ABSTRACT
INTRODUCTION: Engraftment is a critical milestone of the hematopoietic stem cell transplantation (HSCT) process. The immature platelet fraction (IPF) and immature reticulocyte fraction (IRF) are considered early indicators of bone marrow recovery. The objective of this study was to assess these parameters as predictors of HSCT engraftment. METHODS: Neutrophil and platelet engraftment were defined as the first of three consecutive days with an absolute neutrophil count >0.5 × 10(9) /L or platelet count >20 × 10(9) /L, respectively. The IRF cutoff was 12%. Two IPF cutoffs were used: >6.2% and >10%. RESULTS: The study sample comprised 44 patients, of whom 24 had undergone autologous HSCT and 20 had undergone allogeneic HSCT. Absolute neutrophil counts >0.5 × 10(9) /L were preceded by IRF >12% in 86% of patients (38 of 44). Platelet counts >20 × 10(9) /L were preceded by an IPF >6.2% in 90% of patients (37 of 41) and by an IPF >10% in 63% of patients (26 of 41). CONCLUSION: The results show that IRF and IPF are engraftment predictors. Peak in IPF was observed before rise in platelet count, while IRF rises before absolute neutrophil count (ANC) and persists increased. This indicates that IRF and IPF can be considered as new tools for hematopoietic assessment after HSCT.
Subject(s)
Graft Survival , Hematopoietic Stem Cell Transplantation , Platelet Count , Reticulocyte Count , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Leukocyte Count , Male , Middle Aged , Neutrophils , Prognosis , Transplantation, Autologous , Transplantation, Homologous , Young AdultABSTRACT
Intracellular transport based on molecular motors and its regulation are crucial to the functioning of cells. Filamentary tracks of the cells are abundantly decorated with nonmotile microtubule-associated proteins, such as tau. Motivated by experiments on kinesin-tau interactions [Dixit et al., Science 319, 1086 (2008)] we developed a stochastic model of interacting single-headed motor proteins KIF1A that also takes into account the interactions between motor proteins and tau molecules. Our model reproduces experimental observations and predicts significant effects of tau on bound time and run length which suggest an important role of tau in regulation of kinesin-based transport.
Subject(s)
Kinesins/chemistry , Models, Chemical , Models, Molecular , Molecular Motor Proteins/chemistry , tau Proteins/chemistry , Binding Sites , Computer Simulation , Kinesins/ultrastructure , Kinetics , Molecular Motor Proteins/ultrastructure , Motion , Protein Binding , Protein Conformation , tau Proteins/ultrastructureABSTRACT
BACKGROUND: Staged Diabetes Management (SDM) improves glycaemic control and reduces diabetes-related complications in primary care. METHODS: An 18-month randomized controlled cohort study was conducted in two municipalities in the state of Bahia, Brazil, involving 100 patients with Type 2 diabetes in each municipality. In one municipality, healthcare professionals were trained to use SDM customized protocols for clinical decisions and, in the other municipality, no protocols for diabetes care were implemented. We hypothesized that, in the municipality with SDM trained professionals, patients would have better outcomes, including a fall in glycated haemoglobin (HbA(1c)). RESULTS: Improvements in some metabolic parameters were observed in the SDM group, including a 22% decrease in mean random glucose, a significant 15% decrease in mean HbA(1c), a 6% decrease in systolic blood pressure and an 11% decrease in diastolic blood pressure. There were no differences in body mass index and lipid profile. CONCLUSIONS: SDM customized algorithms are effective, practical and easy to use in primary healthcare teams with very limited resources.
Subject(s)
Blood Glucose/metabolism , Diabetes Mellitus, Type 2/therapy , Glycated Hemoglobin/metabolism , Primary Health Care/methods , Adult , Aged , Aged, 80 and over , Brazil , Cohort Studies , Diabetes Mellitus, Type 2/blood , Female , Follow-Up Studies , Humans , Male , Middle Aged , Practice Guidelines as Topic , Primary Health Care/standards , Statistics as Topic , Treatment OutcomeABSTRACT
To study how clinical characteristics influence the risk of peritonitis in African American patients with end-stage renal disease treated with continuous ambulatory peritoneal dialysis (CAPD), we examined the risk of developing a first episode of peritonitis among 1,595 new dialysis patients initially treated by CAPD over a two year period in North Carolina, South Carolina, and Georgia (Network 6). Characteristics examined were demographic and socioeconomic factors, functional status, serum albumin and comorbid conditions. There were 538 initial episodes of peritonitis during an average of 8.8 patient months of follow-up; the time to peritonitis for the entire cohort was 26 months. Factors found to be independently associated with a risk for peritonitis were student status (Odds Ratio and 95% Confidence Interval = 2.4; 1.4 to 4.3), rental housing (1.2; 1.0 to 1.5), and substance abuse (1.9; 1.1 to 3.2). African Americans were 60% more likely to have an initial episode of peritonitis during follow-up than whites (1.6; 1.3 to 1.8). The time to the initial episode was 21 months for African Americans versus 32 months for whites (P < 0.001). Even after adjusting for other factors, African Americans were significantly more likely to develop peritonitis (1.5; 1.2 to 1.8). Thus, the increased risk of peritonitis of African American patients treated by CAPD is independent of other demographic, socioeconomic and comorbid characteristics.
