Autonomous use of a visual biofeedback in early rehabilitation after total knee replacement. Pilot study design

Patients undergoing Total Knee Replacement (TKR) improve functional capabilities, but a lot of them show strength deficits and asymmetric patterns of movement. Early rehabilitation within the first five days improve short-term outcomes, in particular recovery of functional capabilities and levels of physical activity. Biofeedback in early rehabilitation after TKR is effective to improve gait symmetry, reduce pain and increase levels of physical activity. This pilot study aims to evaluate the effects of the autonomous use of a visual biofeedback, based on the use of inertial sensor (KARI, CoRehab, Trento, Italy), on patient outcomes in very short post-TKR period

KIR and their HLA Class I ligands: Two more pieces towards completing the puzzle of chronic rejection and graft loss in kidney transplantation

Kidney transplantation is a life-saving treatment for patients with end-stage renal disease. However, despite progress in surgical techniques and patient management, immunological rejection continues to have a negative impact on graft function and overall survival. Incompatibility between donors and recipients for human leukocyte antigens (HLA) of the major histocompatibility complex (MHC) generates a series of complex cellular and humoral immune response mechanisms that are largely responsible for rejection and loss of graft function. Within this context, a growing amount of evidence shows that alloreactive natural killer (NK) cells play a critical role in the immune response mechanisms elicited by the allograft. Killer immunoglobulin-like receptors (KIRs) are prominent mediators of NK cell alloreactivity

KIR-HLA ligand mismatches/matches in the 174 recipient/donor pairs.

<p>KIR-HLA ligand mismatches/matches in the 174 recipient/donor pairs.</p

Clinical and immunological characteristics of kidney transplant patients.

<p>Clinical and immunological characteristics of kidney transplant patients.</p

Glomerular filtration rate measured at 1, 6, 12, 24, 36, 48, 60 and 72 months after transplantation normalized to baseline levels measured at 1 month after transplantation.

<p>The error bar at each point represents the 95% Confidence Interval. The group of patients with low NK cell inhibition (completely lacking the two functional units rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4) showed a statistically significant difference in comparison to the groups of patients with either partial or high NK cell inhibition; P = 3.5·10⁻¹⁴ obtained by calculating the area under the curve.</p

Donor HLA KIR ligands and KIR-HLA ligand combinations in recipient/donor pairs.

<p>Donor HLA KIR ligands and KIR-HLA ligand combinations in recipient/donor pairs.</p

Risk of chronic rejection according to the presence or absence of specific recipient (r) KIR and donor (d) HLA ligand combinations.

<p>Risk of chronic rejection according to the presence or absence of specific recipient (r) KIR and donor (d) HLA ligand combinations.</p

Serum creatinine levels after transplantation in three groups of patients stratified according to the presence or absence of combinations of recipient (r) KIRs and donor (d) HLA ligands: rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4.

<p>Serum creatinine levels after transplantation in three groups of patients stratified according to the presence or absence of combinations of recipient (r) KIRs and donor (d) HLA ligands: rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4.</p

KIR gene frequencies and KIR haplotypes in patients and 221 healthy controls.

<p>KIR gene frequencies and KIR haplotypes in patients and 221 healthy controls.</p