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1.
Acta Oncol ; 62(6): 648-656, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37338525

RESUMO

INTRODUCTION: The objective of this study was a multicentric evaluation of professional practices, analyzing the irradiation technique itself and its impact on survival and recurrence sites, in primary central nervous system lymphomas (PCNSLs). METHODS: We retrospectively analyzed the technical and clinical records of 79 PCNSL patients included in the database of the national expert network for oculocerebral lymphoma ('LOC') who were treated with brain radiotherapy as first-line treatment for newly diagnosed primary central nervous system lymphoma between 2011 and 2018. RESULTS: The number of patients treated with brain radiotherapy gradually decreased over time. The heterogeneity of radiotherapy prescriptions was significant, and 55% of them did not comply with published recommendations in terms of irradiation dose and/or volume. The proportion of complete responders to induction chemotherapy treated with reduced-dose radiotherapy increased over time. Partial brain radiotherapy was associated with significantly lower overall survival in univariate analysis. In partial responders to induction chemotherapy, increasing the total dose to the brain >30 Gy and adding a boost to the WBRT induced a trend toward improved progression-free and overall survival. Five recurrences (13%) occurred exclusively in the eyes, all in patients whose eyes had been excluded from the irradiation target volume and including 2 patients without ocular involvement at diagnosis. CONCLUSION: The visibility of recommendations for prescribing brain radiotherapy for the treatment of newly diagnosed primary central nervous system lymphoma needs to be improved to harmonize practices and improve their quality. We propose an update of the recommendations.


Assuntos
Neoplasias do Sistema Nervoso Central , Linfoma , Humanos , Neoplasias do Sistema Nervoso Central/radioterapia , Estudos Retrospectivos , Linfoma/radioterapia , Linfoma/patologia , Encéfalo/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Metotrexato , Terapia Combinada
2.
Radiother Oncol ; 176: 127-137, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36195214

RESUMO

BACKGROUND AND PURPOSE: To investigate the association between clinician-scored toxicities and patient-reported health-related quality of life (HRQoL), in early-stage (ES-) and locally-advanced (LA-) non-small cell lung cancer (NSCLC) patients receiving loco-regional radiotherapy, included in the international real-world REQUITE study. MATERIALS AND METHODS: Clinicians scored eleven radiotherapy-related toxicities (and baseline symptoms) with the Common Terminology Criteria for Adverse Events version 4. HRQoL was assessed with the European Organization for Research and Treatment of Cancer core HRQoL questionnaire (EORTC-QLQ-C30). Statistical analyses used the mixed-model method; statistical significance was set at p = 0.01. Analyses were performed for baseline and subsequent time points up to 2 years after radiotherapy and per treatment modality, radiotherapy technique and disease stage. RESULTS: Data of 435 patients were analysed. Pre-treatment, overall symptoms, dyspnea, chest wall pain, dysphagia and cough impacted overall HRQoL and specific domains. At subsequent time points, cough and dysphagia were overtaken by pericarditis in affecting HRQoL. Toxicities during concurrent chemo-radiotherapy and 3-dimensional radiotherapy had the most impact on HRQoL. Conversely, toxicities in sequential chemo-radiotherapy and SBRT had limited impact on patients' HRQoL. Stage impacts the correlations: LA-NSCLC patients are more adversely affected by toxicity than ES-NSCLC patients, mimicking the results of radiotherapy technique and treatment modality. CONCLUSION: Pre-treatment symptoms and acute/late toxicities variously impact HRQoL of ES- and LA-NSCLC patients undergoing different treatment approaches and radiotherapy techniques. Throughout the disease, dyspnea seems crucial in this association, highlighting the additional effect of co-existing comorbidities. Our data call for optimized radiotherapy limiting toxicities that may affect patients' HRQoL.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Transtornos de Deglutição , Neoplasias Pulmonares , Lesões por Radiação , Humanos , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Qualidade de Vida , Neoplasias Pulmonares/tratamento farmacológico , Tosse , Dispneia , Lesões por Radiação/epidemiologia , Lesões por Radiação/etiologia , Medidas de Resultados Relatados pelo Paciente
3.
J Nanosci Nanotechnol ; 21(7): 3847-3852, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33715703

