首页 > 最新文献

Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy最新文献

英文 中文
Improving cellular therapy operations through pre-harvest measurement of peripheral CD34-positive cell counts in allogeneic stem cell harvest. 通过在异体干细胞收获前测量外周 CD34 阳性细胞计数,改进细胞治疗操作。
Shuhei Kurosawa, Kyoko Haraguchi, Yunoka Honma, Fuyuko Kawai, Moemi Ishiwada, Ryoko Iimura, Rei Watanabe, Sayuri Ishibashi, Kae Sakuma, Kiyomi Narishima, Misako Nishimura, Takashi Toya, Hiroaki Shimizu, Yuho Najima, Takeshi Kobayashi, Noriko Doki, Yoshiki Okuyama

Introduction: Previously, our institution measured peripheral blood CD34 cell counts both pre- and post-peripheral blood stem cell harvest (PBSCH), with both samples analyzed simultaneously post-PBSCH. Since 2021, we have measured pre-CD34 cell counts during PBSCH, adjusting the processed blood volume based on these results. We retrospectively evaluated how this change impacted cellular therapy.

Methods: Related healthy donors were included and divided into 1-day and 2-day harvest cohorts. Donors with CD34 cell counts measured post- and during PBSCH were categorized into the previous and current sub-cohorts, respectively.

Results: Regarding the 1-day cohort (n = 212), the current sub-cohort had a significantly shorter average harvest duration (151 [standard deviation, SD = 45.1] vs. 180 [SD = 27.8] minutes, respectively) and higher average infusion rates (87.6% [SD = 21.1] vs. 78.1% [SD = 25.7], respectively) than the previous sub-cohort.

Conclusion: Adjusting the processed blood volume based on pre-PBSCH CD34 cell counts measured during the harvest may reduce donor burden and enhance workflow efficiency.

简介以前,我们机构在外周血干细胞采集(PBSCH)前和采集后测量外周血 CD34 细胞计数,并在 PBSCH 后同时分析两个样本。自2021年起,我们在PBSCH期间测量前CD34细胞计数,并根据这些结果调整处理血量。我们对这一变化对细胞疗法的影响进行了回顾性评估:方法:纳入相关的健康捐献者,并将其分为 1 天和 2 天采血队列。结果:1 天组别中,CD34 细胞计数在 PBSCH 后和 PBSCH 期间测量的捐献者分别归入以前和现在的子组别:结果:就 1 天队列(n = 212)而言,当前子队列的平均采血时间(分别为 151 [标准差,SD = 45.1] 分钟 vs. 180 [SD = 27.8] 分钟)和平均输注率(分别为 87.6% [SD = 21.1] vs. 78.1% [SD = 25.7])明显短于之前的子队列:结论:根据采血过程中测得的预PBSCH CD34细胞计数调整处理血量可减轻献血者负担并提高工作流程效率。
{"title":"Improving cellular therapy operations through pre-harvest measurement of peripheral CD34-positive cell counts in allogeneic stem cell harvest.","authors":"Shuhei Kurosawa, Kyoko Haraguchi, Yunoka Honma, Fuyuko Kawai, Moemi Ishiwada, Ryoko Iimura, Rei Watanabe, Sayuri Ishibashi, Kae Sakuma, Kiyomi Narishima, Misako Nishimura, Takashi Toya, Hiroaki Shimizu, Yuho Najima, Takeshi Kobayashi, Noriko Doki, Yoshiki Okuyama","doi":"10.1111/1744-9987.14202","DOIUrl":"10.1111/1744-9987.14202","url":null,"abstract":"<p><strong>Introduction: </strong>Previously, our institution measured peripheral blood CD34 cell counts both pre- and post-peripheral blood stem cell harvest (PBSCH), with both samples analyzed simultaneously post-PBSCH. Since 2021, we have measured pre-CD34 cell counts during PBSCH, adjusting the processed blood volume based on these results. We retrospectively evaluated how this change impacted cellular therapy.</p><p><strong>Methods: </strong>Related healthy donors were included and divided into 1-day and 2-day harvest cohorts. Donors with CD34 cell counts measured post- and during PBSCH were categorized into the previous and current sub-cohorts, respectively.</p><p><strong>Results: </strong>Regarding the 1-day cohort (n = 212), the current sub-cohort had a significantly shorter average harvest duration (151 [standard deviation, SD = 45.1] vs. 180 [SD = 27.8] minutes, respectively) and higher average infusion rates (87.6% [SD = 21.1] vs. 78.1% [SD = 25.7], respectively) than the previous sub-cohort.</p><p><strong>Conclusion: </strong>Adjusting the processed blood volume based on pre-PBSCH CD34 cell counts measured during the harvest may reduce donor burden and enhance workflow efficiency.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"131-140"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reliability and benefit of estimated continuous cardiac output measurement using shunt-side SpO2 monitor in hemodialysis. 在血液透析中使用分流侧 SpO2 监测仪测量连续心输出量估计值的可靠性和益处。
Koji Nakai, Yuichi Hirate, Takashi Nakajima, Atsushi Doi, Takeyuki Hiramatsu, Toshie Higaki, Aiko Nakai

Introduction: Estimated continuous cardiac output (esCCO) is a novel technology that enables non-invasive and continuous monitoring of cardiac output. We compared the concordance in accuracies among esCCO measurements in the shunt limb and non-shunt limb.

