Delayed kidney allograft function after simultaneous pancreas-kidney transplantation.

Background: Simultaneous pancreas-kidney transplantation (SPKT) is one of the treatments for insulin-dependent chronic renal failure patients.

Methods: One-year patient and kidney allograft survival rates of 150 patients undergoing SPKT were subjected to Cox regression and Kaplan-Meier analyses. Uni- and multivariate methods identified risk factors involved in allograft and patient survival.

Simultaneous pancreas-kidney transplantation: which organ should be transplanted first?

Simultaneous pancreas-kidney transplantation (SPKT) has been accepted as treatment for type I diabetic patients with end-stage renal disease. Its success depends largely on the surgical technique. This study sought to compare groups of SPKT with initial pancreas implantation versus initial kidney implantation.

Socioeconomic disparities in infant mortality after nonaccidental trauma: a multicenter study.

Background: While disparities in abuse-related mortality between minority and white infants have been reported, the influence of socioeconomic status on outcome has not been evaluated. The goal of this study was to determine the impact of socioeconomic status and race on outcomes for abused infants using multiinstitutional data.

Methods: Data on infants (<12 months old) with abusive injuries over a 5-year period were obtained from nine U.

Defect in efferocytosis leads to alternative activation of macrophages in Francisella infections.

The macrophage is a versatile cell type that can sense and respond to a particular need based on the conditions of the microenvironment. Some studies have recently suggested that pathogens can directly influence the polarization of macrophages. As Francisella infections are characterized by intense necrotic infiltrates in the lung as well as in distal sites of infection, we sought to investigate whether pulmonary Francisella infections could cause the polarization of alternatively activated macrophages (M2/aaMs).

Unnecessary imaging, not hospital distance, or transportation mode impacts delays in the transfer of injured children.

Objectives: Timely transfer of injured children to pediatric trauma centers (PTCs) that can address their unique needs is important. This study was designed to understand the characteristics of transferred injured children.

Methods: Data from our level I PTC over 5 years (2002-2006) were reviewed.

Evaluation of fungal adherence to plasma-modified polymethylmethacrylate.

There is a propensity for fungal adherence to the polymethylmethacrylate used for making denture bases. Therefore, this study investigated whether surface modifications with plasma treatments would reduce the adherence of Candida albicans to a denture base resin. Samples (n = 180) with smooth and rough surfaces were made and divided into five groups: control - non-treated; experimental groups - submitted to plasma treatments to obtain surfaces with different hydrophobicities (Ar/50 W; ArO(2) /70 W; AAt/130 W) or with incorporated fluoride (Ar/SF(6) 70 W).

Development, implementation, and assessment of a distance module in endocrine physiology.

This study aimed to develop, implement, and assess a distance module in endocrine physiology in TelEduc for undergraduate nursing students from a public university in Brazil, with a sample size of 44 students. Stage 1 consisted of the development of the module, through the process of creating a distance course by means of the Web. Stage 2 was the planning of the module's practical functioning, and stage 3 was the planning of student evaluations.

Belatacept in clinical and experimental transplantation - progress and promise.

Belatacept is a fusion protein composed of the Fc fragment of a human IgG(1) immunoglobulin linked to the extracellular domain of cytotoxic T-lymphocyte-associated antigen 4 (CTLA4). CTLA4 is a molecule crucial for T-cell costimulation, selectively blocking the process of T-cell activation. Belatacept binds surface costimulatory ligands (CD80 and CD86) of antigen-presenting cells.

The management of incidental findings in neuro-imaging research: framework and recommendations.

This paper addresses the question of how incidental findings (IFs) in clinical research should be managed by researchers, focusing in detail on IFs discovered in neuroimaging research. It begins by engaging the larger research ethics issue of whether researchers have any obligations of clinical care to participants, and assesses the content and merits of one particular framework for answering this question, Richardson and Belsky's ancillary care model. From here the paper develops an organizational structure for integrating the ancillary care model with existing research ethics standards, with the aim of better understanding their respective domains.

