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1.
Middle East Afr J Ophthalmol ; 27(2): 110-116, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874044

RESUMO

PURPOSE: The purpose is to compare the clinical results of using silk versus nylon sutures for conjunctival autograft suturing in pterygium surgery. METHODS: In this prospective, randomized, controlled, clinical trial 50 eyes from 50 patients with primary nasal pterygium were randomized to undergo pterygium surgery with the use of either nylon sutures or silk sutures for conjunctival autograft suturing. Patients were followed up for 6 months. Main outcome measures included recurrence, postoperative discomfort according to a visual analog scale (VAS), graft hyperemia, and graft edema. RESULTS: According to the results, there was no significant difference between groups regarding recurrence rate of pterygium (P = 0.72). A significant decrease in the mean VAS discomfort score from day 1 to day 14 was observed in both groups (P = 0.001); postoperative discomfort during the first 2 weeks, was not significantly different between the two groups. At 2 weeks' postoperatively, significantly greater number of nylon sutures remained on the autograft (P = 0.021), some of which were buried and could not be removed. CONCLUSION: Both silk and nylon are effective suture materials for autograft suturing in pterygium surgery with similar postoperative discomfort and recurrence rate. Significantly greater number of nylon sutures remains buried on the autograft and could not be removed easily.


Assuntos
Túnica Conjuntiva/transplante , Nylons , Pterígio/cirurgia , Seda , Técnicas de Sutura , Suturas , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoenxertos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos/métodos , Período Pós-Operatório , Estudos Prospectivos , Recidiva , Transplante Autólogo , Resultado do Tratamento
2.
Anticancer Res ; 40(10): 5687-5700, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988894

RESUMO

BACKGROUND: We previously developed a novel technique for expanding highly activated and purified natural killer (NK) cells able to maximize the theoretical activation potential of NK cells; thus, we named this cell population zenithal-NK (ZNK). AIM: To evaluate the safety, feasibility, and preliminary efficacy of autologous ZNK cells in patients with different types of advanced cancer with measurable solid lesions. PATIENTS AND METHODS: In this phase I/IIb first-in-human, open-label, dose-escalation study (trial registration ID: UMIN-000011555), eligible patients received ZNK cells intravenously starting from 106 to 108 cells/patient/dose at 2-week dosing intervals. A maximum of six cycles were allowed. Safety and survival analyses were also carried out for cases that were excluded and never administered ZNK cells. RESULTS: As of April 20, 2017, a total of nine patients were enrolled in this study, with one recruited twice. Overall, neither grade 2 or higher toxicities (Common Terminology Criteria for Adverse Events v5.0) caused by cell administration, nor adverse events causing discontinuation of protocol treatment were found. In four cases, the number of administered ZNK cells was increased to 108 cells/body/dose without any serious dose-limiting toxicity; the maximally tolerated dose was therefore considered to be at least 108 cells. The overall response rate was 40.0% in 10 net cases, one of partial response and three of stable disease, and the patient with partial response is still alive after 4 year's observation. CONCLUSION: These results demonstrate that autologous ZNK cells are safe and well-tolerated in patients with different types of advanced solid tumors. Clinical studies using similarly active ZNK cells from human leukocyte antigen/killer cell immunoglobulin-like receptor-mismatched healthy donors under Good Manufacturing Practice-compliant manufacturing, and with modified treatment regimen, i.e. doses and frequencies, are warranted for further investigation to show the potential of ZNK cells in such patients.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos , Células Matadoras Naturais/transplante , Neoplasias/terapia , Transplante Autólogo/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Proliferação de Células/genética , Relação Dose-Resposta Imunológica , Feminino , Humanos , Células Matadoras Naturais/imunologia , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Neoplasias/imunologia , Neoplasias/patologia
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 647-653, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878400

