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Witteveen A, Young S, Cuijpers P, Ayuso-Mateos J, Barbui C, Bertolini F, Cabello M, Cadorin C, Downes N, Franzoi D, Gasior M, John A, Melchior M, McDaid D, Palantza C, Purgato M, Van der Waerden J, Wang S, Sijbrandij M. Remote mental health care interventions during the COVID-19 pandemic: An umbrella review. Behav Res Ther 2022; 159:104226. [PMID: 36410111 PMCID: PMC9661449 DOI: 10.1016/j.brat.2022.104226] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/13/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Mitigating the COVID-19 related disruptions in mental health care services is crucial in a time of increased mental health disorders. Numerous reviews have been conducted on the process of implementing technology-based mental health care during the pandemic. The research question of this umbrella review was to examine what the impact of COVID-19 was on access and delivery of mental health services and how mental health services have changed during the pandemic. A systematic search for systematic reviews and meta-analyses was conducted up to August 12, 2022, and 38 systematic reviews were identified. Main disruptions during COVID-19 were reduced access to outpatient mental health care and reduced admissions and earlier discharge from inpatient care. In response, synchronous telemental health tools such as videoconferencing were used to provide remote care similar to pre-COVID care, and to a lesser extent asynchronous virtual mental health tools such as apps. Implementation of synchronous tools were facilitated by time-efficiency and flexibility during the pandemic but there was a lack of accessibility for specific vulnerable populations. Main barriers among practitioners and patients to use digital mental health tools were poor technological literacy, particularly when preexisting inequalities existed, and beliefs about reduced therapeutic alliance particularly in case of severe mental disorders. Absence of organizational support for technological implementation of digital mental health interventions due to inadequate IT infrastructure, lack of funding, as well as lack of privacy and safety, challenged implementation during COVID-19. Reviews were of low to moderate quality, covered heterogeneously designed primary studies and lacked findings of implementation in low- and middle-income countries. These gaps in the evidence were particularly prevalent in studies conducted early in the pandemic. This umbrella review shows that during the COVID-19 pandemic, practitioners and mental health care institutions mainly used synchronous telemental health tools, and to a lesser degree asynchronous tools to enable continued access to mental health care for patients. Numerous barriers to these tools were identified, and call for further improvements. In addition, more high quality research into comparative effectiveness and working mechanisms may improve scalability of mental health care in general and in future infectious disease outbreaks.
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Affiliation(s)
- A.B. Witteveen
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands,Corresponding author
| | - S. Young
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - P. Cuijpers
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - J.L. Ayuso-Mateos
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - C. Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - F. Bertolini
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - M. Cabello
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - C. Cadorin
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - N. Downes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - D. Franzoi
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Gasior
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - A. John
- Health Data Science, Swansea University Medical School, Swansea, UK
| | - M. Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - D. McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - C. Palantza
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - J. Van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - S. Wang
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Sijbrandij
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
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Rubio S, Medina A, Cabello M, Lavela P, Alcántara R, Vicente CP, Ortiz GF, Tirado JL. Inorganic solids for dual magnesium and sodium battery electrodes. J Solid State Electrochem 2020. [DOI: 10.1007/s10008-020-04620-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ávila C, Cieza A, Chatterji S, Cabello M, Vieta E, Ayuso-Mateos J. Identification of Relevant Problems of Individuals with Bipolar Disorder: A Worldwide Expert Survey. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(09)70797-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aims:We aimed to explore the expert perspective on relevant issues of individuals with bipolar disorder. The specific aims are to identify problems in functioning important to individuals with BD and to quantify these using the ICF.Method:An online survey on functioning in BD was conduced. For each ICF domain one question was presented. Recruited participants were psychiatrists, general physicians, psychologists, nurses and social workers worldwide. Answers were linked to the ICF according to predefined rules (Cieza, 2001). Data analyses include frequencies of ICF categories named by experts.Results:Health professionals from all WHO-world regions and from different professional backgrounds accepted our invitation to participate. The Americas was the highest represented region (36%) and a significant part of the professionals involved were psychiatrists. From all the concepts contained in the answers, body functions categories with highest frequency of appearance were emotional functions (3,5%), mentioned by 62% of the experts and sleep functions (2,4%) mentioned by 58%. The body structure brain corresponds to 2% of the total categories obtained and was included by 56% of the experts. Maintaining one's health was the most mentioned activity and participation (2,8%), referred by 36% of the participants and important environmental factors include health services (4,8%) and immediate family(3,8%), which appeared in 82% of the questionnaires.Conclusion:The present study is an important step in applying of the ICF to BD. It also shows an important level of agreement between experts around the world regarding central issues of the disorder.Funded by MURINET-MRTN-CT-2006-035794
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Caballero A, Palma E, Ruiz-Esteban P, Vazquez T, Sola E, Torio A, Cabello M, Lopez V, Jironda C, Duarte A, Alonso-Titos J, Hernández D. CXCR3 + Monocytes Increase Significantly in Graft Blood Compared to Peripheral Blood in Patients With Stable Kidney Graft Function. Transplant Proc 2018; 50:555-559. [PMID: 29579851 DOI: 10.1016/j.transproceed.2017.11.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 10/20/2017] [Accepted: 11/11/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION We have recently reported that some lymphocyte populations do not maintain the same proportion in kidney graft blood as in peripheral blood, despite a stable function of the transplanted kidney. These results suggest that a comparative study between leukocyte cells from graft blood and those obtained from peripheral blood could provide information about the inflammatory state of the transplanted organ. In this work we selected the population of CD4+ lymphocytes and monocytes expressing CXCR3 to test this hypothesis. MATERIAL AND METHODS The study was performed by flow cytometry during month 3, 6, and 12 after transplantation in 58 patients who received an isolated kidney transplant and the same immunosuppressive regimen. The peripheral blood sample was obtained by venipuncture and the graft blood by fine needle aspiration. RESULTS We found a significant percentage decrease in CXCR3+ monocytes throughout the first year of transplantation in peripheral blood (15.9 ± 20.7 vs. 12.6 ± 12.4 vs. 6.3 ± 9.0, at 3, 6, and 12 months, respectively; P = .001), whereas the percentage of CXCR3+ monocytes in graft blood did not change over this period. This situation resulted in a significant percentage difference between the CXCR3+ monocytes from the graft blood and those from the peripheral blood at the sixth (15.8 ± 8.1 vs. 12.6 ± 12.4, respectively; P = .008) and 12th months (12.9 ± 8.1 vs. 6.3 ± 9.0, respectively; P < .001). CONCLUSIONS Therefore, we can conclude that the significant percentage increase of CXCR3+ monocytes in graft blood with respect to peripheral blood suggests the presence of inflammatory activity despite renal function being stable during the second half of the first year post-transplantation.
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Affiliation(s)
- A Caballero
- Immunology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - E Palma
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - P Ruiz-Esteban
- Immunology Department, Complejo Hospitalario General Universitario de Albacete, Albacete, Spain
| | - T Vazquez
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - E Sola
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - A Torio
- Immunology Department, Complejo Hospitalario General Universitario de Albacete, Albacete, Spain
| | - M Cabello
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - V Lopez
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - C Jironda
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - A Duarte
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - J Alonso-Titos
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - D Hernández
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain.
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Dueñas C, Gordo E, Liger E, Cabello M, Cañete S, Pérez M, Torre-Luque PDL. 7Be, 210Pb and 40K depositions over 11 years in Málaga. J Environ Radioact 2017; 178-179:325-334. [PMID: 28965023 DOI: 10.1016/j.jenvrad.2017.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 09/15/2017] [Accepted: 09/15/2017] [Indexed: 06/07/2023]
Abstract
The monthly bulk depositional fluxes of three natural radionuclides (7Be, 210Pb and 40K) were measured at a Mediterranean coastal station (Málaga) over an 11-year period from 2005 to 2015. The mean annual depositional fluxes of 7Be, 210Pb and 40K were 1215, 144 and 67 Bq m-2 year-1 respectively, showing a clear seasonal trend with minimum values recorded during summer and maximum values in winter. The rainfall regime with dry summers allows estimating the dry deposition. Assuming constant dry deposition through each year, 7Be, 210Pb and 40K would account for 12.5, 26.5 and 33% of the bulk fallout respectively which indicates that deposition for 210Pb and 40K are significantly higher than 7Be. The precipitation-normalized enrichment factor alpha used to explain seasonal variations in the depositional fluxes of radionuclides with respect the rainfall, indicates higher depositional fluxes during spring and summer than expected from the amount of rainfall. Despite their different origin, 210Pb and 7Be monthly depositional fluxes have strong correlation. The atmospheric deposition fluxes of 7Be, 210Pb and 40K were controlled mainly by the amount of rainfall (r = 0.89, 0.91 and 0.66 respectively). Moreover, principal component analysis was applied to the datasets and deposition of radionuclides and rainfall in the same component highlighting the importance of the washout mechanism. The mean depositional velocity of aerosols evaluated using 7Be and 210Pb are similar and are compared to other published values.
