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Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant

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World Journal of Transplantation 2024年第2期14卷 119-125页

作者： Eden M Gallegos Tanner Reed p.ige deville Blake platt Claudia Leonardi Lillian Bellfi Jessica Dufrene Saad Chaudhary John Hunt Lance Stuke patrick Greiffenstein Jonathan Schoen Alan Marr Anil paramesh Alison A Smith Department of physiology Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70124United States Department of Medicine Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Surgery Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Trauma Surgery Tacoma General HospitalTacoma 98405United States Department of public Health Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Donation Services Louisiana Organ Procurement AgencyCovingtonLA 70433United States Department of Surgery Tulane Transplant InstituteTulane University School of MedicineNew OrleansLA 70112United States

BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per *** management of brain-dead potential organ donors(BpODs)is controversial,leading to heterogeneous clinical management *** studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BpODs had better organ recovery and survival outcomes were increased for transplant *** To determine if levothyroxine use in combination with steroids in BpODs increased the number of organs donated in trauma *** A retrospective review of adult BpODs from a single level 1 trauma center over ten years was *** criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital *** and steroid administration,the number of organs donated,the types of organs donated,and demographic information were *** analyses were performed with ppatients met inclusion criteria,69(78%)of whom received levothyroxine and steroids(ST/LT group)vs 19(22%)receiving steroids without levothyroxine(ST group).No differences were observed between the groups for gender,race,pertinent injury factors,age,or other hormone therapies used(p>0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(p=0.038).There was no difference in the total number of organ types donated between the groups(p=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BpODs in the trauma patient *** to this study include

关键词： Organ donation Trauma Brain death Levothyroxine Hormone replacement therapy Steroids Organ donor Retrospective

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Quantitative Computerized Tomography (QCT) versus Dual X-Ray Absorptiometry (DXA) in the Assessment of Bone Mineral Density of HIV-1 Infected Children

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World Journal of AIDS 2012年第4期2卷 306-311页

作者： Joann Lin Maria Ines Boechat Jaime G. deville Diego Gilsanz Richard Stiehm Vicente Gilsanz Isidro Salusky Karin Nielsen-Saines Department of pediatrics David Geffen UCLA School of Medicine Los Angeles USA Department of Radiology Children’s Hospital Los Angeles USA McKinney Allergy and Asthma Center McKinney USA

Bone studies of HIV-infected children using dual X-ray absorptiometry (DXA) suggest bone mineral density (BMD) abnormalities. pediatric studies are often performed using DXA instead of computed tomography (CT), which accounts for 3-dimensional differences in bone size of growing children. We evaluated whether CT would match DXA measurements in this population. For this purpose, the BMD of 16 perinatally HIV-infected patients, ages 6 to 22 was assessed. Subjects were matched by age, gender, and race to controls. BMD was assessed via DXA and QCT. Clinical anthropometric data, body mass index, immunologic and virologic parameters and laboratory markers for osteoblastic and osteoclastic activity were performed. No statistically significant differences in age and anthropometric parameters between subjects and controls were found. Individual CT and DXA z-scores were significantly different when subjects were evaluated as a group (p = 0.0002) or when males and females were analyzed independently (p = 0.001 and 0.03). DXA z-scores were below 1 SD, while CT z-scores were above the mean. 31% of subjects were identified as having poor bone mineralization by DXA while none had osteopenia/osteoporosis by CT. There was no correlation between immunologic/virologic parameters and BMD by either method. Increased osteoclastic activity was noted in 10 patients receiving tenofovir. In summary, decreased BMD diagnosed by DXA in pediatric HIV-infected subjects was not confirmed by CT. Increased bone turnover in patients on tenofovir was suggested by laboratory markers. prospective studies using CT as the imaging standard are needed for evaluation of bone mineral changes in HIV-infected children.

关键词： Bone Mineral Density HIV-Infected Children CT DXA

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老年性黄斑变性患者的视力相关生活质量

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世界核心医学期刊文摘（眼科学分册） 2005年第7期1卷 8-9页

作者： Berdeaux G.H. Nordmann J.-p. Colin E. Arnould B. 张自峰 Alcon Research 4 rue Henri Sainte Claire Deville 92563 Rueil Malmaison Cedex France

purpose: To evaluate the relative impact of best and worst eye on vision- related quality of life in patients suffering from age- related macular degeneration (AMD). Design: Quality of life and visual acuity data were collected at baseline during a randomized clinical trial. Methods: setting: Multicenter (11 centers), international study. patients: One hundred fourteen patients with a diagnosis of exudative AMD and primary or recurrent subfoveal neovascular membrane (greatest linear dimension of lesion ≤ 5400 μ m; ≥ 50% of the total lesion was choroidal neovascularization (CNV); classic component of the total CNV ≥ 1.0 mm2). All patients were over age50 years, of any race, either sex. intervention or observation procedure: NEI- VFQ- 39 questionnaire administered to patients at home by trained telephone interviewers. main outcome measures: ETDRS visual acuity (VA) was measured in both eyes separately. Vision- related quality of life (QoL) was assessed using the NEI- VFQ- 39. An analysis of variance was performed on the NEI- VFQ scores, including best eye VA (VA > 20/40 vs VA ≤ 20/40), worst eye VA (VA > 20/200 vs VA ≤ 20/200), and the interaction between the two as independent variables. Results: Best eye VA was 0.34 on average, with VA > 20/40 in 43.0% of patients. Worst eye VA was 0.85 on average, with VA > 20/200 in 32.5% of patients. VA was not linked to general health and ocular pain scores. General Vision, Near Activities, Distance Vision, Driving, Mental Health, Role Difficulties, Dependency, peripheral Vision, and the Global NEI- VFQ scores were affected by both best eye VA and worst eye VA. Conclusion: In the study sample, worst eye VA (≤ 20/200) and best eye VA (≤ 20/40) contributed independently to vision- related QoL. These results suggest that preserving a minimal visual acuity in the worst eye may contribute to vision- related quality of life.

关键词：老年性黄斑变性生活质量血管膜脉络膜新生血管电话调查随机临床试验精神健康观察过程独立变量任务难度

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