LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 28

Search options

  1. Article: The "servicing-organising-community continuum"

    Jerrard, Marjorie / Buttigieg, Donna / Cockfield, Sandra

    The future of union organising , p. 97-113

    where are Australian unions today?

    2009  , Page(s) 97–113

    Author's details Marjorie Jerrard, Sandra Cockfield and Donna Buttigieg
    Keywords Gewerkschaftsbewegung ; Gewerkschaftsmitgliedschaft ; Sozialpartner ; Australien
    Language English
    Publisher Palgrave Macmillan
    Publishing place Basingstoke [u.a.]
    Document type Article
    Database ECONomics Information System

    More links

    Kategorien

  2. Article: Community unionism and union renewal

    Buttigieg, Donna / Cockfield, Sandra / Jerrard, Marjorie / Rainnie, Al

    Labor studies journal : official journal of the University and College Labor Education Association Vol. 34, No. 4 , p. 461-484

    2009  Volume 34, Issue 4, Page(s) 461–484

    Author's details Sandra Cockfield; Al Rainnie; Donna Buttigieg; Marjorie Jerrard
    Keywords Gewerkschaft ; Regionale Wirtschaftsintegration ; Gewerkschaftsbewegung ; Gewerkschaftspolitik ; Victoria (Staat) ; Australien
    Language English
    Publisher Sage
    Publishing place Thousand Oaks, Calif.
    Document type Article
    ZDB-ID 439646-7 ; 2067609-8
    ISSN 1538-9758 ; 0160-449X
    ISSN (online) 1538-9758
    ISSN 0160-449X
    Database ECONomics Information System

    More links

    Kategorien

  3. Article ; Online: Why take the chance? A qualitative grounded theory study of nocturnal haemodialysis recipients who decline kidney transplantation.

    Rosenthal, Meagen M / Molzahn, Anita E / Chan, Christopher T / Cockfield, Sandra L / Kim, S Joseph / Pauly, Robert P

    BMJ open

    2016  Volume 6, Issue 5, Page(s) e011951

    Abstract: Objective: The objective of this study was to examine the factors that influence decision-making to forgo transplantation in favour of remaining on nocturnal haemodialysis (NHD).: Design: A grounded theory approach using in-depth telephone ... ...

    Abstract Objective: The objective of this study was to examine the factors that influence decision-making to forgo transplantation in favour of remaining on nocturnal haemodialysis (NHD).
    Design: A grounded theory approach using in-depth telephone interviewing was used.
    Setting: Participants were identified from 2 tertiary care renal programmes in Canada.
    Participants: The study participants were otherwise eligible patients with end-stage renal disease who have opted to remain off of the transplant list. A total of 7 eligible participants were interviewed. 5 were male. The mean age was 46 years.
    Analysis: A constant comparative method of analysis was used to identify a core category and factors influencing the decision-making process.
    Results: In this grounded theory study of people receiving NHD who refused kidney transplantation, the core category of 'why take a chance when things are going well?' was identified, along with 4 factors that influenced the decision including 'negative past experience', 'feeling well on NHD', 'gaining autonomy' and 'responsibility'.
    Conclusions: This study provides insight into patients' thought processes surrounding an important treatment decision. Such insights might help the renal team to better understand, and thereby respect, patient choice in a patient-centred care paradigm. Findings may also be useful in the development of education programmes addressing the specific concerns of this population of patients.
    MeSH term(s) Adult ; Decision Making ; Diet ; Female ; Grounded Theory ; Health Status ; Humans ; Immunosuppression/adverse effects ; Interviews as Topic ; Kidney Failure, Chronic/therapy ; Kidney Transplantation/adverse effects ; Kidney Transplantation/psychology ; Male ; Middle Aged ; Personal Autonomy ; Qualitative Research ; Renal Dialysis/methods ; Renal Dialysis/psychology ; Self Care ; Treatment Refusal/psychology ; Uncertainty
    Language English
    Publishing date 2016-05-18
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2747269-3
    ISSN 2044-6055 ; 2044-6055 ; 2053-3624
    ISSN (online) 2044-6055
    ISSN 2044-6055 ; 2053-3624
    DOI 10.1136/bmjopen-2016-011951
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Cardiovascular assessment of diabetic end-stage renal disease patients before renal transplantation.

