Comparison between bovine carotid artery graft and polytetrafluoroethylene graft for haemodialysis vascular access: A systematic review and meta-analysis.
- 作者列表："Kostakis ID","Loukopoulos I
BACKGROUND:There is a renewed interest in using bovine carotid artery grafts for haemodialysis vascular access after recent advances in conduit manufacturing and endovascular management of access-related complications. Our aim was to summarize the results of the recent studies comparing bovine carotid artery grafts with polytetrafluoroethylene grafts as vascular access for haemodialysis. METHODS:A systematic review was conducted for original articles comparing bovine carotid artery with polytetrafluoroethylene grafts for haemodialysis vascular access published between January 2000 and December 2019 searching the databases of Medline, Scopus, Google Scholar, ClinicalTrials.gov and the Cochrane Central Register of Controlled Trials. RESULTS:Four studies were included (one prospective randomized controlled trial and three retrospective studies) with 676 patients in total (bovine carotid artery: 395, polytetrafluoroethylene: 281). There was lower graft infection rate per patient-year in bovine carotid artery grafts (mean difference: -0.03, p < 0.0001). Bovine carotid artery grafts required fewer interventions per patient-year to maintain or restore patency (mean difference: -0.81, p = 0.002). No significant difference was detected regarding pseudoaneurysm formation (p = 0.24), steal syndrome (p = 0.11) or patency rates (primary: 1 year: p = 0.15, 2 years: p = 0.69; primary assisted: 1 year: p = 0.18, 2 years: p = 0.54; secondary: 1 year: p = 0.22, 2 years: p = 0.17). CONCLUSION:Bovine carotid artery and polytetrafluoroethylene grafts have similar short-term and long-term outcomes, with a possible advantage of bovine carotid artery grafts concerning graft infections and number of required interventions. Thus, bovine carotid artery grafts can be a useful alternative modality for haemodialysis vascular access.
背景: 在导管制造和血管内治疗血管相关并发症方面的最新进展之后，使用牛颈动脉移植物进行血液透析血管通路的兴趣重新高涨。我们的目的是总结最近的研究结果，比较牛颈动脉移植物与聚四氟乙烯移植物作为血液透析的血管通路。 方法: 对2000年1月至2019年12月发表的比较牛颈动脉和聚四氟乙烯移植物用于血液透析血管通路的原始文章进行系统综述，检索Medline，Scopus，Google Scholar，clinicaltrials.Gov和Cochrane Central Register of Controlled Trials数据库。 结果: 共纳入4项研究 (1项前瞻性随机对照试验和3项回顾性研究)，共676例患者 (牛颈动脉: 395，聚四氟乙烯: 281)。牛颈动脉移植物每患者年的移植物感染率较低 (平均差异: -0.03，p <0.0001)。牛颈动脉移植物每患者年需要较少的干预措施来维持或恢复通畅 (平均差: -0.81，p = 0.002)。假性动脉瘤形成 (p = 0.24) 、盗血综合征 (p = 0.11) 或通畅率 (主要: 1年: p = 0.15，2年: p = 0.69; 主要辅助: 1年: p = 0.18，2年: p = 0.54; 次要:1年: p = 0.22，2年: p = 0.17)。 结论: 牛颈动脉和聚四氟乙烯移植物具有相似的短期和长期结果，牛颈动脉移植物的优势可能在于移植物感染和所需干预的数量。因此，牛颈动脉移植物可以是用于血液透析血管通路的有用的替代方式。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.