Markssomerville3946
BACKGROUND We evaluated the association of antiretroviral therapy (ART), CD4+ count and HIV plasma viral load (PVL) on high-grade cervical intraepithelial neoplasia (CIN2+) detection at follow-up after CIN management among women living with HIV (WLHIV). METHODS Medline, Embase, Global Health and PubMed were searched from January 1, 1996 to January 15, 2020. Eligible studies investigated the association of ART, CD4+ count or HIV PVL on histology-confirmed CIN2+ detection at follow-up. Summary estimates were obtained using random-effects meta-analyses; heterogeneity was examined using I2 statistic. PROSPERO registrationCRD42018115631. RESULTS Eight studies representing 9 populations were identified, including 1,452 WLHIV followed between 6 to 33 months post-CIN management. Pooled data from 8 populations (n=1,408) suggested weak evidence of a decreased risk of CIN2+ detection at follow-up among ART users compared to ART-naïve women (crude odds ratio [cOR]=0.70, 95% CI 0.36-1.36; I2=64.5%, p=0.006; adjusted risk findings support recommendations of early ART and the integration of CIN2+ screening and management into HIV care. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. selleck products For permissions, e-mail journals.permissions@oup.com.BACKGROUND Although kidney transplantation prolongs survival relative to dialysis, it is associated with a higher death rate than in the general population. The objective of the present study was to assess and compare the risk of mortality and frequency of non-lethal cardiovascular (CV) events in kidney transplant recipients (KTRs) beyond 1 year after successful transplantation versus patients with chronic kidney disease (CKD) using propensity score-matched analysis of estimated glomerular filtration rate (eGFR) and other parameters. METHODS After propensity score matching, we studied 340 KTRs from the French Données Informatisées et Validées en Transplantation cohort and 605 non-transplant patients with CKD (CKDps) from the French Chronic Kidney Disease-Renal Epidemiology and Information Network cohort. The mean ± standard deviation eGFR was 42 ± 13 and 41 ± 12 mL/min/ 1.73 m2, respectively (P = 0.649). Descriptive data were completed by a survival analysis with Cox regression models. RESULTS After a median follow-up period of 2.8 years (KTRs 2.0 years, CKDp 2.9 years), 71 deaths were recorded (31 and 40 in the KTR and CKD groups, respectively). Univariate analysis showed that KTRs had a significantly greater risk of mortality than CKDps. In multivariable analysis, KTRs were found to have a 2.7-fold greater risk of mortality [hazard ratio 2.7 (95% confidence interval 1.6-4.7); P = 0.005]. There was no between-group difference concerning the risk of CV events (P = 0.448). CV death rates in KTRs (29.0%) approximated those of CKDps (22.5%), whereas death rates due to infections were higher in KTRs (19.4% versus 10.0%). CONCLUSION Beyond 1 year after transplantation, KTRs, who possibly had a longer CKD history, had a significantly greater mortality risk than eGFR-matched CKDps. The excess risk was not associated with CV events. © The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.BACKGROUND Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. OBJECTIVES The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. METHODS A retrospective study of patients undergoing abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. RESULTS 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these were wound healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. BMI ≥ 30 kg/m2 was associated with an increased risk for wound healing problems (p=0.001). The frequency of total complications was significantly related to age (p=0.007), BMI (p=0.004) and resection weight (p=0.001). Abdominoplasty technique tended to influence total complications. CONCLUSIONS This study demonstrates in a fairly large sample of post-bariatric patients (N=406), that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. © 2020 The Aesthetic Society. Reprints and permission journals.permissions@oup.com.Restoration of kidney tubular epithelium following sub-lethal injury sequentially involves partial-epithelial-mesenchymal transition (pEMT), proliferation and further re-differentiation into specialized tubule epithelial cells (TECs). Since the immunosuppressant cyclosporine-A produces pEMT in TECs and inhibits the peptidyl-prolyl isomerase (PPIase) activity of cyclophilin (Cyp) proteins, we hypothesized that cyclophilins could regulate TEC phenotype. Here we demonstrate that in cultured TECs, CypA silencing triggers loss of epithelial features and enhances TGFβ-induced EMT in association with up-regulation of epithelial repressors Slug and Snail. This pro-epithelial action of CypA relies on its PPIase activity. By contrast, CypB emerges as an epithelial repressor, since CypB silencing promotes epithelial differentiation, prevents TGFβ-induced EMT, and induces tubular structures in 3D cultures. In addition, in the kidneys of CypB knockout mice subjected to unilateral ureteral obstruction (UUO), inflammatory and pro-fibrotic events were attenuated.