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Thrombocytopenia after liver transplantation:should we care?

World Journal of Gastroenterology 2018年第13期24卷 1386-1397页

作者： Kazuhiro Takahashi Shunji Nagai Mohamed Safwan Chen Liang Nobuhiro Ohkohchi Department of Surgery Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation University of TsukubaTsukubaIbaraki 3058575Japan Transplant and Hepatobiliary Surgery Henry Ford HospitalDetroitMl 48202United States

Transient thrombocytopenia is a common phenomenon after liver transplantation. After liver transplantation(LT), platelet count decreases and reaches a nadir on postoperative days 3-5, with an average reduction in platelet counts of 60%; platelet count recovers to preoperative levels approximately two weeks after LT. The putative mechanisms include haemodilution, decreased platelet production, increased sequestration, medications, infections, thrombosis, or combination of these processes. However, the precise mechanisms remain unclear. The role of platelets in liver transplantation has been highlighted in recent years, and particular attention has been given to their effects beyond hemostasis and thrombosis. Previous studies have demonstrated that perioperative thrombocytopenia causes poor graft regeneration, increases the incidence of postoperative morbidity, and deteriorates the graft and decreases patient survival in both the short and long term after liver transplantation. Platelet therapies to increase perioperative platelet counts, such as thrombopoietin, thrombopoietin receptor agonist, platelet transfusion, splenectomy, and intravenous immunoglobulin treatment might have a potential for improving graft survival, however clinical trials are lacking. Further studies are warranted to detect direct evidence on whether thrombocytopenia is the cause or result of poor-graft function and postoperative complications, and to determine who needs platelet therapies in order to prevent postoperative complications and thus improve post-transplant outcomes.

关键词： Thrombocytopenia Liver regeneration Platelet therapy Platelet Thrombopoietin receptor agonist intravenous immunoglobulin treatment Liver transplantation

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Genetic diversity of HCV among various high risk populations(IDAs,thalassemia,hemophilia,HD patients) in Iran

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Asian Pacific Journal of Tropical Medicine 2013年第7期6卷 556-560页

作者： Rafiei A Darzyani Azizi M Taheri S Haghshenas MR Hosseinian A Makhlough A Molecular and Cell Biology Research Center.Faculty of Medicine Mazandaran University of Medical Sciences18KM Khazar BlvdKhazar Sq.SariIran Department of Internal Medicine Faculty of MedicineMazandaran University of Medical SciencesSari.Iran Nephrology Ward Department of Internal MedicineFaculty of MedicineMazandaran University of Medical SciencesSari.Iran

Objective:To determine the patterns of distribution of HCV genotypes among high risk population in north of ***:A cross-sectional study was conducted on 135 HCV RNA-positive high risk individuals including thalassemia,hemophilia,patients under hemodialysis and intravenous drug *** genotypes were determined based on amplification with type-specific primers ***:Among the 187 anti-HCV positive samples,only 135 (72.2%)gave HCV-RNA *** all,the most identified HCV type was genotype 3a(51.1%) followed by 1a(27.4%),1b(8.2%).Sixteen(11.9%)out of 135 HCV RNA-positive participants have infected with more than one genotype or subtypes as follow:1a/1b in 11(8.2%),2/3a in 3 (2.2%),and 1a/1b/3a in 2(1.5%).Stratification of participants revealed that HCV subtype 3a was more prominent in thalassemia,hemophilia and HD patients but 1a and 1b were frequent in intravenous drug ***:This study is the first report on HCV genotypes among Iranian subjects with different exposure categories resided in *** genotype 3a was found to be the most frequent genotype in thalassemia,hemophilia,and hemodialysis patients but not in *** the addiction age is decreasing in Iran and a lot of addicts are *** might change the subtype pattern of HCV in general population.

关键词： HCV Thalassemia Hemophilia Hemodialysis intravenous drug addicts Iran

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To bridge or not to bridge:summary of the new evidence in endovascular stroke treatment

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Stroke & Vascular Neurology 2022年第3期7卷 179-181页

作者： Anna Podlasek Permesh Singh Dhillon Waleed Butt Iris Q Grunwald Timothy J England Tayside Innovation MedTech Ecosystem(TIME) University of DundeeDundeeUK NIHR Nottingham Biomedical Research Centre University of NottinghamNottinghamUK Interventional Neuroradiology Nottingham University Hospitals NHS TrustNottinghamUK Interventional Neuroradiology University Hospitals Birmingham NHS TrustBirminghamUK Stroke Division of Mental Health and Clinical NeurosciencesSchool of MedicineUniversity of NottinghamNottinghamUK Stroke University Hospitals of Derby and Burton NHS Foundation TrustDerbyUK

WHAT IS ALREADY KNOWN Recently published summaries and meta-analyses of four randomised controlled trials(RCTs)1-5 comparing direct mechan-ical thrombectomy(dMT)and bridging therapy with intravenous(IV)thrombolytics(alteplase)suggested that dMT is non-inferior to bridging therapy to achieve good functional outcome 3 months after stroke(modified Rankin Score 0-2)with the non-inferiority margin(NIM)<−5%.