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Affiliation(s)
- C Dueñas
- Department of Applied Physics I, Faculty of Sciences, University of Málaga, Málaga, Spain.
| | - E Gordo
- Department of Applied Physics I, Faculty of Sciences, University of Málaga, Málaga, Spain
| | - E Liger
- Department of Applied Physics II, Technical College Informatic Engineering, University of Málaga, Málaga, Spain
| | - M Cabello
- Department of Applied Physics I, Faculty of Sciences, University of Málaga, Málaga, Spain
| | - S Cañete
- Department of Applied Physics I, Faculty of Sciences, University of Málaga, Málaga, Spain
| | - M Pérez
- Department of Radiology and Health Physics, Ophthalmology and OTI, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - P de la Torre-Luque
- Department of Applied Physics I, Faculty of Sciences, University of Málaga, Málaga, Spain
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Kamenov K, Twomey C, Cabello M, Prina AM, Ayuso-Mateos JL. The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis. Psychol Med 2017; 47:1337. [PMID: 28007047 DOI: 10.1017/s003329171600341x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kamenov K, Twomey C, Cabello M, Prina AM, Ayuso-Mateos JL. The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis. Psychol Med 2017; 47:414-425. [PMID: 27780478 PMCID: PMC5244449 DOI: 10.1017/s0033291716002774] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 09/30/2016] [Accepted: 10/04/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is growing recognition of the importance of both functioning and quality of life (QoL) outcomes in the treatment of depressive disorders, but the meta-analytic evidence is scarce. The objective of this meta-analysis of randomized controlled trials (RCTs) was to determine the absolute and relative effects of psychotherapy, pharmacotherapy and their combination on functioning and QoL in patients with depression. METHOD One hundred and fifty-three outcome trials involving 29 879 participants with depressive disorders were identified through database searches in Pubmed, PsycINFO and the Cochrane Central Register of Controlled Trials. RESULTS Compared to control conditions, psychotherapy and pharmacotherapy yielded small to moderate effect sizes for functioning and QoL, ranging from g = 0.31 to g = 0.43. When compared directly, initial analysis yielded no evidence that one of them was superior. After adjusting for publication bias, psychotherapy was more efficacious than pharmacotherapy (g = 0.21) for QoL. The combination of psychotherapy and medication performed significantly better for both outcomes compared to each treatment alone yielding small effect sizes (g = 0.32 to g = 0.39). Both interventions improved depression symptom severity more than functioning and QoL. CONCLUSION Despite the small number of comparative trials for some of the analyses, this study reveals that combined treatment is superior, but psychotherapy and pharmacotherapy alone are also efficacious for improving functioning and QoL. The overall relatively modest effects suggest that future tailoring of therapies could be warranted to better meet the needs of individuals with functioning and QoL problems.
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Affiliation(s)
- K. Kamenov
- Instituto de Salud Carlos III, Centro de
Investigación Biomédica en Red, CIBERSAM, Madrid,
Spain
- Department of Psychiatry,
UniversityAutónoma de Madrid, Madrid,
Spain
| | - C. Twomey
- Faculty of Social and Human Sciences,
University of Southampton, Southampton,
UK
| | - M. Cabello
- Instituto de Salud Carlos III, Centro de
Investigación Biomédica en Red, CIBERSAM, Madrid,
Spain
- Department of Psychiatry,
UniversityAutónoma de Madrid, Madrid,
Spain
| | - A. M. Prina
- Health Service and Population Research
Department, Centre for Global Mental Health, Institute of
Psychiatry, Psychology and Neuroscience, King's College London,
London, UK
| | - J. L. Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de
Investigación Biomédica en Red, CIBERSAM, Madrid,
Spain
- Department of Psychiatry,
UniversityAutónoma de Madrid, Madrid,
Spain
- Instituto de investigación de la Princesa,
(IIS-IP), Hospital Universitario de la Princesa,
Madrid, Spain
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Schalamuk S, Velazquez S, Chidichimo H, Cabello M. Fungal spore diversity of arbuscular mycorrhizal fungi associated with spring wheat: effects of tillage. Mycologia 2017. [DOI: 10.1080/15572536.2006.11832708] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | - M. Cabello
- Instituto de Botánica Spegazzini, Avenida 53 Nu. 477, 1900 La Plata, Argentina
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González JR, Nacimiento F, Cabello M, Alcántara R, Lavela P, Tirado JL. Reversible intercalation of aluminium into vanadium pentoxide xerogel for aqueous rechargeable batteries. RSC Adv 2016. [DOI: 10.1039/c6ra11030d] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Rechargeable batteries based on the intercalation of aluminium ions may be competitive against lithium-ion batteries, but their development and comprehension are full of difficulties.
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Affiliation(s)
- J. R. González
- Laboratorio de Química Inorgánica
- Universidad de Córdoba
- 14014 Córdoba
- Spain
| | - F. Nacimiento
- Laboratorio de Química Inorgánica
- Universidad de Córdoba
- 14014 Córdoba
- Spain
| | - M. Cabello
- Laboratorio de Química Inorgánica
- Universidad de Córdoba
- 14014 Córdoba
- Spain
| | - R. Alcántara
- Laboratorio de Química Inorgánica
- Universidad de Córdoba
- 14014 Córdoba
- Spain
| | - P. Lavela
- Laboratorio de Química Inorgánica
- Universidad de Córdoba
- 14014 Córdoba
- Spain
| | - J. L. Tirado
- Laboratorio de Química Inorgánica
- Universidad de Córdoba
- 14014 Córdoba
- Spain
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López V, Cabello M, Ruíz-Esteban P, Sola E, Gutiérrez C, Jironda C, Burgos D, González-Molina M, Hernández D. Impact of Early Low-Grade Proteinuria and Allograft Dysfunction on Survival in Expanded Criteria Donor Kidney Transplant Recipients. Transplant Proc 2015; 47:2611-4. [PMID: 26680050 DOI: 10.1016/j.transproceed.2015.08.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 08/18/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Recent studies have demonstrated a relationship between low-grade proteinuria and worse graft survival, but this has not been fully studied in expanded criteria donor (ECD) kidney transplant recipients. AIM The aim of this study was to assess whether the combination of early low-grade proteinuria (<1 g/d) and allograft dysfunction at the third month post-transplantation predicts outcomes in terms of survival in ECD kidney transplant recipients. MATERIAL AND METHODS We studied a cohort of 269 ECD kidney transplant recipients subdivided into 4 groups according to clinically relevant proteinuria (300 mg/d) and median creatinine (Cr; 1.7 mg/dL; interquartile range, 1.4-2.1 mg/dL) at the third month post-transplantation: Group A (Cr <1.7 mg/dL and proteinuria <300 mg/24 h; n = 97), Group B (Cr <1.7 mg/dL and proteinuria ≥300 mg/24 h; n = 38), Group C (Cr ≥1.7 mg/dL and proteinuria <300 mg/24 h; n = 79), and Group D (Cr ≥1.7 mg/dL and proteinuria ≥300 mg/24 h; n = 55). RESULTS Death-censored graft survival was significantly lower in Group D compared with the rest (P < .007). Multivariate Cox regression analysis using fixed covariates showed that the combination of low-grade proteinuria and a lower estimated glomerular filtration rate (eGFR) as associated with graft failure (hazard rate [HR] 2.5, 95% confidence interval [CI], 1.09-5.97; P = .03). CONCLUSIONS The early association of low-grade proteinuria and allograft dysfunction represents an important risk factor for graft loss in ECD kidney transplant recipients. Strategies to optimize renal function could improve the outcome in this specific population.
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Affiliation(s)
- V López
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain.
| | - M Cabello
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain
| | - P Ruíz-Esteban
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain
| | - E Sola
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain
| | - C Gutiérrez
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain
| | - C Jironda
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain
| | - D Burgos
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain
| | - M González-Molina
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain
| | - D Hernández
- Nephrology Department, Regional University Hospital of Malaga, Malaga Institute of Biomedical Research (IBIMA), University of Malaga, Malaga, Spain
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Delgado E, Cuevas MT, Domínguez F, Vega Y, Cabello M, Fernández-García A, Pérez-Losada M, Castro MÁ, Montero V, Sánchez M, Mariño A, Álvarez H, Ordóñez P, Ocampo A, Miralles C, Pérez-Castro S, López-Álvarez MJ, Rodríguez R, Trigo M, Diz-Arén J, Hinojosa C, Bachiller P, Hernáez-Crespo S, Cisterna R, Garduño E, Pérez-Álvarez L, Thomson MM. Phylogeny and Phylogeography of a Recent HIV-1 Subtype F Outbreak among Men Who Have Sex with Men in Spain Deriving from a Cluster with a Wide Geographic Circulation in Western Europe. PLoS One 2015; 10:e0143325. [PMID: 26599410 PMCID: PMC4658047 DOI: 10.1371/journal.pone.0143325] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 11/03/2015] [Indexed: 11/18/2022] Open
Abstract
We recently reported the rapid expansion of an HIV-1 subtype F cluster among men who have sex with men (MSM) in the region of Galicia, Northwest Spain. Here we update this outbreak, analyze near full-length genomes, determine phylogenetic relationships, and estimate its origin. For this study, we used sequences of HIV-1 protease-reverse transcriptase and env V3 region, and for 17 samples, near full-length genome sequences were obtained. Phylogenetic analyses were performed via maximum likelihood. Locations and times of most recent common ancestors were estimated using Bayesian inference. Among samples analyzed by us, 100 HIV-1 F1 subsubtype infections of monophyletic origin were diagnosed in Spain, including 88 in Galicia and 12 in four other regions. Most viruses (n = 90) grouped in a subcluster (Galician subcluster), while 7 from Valladolid (Central Spain) grouped in another subcluster. At least 94 individuals were sexually-infected males and at least 71 were MSM. Seventeen near full-length genomes were uniformly of F1 subsubtype. Through similarity searches and phylogenetic analyses, we identified 18 viruses from four other Western European countries [Switzerland (n = 8), Belgium (n = 5), France (n = 3), and United Kingdom (n = 2)] and one from Brazil, from samples collected in 2005–2011, which branched within the subtype F cluster, outside of both Spanish subclusters, most of them corresponding to recently infected individuals. The most probable geographic origin and age of the Galician subcluster was Ferrol, Northwest Galicia, around 2007, while the Western European cluster probably emerged in Switzerland around 2002. In conclusion, a recently expanded HIV-1 subtype F cluster, the largest non-subtype B cluster reported in Western Europe, continues to spread among MSM in Spain; this cluster is part of a larger cluster with a wide geographic circulation in diverse Western European countries.