Methods: In this single-center prospective observational study, we include Japanese patients who underwent dialysis at our center between April 27, 2021, and February 28, 2023. Clinical accuracy of esCCO was evaluated in the shunted and non-shunted bilateral digits. Agreement between the measurements was analyzed using Lin's congruent correlation and Bland-Altman analysis.

Results: For 43 individuals, Lin's concordance correlation coefficient was 0.9887 (95% confidence interval of 0.9886-0.9887) indicating good agreement. The values of esCCO measured in the shunt and non-shunt limbs were compatible. The percentage errors for the 43 patients with arterio-venous fistula (AVF) or arterio-venous graft (AVG), 32 with AVF, and 11 with AVG were 9.3%, 9.3%, and 8.9%, respectively.

Conclusion: esCCO could be used in shunt as well as non-shunt limbs during dialysis, allowing continuous and non-invasive hemodynamic monitoring.

简介估计连续心输出量(esCCO)是一种新型技术,可对心输出量进行无创和连续监测。我们比较了分流肢体和非分流肢体的 esCCO 测量精度的一致性:在这项单中心前瞻性观察研究中,我们纳入了 2021 年 4 月 27 日至 2023 年 2 月 28 日期间在本中心接受透析治疗的日本患者。对分流和非分流双侧肢体的 esCCO 临床准确性进行了评估。使用林氏同调相关性和布兰德-阿尔特曼分析法分析测量结果之间的一致性:43人的林氏一致性相关系数为0.9887(95%置信区间为0.9886-0.9887),表明测量结果具有良好的一致性。分流肢体和非分流肢体测得的 esCCO 值是一致的。43例动静脉瘘(AVF)或动静脉移植(AVG)患者、32例动静脉瘘患者和11例动静脉移植患者的误差百分比分别为9.3%、9.3%和8.9%。
{"title":"Reliability and benefit of estimated continuous cardiac output measurement using shunt-side SpO<sub>2</sub> monitor in hemodialysis.","authors":"Koji Nakai, Yuichi Hirate, Takashi Nakajima, Atsushi Doi, Takeyuki Hiramatsu, Toshie Higaki, Aiko Nakai","doi":"10.1111/1744-9987.14193","DOIUrl":"10.1111/1744-9987.14193","url":null,"abstract":"<p><strong>Introduction: </strong>Estimated continuous cardiac output (esCCO) is a novel technology that enables non-invasive and continuous monitoring of cardiac output. We compared the concordance in accuracies among esCCO measurements in the shunt limb and non-shunt limb.</p><p><strong>Methods: </strong>In this single-center prospective observational study, we include Japanese patients who underwent dialysis at our center between April 27, 2021, and February 28, 2023. Clinical accuracy of esCCO was evaluated in the shunted and non-shunted bilateral digits. Agreement between the measurements was analyzed using Lin's congruent correlation and Bland-Altman analysis.</p><p><strong>Results: </strong>For 43 individuals, Lin's concordance correlation coefficient was 0.9887 (95% confidence interval of 0.9886-0.9887) indicating good agreement. The values of esCCO measured in the shunt and non-shunt limbs were compatible. The percentage errors for the 43 patients with arterio-venous fistula (AVF) or arterio-venous graft (AVG), 32 with AVF, and 11 with AVG were 9.3%, 9.3%, and 8.9%, respectively.</p><p><strong>Conclusion: </strong>esCCO could be used in shunt as well as non-shunt limbs during dialysis, allowing continuous and non-invasive hemodynamic monitoring.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"61-69"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Research progress on measurement methods and evaluation of the hemodialysis adequacy index Kt/V. 血液透析充分性指数 Kt/V 的测量方法和评估研究进展。
Le-le Li, Rui-Feng Xu, Ning He, Ta-la Hu, Wu-Niri Gao, Xi-Feng Wang, Dong-Ying Shi, Jian-Rong Zhao, Yan Meng

The most common form of replacement therapy for end-stage renal disease (ESRD) is hemodialysis, and the adequacy of hemodialysis is strongly associated with the quality of life and long-term survival of patients. Kt/V is currently one of the most important indicators for evaluating the adequacy of hemodialysis. There are many methods for measuring Kt/V, such as blood collection and measurement, dialysate measurement, bioresistive resistance, WinNonlin software analysis, and artificial intelligence. There are different views on the importance of Kt/V as an indicator of the adequacy of hemodialysis. This article provides a literature review of the various methods of measuring Kt/V and on different perspectives on Kt/V as an evaluation of hemodialysis adequacy.

