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[PMID]:29505534
[Au] Autor:Wu X; Yu C; Li T; Lin L; Xu Q; Zhu Q; Ye L; Gao X
[Ad] Endereço:Department of Urology, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, Fujian, PR China.
[Ti] Título:Obesity was an independent risk factor for febrile infection after prostate biopsy: A 10-year single center study in South China.
[So] Source:Medicine (Baltimore);97(1):e9549, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To detect the best antibiotic protocol for prostate biopsy and to assess the potential risk factors postbiopsy in Chinese patients.A total of 1526 patients underwent biopsy were assessed retrospectively. The effect of 3 antibiotic protocols was compared, including fluoroquinolone (FQ) monotherapy, third-generation cephalosporin combined with FQ and targeted antibiotics according to the prebiopsy rectal swab culture result. Postbiopsy infection (PBI) was defined as fever and/or active urinary tract symptoms such as dysuria or frequency with pyuria and/or leucocytosis, sepsis is defined as the presence of clinically or microbiologically documented infection in conjunction with systemic inflammatory response syndrome. The relationship between infections and clinical characteristics of patients was assessed. Data were first picked out in univariate analysis and then enter multivariate logistic regression.Thirty-three (2.2%) patients developed febrile infection. The combination antibiotic prophylaxis could significantly decrease the rate of PBI than FQ monotherapy (1.0% vs 4.0%, P = .000). The infection rate of the targeted antibiotic group was 1.1%, but there was no significant statistic difference compared with FQ alone (P = .349). Escherichia coli was the most predominant pathogen causing infection. Rectal swab revealed as high as 47.1% and 36.0% patients harbored FQ resistant and ESBL-producing organisms, respectively. In univariate analysis, overweight (BMI between 25 and 28 kg/m), obesity (BMI > 28 kg/m), diabetes were picked out as potential risk factors. Obesity remained as risk factor (OR = 12.827, 95% CI: 0.983-8.925, P = .001) while overweight and diabetes were close to significance (P = .052, .053, respectively).The combined cephalosporin with FQ prophylaxis could significantly decrease the risk of infectious complications. Obesity was an independent risk factor for PBI.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Antibioticoprofilaxia
Obesidade/complicações
Próstata/cirurgia
Prostatite/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Biópsia/efeitos adversos
Cefalosporinas/uso terapêutico
China
Fluoroquinolonas/uso terapêutico
Seres Humanos
Infecção/etiologia
Masculino
Meia-Idade
Prostatite/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cephalosporins); 0 (Fluoroquinolones)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009549


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[PMID]:29484746
[Au] Autor:Hauge SC; Jensen CK; Nielsen LK; Pedersen OB; Sørensen E; Thørner LW; Hjalgrim H; Erikstrup C; Nielsen KR; Kaspersen KA; Didriksen M; Dziegiel M; Ullum H
[Ad] Endereço:Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.
[Ti] Título:The association of IgA deficiency on infection rate, self-perceived health, and levels of C-reactive protein in healthy blood donors.
[So] Source:APMIS;126(3):248-256, 2018 Mar.
[Is] ISSN:1600-0463
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:The clinical importance of immunoglobulin A (IgA) deficiency in otherwise healthy individuals is not well described. We aimed to investigate the self-reported mental and physical health and the risk of infection in IgA-deficient blood donors compared to healthy control blood donors. Infectious events, recorded in public health registries either as prescriptions filled of any antimicrobial medicine or as hospital infections, were compared between 177 IgA-deficient blood donors and 1770 control blood donors. A subset of the IgA-deficient donors were further characterized by self-reported health (Short Form-12, n = 28) and circulating C-reactive protein (CRP) (n = 10). IgA-deficient individuals had lower self-reported mental health (p = 0.01) and higher CRP (p < 0.05). A strong trend was found regarding prescription of antimicrobial medicine (hazard ratio = 1.19, p = 0.05). No association was found with hospital infections (hazard ratio = 1.02, p = 0.95) or self-reported physical health (p = 0.86). IgA-deficient blood donors have impaired self-reported mental health, enhanced inflammation and possibly an increased risk of infection. Despite these findings, this study does not provide sufficient evidence to warrant specific health precautions for donors with IgA deficiency.