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Affiliation(s)
- Elena Delgado
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - María Teresa Cuevas
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Francisco Domínguez
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Yolanda Vega
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Marina Cabello
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Aurora Fernández-García
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Marcos Pérez-Losada
- Centro de Investigação em Biodiversidade e Recursos Genéticos (CIBIO-InBIO), Vairão, Portugal
| | - María Ángeles Castro
- Department of Internal Medicine, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Vanessa Montero
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Mónica Sánchez
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Ana Mariño
- Infectious Diseases Unit, Department of Internal Medicine, Complejo Hospitalario Universitario Arquitecto Marcide, Ferrol, A Coruña, Spain
| | - Hortensia Álvarez
- Infectious Diseases Unit, Department of Internal Medicine, Complejo Hospitalario Universitario Arquitecto Marcide, Ferrol, A Coruña, Spain
| | - Patricia Ordóñez
- Department of Microbiology, Complejo Hospitalario Universitario Arquitecto Marcide, Ferrol, A Coruña, Spain
| | - Antonio Ocampo
- Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - Celia Miralles
- Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - Sonia Pérez-Castro
- Department of Microbiology, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | | | - Raúl Rodríguez
- Department of Internal Medicine, Complejo Hospitalario Universitario de Ourense, Ourense, Spain
| | - Matilde Trigo
- Department of Microbiology, Complejo Hospitalario Provincial de Pontevedra, Pontevedra, Spain
| | - Julio Diz-Arén
- Department of Internal Medicine, Complejo Hospitalario Provincial de Pontevedra, Pontevedra, Spain
| | - Carmen Hinojosa
- Department of Internal Medicine, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Pablo Bachiller
- Department of Internal Medicine, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Silvia Hernáez-Crespo
- Department of Clinical Microbiology and Infection Control, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain
| | - Ramón Cisterna
- Department of Clinical Microbiology and Infection Control, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain
| | - Eugenio Garduño
- Department of Microbiology, Hospital Infanta Cristina, Badajoz, Spain
| | - Lucía Pérez-Álvarez
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Michael M Thomson
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- * E-mail:
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Barrero MA, Orza JAG, Cabello M, Cantón L. Categorisation of air quality monitoring stations by evaluation of PM(10) variability. Sci Total Environ 2015; 524-525:225-36. [PMID: 25897730 DOI: 10.1016/j.scitotenv.2015.03.138] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 03/27/2015] [Accepted: 03/30/2015] [Indexed: 05/13/2023]
Abstract
Air Quality Monitoring Networks (AQMNs) are composed by a number of stations, which are typically classified as urban, suburban or rural, and background, industrial or traffic, depending on the location and the influence of the immediate surroundings. These categories are not necessarily homogeneous and distinct from one another, regarding the levels of the monitored pollutants. A classification providing groups with these features is of interest for air quality management and research purposes, and therefore, other classification criteria should be explored. In this work, the variations of PM10 concentrations in 43 stations in the AQMN of the Basque Country in the period 2005-2012 have been studied to group them according to common characteristics. The characteristic variations in time are synthesised by the autocorrelation function (ACF), with both daily and hourly data, and by the average diurnal evolution pattern of the normalised concentrations on a seasonal basis (Evol-P). A methodology based on k-means clustering of these features is proposed. Each classification gives a different piece of information that has been phenomenologically related with specific dispersion and emission dynamics. The classification based on Evol-Ps is found to be the most influential one when comparing PM10 levels between groups. A combination of these categorisations provides 5 groups with significantly different levels of PM10, improving the discrimination of the conventional classification. Our results indicate that the time series of the pollutant concentrations contain enough information to provide an objective classification of the monitoring stations in an AQMN.
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Affiliation(s)
- M A Barrero
- Department of Applied Chemistry, Faculty of Chemistry, University of the Basque Country, P. Manuel de Lardizabal, 3, 20018 San Sebastián, Spain.
| | - J A G Orza
- SCOLAb, Department of Physics, Universidad Miguel Hernández, Av. de la Universidad, s/n, edificio Alcudia, 03202 Elche, Spain.
| | - M Cabello
- SCOLAb, Department of Physics, Universidad Miguel Hernández, Av. de la Universidad, s/n, edificio Alcudia, 03202 Elche, Spain.
| | - L Cantón
- Department of Applied Chemistry, Faculty of Chemistry, University of the Basque Country, P. Manuel de Lardizabal, 3, 20018 San Sebastián, Spain.
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Díez-Fuertes F, Cabello M, Thomson MM. Bayesian phylogeographic analyses clarify the origin of the HIV-1 subtype A variant circulating in former Soviet Union's countries. Infect Genet Evol 2015; 33:197-205. [PMID: 25952568 DOI: 10.1016/j.meegid.2015.05.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/24/2015] [Accepted: 05/04/2015] [Indexed: 10/23/2022]
Abstract
The HIV-1 subtype A variant dominating the HIV-1 epidemics in former Soviet Union (FSU) countries (A(FSU)) represents one of the major clades of the HIV-1 pandemic. This variant was reported to have begun spreading among injecting drug users (IDUs) in the Ukrainian city of Odessa in late 1994. Two competing hypotheses have been proposed on the ancestral origin of the A(FSU) variant, locating it either in the Democratic Republic of Congo (DRC) or in the Republic of Guinea (RG). The studies supporting these hypotheses employed phylogenetic analyses to identify HIV-1 sequences collected outside FSU countries ancestrally related to A(FSU). A different approach, based on Bayesian phylogenetic inference and coalescent-based population genetics, has been employed here to elucidate the ancestry of this HIV-1 variant and to improve our knowledge on its spread in FSU countries. The analyses were carried out using env (C2-V3-C3) and p24(gag) fragments of the HIV-1 genome. The inferred migration for the HIV-1 A(FSU) variant revealed only one significantly supported migration pathway from Africa to Eastern Europe, supporting the hypothesis of its origin in the DRC and estimating the upper limit of the migration of the ancestral virus from Africa around 1970. The support for an origin in the RG was negligible. The results supported the main role of Odessa as the epicenter of the A(FSU) epidemic, dating the tMRCA of the A(FSU) variant around 1984, ten years before its explosive expansion among IDUs. The estimated origin of the AFSU subcluster responsible for the IDU outbreak was also located in Odessa, with the estimated tMRCA around 1993. Statistically supported migration routes from Odessa to other cities of Ukraine, Russia, Kazakhstan, Uzbekistan and Belarus were also inferred by the Bayesian phylogeographic analysis. These results shed new light on the origin and spread of the HIV-1 A(FSU) variant.
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Affiliation(s)
- Francisco Díez-Fuertes
- AIDS Immunopathology Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo, Km. 2, 28220 Majadahonda, Madrid, Spain
| | - Marina Cabello
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo, Km. 2, 28220 Majadahonda, Madrid, Spain; Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | - Michael M Thomson
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo, Km. 2, 28220 Majadahonda, Madrid, Spain.
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Kamenov K, Cabello M, Ayuso-Mateos J, Cieza A, Hegerl U, Coenen M. Expert Perspective On Interventions for Improving Psychosocial Difficulties in Depressive Disorders. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)32017-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Cabello M, Alcántara R, Nacimiento F, Ortiz G, Lavela P, Tirado JL. Electrochemical and chemical insertion/deinsertion of magnesium in spinel-type MgMn2O4 and lambda-MnO2 for both aqueous and non-aqueous magnesium-ion batteries. CrystEngComm 2015. [DOI: 10.1039/c5ce01436k] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A veritable magnesium-ion battery is described. Magnesium-ion can be reversibly extracted from MgMn2O4 and reversibly inserted into lambda-MnO2.