RESUMO

Objective: To prepare a three-dimensional (3D) printing donor tooth model and to observe its application in the peri-operative period. Methods: In part one, 192 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ï¼»107 males and 85 females, age (34.2±10.7) yearsï¼½ which need autotransplantation of teeth (ATT) were collected. Whether the donor teeth can be completely extracted was predicted through clinical and imaging examination (first prediction). The second prediction was supplemented by the three-dimensional printing model of the donor teeth. Each of the prediction was compared with the actual results and the coincidence rate was calculated. In part two, 64 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ï¼»28 males, 36 females, age (30.2±8.3) yearsï¼½ which need ATT were randomly divided into the model group and the donor group. The time of alveolar fossa preparation, time of donor tooth in vitro, times of trial implantation and time of pulptomy and root canal location were recorded respectively. Results: In part one, the coincidence rate between the second prediction and the actual results ï¼»97.4%(187/192)ï¼½ was significantly higher than that of the first prediction ï¼»93.2%(179/192)ï¼½ (P<0.05). In part two, the preparation time of the alveolar fossa in the maxillary and mandibular were (18.8±4.6) and (22.7±3.4) min, the time of the teeth in vitro were (3.0±0.6) and (2.1±0.6) min, the times of trial implantation were (1.3±0.8) and (1.0±0.9), and the time of pulpotomy and root canal location were (4.3±0.6) and (4.0±0.5) min. All values in the model groups were better than those in the donor group (P<0.05). Conclusions: The 3D printing model is accurate. It can be used in autogenous tooth transplantation to shorten the preparation time of alveolar fossa and time of donor tooth in vitro, and reduce the times of trial implantation of donor teeth, and to help to improve the prediction accuracy of complete extraction of donor teeth and the time of pulpotomy and root canal location.


Assuntos
Cirurgia Assistida por Computador , Dente , Modelos Dentários , Feminino , Masculino , Impressão Tridimensional , Transplante Autólogo
4.
Zhonghua Wai Ke Za Zhi ; 58(9): 718-722, 2020 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-32878420

RESUMO

Objective: To evaluate the clinical outcome of the reconstruction of Myerson type Ⅲ chronic Achilles tendon rupture by using the total arthroscopic technique combined with free semitendinosus tendon and gracilis tendon autograft. Methods: Clinical data of 32 patients(32 ankles) with Myerson type Ⅲ chronic Achilles tendon rupture who were treated by using the total arthroscopic technique combined with free semitendinosus tendon and gracilis tendon autograft at Department of Hand and Foot Microsurgery, Xuzhou Central Hospital from September 2013 to September 2018 were analyzed retrospectively.There were 28 males and 4 females, aged 45.5 years old(range: 22 to 69 years old), 12 cases in the right side and 20 in the left.All patients were treated by using the total arthroscopic technique combined with free semitendinosus tendon and gracilis tendon autograft for Myerson type Ⅲ chronic Achilles tendon rupture reconstruction.The functional recovery of the ankle was evaluated according to ankle-hindfood score of American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale, Achilles tendon total rupture score (ATRS), visual analogue scale (VAS).Arner-Lindholm score was used to evaluate the excellent and good rate.The quantitative data were compared using t-test or Wilcoxon test. Results: The 32 patients were followed up for 33 months (range: 15 to 72 months).No serious postoperative complications such as infection, sural nerve injury or tend re-rupture outcomes were reported.Three patients complained of mild pain when after a minimum sitting, walking or jogging, which were completely relieved by simple physical therapy or continuous stretching of Achilles tendon.At the last follow-up, the VAS decreased from 3 (5) (M (Q(R)) ) preoperative to 0 (3) (Z=1.357, P<0.01) and AOFAS ankle hindfoot scale improved from 58.6±13.5 preoperative to 95.5±4.0 (t=16.9, P=0.00), ATRS improved from 47.5±9.3 preoperative to 96.6±3.3 (t=25.661, P<0.01).According to the score of Arner-Lindholm, 20 cases were excellent, 12 cases were good, and the excellent and good rate was 100%. Conclusion: The reconstruction of Myerson type Ⅲ chronic Achilles tendon rupture by using the total arthroscopic technique combined with free semitendinosus tendon and gracilis tendon autograft has the advantages of safety, reliability, effectiveness and minor injury.


