Medicine
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Observational Study
Analysis of 4000 kidney transplantations in a single center: Across immunological barriers.
Kidney transplant (KT) is the optimal renal replacement therapy for patients with end-stage renal disease (ESRD). The demand for kidneys, however, continues to exceed the supply. To overcome this problem, efforts to extend the donor pool by including human leukocyte antigen (HLA)- and ABO-incompatible (ABOi) KTs are increasing. ⋯ The overall GS, death-censored GS, and rejection-free GS also did not differ significantly between the FCXM KT and control groups (P = 0.99, 0.42, and 88). The outcomes of KTs continually improved during the study period, while the annual number of KTs increased. ABO or FCXM positive KTs can be performed safely with successful graft outcomes.
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Creatine kinase (CK) values are a critical part of the workup of suspected myopathies and are often assessed in patients that develop myalgia on statin therapy. CK elevations may influence the initiation and cessation of statin treatment, and incidentally discovered CK elevation may lead to further testing. A number of factors influence CK levels in healthy patients, but current reference ranges do not incorporate important influencers of CK such as race. Objectives of this study were to evaluate clinical factors associated with CK among healthy individuals and to develop practical reference ranges for important subgroups to improve test interpretation. ⋯ CK is substantially higher in men and in black patients. Differences in body size and composition are also important but do not explain racial differences in CK. The 95th and 97.5th percentiles in sex and race-ethnicity subgroups provide a practical guide for clinicians interpreting CK values.
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We investigated the risk factors for adenoma occurrence at surveillance colonoscopy, especially focusing on patient characteristics, including metabolic factors. Surveillance colonoscopy intervals depend on baseline adenoma characteristics. However, patients' characteristics may also influence the occurrence of adenomas. ⋯ The cumulative incidence of adenoma occurrence in the high-risk group was higher than that in the low-risk group, whereas the incidence in the high-risk group without MetS was comparable with that in the low-risk group with MetS. Patient characteristics, such as MetS, obesity, older age, and male sex, in addition to adenoma characteristics, were independent risk factors for adenoma occurrence at surveillance colonoscopy. These patient characteristics may be considered in surveillance colonoscopy intervals.
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Observational Study
miR-22 contributes to the pathogenesis of patients with coronary artery disease by targeting MCP-1: An observational study.
The aim of this study is to determine miR-22 expression levels in peripheral blood mononuclear cells (PBMCs) of patients with coronary artery disease (CAD) and to investigate whether MCP-1 expression is regulated by miR-22. miR-22 expression in PBMCs from 60 CAD patients including stable angina pectoris (SAP) (n = 29), unstable angina pectoris (UAP) or non-ST elevation myocardial infarction (NSTEMI) (n = 17), or ST-elevation MI (STEMI) (n = 14) and 20 non-CAD subjects by real-time polymerase chain reaction (qRT-PCR). The luciferase activity assays were employed to determine whether miR-22 binds to 3'UTR of MCP-1. miR-22 mimics and inhibitors were transfected into healthy PBMCs. MCP-1 mRNA and protein levels were determined by qRT-PCR and enzyme-linked immuno sorbent assay, respectively. ⋯ The luciferase activity assays indicated that MCP-1 was a target of miR-22. Overexpression of miR-22 could significantly repress MCP-1 expression at both mRNA and protein levels in PBMCs, whereas inhibition of miR-22 showed the opposite effects. This study revealed that miR-22 is downregulated in PBMCs from patients with CAD and that miR-22 may participate in inflammatory response by targeting MCP-1, therefore contributing CAD.
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The aim of this study was to determine the features of triple-negative breast cancer (TNBC) using a large national database. TNBC is known to be an aggressive subtype, but national epidemiologic data are sparse. All patients with invasive breast cancer and known molecular subtype diagnosed in 2010 to 2011 were identified from the National Cancer Data Base (NCDB). ⋯ On univariate analysis, TNBC was no more likely than non-TNBC to have node-positive disease (32.0% vs 31.7%, respectively, P = 0.218) but in a multivariable analysis controlling for tumor size and grade, TNBC was associated with significantly less node-positivity (OR = 0.59; 95% confidence interval [CI]: 0.57-0.60). TNBC has distinct features regarding age, gender, geographic, and racial distribution. Compared to non-TNBC, TNBC is larger and higher grade, but less likely to have lymph node metastases.