RESUMO

Top-gate amorphous indium gallium zinc oxide (IGZO) thin-film transistors (TFTs) are designed with numerical analysis to control their electron potential energy. Design simulations show the effects of structural design on the electrical characteristics of these TFTs. In particular, the thicknesses of the channel (tch) and conducting (tc) layers, which play vital roles in TFT electrical performance, are varied from 1 to 50 nm to investigate the effect of thicknesses on the electron potential energies of the channel region and the electrode-semiconductor interfaces. The potential energies are precisely optimized for efficient charge transport, injection, and extraction, thus enhancing the electrical performance of these devices. It is also demonstrated that tch mainly affects mobility and threshold voltage, while tc mainly affects on-current. An acceptable threshold voltage of 0.55 V and high mobility of 14.7 cm²V-1s-1 are obtained with a tch of 30 nm and tc of 10 nm. Controllability of the electron potential energies and electrical performance of IGZO TFTs by means of structural design will contribute to realization of next-generation displays that have large areas and high resolutions.

4.
Geriatr Psychol Neuropsychiatr Vieil ; 19(1): 42-52, 2021 Mar 01.
Artigo em Francês | MEDLINE | ID: mdl-33692016

RESUMO

OBJECTIVE: The objective of this study is to determine whether the implementation of regular and structured follow-up of patients with chronic heart failure (CHF), combined with therapeutic education, led to better management of these patients. PATIENTS AND METHOD: This was a monocentric, retrospective study on a cohort of patients with a proven CHF, followed in the Mulhouse region (France), between January 2016 and December 2017, by the Unit for Monitoring Heart Failure Patients (USICAR). These patients benefited from a regular protocolized follow-up and a therapeutic education program for a period of 2 years. The main criterion of this study was: the number of days of hospitalization for HF per year and per patient. The secondary endpoints were: the number of days of hospitalization for cardiac causes other than HF and the number of hospital stays for HF per patient. These criteria were collected over the one-year period before inclusion, at one-year-follow-up, and at two-years-follow-up. RESULTS: 159 patients with a mean age of 72.9 years were included in this study. They all had a CHF, mainly stage I-II NYHA (88.7%), of predominantly ischemic origin (50.9%), with altered left ventricular ejection fraction in 69.2% of cases. The primary endpoint averaged 8.33 days (6.84-10.13) in the year prior to inclusion, 2.6 days (1.51-4.47) in the first year of follow-up, and 2.82 days (1.30-6.11) (p <0.01 for both comparisons). The mean number of days of hospitalization for other cardiac causes other than HF to patient numbers was: 1.73 days (1.16-2.6), 1.81 days (1.04-3.16), and 1.32 days (0.57-3.08) (p = ns). The percentage of hospitalization for HF for each patient was: 69.5% (60.2-77.4) before inclusion, 16.2% (10-25.2) during the first year of follow-up and 19.3% (11-31.8) during the second (p < 0.001 for both comparisons). CONCLUSION: This study demonstrates the value of a protocolized follow-up associated with a therapeutic education program to improve the management of ambulatory CHF patients, particularly for moderate CHF.


Assuntos
Assistência Ambulatorial , Protocolos Clínicos , Insuficiência Cardíaca/terapia , Educação de Pacientes como Assunto , Idoso , Seguimentos , Insuficiência Cardíaca/fisiopatologia , Hospitalização , Humanos , Estudos Retrospectivos , Volume Sistólico , Função Ventricular Esquerda
5.
J Clin Med ; 9(10)2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32993030