终末期肾病(ESRD)最常见的替代疗法是血液透析,血液透析的充分性与患者的生活质量和长期生存密切相关。目前,Kt/V 是评估血液透析充分性的最重要指标之一。测量 Kt/V 的方法有很多,如采血和测量、透析液测量、生物电阻、WinNonlin 软件分析和人工智能等。对于 Kt/V 作为血液透析充分性指标的重要性,存在不同的观点。本文对测量 Kt/V 的各种方法以及将 Kt/V 作为血液透析充分性评价指标的不同观点进行了文献综述。
{"title":"Research progress on measurement methods and evaluation of the hemodialysis adequacy index Kt/V.","authors":"Le-le Li, Rui-Feng Xu, Ning He, Ta-la Hu, Wu-Niri Gao, Xi-Feng Wang, Dong-Ying Shi, Jian-Rong Zhao, Yan Meng","doi":"10.1111/1744-9987.14217","DOIUrl":"10.1111/1744-9987.14217","url":null,"abstract":"<p><p>The most common form of replacement therapy for end-stage renal disease (ESRD) is hemodialysis, and the adequacy of hemodialysis is strongly associated with the quality of life and long-term survival of patients. Kt/V is currently one of the most important indicators for evaluating the adequacy of hemodialysis. There are many methods for measuring Kt/V, such as blood collection and measurement, dialysate measurement, bioresistive resistance, WinNonlin software analysis, and artificial intelligence. There are different views on the importance of Kt/V as an indicator of the adequacy of hemodialysis. This article provides a literature review of the various methods of measuring Kt/V and on different perspectives on Kt/V as an evaluation of hemodialysis adequacy.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"3-11"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continuous renal replacement therapy with vitamin E-coated polysulfone hemofilter reduces inflammatory responses in a porcine lipopolysaccharide-treated model. 使用维生素 E 涂层聚砜血液滤过器进行连续肾脏替代治疗可减少猪脂多糖处理模型的炎症反应。
Takumi Horikawa, Kana Yagi, Chika Ishikawa, Machi Atarashi, Atsushi Watanabe, Yoshihisa Kato

Introduction: Biological invasions may promote the onset of systemic inflammatory response syndrome in patients eligible for continuous renal replacement therapy (CRRT), leading to poor prognosis. Hence, we aimed to examine the inflammatory reactions in circulation using vitamin E-coated polysulfone hollow fiber membrane (ViLIFE).

Methods: Lipopolysaccharides were intravenously administered to pigs (2 μg/kg/30 min) to establish an acute inflammation model. Extracorporeal circulation was performed for 6 h in continuous venovenous hemodiafiltration mode using a hemofilter for CRRT filled with a polysulfone hollow fiber membrane or ViLIFE, and the differences in inflammatory reactions were evaluated.

Results: The ViLIFE group exhibited low platelet and cytokine levels (p < 0.05 vs. sham-CRRT group). Additionally, the ViLIFE group had lower lactate and high mobility group box 1 levels than the other groups.

Conclusion: ViLIFE represents a promising CRRT modality that can inhibit the inflammatory response in circulation and inhibit further biological invasions.