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Affiliation(s)
- M. Cabello
- Department of Inorganic Chemistry
- University of Cordoba
- 14071 Córdoba, Spain
| | - R. Alcántara
- Department of Inorganic Chemistry
- University of Cordoba
- 14071 Córdoba, Spain
| | - F. Nacimiento
- Department of Inorganic Chemistry
- University of Cordoba
- 14071 Córdoba, Spain
| | - G. Ortiz
- Department of Inorganic Chemistry
- University of Cordoba
- 14071 Córdoba, Spain
| | - P. Lavela
- Department of Inorganic Chemistry
- University of Cordoba
- 14071 Córdoba, Spain
| | - J. L. Tirado
- Department of Inorganic Chemistry
- University of Cordoba
- 14071 Córdoba, Spain
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Dueñas C, Fernández MC, Cabello M, Gordo E, Liger E, Cañete S, Pérez M. Study of the cosmogenic factors influence on temporal variation of 7Be air concentration during the 23rd solar cycle in Málaga (South Spain). J Radioanal Nucl Chem 2014. [DOI: 10.1007/s10967-014-3737-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cabello M, Mendoza Y, Bello G. Spatiotemporal dynamics of dissemination of non-pandemic HIV-1 subtype B clades in the Caribbean region. PLoS One 2014; 9:e106045. [PMID: 25148215 PMCID: PMC4141835 DOI: 10.1371/journal.pone.0106045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/29/2014] [Indexed: 11/18/2022] Open
Abstract
The Human immunodeficiency virus type-1 (HIV-1) epidemic in the Caribbean region is mostly driven by subtype B; but information about the pattern of viral spread in this geographic region is scarce and different studies point to quite divergent models of viral dissemination. In this study, we reconstructed the spatiotemporal and population dynamics of the HIV-1 subtype B epidemic in the Caribbean. A total of 1,806 HIV-1 subtype B pol sequences collected from 17 different Caribbean islands between 1996 and 2011 were analyzed together with sequences from the United States (n = 525) and France (n = 340) included as control. Maximum Likelihood phylogenetic analyses revealed that HIV-1 subtype B infections in the Caribbean are driven by dissemination of the pandemic clade (BPANDEMIC) responsible for most subtype B infections across the world, and older non-pandemic lineages (BCAR) characteristics of the Caribbean region. The non-pandemic BCAR strains account for >40% of HIV-1 infections in most Caribbean islands; with exception of Cuba and Puerto Rico. Bayesian phylogeographic analyses indicate that BCAR strains probably arose in the island of Hispaniola (Haiti/Dominican Republic) around the middle 1960s and were later disseminated to Trinidad and Tobago and to Jamaica between the late 1960s and the early 1970s. In the following years, the BCAR strains were also disseminated from Hispaniola and Trinidad and Tobago to other Lesser Antilles islands at multiple times. The BCAR clades circulating in Hispaniola, Jamaica and Trinidad and Tobago appear to have experienced an initial phase of exponential growth, with mean estimated growth rates of 0.35-0.45 year(-1), followed by a more recent stabilization since the middle 1990s. These results demonstrate that non-pandemic subtype B lineages have been widely disseminated through the Caribbean since the late 1960s and account for an important fraction of current HIV-1 infections in the region.
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Affiliation(s)
- Marina Cabello
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | - Yaxelis Mendoza
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama
- Department of Biotechnology, Acharya Nagarjuna University, Guntur City, Andhra Pradesh, India
- Department of Genetics and Molecular Biology, University of Panama, Panama City, Panama
- INDICASAT-AIP, City of Knowledge, Clayton, Panama City, Panama
| | - Gonzalo Bello
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
- * E-mail:
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Borrego J, Mazuecos A, Gentil M, Cabello M, Rodríguez A, Osuna A, Pérez M, Castro P, Alonso M. Proteinuria as a Predictive Factor in the Evolution of Kidney Transplantation. Transplant Proc 2013; 45:3627-9. [DOI: 10.1016/j.transproceed.2013.10.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Blanca L, Jiménez T, Cabello M, Sola E, Gutierrez C, Burgos D, Lopez V, Hernandez D. Cardiovascular risk in recipients with kidney transplants from expanded criteria donors. Transplant Proc 2013; 44:2579-81. [PMID: 23146460 DOI: 10.1016/j.transproceed.2012.09.086] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Posttransplant cardiovascular disease (CVD) is the leading cause of death in renal transplant (RT) recipients and is more evident in recipients with transplants from expanded criteria donors (ECD). OBJECTIVES We analyzed the evolution of cardiovascular risk factors and their association with patient mortality. MATERIALS AND METHODS We undertook a single-center, prospective study of RT patients (n = 360) between 1999 and 2006. These were 180 recipients with transplants from ECD and 180 controls. We analyzed the baseline characteristics and the cardiovascular risk factors: hypertension, diabetes, dyslipidemia, CVD, and anemia. Posttransplant analyses included the evolution of cardiovascular risk factors and causes of death. RESULTS The mean age of the ECD was 63.5 ± 5.4 versus 32.0 ± 13.2 years in the non-ECD (P < .001) and the recipient ages were 58.4 ± 8.7 versus 40.8 ± 13.3 years, respectively (P < .001). The median interquartile range [IQR] dialysis time was 25 months (15-39) versus 20 months (12-44; P = .017). The pretransplant body mass index was 26.89 ± 3.91 versus 25.43 ± 4.72 kg/m(2) (P = .002); the median (IQR) number of antihypertensive drugs was two (1-2) versus two (1-2.75; P = .015); dyslipidemia was present in 32.5% versus 21.6% (P = .024), diabetes in 10.6% versus 5.6% (P = .087), and CVD in 13.3% versus 7.8% (P = .086). Treatment with erythropoiesis-stimulating agents (ESA) was received by 84.9% versus 83.9% (P = .857). Concerning transplantation, the mean follow-up was 64.3 ± 33.7 months. Hypertension was present at 3 and 5 years in 85.6% versus 69.5% (P = .001) and 87.9% versus 72.8% (P = .009), respiratory. Treatment with angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers at 3 and 5 years was 79.8% versus 64.5% and 85.6% versus 65%. Dyslipidemia was present at 5 years in 63.1% versus 58.0% (P = .482). De novo diabetes occurred in 16.7% versus 11.1% (P = .128), and CVD in 13.5% versus 4.5% (P = .003). Univariate and multivariate Cox regression proportional hazards models were constructed to analyze the factors associated with patient death. CONCLUSIONS CVD is the most common cause of death in recipients of ECD, RT, 40% in the ECD group versus 28.6% in the control group. Tight control of cardiovascular risk factors and a good pretransplant patient selection contributed to the good results obtained.
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Affiliation(s)
- L Blanca
- Nephrology and Pathology Departments, H.U. Carlos Haya, Malaga, Spain.
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Marques IB, Silva RDM, Moraes CE, Azevedo LS, Nahas WC, David-Neto E, Furmanczyk-Zawiska A, Baczkowska T, Chmura A, Szmidt J, Durlik M, Joslin J, Blaker P, White B, Marinaki A, Sanderson J, Goldsmith DJ, Medani S, Traynor C, Mohan P, Little D, Conlon P, Molina M, Gonzalez E, Gutierrez E, Sevillano A, Polanco N, Morales E, Hernandez A, Praga M, Morales JM, Andres A, Park SJ, Kim TH, Kim YW, Kim YH, Kang SW, Kujawa-Szewieczek A, Szotowska M, Kuczera P, Chudek J, Wiecek A, Kolonko A, Mahrova A, Svagrova K, Bunc V, Stollova M, Teplan V, Hundt F, van Heteren P, Woitas R, Cavallo MC, Sepe V, Conte F, Albrizio P, Bottazzi A, Geraci PM, Alpay N, Gumber MR, Kute VB, Vanikar AV, Patel HV, Shah PR, Engineer DP, Trivedi HL, Golebiewska JE, Debska-Slizien A, Rutkowski B, Matias P, Martins AR, Raposo L, Jorge C, Weigert A, Birne R, Bruges M, Adragao T, Almeida M, Mendes M, Machado D, Masin-Spasovska J, Dohcev S, Stankov O, Stavridis S, Saidi S, Dejanova B, Rambabova-Busletic I, Dejanov P, Spasovski G, Nho KW, Kim YH, Han DJ, Park SK, Kim SB, Fenoglio R, Lazzarich EE, Cagna D, Cena T, Conti N, Quaglia M, Radin E, Izzo C, Stratta P, Oh IH, Park JS, Lee CH, Kang CM, Kim GH, Leone F, Lofaro D, Gigliotti P, Lupinacci S, Toteda P, Vizza D, Perri A, Papalia T, Bonofiglio R, di Loreto P, de Silvestro L, Montanaro D, Martino F, Sandrini S, Minetti E, Cabiddu G, Yildirim T, Yilmaz R, Turkmen E, Abudalal A, Altindal M, Ertoy-Baydar D, Erdem Y, Panuccio V, Tripepi R, Parlongo G, Versace MC, Politi R, Zoccali C, Mallamaci F, Porrini E, Silva I, Diaz J, Ibernon M, Moreso F, Benitez R, Delgado Mallen P, Osorio J, Lauzurica R, Torres A, Ersoy A, Koca N, Gullu Koca T, Kirhan E, Sarandol E, Ersoy C, Dirican M, Milne J, Suter V, Mikhail A, Akalin H, Dizdar O, Ersoy A, Pascual J, Torio A, Garcia C, Hernandez J, Perez-Saez MJ, Mir M, Anna F, Crespo M, Carta P, Zanazzi M, Antognoli G, Di Maria L, Caroti L, Minetti E, Dizdar O, Ersoy A, Akalin H, Ray DS, Mukherjee K, Bohidar NP, Pattanaik A, Das P, Thukral S, Kimura T, Yagisawa T, Ishikawa N, Sakuma Y, Fujiwara T, Nukui A, Gavela EE, Sancho AA, Kanter JJ, Avila AA, Beltran SS, Pallardo LL, Dawoud FG, Aithal V, Mikhail A, Majernikova M, Rosenberger J, Prihodova L, Nagyova I, Jarcuskova M, Roland R, Groothoff JW, van Dijk JP, van Agteren M, de Weerd A, van de