    Welsh, Robert C / Cockfield, Sandra M / Campbell, Patrica / Hervas-Malo, Marilou / Gyenes, Gabor / Dzavik, Vladamir

    Transplantation

    2011  Volume 91, Issue 2, Page(s) 213–218

    Abstract: Background: Although consensus guidelines for preoperative cardiovascular (CV) assessment exist, diabetic patients with renal insufficiency (DM/RI) undergoing assessment for renal transplantation are a unique high-risk group that remains poorly ... ...

    Abstract Background: Although consensus guidelines for preoperative cardiovascular (CV) assessment exist, diabetic patients with renal insufficiency (DM/RI) undergoing assessment for renal transplantation are a unique high-risk group that remains poorly investigated.
    Methods: A consecutive cohort of DM/RI patients being assessed for renal transplantation was studied. We analyzed the ability of clinical characteristics and noninvasive investigation to predict significant coronary artery disease (CAD) and incidence of major adverse CV events.
    Results: Baseline characteristics (n = 280) are as follows: mean age 48.6 years (± 11.5 standard deviation), 66% men, diabetes duration 22.6 years (mean ± 8.9 standard deviation), 92% hypertension, 46% hypercholesterolemia, 24% family history CAD, and 21% known CAD. Abnormal myocardial perfusion imaging was found in 27.8%, and 56.5% had CAD more than or equal to 50%. Although positive myocardial perfusion imaging was the only independent predictor of CAD (odds ratio 7.18, 95% confidence interval 2.98-17.3), a poor negative predicted value was observed with normal imaging in 50.3% of patients having CAD more than or equal to 50%, 35.4% CAD more than 70%, and 41.8% Duke angiographic score more than or equal to 4. At mean follow up of 4 years (median 3.9), 76 of 280 patients suffered major adverse cardiovascular events including 17% mortality. Angiographic evidence of CAD (≥ 70% odds ratio 1.81, 95% confidence interval 1.02-3.23) was the only independent predictor of major adverse cardiac events.
    Conclusion: DM/RI patients being assessed for renal transplantation have frequent CV risk factors, high likelihood of CAD, and a 28% incidence of major adverse cardiac events after 4 years. Myocardial perfusion imagining is of little clinical utility as a screening tool for CAD in this population. Only angiographic CAD was predictive of subsequent major adverse cardiac events. Further studies of risk stratification and revascularization in this high-risk population are warranted.
    MeSH term(s) Adult ; Cardiac Catheterization ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/physiopathology ; Cohort Studies ; Coronary Angiography ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/physiopathology ; Diabetes Complications/diagnosis ; Diabetes Complications/physiopathology ; Diabetic Nephropathies/complications ; Diabetic Nephropathies/physiopathology ; Female ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/physiopathology ; Kidney Transplantation ; Male ; Middle Aged ; Predictive Value of Tests ; Risk Factors
    Language English
    Publishing date 2011-01-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0b013e3181ff4f61
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article ; Online: The prognostic utility of deceased donor implantation biopsy in determining function and graft survival after kidney transplantation.

    Cockfield, Sandra M / Moore, Ronald B / Todd, Gerald / Solez, Kim / Gourishankar, Sita

    Transplantation

    2010  Volume 89, Issue 5, Page(s) 559–566

    Abstract: Background: Uncertainty remains in the prognostic utility of biopsies of deceased donor kidneys in predicting graft outcomes.: Methods: We examined implantation biopsies for 730 kidney transplant recipients from 491 deceased donors from 1990 to 2004. ...

