Current Issue : July - September Volume : 2016 Issue Number : 3 Articles : 4 Articles
Background. Hydrophilic and moderately rough implant surfaces have been proposed to enhance the osseointegration response.\nAim.The aim of this study was to compare early changes of stability for two implants with identical macrodesign but with different\nsurface topographies. Materials and Methods. In 11 patients, a total of 22 implants (11 bimodal (minimally rough, control) and\n11 proactive (moderately rough and hydrophilic, test), Neoss Ltd., Harrogate, UK) were immediately placed into fresh extraction\nsockets and immediately loaded.The peak insertion torque (IT) was measured inNcmat placement. Resonance Frequency Analysis\n(RFA) measurements were made at baseline and 2, 4, 6, and 12 weeks after surgery. Results.The two implant types showed similar IT\nand RFA values at placement (NS). A dip of RFA values after 2 weeks followed by an increase was observed, where the test implant\nshowed a less pronounced decrease and a more rapid recovery than the control implant. The test implants were significantly more\nstable than the control ones after 12 weeks. Conclusions. The results from the present study indicated that the hydrophilic and\nrougher test implant was more resistant to immediate loading and showed a significantly higher stability than the smoother control\nimplant after 12 weeks....
In haploidentical stem cell transplantations (haplo-SCT), nearly all patients have more than one donor. A key issue in\nthe haplo-SCT setting is the search for the best donor, because donor selection can significantly impact the\nincidences of acute and chronic graft-versus-host disease, transplant-related mortality, and relapse, in addition to\noverall survival. In this review, we focused on factors associated with transplant outcomes following unmanipulated\nhaplo-SCT with anti-thymocyte globulin (ATG) or after T-cell-replete haplo-SCT with post-transplantation\ncyclophosphamide (PT/Cy). We summarized the effects of the primary factors, including donor-specific antibodies\nagainst human leukocyte antigens (HLA); donor age and gender; killer immunoglobulin-like receptor-ligand\nmismatches; and non-inherited maternal antigen mismatches. We also offered some expert recommendations and\nproposed an algorithm for selecting donors for unmanipulated haplo-SCT with ATG and for T-cell-replete haplo-SCT\nwith PT/Cy....
Background: Increasing numbers of patients are receiving haplo-identical stem cell transplantation (haplo-SCT) for\ntreatment of acute leukemia with reduced intensity (RIC) or myeloablative (MAC) conditioning regimens. The impact of\nconditioning intensity in haplo-SCT is unknown.\nMethods: We performed a retrospective registry-based study comparing outcomes after T-replete haplo-SCT for\npatients with acute myeloid (AML) or lymphoid leukemia (ALL) after RIC (n = 271) and MAC (n = 425). Regimens were\nclassified as MAC or RIC based on published criteria.\nResults: A combination of post-transplant cyclophosphamide (PT-Cy) with one calcineurin inhibitor and mycophenolate\nmofetil (PT-Cy-based regimen) for graft-versus-host disease (GVHD) prophylaxis was used in 66 (25 %) patients in RIC and\n125 (32 %) in MAC groups. Patients of RIC group were older and had been transplanted more recently and more\nfrequently for AML with active disease at transplant. Percentage of engraftment (90 vs. 92 %; p = 0.58) and day\n100 grade II to IV acute GVHD (24 vs. 29 %, p = 0.23) were not different between RIC and MAC groups. Multivariable\nanalyses, run separately in AML and ALL, showed a trend toward higher relapse incidence with RIC in comparison to\nMAC in AML (hazard ratio (HR) 1.34, p = 0.09), and no difference in both AML and ALL in terms of non-relapse mortality\n(NRM) chronic GVHD and leukemia-free survival. There was no impact of conditioning regimen intensity in overall survival\n(OS) in AML (HR = 0.97, p = 0.79) but a trend for worse OS with RIC in ALL (HR = 1.44, p = 0.10). The main factor impacting\noutcomes was disease status at transplantation (HR � 1.4, p � 0.01). GVHD prophylaxis with PT-Cy-based regimen was\nindependently associated with reduced NRM (HR 0.63, p = 0.02) without impact on relapse incidence (HR 0.99, p = 0.94).\nConclusions: These data suggest that T-replete haplo-SCT with both RIC and MAC, in particular associated with PT-Cy,\nare valid options in first line treatment of high risk AML or ALL....
Background: The influence of donor and recipient factors on outcomes following kidney transplantation is\ncommonly analysed using Cox regression models, but this approach is not useful for predicting long-term\nsurvival beyond observed data. We demonstrate the application of a flexible parametric approach to fit a\nmodel that can be extrapolated for the purpose of predicting mean patient survival. The primary motivation\nfor this analysis is to develop a predictive model to estimate post-transplant survival based on individual\npatient characteristics to inform the design of alternative approaches to allocating deceased donor kidneys\nto those on the transplant waiting list in the United Kingdom.\nMethods: We analysed data from over 12,000 recipients of deceased donor kidney or combined kidney and\npancreas transplants between 2003 and 2012. We fitted a flexible parametric model incorporating restricted cubic\nsplines to characterise the baseline hazard function and explored a range of covariates including recipient, donor and\ntransplant-related factors.\nResults: Multivariable analysis showed the risk of death increased with recipient and donor age, diabetic nephropathy\nas the recipient�s primary renal diagnosis and donor hypertension. The risk of death was lower in female\nrecipients, patients with polycystic kidney disease and recipients of pre-emptive transplants. The final model\nwas used to extrapolate survival curves in order to calculate mean survival times for patients with specific\ncharacteristics.\nConclusion: The use of flexible parametric modelling techniques allowed us to address some of the\nlimitations of both the Cox regression approach and of standard parametric models when the goal is\nto predict long-term survival....
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