Patients with LLV that had fewer clinic visits and a trend toward increasing VLs had an increased risk of VF. Noncompliance seems to be a major component of VF. Physicians should emphasize the critical nature of medication adherence.
Evaluar el resultado funcional y la incidencia de complicaciones en una serie de trasplantes renales pediátricos utilizando injertos de donantes infantiles.MATERIAL Y MÉTODO: Se revisa una serie de 34 trasplantes renales en receptores pediátricos realizados de forma consecutiva. De ellos, en 19 casos (55,8%) el riñón procedía de donantes de edad inferior a 3 años (Grupo A). En 15 pacientes (44,2%), los donantes tuvieron una edad ≥ 3-6 años (Grupo B). Analizamos comparativamente el funcionalismo inmediato, complicaciones médicas y quirúrgicas, supervivencia del injerto y del paciente a medio y largo plazo.RESULTADOS: Observamos disfunción inicial del injerto en 9 pacientes del grupo A (47,4%). En el grupo B la incidencia fue del 46,7%. En el grupo A, 7 pacientes sufrieron complicaciones vasculares (36,7%) frente a 3 en el grupo B (20%) (p<0,05). Se produjeron más complicaciones vasculares en los riñones preservados en solución EC (35,3%) frente a UW (23,5%) (p<0,05). En el grupo A la supervivencia actuarial de los injertos a 10 años fue significativamente menor frente al grupo B (35,5%-58,6%, p<0,05). En base al tipo utilizado de solución de preservación, EC ofreció valores de supervivencia actuarial del injerto a 1-5-10 años de 47%-26,8%-26,8%; UW incrementó estas cifras a 82,3%-63%-63% (p<0,001).CONCLUSIONES: La limitación de la edad mínima para aceptación de donantes en Programas de Trasplante Renal Pediátrico en 3 años y la utilización de soluciones de preservación óptimas, resulta en una disminución de las complicaciones vasculares y un aumento de la supervivencia del injerto a largo plazo.
We have used two different primer pairs to assess HIV-1 infection of peripheral blood mononuclear cells (PBMC) by polymerase chain reaction (PCR). The study was carried out on 150 individuals: 50 seronegative individuals without risk behaviours for HIV-1 infection, 50 individuals with risk-behaviours but seronegative for HIV-1 and 50 patients with risk-behaviours who were HIV-1 seropositive. Discordances were found between the two primer pairs (SK38/39; SK68/69) in 3 cases. In the non-risk seronegative group, one specimen was scored positive with only one primer pair (SK38/SK39); all the samples belonging to seropositive individuals were found to be positive for HIV-1 DNA using both primer pairs; in the seronegative at risk group 2 samples were positive with only one primer pair (SK38/SK39), and 4 samples were found positive by both primer pairs (SK38/39 & SK68/69). Our study demonstrates that discrepant results take place with relatively high frequency; we propose that all specimens should be tested twice using at least two different primer pairs.
Nowadays, the risk factors of patients with an indication of biopsy have less weight than ten years ago. We currently diagnose patients with PC with more favourable prognostic factors. However, the price we pay for this earlier diagnosis is reflected in a less effective biopsy, a larger proportion of the population without PC having to experience the physical complications and psychological stress of a biopsy, a greater number of patients having to undergo a second biopsy and, therefore, a greater and more costly use of resources to diagnose PC.
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