Risk factors associated with post-kidney transplant malignancies: An article from the Cancer-Kidney International Network

© The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.. In kidney transplant recipients, cancer is one of the leading causes of death with a functioning graft beyond the first year of kidney transplantation, and malignancies account for 8-10% of all deaths in the USA (2.6 deaths/1000 patient-years) and exceed 30% of deaths in Australia (5/1000 patient-years) in kidney transplant recipients. Patient-, transplant- and medication-related factors contribute to the increased cancer risk following kidney transplantation. While it is well established that the overall immunosuppressive dose is associated with an increased risk for cancer following transplantation, the contributive effect of different immunosuppressive agents is not well established. In this review we will discuss the different risk factors for malignancies after kidney transplantation

Cancer and renal insufficiency results of the BIRMA study

Background: Half of anticancer drugs are predominantly excreted in urine. Dosage adjustment in renal insufficiency (RI) is, therefore, a crucial issue. Moreover, patients with abnormal renal function are at high risk for drug-induced nephrotoxicity. The Belgian Renal Insufficiency and Anticancer Medications (BIRMA) study investigated the prevalence of RI in cancer patients, and the profile/dosing of anticancer drugs prescribed. Methods:Primary end point: to estimate the prevalence of abnormal glomerular filtration rate (GFR; estimated with the abbreviated Modification of Diet in Renal Disease formula) and RI in cancer patient. Secondary end point: to describe the profile of anticancer drugs prescribed (dose reduction/nephrotoxicity). Data were collected for patients presenting at one of the seven Belgian BIRMA centres in March 2006. Results: A total of 1218 patients were included. The prevalence of elevated SCR (1.2 mg per 100 ml) was 14.9%, but 64.0% had a GFR90 ml min 1 per 1.73 m 2. In all, 78.6% of treated patients (n1087) were receiving at least one drug needing dosage adjustment and 78.1% received at least one nephrotoxic drug. In all, 56.5% of RI patients receiving chemotherapy requiring dose reduction in case of RI did not receive dose adjustment. Conclusions: The RI is highly frequent in cancer patients. In all, 80% of the patients receive potentially nephrotoxic drugs and/or for which dosage must be adjusted in RI. Oncologists should check the appropriate dose of chemotherapeutic drugs in relation to renal function before prescribing. © 2010 Cancer Research UK.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Aggressive behavior after traumatic brain injury

INTRODUCTION: In cases of agitation and aggressive behavior after severe traumatic brain injury (TBI), the benefits/risks ratio of pharmacological treatments remains unclear. A qualitative analysis of clinical situations could highlight the relevance of psychotherapy care.CASE REPORT: In January 2005, this 24-year-old patient sustained severe traumatic brain injury (Glasgow at 4/15), with bilateral frontotemporal injury and temporal extradural hematoma. On the third day, a temporal lobectomy was performed. The patient\u27s evolution showed severe neurobehavioral disorders, with agitation and aggressive behavior towards family members and medical caregivers. Maximum doses of antipsychotic drugs brought no improvement. Antidepressant medication improved social contact. Several stays in the psychiatric unit, where institutionalized and psychotherapy care were implemented, showed systematically a real improvement of the behavioral disorders, increased participation in group activities and the ability to walk around alone in a closed environment. DISCUSSION/CONCLUSION: Aggressive behavior can unveil organic brain injuries, depressive syndrome as well as iatrogenic nature of the environment. This clinical case is based on the fact that antipsychotic drugs, aside from their sedative effect, are not the proper treatment for agitation following traumatic brain injury. This case also highlights how management of behavioral disorders following TBI should not be based on pharmacological treatments only but instead should focus on multidisciplinary strategies of care

Atomic Diagnostics of X-ray Irradiated Protoplanetary Disks

We study atomic line diagnostics of the inner regions of protoplanetary disks with our model of X-ray irradiated disk atmospheres which was previously used to predict observable levels of the NeII and NeIII fine-structure transitions at 12.81 and 15.55mum. We extend the X-ray ionization theory to sulfur and calculate the fraction of sulfur in S, S+, S2+ and sulfur molecules. For the D'Alessio generic T Tauri star disk, we find that the SI fine-structure line at 25.55mum is below the detection level of the Spitzer Infrared Spectrometer (IRS), in large part due to X-ray ionization of atomic S at the top of the atmosphere and to its incorporation into molecules close to the mid-plane. We predict that observable fluxes of the SII 6718/6732AA forbidden transitions are produced in the upper atmosphere at somewhat shallower depths and smaller radii than the neon fine-structure lines. This and other forbidden line transitions, such as the OI 6300/6363AA and the CI 9826/9852AA lines, serve as complementary diagnostics of X-ray irradiated disk atmospheres. We have also analyzed the potential role of the low-excitation fine-structure lines of CI, CII, and OI, which should be observable by SOFIA and Herschel.Comment: Accepted by Ap

ADMAN: an Alarm-based mobile Diabetes MANagement system for mobile geriatric teams