关键词： intravenous bridging treatment

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The progress of telestroke in China

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Stroke & Vascular Neurology 2017年第3期2卷 168-171页

作者： Gang Zhao Huan Huang Fang Yang Department of Neurology Xijing HospitalThe Fourth Military Medical UniversityXi'anChina

Stroke remains the leading cause of death in *** disparity of distribution in specialists and hospitals affects access to timely stroke ***,the use of telemedicine for stroke,may be the solution to access to stroke *** can improve the rate of successful intravenous thrombolysis and shorten the time to *** we review the progress of telestroke in China.

关键词： China. intravenous death

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Long-term stabilization of stage 4 colon cancer using sodium dichloroacetate therapy

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World Journal of Clinical Cases 2016年第10期4卷 336-343页

作者： Akbar Khan Douglas Andrews Anneke C Blackburn Medicor Cancer Centres Inc. The John Curtin School of Medical Research The Australian National University

Oral dichloroacetate sodium(DCA) has been investigated as a novel metabolic therapy for various cancers since 2007, based on data from Bonnet et al that DCA can trigger apoptosis of human lung, breast and brain cancer cells. Response to therapy in human studies is measured by standard response evaluation criteria for solid tumours definitions, which define "response" by the degree of tumour reduction, or tumour disappearance on imaging. However, Blackburn et al have demonstrated that DCA can also act as a cytostatic agent in vitro and in vivo, without causing apoptosis(programmed cell death). A case is presented in which oral DCA therapy resulted in tumour stabilization of stage 4 colon cancer in a 57 years old female for a period of nearly 4 years, with no serious toxicity. Since the natural history of stage 4 colon cancer consists of steady progression leading to disability and death, this case highlights a novel use of DCA as a cytostatic agent with a potential to maintain long-term stability of advanced-stage cancer.

关键词： Dichloroacetate Cancer Colon Colorectal Cytostatic Stabilization Growth inhibition intravenous

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Tattooing: A potential novel risk factor for iliopsoas abscess

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World Journal of Clinical Cases 2014年第9期2卷 459-462页

作者： Sweny Gulati Ankur Jain Maryam Sattari Department of Medicine University of Florida College of MedicineGainesville FL 32610 United States

Iliopsoas abscess(IPA) is an uncommon infection. The clinical presentation is usually insidious. Most patients present with nonspecific symptoms, leading to difficulty in prompt and accurate diagnosis. Delay in diagnosis can lead to complications, such as sepsis and death. Tattooing has become more popular over the recent years and has been associated with tattooing-related and blood-borne infections. We present two related cases of methicillin-resistant Staphylococcus aureus IPA after tattooing and review the epidemiology, etiology, clinical features, and management of IPA.

关键词： Iliopsoas abscess Methicillin-resistant Staphylococcus aureus intravenous drug abuse Tattooing Primary iliopsoas abscess Secondary iliopsoas abscess

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Impact of hepatitis B immunoglobulin mode of administration on treatment experiences of patients after liver transplantation: Results from an online survey

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World Journal of Transplantation 2024年第3期14卷 144-155页

作者： Giorgia Rizza Kyriaki Glynou Masha Eletskaya General Surgery and Liver Transplant Center S.Giovanni Battista HospitalTurin I-10126Italy Medical Affairs Biotest AGDreieich 63303Germany Lumanity Insight(Cello Health Insight) London SE11PPUnited Kingdom

BACKGROUND Hepatitis B immunoglobulin(HBIG)in combination with a potent nucleos(t)ide analog is considered the standard of care for prophylaxis against hepatitis B virus(HBV)reinfection after liver transplantation for HBV-associated *** To evaluate patients’satisfaction,preferences,and requirements for subcutaneous(SC),intramuscular(IM),and intravenous(IV)HBIG *** A self-completion,cross-sectional,online,22-question survey was conducted to examine perceptions and satisfaction with current HBIG treatment in adults receiving HBIG treatment following liver transplantation for HBV-associated disease in France,Italy,and *** HBIG products with different administration modes were evaluated using target product profile assessment and a conjoint(trade-off)*** Ninety patients were enrolled;32%,17%,and 51%were SC,IM,and IV HBIG users,*** duration of treatment was 36.2 *** HBIG had the least negative impact on emotional well-being and social life and was perceived as the most convenient,easiest to administer,least painful,and had the highest self-rating of treatment *** IM HBIG users than SC or IV HBIG users reported that administration frequency was excessive(67%,28%,and 28%,respectively).In the target product profile assessment,76%of patients were likely to use hypothetical SC *** the conjoint exercise,administration route,frequency,and duration were key drivers of treatment *** Ease,frequency,duration,and side effects of HBIG treatment administration were key drivers of treatment preferences,and SC HBIG appeared advantageous over IM and IV HBIG for administration ease,convenience,and pain.A hypothetical SC HBIG product elicited a favorable *** demographics,personal preferences,and satisfaction with HBIG treatment modalities may influence long-term treatment compliance.