导言:生物入侵可能会促使符合持续肾脏替代治疗(CRRT)条件的患者出现全身炎症反应综合征,从而导致不良预后。因此,我们旨在使用维生素 E 涂层聚砜中空纤维膜(ViLIFE)检测循环中的炎症反应:方法:给猪静脉注射脂多糖(2 μg/kg/30分钟),建立急性炎症模型。使用装有聚砜中空纤维膜或 ViLIFE 的 CRRT 用血液滤过器,在连续静脉血液滤过模式下进行体外循环 6 小时,并评估炎症反应的差异:结果:ViLIFE 组的血小板和细胞因子水平较低(PViLIFE 是一种很有前景的 CRRT 模式,它可以抑制循环中的炎症反应,并抑制进一步的生物入侵。
{"title":"Continuous renal replacement therapy with vitamin E-coated polysulfone hemofilter reduces inflammatory responses in a porcine lipopolysaccharide-treated model.","authors":"Takumi Horikawa, Kana Yagi, Chika Ishikawa, Machi Atarashi, Atsushi Watanabe, Yoshihisa Kato","doi":"10.1111/1744-9987.14183","DOIUrl":"10.1111/1744-9987.14183","url":null,"abstract":"<p><strong>Introduction: </strong>Biological invasions may promote the onset of systemic inflammatory response syndrome in patients eligible for continuous renal replacement therapy (CRRT), leading to poor prognosis. Hence, we aimed to examine the inflammatory reactions in circulation using vitamin E-coated polysulfone hollow fiber membrane (ViLIFE).</p><p><strong>Methods: </strong>Lipopolysaccharides were intravenously administered to pigs (2 μg/kg/30 min) to establish an acute inflammation model. Extracorporeal circulation was performed for 6 h in continuous venovenous hemodiafiltration mode using a hemofilter for CRRT filled with a polysulfone hollow fiber membrane or ViLIFE, and the differences in inflammatory reactions were evaluated.</p><p><strong>Results: </strong>The ViLIFE group exhibited low platelet and cytokine levels (p < 0.05 vs. sham-CRRT group). Additionally, the ViLIFE group had lower lactate and high mobility group box 1 levels than the other groups.</p><p><strong>Conclusion: </strong>ViLIFE represents a promising CRRT modality that can inhibit the inflammatory response in circulation and inhibit further biological invasions.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"96-105"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of COVID-19 pandemic on personal hygiene behavior and the frequency of peritonitis in peritoneal dialysis patients.
Ezgi Simsek, Dilek Barutcu Atas, Murat Tugcu, Arzu Velioglu, Izzet Hakki Arikan, Ebru Asicioglu

Introduction and aim: Peritonitis is a critical complication in peritoneal dialysis (PD) patients, making compliance with personal hygiene essential. This study examines the impact of the COVID-19 (Coronavirus Disease 2019) pandemic on hygiene behaviors and peritonitis incidence in PD patients.

Materials and methods: Fifty-two PD patients were assessed for hygiene behaviors, demographic, and medical data. Laboratory parameters and peritonitis culture results were compared before and after COVID-19.

Results: Post-COVID-19, significant improvements were observed in 11 hygiene behaviors, including hand washing (p < 0.001). The peritonitis rate decreased from 28.8.% to 13.5%, though this was not statistically significant (p = 0.093). Among those without post-COVID peritonitis, hand washing before connecting the transfer set and regular exit site dressing were more frequent.

Conclusion: Following COVID-19, PD patients demonstrated improved hygiene behaviors and reduced peritonitis rates. Emphasis on hand washing and exit site care is recommended in all PD programs.

{"title":"The effect of COVID-19 pandemic on personal hygiene behavior and the frequency of peritonitis in peritoneal dialysis patients.","authors":"Ezgi Simsek, Dilek Barutcu Atas, Murat Tugcu, Arzu Velioglu, Izzet Hakki Arikan, Ebru Asicioglu","doi":"10.1111/1744-9987.14251","DOIUrl":"https://doi.org/10.1111/1744-9987.14251","url":null,"abstract":"<p><strong>Introduction and aim: </strong>Peritonitis is a critical complication in peritoneal dialysis (PD) patients, making compliance with personal hygiene essential. This study examines the impact of the COVID-19 (Coronavirus Disease 2019) pandemic on hygiene behaviors and peritonitis incidence in PD patients.</p><p><strong>Materials and methods: </strong>Fifty-two PD patients were assessed for hygiene behaviors, demographic, and medical data. Laboratory parameters and peritonitis culture results were compared before and after COVID-19.</p><p><strong>Results: </strong>Post-COVID-19, significant improvements were observed in 11 hygiene behaviors, including hand washing (p < 0.001). The peritonitis rate decreased from 28.8.% to 13.5%, though this was not statistically significant (p = 0.093). Among those without post-COVID peritonitis, hand washing before connecting the transfer set and regular exit site dressing were more frequent.</p><p><strong>Conclusion: </strong>Following COVID-19, PD patients demonstrated improved hygiene behaviors and reduced peritonitis rates. Emphasis on hand washing and exit site care is recommended in all PD programs.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Not everything shining is gold: Strawberry can mimic hemoperitoneum. 并非所有发光的东西都是金子:草莓可以模拟腹膜出血。
Abdullah Al-Hwiesh, Abdelgalil Moaz Mohammed, Amani Al-Hwiesh, Ibrahiem Saeed Abdul-Rahman, Khadija M Alshehabi, Reema Al-Hwiesh, Nadia Al-Audah
{"title":"Not everything shining is gold: Strawberry can mimic hemoperitoneum.","authors":"Abdullah Al-Hwiesh, Abdelgalil Moaz Mohammed, Amani Al-Hwiesh, Ibrahiem Saeed Abdul-Rahman, Khadija M Alshehabi, Reema Al-Hwiesh, Nadia Al-Audah","doi":"10.1111/1744-9987.14254","DOIUrl":"https://doi.org/10.1111/1744-9987.14254","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of apheresis in antibody-negative progressive encephalomyelitis with rigidity and myoclonus. 单采治疗抗体阴性进行性脑脊髓炎伴强直及肌阵挛的疗效。
Yohei Aoki, Mayumi Sakata, Hidekazu Suzuki, Kohei Hori, Junko Taruya, Katsuichi Miyamoto