    Abstract Background: Uncertainty remains in the prognostic utility of biopsies of deceased donor kidneys in predicting graft outcomes.
    Methods: We examined implantation biopsies for 730 kidney transplant recipients from 491 deceased donors from 1990 to 2004. The median follow-up time was 5.1 years. Of the 730 transplants, 633 (86.7%) had implantation biopsies (wedge 89.1%). Of these 633, 541 (85.5%) could be assessed for % glomerulosclerosis (GS), interstitial fibrosis, tubular atrophy, arteriolar hyalinosis, and fibrous intimal thickening. Independent risk factors for delayed graft function include regraft, longer cold ischemia time, and DR mismatch, but not donor age. Independent risk factors for worse function at 6 months include regraft, older donor and recipient, female donor and recipient, and rejection. Independent risk factors of graft failure include regraft, older donor age, male recipient, and rejection.
    Results: Of the histologic scores, arteriolar hyalinosis was independently associated with delayed graft function and graft loss, whereas fibrous intimal thickening was associated with decreased 6-month renal function. Importantly, the degree of GS was not independently associated with outcomes.
    Conclusions: Therefore, although biopsy evidences of vascular pathologic condition, kidney may contribute meaningfully to the assessment of donor quality but the degree of GS does not.
    MeSH term(s) Age Distribution ; Age Factors ; Biopsy ; Cadaver ; Female ; Follow-Up Studies ; Graft Rejection/epidemiology ; Graft Rejection/pathology ; Graft Survival/physiology ; Histocompatibility Testing ; Humans ; Immunosuppression/methods ; Kidney/pathology ; Kidney Diseases/epidemiology ; Kidney Diseases/pathology ; Kidney Transplantation/immunology ; Kidney Transplantation/mortality ; Kidney Transplantation/pathology ; Male ; Patient Selection ; Prognosis ; Reoperation/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Tissue Donors
    Language English
    Publishing date 2010-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0b013e3181ca7e9b
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: Comparison of the effects of standard vs low-dose prolonged-release tacrolimus with or without ACEi/ARB on the histology and function of renal allografts.

    Cockfield, Sandra M / Wilson, Sam / Campbell, Patricia M / Cantarovich, Marcelo / Gangji, Azim / Houde, Isabelle / Jevnikar, Anthony M / Keough-Ryan, Tammy M / Monroy-Cuadros, Felix-Mauricio / Nickerson, Peter W / Pâquet, Michel R / Ramesh Prasad, G V / Senécal, Lynne / Shoker, Ahmed / Wolff, Jean-Luc / Howell, John / Schwartz, Jason J / Rush, David N

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2019  Volume 19, Issue 6, Page(s) 1730–1744

    Abstract: Targeting the renin-angiotensin system and optimizing tacrolimus exposure are both postulated to improve outcomes in renal transplant recipients (RTRs) by preventing interstitial fibrosis/tubular atrophy (IF/TA). In this multicenter, prospective, open- ... ...

    Abstract Targeting the renin-angiotensin system and optimizing tacrolimus exposure are both postulated to improve outcomes in renal transplant recipients (RTRs) by preventing interstitial fibrosis/tubular atrophy (IF/TA). In this multicenter, prospective, open-label controlled trial, adult de novo RTRs were randomized in a 2 × 2 design to low- vs standard-dose (LOW vs STD) prolonged-release tacrolimus and to angiotensin-converting enzyme inhibitors/angiotensin II receptor 1 blockers (ACEi/ARBs) vs other antihypertensive therapy (OAHT). There were 2 coprimary endpoints: the prevalence of IF/TA at month 6 and at month 24. IF/TA prevalence was similar for LOW vs STD tacrolimus at month 6 (36.8% vs 39.5%; P = .80) and ACEi/ARBs vs OAHT at month 24 (54.8% vs 58.2%; P = .33). IF/TA progression decreased significantly with LOW vs STD tacrolimus at month 24 (mean [SD] change, +0.42 [1.477] vs +1.10 [1.577]; P = .0039). Across the 4 treatment groups, LOW + ACEi/ARB patients exhibited the lowest mean IF/TA change and, compared with LOW + OAHT patients, experienced significantly delayed time to first T cell-mediated rejection. Renal function was stable from month 1 to month 24 in all treatment groups. No unexpected safety findings were detected. Coupled with LOW tacrolimus dosing, ACEi/ARBs appear to reduce IF/TA progression and delay rejection relative to reduced tacrolimus exposure without renin-angiotensin system blockade. ClinicalTrials.gov identifier: NCT00933231.
    MeSH term(s) Adult ; Allografts ; Angiotensin II Type 1 Receptor Blockers/administration & dosage ; Angiotensin-Converting Enzyme Inhibitors/administration & dosage ; Atrophy ; Delayed-Action Preparations ; Drug Therapy, Combination ; Female ; Fibrosis ; Graft Rejection/etiology ; Graft Rejection/immunology ; Humans ; Immunosuppressive Agents/administration & dosage ; Kidney/pathology ; Kidney/physiopathology ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods ; Male ; Middle Aged ; Polyomavirus Infections/etiology ; Prognosis ; Prospective Studies ; Renin-Angiotensin System/drug effects ; Renin-Angiotensin System/physiology ; Tacrolimus/administration & dosage ; Virus Activation
    Chemical Substances Angiotensin II Type 1 Receptor Blockers ; Angiotensin-Converting Enzyme Inhibitors ; Delayed-Action Preparations ; Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM)
    Language English
    Publishing date 2019-02-01
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.15225
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article: Monitoring of Polyomavirus BK Virus Viruria and Viremia in Renal Allograft Recipients by Use of a Quantitative Real-Time PCR Assay: One-Year Prospective Study

