Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study

Background: Premature cardiovascular (CV) death is the commonest cause of death in renal transplant recipients. Abnormalities of left ventricular (LV) structure (collectively termed uremic cardiomyopathy) and left atrial (LA) dilation, a marker of fluid status and diastolic function, are risk factors for reduced survival in patients with end stage renal disease (ESRD). In the present analysis, we studied the impact of pre-transplant LA and LV abnormalities on survival after successful renal transplantation (RT).<p></p> Methods: One hundred nineteen renal transplant recipients (first transplant, deceased donors) underwent cardiovascular MRI (CMR) as part of CV screening prior to inclusion on the waiting list. Data regarding transplant function and patient survival after transplantation were collected.<p></p> Results: Median post-transplant follow-up was 4.3 years (interquartile range (IQR) 1.9, 6.2). During the post-transplant period, 13 patients returned to dialysis after graft failure and 23 patients died with a functioning graft. Survival analyses, censoring for patients returning to dialysis, showed that pre-transplant LV hypertrophy and elevated LA volume were significantly associated with reduced survival after transplantation. Multivariate Cox regression analyses demonstrated that longer waiting time, poorer transplant function, presence of LV hypertrophy and higher LA volume on screening CMR and female sex were independent predictors of death in patients with a functioning transplant.<p></p> Conclusions: Presence of LVH and higher LA volume are significant, independent predictors of death in patients who are wait-listed and proceed with renal transplantation.<p></p> METHODS: One hundred nineteen renal transplant recipients (first transplant, deceased donors) underwent cardiovascular MRI (CMR) as part of CV screening prior to inclusion on the waiting list. Data regarding transplant function and patient survival after transplantation were collected.<p></p> RESULTS: Median post-transplant follow-up was 4.3 years (interquartile range (IQR) 1.9, 6.2). During the post-transplant period, 13 patients returned to dialysis after graft failure and 23 patients died with a functioning graft. Survival analyses, censoring for patients returning to dialysis, showed that pre-transplant LV hypertrophy and elevated LA volume were significantly associated with reduced survival after transplantation. Multivariate Cox regression analyses demonstrated that longer waiting time, poorer transplant function, presence of LV hypertrophy and higher LA volume on screening CMR and female sex were independent predictors of death in patients with a functioning transplant.<p></p> CONCLUSIONS: Presence of LVH and higher LA volume are significant, independent predictors of death in patients who are wait-listed and proceed with renal transplantation

Cognitive representations of disability behaviours in people with mobility limitations : consistency with theoretical constructs

Disability is conceptualised as behaviour by psychological theory and as a result of bodily impairment by medical models. However, how people with disabilities conceptualise those disabilities is unclear. The purpose of this study was to examine disability representations in people with mobility disabilities. Thirteen people with mobility disabilities completed personal repertory grids (using the method of triads) applied to activities used to measure disabilities. Ten judges with expertise in health psychology then examined the correspondence between the elicited disability constructs and psychological and medical models of disability. Participants with mobility disabilities generated 73 personal constructs ofdisability. These constructs were judged consistent with the content of two psychological models, namely the theory of planned behaviour and social cognitive theory and with the main medical model of disability, the International Classification of Functioning Disability and Health.Individuals with activity limitations conceptualise activities in a manner that is compatible with both psychological and medical models. This ensures adequate communication in contexts where the medical model is relevant, e.g. clinical contexts, as well as in everyday conversation about activities and behaviours. Finally, integrated models of disability may be of value for theory driven interdisciplinary approaches to disability and rehabilitation

Identification of genes differentially expressed between benign and osteopontin transformed rat mammary epithelial cells

<p>Abstract</p> <p>Background</p> <p>Osteopontin is a secreted, integrin-binding and phosphorylated acidic glycoprotein which has an important role in tumor progression.</p> <p>Findings</p> <p>In this study, we have utilized suppressive subtractive hybridization (SSH) to evaluate OPN regulated gene expression, using the Rama 37 benign non-invasive rat mammary cell line and a subclone, Rama 37-OPN. Rama 37-OPN was produced by stably transfecting Rama 37 with an OPN expression vector and it demonstrates increased malignant properties <it>in vitro</it>. Sequence and expression array analysis of the respective cDNA libraries of over 1600 subtracted cDNA fragments revealed 982 ESTs, 45 novel sequences and 659 known genes. The known up-regulated genes in the Rama 37-OPN library code for proteins with a variety of functions including those involved in metabolism, cell adhesion and migration, signal transduction and in apoptosis. Four of the most differentially expressed genes between the benign and <it>in vitro </it>malignant rat mammary cell lines are tumor protein translationally controlled I (TPTI), aryl hydrocarbon receptor nuclear translocator (ARNT), ataxia telangiectasia mutated (ATM) and RAN GTPase (RAN). The largest difference (ca 10,000 fold) between the less aggressively (MCF-7, ZR-75) and more aggressively malignant (MDA MB 231, MDA MB 435S) human breast cancer cell lines is that due to RAN, the next is that due to osteopontin itself.</p> <p>Conclusion</p> <p>The results suggest that enhanced properties associated with the malignant state <it>in vitro </it>induced by osteopontin may be due to, in part, overexpression of RAN GTPase and these biological results are the subject of a subsequent publication <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>.</p