Assuntos
Tendão do Calcâneo/lesões , Tendão do Calcâneo/cirurgia , Traumatismos dos Tendões/cirurgia , Tendões/transplante , Adulto , Idoso , Artroscopia , Autoenxertos , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Ruptura , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
5.
Rinsho Ketsueki ; 61(8): 890-900, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32908053

RESUMO

Although Hodgkin lymphoma is now among the most curable of the lymphomas, the relapse rate after the first-line treatment remains at 20-30%. Brentuximab vedotin (BV) has been developed for the treatment of newly diagnosed classical Hodgkin lymphoma (cHL), relapsed/refractory cHL, or consolidation after autologous stem cell transplantation. Notably, BV treatment combined with doxorubicin, vinblastine, and dacarbazine treatment has been established as standard treatment for newly diagnosed advanced-stage cHL. Immune-checkpoint inhibitors represent another class of promising cancer immunotherapies that may be used to treat advanced cancers, including cHL. Anti-programmed death-1-blocking antibodies have been used to enhance immunity in cases of several malignancies and obtain durable responses, most notably in patients who have been administered heavy treatment for relapsed/refractory cHL. Several clinical trials, including single agents or combination therapies for cHL, have been developed or are currently under investigation. The results of the ongoing and future clinical trials may establish new paradigms for the treatment of cHL.


Assuntos
Brentuximab Vedotin/uso terapêutico , Doença de Hodgkin , Transplante de Células-Tronco Hematopoéticas , Doença de Hodgkin/tratamento farmacológico , Humanos , Imunoconjugados , Recidiva Local de Neoplasia , Transplante Autólogo
6.
Plast Reconstr Surg ; 146(4): 409e-413e, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32969997

RESUMO

Breast reconstruction remains an important field in plastic surgery, with most procedures using implants and/or autologous tissue. Few series report on experience with fat grafting as the primary form of breast reconstruction. The present article describes a new method of breast reconstruction using a three-dimensional absorbable mesh construct-or Lotus scaffold-and autologous fat grafting. A retrospective review was performed for all patients who underwent breast reconstruction using the Lotus scaffold and autologous fat grafting. Postoperative mammograms and magnetic resonance imaging scans were analyzed. Tissue specimens collected at subsequent procedures were harvested and stained with hematoxylin and eosin for histologic evaluation. Lastly, compression testing of the scaffold was performed using a tensiometer and digital tracking technology. Twenty-two patients underwent reconstruction of 28 breasts using the Lotus scaffold and autologous fat grafting between February of 2015 and February of 2018. Average follow-up was 19 months. All patients were satisfied with final breast shape and size. Mean patient age was 60.5 years and the average body mass index was 28 kg/m. Patients required on average two fat grafting sessions to achieve a successful result (range, zero to four). Postoperative mammography and magnetic resonance imaging showed robust adipose tissue in the breast with a slowly resorbing mesh and no oil cysts or calcifications. Histologic evaluation showed the presence of fat tissue around the scaffold and no evidence of capsule formation. Compression testing revealed the Lotus scaffold to be compliant with a high-resilience profile. The Lotus scaffold with autologous fat grafting is a viable method for breast reconstruction, giving the patient an autologous reconstruction with less morbidity compared to free tissue transfer. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.


Assuntos
Implantes Absorvíveis , Tecido Adiposo/transplante , Mamoplastia/métodos , Telas Cirúrgicas , Engenharia Tecidual/métodos , Tecidos Suporte , Idoso , Feminino , Humanos , Mamoplastia/instrumentação , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante Autólogo
7.
Medicine (Baltimore) ; 99(31): e21431, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756151

