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Effect of Hepatitis C Treatment on Renal Function in Liver Transplant Patients

Journal of Clinical and Translational Hepatology 2018年第4期6卷 391-395页

作者： Mohamed Shoreibah john romano Ornar T.Sims Yuqi Guo DeAnn Jones Krishna Venkata Vishnu Kommineni Jordan Orr Paul Fitzmorris Omar I.Massoud Division of Gastroenterology&Hepatology School of MedicineUniversity of Alabama at BirminghamBirminghamALUSA Department of Internal Medicine School of MedicineUniversity of Alabama at BirminghamBirminghamALUSA Department of Social Work College of Arts and SciencesUniversity of Alabama at BirminghamBirminghamALUSA Department of Health Behavior School of Public HealthUniversity of Alabama at BirminghamBirminghamALUSA Center for AIDS Research School of MedicineUniversity of Alabama at BirminghamBirminghamALUSA School of Social Work University of AlabamaTuscaloosaALUSA Department of Pharmacology University of Alabama at BirminghamBirminghamALUSA Division of Gastroenterology and Hepatology Department of MedicineVanderbilt UniversityNashvilleTNUSA

Background andAims:Hepatitis C Virus(HCV)is uniformly recurrent after liver transplant(LT)and recurrence is associated with an increased risk of *** medications increase the risk of chronic kidney disease,and the presence of chronic kidney disease presents a challenge for HCV treatment in LT *** aim of this study was to assess changes in glomerular filtration rates(GFRs)of LT recipients receiving HCV ***:This is a retrospective study of LT patients who received HCV treatment between 2015 and 2016(n=60).The outcomes of interest were differences in serum creatinine levels and in GFR,measured at treatment initiation and at 24 weeks after *** average age of the patients was 59 years-old,and 17%were cirrhotic and 67%were *** patients received sofosbuvir/ledipasvir without ***:All patients achieved sustained virologic response at 12 weeks after treatment(SVR12).At baseline,55%of patients had GFR60 mL/min per 1.73 *** those patients,GFR did not change in 81%,and 19%had worsened *** the entire cohort,65%of patients had improved or stable GFR and 35%had worsened *** average change in serum creatinine between baseline and 24 weeks was 0.10(p=0.18).Conclusions:This study showed improved or unchanged GFR in 65%and worsened GFR in 35%of LT recipients who achieved *** of GFR was more frequently encountered in those with impaired renal function at *** should be used when treating HCV in LT recipients,especially those with baseline status of renal impairment.

关键词： Hepatitis C Renal function Direct-acting antivirals Liver transplant Treatment

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Primary Hyperparathyroidism:A Tale of Two Cities Revisited-New York and Shanghai

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Bone Research 2013年第2期1卷 162-169页

作者： Jian-min Liu Natalie E. Cusano Barbara C. Silva Lin Zhao Xiao-yan He Bei Tao Li-hao Sun Hong-yan Zhao Wen-wei Fan Megan E. romano Guang Ning john P. Bilezikian Department of Endocrine and Metabolic Diseases Rui-jin HospitalShanghai Jiao-tong University School of Medicine Department of Medicine Division of EndocrinologyCollege of Physicians and surgeonsColumbia University

In the 1970s, with the advent of biochemical multichannel screening in the United States and other western countries, the clinical presentation of primary hyperparathyroidism （PHPT） changed from a symptomatic to an asymptomatic disorder. However, in Asian countries, like China, PHPT did not show this evolution, but rather continued to be a symptomatic disease with target organ involvement. In this paper, we revisit the clinical features of PHPT in New York and Shanghai, representative United States and Chinese cites, over the past decade. The questions we address are whether the disease evolved in China to a more asymptomatic one and, whether in the United States further changes are evident. The results indicate that while PHPT con- tinues to present primarily as an asymptomatic disease in the United States, a new phenotype characterized by normal serum calcium and high parathyroid hormone levels, normocalcemic PHPT, has emerged. Data from Shanghai demonstrates a trend for PHPT to present more commonly as an asymptomatic disorder in China. However, most patients with PHPT in China still manifest classical symptoms, i.e. nephrolithiasis and fractures. A comparison of the two cohorts shows that Chinese patients with PHPT are younger, with higher serum calcium and PTH levels, and lower 25-hydroxyvitamin D levels than patients in New York. Normocalcemic PHPT has not yet been recognized in Shanghai. In summary, although the phenotypes of PHPT in both cities are evolving towards less evident disease, sharp clinical and biochemical differences are still apparent in PHPT as expressed in China and the United States.