Introduction: Progressive encephalomyelitis with rigidity and myoclonus (PERM) is characterized by brainstem symptoms, muscle rigidity, and myoclonus. While autoantibodies to inhibitory neurons have been associated with the pathology, about 30% of cases are negative for autoantibodies. There are few reported cases of antibody-negative PERM and its clinical course and prognosis are unknown.

Methods: We report three cases of antibody-negative PERM in which plasma exchange was effective.

Results: Case 1 was a 68-year-old man, case 2 was a 27-year-old woman, and case 3 was a 47-year-old woman. In all three cases, steroid pulse therapy and intravenous immunoglobulin had limited effect and plasma exchange was markedly effective. All patients experienced disease relapse, which was effectively treated with plasma exchange.

Conclusion: In the present cases of antibody-negative PERM, plasma exchange was most effective and was maintained long-term despite repeated relapses. Plasma exchange should be actively chosen in antibody-negative PERM.

进行性脑脊髓炎伴强直和肌阵挛(PERM)以脑干症状、肌肉强直和肌阵挛为特征。虽然抑制神经元的自身抗体与病理有关,但约30%的病例自身抗体阴性。抗体阴性的PERM病例报道很少,其临床病程和预后尚不清楚。方法:报告3例抗体阴性PERM患者血浆置换治疗有效。结果:病例1为68岁男性,病例2为27岁女性,病例3为47岁女性。在这三个病例中,类固醇脉冲治疗和静脉注射免疫球蛋白效果有限,血浆置换明显有效。所有患者均出现疾病复发,经血浆置换有效治疗。结论:在抗体阴性的PERM病例中,血浆置换是最有效的,尽管反复复发,但仍能长期维持。抗体阴性的PERM应积极选择血浆置换。
{"title":"Efficacy of apheresis in antibody-negative progressive encephalomyelitis with rigidity and myoclonus.","authors":"Yohei Aoki, Mayumi Sakata, Hidekazu Suzuki, Kohei Hori, Junko Taruya, Katsuichi Miyamoto","doi":"10.1111/1744-9987.14253","DOIUrl":"https://doi.org/10.1111/1744-9987.14253","url":null,"abstract":"<p><strong>Introduction: </strong>Progressive encephalomyelitis with rigidity and myoclonus (PERM) is characterized by brainstem symptoms, muscle rigidity, and myoclonus. While autoantibodies to inhibitory neurons have been associated with the pathology, about 30% of cases are negative for autoantibodies. There are few reported cases of antibody-negative PERM and its clinical course and prognosis are unknown.</p><p><strong>Methods: </strong>We report three cases of antibody-negative PERM in which plasma exchange was effective.</p><p><strong>Results: </strong>Case 1 was a 68-year-old man, case 2 was a 27-year-old woman, and case 3 was a 47-year-old woman. In all three cases, steroid pulse therapy and intravenous immunoglobulin had limited effect and plasma exchange was markedly effective. All patients experienced disease relapse, which was effectively treated with plasma exchange.</p><p><strong>Conclusion: </strong>In the present cases of antibody-negative PERM, plasma exchange was most effective and was maintained long-term despite repeated relapses. Plasma exchange should be actively chosen in antibody-negative PERM.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tenapanor: A novel therapeutic agent for dialysis patients with hyperphosphatemia. Tenapanor:一种用于透析患者高磷血症的新型治疗剂。
Tadao Akizawa, Natsuki Urano, Kazuaki Ikejiri, Kaoru Nakanishi, Masafumi Fukagawa

Patients on dialysis often develop hyperphosphatemia, contributing to an increased risk of cardiovascular events and mortality. Currently, several types of phosphate binders (PBs) exist for the treatment of hyperphosphatemia, but they are sometimes associated with drug-specific side effects and high pill burden, making it difficult to control serum phosphorus appropriately. Tenapanor, which has a novel mechanism to reduce serum phosphorus via selective sodium/proton exchange transporter 3 inhibition, was approved for hyperphosphatemia in Japan in 2023. Four phase 3 studies of tenapanor have been performed in Japan and have demonstrated its efficacy and safety as a single-agent drug, add-on effects to PBs for patients with refractory hyperphosphatemia that cannot be improved with PBs alone, and reduction of the pill burden associated with PBs. This review provides an overview of the characteristics and previous clinical studies of tenapanor and describes the clinical benefits of tenapanor over current therapy in patients on dialysis.