RESUMO

RATIONALE: The use of autologous hematopoietic stem cell transplantation (AHSCT) for autoimmune diseases has become the first indication for transplant in nonmalignant disease. Mucormycosis is a rare invasive infection with increasing incidence in patients treated with AHSCT. We report the first case of pulmonary mucormycosis following AHSCT for systemic sclerosis (SSc). PATIENT CONCERNS: A 24-year-old woman with rapidly progressive diffuse cutaneous SSc presented with an acute respiratory distress syndrome 6 days after AHSCT. DIAGNOSES: The results of clinical and computed tomography scan were consistent with pulmonary mucormycosis and the diagnosis was confirmed by a positive Mucorales Polymerase Chain Reaction on a peripheral blood sample. INTERVENTIONS AND OUTCOMES: Early antifungal therapy by intravenous amphotericin B provided rapid improvement within 4 days and sustained recovery after 2 years of follow-up. LESSONS: With the progressively increasing use of AHSCT and other stem cell therapy for treatment of severe SSc and other autoimmune diseases, the potential onset of rare post-transplant fungal infections, such as mucormycosis, requires careful patient monitoring and better awareness of early initiation of adequate therapy.


Assuntos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Mucormicose/etiologia , Esclerodermia Difusa/etiologia , Escleroderma Sistêmico/terapia , Transplante Autólogo/efeitos adversos , Doença Aguda , Administração Intravenosa , Assistência ao Convalescente , Anfotericina B/administração & dosagem , Anfotericina B/uso terapêutico , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Feminino , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Pneumopatias Fúngicas/diagnóstico por imagem , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/patologia , Mucorales/genética , Síndrome do Desconforto Respiratório do Adulto/etiologia , Esclerodermia Difusa/patologia , Transplante Autólogo/métodos , Resultado do Tratamento , Adulto Jovem
9.
Plast Reconstr Surg ; 146(2): 215-225, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740564

RESUMO

BACKGROUND: Autologous fat grafting is a useful adjunct following breast reconstruction. The impact of autologous fat grafting on oncologic safety and surveillance remains questionable, particularly following breast conservation therapy. METHODS: The authors performed a retrospective review of patients who underwent delayed fat grafting following breast conservation therapy between 2006 and 2016. A control group of conservatively managed patients without grafting was matched for cancer stage, age, body mass index, and follow-up. Outcomes included locoregional recurrence and oncologic surveillance. RESULTS: Seventy-two patients were identified per cohort. There were no differences in median age (50 years versus 51 years; p = 0.87), body mass index (28.2 kg/m versus 27.2 kg/m; p = 0.38), or length of follow-up (61.9 months versus 66.8 months; p = 0.144) between controls and grafted patients, respectively. Overall, four patients in each cohort experienced recurrence (5.6 percent; p = 1.00) with similar cumulative incidence estimates observed (log-rank test, p = 0.534). There were no significant differences in palpable mass (9.7 percent versus 19.4 percent; p = 0.1), fat necrosis (34.7 percent versus 33.3 percent; p = 0.86), calcifications (37.5 percent versus 34.7 percent; p = 0.73), or indication for breast biopsy (15.3 percent versus 22.2 percent; p = 0.23) between breast conservation and breast conservation therapy plus autologous fat grafting cohorts, respectively. CONCLUSIONS: Overall, the authors found no difference in recurrence rates after breast conservation with or without delayed fat grafting. Furthermore, there were no differences in the rates of fat necrosis, palpable mass, and abnormal radiographic findings. This study represents the longest follow-up to date in in a large matched study of autologous fat grafting with breast conservation therapy demonstrating oncologic safety and no interference with follow-up surveillance. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Assuntos
Tecido Adiposo/transplante , Neoplasias da Mama/cirurgia , Mama/cirurgia , Mamoplastia/métodos , Mastectomia Segmentar/métodos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
10.
Arthroscopy ; 36(8): 2292-2294, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32747068