Labile plasma iron generation after intravenous iron is time-dependent and transitory in patients undergoing chronic hemodialysis.

Iron supplementation in hemodialysis patients is fundamental to erythropoiesis, but may cause harmful effects. We measured oxidative stress using labile plasma iron (LPI) after parenteral iron replacement in chronic hemodialysis patients. Intravenous iron saccharate (100 mg) was administered in patients undergoing chronic hemodialysis (N = 20).

Analysis of reoperations and their impact on the results of pancreas transplantation.

Background: Many factors, including the advances in surgical techniques and immunosuppression, have been brought significant improvement to graft and patient survivals of patients undergoing pancreatic transplantations. However, one third of these patients require reoperations (ReOps).

Purpose: We sought to evaluate the distribution of ReOps in the early or late postoperative period and analyze their impact on patient and graft survivals.

Multivariate analysis of risk factors for early loss of pancreas grafts among simultaneous pancreas-kidney transplants.

Unlabelled: To evaluate the risk factors for pancreas graft loss within 3 months postoperatively among 170 simultaneous pancreas-kidney transplantation (SPKT) we examined 38 variables.

Methods: Twenty-two variables were related to recipients; 12 to donors and 4 to the surgical procedure. In addition the latest follow-up dates as well as the transplant and/or death dates.

Family history of diabetes as a new determinant of insulin sensitivity and secretion in patients who have undergone a simultaneous pancreas-kidney transplant.

Objectives: We used homeostasis model assessment to investigate insulin sensitivity and secretion after a simultaneous pancreas-kidney transplant or kidney transplant alone. In that model, fasting plasma glucose and C-peptide levels are used to evaluate insulin sensitivity and beta-cell function.

Materials And Methods: Factors (eg, age, sex, race, delayed kidney allograft function) were correlated with homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin sensitivity values after simultaneous pancreas-kidney transplant (n=89) or kidney transplant alone (n=68), and the results were compared with those in healthy subjects (n=49).

Hemoglobin and hematocrit at the end of hemodialysis: a better way to adjust erythropoietin dose?

A severe disadvantage of administration of recombinant human erythropoietin to hemodialysis patients has been reported. A significant correlation has been shown with hemoglobin values determined online by use of the blood volume monitor (BVM) and by laboratory measurement. Online hemoglobin and hematocrit were measured by use of the BVM during hemodialysis session.

Toxicological and phytochemical studies of Aspidosperma subincanum Mart. stem bark (Guatambu).

Aspidosperma subincanum Mart. is widely used in Brazilian folk medicine to treat digestive disorders. In this study, acute and subchronic toxicity and cytotoxicity of stem bark ethanolic extract of Aspidosperma subincanum (EEAs) have been evaluated.

Antibody-mediated rejection (AMR) after pancreas and pancreas-kidney transplantation.

Antibody-mediated rejection (AMR) requires specific diagnostic tools and treatment and is associated with lower graft survival. We prospectively screened C4d in pancreas (n = 35, in 27 patients) and kidney (n = 33, in 21 patients) for cause biopsies. Serum amylase and lipase, amylasuria, fasting blood glucose (FBG) and 2-h capillary glucose (CG) were also analysed.

Proven and putative vectors of American cutaneous leishmaniasis in Brazil: aspects of their biology and vectorial competence.

The aim of the present review is to give relevant information on aspects of the biology and ecology, including the vectorial competence of Lutzomyia sand fly species suggested as vectors of American cutaneous leishmaniasis in Brazil. The disease, due to Leishmania (Viannia) braziliensis, has been registered in most municipalities in all the Brazilian states and its transmission is associated with more than one sand fly species in each geographical region. A variety of Leishmania species can be found in the Amazon basin, where different epidemiological chains have been detected with the participation of different phlebotomine vectors.