关键词： normocalcemic primay hyperparathyroidism asymptomatic symptomatic

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A New Model to Study Healing of a Complex Femur Fracture with Concurrent Soft Tissue Injury in Sheep

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Open Journal of Orthopedics 2013年第2期3卷 62-68页

作者： Martin E. Wullschleger Roland Steck romano Matthys john D. Webster Maria A. Woodruff Devakar R. Epari Keita Ito Michael A. Schuetz AO Research Institute Davos Switzerland Department of Biomedical Engineering Eindhoven University of Technology Eindhoven Netherlands Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia Trauma Service Princess Alexandra Hospital Brisbane Australia

High energy bone fractures resulting from impact trauma are often accompanied by subcutaneous soft tissue injuries, even if the skin remains intact. There is evidence that such closed soft tissue injuries affect the healing of bone fractures, and vice versa. Despite this knowledge, most impact trauma studies in animals have focussed on bone fractures or soft tissue trauma in isolation. However, given the simultaneous impact on both tissues a better understanding of the interaction between these two injuries is necessary to optimise clinical treatment. The aim of this study was therefore to develop a new experimental model and characterise, for the first time, the healing of a complex fracture with concurrent closed soft tissue trauma in sheep. A pendulum impact device was designed to deliver a defined and standardised impact to the distal thigh of sheep, causing a reproducible contusion injury to the subcutaneous soft tissues. In a subsequent procedure, a reproducible femoral butterfly fracture (AO C3-type) was created at the sheep’s femur, which was initially stabilised for 5 days by an external fixator construct to allow for soft tissue swelling to recede, and ultimately in a bridging construct using locking plates. The combined injuries were applied to twelve sheep and the healing observed for four or eight weeks (six animals per group) until sacrifice. The pendulum impact led to a moderate to severe circumferential soft tissue injury with significant bruising, haematomas and partial muscle disruptions. Posttraumatic measurements showed elevated intra-compartmental pressure and circulatory tissue breakdown markers, with recovery to normal, pre-injury values within four days. Clinically, no neurovascular deficiencies were observed. Bi-weekly radiological analysis of the healing fractures showed progressive callus healing over time, with the average number of callus bridges increasing from 0.4 at two weeks to 4.2 at eight weeks. Biomechanical testing after sacrific

关键词： Fracture Ovine Large Animal Model Bone Soft Tissue Injury

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Decreased expression of Klotho in cardiac atria biopsy samples from patients at higher risk of atherosclerotic cardiovascular disease

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Journal of Geriatric Cardiology 2016年第8期13卷 701-711页

作者： Giovanni Corsetti Evasio Pasini Tiziano M Scarabelli Claudia romano Pratik R Agrawal Carol Chen-Scarabelli Richard Knight Louis Saravolatz Jagat Narula Mario Ferrari-Vivaldi Vincenzo Flati Deodato Assanelli Francesco S Dioguardi Department of Clinical & Experimental Sciences Division of Human Anatomy & Physiopathology University of Brescia Brescia Italy 'S.Maugeri Foundation ' IRCCS Cardiology Division Medical Centre of Lumezzane Brescia Italy Zena and Michael A Wiener Cardiovascular Institute Mount Sinai Medical Center New York USA Center for Heart and Vessel Preclinical Studies St. John Hospital & Medical Center Wayne State University School of Medicine Detroit USA VA Ann Arbor Health Care System University of Michigan Ann Arbor USA Department of Cardiovascular Surgery 'San Rocco' Hospital Ome Brescia Italy Department of Biotechnological and Applied Clinical Sciences University of L 'Aquila L 'Aquila Italy Division of Sport-Internal Medicine Department of Clinical & Experimental Sciences University of Brescia Brescia Italy Department of Clinical Sciences and Community Health University of Milan Milan Italy

Background Klotho proteins （α- and β） are membrane-based circulating proteins that regulate cell metabolism, as well as the lifespan modulating activity of Fibroblast Growth Factors （FGFs）. Recent data has shown that higher plasma circulating Klotho levels reduce cardio- vascular risk, suggesting Klotho has a protective role in cardiovascular diseases. However, although so far it has been identified in various organs, it is unknown whether cardiomyocytes express Klotho and FGFs, and whether high cardiovascular risk could affect cardiac expres- sion ofKlotho, FGFs and other molecules. Methods We selected 20 patients with an estimated 10-year high atherosclerotic cardiovascular disease and 10 age-matched control subjects with an estimated 10-year low risk undergone cardiac surgery for reasons other than coronary artery by-pass. In myocardial biopsies, we evaluated by immuno-histochemistry whether Klotho and FGFs were expressed in cardiomyo- cytes, and whether higher cardiovascular risk influenced the expression of other molecules involved in endoplasmic reticulum stress, oxida- tive stress, inflammation and fibrosis. Results Only cardiomyocytes of patients with a higher cardiovascular risk showed lower expression of Klotho, but higher expressions of FGFs. Furthermore, higher cardiovascular risk was associated with increased expression of oxidative and endoplasmic reticular stress, inflammation and fibrosis. Conclusions This study showed for the first time that Klotho proteins are ex- pressed in human cardiomyocytes and that cardiac expression of Klotho is down-regulated in higher cardiovascular risk patients, while expression of stress-related molecules were significantly increased.

关键词： Atherosclerotic disease Cardiomyocytes Cardiovascular risk Human heart Klotho

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