RESUMO

The role of graft selection on clinical and functional outcomes following anterior cruciate ligament (ACL) reconstruction has gained significant attention in the orthopaedic sports medicine community in recent years. Bone-patellar tendon-bone (BPTB) and semitendinosus/gracilis hamstring tendon (HT) autografts are 2 of the most commonly used grafts, given their low failure rates, predictable outcomes, and ability to incorporate appropriately at the graft site. However, multiple studies have recently shown each of these graft options to have some potentially less-desirable characteristics in regards to outcomes in specific patient populations. More specifically, in 14- to 25-year-old athletes, HT autografts have been shown to result in decreased rotational stability, decreased return to sport rates, and increased graft failure rates. On the other hand, BPTB autografts can require a prolonged recovery period and have been associated with increased postoperative pain and long-term kneeling pain. HT and BPTB grafts are both excellent grafts; however, it is important to understand the differences in clinical and functional outcomes between these graft options for ACL reconstruction. The characteristics of the graft need to be considered and individualized for each patient who is being treated for an ACL injury.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Músculos Isquiossurais , Ligamento Patelar/cirurgia , Adolescente , Adulto , Ligamento Cruzado Anterior/cirurgia , Autoenxertos , Seguimentos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transplante Autólogo , Adulto Jovem
11.
Artigo em Chinês | MEDLINE | ID: mdl-32791613

RESUMO

Objective:To compare the different therapeutic effects of modified syringe forearm quantitative injection and forearm brachioradialis intramuscular transplantation after receiving total parathyroidectomy in patients with secondary hyperparathyroidism. Method:One hundred and fifty-two patients with secondary hyperparathyroidism who underwent total parathyroidectomy were divided into the forearm brachioradialis intramuscular transplantation group and the modified syringe forearm quantitative injection group according to the different forearm transplantation methods. The study counted and compared the duration of surgery, preoperative and postoperative parathyroid hormone levels, blood calcium and other indicators. Result:The results showed that there was no statistically significant difference in laboratory test data between the two groups, but the modified syringe forearm quantitative injection method was more convenient, and the recovery time of the parathyroid function was shortened from an average of 6 months to an average of 3 months(P=0.03). There was no statistical difference in the recurrence of the two groups of patients after transplantation. Conclusion:The modified syringe forearm quantitative injection method for transplantation of parathyroid gland is relatively simple to operate, saves time, and enables the transplanted parathyroid gland to function faster. It is worthy of being widely used.


Assuntos
Hiperparatireoidismo Secundário/cirurgia , Paratireoidectomia , Antebraço , Humanos , Glândulas Paratireoides , Hormônio Paratireóideo , Recidiva , Transplante Autólogo
12.
Lancet HIV ; 7(9): e652-e660, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32791046

RESUMO

Haemopoietic cell transplantation is established as a standard treatment approach for people living with HIV who have haematological malignancies with poor prognosis. Studies with autologous and allogeneic haemopoietic cell transplantation suggest that HIV status does not adversely affect outcomes, provided that there is adequate infection prophylaxis. Attention to possible drug-drug interactions is important. Allogeneic haemopoietic cell transplantation substantially reduces the long-term HIV reservoir when complete donor chimerism is established. When transplants from CCR5Δ32 homozygous donors are used, HIV cure is possible.


Assuntos
Infecções por HIV/complicações , Transplante de Células-Tronco Hematopoéticas , Terapia Antirretroviral de Alta Atividade , Gerenciamento Clínico , Suscetibilidade a Doenças , Predisposição Genética para Doença , Doença Enxerto-Hospedeiro/etiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Infecções por HIV/virologia , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Homozigoto , Humanos , Mutação , Receptores CCR5 , Transplante Autólogo , Transplante Homólogo , Resultado do Tratamento
13.
Crit Rev Oncol Hematol ; 153: 103038, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32739830