[Mh] Termos MeSH primário: Proteína C-Reativa/metabolismo
Autoavaliação Diagnóstica
Predisposição Genética para Doença
Deficiência de IgA/imunologia
Imunoglobulina A/imunologia
Infecção/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Doadores de Sangue
Dinamarca/epidemiologia
Feminino
Seres Humanos
Deficiência de IgA/genética
Imunoglobulina A/genética
Infecção/imunologia
Masculino
Meia-Idade
Risco
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunoglobulin A); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180228
[St] Status:MEDLINE
[do] DOI:10.1111/apm.12807


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[PMID]:29267496
[Au] Autor:Wu L; Wang X; Chen F; Lv X; Sun W; Guo Y; Hou H; Ji H; Wei W; Gong L
[Ad] Endereço:Department of Ultrasonography, Tianjin Medical University General Hospital, Tianjin, China.
[Ti] Título:T cell subsets and immunoglobulin G levels are associated with the infection status of systemic lupus erythematosus patients.
[So] Source:Braz J Med Biol Res;51(2):e4547, 2017 Dec 11.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Systemic lupus erythematosus (SLE) is a chronic, autoimmune disorder that affects nearly all organs and tissues. As knowledge about the mechanism of SLE has increased, some immunosuppressive agents have become routinely used in clinical care, and infections have become one of the direct causes of mortality in SLE patients. To identify the risk factors indicative of infection in SLE patients, a case control study of our hospital's medical records between 2011 and 2013 was performed. We reviewed the records of 117 SLE patients with infection and 61 SLE patients without infection. Changes in the levels of T cell subsets, immunoglobulin G (IgG), complement C3, complement C4, globulin, and anti-double-stranded DNA (anti-ds-DNA) were detected. CD4+ and CD4+/CD8+ T cell levels were significantly lower and CD8+ T cell levels were significantly greater in SLE patients with infection than in SLE patients without infection. Additionally, the concentrations of IgG in SLE patients with infection were significantly lower than those in SLE patients without infection. However, complement C3, complement C4, globulin, and anti-ds-DNA levels were not significantly different in SLE patients with and without infection. Therefore, clinical testing for T cell subsets and IgG is potentially useful for identifying the presence of infection in SLE patients and for distinguishing a lupus flare from an acute infection.
[Mh] Termos MeSH primário: Imunoglobulina G/sangue
Infecção/sangue
Infecção/patologia
Lúpus Eritematoso Sistêmico/sangue
Lúpus Eritematoso Sistêmico/patologia
Subpopulações de Linfócitos T/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Anticorpos Antinucleares/sangue
Complemento C3/análise
Complemento C4/análise
Ensaio de Imunoadsorção Enzimática
Feminino
Citometria de Fluxo
Seres Humanos
Infecção/imunologia
Lúpus Eritematoso Sistêmico/imunologia
Masculino
Meia-Idade
Nefelometria e Turbidimetria
Reação em Cadeia da Polimerase
Fatores de Risco
Soroglobulinas/análise
Estatísticas não Paramétricas
Subpopulações de Linfócitos T/imunologia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Antinuclear); 0 (Complement C3); 0 (Complement C4); 0 (Immunoglobulin G); 0 (Serum Globulins)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
[PMID]:29298160
[Au] Autor:Sullivan KM; Goldmuntz EA; Keyes-Elstein L; McSweeney PA; Pinckney A; Welch B; Mayes MD; Nash RA; Crofford LJ; Eggleston B; Castina S; Griffith LM; Goldstein JS; Wallace D; Craciunescu O; Khanna D; Folz RJ; Goldin J; St Clair EW; Seibold JR; Phillips K; Mineishi S; Simms RW; Ballen K; Wener MH; Georges GE; Heimfeld S; Hosing C; Forman S; Kafaja S; Silver RM; Griffing L; Storek J; LeClercq S; Brasington R; Csuka ME; Bredeson C; Keever-Taylor C; Domsic RT; Kahaleh MB; Medsger T; Furst DE; SCOT Study Investigators
[Ad] Endereço:From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.)
[Ti] Título:Myeloablative Autologous Stem-Cell Transplantation for Severe Scleroderma.
