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Relative carcinogenicity of tacrolimus vs mycophenolate after solid organ transplantation and its implications for liver transplant care

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World Journal of Hepatology 2024年第4期16卷 650-660页

作者： Dorothy Liu Mark M Youssef Josephine A grace marie Sinclair Department of Gastroenterology Austin HealthMelbourne 3084VictoriaAustralia Victorian Liver Transplant Unit Austin HealthMelbourne 3084VictoriaAustralia Department of Medicine University of MelbourneMelbourne 3084VictoriaAustralia

BACKGROUND De novo malignancy is a leading cause of late morbidity and mortality in liver transplant *** immunosuppression has been shown to contribute to post-transplant malignancy(PTM)*** is emerging evidence on the differential carcinogenic risk profile of individual immunosuppressive drugs,independent of the net effect of *** inhibitors such as tacrolimus may promote tumourigenesis,whereas mycophenolic acid(MPA),the active metabolite of mycophenolate mofetil,may limit tumour *** transplantation(LT)is relatively unique among solid organ transplantation in that immunosuppression monotherapy with either tacrolimus or MPA is often achievable,which makes careful consideration of the risk-benefit profile of these immunosuppression agents particularly relevant for this ***,there is limited clinical data on this subject in both LT and other solid organ transplant *** To investigate the relative carcinogenicity of tacrolimus and MPA in solid organ *** A literature search was conducted using MEDLINE and Embase databases using the key terms“solid organ transplantation”,“tacrolimus”,“mycophenolic acid”,and“carcinogenicity”,in order to identify relevant articles published in English between 1st January 2002 to 11th August *** terms,synonyms and explosion of MeSH terms,Boolean operators and truncations were also utilised in the *** lists of retrieved articles were also reviewed to identify any additional *** duplicates,abstracts from 1230 records were screened by a single reviewer,whereby 31 records were reviewed in ***-text articles were assessed for eligibility based on pre-specified inclusion and exclusion *** A total of 6 studies were included in this *** studies were large population registries or cohort studies,which varied in transplant era,type of organ transplanted and immunosuppression protocol us

关键词： Immunosuppression Solid organ transplantation Liver transplantation Carcinogenicity Tacrolimus Mycophenolate

Statin, aspirin and metformin use and risk of hepatocellular carcinoma related outcomes following liver transplantation: A retrospective study

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World Journal of Transplantation 2024年第3期14卷 120-131页

作者： William Chung Kevin Wong Noel Ravindranayagam Lauren Tang Josephine grace Darren Wong Danny Con marie Sinclair Avik Majumdar Numan Kutaiba Samuel Hui Paul Gow Vijayaragavan Muralidharan Alexander Dobrovic Adam Testro Department of Gastroenterology Austin HealthHeidelberg 3084VictoriaAustralia Victorian Liver Transplant Unit Austin HealthHeidelberg 3084VictoriaAustralia Department of Radiology Austin HealthHeidelberg 3084VictoriaAustralia Department of Gastroenterology Monash HealthClayton 3168VictoriaAustralia Department of Surgery University of MelbourneAustin HealthHeidelberg 3048VictoriaAustralia Department of Surgery Beacon LaboratoryAustin PrecinctThe University of MelbourneAustin HospitalHeidelberg 3048VictoriaAustralia