透析患者经常出现高磷血症,导致心血管事件和死亡风险增加。目前,有几种类型的磷酸盐结合剂(PBs)用于治疗高磷血症,但它们有时伴有药物特异性副作用和高药丸负担,难以适当控制血清磷。Tenapanor具有通过选择性钠/质子交换转运蛋白3抑制降低血清磷的新机制,于2023年在日本被批准用于高磷血症。tenapanor已经在日本进行了四项三期研究,并证明了其作为单药药物的有效性和安全性,对难治性高磷血症患者的PBs附加效应不能单独使用PBs改善,并且减少了与PBs相关的药丸负担。这篇综述综述了泰纳帕诺的特点和以前的临床研究,并描述了泰纳帕诺在透析患者中比目前治疗的临床益处。
{"title":"Tenapanor: A novel therapeutic agent for dialysis patients with hyperphosphatemia.","authors":"Tadao Akizawa, Natsuki Urano, Kazuaki Ikejiri, Kaoru Nakanishi, Masafumi Fukagawa","doi":"10.1111/1744-9987.14241","DOIUrl":"https://doi.org/10.1111/1744-9987.14241","url":null,"abstract":"<p><p>Patients on dialysis often develop hyperphosphatemia, contributing to an increased risk of cardiovascular events and mortality. Currently, several types of phosphate binders (PBs) exist for the treatment of hyperphosphatemia, but they are sometimes associated with drug-specific side effects and high pill burden, making it difficult to control serum phosphorus appropriately. Tenapanor, which has a novel mechanism to reduce serum phosphorus via selective sodium/proton exchange transporter 3 inhibition, was approved for hyperphosphatemia in Japan in 2023. Four phase 3 studies of tenapanor have been performed in Japan and have demonstrated its efficacy and safety as a single-agent drug, add-on effects to PBs for patients with refractory hyperphosphatemia that cannot be improved with PBs alone, and reduction of the pill burden associated with PBs. This review provides an overview of the characteristics and previous clinical studies of tenapanor and describes the clinical benefits of tenapanor over current therapy in patients on dialysis.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-effectiveness of plasmapheresis and hemoperfusion in COVID-19 survivors: A six-month follow-up analysis after hospital discharge. COVID-19幸存者血浆置换和血液灌流的成本效益:出院后6个月随访分析
Soroush Dianaty, Farshid Gholami, Hamid Reza Gholamrezaie, Abasat Mirzaei

Introduction: To evaluate the short- and long-term clinical and financial outcomes of apheresis in COVID-19 survivors after hospital discharge.

Methods: Intensive care unit-discharged patients were followed for 6 months. Vital signs, laboratory markers, quality of life, and direct medical costs were analyzed to calculate incremental cost-effectiveness ratios (ICER) and to plot cost-effectiveness planes and acceptability curves.

Results: A total of 68 patients (45 control, 18 plasmapheresis, and 5 hemoperfusion) were included. ICERs for plasmapheresis and hemoperfusion patients at discharge were $867.58 and $198.89 per quality-adjusted life years (QALY) gained, respectively. Respiration and blood pressure improved significantly at discharge. The improvements in oxygenation markers for plasmapheresis and hemoperfusion groups were lower than controls (8.56 ± 10.31 and 11.75 ± 16.88 vs. 11.37 ± 7.28 percent for SpO2, 11.15 ± 21.15 and 11.05 ± 24.95 vs. 16.03 ± 5.61 mm Hg for PaO2, respectively) However, the respiratory rate improvements corresponded to ICERs of $1034.77 and $269.94 for plasmapheresis and hemoperfusion, respectively. The ICERs for increasing mean arterial pressure were $24.83 and $30.94 per mm Hg, and plasmapheresis was more cost-effective than hemoperfusion in increasing serum calcium levels ($1649.35 per mg/dL). At 1-month post-discharge, both treatments showed worse outcomes compared to controls. At 6 months, the plasmapheresis ICER ($1884.95) exceeded the willingness-to-pay threshold. The ICER for plasmapheresis at 6 months was $112.83 per rehospitalization day avoided, while hemoperfusion remained less effective than controls.

Conclusion: While plasmapheresis and hemoperfusion improved some clinical outcomes, their high costs and limited long-term cost-effectiveness suggest that these interventions may not be economically justified for treating COVID-19 patients. Careful evaluation is needed when considering their use in clinical practice.

