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Search Results: 1 - 10 of 12055 matches for " graft vs host diseases. "
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Importancia del estudio del quimerismo en el trasplante alogénico de médula ósea
Amor Vigil,Ana M; Martínez Antu?a,Gisela;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2003,
Abstract: since the hematopoietic transplantation was performed for the first time, the importance of knowing chimerism was underlined. the present paper updates the concepts of chimerism, its classification and the different ways to determine it. the most recommended is the highly polymorphic area amplification in the dna using the polymerase chain reaction technique. this technique has allowed carrying out studies on the evolution of chimera, to relate the set level of chimerism with the graft behaviour and the graft-versus-host disease under different conditioning. it has also made it possible to early detect relapse of transplanted patients and the prompt administration of additional immunotherapy. finally, the paper presents the recommendations of the american society of blood and bone marrow transplantation for standardizing the study of chimerism in the therapy centers
Avalia??o do comportamento biológico de homoenxertos valvares pulmonares descelularizados: estudo experimental em ovinos
Navarro, Fábio Binhara;Costa, Francisco Diniz Affonso da;Mulinari, Leonardo Andrade;Pimentel, Gustavo Klug;Roderjan, Jo?o Gabriel;Vieira, Eduardo Discher;Noronha, Lúcia de;Miyague, Nelson Itiro;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000300015
Abstract: introduction: the cryopreserved homograft is a good valve substitute due attributes like excellent hemodynamics, low incidence of thromboembolic events, infection resistance and good mid-term durability. however, progressive homograft degeneration and fibrocalcification may occur, particularly in the childhood and young adults. their antigenicity triggers an immunological reaction that plays an important role in their degeneration and failure. the decellularization process was proposed to decrease this antigenicity. by the action of detergents and enzymes, this process removes all cellular components from the homograft matrix, diminishing immunogenicity and probably delaying its degeneration. objective: the objective of this experimental and descriptive study is to evaluate the biological and functional behavior of decellularized pulmonary homografts (decell-h), treated by a sodium dodecil sulfate solution (0.1%), developed in our university (pontifícia universidade católica do paraná). for the characterization of decell-h performance, parameters like recellularization, calcification, and echocardiographic data will be analyzed. methods: eight juvenile sheep were submitted to the implantation of the decell-h sutured into orthotopic position, through a left thoracotomy and with cardiopulmonary bypass support. they were followed-up clinically and by periodical echocardiograms until the explantation, which were performed in different time for every two sheep: seven, 30, 90 and 180 postoperative days. for histological analysis we used hematoxilin-eosin, movat and alizarin-red staining. results: the sheep reached their follow-up period in a good clinical state. there was no valve regurgitation or stenonis by the echocardiogram. the animals submitted to the explantation in 90 and 180 days had a significant somatic growth and these decell-h(s) had a diameter increase, without central valve insufficiency. histologically, all homografts preserved their extra-cellular matrix
Importancia del estudio del quimerismo en el trasplante alogénico de médula ósea IMPORTANCE OF THE STUDY OF CHIMERISM IN THE ALLOGENEIC BONE MARROW TRANSPLANTATION
Ana M Amor Vigil,Gisela Martínez Antu?a
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2003,
Abstract: Desde que se comenzó a realizar el trasplante hematopoyético se reconoció la importancia de conocer el establecimiento de quimerismo. El presente trabajo actualiza los conceptos de quimerismo, su clasificación y las diferentes vías para su determinación. Se destaca como la más recomendada, la amplificación de zonas altamente polimórficas en el ADN por la técnica de la reacción en cadena de la polimerasa. La utilización de esta técnica ha permitido realizar estudios de la evolución de la quimera, relacionar el grado de quimerismo establecido con el comportamiento del injerto y de la enfermedad de injerto contra hospedero en los diferentes regímenes de acondicionamiento. También ha posibilitado la detección precoz de la recaída en los pacientes trasplantados y la administración oportuna de inmunoterapia adicional. Finalmente, se presentan las recomendaciones de la Sociedad Americana de Trasplante de Sangre y Médula ósea para estandarizar el estudio del quimerismo en los diferentes centros de tratamiento Since the hematopoietic transplantation was performed for the first time, the importance of knowing chimerism was underlined. The present paper updates the concepts of chimerism, its classification and the different ways to determine it. The most recommended is the highly polymorphic area amplification in the DNA using the polymerase chain reaction technique. This technique has allowed carrying out studies on the evolution of chimera, to relate the set level of chimerism with the graft behaviour and the graft-versus-host disease under different conditioning. It has also made it possible to early detect relapse of transplanted patients and the prompt administration of additional immunotherapy. Finally, the paper presents the recommendations of the American Society of Blood and Bone Marrow Transplantation for standardizing the study of chimerism in the therapy centers