BACKGROUND Liver transplantation(LT)is a potentially curative therapy for patients with hepatocellular carcinoma(HCC).HCC-recurrence following LT is associated with reduced *** is increasing interest in chemoprophylaxis to improve HCC-related outcomes *** To investigate whether there is any benefit for the use of drugs with proposed chemoprophylactic properties against HCC,and patient outcomes following *** This was a retrospective study of adult patients who received Deceased Donor LT for HCC from 2005-2022,from a single Australian *** use was defined as statin,aspirin or metformin therapy for≥29 days,within 24 months post-LT.A cox proportional-hazards model with time-dependent covariates was used for survival *** measures were the composite-endpoint of HCC-recurrence and all-cause mortality,HCC-recurrence and HCC-related *** analysis was performed to account for immortality time bias and statin *** Three hundred and five patients were included in this study,with 253(82.95%)males with a median age of 58.90 *** of liver disease were 150(49.18%)hepatitis C,73(23.93%)hepatitis B(HBV)and 33(10.82%)non-alcoholic fatty liver disease(NAFLD).56(18.36%)took statins,51(16.72%)aspirin and 50(16.39%)*** a median follow-up time of 59.90 months,34(11.15%)developed HCC-recurrence,48(15.74%)died,17(5.57%)from HCC-related ***,aspirin or metformin use was not associated with statistically significant differences in the composite endpoint of HCC-recurrence or all-cause mortality[hazard ratio(HR):1.16,95%CI:0.58-2.30;HR:1.21,95%CI:0.28-5.27;HR:0.61,95%CI:0.27-1.36],HCC-recurrence(HR:0.52,95%CI:0.20-1.35;HR:0.51,95%CI:0.14-1.93;HR 1.00,95%CI:0.37-2.72),or HCC-related mortality(HR:0.32,95%CI:0.033-3.09;HR:0.71,95%CI:0.14-3.73;HR:1.57,95%CI:0.61-4.04)*** dosing was not associated with statist-ically significant differences in HCC-related ***

关键词： Liver transplantation Hepatocellular carcinoma Transplant oncology Statins HMG-Co-A reductase Aspirin Metformin Mammalian target of rapamycin

Neurocognitive Profile of People Living with Human Immunodeficiency Virus Initiating Treatment in Kinshasa in the Dolutegravir Era, Democratic Republic of Congo

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Neuroscience & Medicine 2024年第1期15卷 1-22页

作者： Candide About Kabamba Berry Ikolango Bongenya Jocelyn Ewuti Nonga Lambert Omombo Losenga Noëlla Maketi Dikati Thérèse Kasaka Ntumba grace Ipaya Booto Rosalie Djamba Dembo Stéphanie Mauwa Selenge Benoit Obel Kabengele Guy Makila Mabe Bumoko marie-Thérèse Ayane Safi Sombo Erick Ntambwe Kamangu Department of Neurology Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of Congo Faculty of Medicine Bel Campus Technological University Kinshasa Democratic Republic of Congo “Focus HIV/AIDS” Research Group Kinshasa Democratic Republic of Congo Department of Internal Medicine University Clinic of Kinshasa Kinshasa Democratic Republic of Congo Molecular Biochemistry Department Department of Basic Sciences Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of Congo

Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to present the neurological and cognitive profile of People Living with HIV (PLHIV) initiating antiretroviral treatment in Kinshasa in the era of Dolutegravir (DTG). Methods: This is a multicenter, cross-sectional study with a descriptive aim carried out in 16 HIV Outpatient Treatment Centers (OTC) in Kinshasa from October 4, 2021 to February 15, 2022. The International HIV Dementia Scale (IHDS) correlated with the Activities of Daily Living (IADL) scale facilitated the categorization of NeuroCognitive Disorders (NCD) of PLHIV evaluated after carrying out a summary neurological examination. Results: Of the 96 patients recruited, 56.3% were women with a sex ratio of 0.68. The average age was 40.1 ± 12.1 years. The secondary education level was the majority at 64.6%. Malaria (44.8%) and tuberculosis (32.3%) were more common as opportunistic infections. They were alcoholics in (30.2%). Their history was heart disease (15.6%), high blood pressure (18.8%);drug abuse (10.4%). The IHDS score was light in 55.2% of cases. The correlation between IHDS/IADL watches asymptomatic neurocognitive impairments (ANI) in 77.1%, almost all of subjects are found with normal overall functioning (94.8%) and a disturbed neurological examination in 53.1% of cases with a predominance of motor impairments in 79.1%. Conclusion: In view of these results, early and systematic screening of NCD and associated factors remains necessary in our context. .

