Cardiopulmonary assessment of patients with systemic sclerosis for hematopoietic stem cell transplantation: recommendations from the European Society for Blood and Marrow Transplantation Autoimmune Diseases Working Party and collaborating partners.

Systemic sclerosis (SSc) is a rare disabling autoimmune disease with a similar mortality to many cancers. Two randomized controlled trials of autologous hematopoietic stem cell transplantation (AHSCT) for SSc have shown significant improvement in organ function, quality of life and long-term survival compared to standard therapy. However, transplant-related mortality (TRM) ranged from 3-10% in patients undergoing HSCT. In SSc, the main cause of non-transplant and TRM is cardiac related. We therefore updated the previously published guidelines for cardiac evaluation, which should be performed in dedicated centers with expertize in HSCT for SSc. The current recommendations are based on pre-transplant cardiopulmonary evaluations combining pulmonary function tests, echocardiography, cardiac magnetic resonance imaging and invasive hemodynamic testing, initiated at Northwestern University (Chicago) and subsequently discussed and endorsed within the EBMT ADWP in 2016

Cardiopulmonary assessment of patients with systemic sclerosis for hematopoietic stem cell transplantation: recommendations from the European Society for Blood and Marrow Transplantation Autoimmune Diseases Working Party and collaborating partners.

Systemic sclerosis (SSc) is a rare disabling autoimmune disease with a similar mortality to many cancers. Two randomized controlled trials of autologous hematopoietic stem cell transplantation (AHSCT) for SSc have shown significant improvement in organ function, quality of life and long-term survival compared to standard therapy. However, transplant-related mortality (TRM) ranged from 3-10% in patients undergoing HSCT. In SSc, the main cause of non-transplant and TRM is cardiac related. We therefore updated the previously published guidelines for cardiac evaluation, which should be performed in dedicated centers with expertize in HSCT for SSc. The current recommendations are based on pre-transplant cardiopulmonary evaluations combining pulmonary function tests, echocardiography, cardiac magnetic resonance imaging and invasive hemodynamic testing, initiated at Northwestern University (Chicago) and subsequently discussed and endorsed within the EBMT ADWP in 2016

Profils épidémiologiques cliniques et bactériologiques des infections du tractus urinaire dans le service des maladies infectieuses et tropicales de l’hôpital Tenon de Paris: « étude préliminaire ».

Objectif : décrire les caractéristiques épidémiologiques, cliniques et bactériologiques des infections du tractus urinaire(ITU) dans le service des maladies infectieuses et tropicales du CHU de Ténon à Paris. Patients et méthodes : Il s’est agi d’une étude rétrospective réalisée le 25 Octobre 2016 dans le service des maladies infectieuses et tropicales du CHU de Ténon à Paris. Etaient inclus tous les patients hospitalisés, ayant à l’examen cytobactériologique des urines(ECBU) une leucocyturie significative et une uroculture positives. Résultats : Quatre patients avaient été recensés sur un total de 28 patients hospitalisés, soit une prévalence hospitalière de 14%. Leurs âges variaient entre 22 ans et 82 ans. Les signes urinaires étaient présents chez un seul patient, et étaient représentés par une dysurie et une douleur lombaire évoluant dans un contexte fébrile. Les bactéries isolées à l’examen cytobactériologique des urines(ECBU) étaient représentées par E. coli (2) dont 1 productrice de bétalactamase à spectre élargi(BLSE), P. aeruginosa(1), et K. pneumoniae (1) de phénotype sauvage tous les deux. Conclusion : Les ITU semblent relativement fréquentes au service des maladies infectieuses de l’hôpital Tenon. Ces infections évoluaient presque toujours avec d’autres comorbidités chez tous les patients. Elles s’accompagnaient rarement de signes d’appel urinaire d’où l’intérêt de leur recherche systématique dans le cadre de tout bilan infectieux

Nephrectomy in autosomal dominant polycystic kidney disease: A consensus statement of the ERA Genes & Kidney Working Group

\ua9 2025 The Author(s). A substantial number of patients with autosomal dominant polycystic kidney disease (ADPKD) undergo a nephrectomy, especially in workup for a kidney transplantation. Currently, there is no evidence-based algorithm to guide clinicians about which patients should undergo nephrectomy, the optimal timing of this procedure, or the preferred surgical technique. This systematic review-based consensus statement aimed to answer important questions regarding nephrectomy in ADPKD. A literature review was performed and extended to a meta-analysis when possible. For this purpose, PubMed and EMBASE were searched up to May 2024. Fifty-four publications, describing a total of 2391 procedures, were included. In addition, an exploratory questionnaire was sent to urologists, nephrologists, and transplant surgeons. These sources were used to develop practice points about indications, complications, mortality, and timing and technique of nephrectomy. In addition, data on renal embolization as a potential alternative to nephrectomy were explored and summarized. To reach consensus, practice points were defined and improved in three Delphi survey rounds by experts of the European Renal Association Working Group Genes & Kidney and the European Association of Urology Section of Transplantation Urology. A total of 23 practice points/statements were developed, all of which reached consensus. Among others, it was deemed that nephrectomy can be performed successfully for various indications and is an intermediate risk procedure with acceptable mortality and minimal impact on kidney graft function when performed before, in the same session or after transplantation. The complication rate seems to increase when the procedure is performed as an emergency. During the workup for transplantation, patient complaints should be assessed routinely by questionnaires to indicate symptom burden. Deciding on the need for nephrectomy and exploring potential alternatives such as kidney embolization should be a process of shared decision-making, preferably after multidisciplinary consultation

Replacement of the ascending aorta in children: A series of fourteen patients

AbstractJ Thorac Cardiovasc Surg 2002;124:411-