Immunosuppression

2018 ◽  
Author(s):  
Steven Gabardi ◽  
Miae Kim
Keyword(s):  
Renal Transplantation ◽  
Allograft Rejection ◽  
Immunosuppressive Agents ◽  
Graft Loss ◽  
Primary Objective ◽  
Short Term ◽  
Key Words Immunosuppression ◽  
Advantages And Disadvantages ◽  
Donor Characteristics

The primary objective of clinical immunosuppression following renal transplantation is to prevent rejection while limiting the toxicities of the immunosuppressive agents. A balance between over- and underimmunosuppression can be difficult to accomplish and has significant ramifications if not achieved. The major sequelae of underimmunosuppression are cellular and antibody-mediated allograft rejection, whereas overimmunosuppression can give rise to complications such as infection and malignancy. Local protocols and national/international guidelines have been established to aid in the streamlining of immunosuppressive regimens; however, the development of the most appropriate immunosuppressive therapy in an individual transplant recipient is highly dependent on a practitioner’s experience, preexisting medical conditions/medications, and donor characteristics. Despite the success seen by our individualized immunosuppressive regimens in improving short-term outcomes, late graft loss and the morbidity associated with long-term immunosuppression remain major concerns. To improve outcomes in renal transplantation, it is imperative that clinicians be aware of the specific advantages and disadvantages of the available immunosuppressants, as well as the potential for adverse drug reactions and drug-drug interactions commonly seen with these agents.  This review contains 5 figures, 5 tables and 92 references Key Words: immunosuppression, pharmacodynamics, pharmacokinetics, renal transplantation

Renal transplantation

2020 ◽  
pp. 4879-4908
Author(s):  
Nicholas Torpey ◽  
John D. Firth
Keyword(s):  
Renal Transplantation ◽  
Supply And Demand ◽  
Transplant Rejection ◽  
Immunosuppressive Agents ◽  
Graft Loss ◽  
Parasitic Infections ◽  
First Year ◽  
Antibody Mediated Rejection ◽  
Standard Triple Therapy

Renal transplantation is the preferred option for the treatment of endstage chronic renal failure in patients for whom there are no major medical contraindications. In well-selected recipients, both life expectancy and quality of life are superior to treatment with long-term dialysis. However, as the dialysis population continues to grow, the gap between supply and demand for renal transplantation is widening. Immunosuppression—excepting for transplants between HLA-identical twins, immunosuppression is required to prevent rejection, but there is no clear consensus on the best immunosuppressive regimen. Most centres use an induction antibody directed against CD25 or a T-lymphocyte-depleting antibody (thymoglobulin or alemtuzumab), followed by what is now called standard triple therapy—comprising a calcineurin inhibitor (almost always tacrolimus), combined with either mycophenolate mofetil or azathioprine, and steroids. Steroids are not infrequently tailed off rapidly in the early post-transplant period. Transplant rejection can be classified into four main categories: (1) hyperacute, (2) accelerated, (3) acute cellular, and (4) humoral. Complications of renal transplantation—this chapter discusses specific and nonspecific side effects of immunosuppressive agents, infective complications (including viral, bacterial, fungal, and parasitic infections), malignant complications, and other complications (including hypertension, accelerated atherosclerosis, and electrolyte, musculoskeletal, haematological, gastrointestinal, and cosmetic disorders) in detail. Prognosis—first-year transplant losses from rejection have been dramatically reduced from about 40% in the 1970s to 5%. However, the rate of chronic graft loss remains at about 4% per year. The commonest cause of insidious late graft failure is probably chronic antibody-mediated rejection, frequently associated with poor adherence to immunosuppression. Calcineurin toxicity may also contribute. A major focus of research is to identify non-nephrotoxic immunosuppressive agents able to suppress antibody-mediated rejection.

Economic conditions and perceptions of immigrants as an economic threat in Europe: Temporal dynamics and mediating processes

2021 ◽  
pp. 002071522199352
Author(s):  
Boris Heizmann ◽  
Nora Huth
Keyword(s):  
Temporal Dynamics ◽  
European Social Survey ◽  
Primary Objective ◽  
Conflict Theory ◽  
Economic Conditions ◽  
Political Climate ◽  
Short Term ◽  
Economic Threat ◽  
Party Positions