关键词： IHDS Dolutegravir Initiation Kinshasa Neurological Profile PLHIV

Hepatocellular carcinoma surveillance and quantile regression for determinants of underutilisation in at-risk Australian patients

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World Journal of Gastrointestinal Oncology 2021年第12期13卷 2149-2160页

作者： Elizabeth SL Low Ross Apostolov Darren Wong Sandra Lin Numan Kutaiba Josephine A grace marie Sinclair Department of Gastroenterology and Liver Transplant Unit Austin HealthHeidelberg 3084VictoriaAustralia Department of Medicine University of MelbourneMelbourne 3000VictoriaAustralia Department of Radiology Monash HealthClayton 3168VictoriaAustralia Department of Radiology Austin HealthHeidelberg 3084VictoriaAustralia

BACKGROUND While clinical guidelines recommend hepatocellular carcinoma(HCC)surveillance for at-risk individuals,reported surveillance rates in the United States and Europe remain disappointingly *** To quantify HCC surveillance in an Australian cohort,and assess for factors associated with surveillance *** All patients undergoing HCC surveillance liver ultrasounds between January 1,2018 to June 30,2018 at a tertiary hospital in Melbourne,Australia,were followed until July 31,2020,or when surveillance was no longer *** primary outcome was the percentage of time up-to-date with HCC surveillance(PTUDS).Quantile regression was performed to determine the impact of factors associated with HCC surveillance *** Among 775 at-risk patients followed up for a median of 27.5 months,the median PTUDS was 84.2%(IQR:66.3%-96.3%).85.0%of patients were followed up by specialist *** those receiving specialist care,quantile regression demonstrated differential associations at various quantile levels of PTUDS for several *** age at the 25th quantile(estimate 0.002 per percent,P=0.03),and cirrhotic status at the 75th quantile(estimate 0.021,P=0.017),were significantly associated with greater percentage of time *** ethnicity(estimate-0.089,P=0.048)and a culturally and linguistically diverse(CALD)background(estimate-0.063,P=0.01)were significantly associated with lower PTUDS at the 50th quantile,and again for CALD at the 75th quantile(estimate-0.026,P=0.045).CONCLUSION While median PTUDS in this Australian cohort study was 84.2%,awareness of the impact of specific factors across PTUDS quantiles can aid targeted interventions towards improved HCC surveillance.

关键词： Liver cirrhosis Hepatitis,viral,human Carcinoma,hepatocellular Liver neoplasms Early detection of cancer Population surveillance

Morpho-anatomical characterization of Rhododendron subsessile Rendle,an endangered species of the Cordillera Central Range,Philippines

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Journal of Forestry Research 2021年第1期32卷 241-247页

作者： Mabel grace V.Bitayan Starleene S.Cervantes Jones T.Napaldet College of Teacher Education Benguet State UniversityLa TrinidadBenguetPhilippines Biology Department College of Arts and SciencesBenguet State UniversityLa TrinidadBenguetPhilippines

Conservation of endangered plant species requires a prerequisite basic knowledge of their taxonomy and *** in the Cordillera Central Range,several species have not been studied,even though this area harbors a unique type of vegetation not found in other parts of the *** study documents the morpho-anatomical characteristics of Rhododendron subsessile Rendle,one of the unique and endangered fl ora in the *** species exhibits a morphology typical of plants in high elevations,being a hardy shrub with small tough leaves,and showy pink fl owers that rival those of commercial rhododendron *** fi ndings on the species morphology include a variable number of corolla lobes,stamens and a description of its fruits and *** anatomical features of the species are reported here for the fi rst *** plant exhibits a typical dicot anatomy with dorsiventral leaves,woody stem and root system with the usual arrangement of periderm followed by secondary phloem,vascular cambium,secondary xylem with vessel elements and pith(in the case of the stem).A unique characteristic was identifi ed as the biseriate upper epidermis of the *** themorphological and anatomical features of the species should prove valuable as input baseline information in formulating measures for its conservation.

