Role of crossmatch testing when Luminex-SAB is negative in renal transplantation

The human leukocyte antigen (HLA) system plays an important role in the acceptance of renal graft. Long and better graft survival has been reported in patients with HLA-identical siblings and a nonreactive cytotoxicity assay (CDC). New methods of HLA-typing and anti-HLA antibody detection techniques such as flow cytometry, solid-phase immunoassays, or antigen bead assays have further improved the outcomes of renal transplant recipients. In the present review, the explicit details of these methodologies are discussed in detail

PENYULUHAN TENTANG DETEKSI DINI PEYAKIT PARKINSON

Parkinson's disease is a disease that interferes with the brain works because sufferers lack dopamine, dopamine deficiency in the human brain are not easy to identify. Parkinson's disease is not diagnosed with blood tests but rather with symptoms that cause a loss of dopamine. Which may include symptoms that is shaking the hands, stiffness-muscle stiffness, as well as abnormalities in movement. In addition to the motor symptoms of parkinson's, also can cause the sufferer experiencing a decline in cognitive functions, such as dementia, anxiety, depression, a change in the way the talk, as well as insomnia. In finding related information treatment of parkinson's disease sufferers, particularly in Indonesia experienced various constraints. The first one that is only a few hospitals in Indonesia that specifically deal with the treatment of Parkinson's disease, ranging from therapy treatment to other medical actions. Even Parkinson's drug availability in Indonesia is still very little, compared to other countrie

Niekorzystny wpływ terapii lekiem b-adrenolitycznym na chorego z omdleniami wazowagalnymi

Leki b-adrenolityczne stosuje się w leczeniu omdleń wazowagalnych, gdyż poprzez zmniejszanie kurczliwości mięśnia sercowego i aktywacji jego mechanoreceptorów mogą istotnie przyczyniać się do zahamowania reakcji neurokardiogennej. Jednak teoretycznie istnieje niebezpieczeństwo, że w razie wystąpienia omdlenia leki te mogą zaostrzyć jego przebieg poprzez swoje ujemne działanie chronotropowe, dromotropowe i batmotropowe. Przedstawiono przypadek 23-letniego mężczyzny, u którego pierwotnie rozpoznano omdlenia neurokardiogenne o mechanizmie mieszanym, a podczas badania na stole pochyleniowym wystąpił rytm zastępczy węzłowy o częstości 46/min. Kliniczny efekt leczenia b-adrenolitykiem był dobry. Kontrolne badanie na stole pochyleniowym sprowokowało omdlenie wazowagalne o mechanizmie kardiodepresyjnym z pauzą RR równą 6,3 s. Wobec nielicznych pozycji piśmiennictwa na ten temat autorzy przedstawiają możliwe hipotezy opisanej reakcji

Niekorzystny wpływ terapii lekiem b-adrenolitycznym na chorego z omdleniami wazowagalnymi

Leki b-adrenolityczne stosuje się w leczeniu omdleń wazowagalnych, gdyż poprzez zmniejszanie kurczliwości mięśnia sercowego i aktywacji jego mechanoreceptorów mogą istotnie przyczyniać się do zahamowania reakcji neurokardiogennej. Jednak teoretycznie istnieje niebezpieczeństwo, że w razie wystąpienia omdlenia leki te mogą zaostrzyć jego przebieg poprzez swoje ujemne działanie chronotropowe, dromotropowe i batmotropowe. Przedstawiono przypadek 23-letniego mężczyzny, u którego pierwotnie rozpoznano omdlenia neurokardiogenne o mechanizmie mieszanym, a podczas badania na stole pochyleniowym wystąpił rytm zastępczy węzłowy o częstości 46/min. Kliniczny efekt leczenia b-adrenolitykiem był dobry. Kontrolne badanie na stole pochyleniowym sprowokowało omdlenie wazowagalne o mechanizmie kardiodepresyjnym z pauzą RR równą 6,3 s. Wobec nielicznych pozycji piśmiennictwa na ten temat autorzy przedstawiają możliwe hipotezy opisanej reakcji

Is <i>de novo</i> membranous nephropathy suggestive of alloimmunity in renal transplantation? A case report.