RESUMO

MCL is a well-characterized generally aggressive lymphoma with a poor prognosis. However, patients with a more indolent disease have been reported in whom the initiation of therapy can be delayed without any consequence for the survival. In 2017 the World Health Organization updated the classification of MCL describing two main subtypes with specific molecular characteristics and clinical features, classical and indolent leukaemic nonnodal MCL. Recent research results suggested an improving outcome of this neoplasm. The addition of rituximab to conventional chemotherapy has increased overall response rates, but it did not improve overall survival compared to chemotherapy alone. The use of intensive frontline therapies including rituximab and consolidation with autologous stem cell transplantation ameliorated response rate and prolonged progression-free survival in young fit patients, but any impact on survival remains to be proven. Furthermore, the optimal timing, cytoreductive regimen and conditioning regimen, and the clinical implications of achieving a disease remission even at molecular level remain to be elucidated. The development of targeted therapies as the consequence of better understanding of pathogenetic pathways in MCL might improve the outcome of conventional chemotherapy and spare the toxicity of intense therapy in most patients. Cases not eligible for intensive regimens, may be considered for less demanding therapies, such as the combination of rituximab either with CHOP or with purine analogues, or bendamustine. Allogeneic SCT can be an effective option for relapsed disease in patients who are fit enough and have a compatible donor. Maintenance rituximab may be considered after response to immunochemotherapy as the first-line strategy in a wide range of patients. Finally, since the optimal approach to the management of MCL is still evolving, it is critical that these patients are enrolled in clinical trials to identify the better treatment options.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma de Célula do Manto , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Recidiva Local de Neoplasia , Prognóstico , Rituximab , Transplante Autólogo
14.
Ann Hematol ; 99(10): 2385-2392, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32748163

RESUMO

Up to 30% of patients with classical Hodgkin lymphoma (cHL) are not responsive to frontline therapy or relapse after primary treatment. In these cases, autologous hematopoietic stem cell transplantation (AHSCT) is the standard of care. The combination of brentuximab vedotin and bendamustine (BV + B) is an effective salvage regimen in this challenging subpopulation. This nationwide multicenter study investigated the real-world efficacy and safety of the BV + B regimen as a bridge to AHSCT in patients with primary refractory or relapsed cHL. A total of 41 cHL patients underwent AHSCT after receiving at least 1 cycle of BV + B (with brentuximab vedotin given at 1.8 mg/kg on day 1 and bendamustine at 90 mg/m2 on days 1-2 every 4 weeks). After a median of 3 (1-6) cycles of BV + B, the objective response rate was 78%, with 29 (70.7%) patients achieving complete remission. Twelve (29.3%) patients relapsed after AHSCT, 2 (4.9%) of them died, while 2 (4.9%) patients are lost to follow-up. After a median of 17 months of follow-up, the estimated 2-year overall- and progression-free survival after AHSCT was 93 and 62%, respectively. Features of advanced disease at recurrence (p = 0.038) and the presence of stage IV cHL at relapse (p = 0.024) are strong predictor markers of unfavorable outcomes. Twenty-four (58.5%) patients experienced adverse events of any grade, while no grade IV toxicities were reported. BV + B is an effective salvage option with a manageable toxicity profile in cHL. The real-world safety and efficacy of this combination are similar to the observations made on the study population.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Células-Tronco Hematopoéticas , Doença de Hodgkin/tratamento farmacológico , Terapia de Salvação , Adolescente , Adulto , Idoso , Antineoplásicos Alquilantes/administração & dosagem , Antineoplásicos Alquilantes/efeitos adversos , Antineoplásicos Imunológicos/administração & dosagem , Antineoplásicos Imunológicos/efeitos adversos , Cloridrato de Bendamustina/administração & dosagem , Cloridrato de Bendamustina/efeitos adversos , Brentuximab Vedotin/administração & dosagem , Brentuximab Vedotin/efeitos adversos , Terapia Combinada , Avaliação de Medicamentos , Resistencia a Medicamentos Antineoplásicos , Feminino , Seguimentos , Doença de Hodgkin/diagnóstico por imagem , Doença de Hodgkin/terapia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto/estatística & dados numéricos , Neutropenia/induzido quimicamente , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Tomografia por Emissão de Pósitrons , Intervalo Livre de Progressão , Estudos Retrospectivos , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
15.
Am J Orthod Dentofacial Orthop ; 158(4): 587-598, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32839074

RESUMO

A boy aged 8 years 11-months with 4 missing teeth in his mandibular arch and with a skeletal Class II pattern was treated with autotransplantation of developing premolars from his maxillary arch with the aid of temporary skeletal anchorage devices. The active treatment duration was 25 months. After treatment, he had a normal occlusion, and his profile was improved. Posttreatment records at 12 months showed stable occlusion and successfully autotransplanted premolars.