关键词： Taxonomy Biodiversity conservation Biseriate epidermis Variable stamens

Maternal Knowledge of Tuberculosis and Bacillus Calmette Guerin Vaccination in Pediatric Health Services in Kinshasa

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Journal of Tuberculosis Research 2017年第1期5卷 30-43页

作者： Loukia Aketi Joseph Shiku Diayisu Zacharie Kashongwe grace Nkabikueni Patrick Kayembe Kalambay Jean-marie Kayembe Cardio-Pulmonary and Infectious Diseases Unit Department of Pediatrics University Hospital of Kinshasa University of Kinshasa Kinshasa Democratic Republic of Congo Pneumology Service Department of Internal Medicine University Hospital of Kinshasa University of Kinshasa Kinshasa Democratic Republic of Congo Epidemiology and Biostatistics Public Health School University of Kinshasa Kinshasa Democratic Republic of Congo

Introduction: To participate effectively in the fight against tuberculosis (TB), mothers need to have a good knowledge of TB and its prevention. The objective of this study was to evaluate the knowledge of mothers about TB and Bacillus Calmette Guérin (BCG). Methods: This was a cross-sectional survey performed from September to December 2015 in 4 health care facilities of Kinshasa. It concerned mothers of children who received BCG vaccine. The frequencies and chi-square of Pearson were used to report results. Results: A total of 380 couples of the children and their mothers were recruited. The median age of children was 16 months (ranges: 6 days to 59 months);224 (58.9%) of them received BCG during the period recommended;62 (16.3%) experienced a side effect. There was a significant association (p = 0.00) between sides effects and the delayed vaccination. The average age of the mothers was 29.3 ± 6.4 years;352 (92.6%) had heard about TB;28 (7.4%) never heard about it;168 (44.2%) knew that TB is a contagious disease;only 111 (29.2%) knew the mode of transmission;87 (22.9%) did not know any signs of TB, and 54 (14.2%) knew about prevention with the BCG vaccine. Factors significantly associated with the mothers’ lack of knowledge were a low level of education (p = 0.01), young age (p = 0.02), and place of residence (p = 0.04). Conclusion: There is an urgent need to improve the education of the population, particularly those who lives in poor conditions and who are uneducated.

关键词： Maternal Knowledge Tuberculosis BCG Children

Study of the Curing Temperature of 600°C, 700°C and 800°C of Mouyondzi Clay on the Mechanical, Physical and Microstructural Properties of Geopolymer Obtained

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Journal of Minerals and Materials Characterization and Engineering 2022年第2期10卷 185-197页

作者： Vezolo Stanislas Ifo grace Mazel Foutou Paul Mozalin Loubaki Raunel Diamouangana Zita Flora Moutou Joseph-marie Laboratoire de Chimie Minérale et Appliquée Faculté des Sciences et Techniques Université Marien NGOUABI Brazzaville Republic of the Congo Faculté des Sciences et Techniques Université Marien NGOUABI Brazzaville Republic of the Congo Ecole Normale Supérieure Université Marien Ngouabi Brazzaville Republic of the Congo

This work consists of determining the right curing temperature for Mouyondzi clay, with a view to obtaining a very reactive metakaolinic amorphous phase, which will give us a geopolymer with good physical and mechanical performance. The kaolin-dominant Mouyondzi clay was calcined at 600℃, 700℃ and 800℃ with a heating rate of one degree per minute. In order to achieve the objective of this work, the performance of geopolymer was measured by compressive strength on geopolymer prisms of 28 days of age, by XRD and IRFT of geopolymer powders, calcined clay and raw clay, and by SEM of geopolymer blocks. Analysis of the results shows that the resistance value increases with the curing temperature of the clay and reaches a maximum of 49 MPa at 800℃. At 600℃ we already have 31 MPa, the equivalent of Portland cement with the addition. The XRD confirms the disappearance of clay species from 600℃. At 800℃ there is not yet the appearance of a new crystalline phase. Quartz is the only mineral species present. We can therefore confirm that at 800℃, the geopolymer obtained exhibits higher physical and mechanical performance than the other curing temperatures studied for Mouyondzi clay. This is confirmed by the appearance of a new aluminosilicate phase in the IRFT spectra and in the SEM images appearing as a continuous plate.