目的:评价COVID-19幸存者出院后采血的短期和长期临床和财务结果。方法:对重症监护病房出院患者进行6个月的随访。分析生命体征、实验室指标、生活质量和直接医疗费用,计算增量成本-效果比(ICER),绘制成本-效果平面和可接受曲线。结果:共纳入68例患者,其中对照组45例,血浆置换18例,血液灌流5例。血浆置换和血液灌注患者出院时的ICERs分别为每获得的质量调整生命年(QALY) 867.58美元和198.89美元。出院时呼吸和血压明显改善。血浆置换组和血液灌注组氧合指标的改善均低于对照组(SpO2组为8.56±10.31和11.75±16.88,SpO2组为11.37±7.28%;PaO2组为11.15±21.15和11.05±24.95,PaO2组为16.03±5.61 mm Hg)。然而,呼吸频率的改善与血浆置换组和血液灌注组的ICERs分别为1034.77美元和269.94美元。提高平均动脉压的ICERs分别为每毫米汞柱24.83美元和30.94美元,血浆置换在提高血清钙水平方面比血液灌注更具成本效益(每毫克/分升1649.35美元)。在出院后1个月,两种治疗方法的结果都比对照组差。6个月时,血浆置换ICER($1884.95)超过了支付意愿阈值。6个月血浆置换的ICER为每避免再住院日112.83美元,而血液灌流仍然不如对照组有效。结论:虽然血浆置换和血液灌流改善了一些临床结果,但其高昂的成本和有限的长期成本效益表明,这些干预措施在治疗COVID-19患者方面可能不具有经济合理性。在考虑其在临床实践中的应用时,需要仔细评估。
{"title":"Cost-effectiveness of plasmapheresis and hemoperfusion in COVID-19 survivors: A six-month follow-up analysis after hospital discharge.","authors":"Soroush Dianaty, Farshid Gholami, Hamid Reza Gholamrezaie, Abasat Mirzaei","doi":"10.1111/1744-9987.14235","DOIUrl":"https://doi.org/10.1111/1744-9987.14235","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the short- and long-term clinical and financial outcomes of apheresis in COVID-19 survivors after hospital discharge.</p><p><strong>Methods: </strong>Intensive care unit-discharged patients were followed for 6 months. Vital signs, laboratory markers, quality of life, and direct medical costs were analyzed to calculate incremental cost-effectiveness ratios (ICER) and to plot cost-effectiveness planes and acceptability curves.</p><p><strong>Results: </strong>A total of 68 patients (45 control, 18 plasmapheresis, and 5 hemoperfusion) were included. ICERs for plasmapheresis and hemoperfusion patients at discharge were $867.58 and $198.89 per quality-adjusted life years (QALY) gained, respectively. Respiration and blood pressure improved significantly at discharge. The improvements in oxygenation markers for plasmapheresis and hemoperfusion groups were lower than controls (8.56 ± 10.31 and 11.75 ± 16.88 vs. 11.37 ± 7.28 percent for SpO<sub>2</sub>, 11.15 ± 21.15 and 11.05 ± 24.95 vs. 16.03 ± 5.61 mm Hg for PaO<sub>2</sub>, respectively) However, the respiratory rate improvements corresponded to ICERs of $1034.77 and $269.94 for plasmapheresis and hemoperfusion, respectively. The ICERs for increasing mean arterial pressure were $24.83 and $30.94 per mm Hg, and plasmapheresis was more cost-effective than hemoperfusion in increasing serum calcium levels ($1649.35 per mg/dL). At 1-month post-discharge, both treatments showed worse outcomes compared to controls. At 6 months, the plasmapheresis ICER ($1884.95) exceeded the willingness-to-pay threshold. The ICER for plasmapheresis at 6 months was $112.83 per rehospitalization day avoided, while hemoperfusion remained less effective than controls.</p><p><strong>Conclusion: </strong>While plasmapheresis and hemoperfusion improved some clinical outcomes, their high costs and limited long-term cost-effectiveness suggest that these interventions may not be economically justified for treating COVID-19 patients. Careful evaluation is needed when considering their use in clinical practice.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of transcutaneous vagus nerve stimulation in hemodialysis patients: A randomized controlled trial. 经皮迷走神经刺激对血液透析患者的影响:一项随机对照试验。
Qiuling Zhang, Jun Dou, Hua Ao, Dongmei Guo, Xi Yang, Ming Li

Introduction: Transcutaneous auricular vagus nerve stimulation (tVNS) has shown potential in neurological, autoimmune, and cardiovascular disorders, but its effects on HD patients remain unclear. This study aimed to evaluate the efficacy and safety of tVNS in HD patients.

