RESUMO
BACKGROUND: African Americans with lupus who receive kidney transplants have high prevalence of predictors of allograft failure, which can explain their poor outcomes. METHODS: Of 1223 African Americans and 1029 Caucasian Americans with lupus who received kidney transplants from deceased donors between 1987 and 2006 with complete records in the UNOS program, 741 pairs were matched in 16 predictors employing a predicted probability of group membership. The primary outcome was allograft failure. Main secondary outcomes were rejection, allograft failure due to rejection, and mortality. RESULTS: Matched pairs were predominantly women (82%) with a mean age of 39 years. Twenty-four percent of recipients received kidneys from expanded criteria donors. African Americans and Caucasian Americans matched well (p ≥ 0.05): donor age, gender and race; recipient age, gender, education and insurance; dialysis prior to transplant, kidneys from expanded criteria donors, cold ischemia time, history of prior kidney transplant, panel reactive antibodies, human leukocyte antigens mismatch, blood type compatibility, transplant Era, and follow-up time. Contrary to the unmatched cohort with significantly higher allograft failure rate (events per 100 patient-years) in African Americans compared to Caucasian Americans (10.49 vs 6.18, p<0.001), matched pairs had similar allograft failure rates (8.41 vs 7.81, p=0.418). Matched pairs also had similar rates of rejections (9.82 vs 9.39, p=0.602), allograft failure due to rejection (6.19 vs 5.71, p=0.453), and mortality (2.79 vs 3.52, p=0.097). CONCLUSION: In lupus recipients of kidney transplants from deceased donors, African American and Caucasian Americans have similar allograft failure rates when predictors are matched between groups.
Assuntos
Sobrevivência de Enxerto , Transplante de Rim , Nefrite Lúpica/cirurgia , Adulto , Negro ou Afro-Americano , Aloenxertos , Estudos de Coortes , Feminino , Sobrevivência de Enxerto/imunologia , Teste de Histocompatibilidade , Humanos , Falência Renal Crônica/etiologia , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Nefrite Lúpica/complicações , Masculino , Doadores de Tecidos , Estados Unidos , População BrancaRESUMO
Se plantea como objetivo describir las técnicas de necropsia en animales de experimentación, una revisión bibliográfica y actualización. Se describieron las técnicas de necropsia en cobayos (Cavia porcellus), conejos (Oryctolaguscuniculus), ratones (Mus musculus), la rata (Rattusnorvegicus (variedad albina), incluyendo peces. La necropsia sistemática incluye una revisión de la historia clínica, y/o datos del experimento realizado. El siguiente paso corresponde al examen externo, donde se describen lesiones sobre el tejido tegumentario, sistema locomotor, mucosas, cavidades naturales y cambios post-mortem. Posteriormente se realiza el desollado, de manera simultánea la apertura de cavidades, con la evaluación de órganos, mediante un exhaustivo examen macroscópico. Este procedimiento continua con la extracción de órganos y toma de muestras. Por último se debe elaborar un informe de necropsia donde el patólogo veterinario emitirá las conclusiones o diagnósticos comentarios, recomendaciones y las apreciaciones enmarcados en la epicrisis del caso. El proceso de necropsia junto con la recolección y envío de muestras apropiadas para la realización de pruebas de laboratorio es trascendental en el proceso de emisión de un diagnóstico, de la práctica de la toma de muestra y envío al laboratorio depende el diagnostico morfológico y etiológico. En conclusión se describieron las técnicas de necropsia y toma de muestras en animales de experimentación con énfasis en cobayos (Cavia porcellus), conejos (Oryctolaguscuniculus), ratones (Mus musculus), la rata (Rattusnorvegicus, variedad albina), incluyendo peces, como una herramienta básica para el diagnostico de patologías en animales de experimentación así como se mencionaron las condiciones de envío de muestras a los distintos laborator
The aim of this study was to describe the necropsy techniques in experimental animals, a literature review and update. Necropsy techniques were described in guinea pigs (Cavia porcellus), rabbits (Oryctolagus cuniculus), mice (Mus musculus), rat (Rattus norvegicus (albino variety), including fish, systematic necropsy includes a review of clinical history, and/or data of the experiment performed. The next step corresponds to the external examination, where lesions are described on the integumentary tissue, locomotor system, mucous membranes, natural cavities and post-mortem changes, followed by flaying, simultaneously opening cavities, with the evaluation of organs, through an exhaustive macroscopic examination. This procedure continues with the extraction of organs and sampling. Finally, a necropsy report must be prepared where the veterinary pathologist will issue the conclusions or diagnoses comments, recommendations and assessments framed in the epicrisis of the case, the necropsy process together with the collection and shipment of appropriate samples for the performance of laboratory tests is crucial in the process of issuing a diagnosis, the practice of sampling and sending to the laboratory depends on the morphological and etiological diagnosis. In conclusion, necropsy and sampling techniques were described in experimental animals with emphasis on guinea pigs (Cavia porcellus), rabbits (Oryctolagus cuniculus), mice (Mus musculus), rat (Rattus norvegicus albino variety), including fish, as a basic tool for the diagnosis of pathologies in experimental animals, as well as the conditions for sending samples to different laboratories.
Assuntos
Animais , Masculino , Feminino , Cobaias , Camundongos , Coelhos , Ratos , Patologia , Manejo de Espécimes , Experimentação Animal , Animais de LaboratórioRESUMO
Antecedentes: La Incontinencia Urinaria de Esfuerzo (IUE) es una patología frecuente y en ascenso entre las mujeres, produce un deterioro significativo en la calidad de vida de ellas. Objetivos: Evaluar los resultados en el tratamiento de la IUE mediante un TOT ambulatorio con ajuste intraoperatorio de la tensión de la malla. Método: Se realizó un estudio prospectivo, descriptivo en el que se evaluaron los resultados objetivos y subjetivos en el tratamiento de la IUE con TOT ambulatorio, con ajuste intraoperatorio de la tensión de la malla. Resultados: Se obtuvo continencia normal en el 93,3 por ciento de las pacientes, 87 por ciento se consideró "sana". No se presentaron complicaciones mayores ni sobrecorrección a los 24 meses de seguimiento. El 93 por ciento de las pacientes abandonó el hospital el mismo día de la cirugía. Conclusiones: El ajuste de la malla intrao-peratorio permitiría mejorar los resultados publicados de continencia en la cirugía de TOT ambulatorio, disminuyendo el riesgo de sobrecorrección de la IUE en forma segura y rápida. Consideramos que debiera ser un paso obligatorio en el TOT.
Background: Stress urinary incontinence (SUI) is a common condition and rising among women, with a significant deterioration of quality of life. Objectives: To evaluate the results in the treatment of SUI by ambulatory TOT with intraoperative adjustment of mesh tension. Methods: We performed a prospective descriptive study that evaluated the objective and subjective outcomes of the SUI treatment with ambulatory TOT intraoperative adjustment of mesh tension. Results: Normal continence was obtained 93.3 percent of patients, 87 percent were considered cured. There were no major complications or over correction at 24 months follow up. 93.3 percent were discharged on the day of surgery. Conclusions: The intraoperative adjustment of the mesh would improve continence results published in TOT outpatient surgery, reducing the risk of overcorrection of SUI safely and quickly. We believe it should be a mandatory step in the TOT.