This article addresses the extent to which economic downturns influence the perception of immigrants as an economic threat and through which channels this occurs. Our primary objective is an investigation of the specific mechanisms that connect economic conditions to the perception of immigrants as a threat. We therefore also contribute to theoretical discussions based on group threat and realistic group conflict theory by exposing the dominant source of competition relevant to these relationships. Furthermore, we investigate whether people react more sensitive to short-term economic dynamics within countries than to the long-term economic circumstances. Our database comprises all waves of the European Social Survey from 2002 to 2017. The macro-economic indicators we use include GDP per capita, unemployment, and national debt levels, covering the most salient economic dimensions. We furthermore control for the country’s migration situation and aggregate party positions toward cultural diversity. Our results show that the dynamic short-term developments of the economy and migration within countries are of greater relevance for perceived immigrant threat than the long-term situation. In contrast, the long-term political climate appears to be more important than short-term changes in the aggregate party positions. Further mediation analyses show that objective economic conditions influence anti-immigrant attitudes primarily through individual perceptions of the country’s economic performance and that unemployment rates are of primary importance.

The differences between late graft loss group and long-term graft survival group in renal transplantation

2001 ◽  
Vol 15 ◽  
pp. 16-21 ◽  
Author(s):  
Toshiyuki Tanaka ◽  
Shiro Takahara ◽  
Motoaki Hatori ◽  
Kiyohide Toki ◽  
Jing-Ding Wang ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Graft Survival ◽  
Graft Loss ◽  
Survival Group

Undergraduate Rehabilitation Accreditation as a Tool in the Social Justice Movement

2020 ◽  
Vol 51 (4) ◽  
pp. 323-333
Author(s):  
Penny Pears Willmering
Keyword(s):  
Social Justice ◽  
Professional Identity ◽  
Curriculum Standards ◽  
Short Term ◽  
Advantages And Disadvantages ◽  
The Social ◽  
New Curriculum ◽  
Financial Challenges ◽  
The Relationship

Accreditation of undergraduate rehabilitation education (URE) programs is a tool to further the cause of social justice. In addition to supporting this statement, this article explores the relationship between URE, accreditation curriculum, and the training of graduates to facilitate justice for all members of society. The social justice struggle for accreditation equity for URE is reviewed, as well as continued threats to accreditation, and the need for consistent professional identity and nomenclature. The new accreditation curriculum standards and their attention to social justice concepts is discussed. Accreditation advantages and disadvantages as they relate to justice are offered. Advantages include the strength of consistency of curriculum, while disadvantages involve leaning toward homogenization of the course of study, and a threat of return to a paternalistic view of consumers. In addition, financial challenges presented by the pandemic to URE programs is discussed, along with a strategy to address those issues. An analysis of advantages and disadvantages to accreditation as it relates to social justice and consumers reveals that benefits far outweigh potential issues. Further, short-term and long-term strategies to address threats to accreditation, challenges to consistent names for the profession, its graduates and professional scope, and a stratagem to address nomenclature is offered. Finally, strategies to strengthen the new curriculum to reflect current day understanding of social justice are presented. The country has awakened to social justice issues, and is time that intentional curriculum, driven by accreditation, trains graduates to become social justice advocates and allies.

Stability and Construction of Caverns for The Disposal Of Cemented Low-And Medium-Level Wastes

1981 ◽  
Vol 11 ◽  
Author(s):  
W. Raab ◽  
C. Frohn ◽  
M.W. Schmidt
Keyword(s):  
Stability Analysis ◽  
Vertical Axis ◽  
Short Term ◽  
Advantages And Disadvantages ◽  
Medium Level ◽  
Practical Engineering ◽  
The Stability ◽  
The One ◽  
Salt Caverns

ABSTRACTThe geomechanical and mining-technological aspects of the construction of salt caverns as disposal chambers have been investigated during project phase 2, completed by mid 1981. With a view towards the stability analysis of such a cavern, FEM-estimates have been carried out and evaluated. From these it can be derived that- a rotational ellipsoid would be the most suitable shape- its dimensions should be 82 m (vertical axis) and 42 m (horizontal axis)- the distance (safety pillar) between the neighbouring caverns should be 170 m (vertical) and 180 m (horizontal).For practical engineering purposes the rotational ellipsoid can be modified into a cylinder with conic bottom and top. The numerical model simulated the short term as well as the long term characteristics of the surrounding salt rocks. The short term characteristics were assessed by an elastic approach, the long term characteristics by a rheological model. The input parameters have been determined by means of laboratory tests on ASSE rock salt.In a second step the characteristics of partially and completely filled caverns were simulated. It was shown clearly that deformation of the salt rock comes to a halt when counteracted by the filling.Based upon the results of the stability analysis, investigations were made to find out a suitable mining technique for the construction of the cavern. Solution mining and conventional development by means of drilling and blasting have been studied alternatively. Since both methods have their advantages and disadvantages a decision in favour of the one or the other cannot be made until the actual site has been defined.