Differential midgut attachment of Leishmania (Viannia) braziliensis in the sand flies Lutzomyia (Nyssomyia) whitmani and Lutzomyia (Nyssomyia) intermedia.

The interaction between Leishmania and sand flies has been demonstrated in many Old and New World species. Besides the morphological differentiation from procyclic to infective metacyclic promastigotes, the parasite undergoes biochemical transformations in its major surface lipophosphoglycan (LPG). An upregulation of beta-glucose residues was previously shown in the LPG repeat units from procyclic to metacyclic phase in Leishmania (Viannia) braziliensis, which has not been reported in any Leishmania species.

Mycophenolate mofetil versus enteric-coated mycophenolate sodium after simultaneous pancreas-kidney transplantation.

Introduction: Adverse gastrointestinal events are frequent after mycophenolate use. The objectives of the present study were to report the incidence of acute noninfectious diarrhea, to determine the risk factors, and to compare the severity of reactions between mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS) after simultaneous pancreas kidney transplantation (SPKT).

Methods: We included 165 SPKT patients from December 2000 to May 2007.

Extreme subcutaneous, intramuscular and inhaled insulin resistance treated by pancreas transplantation alone.

Diabetes mellitus with resistance to insulin administered subcutaneously or intramuscularly (DRIASM) is a rare syndrome and is usually treated with continuous intravenous insulin infusion. We present here two cases of DRIASM in 16 and 18 years female patients that were submitted to pancreas transplantation alone (PTA). Both were diagnosed with type 1 diabetes as young children and had labile glycemic control with recurrent episodes of diabetic ketoacidosis.

Severity of head computed tomography scan findings fail to explain racial differences in mortality following child abuse.

Introduction: Differences in head injury severity may not be fully appreciated in child abuse victims. The purpose of this study was to determine if differential findings on initial head computed tomography (CT) scan could explain observed differential outcome by race.

Methods: We identified 164 abuse patients from our trauma registry with an Injury Severity Score (ISS) > or = 15.

Kidney transplant in diabetic patients: modalities, indications and results.

Background: Diabetes is a disease of increasing worldwide prevalence and is the main cause of chronic renal failure. Type 1 diabetic patients with chronic renal failure have the following therapy options: kidney transplant from a living donor, pancreas after kidney transplant, simultaneous pancreas-kidney transplant, or awaiting a deceased donor kidney transplant. For type 2 diabetic patients, only kidney transplant from deceased or living donors are recommended.

The evolution of diabetic chronic complications after pancreas transplantation.

Pancreas transplantation is an invasive procedure that can restore and maintain normoglycemic level very successfully and for a prolonged period in DM1 patients. The procedure elevates the morbimortality rates in the first few months following the surgery if compared to kidney transplants with living donors, but it offers a better quality of life to patients.Although controversial, several studies have shown the stabilization or the improvement of some of the chronic complications related to diabetes, as well as the extra number of years of life that patients submitted to a double pancreas-kidney transplantation may gain.

Effect of fruit and leaves of Meliaceae plants (Azadirachta indica and Melia azedarach) on the development of Lutzomyia longipalpis larvae (Diptera: Psychodidae: Phlebotominae) under experimental conditions.

This no-choice, laboratory study focuses on the feeding of dried, ground, homogeneous powdered, unprocessed fruit and leaves of Azadirachta indica and Melia azedarach to Lutzomyia longipalpis larvae to determine the effects on their mortality and metamorphosis. A. indica and M.

Pancreas transplantation alone in children: a case report.

Pancreas transplantation (PT) is a relatively uncommon therapy for non-uremic type 1 diabetes, as the severity of diabetes must warrant the risk of immunosuppression. In pediatric diabetic patients, who are less likely to display uremia because of the duration of diabetes, there is very little experience with pancreas transplantation alone (PTA). This report describes a 13-yr-old male PTA recipient.