关键词： Geopolymer Compressive Strength Mouyonszi Clay Amorphous Phase

Characterization of the Clay Collected in the Locality of Dolisie in Congo-Brazzaville

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Journal of Minerals and Materials Characterization and Engineering 2022年第2期10卷 93-105页

作者： Rarahu Nursie Mboho Oba grace Mazel Ifo Erman Eloge Nzaba Madila Flora Zita Mpissi Diamouangana Thierry Vila Mozalin Paul Foutou Joseph-marie Moutou Laboratoire de Chimie Minérale Appliquée (LACMA) Faculté des Sciences et Techniques Université Marien Ngouabi Brazzaville Congo Brazzaville Faculté des Sciences et Techniques Université Marien Ngouabi Brazzaville Congo Brazzaville Département de Chimie Biochimie et Physique and Institut de Recherche sur l’Hydrogène Université du Québec à Trois-Rivières Trois-Rivières Québec Canada Ecole Normale Supérieure Université Marien Ngouabi Brazzaville Congo Brazzaville

This work aims at the characterization of the clay of the locality of Dolisie for its valorization. The mineralogical analysis was determined by the following techniques (DRX, IR, ATG and ATD), chemical analysis was determined by ICP-AES, CEC was assessed by the Metson method. The geothermal properties were determined by the granulometric analysis of the clay soil and allowed us to position the Dolisie clay in the texture triangle, the landings limits obtained allowed to place the Dolisie clay in the abacus of Casagrande and on the workability map of Bain and Highy. Chemical analysis showed that silica alumina as well as iron oxides are the major constituents in Dolisie clay The mineralogical balance showed that kaolinite and illite have similar percentages which are (20.51%) kaolinite, (28.08) illites. This leads us to believe that kaolinite is not the dominant mineral and the IR spectrum shows that kaolinite is poorly crystallized.

关键词： Clay Characterization Mineralogy Valuation

Hypercoagulability in the Context of Pre-Eclampsia: Case-Control Study at the Laquintinie Douala Hospital (Cameroon)

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Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1708-1727页

作者： Henri Essome marie Solange Ndom Idjem Théophile Nana Njamen Thomas Egbe Obinchemti Merlin Boten grace Tocki Toutou Grégory Eddie Halle Guy Pascal Ngaba Pascal Foumane Laquintinie Douala Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences of Douala University of Douala Douala Cameroon Faculty of Health Sciences of Buea University of Buea Buea Cameroon Kribi District Hospital Kribi Cameroon Faculty of Biomedical Sciences of Yaoundé University of Yaoundé 1 Yaoundé Cameroon

Introduction: Preeclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etio-pathogenesis involves, among other things, hypercoagulability, which alone accounts for about 15% of his deaths. Our objective was to study the parameters of coagulation (prothrombin level, activated cephalin time) in pregnant women with preeclampsia and non-preeclampsia at Laquintinie Hospital in Douala. Methodology: We carried out an analytical cross-sectional case-control study from November 01st, 2018 to May 31st, 2019, in the gynecology and obstetrics department of Laquintinie Hospital in Douala. We included preeclampsia and non-preeclampsia pregnant women with a gestational age greater than or equal to 20 weeks amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index, prothrombin level (PL) and activated cephalin time (ACT). Hypercoagulability was defined by the presence of at least one of the following abnormalities: PL > 100%, ACT 25

关键词： Preeclampsia Hypercoagulability Prothrombin Cephalin Lacintinia