RESUMO

This study sought to determine whether the implementation of regular and structured follow-up of patients with chronic heart failure (CHF), combined with therapeutic education and remote monitoring solution, leads to better management. This was a single-center retrospective study conducted in a cohort of patients with proven CHF who were followed up in the Mulhouse region (France) between January 2016 and December 2017 by the Unité de Suivi des Patients Insuffisants Cardiaques (USICAR) unit. These patients received regular protocolized follow-up, a therapeutic education program, and several used a telemedicine platform for a two-year period. The primary endpoint was the number of days hospitalized for heart failure (HF) per patient per year. The main secondary endpoints included the number of days hospitalized for a heart condition other than HF and the number of hospital stays for HF per patient. These endpoints were collected during the year preceding enrollment, at one year of follow-up, and at two years of follow-up. The remote monitoring solution was evaluated on the same criterion. Overall, 159 patients with a mean age of 72.9 years were included in this study. They all had CHF, mainly NYHA Class I-II (88.7%), predominantly of ischemic origin (50.9%), and with altered left ventricular ejection fraction in 69.2% of cases. The mean number of days hospitalized for HF per patient per year was 8.33 (6.84-10.13) in the year preceding enrollment, 2.6 (1.51-4.47) at one year of follow-up, and 2.82 at two years of follow-up (1.30-6.11) (p < 0.01 for both comparisons). The mean number of days hospitalized for a heart condition other than HF was 1.73 (1.16-2.6), 1.81 (1.04-3.16), and 1.32 (0.57-3.08), respectively (p = ns). The percentage of hospitalization for HF for each patient was 69.5% (60.2-77.4), 16.2% (10-25.2), and 19.3% (11-31.8), respectively (p < 0.001 for both comparisons). In the group telemedicine, the mean number of days hospitalized for HF per patient per year was 8.33 during the year preceding enrollment, 2.3 during the first year of follow-up, and 1.7 during the second. This difference was significant (p < 0.001). The "number of days hospitalized for a heart condition other than HF" was significantly reduced in the group of patient's beneficiating from the remote monitoring solution. This study demonstrates the value of a protocolized follow-up associated with a therapeutic optimization, therapeutic education program, and the use of a remote monitoring solution to improve the management of ambulatory patients with CHF, particularly of moderate severity.

6.
J Colloid Interface Sci ; 573: 165-175, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32278948

RESUMO

Unsupported nanoparticles are now recognized as model catalysts to evaluate the intrinsic activity of metal particles, irrespectively of that of the support. Co nanoparticles with different morphologies, rods, diabolos and cubes have been prepared by the polyol process and tested for the acceptorless catalytic dehydrogenation of alcohols under solvent-free conditions. Rods crystallize with the pure hcp structure, diabolos with a mixture of hcp and fcc phases, while the cubes crystallize in a complex mixture of hcp, fcc and ε-Co phases. All the cobalt particles are found to be highly selective towards the oxidation of a model secondary alcohol, octan-2-ol, into the corresponding ketone while no significant activity is found with octan-1-ol. Our results show the strong influence of particle shape on the activity and catalytic stability of the catalysts: Co nanorods display the highest conversion (85%), selectivity (95%) and recyclability compared to Co diabolos and Co cubes. We correlate the nanorods excellent stability with a strong binding of carboxylate ligands on their {1 1 2¯ 0} facets, preserving their crystalline superficial structure, as evidenced by phase modulation infrared reflection absorption spectroscopy.

7.
J Nanosci Nanotechnol ; 20(9): 5486-5490, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32331122

RESUMO

We explore the effect of high-speed blade coating on electrical characteristics of conjugated polymer-based thin-film transistors (TFTs). As the blade-coating speed increased, the thickness of the polymer thin-film was naturally increased while the surface roughness was found to be unchanged. Polymer TFTs show two remarkable tendencies on the magnitude of field-effect mobility with increasing blade-coating speed. As the blade-coating speed increased up to 2 mm/s, the fieldeffect mobility increased to 4.72 cm²V-1s-1. However, when the coating speed reached 6 mm/s beyond 2 mm/s, the field-effect mobility rather decreased to 3.18 cm²V-1s-1. The threshold voltage was positively shifted from 2.09 to 8.29 V with respect to increase in blade-coating speed.