    Pang, Xiaoli L / Doucette, Karen / LeBlanc, Barbara / Cockfield, Sandra M / Preiksaitis, Jutta K

    Journal of clinical microbiology JCM. 2007 Nov., v. 45, no. 11

    2007  

    Abstract: We have developed a real-time quantitative PCR (rt-QPCR) assay to detect and kinetically monitor BK virus viruria and viremia in renal transplant recipients (RTRs). A total of 607 urine and 223 plasma samples were collected from 203 individuals including ...

    Abstract We have developed a real-time quantitative PCR (rt-QPCR) assay to detect and kinetically monitor BK virus viruria and viremia in renal transplant recipients (RTRs). A total of 607 urine and 223 plasma samples were collected from 203 individuals including those with BK virus-associated nephropathy (BKVAN) (n = 8), those undergoing routine posttransplant surveillance (SV) (n = 155), those with nontransplant chronic kidney disease (NT-CKD) (n = 20), and healthy living kidney donors (LD) (n = 20). The rt-QPCR assay was found to be highly sensitive and specific, with a wide dynamic range (2.4 to 11 log₁₀ copies/ml) and very good precision (coefficient of variation, ~5.9%). There was a significant difference in the prevalences of viruria and viremia between the BKVAN (100% and 100%) and SV (23% and 3.9%) groups (P < 0.001). No viruria or viremia was detected in LD or in NT-CKD patients. The median (range) peak levels of BK virus viruria and viremia, in log₁₀ copies/ml, were 10.26 (9.04 to 10.83) and 4.83 (3.65 to 5.86) for the BKVAN group versus 0 (0 to 10.83) and 0 (0 to 5.65) for the SV group, respectively (P < 0.001). When the BK virus load in the urine was <7.0 log₁₀ copies/ml, no BK virus viremia was detected. When the BK virus load in the urine reached 7.0, 8.0, 9.0, and >=10.0 log₁₀ copies/ml, the corresponding detection of BK virus viremia increased to 20, 33, 50, and 100%, respectively. We propose monitoring of BK virus viruria in RTRs, with plasma BK virus load testing reserved for those with viruria levels of >=7.0 log₁₀ copies/ml.
    Language English
    Dates of publication 2007-11
    Size p. 3568-3573.
    Publishing place American Society for Microbiology
    Document type Article
    ZDB-ID 390499-4
    ISSN 1098-660X ; 0095-1137
    ISSN (online) 1098-660X
    ISSN 0095-1137
    Database NAL-Catalogue (AGRICOLA)

    More links

    Kategorien

  8. Article ; Online: Non-melanoma skin cancer incidence and risk factors after kidney transplantation: a Canadian experience.

    Comeau, Sherry / Jensen, Louise / Cockfield, Sandra M / Sapijaszko, Mariusz / Gourishankar, Sita

    Transplantation

    2008  Volume 86, Issue 4, Page(s) 535–541

    Abstract: Background: Non-melanoma skin cancer (NMSC) after kidney transplantation is common and can result in significant morbidity and mortality. Incidence and risk factors for NMSC can vary between geographic locations and there is no literature describing the ...