A computer program for use in sheep enterprise decision making.

1981 ◽  
Vol 3 (1) ◽  
pp. 110
Author(s):  
HG Gardiner ◽  
KR Shackleton
Keyword(s):  
Computer Program ◽  
Low Cost ◽  
Management Strategies ◽  
Long Term Effects ◽  
Short Term ◽  
Management Decisions ◽  
Department Of Agriculture ◽  
Advantages And Disadvantages ◽  
Kitchen Table

The profitability and long term viability of any business enterprise depends on careful, well thought out, long term planning. The pastoral industry is no exception and management decisions need to be based on the long term as well as short term advantages and disadvantages of any parficular strategy. Examination of the long term effects of management decisions has always been difficult. Not only is the future uncertain but the necessary financial and stock calculations are tedious, particularly if several strategies are considered. A computer program, suitable for use on programmable calculators, has been designed with the specific aim of reducing the tedium of calculation. Emphasis in the design has been placed on flexibility and applicability to actual decsion making situations. The program, devised for use on the Hewlett Packard 41C calculator, is very similar in aim to the model reported by Barber (I 9801, which aimed 'to provide a tool for producers, extension workers and researchers that could be used anywhere from the office desk to the kitchen table'. A recent summary of enterprise modelling work in 'Computers in Farming' (Department of Agriculture, Victoria 1980) indicates that most of the modelling work has been centred around larger, less portable micro-computers. The ease of operation, transportability and low cost of programmable calculators should make them a valuable tool for use on properties by managers. owners, extension workers, bankers and stock agents. They will enable the manager quickly and accurately to assess the likely outcome of various management strategies.

scholarly journals Cryopreservation of Dental Stem Cells

2018 ◽  
Vol 61 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Nela Pilbauerová ◽  
Jakub Suchánek
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Tooth Extraction ◽  
Adult Stem Cells ◽  
Dental Stem Cells ◽  
Short Term ◽  
Advantages And Disadvantages ◽  
Long Term Storage ◽  
Term Storage

Nowadays, regenerative and reparative medicine has grown in popularity. Dental stem cells are easily accessible source of adult stem cells. They can be harvested by a tooth extraction or spontaneous deciduous tooth exfoliation. They have to be isolated, expanded and stored until time they would be needed for individual stem cell therapy. Cryopreservation is both a short-term and long-term storage of tissues or cells at sub-zero temperatures. There are several methods of cryopreservation requiring different technologies. The objective of this review is to compare them and highlight their advantages and disadvantages.

scholarly journals Renal transplantation in patients treated with haemodialysis and short term and long term continuous ambulatory peritoneal dialysis.

BMJ ◽  
1985 ◽  
Vol 291 (6501) ◽  
pp. 1004-1007 ◽  
Author(s):  
J B Evangelista ◽  
D Bennett-Jones ◽  
J S Cameron ◽  
C Ogg ◽  
D G Williams ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Short Term

scholarly journals Long-Term and Short-Term Export Contracts for Natural Gas Supply

2020 ◽  
Vol 3 ◽  
pp. 103-107
Author(s):  
Sergey S. Koshman ◽  
Keyword(s):  
Natural Gas ◽  
Foreign Trade ◽  
Gas Extraction ◽  
Electronic Trading ◽  
Short Term ◽  
Advantages And Disadvantages ◽  
The Impact ◽  
Gas Supply ◽  
Storage Processes

Natural gas is exported in accordance with the terms and conditions of foreign trade contracts between the seller and the buyer. Research into the execution procedure, terms and conditions of such contracts has both theoretical and practical value. The importance of a foreign trade contract for relations between the parties cannot be overemphasized as its scope determines and legally binds the parties for the achievement of their respective goals. When entering into foreign trade contracts, the parties should consider the impact of natural gas extraction, processing, transportation, storage processes on terms of foreign trade transactions with natural gas. These terms are especially important for long-term natural gas export contracts which are considered to be the traditional form of natural gas trading. However, more recently, forms of foreign trade contracts for natural gas export used to interact with foreign buyers have become more diversified. Natural gas trading under short-term contracts using electronic trading platforms is becoming increasingly important. In this article, the author examines the key peculiarities of such contracts, defines basic advantages and disadvantages of using various contract forms for natural gas export.

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