8.
J Nanosci Nanotechnol ; 20(8): 4666-4670, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32126638

RESUMO

Electrically enhanced triboelectric nanogenerators (TENGs) using 3D fabrics and polydimethylsiloxane (PDMS) are suggested for next-generation wearable electronics. TENGs with fabric-fabric- fabric (FFF) and PDMS-fabric-PDMS (PFP) structures were fabricated with ordinary 2D fabrics and honeycomb-like 3D fabrics. A 3D fabric TENG with an FFF structure showed an output voltage of 7 V, 7 times higher than a 2D fabric FFF structured TENG. Interestingly, an extremely high output voltage of 240 V was achieved by a 3D fabric PFP structured TENG. This was attributed to the high surface frictional triboelectric effect between fabric and PDMS and also marginal 3D structure in the 3D fabric active layer.

9.
J Nanosci Nanotechnol ; 20(8): 4878-4883, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32126669

RESUMO

Few reports have researched on utilization of laser power conversion systems for wireless power transfer in aeronautical applications. III-V compound semiconductors are commonly used as photovoltaic (PV) power converters in the previous studies. We propose the prospects of using organic absorbers as PV power converters. For laser power conversion to be applied for portable devices, the PV module should be easily processable, thin, low-weight, and printable on flexible substrates. Organic PVs provide all the above advantages, and thus, could serve as a potential candidate for laser power harvesting applications. Moreover, they can also be made transparent, which could be utilized in power harvesting lamination coatings and windows. We had simulated the possibility of using single-junction and tandem photovoltaic structures for 670 nm and 850 nm laser power harvesting. FDTD simulations were conducted to optimize the PV structure in order to maximize the absorption at the laser wavelengths. A maximum PCE of 16.17% for single-junction PV and 24.85% for tandem PV was theoretically obtained.

10.
Front Immunol ; 11: 34, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32038663

RESUMO

High dose intravenous immunoglobulin (IVIG) are widely used after kidney transplantation and its biological effect on T and B cell phenotype in the context of maintenance immunosuppression was not documented yet. We designed a monocentric prospective cohort study of kidney allograft recipients with anti-HLA donor specific antibodies (DSA) without acute rejection on screening biopsies treated with prophylactic high-dose IVIG (2 g/kg) monthly for 2 months. Any previous treatment with Rituximab was an exclusion criterion. We performed an extensive analysis of phenotypic and transcriptomic T and B lymphocytes changes and serum cytokines after treatment (day 60). Twelve kidney transplant recipients who completed at least two courses of high-dose IVIG (2 g/kg) were included in a median time of 45 (12-132) months after transplant. Anti-HLA DSA characteristics were similar before and after treatment. At D60, PBMC population distribution was similar to the day before the first infusion. CD8+ CD45RA+ T cells and naïve B-cells (Bm2+) decreased (P = 0.03 and P = 0.012, respectively) whereas Bm1 (mature B-cells) increased (P = 0.004). RORγt serum mRNA transcription factor and CD3 serum mRNA increased 60 days after IVIG (P = 0.02 for both). Among the 25 cytokines tested, only IL-18 serum concentration significantly decreased at D60 (P = 0.03). In conclusion, high dose IVIG induced limited B cell and T cell phenotype modifications that could lead to anti-HLA DSA decrease. However, no clinical effect has been isolated and the real benefit of prophylactic use of IVIG after kidney transplantation merits to be questioned.


Assuntos
Aloenxertos , Rejeição de Enxerto/terapia , Imunização Passiva/métodos , Imunoglobulinas Intravenosas/administração & dosagem , Transplante de Rim , Linfócitos/imunologia , Fenótipo , Transcriptoma , Transplantados , Adulto , Idoso , Feminino , Rejeição de Enxerto/sangue , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/efeitos dos fármacos , Sobrevivência de Enxerto/imunologia , Antígenos HLA/imunologia , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doadores de Tecidos , Transplante Homólogo
11.
Polymers (Basel) ; 11(9)2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31484316

RESUMO

A comparative study of the electrical performance of triboelectric nanogenerators (TENGs) with plain- and 2/1 twill-woven cotton textiles was conducted. Furthermore, the microstructures of the cotton fiber surfaces were examined to understand the fundamental mechanical interaction among the cotton fibers in the TENGs. The TENG with 2/1 twill-woven cotton textiles exhibited higher output voltages compared to that with plain-woven cotton textiles. The difference in the output voltage between the two types of TENGs resulted from the difference in triboelectric charge generation between the constituent cotton textiles. The higher output voltage of the TENG with 2/1 twill-woven cotton textiles was attributed to the higher density in triboelectric interactions among the cotton fiber molecules.

