft recipients.

Methods: We conducted an open cohort study of 2041 first renal allograft recipients, transplanted at the Medical University of Vienna between 1990 and 2003.

Expression of the human MTA1 gene in breast cell lines and in breast cancer tissues.

MTA1 was reported as a metastasis-associated gene. Tumors with higher MTA1 mRNA level were shown to have higher rates of invasion and lymph node metastasis and tended to have higher rates of vascular involvement. The majority of invasive breast carcinomas were demonstrated to overexpress MTA1 compared to surrounding normal tissues.

Metal-on-metal hip implants: do they impair renal function in the long-term? A 10-year follow-up study.

Introduction: The aim of our study was to investigate a potential influence of elevated serumcobalt and serumchromiumlevels on renal function at minimum 10 years after implantation of a metal-on-metal hip.

Materials And Methods: Between November 1992 and June 1994 98 patients (44 m, 54 f) with an average age of 56 (22-79) years received a metal-on-metal bearing Metasul. At the time of the 10-year follow-up, 15 patients had died and 8 were lost to follow-up.