The representation of tropical upper tropospheric water in EC Earth V2

Tropical upper tropospheric humidity, clouds, and ice water content, as well as outgoing longwave radiation (OLR), are evaluated in the climate model EC Earth with the aid of satellite retrievals. The Atmospheric Infrared Sounder and Microwave Limb Sounder together provide good coverage of relative humidity. EC Earth's relative humidity is in fair agreement with these observations. CloudSat and CALIPSO data are combined to provide cloud fractions estimates throughout the altitude region considered (500-100 hPa). EC Earth is found to overestimate the degree of cloud cover above 200 hPa and underestimate it below. Precipitating and non-precipitating EC Earth ice definitions are combined to form a complete ice water content. EC Earth's ice water content is below the uncertainty range of CloudSat above 250 hPa, but can be twice as high as CloudSat's estimate in the melting layer. CERES data show that the model underestimates the impact of clouds on OLR, on average with about 9 W m(-2). Regionally, EC Earth's outgoing longwave radiation can be similar to 20 W m(-2) higher than the observation. A comparison to ERA-Interim provides further perspectives on the model's performance. Limitations of the satellite observations are emphasised and their uncertainties are, throughout, considered in the analysis. Evaluating multiple model variables in parallel is a more ambitious approach than is customary

Surgical treatment of a rare primary renal carcinoid tumor with liver metastasis

BACKGROUND: Carcinoid tumors are characteristically low grade malignant neoplasms with neuroendocrine differentiation that arise in various body sites, most commonly the lung and gastrointestinal tract, but less frequently the kidneys, breasts, ovaries, testes, prostate and other locations. We report a case of a carcinoid of renal origin with synchronous single liver metastases on radiological studies. CASE PRESENTATION: A 45 year-old patient who presented with abdominal pain was found on CT scan to have lesions in the right ovary, right kidney, and left hepatic lobe. CA-125, CEA, and CA 19-9 were within normal limits, as were preoperative liver function tests and renal function. Biopsy of the liver mass demonstrated metastatic neuroendocrine tumor. At laparotomy, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, radical right nephrectomy with lymphadenectomy, and left hepatectomy. Pathology evaluation reported a right ovarian borderline serous tumor, well-differentiated neuroendocrine carcinoma of the kidney (carcinoid) with 2 positive retroperitoneal lymph nodes, and a single liver metastasis. Immunohistochemistry revealed that this lesion was positive for synaptophysin and CD56, but negative for chromogranin as well as CD10, CD7, and CD20, consistent with a well-differentiated neuroendocrine tumor. She is doing well one year after her initial surgery, with no evidence of tumor recurrence. CONCLUSION: Early surgical intervention, together with careful surveillance and follow-up, can achieve successful long-term outcomes in patients with this rare malignancy

How Academic Achievement, Attitudes, and Behaviors Relate to the Course of Substance Use During Adolescence: A 6-Year, Multiwave National Longitudinal Study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75027/1/1532-7795.1303005.pd

HIV/AIDS: Risk Protective Behaviors among American Young Adults, 2004-2011.

https://deepblue.lib.umich.edu/bitstream/2027.42/137923/1/mtf-hiv-aids_2011.pd

HIV/AIDS: Risk Protective Behaviors among American Young Adults, 2004-2012.

https://deepblue.lib.umich.edu/bitstream/2027.42/137918/1/mtf-hiv-aids_2012.pd

HIV/AIDS: Risk & protective behaviors among adults ages 21 to 40 in the U.S., 2004-2017

National Institute on Drug Abusehttps://deepblue.lib.umich.edu/bitstream/2027.42/146526/1/FINAL FINAL 2.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146526/3/license_rdfDescription of FINAL FINAL 2.pdf : Annual monograp

HIV/AIDS: Risk protective behaviors among adults ages 21 to 40 in the U.S., 2004-2015.

https://deepblue.lib.umich.edu/bitstream/2027.42/137905/1/mtf-hiv-aids_2015.pd