[So] Source:N Engl J Med;378(1):35-47, 2018 01 04.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite current therapies, diffuse cutaneous systemic sclerosis (scleroderma) often has a devastating outcome. We compared myeloablative CD34+ selected autologous hematopoietic stem-cell transplantation with immunosuppression by means of 12 monthly infusions of cyclophosphamide in patients with scleroderma. METHODS: We randomly assigned adults (18 to 69 years of age) with severe scleroderma to undergo myeloablative autologous stem-cell transplantation (36 participants) or to receive cyclophosphamide (39 participants). The primary end point was a global rank composite score comparing participants with each other on the basis of a hierarchy of disease features assessed at 54 months: death, event-free survival (survival without respiratory, renal, or cardiac failure), forced vital capacity, the score on the Disability Index of the Health Assessment Questionnaire, and the modified Rodnan skin score. RESULTS: In the intention-to-treat population, global rank composite scores at 54 months showed the superiority of transplantation (67% of 1404 pairwise comparisons favored transplantation and 33% favored cyclophosphamide, P=0.01). In the per-protocol population (participants who received a transplant or completed ≥9 doses of cyclophosphamide), the rate of event-free survival at 54 months was 79% in the transplantation group and 50% in the cyclophosphamide group (P=0.02). At 72 months, Kaplan-Meier estimates of event-free survival (74% vs. 47%) and overall survival (86% vs. 51%) also favored transplantation (P=0.03 and 0.02, respectively). A total of 9% of the participants in the transplantation group had initiated disease-modifying antirheumatic drugs (DMARDs) by 54 months, as compared with 44% of those in the cyclophosphamide group (P=0.001). Treatment-related mortality in the transplantation group was 3% at 54 months and 6% at 72 months, as compared with 0% in the cyclophosphamide group. CONCLUSIONS: Myeloablative autologous hematopoietic stem-cell transplantation achieved long-term benefits in patients with scleroderma, including improved event-free and overall survival, at a cost of increased expected toxicity. Rates of treatment-related death and post-transplantation use of DMARDs were lower than those in previous reports of nonmyeloablative transplantation. (Funded by the National Institute of Allergy and Infectious Diseases and the National Institutes of Health; ClinicalTrials.gov number, NCT00114530 .).
[Mh] Termos MeSH primário: Ciclofosfamida/uso terapêutico
Transplante de Células-Tronco Hematopoéticas
Imunossupressores/uso terapêutico
Escleroderma Sistêmico/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Ciclofosfamida/efeitos adversos
Intervalo Livre de Doença
Feminino
Seguimentos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Transplante de Células-Tronco Hematopoéticas/mortalidade
Seres Humanos
Imunossupressores/efeitos adversos
Infecção/etiologia
Análise de Intenção de Tratamento
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Escleroderma Sistêmico/tratamento farmacológico
Escleroderma Sistêmico/mortalidade
Condicionamento Pré-Transplante
Transplante Autólogo
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Immunosuppressive Agents); 8N3DW7272P (Cyclophosphamide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180304
[Lr] Data última revisão:
180304
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:27771280
[Au] Autor:Chappidi MR; Chalfin HJ; Johnson DJ; Kates M; Sopko NA; Johnson MH; Liu JJ; Frank SM; Bivalacqua TJ
[Ad] Endereço:The James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: mchappi1@jhmi.edu.
[Ti] Título:Longer average blood storage duration is associated with increased risk of infection and overall morbidity following radical cystectomy.
[So] Source:Urol Oncol;35(2):38.e17-38.e24, 2017 02.
[Is] ISSN:1873-2496
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients with bladder cancer undergoing radical cystectomy (RC) experience high rates of perioperative blood transfusions (PBTs) and morbidity. The aim of this study was to evaluate the effect of blood storage duration on the risk of adverse perioperative outcomes in this high-risk patient population. MATERIALS AND METHODS: In a retrospective review of RC patients from 2010 to 2014 who received PBTs, the average storage duration for all units transfused was used to classify patients as receiving older blood using 3 different definitions (≥21 days,≥28 days, and≥35 days). Multivariable Poisson regression models were used to determine the adjusted relative risk of perioperative infections and overall morbidity in those given older blood compared to fresher blood. RESULTS: Of the 451 patients undergoing RC, 205 (45%) received nonirradiated PBTs. In multivariable modeling, increasing average blood storage duration, as a continuous variable, was associated with an increased risk of infections (risk ratio [RR] = 1.08 per day, 95% CI: 1.01-1.17) and overall morbidity (RR = 1.08 per day, 95% CI: 1.01-1.15). Furthermore, ≥28-day blood storage (vs.<28) was associated with increased infections (RR = 2.69, 95% CI: 1.18-6.14) and morbidity (RR = 2.54, 95% CI: 1.31-4.95), and ≥35-day blood storage (vs.<35) was also associated with increased infections (RR = 2.83, 95% CI: 1.42-5.66) and morbidity (RR = 3.35, 95% CI: 1.95-5.77). CONCLUSIONS: Although blood is stored up to 42 days, storage≥28 days may expose RC patients to increased perioperative infections and overall morbidity compared with storage<28 days. Prospective cohort studies are warranted in cystectomy and other high-risk surgical oncology patients to better determine the effect of blood storage duration.