BackgroundPost-transplant nephrotic syndrome (PTNS) in a renal allograft carries a 48% to 77% risk of graft failure at 5 years if proteinuria persists. PTNS can be due to either recurrence of native renal disease or de novo glomerular disease. Its prognosis depends upon the underlying pathophysiology. We describe a case of post-transplant membranous nephropathy (MN) that developed 3 mo after kidney transplant. The patient was properly evaluated for pathophysiology, which helped in the management of the case.Case summaryThis 22-year-old patient had chronic pyelonephritis. He received a living donor kidney, and human leukocyte antigen-DR (HLA-DR) mismatching was zero. PTNS was discovered at the follow-up visit 3 mo after the transplant. Graft histopathology was suggestive of MN. In the past antibody-mediated rejection (ABMR) might have been misinterpreted as de novo MN due to the lack of technologies available to make an accurate diagnosis. Some researchers have observed that HLA-DR is present on podocytes causing an anti-DR antibody deposition and development of de novo MN. They also reported poor prognosis in their series. Here, we excluded the secondary causes of MN. Immunohistochemistry was suggestive of IgG1 deposits that favoured the diagnosis of de novo MN. The patient responded well to an increase in the dose of tacrolimus and angiotensin converting enzyme inhibitor.ConclusionExposure of hidden antigens on the podocytes in allografts may have led to subepithelial antibody deposition causing de novo MN

Seizures, CSF neurofilament light and tau in patients with subarachnoid haemorrhage

Objectives: Patients with severe subarachnoid haemorrhage (SAH) often suffer from complications with delayed cerebral ischaemia (DCI) due to vasospasm that is difficult to identify by clinical examination. The purpose of this study was to monitor seizures and to measure cerebrospinal fluid (CSF) concentrations of neurofilament light (NFL) and tau, and to see whether they could be used for predicting preclinical DCI. Methods: We prospectively studied 19 patients with aneurysmal SAH who underwent treatment with endovascular coiling. The patients were monitored with continuous EEG (cEEG) and received external ventricular drainage (EVD). CSF samples of neurofilament light (NLF) and total tau (T‐tau) protein were collected at day 4 and day 10. Cox regression analysis was applied to evaluate whether seizures and protein biomarkers were associated with DCI and poor outcome. Results: Seven patients developed DCI (37%), and 4 patients (21%) died within the first 2 months. Six patients (32%) had clinical seizures, and electrographic seizures were noted in one additional patient (4.5%). Increased tau ratio (proportion tau10/tau4) was significantly associated with DCI and hazard ratio [HR=1.33, 95% confidence interval (CI) 1.055‐1.680. P = .016]. Conclusion: Acute symptomatic seizures are common in SAH, but their presence is not predictive of DCI. High values of the tau ratio in the CSF may be associated with development of DCI

The Impact of COVID-19 on Physical (In)Activity Behavior in 10 Arab Countries.

Insufficient physical activity is considered a strong risk factor associated with non-communicable diseases. This study aimed to assess the impact of COVID-19 on physical (in)activity behavior in 10 Arab countries before and during the lockdown. A cross-sectional study using a validated online survey was launched originally in 38 different countries. The Eastern Mediterranean regional data related to the 10 Arabic countries that participated in the survey were selected for analysis in this study. A total of 12,433 participants were included in this analysis. The mean age of the participants was 30.3 (SD, 11.7) years. Descriptive and regression analyses were conducted to examine the associations between physical activity levels and the participants\u27 sociodemographic characteristics, watching TV, screen time, and computer usage. Physical activity levels decreased significantly during the lockdown. Participants\u27 country of origin, gender, and education were associated with physical activity before and during the lockdown (p \u3c 0.050). Older age, watching TV, and using computers had a negative effect on physical activity before and during the lockdown (p \u3c 0.050). Strategies to improve physical activity and minimize sedentary behavior should be implemented, as well as to reduce unhealthy levels of inactive time, especially during times of crisis. Further research on the influence of a lack of physical activity on overall health status, as well as on the COVID-19 disease effect is recommended

Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury

Results of previous studies suggest that β-adrenoreceptor activation may augment pain, and that β-adrenoreceptor antagonists may be effective in reducing pain, particularly in individuals not homozygous for the catechol-O-methyltransferase (COMT) high activity haplotype