Wetering J, IJzermans J, Betjes M, Weimar W, Popoola J, Reed A, Tavarro R, Chryssanthopoulou C, MacPhee I, Mayor M, Franco S, Jara P, Ayala R, Orue MG, Martinez A, Martinez M, Wasmouth N, Arik G, Yasar A, Turkmen E, Yildirim T, Altindal M, Abudalal A, Yilmaz S, Arici M, Bihari Bansal S, Pokhariyal S, Jain S, Sethi S, Ahlawat R, Kher V, Martins LS, Aguiar P, Dias L, Fonseca I, Henriques AC, Cabrita A, Davide J, Sparkes TM, Trofe-Clark J, Reese PP, Jakobowski D, Goral S, Doll SL, Abt PL, Sawinski D, MBloom RD, Knap B, Lukac J, Lukin M, Majcen I, Pavlovec F, Kandus A, Bren AF, Kong JM, Jeong JH, Ahn J, Lee DR, Son SH, Kim BC, Choi WY, Whang EJ, Czajka B, Malgorzewicz S, Debska-Slizien A, Rutkowski B, Panizo N, Rengel MA, Vega A, Abad S, Tana L, Arroyo D, Rodriguez-Ferrero M, Perez de Jose A, Lopez-Gomez JM, Koutroutsos K, Sackey J, Paolini L, Ramkhelawon R, Tavarro R, Chowrimootoo M, Whelan D, Popoola J, Szotowska M, Kuczera P, Chudek J, Wiecek A, Kolonko A, Slatinska J, Honsova E, Wohlfahrtova M, Slimackova E, Rajnochova SB, Viklicky O, Yankovoy A, Smith ISJ, Wylie E, Ruiz-Esteban P, Lopez V, Garcia-Frias P, Cabello M, Gonzalez-Molina M, Vozmediano C, Hernandez D, Pavlovic J, Radivojevic D, Lezaic V, Simic-Ogrizovic S, Lausevic M, Naumovic R, Ersoy A, Koca N, Kirhan E, Gullu Koca T, Ersoy C, Sarandol E, Dirican M, Sakhuja V, Gundlapalli S, Rathi M, Jha V, Kohli HS, Sharma A, Minz M, Nimgirova A, Esayan A, Kayukov I, Zuyeva E, Bilen Y, Cankaya E, Keles M, Gulcan E, Turkeli M, Albayrak B, Uyanik A, Yildirim R, Molitor N, Praktiknjo M, Woitas R, Abeygunaratne TN, Balasubramanian S, Baker R, Nicholson T, Toprak O, Sari Y, Keceli S, Kurt H, Rocha A, Malheiro J, Martins LS, Fonseca I, Dias L, Pedroso S, Almeida M, Henriques A, Nihei C, Bacelar Marques I, Seguro CA, David-Neto E, Mate G, Martin N, Colon L, Casellas L, Garangou D, de la Torre M, Torguet P, Garcia I, Calabia J, Valles M, Pruthi R, Calestani M, Leydon G, Ravanan R, Roderick P, Korkmaz S, Ersoy A, Gulten S, Koca N. Transplantation - clinical studies II. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hruba P, Brabcova I, Krejcik Z, Stranecky V, Honsova E, Viklicky O, Rocchetti MT, Pontrelli P, Rascio F, Fiorentino M, Stallone G, Gesualdo L, Grandaliano G, Lemy A, Lionet A, Noel C, Couzi L, Taupin JL, Merville P, Hiesse C, Suberbielle-Boissel C, De Meyer M, Latinne D, Racape J, Wissing KM, Claas FHJ, Toungouz M, Abramowicz D, Caballero A, Ruiz-Esteban P, Leon M, Palma-Merida E, Burgos D, Cabello M, Gonzalez-Molina M, Torres A, Hernandez D, Janssen EHCC, Ledeganck KJ, Hoenderop JGJ, Verpooten GAL, De Winter BY. Transplantation - basic. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Frutos MA, Mansilla JJ, Cabello M, Soler J, Ruiz P, Lebrón M, Baena V, Hernández D. Optimization of expanded donors using dual kidney transplantation: case-control study. Transplant Proc 2013; 44:2060-2. [PMID: 22974909 DOI: 10.1016/j.transproceed.2012.07.076] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cadaveric donation is now experiencing a trend toward the use of expanded criteria donors (ECD) who may not yield a suitable kidney for single organ transplantation which has occasionally led to their use as dual renal transplantations. MATERIAL AND METHODS We undertook a case-control study to analyze our experiences between May 2007 and March 2011 with 80 kidneys from ECD who were older than 65 years. Of these, 40 were used as single transplants (STX) and the other 40 as dual cases (DTX). Criteria to determine STX versus DTX were established by biopsy results and other donor factors. RESULTS The mean age of the ECD for STX was 68.7 ± 3.0 years and for DTX, 74.2 ± 4.3 years (P < .001), with more women among DTX (75%) versus STX (40%; P < .001). The DTX kidneys showed higher biopsy scores than the STX organs. DTX were older than STX recipients, but there were no differences in cold ischemia time, delayed graft function, hemorrhagic complications or reinterventions. DTX recipients achieved better CrCl at 1, 3, 6, and 12 months, although only significantly so at 6 months (53.4 ± 19.5 Ml/min versus 44.5 ± 15.6 mL/min; P < .05). Death-censored graft survival was 90% at 3 years for both groups. CONCLUSIONS DTX offered good results for graft survival and renal function, despite the more complicated surgery and worse quality of the allografts. DTX allowed the use of ECD kidneys that showed less satisfactory histologic and donor characteristics.
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Affiliation(s)
- M A Frutos
- Coordination Transplant Unit, Hospital Regional Universitario Carlos Haya de Málaga, Málaga, Spain.
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Gonzalez-Molina M, Ruiz-Esteban P, Burgos D, Rodriguez MA, Cabello M, Gutierrez E, Hernandez D. Mycophenolate mofetil and tacrolimus reduce mortality after deceased donor kidney transplantation. Transplant Proc 2012; 44:2577-8. [PMID: 23146459 DOI: 10.1016/j.transproceed.2012.09.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A study of mortality in renal transplantation recipients showed that the combination of mycophenolate mofetil (MMF) and tacrolimus (TaC) reduced the mortality rate. We studied 1045 consecutive adult deceased donor kidney transplant recipients from 1986-2001, where follow-up to 2011 was a minimum of 10 years, to analyze the impact of these immunosuppressive drugs on patient survival. Cox multivariate analysis showed that treatment with MMF and the use of TaC instead of cyclosporine reduced the risk of death by 43%. In conclusion, both immunosuppressive drugs reduced the risk of death of patients receiving from renal transplants deceased donors.
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Affiliation(s)
- M Gonzalez-Molina
- Nephrology Department, Carlos Haya University Hospital, Malaga and Torrecardenas Hospital, Almeria, Spain.
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López Jiménez V, Fuentes L, Jiménez T, León M, Garcia I, Sola E, Cabello M, Gutierrez C, Burgos D, Ruiz P, Hernandez D. Transplant Glomerulopathy: Clinical Course and Factors Relating to Graft Survival. Transplant Proc 2012; 44:2599-600. [DOI: 10.1016/j.transproceed.2012.09.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Ruiz-Esteban P, López V, García-Frías P, Cabello M, González-Molina M, Vozmediano C, Hernandez D. Concordance of Estimated Glomerular Filtration Rates Using Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology in Renal Transplant Recipients. Transplant Proc 2012; 44:2561-3. [DOI: 10.1016/j.transproceed.2012.09.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cabello M, Orza JAG, Barrero MA, Gordo E, Berasaluce A, Cantón L, Dueñas C, Fernández MC, Pérez M. Spatial and temporal variation of the impact of an extreme Saharan dust event. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2012jd017513] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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López V, Sola E, Jironda C, León M, García I, Gutierrez C, Cabello M, Burgos D, González-Molina M, Hernandez D. Biopsies in Renal Transplant Patients With Proteinuria: Histological Findings. Transplant Proc 2011; 43:2191-3. [DOI: 10.1016/j.transproceed.2011.05.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pérez Valdivia M, Gentil M, Toro M, Cabello M, Rodríguez-Benot A, Mazuecos A, Osuna A, Alonso M. Impact of Cold Ischemia Time on Initial Graft Function and Survival Rates in Renal Transplants From Deceased Donors Performed in Andalusia. Transplant Proc 2011; 43:2174-6. [DOI: 10.1016/j.transproceed.2011.06.047] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lopez V, Gutierrez C, Sola E, Garcia I, Burgos D, Cabello M, Leon M, Molina MG, Hernandez D. Does JC polyomavirus cause nephropathy in renal transplant patients? Transplant Proc 2011; 42:2889-91. [PMID: 20970561 DOI: 10.1016/j.transproceed.2010.07.061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION BK polyomavirus (BKV) reactivation characterized by active viruria occurs in 23%-57% of renal allograft recipients and BKV-associated nephropathy in as many as 8% of renal allograft recipients. Only a few cases of nephritis have been attributed to JC polyomavirus (JCV) with limited information about JCV replication and its impact on graft function and survival of kidney transplant patients. We sought to determine the prevalence of BKV and JCV replication, the risk factors associated with viral reactivation, and their implications for the development of polyomavirus nephropathy (PVN) among renal transplant patients. MATERIALS AND METHODS The study included 186 kidney transplant recipients who were transplanted between 2005 and 2009 with a 1-year follow-up. If the urine polymerase chain reaction (PCR) was positive, we performed a PCR on blood. If this was positive or renal dysfunction was present, we performed a renal biopsy. RESULTS Viruria was positive in 72 cases (39%) and viremia in 12 (6.5%); including, 3 patients (1.6%) who developed PVN. In the patients with viruria, BKV was detected in 47% and JCV in 46%; both were detected in 7%, although the combination of viremia and nephropathy were caused by BKV in all cases. CONCLUSION In renal transplant patients, the incidence of BKV and JCV viruria was similar, although in our series the JCV serotype did not cause viremia or PVN. Our experience suggested that JCV did not have the ability to cause PVN.