12.
Radiat Oncol ; 14(1): 83, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118057

RESUMO

BACKGROUND: Low-level laser therapy (LLLT) also called Photobiomodulation therapy (PBMT) could reduce oral mucositis (OM) incidence and severity in head and neck cancer patients treated by chemoradiotherapy, however randomised data about efficacy and safety are missing with curative dose 4 J/cm2. METHODS: This phase III trial was conducted in patients with oral cavity, or oro/hypopharyngeal cancers (stage III or IV). Patients were treated by lasertherapy on OM lesions grade ≥ 2 (4 J/cm2 or placebo), during chemoradiotherapy and until recovery. Severity of OM (incidence and duration of grades ≥3) was used as primary endpoint and blindly assessed. RESULTS: Among 97 randomised patients, 83 patients (85.6%) could be assessed finally (erroneous inclusions, chemoradiotherapy interruptions) and 32 patients had no lasertherapy because of unreachable OM lesions. Randomisation and population characteristics (sex ratio, age, chemoradiotherapy procedures, toxicities incidence) were still comparable between the two LLLT/PBMT groups. An acute OM (grade ≥ 3) was observed in 41 patients (49.4%): 23 patients (54.8%) of the active laser group versus 18 (43.9%) in the control group (modified intend to treat, p = 0.32). Median time before occurrence of OM ≥ grade 3 in half of the patients was 8 weeks in active laser group (vs. 9 weeks in control group). However, 95% of patients exhibited a very good tolerance of LLLT/PBMT. CONCLUSIONS: This study assessed LLLT/PBMT according to the Multinational Association of Supportive care in Cancer recommendations but lacked power. LLLT/PBMT was well tolerated with a good safety profile, which promotes its use in clinical routine for severe OM treatment. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01772706 . TITLE: Laser Mucite ORL: Effectiveness of Laser Therapy for Mucositis Induced by a Radio-chemotherapy in Head and Neck Cancer (LaserMucite). Study Start Date: October 2008. Primary Completion Date: October 2016. Responsible Party: Institut de Cancérologie de l'Ouest - Paul Papin. Principal Investigator: Eric Jadaud, M.D., Institut de Cancérologie de l'Ouest - Paul Papin. FUNDING: French Ministry of Health, French national funding scheme (PHRC 2008).


Assuntos
Carcinoma de Células Escamosas/terapia , Quimiorradioterapia/efeitos adversos , Neoplasias de Cabeça e Pescoço/terapia , Terapia com Luz de Baixa Intensidade/métodos , Qualidade de Vida , Estomatite/radioterapia , Idoso , Carcinoma de Células Escamosas/patologia , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Índice de Gravidade de Doença , Estomatite/etiologia
13.
J Nanosci Nanotechnol ; 19(8): 4638-4642, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30913760

RESUMO

We demonstrate the preparation of water-dispersible polyaniline:polystyrene sulfonate (PANI:PSS), which was doped with camphorsulfonic acid (CSA) and co-doped with poly (4-styrenesulfonic acid) (PSS). The proper formation of the PANI and PANI:PSS was verified by FTIR measurements. The synthesized samples were further characterized via UV-vis spectroscopy. The intensive study on the current density (J)-voltage (V) characteristics within the temperature range (143-303 K) of the synthesized sample was performed systematically. The electrical study shows that the doping of PANI with CSA as a dopant and PSS as a co-dopant significantly improves the overall semi-conducting property of PANI. The detailed analysis of the current density (J)-voltage (V) curve at various temperatures reveals the electrical conduction behavior, which follows the trap-dependent space-charge limited conduction (SCLC) mechanism.