    Abstract Background: Non-melanoma skin cancer (NMSC) after kidney transplantation is common and can result in significant morbidity and mortality. Incidence and risk factors for NMSC can vary between geographic locations and there is no literature describing the incidence or risk factors for NMSC in Canada.
    Methods: The purpose of this retrospective cohort study was to determine the incidence of NMSC, the time of development of NMSC, and risk factors (including sun exposure history) for NMSC in kidney transplant recipients between 1990 and 2003 in our center (n=926).
    Results: We observed a 9.7% incidence of NMSC lesions after kidney transplant with a median time of development of a first NMSC lesion of 4 years. Risk factors for NMSC (multivariate analysis) include older men (>45 years), a history of posttransplant warts, and longer duration of residence in a northern climate.
    Conclusion: We conclude that NMSC is common after kidney transplantation in a northern climate and these individuals require disease prevention-specific education, more vigilant surveillance and early referral and treatment.
    MeSH term(s) Age Factors ; Canada/epidemiology ; Cause of Death ; Climate ; Cohort Studies ; Humans ; Incidence ; Kidney Transplantation/adverse effects ; Kidney Transplantation/mortality ; Middle Aged ; Multivariate Analysis ; Patient Education as Topic ; Postoperative Complications/epidemiology ; Retrospective Studies ; Risk Factors ; Skin Neoplasms/epidemiology
    Language English
    Publishing date 2008-08-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0b013e318180482d
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article: Monitoring of polyomavirus BK virus viruria and viremia in renal allograft recipients by use of a quantitative real-time PCR assay: one-year prospective study.

    Pang, Xiaoli L / Doucette, Karen / LeBlanc, Barbara / Cockfield, Sandra M / Preiksaitis, Jutta K

    Journal of clinical microbiology

    2007  Volume 45, Issue 11, Page(s) 3568–3573

    Abstract: We have developed a real-time quantitative PCR (rt-QPCR) assay to detect and kinetically monitor BK virus viruria and viremia in renal transplant recipients (RTRs). A total of 607 urine and 223 plasma samples were collected from 203 individuals including ...

    Abstract We have developed a real-time quantitative PCR (rt-QPCR) assay to detect and kinetically monitor BK virus viruria and viremia in renal transplant recipients (RTRs). A total of 607 urine and 223 plasma samples were collected from 203 individuals including those with BK virus-associated nephropathy (BKVAN) (n = 8), those undergoing routine posttransplant surveillance (SV) (n = 155), those with nontransplant chronic kidney disease (NT-CKD) (n = 20), and healthy living kidney donors (LD) (n = 20). The rt-QPCR assay was found to be highly sensitive and specific, with a wide dynamic range (2.4 to 11 log(10) copies/ml) and very good precision (coefficient of variation, approximately 5.9%). There was a significant difference in the prevalences of viruria and viremia between the BKVAN (100% and 100%) and SV (23% and 3.9%) groups (P < 0.001). No viruria or viremia was detected in LD or in NT-CKD patients. The median (range) peak levels of BK virus viruria and viremia, in log(10) copies/ml, were 10.26 (9.04 to 10.83) and 4.83 (3.65 to 5.86) for the BKVAN group versus 0 (0 to 10.83) and 0 (0 to 5.65) for the SV group, respectively (P < 0.001). When the BK virus load in the urine was <7.0 log(10) copies/ml, no BK virus viremia was detected. When the BK virus load in the urine reached 7.0, 8.0, 9.0, and > or =10.0 log(10) copies/ml, the corresponding detection of BK virus viremia increased to 20, 33, 50, and 100%, respectively. We propose monitoring of BK virus viruria in RTRs, with plasma BK virus load testing reserved for those with viruria levels of > or =7.0 log(10) copies/ml.
    MeSH term(s) BK Virus/isolation & purification ; DNA, Viral/analysis ; Humans ; Kidney Transplantation/adverse effects ; Polymerase Chain Reaction/methods ; Prospective Studies ; Transplantation, Homologous ; Urine/virology ; Viral Load ; Viremia/diagnosis
    Chemical Substances DNA, Viral
    Language English
    Publishing date 2007-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 390499-4
    ISSN 1098-660X ; 0095-1137
    ISSN (online) 1098-660X
    ISSN 0095-1137
    DOI 10.1128/JCM.00655-07
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article ; Online: Levofloxacin for BK virus prophylaxis following kidney transplantation: a randomized clinical trial.