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Affiliation(s)
- V Lopez
- Nephrology Department, H.U. Carlos Haya, Malaga, Spain.
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Cabello M, Cobelo C, Gonzalez-Molina M, Leon G, Garcia I, Gutierrez E, Sola E, Lopez V, Gutierrez C, Burgos D, Hernandez D. Renal transplantation in old recipients from expanded criteria donors selected by kidney biopsy. Transplant Proc 2010; 42:2845-7. [PMID: 20970546 DOI: 10.1016/j.transproceed.2010.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Spain, the number of ideal kidney transplant donors has fallen, with at the same time an increase in the number of older recipients on the waiting list. AIM To analyze the results of expanded criteria cadaveric donor kidney transplants into older recipients using grafts selected by kidney biopsy. PATIENTS AND METHODS We studied 360 kidney transplant recipients who had been followed to December 2009: 180 in the study group and 180 in a control group composed of younger patients who received grafts from non-expanded criteria donors between 1999 and 2006. A paraffin-embedded kidney biopsy was evaluated by the percentages of sclerosed glomeruli, arteriolar hyalinosis, intimal wall thickening, interstitial fibrosis, and tubular atrophy. RESULTS Significant differences were observed in donor age (63.50±5.46 vs 31.90±13.29 years; P<.001) and recipient age (58.40±8.80 vs 40.71±13.23 years; P<.001). Donor renal function was significantly worse among the expanded criteria group (90.80 vs 108.11 mL/min/1.73 m2; P=.006), remaining so over time in the recipient (at 1 year: 42.08 vs 63.71 [P<.001]; at 3 years: 41.25 vs 62.31 [P<.001], and at 7 years: 38.17 vs 64.18 [P<.001]). Censored 7-year graft survivals were 73% versus 87% (P<.001) with similar patient survivals (90.5% vs 95%; P=.39). CONCLUSIONS Selection of expanded criteria donors by kidney biopsy resulted in good renal function as well as graft and patient survivals at 7 years in older recipients.
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Affiliation(s)
- M Cabello
- Nephrology Department, Carlos Haya University Hospital, Malaga, Spain
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Sola E, Lopez V, Gutierrez C, Cabello M, Burgos D, Molina M, Hernandez D. Late Conversion to Mammalian Target of Rapamycin Inhibitor/Proliferation Signal Inhibitors in Kidney Transplant Patients: Clinical Experience in the Last 5 Years. Transplant Proc 2010; 42:2859-60. [DOI: 10.1016/j.transproceed.2010.07.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Schalamuk S, Cabello M. Arbuscular mycorrhizal fungal propagules from tillage and no-tillage systems: possible effects on Glomeromycota diversity. Mycologia 2010; 102:261-8. [PMID: 20361494 DOI: 10.3852/08-118] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Arbuscular mycorrhizal fungi (AMF) can use different types of propagules to colonize new roots. In this work we tested different types of AMF inocula obtained from a field experiment with tilled and no-tilled soils planted with wheat as well as from nondisturbed treatments with spontaneous vegetation. AMF trap cultures were carried out with soil, mycelium, segments of roots and wheat plants from the field as sources of inocula. Then after the senescence of the trap plants Glomeromycota species that had been established from each type of propagule in the substrate from the pots were identified. In field soils the proportions of Acaulosporaceae and Gigasporaceae were relatively similar to that of Glomeraceae, mainly in conventional tillage, whereas in all trap cultures investigated the percentages of members of the Glomeraceae family were higher than 90%. Because most of the trap cultures were based on intra- and/or extraradical mycelium our results show that members of Glomeraceae have advantages in the use of these propagules over Acaulosporaceae and Gigasporaceae species. We suggest that the higher contribution of Glomeraceae previously found in no-tillage systems could be related partially to the lack of disruption of the hyphal network and the composition of the soil propagules in this system.
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Affiliation(s)
- S Schalamuk
- Instituto de Botánica Spegazzini, Avenida 53 No. 477, 1900 La Plata, Argentina.
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Sola E, Lopez V, Gutierrez C, Cabello M, Burgos D, Gonzalez Molina M, Hernandez D. Evaluation of the efficacy and safety of conversion to sirolimus in 85 renal transplant recipients. Transplant Proc 2009; 41:2137-8. [PMID: 19715855 DOI: 10.1016/j.transproceed.2009.06.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Treatment with sirolimus (SRL) is a potential therapeutic option for renal transplant recipients, especially those who have developed chronic graft nephropathy (CGN) or a neoplasm. Our aim was to analyze the efficacy and safety of conversion to SRL in renal transplant recipients. MATERIALS AND METHODS We undertook a retrospective study of 85 patients converted to SRL, 47% for tumors, 39% for CGN, and 14% for other causes. The follow-up period was 34 months (range, 1-93 months). RESULTS Baseline creatinine was 1.8 +/- 0.69 mg/dL (1.6 +/- 0.59 for tumors and 2.3 +/- 0.6 for CGN). At 1 year, the creatinine was the same in both groups: 1.8 mg/dL (P = NS). Graft survival at 12 months was 89% (81% for tumors, 81% for CGN, and 100% for other causes). SRL was withdrawn in 34% of patients: 18% for severe side effects, 7% for patient death, and 9% for graft loss. The serum creatinine and proteinuria were significantly increased among those subjects who returned to dialysis because of CGN compared with those with conserved renal function. Patients who developed pneumonitis showed a lower baseline aMDRD, but no difference in SRL levels. Side effects occurred in 40% of patients, with no difference in renal function, proteinuria, or SRL levels. Renal function showed a significant improvement in the patients who continued SRL (aMDRD 45.7 vs 50.7 mL/min/1.73 m(2) at 12 months; P = .08), more marked among those who converted due to CGN. Increases were seen in levels of serum lipids, as well as in the percentage of patients treated with statins. Proteinuria increased significantly, as did the percentage of patients treated with ACE inhibitors/ARA2. CONCLUSIONS Conversion to SRL in patients with CGN was safe when renal function had not undergone marked worsening and there was no proteinuria. Patients who were converted experienced an improvement in renal function.
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Affiliation(s)
- E Sola
- Nephrology Department, Carlos Haya Hospital, Malaga, Spain.
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Sola E, Vega E, Gutiérrez C, López V, Cabello M, Burgos D, González Molina M, Siles J. [Disease by CMV resistant to Ganciclovir. Should plasma valganciclovir levels be monitored in high risk patients?]. Nefrologia 2009; 29:180-181. [PMID: 19396331 DOI: 10.3265/nefrologia.2009.29.2.4889.en.full] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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López V, Gutiérrez C, Burgos D, González Molina M, Cabello M, Sola E, Garcia I, Siles J, Florez P. Prospective Study of Infection and Nephropathy Due to BK and JC Polyomavirus in 76 Kidney Transplant Recipients. Transplant Proc 2008; 40:2927-9. [DOI: 10.1016/j.transproceed.2008.08.098] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cabello M, Orza JAG, Galiano V, Ruiz G. Influence of meteorological input data on backtrajectory cluster analysis – a seven-year study for southeastern Spain. Adv Sci Res 2008. [DOI: 10.5194/asr-2-65-2008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract. Backtrajectory differences and clustering sensitivity to the meteorological input data are studied. Trajectories arriving in Southeast Spain (Elche), at 3000, 1500 and 500 m for the 7-year period 2000–2006 have been computed employing two widely used meteorological data sets: the NCEP/NCAR Reanalysis and the FNL data sets. Differences between trajectories grow linearly at least up to 48 h, showing faster growing after 72 h. A k-means cluster analysis performed on each set of trajectories shows differences in the identified clusters (main flows), partially because the number of clusters of each clustering solution differs for the trajectories arriving at 3000 and 1500 m. Trajectory membership to the identified flows is in general more sensitive to the input meteorological data than to the initial selection of cluster centroids.
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Abstract
Abstract. A k-means cluster analysis of 96 hour trajectories arriving in Southeast (SE) Spain at 3000, 1500 and 500 m for the 7-year period 2000–2006 has been performed to identify and describe the main flows arriving at the study area. The dependence of the aerosol size distribution on the air mass origin has been studied by using non-parametric statistics. There are statistically significant differences on aerosol size distribution and meteorological variables at surface level according to the identified clusters.