14.
Int J Radiat Oncol Biol Phys ; 104(2): 365-373, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30776452

RESUMO

PURPOSE: The "PRAVACUR" phase 2 trial (NCT01268202) assessed the efficacy of pravastatin as an antifibrotic agent in patients with established cutaneous and subcutaneous radiation-induced fibrosis (RIF) after head and neck squamous cell carcinoma (HNSCC) radiation therapy and/or radiochemotherapy. METHODS AND MATERIALS: The main inclusion criteria were: NSCC in remission, grade ≥2 cutaneous and subcutaneous neck RIF (National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0), and no current treatment with statins or fibrates. Patients received pravastatin 40 mg/d for 12 months. The primary endpoint was reduction of RIF thickness by more than 30% at 12 months, as measured by cutaneous high-frequency ultrasonography. Secondary endpoints included RIF severity reduction, pravastatin tolerance, and quality of life. RESULTS: Sixty patients with grade 2 (n = 37), grade 3 (n = 22), or grade 4 (n = 1) RIF were enrolled from February 2011 to April 2016. The mean interval between RIF diagnosis and pravastatin initiation was 17.1 months. Pravastatin was stopped before 11 months of treatment in 18 patients (because of grade ≥2 adverse events related to pravastatin in 8 patients [13%]). In the 40 patients in whom pravastatin efficacy was assessed by high-frequency ultrasonography at baseline and at 12 months of treatment, a reduction of RIF thickness ≥30% was observed in 15 of 42 patients (35.7%; 95% confidence interval, 21.6%-52.0%). At the 12-month clinical evaluation, RIF severity was decreased in 50% of patients (n = 21; 95% confidence interval, 34.2%-65.8%), and the patients' self-perception, mood state, and social functioning were significantly improved. Pravastatin was well tolerated, with a very low occurrence of grade 3 toxicities (myalgia, n = 1) and grade 2 toxicities (myalgia/arthralgia or esophagitis, n = 3). CONCLUSIONS: This phase 2 prospective study supports the notion of radioinduced fibrosis reversibility. It showed that pravastatin (40 mg/d for 12 months) is an efficient antifibrotic agent in patients with grade ≥2 cutaneous and subcutaneous fibrosis after HNSCC radiation therapy.


Assuntos
Fármacos Dermatológicos/uso terapêutico , Neoplasias de Cabeça e Pescoço/radioterapia , Pravastatina/uso terapêutico , Lesões por Radiação/tratamento farmacológico , Pele/efeitos da radiação , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Intervalos de Confiança , Fármacos Dermatológicos/efeitos adversos , Fibrose , Humanos , Pravastatina/efeitos adversos , Estudos Prospectivos , Qualidade de Vida , Lesões por Radiação/patologia , Pele/patologia
15.
Front Immunol ; 10: 2908, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31921167

RESUMO

The induction of specific and sustainable tolerance is a challenging issue in organ transplantation. The discovery of the immunosuppressive properties of apoptotic cells in animal models has paved the way for their use in human transplantation. In this work, we aimed to define a stable, reproducible, and clinically compatible production procedure of human apoptotic cells (Apo-cells). Using a clinically approved extracorporeal photopheresis technique, we have produced and characterized phenotypically and functionally human apoptotic cells. These Apo-cells have immunosuppressive properties proved in vitro and in vivo in NOD/SCID/γC mice by their capacity to modulate an allogeneic response following both a direct and an indirect antigen presentation. These results brought the rationale for the use of Apo-cells in tolerance induction protocol for organ transplantation.