    Knoll, Greg A / Humar, Atul / Fergusson, Dean / Johnston, Olwyn / House, Andrew A / Kim, S Joseph / Ramsay, Tim / Chassé, Michaël / Pang, Xiaoli / Zaltzman, Jeff / Cockfield, Sandra / Cantarovich, Marcelo / Karpinski, Martin / Lebel, Louise / Gill, John S

    JAMA

    2014  Volume 312, Issue 20, Page(s) 2106–2114

    Abstract: Importance: BK virus infection is a significant complication of modern immunosuppression used in kidney transplantation. Viral reactivation occurs first in the urine (BK viruria) and is associated with a high risk of transplant failure. There are ... ...

    Abstract Importance: BK virus infection is a significant complication of modern immunosuppression used in kidney transplantation. Viral reactivation occurs first in the urine (BK viruria) and is associated with a high risk of transplant failure. There are currently no therapies to prevent or treat BK virus infection. Quinolone antibiotics have antiviral properties against BK virus but efficacy at preventing this infection has not been shown in prospective controlled studies.
    Objective: To determine if levofloxacin can prevent BK viruria in kidney transplant recipients.
    Design, setting, and participants: Double-blind, placebo-controlled randomized trial involving 154 patients who received a living or deceased donor kidney-only transplant in 7 Canadian transplant centers between December 2011 and June 2013.
    Interventions: Participants were randomly assigned to receive a 3-month course of levofloxacin (500 mg/d; n = 76) or placebo (n = 78) starting within 5 days after transplantation.
    Main outcomes and measures: The primary outcome was time to occurrence of BK viruria (detected using quantitative real-time polymerase chain reaction) within the first year after transplantation. Secondary outcomes included BK viremia, peak viral load, rejection, and patient and allograft survival.
    Results: The mean follow-up time was 46.5 weeks in the levofloxacin group and 46.3 weeks in the placebo group (27 patients had follow-up terminated before the end of the planned follow-up period or development of viruria because the trial was stopped early owing to lack of funding). BK viruria occurred in 22 patients (29%) in the levofloxacin group and in 26 patients (33.3%) in the placebo group (hazard ratio, 0.91; 95% CI, 0.51-1.63; P = .58). There was no significant difference between the 2 groups in regard to any of the secondary end points. There was an increased risk of resistant infection among isolates usually sensitive to quinolones in the levofloxacin group vs placebo (14/24 [58.3%] vs 15/45 [33.3%], respectively; risk ratio, 1.75; 95% CI, 1.01-2.98) as well as a nonsignificant increased risk of suspected tendinitis (6/76 [7.9%] vs 1/78 [1.3%]; risk ratio, 6.16; 95% CI, 0.76-49.95).
    Conclusions and relevance: Among kidney transplant recipients, a 3-month course of levofloxacin initiated early following transplantation did not prevent BK viruria. Levofloxacin was associated with an increased risk of adverse events such as bacterial resistance. These findings do not support the use of levofloxacin to prevent posttransplant BK virus infection.
    Trial registration: clinicaltrials.gov Identifier: NCT01353339.
    MeSH term(s) Adult ; Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis ; BK Virus/genetics ; BK Virus/isolation & purification ; Double-Blind Method ; Female ; Humans ; Immunosuppression/adverse effects ; Kidney Transplantation ; Levofloxacin/therapeutic use ; Male ; Middle Aged ; Polyomavirus Infections/prevention & control ; Prospective Studies ; Tumor Virus Infections/prevention & control ; Urine/virology ; Viral Load ; Viremia
    Chemical Substances Anti-Bacterial Agents ; Levofloxacin (6GNT3Y5LMF)
    Language English
    Publishing date 2014-11-26
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2014.14721
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top