关键词： Hepatitis B immunoglobulin Liver transplantation Subcutaneous Intramuscular intravenous Patient satisfaction

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Clinical factors associated with hepatitis B screening andvaccination in high-risk adults

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World Journal of Hepatology 2019年第1期11卷 86-98页

作者： Rotimi Ayoola Sebastian Larion David M Poppers Renee Williams Department of Medicine Division of Gastroenterology Howard University Department of Medicine Augusta University Department of Medicine Division of Gastroenterology New York University Langone Health

BACKGROUND Hepatitis B virus is a viral infection that can lead to acute and/or chronic liver disease, and hepatocellular carcinoma(HCC). Hepatitis B vaccination is 95% effective in preventing infection and the development of chronic liver disease and HCC due to hepatitis B. In 2011, the Centers for Disease Control updated their guidelines recommending that adults at high-risk for hepatitis B infection be vaccinated against hepatitis B including those with diabetes mellitus(DM). We hypothesize that adults at high-risk for hepatitis B infection are not being adequately screened and/or vaccinated for hepatitis B in a large urban healthcare *** To investigate clinical factors associated with Hepatitis B screening and vaccination in patients at high-risk for Hepatitis B *** We conducted a retrospective review of 999 patients presenting at a large urban healthcare system from 2012-2017 at high-risk for hepatitis B infection. Patients were considered high-risk for hepatitis B infection based on hepatitis B practice recommendations from the Center for Disease Control. Medical history including hepatitis B serology, concomitant medical diagnoses, demographics, insurance status and social history were extracted from electronic health *** logistic regression was used to identify clinical risk factors independently associated with hepatitis B screening and *** Among the 999 patients, 556(55.7%) patients were screened for hepatitis B. Of those who were screened, only 242(43.5%) patients were vaccinated against hepatitis B. Multivariate regression analysis revealed end-stage renal disease[odds ratio(OR): 5.122; 2.766-9.483], alcoholic hepatitis(OR: 3.064; 1.020-9.206),and cirrhosis or end-stage liver disease(OR: 1.909; 1.095-3.329); all P < 0.05 were associated with hepatitis B screening, while age(OR: 0.785; 0.680-0.906),insurance status(0.690; 0.558-0.854), history of DM(OR: 0.518; 0.364-0.737), and human immunodeficiency v

关键词： Health prevention Vaccination Hepatitis B virus Screening Diabetes mellitus Cirrhosis End-stage renal disease Human immunodeficiency virus intravenous drug users

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直肠应用蒿甲醚与静脉注射奎宁治疗乌干达儿童脑疟疾的随机临床研究

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世界核心医学期刊文摘（神经病学分册） 2005年第7期1卷 1-2页

作者： Aceng J.R. Byarugaba J.S. Tumwine J.K. 黄卫东 Dept. of Paediatr. and Child Health Makerere Medical School PO Box 7072 Kampala Uganda

Objective: To compare the efficacy and safety of rectal artemether with intrav enous quinine in the treatment of cerebral malaria in children. Design: Randomis ed, single blind, clinical trial. Setting: Acute care unit at Mulago Hospital, U ganda’s national referral and teaching hospital in Kampala. Participants: 103 ch ildren aged 6 months to 5 years with cerebral malaria. Intervention: Patients we re randomised to either intravenous quinine or rectal artemether for seven days. Main outcome measures: Time to clearance of parasites and fever; time to regain ing consciousness, starting oral intake, and sitting unaided; and adverse effects. Results: The difference in parasitological and clinical outco mes between rectal artemether and intravenous quinine did not reach significance (parasite clearance time 54.2 (SD 33.6) hours v 55.0 (SD 24.3) hours, P = 0.90; fever clearance time 33.2 (SD 21.9) hours v 24.1(SD 18.9 hours, P = 0.08; time to regaining consciousness 30.1 (SD 24.1) hours v 22.67 (SD 18.5) hours, P = 0.1 0; time to starting oral intake 37.9 (SD 27.0) hours v 30.3 (SD 21.1) hours, P = 0.14). Mortality was higher in the quinine group than in the artemether group ( 10/52 v 6/51; relative risk 1.29, 95%confidence interval 0.84 to 2.01). No seri ous immediate adverse effects occurred. Conclusion: Rectal artemether is effecti ve and well tolerated and could be used as treatment for cerebral malaria.

关键词：随机临床研究蒿甲醚意识恢复时间退热时间 rectal clearance intravenous 经口寄生虫学坎帕拉

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减轻马抗人淋巴细胞球蛋白静脉注射类过敏反应的初步研究——降低ALG的抗补体活性

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中华器官移植杂志 1986年第3期7卷 131-133页

作者：魏林娜周北平董之昌谢毓晋卫生部武汉生物制品研究所

我们选择手解剖学鼻烟壶部位作动静脉内瘘,以改善或克服前臂内瘘的诸如血栓形成、增加心脏负担等不足之处,现报告如下。

关键词：抗人淋巴细胞球蛋白静脉注射类过敏反应初步研究 ALG 抗补体活性 Experimental Study intravenous Injection

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