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Gonzalez Molina M, Morales JM, Marcen R, Campistol JM, Oppenheimer F, Serón D, Gil-Vernet S, Capdevila L, Andrés A, Lampreave I, Del Castillo D, Cabello M, Burgos D, Valdés F, Anaya F, Escuín F, Arias M, Pallardó L, Bustamante J. Renal function in patients with cadaveric kidney transplants treated with tacrolimus or cyclosporine. Transplant Proc 2007; 39:2167-9. [PMID: 17889126 DOI: 10.1016/j.transproceed.2007.07.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Renal function predicts graft survival in kidney transplant patients. This study compared the 2-year evolution of renal function in patients treated with cyclosporine or tacrolimus in combination with mycophenolate mofetil (MMF) and prednisone. METHODS We studied 1558 cadaveric renal transplant recipients from 14 Spanish hospitals between January 2000 and December 2002. Of these, 1168 were treated with tacrolimus and 390 with cyclosporine. The primary efficacy endpoint was long-term renal function. Renal function was measured by serum creatinine and glomerular filtration rate (GFR) by creatinine clearance calculated from the Cockcroft-Gault formula. This report summarizes the 2-year results. RESULTS At 24 months the tacrolimus group showed significantly better serum creatinine (1.5 +/- 0.7 vs 1.8 +/- 0.8 mg/dL, P < .001) and GFR (60.5 +/- 20.9 mL/min vs 47.9 +/- 10.0, P < .001) than the cyclosporine group. Additionally, recipients with ideal graft donors (23.5 +/- 2.8 vs 24.0 +/- 2.9 years) had a better serum creatinine at 2 years (1.23 +/- 0.2 vs 1.5 +/- 0.4 mg/dL, P < .05). Multivariate analysis showed that tacrolimus was an independent factor associated with better renal function: odds ratio 1.6, 95% confidence interval (1.2 to 2.2), P < .001. CONCLUSIONS Patients with a renal transplant treated with tacrolimus in combination with MMF and prednisone displayed better renal function at 2 years than those who received cyclosporine.
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Affiliation(s)
- M Gonzalez Molina
- Department of Nephrology and the Kidney Transplantation Unit, Carlos Haya, Malaga, Spain.
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Abstract
BACKGROUND Calcineurin inhibitors (CNIs) have been associated with the development of posttransplant malignancies, especially lymphoma and solid organ tumors. Sirolimus (SRL) has been shown to inhibit the growth of tumor cell lines in vitro and in vivo and has proven effective in clinical practice for the treatment of Kaposi's sarcoma. Organ transplant patients treated with CNIs who develop a tumor may thus benefit from conversion to SRL. PATIENTS AND METHODS From December 2001 to May 2006, 25 patients who developed a tumor were converted from a CNI-based immunosuppressive regimen to SRL. We analyzed the evolution of the tumor, renal function, and the adverse effects resulting from the change of immunosuppression. RESULTS The mean follow-up was 19 months. Creatinine clearance (Cockcroft-Gault) increased from 59.5 +/- 21.7 to 66.0 +/- 24.2 mL/min at 12 months (P = .4) and serum cholesterol from 176.7 +/- 46.8 to 216.4 +/- 40.3 mg/dL (P = .01). Proteinuria rose from 0.3 +/- 0.1 to 1.3 +/- 0.9 g/24 hours (P = .004). Adverse events included anemia, thrombocytopenia, and oral ulcers in 20% of cases, cutaneous eruption and gastrointestinal alterations in 12%, and edema in 24%. Four (16%) patients had improved blood pressure readings. Six (24%) patients died and one experienced an acute rejection episode after conversion to SRL. Nineteen (76%) patients displayed a favorable evolution with no evidence of tumor progression. CONCLUSIONS Conversion to SRL stabilized tumor progression in 76% of long-term renal transplant patients who developed a neoplasm over a mean follow-up of 19 months. Moreover, renal function improved. The most important adverse effects were increased cholesterol and proteinuria.
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Affiliation(s)
- V Lopez
- Nephrology Department, Carlos Haya Hospital, Malaga, Spain.
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Sola E, Lopez V, Burgos D, Cabello M, Gutierrez C, Martin A, Peña M, Gonzalez-Molina M. Pulmonary toxicity associated with sirolimus treatment in kidney transplantation. Transplant Proc 2007; 38:2438-40. [PMID: 17097960 DOI: 10.1016/j.transproceed.2006.08.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION An important side effect of sirolimus, a drug often used in organ transplantation, is pulmonary toxicity. MATERIALS AND METHODS We present five kidney transplant patients who developed this toxicity associated with sirolimus. All underwent chest radiography computed tomography, fiberoptic bronchoscopy with bronchoalveolar lavage (BAL), microbiological studies of the bronchial aspirate, blood, and sputum, and cytomegalovirus (CMV) polymerase chain reaction (PCR) in blood as well as two had transbronchial biopsies. RESULTS All five were men of mean age 54.8 +/- 10.3 years. In two sirolimus formed part of de novo therapy, and three were converted from calcineurin inhibitors. The mean treatment time was 16.6 +/- 13.7 months, with trough levels of 11.3 +/- 3 ng/mL. The patients presented with fever, cough, dyspnea, anemia, and dyslipidemia. The radiological pattern was diffuse alveolointerstitial (n = 2), or bilateral basal interstitial (n = 2), or bilateral basal alveolar (n = 1). The cell count in the BAL was 95% to 99% macrophages. In two patients cultures for bacteria were positive: Hemophilus and Pseudomonas. Tests for fungi, mycobacteria, pneumocystis, and legionella, as well as PCR for CMV were all negative. Transbronchial biopsy yielded insufficient material in one patient and a deposit of fibrinoid material and nonnecrotizing granuloma in the other. Antibacterial therapy was started, three with cotrimoxazole and two with ganciclovir, with no response. The respiratory symptoms improved after withdrawal of sirolimus (mean, 2.4 +/- 1.5 days). The mean hospital stay was 19.8 +/- 14.1 days. CONCLUSION Pulmonary toxicity due to sirolimus should be included in the differential diagnosis of kidney transplant patients who display signs of interstitial pneumonia. Its diagnosis is difficult requiring exclusion of other pulmonary diseases. Resolution of the symptoms was quick after suspension of the drug.
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Affiliation(s)
- E Sola
- Nephrology Department, Carlos Haya Hospital, Malaga, Spain.
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Burgos D, López V, Cabello M, Sola E, Gutiérrez C, García I, Siles J, Florez P, González Molina M. Polyomavirus BK nephropathy: the effect of an early diagnosis on renal function or graft loss. Transplant Proc 2007; 38:2409-11. [PMID: 17097951 DOI: 10.1016/j.transproceed.2006.08.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Polyomavirus BK nephropathy is a new complication among renal transplant patients. We studied 664 cadaver renal transplant recipients from February 1998 to February 2005, divided into two periods: 448 (group A, February 1998 to July 2003) and 176 (group B, August 2003 to February 2005). Twenty patients (3%) developed biopsy-confirmed polyomavirus BK nephropathy; 13 (2.9%) in group A after worsening renal function and 7 (3.9%) in group B after a prospective cytologic study in urine, examining for decoy cells, and a qualitative polymerase chain reaction (PCR) assay in urine and blood. The mean time to diagnosis was higher among group A (15.0 +/- 1.6 versus 7.2 +/- 4.0 months), as was the serum creatinine (2.5 +/- 0.7 versus 2.0 +/- 0.6 mg/dL). After 12 months the serum creatinine was 2.7 +/- 1.3 versus 1.7 +/- 0.2 mg/dL, respectively. Poor prognostic factors were a persistently positive PCR in blood and viral inclusions in the control biopsy.
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Affiliation(s)
- D Burgos
- Nephrology Department, Hospital Universitario Carlos Haya, Malaga, Spain
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Martín-Gómez MA, Peña M, Cabello M, Burgos D, Gutierrez C, Sola E, Acedo C, Bailén A, Gonzalez-Molina M. Posttransplant Lymphoproliferative Disease: A Series of 23 Cases. Transplant Proc 2006; 38:2448-50. [PMID: 17097963 DOI: 10.1016/j.transproceed.2006.08.050] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Posttransplant lymphoproliferative disease (PTLD) is a rare but clinically important disorder due to its increasing incidence and its impact on renal function and the life of the patient. Between 1979 and 2005, this center performed 1614 kidney transplants, and 23 patients had PTLD. We undertook a retrospective study, analyzing risk factors, presentation, and evolution of the disorder. The most common clinical presentation was fever and adenopathy. All cases except one received calcineurin inhibitors, and nine were treated with monoclonal or polyclonal antibodies. Serology for Epstein Barr virus (EBV) was negative in nine patients at the time of transplant, and in five it became positive on diagnosis of PTLD. The predominant disorder was non-Hodgkin's lymphoma (NHL), either polymorphous (n = 11) or monomorphous (n = 7). The base therapy consisted of reducing or suspending calcineurin inhibitors and the addition of sirolimus and antivirals. Three patients received rituximab, and five chemotherapy. The disease progressed in 36% of the polymorphous NHL, in 67% of the monomorphous, and in 100% of the Hodgkin's lymphoma, whereas 10 patients had remission. Renal function worsened on diagnosis in eight patients, and the graft was infiltrated in five (confirmed histologically). Five patients lost the graft and 12 died; six due to infection and five due to PTLD. Survival was worse in the patients aged over 55 years. We conclude that in most cases EBV is positive on diagnosis of the PTLD, an age older than 55 years affords a poor prognosis, and lymphocyte infiltration of the graft is common, as is worsening renal function.