Assuntos
Apresentação de Antígeno , Apoptose/imunologia , Tolerância Imunológica , Fotoferese , Animais , Humanos , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID
16.
Nephrol Ther ; 14(3): 179-188, 2018 May.
Artigo em Francês | MEDLINE | ID: mdl-29706414

RESUMO

Recurrence of glomerular disease after renal transplantation is a frequent cause of graft loss. Incidence, risk factors and outcome of recurrence are widely due to the underlying glomerular disease. Graft biopsy analysis is required to confirm the definitive diagnosis of recurrence and to start an appropriate therapy that, in some cases, remains challenging to prevent graft failure. Increased use of protocol biopsy and recent advances in our understanding of the pathogenesis of some glomerular diseases with the identification of some relevant biomarkers provide a unique opportunity to initiate kidney-protective therapy at early stages of recurrence on the graft. This review summarizes our current knowledge on the management of many recurrent primary and secondary glomerulonephritis after kidney transplantation.


Assuntos
Glomerulonefrite/terapia , Transplante de Rim/efeitos adversos , Rim/patologia , Glomerulonefrite/etiologia , Sobrevivência de Enxerto , Humanos , Prognóstico , Recidiva , Fatores de Risco
17.
Nephrol Dial Transplant ; 33(4): 709-716, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29346631

RESUMO

Background: In kidney transplant recipients, anticardiolipin (ACL) antibodies without antiphospholipid syndrome (APS) are found in up to 38% of patients and could be associated with thrombotic events (TEs). However, the prognostic role of ACL regarding kidney transplant and patients outcomes have still not been well defined. Methods: We conducted an observational, monocentric, retrospective cohort study including 446 kidney transplant recipients and standardized follow-up: 36-month allograft and patient survival, 12-month estimated glomerular filtration rate (eGFR) and 3- and 12-month screening biopsies. Results: ACL tests were run on 247 patients, 101 were positive (ACL+ group, 41%) and 146 were negative (ACL- group, 59%). Allografts and patient survival within 36 months as TE were similar between both groups [hazard ratio (HR) = 1.18 and HR = 0.98, respectively]. The 12-month eGFR was significantly lower in the ACL+ group [median (95% confidence interval) 48.5 (35.1-60.3) versus 51.9 (39.1-65.0) mL/min/1.73 m2, P= 0.042]. ACL+ was independently associated with eGFR decrease (P = 0.04). In 12-month screening biopsies, tubular atrophy was significantly more severe in the ACL+ group compared with the ACL- group (P = 0.02). Conclusions: ACL without APS before kidney transplantation is an independent risk factor of eGFR decline within the first year post-transplant without over-incidence of TEs. Specific immunosuppressive therapy including mammalian target of rapamycin inhibitors should be discussed in the future.


Assuntos
Anticorpos Anticardiolipina/efeitos adversos , Taxa de Filtração Glomerular , Rejeição de Enxerto/etiologia , Sobrevivência de Enxerto , Nefropatias/cirurgia , Transplante de Rim/efeitos adversos , Adulto , Anticorpos Anticardiolipina/sangue , Anticorpos Anticardiolipina/imunologia , Feminino , Rejeição de Enxerto/sangue , Rejeição de Enxerto/patologia , Humanos , Nefropatias/sangue , Nefropatias/imunologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Transplantados
18.
Transpl Int ; 31(4): 377-385, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28945291

RESUMO

Solid organ transplantation societies recommend a relative contraindication of transplantation for people with bipolar or psychotic disorders. Very few data are available on the outcome of kidney transplantation and the increased risk of kidney disease in those patients. We conducted a retrospective multicenter cohort study (1979-2014) including kidney allograft recipients with either bipolar (BD) or psychotic disorders prior to transplant. Objectives were kidney allograft and patient outcomes compared to a matched control group without psychiatric disorders and the evolution of psychiatric disorder at 60 months after transplantation. Forty-seven patients including 25 women were identified, 34 with BD and 13 with psychotic disorder. Patients' overall cumulative death rates at 60 months were not significantly different in both groups [12.2%; 95% confidence interval: (4.5-24.1) in the group with psychiatric disorder versus 5.2%; (1.7-11.7) in control group P = 0.11] as for cumulative allograft loss rates [11.7% (3.5-25.2) vs. 9.4% (4.4-16.8) in control group (P = 0.91)]. Twenty-three patients (16 with BD and seven with psychotic disorder) experienced at least one psychiatric relapse [incidence rate: 1.8/100 persons- months; 95% CI; (1.2-2.7)] totaling 13 hospitalizations within 60 months of follow-up. Four patients stopped immunosuppressive therapy leading to allograft loss in three. Our study suggests that patients with BD or psychotic disorders have to be considered for renal transplantation with close psychiatric follow-up after transplant.