Methods: We conducted a randomized controlled clinical trial on patients receiving HD ≥6 months. The tVNS group received stimulation for 1 h during the first 2 h of HD sessions, three times weekly for 8 weeks, while the control group received standard care. The primary outcomes were dialysis efficiency (Single-pool Kt/V, Sp Kt/V) and dialysis-related symptoms (Dialysis Symptom Index, DSI), assessed every 4 weeks. Secondary outcomes included pain and fatigue scores, physical performance, Hemodialysis Comfort Scale, hemoglobin levels, Mini-Mental State Examination, and anxiety and depression scores, measured at baseline and 8 weeks after intervention.

Results: A total of 63 patients were enrolled in the study, with 32 patients assigned to the tVNS group and 31 patients to the control group. At 8 weeks, the tVNS group showed significant improvements in Sp Kt/V (1.31 ± 0.11 vs. 1.25 ± 0.10, p = 0.02), and DSI (12.09 ± 5.84 vs. 16.26 ± 5.27, p = 0.004), as well as reductions in pain and fatigue, and increases in physical function, comfort, and hemoglobin. However, there were no statistically significant changes observed in cognitive function, anxiety, or depression.

Conclusions: tVNS could improve dialysis efficiency, symptoms, and physical function in HD patients, indicating it may have a role as a complementary therapy.

导读:经皮耳迷走神经刺激(tVNS)已显示出在神经、自身免疫和心血管疾病方面的潜力,但其对HD患者的影响尚不清楚。本研究旨在评价tVNS治疗HD患者的有效性和安全性。方法:我们对接受HD治疗≥6个月的患者进行随机对照临床试验。tVNS组在HD疗程的前2小时内接受1小时的刺激,每周3次,持续8周,而对照组接受标准治疗。主要结局是透析效率(单池Kt/V, Sp Kt/V)和透析相关症状(透析症状指数,DSI),每4周评估一次。次要结局包括在基线和干预后8周测量的疼痛和疲劳评分、身体表现、血液透析舒适量表、血红蛋白水平、迷你精神状态检查以及焦虑和抑郁评分。结果:共纳入63例患者,其中32例患者被分配到tVNS组,31例患者被分配到对照组。8周时,tVNS组明显改善了Sp Kt/V(1.31±0.11比1.25±0.10,p = 0.02)和DSI(12.09±5.84比16.26±5.27,p = 0.004),疼痛和疲劳减轻,身体功能、舒适度和血红蛋白增加。然而,在认知功能、焦虑或抑郁方面没有观察到统计学上显著的变化。结论:tVNS可以改善HD患者的透析效率、症状和身体功能,提示其可能具有补充治疗的作用。
{"title":"Effect of transcutaneous vagus nerve stimulation in hemodialysis patients: A randomized controlled trial.","authors":"Qiuling Zhang, Jun Dou, Hua Ao, Dongmei Guo, Xi Yang, Ming Li","doi":"10.1111/1744-9987.14243","DOIUrl":"https://doi.org/10.1111/1744-9987.14243","url":null,"abstract":"<p><strong>Introduction: </strong>Transcutaneous auricular vagus nerve stimulation (tVNS) has shown potential in neurological, autoimmune, and cardiovascular disorders, but its effects on HD patients remain unclear. This study aimed to evaluate the efficacy and safety of tVNS in HD patients.</p><p><strong>Methods: </strong>We conducted a randomized controlled clinical trial on patients receiving HD ≥6 months. The tVNS group received stimulation for 1 h during the first 2 h of HD sessions, three times weekly for 8 weeks, while the control group received standard care. The primary outcomes were dialysis efficiency (Single-pool Kt/V, Sp Kt/V) and dialysis-related symptoms (Dialysis Symptom Index, DSI), assessed every 4 weeks. Secondary outcomes included pain and fatigue scores, physical performance, Hemodialysis Comfort Scale, hemoglobin levels, Mini-Mental State Examination, and anxiety and depression scores, measured at baseline and 8 weeks after intervention.</p><p><strong>Results: </strong>A total of 63 patients were enrolled in the study, with 32 patients assigned to the tVNS group and 31 patients to the control group. At 8 weeks, the tVNS group showed significant improvements in Sp Kt/V (1.31 ± 0.11 vs. 1.25 ± 0.10, p = 0.02), and DSI (12.09 ± 5.84 vs. 16.26 ± 5.27, p = 0.004), as well as reductions in pain and fatigue, and increases in physical function, comfort, and hemoglobin. However, there were no statistically significant changes observed in cognitive function, anxiety, or depression.</p><p><strong>Conclusions: </strong>tVNS could improve dialysis efficiency, symptoms, and physical function in HD patients, indicating it may have a role as a complementary therapy.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1