Assuntos
Anodontia , Perda de Dente , Autoenxertos , Dente Pré-Molar , Criança , Humanos , Masculino , Transplante Autólogo
16.
Plast Reconstr Surg ; 146(3): 486-497, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32842097

RESUMO

BACKGROUND: The purpose of this study was to compare the commonly used fat grafting techniques-Telfa rolling and a closed washing system-in breast reconstruction patients. METHODS: Consecutive patients undergoing fat grafting were retrospectively reviewed and grouped by technique. Patients with less than 180 days of follow-up were excluded. Demographics, operative details, and complications were compared using univariate analysis with significance set at p < 0.05. RESULTS: Between January of 2013 and September of 2017, 186 women underwent a total of 319 fat grafting procedures. There was no difference in demographics, number of procedures performed, volume of fat grafted, and number of days after reconstruction that fat grafting was performed between groups (p > 0.05). Telfa rolling patients had longer operative times for second fat grafting procedures (implant exchange often completed prior) [100.0 minutes (range, 60.0 to 150.0 minutes) versus 79.0 minutes (range, 64.0 to 94.0 minutes); p = 0.03]. Telfa rolling breasts had more palpable masses requiring imaging (26.0 percent versus 14.4 percent; p = 0.01) and an increased incidence of fat necrosis (20.6 percent versus 8.0 percent; p < 0.01). The closed washing system was found to be an independent predictor of decreased rates of imaging-confirmed fat necrosis (OR, 0.29; p = 0.048). There was no difference in fat necrosis excision or cancer recurrence between the groups. CONCLUSION: The closed washing system was independently associated with decreased rates of imaging-confirmed fat necrosis compared to Telfa rolling without an increase in other complications. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.


Assuntos
Tecido Adiposo/transplante , Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Mastectomia/métodos , Cuidados Pré-Operatórios/métodos , Coleta de Tecidos e Órgãos/instrumentação , Adulto , Desenho de Equipamento , Feminino , Humanos , Pessoa de Meia-Idade , Reoperação , Estudos Retrospectivos , Transplante Autólogo
17.
Arthroscopy ; 36(7): 1939-1941, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32624127

RESUMO

Autologous chondrocyte implantation (ACI) is an increasingly performed procedure, with rapidly evolving technology. First-generation ACI used a periosteal patch, leading to the second generation, in which a type I-type III collagen membrane is used to cover the autologous chondrocytes, and ultimately the third generation, in which autologous chondrocytes are seeded onto the scaffold itself. As third-generation, scaffold-based ACI techniques are becoming more widely available, interest in the long-term clinical and radiographic outcomes continues to grow, especially given the high costs associated with these procedures. Several studies have now shown persistently improved clinical outcomes at long-term follow-up, which support the increasing utilization of third-generation ACI techniques. However, it is important to continue to develop our understanding of the limitations of and expectations with third-generation ACI, particularly regarding reoperation, as well as to continue to design high-quality long-term studies that can evaluate differences in technology.


Assuntos
Cartilagem Articular , Condrócitos , Humanos , Imagem por Ressonância Magnética , Medidas de Resultados Relatados pelo Paciente , Transplante Autólogo
18.
Zhongguo Gu Shang ; 33(7): 677-83, 2020 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-32700496