Assuntos
Transtorno Bipolar/complicações , Falência Renal Crônica/complicações , Transplante de Rim/mortalidade , Complicações Pós-Operatórias/epidemiologia , Transtornos Psicóticos/complicações , Adulto , Feminino , França/epidemiologia , Sobrevivência de Enxerto , Humanos , Falência Renal Crônica/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
19.
Clin J Am Soc Nephrol ; 12(10): 1663-1670, 2017 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-28818847

RESUMO

BACKGROUND AND OBJECTIVES: Post-transplant lymphoproliferative disorders arising after kidney transplantation portend an increased risk of morbidity and mortality. Retransplantation of patients who had developed post-transplant lymphoproliferative disorder remains questionable owing to the potential risks of recurrence when immunosuppression is reintroduced. Here, we investigated the feasibility of kidney retransplantation after the development of post-transplant lymphoproliferative disorder. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We reviewed the data from all patients who underwent kidney retransplantation after post-transplant lymphoproliferative disorder in all adult kidney transplantation centers in France between 1998 and 2015. RESULTS: We identified a total of 52 patients with kidney transplants who underwent 55 retransplantations after post-transplant lymphoproliferative disorder. The delay from post-transplant lymphoproliferative disorder to retransplantation was 100±44 months (28-224); 98% of patients were Epstein-Barr virus seropositive at the time of retransplantation. Induction therapy for retransplantation was used in 48 patients (i.e., 17 [31%] patients received thymoglobulin, and 31 [57%] patients received IL-2 receptor antagonists). Six patients were also treated with rituximab, and 53% of the patients received an antiviral drug. The association of calcineurin inhibitors, mycophenolate mofetil, and steroids was the most common maintenance immunosuppression regimen. Nine patients were switched from a calcineurin inhibitor to a mammalian target of rapamycin inhibitor. One patient developed post-transplant lymphoproliferative disorder recurrence at 24 months after retransplantation, whereas post-transplant lymphoproliferative disorder did not recur in 51 patients. CONCLUSIONS: The recurrence of post-transplant lymphoproliferative disorder among patients who underwent retransplantation in France is a rare event.


Assuntos
Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Transtornos Linfoproliferativos/cirurgia , Adulto , Idoso , Substituição de Medicamentos , Quimioterapia Combinada , Estudos de Viabilidade , Feminino , França , Sobrevivência de Enxerto , Humanos , Imunossupressores/administração & dosagem , Transtornos Linfoproliferativos/diagnóstico , Transtornos Linfoproliferativos/etiologia , Masculino , Pessoa de Meia-Idade , Recidiva , Sistema de Registros , Reoperação , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
20.
Sci Rep ; 7: 46365, 2017 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-28402330

RESUMO

We demonstrated modulation of charge carrier densities in all-solution-processed organic field-effect transistors (OFETs) by modifying the injection properties with self-assembled monolayers (SAMs). The all-solution-processed OFETs based on an n-type polymer with inkjet-printed Ag electrodes were fabricated as a test platform, and the injection properties were modified by the SAMs. Two types of SAMs with different dipole direction, thiophenol (TP) and pentafluorobenzene thiol (PFBT) were employed, modifying the work function of the inkjet-printed Ag (4.9 eV) to 4.66 eV and 5.24 eV with TP and PFBT treatments, respectively. The charge carrier densities were controlled by the SAM treatment in both dominant and non-dominant carrier-channel regimes. This work demonstrates that control of the charge carrier densities can be efficiently achieved by modifying the injection property with SAM treatment; thus, this approach can achieve polarity conversion of the OFETs.

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