• McCulloch Valdez posted an update 6 months, 1 week ago

    01). In females but not in males, compared to BMI, BRI and WHR had a greater area under the curve (AUC) for detecting HMOD. In the further stepwise logistic regression with all anthropometric indices put into models simultaneously, only BRI remained in the LVH (odds ratio 1.42, 95% confidence interval 1.30-1.55) and LLA (OR 1.48, 95% CI 1.23-1.77) models, and WHR remained in the AS (OR 1.30, 95% CI 1.18-1.43) and MAU (OR 1.48, 95% CI 1.28-1.72, all P<0.01) models.

    Compared to BMI, the novel anthropometric parameter BRI, together with the conventional parameter WHR, exhibits a closer relationship with HMOD in the elderly population, especially in females.

    Compared to BMI, the novel anthropometric parameter BRI, together with the conventional parameter WHR, exhibits a closer relationship with HMOD in the elderly population, especially in females.

    The Global Leadership Initiative on Malnutrition (GLIM) released new universal criteria for diagnosing and grading malnutrition, and calls for further investigations not only in different clinical setting but also in GLIM itself including reference value, combination and weight of different GLIM criteria. This study aimed to weigh the GLIM criteria and develop a scored-GLIM system, and then validate as well as evaluate its application in nutritional assessment and survival prediction for patients with cancer.

    A total of 3547 patients in the primary cohort and 415 patients in the validation cohort were included in the study. Patients’ nutritional status were retrospectively assessed using the GLIM criteria. Kaplan-Meier survival curves and multivariate Cox regression analyses were performed to analyze the association between nutritional status and overall survival (OS). A nomogram was produced to quantify the GLIM criteria and develop the scored-GLIM system. C-index, receiver operating characteristic (ROC)he scored-GLIM system.

    The accuracy and net clinical benefit of scored-GLIM system were similar to scored-PG-SGA but higher than GLIM both in nutrition assessment and in survival prediction for patients with cancer. check details These findings, along with its time-savings advantages over scored-PG-SGA, suggest scored-GLIM be a better nutritional assessment tool.

    The accuracy and net clinical benefit of scored-GLIM system were similar to scored-PG-SGA but higher than GLIM both in nutrition assessment and in survival prediction for patients with cancer. These findings, along with its time-savings advantages over scored-PG-SGA, suggest scored-GLIM be a better nutritional assessment tool.Delayed graft function (DGF) after kidney transplantation is associated with an increased risk of graft failure. We studied the histologic findings among adult kidney transplant recipients transplanted between January 2000 and June 2015 who had DGF and had a kidney biopsy within 14 days of transplant. Death censored graft failure (DCGF) and death at 1 and 3 years after transplant were examined. A total of 269 transplant recipients fulfilled our selection criteria, of which 152 (56.51%) had acute tubular necrosis (ATN), 44 (16.4%) had acute rejection (AR), mainly T-cell mediated rejection (n = 31), 35 (13%) had ATN with AR (mainly T-cell mediated rejection, n = 26), and 38 (14.1%) had other pathology. Compared with those with ATN alone, kidney transplant recipients with AR alone had a significantly higher risk of DCGF at 1 year post transplant (adjusted hazard ratio = 3.70; 95% confidence interval 1.5-9.5; P = .006). Those with AR alone had an increased risk of DCGF at 3 years post transplant (hazard ratio = 3.10; 95% confidence interval 1.3-8.5; P = .01) in crude analyses. There was no association between DGF etiology and mortality. Early renal biopsy can be used to distinguish AR, which has protocolized treatments, from other etiologies. This could potentially alter allograft survival within 1 year of transplant complicated by DGF.

    Angiotensin II type-1 receptor (AT

    R) and endothelin-1 type A receptor (ET

    R) autoantibodies, in addition to allograft injury, can bind native endothelial cells and cause vascular vasoconstriction and fibrosis progression in nontransplanted organs. Therefore, we investigated long-term native renal function in liver transplant (LT) recipients with and without anti-AT

    R-Abs and/or anti-ET

    R-Abs present in serum.

    Primary LT recipients at our single center from January 2000 to April 2009 had their prospectively collected pre-LT (1269 patients) and year 1 post-LT (795 patients) serum tested retrospectively for anti-AT

    R-Abs and/or anti-ET

    R-Abs. Anti-AT

    R-Abs and anti-ET

    R-Abs testing was accomplished with a standardized solid phase assay in which >10 U was considered positive.

    Pretransplant anti-AT

    R-Abs and/or anti-ET

    R-Abs did not change the median delta creatinine from pretransplant to 1 year post-transplant. In multivariable analysis controlling for diabetes (DM) and calcineurin inhibitor (CNI) use, anti-AT

    R-Abs and/or anti-ET

    R-Abs at 1-year remained statistically significantly associated with a decline in GFR (measured by Modification of Diet in Renal Disease-6) from years 1-5 post-LT (P= .04). In diabetic patients the association with a decline in renal function was more pronounced with (-9.29 mL/min) vs without (-2.28 mL/min) anti-AT

    R-Abs and/or anti-ET

    R-Abs at year 1, respectively (P= .004).

    At 1-year post-LT, the autoantibodies anti-AT

    R-Abs and/or anti-ET

    R-Abs are associated in multivariable analysis with an increased risk of native renal function decline especially in diabetic patients.

    At 1-year post-LT, the autoantibodies anti-AT1R-Abs and/or anti-ETAR-Abs are associated in multivariable analysis with an increased risk of native renal function decline especially in diabetic patients.

    Delayed graft function (DGF) adversely affects graft survival and function. Machine perfusion (MP) improves DGF rate and may compensate for extended storage time.

    In this single-center cohort study, we included 193 consecutive kidney transplantations. MP was used in 78 kidneys (36%) and static cold storage (CS) in 115 kidneys (64%). CS kidneys were transplanted first followed by MP kidneys if stored differently. Pairs of kidneys from the same donor were subjected for subgroup analysis and included 58 pairs. The primary endpoints were the rate of DGF and 1- and 5-year graft survival. The secondary endpoints were the rate of the primary nonfunction, mortality, acute rejection, duration of DGF, and 5-year estimated glomerular filtration rate.

    Median cold ischemia time (CIT) was significantly different between the MP and CS groups (24 vs 20 hours, P< .05). MP significantly reduced the rate of DGF (MP vs CS 21.8% vs 42.6%, P< .05, odds ratio 0.34, 95% confidence interval 0.17-0.67) with no impact on overall 1- and 5-year survival rates.

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