[Mh] Termos MeSH primário: Preservação de Sangue/métodos
Cistectomia/métodos
Infecção/diagnóstico
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Idoso
Preservação de Sangue/efeitos adversos
Transfusão de Sangue/métodos
Comorbidade
Feminino
Seres Humanos
Infecção/epidemiologia
Infecção/etiologia
Masculino
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)/métodos
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Neoplasias da Bexiga Urinária/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29360884
[Au] Autor:Adams NL; Rose TC; Hawker J; Violato M; O'Brien SJ; Barr B; Howard VJK; Whitehead M; Harris R; Taylor-Robinson DC
[Ad] Endereço:NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom.
[Ti] Título:Relationship between socioeconomic status and gastrointestinal infections in developed countries: A systematic review and meta-analysis.
[So] Source:PLoS One;13(1):e0191633, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The association between socioeconomic status (SES) and health is well-documented; however limited evidence on the relationship between SES and gastrointestinal (GI) infections exists, with published studies producing conflicting results. This systematic review aimed to assess the association between SES and GI infection risk, and explore possible sources of heterogeneity in effect estimates reported in the literature. METHODS: MEDLINE, Scopus, Web of Science and grey literature were searched from 1980 to October 2015 for studies reporting an association between GI infections and SES in a representative population sample from a member-country of the Organisation for Economic Co-operation and Development. Harvest plots and meta-regression were used to investigate potential sources of heterogeneity such as age; level of SES variable; GI infection measurement; and predominant mode of transmission. The protocol was registered on PROSPERO: CRD42015027231. RESULTS: In total, 6021 studies were identified; 102 met the inclusion criteria. Age was identified as the only statistically significant potential effect modifier of the association between SES and GI infection risk. For children, GI infection risk was higher for those of lower SES versus high (RR 1.51, 95% CI;1.26-1.83), but there was no association for adults (RR 0.79, 95% CI;0.58-1.06). In univariate analysis, the increased risk comparing low and high SES groups was significantly higher for pathogens spread by person-to-person transmission, but lower for environmental pathogens, as compared to foodborne pathogens. CONCLUSIONS: Disadvantaged children, but not adults, have greater risk of GI infection compared to their more advantaged counterparts. There was high heterogeneity and many studies were of low quality. More high quality studies are needed to investigate the association between SES and GI infection risk, and future research should stratify analyses by age and pathogen type. Gaining further insight into this relationship will help inform policies to reduce inequalities in GI illness in children.
[Mh] Termos MeSH primário: Gastroenteropatias/epidemiologia
Infecção/epidemiologia
Classe Social
[Mh] Termos MeSH secundário: Países Desenvolvidos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191633


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[PMID]:28462526
[Au] Autor:Man SM; Karki R; Kanneganti TD
[Ad] Endereço:Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA.
[Ti] Título:Molecular mechanisms and functions of pyroptosis, inflammatory caspases and inflammasomes in infectious diseases.
[So] Source:Immunol Rev;277(1):61-75, 2017 05.
[Is] ISSN:1600-065X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Cell death is a fundamental biological phenomenon that is essential for the survival and development of an organism. Emerging evidence also indicates that cell death contributes to immune defense against infectious diseases. Pyroptosis is a form of inflammatory programmed cell death pathway activated by human and mouse caspase-1, human caspase-4 and caspase-5, or mouse caspase-11. These inflammatory caspases are used by the host to control bacterial, viral, fungal, or protozoan pathogens. Pyroptosis requires cleavage and activation of the pore-forming effector protein gasdermin D by inflammatory caspases. Physical rupture of the cell causes release of the pro-inflammatory cytokines IL-1ß and IL-18, alarmins and endogenous danger-associated molecular patterns, signifying the inflammatory potential of pyroptosis. Here, we describe the central role of inflammatory caspases and pyroptosis in mediating immunity to infection and clearance of pathogens.