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Affiliation(s)
- M A Martín-Gómez
- Servicio de Nefrología, Hospital Universitario Carlos Haya, Malaga, Spain
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Lopez V, Sola E, Gutierrez C, Burgos D, Cabello M, García I, Florez P, Lopez J, Gonzalez-Molina M. Anterior Uveitis Associated With Treatment With Intravenous Cidofovir in Kidney Transplant Patients With BK Virus Nephropathy. Transplant Proc 2006; 38:2412-3. [PMID: 17097952 DOI: 10.1016/j.transproceed.2006.08.067] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Polyomavirus-associated nephropathy (PVAN) is an important cause of kidney dysfunction and graft loss. Different treatment regimens have been used, including low-dose intravenous cidofovir. Anterior uveitis, a complication of this treatment, has been reported after its use in patients with cytomegalovirus-associated retinitis. We analyzed the incidence and associated risk factors for this disorder in patients with PVAN. PATIENTS AND METHODS The study included 14 kidney-transplant patients who had received low doses of cidofovir after being diagnosed with PVAN. RESULTS Five (35%) patients developed an episode of anterior uveitis. The mean number of cidofovir doses given was 6.8 +/- 1.6 as compared with 9.1 +/- 2.1 in patients who did not develop the disease. Creatinine clearance at diagnosis of the nephropathy and after terminating treatment was lower in the uveitis patients, who had a graft survival of 40% versus 100% in the patients who did not develop eye involvement. Treatment was suspended in the affected patients, with complete resolution in 80% after the administration of topical corticoids and cycloplegics. CONCLUSIONS Anterior uveitis secondary to low-dose treatment with cidofovir is a common complication in patients with PVAN and is associated with the degree of renal involvement. In the absence of larger studies, cidofovir should be used with caution in patients with creatinine clearance below 30 mL/min.
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Affiliation(s)
- V Lopez
- Nephrology, Carlos Haya Hospital, Malaga, Spain.
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Navarro A, Castro MJ, Cabello M, Aranda JM, Burgos D, Lopez B, Perez A, Solas E. Outcome and morbidity of pancreas transplantation in a single Spanish institution. Transplant Proc 2006; 38:1543-8. [PMID: 16797354 DOI: 10.1016/j.transproceed.2006.02.082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pancreas transplantation is nowadays the only treatment to reestablish normal blood glucose in diabetic patients. Moreover, transplantation may also prevent and possibly even revert diabetes-related complications. We present our results with the first 4 years of a pancreas transplantation program. MATERIALS AND METHODS From February 2000 to June 2004, we performed 43 pancreas transplants in 42 recipients. In all cases the technique was enteric drainage of the exocrine secretions and systemic venous derivation to the inferior vena cava for endocrine secretions. RESULTS A simultaneous pancreas-kidney transplant was performed in 37 (88.1%) patients, a pancreas after kidney in 4 (9.5%) patients, and a retransplant in 1 (2.4%) patient. Glycosylated hemoglobin and C peptide returned to normal values in all cases. Patient and graft survivals were 91% and 84%, respectively, after a median follow-up of 19 months. The rate of reoperations was 31% with an overall 16% graft loss. CONCLUSIONS Our results were comparable to those of larger series.
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Affiliation(s)
- A Navarro
- Hospital Carlos Haya, Malaga, Spain.
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Schalamuk S, Velazquez S, Chidichimo H, Cabello M. Fungal spore diversity of arbuscular mycorrhizal fungi associated with spring wheat: effects of tillage. Mycologia 2006; 98:16-22. [PMID: 16800300 DOI: 10.3852/mycologia.98.1.16] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We investigated the influence of tilling, N fertilization and crop stage on arbuscular mycorrhizae (AM) fungal species diversity in a wheat monoculture in the Pampa region of Argentina. Glomalean spores were isolated by wet sieving and decanting from conventionally tilled and nontilled soils cropped with wheat with or without N fertilization, at three phenological stages of the crop (tilling, flowering and grain filling) and fallow. Morphological characterization yielded at least 24 AM fungi taxa in the field samples, belonging to six genera of AMF: Acaulospora Archaeospora, Entrophospora, Gigaspora, Glomus and Scutellospora. Tilling and fertilization treatments did not result in decreased spore biodiversity. Wheat phenology influenced AM communities, with highest spore biodiversity during grain filling.
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Affiliation(s)
- S Schalamuk
- Instituto de Botánica Spegazzini, La Plata, Argentina
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Gonzalez Molina M, Alonso A, Briones R, Fernandez N, Caballero A, Miranda JM, Navarro A, Castro MJ, Burgos D, Cabello M, Sola E, Escaño A, Muñoz J, Aranda J, De la Fuente A. Pancreas Islet Transplantation in Patients With Type 1 Diabetes Mellitus After Kidney Transplantation. Transplant Proc 2005; 37:1443-5. [PMID: 15866632 DOI: 10.1016/j.transproceed.2005.02.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Diabetic patients with end-stage renal disease have a high mortality rate. A combined kidney-pancreas transplant is associated with greater life expectancy. Pancreas islet transplantation is an alternative involving a lower degree of morbidity. We present two patients, of 41 and 37 years of age, with a long history of diabetes mellitus (C-peptide negative), both with a previous kidney transplant, who had been treated with 22 and 28 U of insulin/d, respectively. Both patients had frequent episodes of unawareness hypoglycemia. Pancreatic islets were infused to a total of 7809 and 19,180 IE/kg, respectively. Basal posttransplant C peptide levels were 2.9 and 1.3 ng/mL. After the implant, one patient required occasional doses of insulin, and the other patient more than 50% reduced dose. After the first implant neither patient had any episodes of unawareness hypoglycemia. HbA1c at 4 months were 6.2% and 6.9%. There were no transplant-related complications.
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Gutiérrez de la Fuente C, Sola E, Alférez MJ, Navarro A, Cabello M, Burgos D, González Molina M. [De novo hemolytic uremic syndrome in a kidney-pancreas recipient in the postoperative period]. Nefrologia 2004; 24 Suppl 3:3-6. [PMID: 15219059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Among the numeruos adverse side effects of tacrolimus (TAC), de novo thrombotic microangiopathy stands out as an infrecuente but severe complication. Renal dysfunction is the only alteration that should lead to suspicion of thrombotic microangiopathy, because the clinical features of intravascular hemolysis are not always found. The definitive diagnosis can usually be made with kidney biopsy. Patientes with TAC induced thrombotic microangiopathy usually promptly recover after treatment withdrawal or reduction in the dose of TAC and a short course of plasma therapy, but the risk of rejection increases. Switching from TAC to cyclosporine has also been tried with resolution of the hemolysis but thrombotic microangiopathy has been noted with both and this condition may later recur. We present a 29-year-old man who received a kidney-pancreas transplant for end-stage diabetic nephropathy. After initial induction with basiliximab, the immunosuppression consisted of prednisone, tacrolimus and mycophenolate mofetil. Twenty four days posttransplantation his renal function declined with a peak creatine level of 2.35 mg/dl. Laboratory studies showed thrombocytopenia and features of intravascular hemolysis. TAC associated hemolytic uremic syndrome was suspected and drug was immediately stopped and converted to sirolimus. Also he was treated with plasma infusion. The allograft biopsy showed focal glomerular and arteriolar acute thrombosis without evidence of rejection. Our experience demostrate that switching from tacrolimus to sirolimus could be an adecuate strategy for patients who develop FK506-associated de novo thrombotic microangiopathy without increase risk of acute rejection.
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Alférez MJ, Sola E, García I, Mellado J, Cabello M, Burgos D, González Molina M. Protocol for histologic evaluation of marginal grafts in kidney transplants. Transplant Proc 2003; 35:695-6. [PMID: 12644097 DOI: 10.1016/s0041-1345(03)00050-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M J Alférez
- Department of Nephrology, Carlos Haya University Hospital, Malaga, Spain
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Sola E, Alférez MJ, Cabello M, Burgos D, González Molina M. Low-dose and rapid steroid withdrawal in renal transplant patients treated with tacrolimus and mycophenolate mofetil. Transplant Proc 2002; 34:1689-90. [PMID: 12176537 DOI: 10.1016/s0041-1345(02)02983-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- E Sola
- Nephrology Division, Hospital Universitario Carlos Haya, Plaza Dr Gutierrez Calzada s/n, Málaga 29010, Spain
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Sola E, García I, Burgos D, Cabello M, Alférez MJ, López J, Fernández M, Mellado JM, Campos J, González Molina M. [Nephropathy caused by polyomavirus type BK in renal transplantation]. Nefrologia 2002; 21:548-55. [PMID: 11881424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Affiliation(s)
- E Sola
- Servicio de Nefrología, Hospital Carlos Haya, Avda. Carlos Haya, s/n. 29010 Málaga.
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