Eficácia do adesivo tecidual de fibrina na fixa??o de enxerto conjuntival autógeno em cirurgias de pterígio primário
Rubin, Michel Risnic;Dantas, Paulo Elias C.;Nishiwaki-Dantas, M. Cristina;Felberg, Sergio;
Arquivos Brasileiros de Oftalmologia , 2011, DOI: 10.1590/S0004-27492011000200011
Abstract: purpose: to compare the efficacy of conjunctival autograft surgery with the attachment to the scleral bed using fibrin tissue adhesive or mononylon 10-0 suture after resection of primary pterygium. methods: a comparative, prospective and randomized clinical trial was performed in 47 eyes of 47 patients with primary medial located pterygium. group 1 (adhesive) was composed by 21 patients that underwent conjunctival autograft closure with fibrin tissue adhesive (quixiltm) and group 2 (suture) was composed by 26 patients that underwent pterygium surgery with mononylon 10-0 (ethicon?) suture (suture group) after pterygium excision. all surgeries were performed by the same surgeon. patients were assessed on the preoperative period and on the 1st, 14th and 21st postoperative days. they were followed-up with a questionnaire of ocular discomfort and by the surgical time spent, ocular hyperemia, complications and recurrence signals, being the recurrence also evaluated at the 6th postoperative month. data were submitted to statistical analysis. a value of p<0.005 was considered statistically significant. results: the average surgical time was 19.05 ± 6.12 minutes in group 1 (glue) and 48.15 ± 7.13 minutes in the group 2 (suture) (p<0.001). the ocular discomfort scale analysis showed a lower score in the 1st (p<0.005), 7th (p<0.001) and 21th (p<0.001) postoperative days in group 1. ocular hyperemia was less intense in all periods of this study in group 1 (p<0.001). complications were one in each group and both were managed with clinical treatment until the 21th postoperative day. there was one recurrence in group 1 and two in group 2 until the 6th postoperative month. conclusion: in the surgical management of primary pterygium, fibrin tissue adhesive attached the conjunctival autograft, decreased the surgical time and diminished the conjunctival hyperemia and ocular discomfort with similar recurrences on the postoperative period, compared to fixation with mononylon 10.0 suture
Brazilian workshop model to train investigators in chronic graft-versus-host disease clinical trials according to the 2005-2006 National Institutes of Health recommendations
Tavares, Rita de Cássia Barbosa da Silva;Silva, Márcia de Matos;Bouzas, Luis Fernando da Silva;Rodrigues, Maria Cláudia;Vigorito, Afonso Celso;Funke, Vaneusa;Mauad, Marcos;Correa, Maria Elvira Pizzigatti;Souza, Clarissa Vasconcellos de;Nunes, Elenaide;Ferrari, Alessandra;Paix?o, Ariana;Martins, Talita;Pallottino, érika;Flowers, Mary Evelyn Dantas;
Revista Brasileira de Hematologia e Hemoterapia , 2011, DOI: 10.5581/1516-8484.20110099
Abstract: background: the lack of standardization of clinical diagnostic criteria, classification and severity scores of chronic graft-versus-host disease led the national institutes of health to propose consensus criteria for the purpose of clinical trials. methods: here we describe a one-day workshop model conducted by the chronic graft-versus-host disease brazil-seattle consortium study group to train investigators interested in participating in multicenter clinical trials in brazil. workshop participants included eight transplant physicians, one dermatologist, two dentists, three physical therapists and one psychologist from five institutions. workshop participants evaluated nine patients with varying degrees of severity of mucocutaneous lesions and other manifestations of the disease followed by a training session to review and discuss the issues encountered with the evaluation and scoring of patients and in the methods used to evaluate grip strength and the 2-minute walk test. results: most participants had difficulties in rating the percentage of each type of mucocutaneous lesion and thought 20 minutes was insufficient to evaluate and record the scores of each patient using the national institutes of health criteria and other cutaneous assessments. several specific areas of difficulties encountered by the evaluators were: 1) determining the percentage of erythema in movable and non-movable sclerosis, 2) whether to score all cutaneous findings in a particular area or just the dominant lesion; 3) clarification of the definition of poikiloderma in chronic graft-versus-host disease; 4) discrepant interpretation of the mouth score and 5) clarification on the methodology used for the evaluation of grip strength and the 2-minute walk tests. conclusions: results of this workshop support the need to train investigators participating in clinical trials on chronic graft-versus-host disease.