[Mh] Termos MeSH primário: Caspases/metabolismo
Infecção/imunologia
Inflamassomos/metabolismo
Mediadores da Inflamação/metabolismo
Piroptose
[Mh] Termos MeSH secundário: Animais
Seres Humanos
Imunidade
Interleucina-18/metabolismo
Interleucina-1beta/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Inflammasomes); 0 (Inflammation Mediators); 0 (Interleukin-18); 0 (Interleukin-1beta); EC 3.4.22.- (Caspases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1111/imr.12534


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[PMID]:29211220
[Au] Autor:Campos IC; Tanganelli V; Maues HP; Coelho MCM; Martins FA; Munhoz G; Egito JGT; Souza HCC; Giannini CMC; Farsky PS
[Ad] Endereço:Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
[Ti] Título:Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts.
[So] Source:Braz J Cardiovasc Surg;32(5):394-400, 2017 Sep-Oct.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To correlate blood transfusions and clinical outcomes during hospitalization in coronary artery bypass grafting surgery (CABG). METHODS: Transfusion, clinical and hematological data were collected for 1,378 patients undergoing isolated or combined CABG between January 2011 and December 2012. The effect of blood transfusions was evaluated through multivariate analysis to predict three co-primary outcomes: composite ischemic events, composite infectious complications and hospital mortality. Because higher risk patients receive more transfusions, the hospital mortality outcome was also tested on a stratum of low-risk patients to isolate the effect of preoperative risk on the results. RESULTS: The transfusion rate was 63.9%. The use of blood products was associated with a higher incidence of the three coprimary outcomes: composite infectious complications (OR 2.67, 95% CI 1.70 to 4.19; P<0.001), composite ischemic events (OR 2.42, 95% CI 1.70 to 3.46; P<0.001) and hospital mortality (OR 3.07, 95% CI 1.53 to 6.13; P<0.001). When only patients with logistic EuroSCORE ≤ 2% were evaluated, i.e., low-risk individuals, the mortality rate and the incidence of ischemic events and infectious complications composites remained higher among the transfused patients [6% vs. 0.4% (P<0.001), 11.7% vs. 24,3% (P<0.001) and 6.5% vs. 12.7% (P=0.002), respectively]. CONCLUSION: The use of blood components in patients undergoing CABG was associated with ischemic events, infectious complications and hospital mortality, even in low-risk patients.
[Mh] Termos MeSH primário: Transfusão de Sangue/estatística & dados numéricos
Ponte de Artéria Coronária/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Transfusão de Sangue/mortalidade
Ponte de Artéria Coronária/métodos
Ponte de Artéria Coronária/mortalidade
Feminino
Mortalidade Hospitalar
Seres Humanos
Infecção/etiologia
Masculino
Meia-Idade
Isquemia Miocárdica/etiologia
Período Perioperatório
Complicações Pós-Operatórias
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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Registro de Ensaios Clínicos
Texto completo
[PMID]:29231133
[Au] Autor:Mateos MV; Dimopoulos MA; Cavo M; Suzuki K; Jakubowiak A; Knop S; Doyen C; Lucio P; Nagy Z; Kaplan P; Pour L; Cook M; Grosicki S; Crepaldi A; Liberati AM; Campbell P; Shelekhova T; Yoon SS; Iosava G; Fujisaki T; Garg M; Chiu C; Wang J; Carson R; Crist W; Deraedt W; Nguyen H; Qi M; San-Miguel J; ALCYONE Trial Investigators
[Ad] Endereço:From University Hospital of Salamanca-Instituto de Investigación Biomédica de Salamanca, Salamanca (M.-V.M.), and Clínica Universidad de Navarra-Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra, Centro de Investigación Biomédica en Red de Cáncer, Pamplona (J.S
[Ti] Título:Daratumumab plus Bortezomib, Melphalan, and Prednisone for Untreated Myeloma.