In this article, we introduce ADMAN an alarm-based diabetes management system for the disposal of Mobile Geriatric Teams MGT. The system aims at providing a form of remote monitoring in order to control the diabetes rate for elder patients. The system is multidimensional in a way that it resides at the patient mobile machine from a side, the doctor’s mobile machine from another side and can be connected to any other entity related to the MGT that is handling his case (e.g. dietitian)

La mesure des déformations pour l'étude du comportement et la mise en forme des renforts de composites

Nous faisons ici le bilan de campagnes d'essais mécaniques sur des renforts secs de composites réalisées au LMSP, au cours desquelles les déformations ont été mesurées par des méthodes optiques. La nature des renforts conduit dans certains cas à utiliser la corrélation d'images et dans d'autres le suivi de marqueurs. Dans tous les cas il est nécessaire d'avoir un marquage adapté des renforts pour faire ces mesures. Il faut éviter le fractionnement des marqueurs à deux échelles : celle des fibres puis celle des mèches. La brillance des fibres gêne souvent les mesures. Ces problèmes techniques résolus, ces méthodes permettent d'obtenir des résultats très intéressants pour l'étude de ces matériaux

Molecular hydrogen in the cosmic recombination epoch

The advent of precise measurements of the cosmic microwave background (CMB) anisotropies has motivated correspondingly precise calculations of the cosmic recombination history. Cosmic recombination proceeds far out of equilibrium because of a "bottleneck" at the $n=2$ level of hydrogen: atoms can only reach the ground state via slow processes: two-photon decay or Lyman-$\alpha$ resonance escape. However, even a small primordial abundance of molecules could have a large effect on the interline opacity in the recombination epoch and lead to an additional route for hydrogen recombination. Therefore, this paper computes the abundance of the H$_2$ molecule during the cosmic recombination epoch. Hydrogen molecules in the ground electronic levels X$^1\Sigma^+_g$ can either form from the excited H$_2$ electronic levels B$^1\Sigma^+_u$ and C$^1\Pi_u$ or through the charged particles H$_2^+$, HeH$^+$ and H$^-$. We follow the transitions among all of these species, resolving the rotational and vibrational sub-levels. Since the energies of the X$^1\Sigma^+_g$--B$^1\Sigma^+_u$ (Lyman band) and X$^1\Sigma^+_g$-C$^1\Pi_u$ (Werner band) transitions are near the Lyman-$\alpha$ energy, the distortion of the CMB spectrum caused by escaped H Lyman-line photons accelerates both the formation and the destruction of H$_2$ due to this channel relative to the thermal rates. This causes the populations of H$_2$ molecules in X$^1\Sigma^+_g$ energy levels to deviate from their thermal equilibrium abundances. We find that the resulting H$_2$ abundance is $10^{-17}$ at $z=1200$ and $10^{-13}$ at $z=800$, which is too small to have any significant influence on the recombination history.Comment: 13 pages, 10 figures, to be submitted to PR

Wide-Angle Wind Driven Bipolar Outflows: High Resolution Models with Application to Source I of the Becklin-Neugebauer / Kleinmann-Low OMC-I Region

We carry out high resolution simulations of the inner regions of a wide angle wind driven bipolar outflow using an Adaptive Mesh Refinement code. Our code follows H-He gas with molecular, atomic and ionic components and the associated time dependent molecular chemistry and ionization dynamics with radiative cooling. Our simulations explore the nature of the outflow when a spherical wind expands into a rotating, collapsing envelope. We compare with key observational properties of the outflow system of Source I in the BN/KL region. Our calculations show that the wind evacuates a bipolar outflow cavity in the infalling envelope. We find the head of the outflow to be unstable and that it rapidly fragments into clumps. We resolve the dynamics of the strong shear layer which defines the side walls of the cavity. We conjecture that this layer is the likely site of maser emission and examine its morphology and rotational properties. The shell of swept up ambient gas that delineates the cavity edge retains its angular momentum. This rotation is roughly consistent with that observed in the Source I SiO maser spots. The observed proper motions and line-of-sight velocity are approximately reproduced by the model. The cavity shell at the base of the flow assumes an X-shaped morphology which is also consistent with Source I. We conclude that the wide opening angle of the outflow is evidence that a wide-angle wind drives the Source I outflow and not a collimated jet.Comment: 27 pages, 10 figure

Field-linked States of Ultracold Polar Molecules

We explore the character of a novel set of ``field-linked'' states that were predicted in [A. V. Avdeenkov and J. L. Bohn, Phys. Rev. Lett. 90, 043006 (2003)]. These states exist at ultralow temperatures in the presence of an electrostatic field, and their properties are strongly dependent on the field's strength. We clarify the nature of these quasi-bound states by constructing their wave functions and determining their approximate quantum numbers. As the properties of field-linked states are strongly defined by anisotropic dipolar and Stark interactions, we construct adiabatic surfaces as functions of both the intermolecular distance and the angle that the intermolecular axis makes with the electric field. Within an adiabatic approximation we solve the 2-D Schrodinger equation to find bound states, whose energies correlate well with resonance features found in fully-converged multichannel scattering calculations