Manifesta??es tegumentares da doen?a enxerto contra hospedeiro em pacientes transplantados de medula óssea
Silva, Márcia de Matos;Bouzas, Luis Fernando S.;Filgueira, Absalom L.;
Anais Brasileiros de Dermatologia , 2005, DOI: 10.1590/S0365-05962005000100010
Abstract: graft-versus-host disease (gvhd) is a systemic disease that occurs in patients that receive immunocompetent lymphocytes. pathophysiology involves an immunologic reaction between transplanted lymphocytes and tissues of the host, through an immune attack of donor t cells against recipient cells that differ from the donor's by histocompatibility antigens. it is a major complication of allogeneic hematopoietic stem cell transplantation. gvhd skin involvement is frequent and contributes to morbidity and mortality of bone marrow transplantation. dermatologists have an important role on patient's evaluation, providing early diagnosis of gvhd disease and its complications, so as to follow-up these patients. in this review, we emphasize the skin manifestations of gvhd, taking into account our 14-year personal experience at centro nacional de transplante de medula óssea/inca/ms.
Impacto da DECH cr?nica na qualidade de vida pós-TCTH alogênico
Mastropietro, Ana Paula;Oliveira-Cardoso, érika Arantes de;Sim?es, Belinda Pinto;Voltarelli, Júlio César;Santos, Manoel Ant?nio dos;
Revista Brasileira de Hematologia e Hemoterapia , 2010, DOI: 10.1590/S1516-84842010000500007
Abstract: the aim of this work was to identify possible relationships between chronic graft versus host disease (gvhd), quality of life and psychosocial adjustment in patients submitted to hematopoietic stem cell transplantation (hsct). a cross-sectional correlation study was performed of a sample of 62 patients submitted to hsct. to collect data we used the following instruments: questionnaire for post-hsct data, sf-36, fact-bmt, had and lssi. the standardized instruments were applied individually and the results listed according to the recommendations made in the literature for each technique, with the exception of the post-hsct questionnaire; this was recorded and later the contents accurately transcribed in full and the replies were submitted to thematic content analysis. the results obtained in other instruments were statistically analyzed to assess associations between variables and their respective degrees of statistical significance. the variable gvhd is predictive of a poorer quality of life and greater susceptibility to anxiety (χ2 = 4.56; p = 0.03) as patients suffering from gvhd had lower rates in most domains of the quality of life. this finding of a drop in the quality of life after hsct is an indicator that should be taken into account by the healthcare team, as hsct is becoming more and more important as a therapeutic option for many serious disease.
