224 research outputs found

    Alemtuzumab induction and tacrolimus monotherapy in pancreas transplantation: One- and two-year outcomes

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    BACKGROUND. Alemtuzumab (Campath-1H) induction with tacrolimus monotherapy has been shown to provide effective immunosuppression for kidney, liver, lung, and small bowel transplantation. This drug combination was evaluated in pancreas transplant recipients. METHODS. Sixty consecutive pancreas transplants (30 simultaneous pancreas-kidney, 20 pancreas after kidney, and 10 pancreas alone) were carried out under this protocol between July 2003 to January 2005. The mean follow-up was 22 months (range 17-33). RESULTS. One-year patient, pancreas, and kidney allograft survival were 95%, 93%, and 90%, respectively. With 22 months follow-up, patient, pancreas, and kidney survival were 94%, 89%, and 87%, respectively. The rejection rate was 30% (18/60), with four patients (7%) experiencing steroid-resistant rejection. Major infection occurred in three (5%) patients resulting in two (3.3%) deaths from disseminated histoplasmosis and a herpes virus infection. One patient with cryptococcal meningitis was successfully treated. Seven (11.7%) patients experienced cytomegalovirus infection, all of whom responded to treatment with ganciclovir. One (1.7%) case of polymorphic posttransplant lymphoproliferative disease was seen, which regressed with a temporary discontinuation of tacrolimus and high-dose ganciclovir. The mean serum creatinine of the 30 simultaneous pancreas-kidney transplants at one year posttransplant was 1.37¹0.33 mg/ml. The preexisting creatinine in pancreas after kidney transplants was not adversely affected by this immunosuppressive protocol. CONCLUSION. A single dose of perioperative alemtuzumab followed by daily tacrolimus monotherapy provides effective immunosuppression for pancreas transplantation, but the optimal use of this drug combination is not yet clear. Š 2006 Lippincott Williams & Wilkins, Inc

    Twenty Years After the Velvet Revolution: Shifts in Czech Adolescents’ Perceptions of Family, School, and Society

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    Families and schools are traditionally seen as substantial socialization agents forming adolescents’ social values and their views of society. Special attention is paid to the question whether the relative importance of these influences remains stable in times of major social changes. In this study, two different generations of Czech middle adolescents are compared: (a) the “post-totalitarian” generation that grew up in the last decade of the communist regime and entered adolescence during the time of rapid political and socioeconomic changes (data collected in 1995) and (b) the current generation without personal experience with the communist regime, raised in a stable democratic society (data collected in 2010). Both groups of participants (total N = 2,127, aged from 14 to 17 years) were administered an identical questionnaire. First, we examined the changes in adolescents’ perception and evaluation of the society over the last 15 years. Today’s adolescents perceive society more as a community and their future orientations are more focused on materialistic and less on environmental values. While the emotional relationship between the children and parentsremains the same, adolescents learn a somewhat different message in the family, emphasizing self-reliance. School environment is perceived more as positive and engaging than 15 years ago. Second, we predicted adolescents’ social views and values from their assessment of family and school environment. Our results show that the effect of parental values on adolescents’ value orientations is higher in the current generation. Positive school environment contributes to the development of socially responsible orientations despite the changes in society

    Towards a framework for critical citizenship education

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    Increasingly countries around the world are promoting forms of "critical" citizenship in the planned curricula of schools. However, the intended meaning behind this term varies markedly and can range from a set of creative and technical skills under the label "critical thinking" to a desire to encourage engagement, action and political emancipation, often labelled "critical pedagogy". This paper distinguishes these manifestations of the "critical" and, based on an analysis of the prevailing models of critical pedagogy and citizenship education, develops a conceptual framework for analysing and comparing the nature of critical citizenship

    Static Analysis-based Debugging, Certification, Testing, and Optimization with CiaoPP

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    Facilitate the development of safe, efficient programs. Approach: •Next-generation, higher-level, multiparadigm prog. languages. •Improved program development environments. •A framework (CiaoPP) which integrates: •Debugging. •Verification and certification. •Testing. •Optimization (optimized compilation, parallelization, ...

    Cardiac Alterations in Human African Trypanosomiasis (T.b. gambiense) with Respect to the Disease Stage and Antiparasitic Treatment

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    In Human African Trypanosomiasis (HAT), neurological symptoms dominate and cardiac involvement has been suggested. Because of increasing resistance to the available drugs for HAT, new compounds are desperately needed. Evaluation of cardiotoxicity is one parameter of drug safety, but without knowledge of the baseline heart involvement in HAT, cardiologic findings and drug-induced alterations will be difficult to interpret. The electrocardiogram (ECG) is a tool to evaluate cardiac involvement and the risk of arrythmias. We analysed the ECG of 465 HAT patients and compared them with the ECG of 61 healthy volunteers. In HAT patients the QTc interval was prolonged. This comprises a risk of fatal arrhythmias if new drugs with antiarrhythmic potential will be used. Further, repolarization changes and low voltage were more frequent than in healthy controls. This could be explained by an inflammation of the heart. Treatment of HAT was associated with appearance of repolarization changes but not with a QTc prolongation. These changes appear to be associated with the disease, but not with a specific drug. The main conclusion of this study is that heart involvement is frequent in HAT and mostly well tolerated. However, it can become relevant, if new compounds with antiarrhythmic potential will be used
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