RESUMO

OBJECTIVE: To evaluate clinical effect of quadriceps tendon autograft and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction by Meta-analysis. METHODS: From the time of building databases to May 2019, literatures on case control study on quadriceps tendon and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction were searched form PubMed, EMbase, the Cochrane library, Wanfang and CNKI database. Literature screening, quality evaluation and data extraction were carried out according to include and exclude standard. Difference of forward displacement between the affected and health knee, Lachman test, axial shift test, Lysholm score, international knee documentation committee (IKDC) objective grade, anterior knee joint pain and transplant failure rate were analyzed by Meta analysis. RESULTS: Totally 6 literatures were included, including 915 patients with anterior cruciate ligament reconstruction, 495 patients with quadriceps tendon autograft and 420 patients with bone patellar tendon bone autograft. There were no statistical differences in anterior displacement of tibia was less than 3 mm[OR=1.53, 95%CI(0.68, 3.44), P=0.31], 3 to 5 mm [OR=0.64, 95%CI(0.31, 1.35), P=0.24], greater than 5 mm[OR=1.18, 95%CI(0.33, 4.22), P=0.80], negative rate of Lachman test[OR=0.88, 95%CI(0.38, 2.02), P=0.76], negative rate of axial shift test[OR=0.63, 95%CI(0.24, 1.68), P=0.36] between two groups. There were no differences in Lyshlom score[MD=-0.56, 95%CI(-2.00, 0.89), P=0.45], IKDC objective grade A and B[OR=0.87, 95%CI (0.47, 1.60), P=0.66], and transplant failure rate [OR=0.76, 95%CI (0.28, 2.02), P= 0.58]. In reducing anterior knee pain, quadriceps tendon autograft was better than that of bone patellar tendon bone autograft [OR=0.16, 95%CI (0.09, 0.29), P<0.000 01]. CONCLUSION: Quadriceps tendon autograft and bone patellar tendon bone autograft on anterior cruciate ligament reconstruction has equal clinical and functional outcomes, transplant failure rate, quadriceps tendon autograft could reduce anterior knee pain. For patients with anterior cruciate ligament reconstruction, quadriceps tendon autograft could be seen as suitable alternative bone graft substitutes for anterior cruciate ligament reconstruction.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Ligamento Patelar/cirurgia , Autoenxertos , Estudos de Casos e Controles , Humanos , Tendões , Transplante Autólogo , Resultado do Tratamento
19.
Zhonghua Xue Ye Xue Za Zhi ; 41(6): 456-461, 2020 Jun 14.
Artigo em Chinês | MEDLINE | ID: mdl-32654457

RESUMO

Objective: To evaluate the clinicopathologic characteristics and outcomes of HIV-negative plasmablastic lymphoma (PBL) . Methods: Medical records of 15 patients diagnosed with HIV-negative PBL in Changhai Hospital between January 2013 and August 2019 were reviewed, and clinicopathologic characteristics and outcomes were analyzed. Results: Median age was 59 years (range: 17-69) . All patients had extranodal involvement. According to the Cotswolds-modified Ann Arbor staging system, 1 (6.7%) , 2 (13.3%) , 3 (20.0%) , and 9 (60.0%) patients were classified as at Ⅰ,Ⅱ,Ⅲ and Ⅳ, respectively. Plasmablast and immunoblast proliferations were typical manifestations of PBL. Immunohistochemical staining showed tumor cells were diffusely positive for plasma cell markers CD38, CD138, and Mum-1, while negative for B cell markers CD20, CD10, PAX-5, and BCL-6. Median Ki-67 index was 80% (70%-90%) . Epstein-Barr virus-encoded RNA (EBER) expression was detected in 3 patients, and 1 of them was positive. All patients received chemotherapy, 80% combined with bortezomib as the first line, and responses were observed in 8 patients (6 complete and 2 partial responses) . Median progression-free survival (PFS) and overall survival (OS) were 6.8 (95% CI 2.5-11.1) months and 17.9 (95% CI 5.6-30.2) months, the 3-year PFS and OS rates were 21.2% (95% CI 1.4%-56.8%) and 38.5% (95% CI 12.0%-65.0%) , respectively. Conclusion: HIV-negative PBL with high invasiveness is extremely prone to extranodal involvement and most patients were at the advanced stage. Patients receiving an intensive therapy combined with bortezomib and bridged autologous stem cell transplantation may improve long-time survival.


Assuntos
Linfoma Plasmablástico , Adolescente , Adulto , Idoso , Infecções por HIV , Transplante de Células-Tronco Hematopoéticas , Humanos , Pessoa de Meia-Idade , Análise de Sobrevida , Transplante Autólogo , Adulto Jovem
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