The influence of dental care associated with laser therapy on oral mucositis during allogeneic hematopoietic cell transplant: retrospective study
Fernanda de Paula Eduardo,Letícia Mello Bezinelli,Mariane Couto Estácio Orsi,Morgani Rodrigues
Einstein (S?o Paulo) , 2011,
Abstract: Objective: To verify decrease in frequency and severity of oralmucositis in patients submitted to dental care and laser therapyduring allogeneic hematopoietic cell transplant. Methods: Medicalrecords of patients submitted or not to dental care associatedwith laser therapy during allogeneic transplant were reviewed.The following data were collected: sex, age, underlying disease,myeloablative conditioning regimens, prophylaxis for graftversus host disease, extension and severity of oral mucositis,pain in the oral cavity and when swallowing, diarrhea, need ofperipheral parenteral nutrition and presence of acute graft versushost disease. Results: Significant reduction in extension andseverity of oral mucositis, as well as in frequency of oral cavitypain, was observed in patients with dental care/laser therapy(p < 0.01). There were no statistically significant differencesregarding frequency of diarrhea, pain when swallowing, and needof parenteral nutrition among the groups. Significant associationwas found between acute graft versus host disease and painwhen swallowing (p < 0.01). Acute graft versus host diseasewas not associated with oral mucositis severity, oral cavity pain,and diarrhea. Conclusion: Dental care associated with lasertherapy reduces the extension and severity of oral mucositis inpatients with allogeneic hematopoietic transplant. Further studiesare necessary to clarify the isolate efficacy of laser therapy inthese conditions, mainly regarding the influence of reduced oralmucositis on the graft versus host disease.
Dry eye evaluation and immunohistochemical study of the conjunctiva and lacrimal gland of patients submitted to bone marrow transplantation
Cunha, Rosana Nogueira Pires da;Campos, Mauro;Dulley, Frederico Luis;Rojas, Bianca;Foster, Charles Stephen;
Arquivos Brasileiros de Oftalmologia , 2003, DOI: 10.1590/S0004-27492003000100004
Abstract: purpose: the primary ocular targets of chronic graft-versus-host disease (gvhd) are the lacrimal gland (lg) and the conjunctiva, and their involvement results in keratoconjunctivitis sicca (kcs). the purpose of the present study was to evaluate the frequency of signs and symptoms of kcs present in patients submitted to bmt, to identify the cellular phenotype of the conjunctival and lacrimal gland biopsies of these patients by immunohistochemistry and to correlate the findings with the presence of dry eye due to gvhd. methods: forty-seven patients were clinically classified into two groups: group i, with ocular gvhd, submitted to allogeneic bmt and group ii, without ocular gvhd, submitted to autologous and allogeneic bmt. thorough eye examination, including clinical lacrimal function tests and biopsies of the conjunctiva and of the lg were performed in the pre- and posttransplantation period. the biopsies were submitted to immunohistochemical analysis using a panel of monoclonal antibodies. results: of the 28 (82.4%) patients with chronic gvhd, 13 (46.4%) presented ocular gvhd. of the six patients without gvhd, one (16.7%) presented ocular gvhd. none of those submitted to autologous bmt presented ocular gvhd and 14 (41.2%) of 34 patients with allogeneic bmt presented ocular gvhd. all patients with ocular gvhd (group i) had symptoms and the most frequent were burning, foreign body sensation, blurred vision and dryness. the rose bengal test was one of the most sensitive in this study and slit lamp examination was very useful in the evaluation of corneal and conjunctival alterations, since these alterations were always present in patients with dry eye in our study. neither symptoms and signs of dry eye nor significant immunologic reaction was observed in the conjunctiva and in the lg of patients without ocular gvhd (group ii). there was an increase in the t lymphocyte population, of t helper lymphocyte (th/i) and t suppressor-cytotoxic lymphocyte (ts/c) subpopulation in
Doen?a enxerto versus hospedeiro aguda A- GVHD
Azevedo, Wellington;
Revista Brasileira de Hematologia e Hemoterapia , 2010, DOI: 10.1590/S1516-84842010005000060
Abstract: graft versus host disease (a-gvhd) is a systemic disease that affects bone marrow transplant patients receiving immunocompetent lymphocytes. the pathophysiology of this phenomenon is complex and involves a number of different effector immune responses to antigenic stimuli that are expressed due to tissue damage caused by disease or conditioning. this complication is frequent in bone marrow transplants and often determines the clinical outcome. in this chapter we discuss aspects of the biology of chronic graft versus host disease, its clinical evolution and the prophylactic and therapeutic management of this problem which can be devastating for patients undergoing allogeneic bone marrow transplantation.
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