[So] Source:N Engl J Med;378(6):518-528, 2018 02 08.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The combination of bortezomib, melphalan, and prednisone is a standard treatment for patients with newly diagnosed multiple myeloma who are ineligible for autologous stem-cell transplantation. Daratumumab has shown efficacy in combination with standard-of-care regimens in patients with relapsed or refractory multiple myeloma. METHODS: In this phase 3 trial, we randomly assigned 706 patients with newly diagnosed multiple myeloma who were ineligible for stem-cell transplantation to receive nine cycles of bortezomib, melphalan, and prednisone either alone (control group) or with daratumumab (daratumumab group) until disease progression. The primary end point was progression-free survival. RESULTS: At a median follow-up of 16.5 months in a prespecified interim analysis, the 18-month progression-free survival rate was 71.6% (95% confidence interval [CI], 65.5 to 76.8) in the daratumumab group and 50.2% (95% CI, 43.2 to 56.7) in the control group (hazard ratio for disease progression or death, 0.50; 95% CI, 0.38 to 0.65; P<0.001). The overall response rate was 90.9% in the daratumumab group, as compared with 73.9% in the control group (P<0.001), and the rate of complete response or better (including stringent complete response) was 42.6%, versus 24.4% (P<0.001). In the daratumumab group, 22.3% of the patients were negative for minimal residual disease (at a threshold of 1 tumor cell per 10 white cells), as compared with 6.2% of those in the control group (P<0.001). The most common adverse events of grade 3 or 4 were hematologic: neutropenia (in 39.9% of the patients in the daratumumab group and in 38.7% of those in the control group), thrombocytopenia (in 34.4% and 37.6%, respectively), and anemia (in 15.9% and 19.8%, respectively). The rate of grade 3 or 4 infections was 23.1% in the daratumumab group and 14.7% in the control group; the rate of treatment discontinuation due to infections was 0.9% and 1.4%, respectively. Daratumumab-associated infusion-related reactions occurred in 27.7% of the patients. CONCLUSIONS: Among patients with newly diagnosed multiple myeloma who were ineligible for stem-cell transplantation, daratumumab combined with bortezomib, melphalan, and prednisone resulted in a lower risk of disease progression or death than the same regimen without daratumumab. The daratumumab-containing regimen was associated with more grade 3 or 4 infections. (Funded by Janssen Research and Development; ALCYONE ClinicalTrials.gov number, NCT02195479 .).
[Mh] Termos MeSH primário: Anticorpos Monoclonais/administração & dosagem
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Mieloma Múltiplo/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Anticorpos Monoclonais/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Bortezomib/administração & dosagem
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Infecção/induzido quimicamente
Infecção/mortalidade
Análise de Intenção de Tratamento
Estimativa de Kaplan-Meier
Masculino
Melfalan/administração & dosagem
Meia-Idade
Mieloma Múltiplo/mortalidade
Prednisona/administração & dosagem
Taxa de Sobrevida
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 4Z63YK6E0E (daratumumab); 69G8BD63PP (Bortezomib); Q41OR9510P (Melphalan); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171213
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1714678


  10 / 30175 MEDLINE  
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[PMID]:27770851
[Au] Autor:Doern CD; Butler-Wu SM
[Ad] Endereço:Association for Molecular Pathology's Matrix-Assisted Laser Desorption Ionization Time-of-Flight Working Group, Bethesda, Maryland; Department of Pathology, Virginia Commonwealth University Medical Center, Richmond, Virginia. Electronic address: cdoern@mcvh-vcu.edu.
[Ti] Título:Emerging and Future Applications of Matrix-Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) Mass Spectrometry in the Clinical Microbiology Laboratory: A Report of the Association for Molecular Pathology.
[So] Source:J Mol Diagn;18(6):789-802, 2016 11.
[Is] ISSN:1943-7811
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The performance of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MS) for routine bacterial and yeast identification as well as direct-from-blood culture bottle identification has been thoroughly evaluated in the peer-reviewed literature. Microbiologists are now moving beyond these methods to apply MS to other areas of the diagnostic process. This review discusses the emergence of advanced matrix-assisted laser desorption ionization time-of-flight MS applications, including the identification of filamentous fungi and mycobacteria and the current and future state of antimicrobial resistance testing.
[Mh] Termos MeSH primário: Serviços de Laboratório Clínico
Técnicas Microbiológicas
Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos
[Mh] Termos MeSH secundário: Bactérias/química
Bactérias/classificação
Serviços de Laboratório Clínico/tendências
Resistência Microbiana a Medicamentos
Seres Humanos
Infecção/diagnóstico
Infecção/microbiologia
Testes de Sensibilidade Microbiana
Técnicas Microbiológicas/métodos
Técnicas Microbiológicas/tendências
Leveduras/química
Leveduras/classificação
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180122
[Lr] Data última revisão:
180122
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE



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