United States for 2002-2016. The cohort was divided into 3 groups on the basis of induction type: rabbit antithymocyte globulin (r-ATG; n = 831), interleukin 2 receptor antagonist (IL2RA; n = 1558), and no induction (n = 2333). Primary outcomes were posttransplant all-cause mortality and acute rejection rates in kidney and liver allografts at 12 months. Survival rates were analyzed by the Kaplan-Meier method. A propensity score analysis was used to control potential selection bias. Multivariate inverse probability weighted Cox proportional hazard and logistic regression models were used to estimate the hazard ratios (HRs) and odds ratios. Among SLKT recipients, survival estimates at 3 years were lower for recipients receiving r-ATG (P = 0.05). Compared with no induction, the multivariate analyses showed an increased mortality risk with r-ATG (HR, 1.29; 95% confidence interval [CI], 1.10-1.52; P = 0.002) and no difference in acute liver or kidney rejection rates at 12 months across all induction categories. No difference in outcomes was noted with IL2RA induction over the no induction category. In conclusion, there appears to be no survival benefit nor reduction in rejection rates for SLKT recipients who receive induction therapy, and r-ATG appears to increase mortality risk compared with no induction.

BK virus is a polyomavirus with seroprevalence rates of 80% in adults. Infection is usually acquired during childhood, and the virus is benign or pathologic depending on immune status. The virus reactivates in immunodeficiency states, mostly among transplant (either kidney or bone marrow) recipients. There are approximately 15 000 renal transplants every year in the USA, of which 5–10% develop BK polyomavirus nephropathy; 50–80% of patients who develop nephropathy go on to develop graft failure. BK virus is associated with BK polyomavirus nephropathy, ureteral stenosis, late-onset hemorrhagic cystitis, bladder cancer and other nonlytic large T-expressing carcinomas. The renal spectrum begins with viruria and can end with graft failure. The clinical spectrum and outcomes vary among transplant patients. New noninvasive diagnostic methods, such as urinary polyomavirus Haufen detected by electron microscopy, are currently under study. Treatment is primarily directed at decreasing immunosuppression but may be associated with graft rejection. Repeat transplantation is encouraged as long as viral clearance in plasma prior to transplant is accomplished. There remain no definitive data regarding the utility of transplant nephrectomy.

Objectives This study capitalizes on the unique molecular and developmental similarities between the auditory organs of Drosophila and mammals, to investigate genes implicated in human syndromic and nonsyndromic hearing loss in a genetically tractable experimental animal model, the fruit fly Drosophila. Methods The Drosophila counterparts of 3 human deafness genes (DIAPH1/DFNA1, ESPN/DFNB36, and TMHS/DFNB67) were identified by sequence similarity. An electrophysiological assay was used to record sound-evoked potentials in response to an acoustic stimulus, the Drosophila courtship song. Results Flies with mutations affecting the diaphanous, forked, and CG12026/TMHS genes displayed significant reductions in the amplitude of sound-evoked potentials compared to wild-type flies (p < 0.05 to p < 0.005). The mean responses were reduced from approximately 500 to 600 μV in wild-type flies to approximately 100 to 300 μV in most mutant flies. Conclusions The identification of significant auditory dysfunction in Drosophila orthologs of human deafness genes will facilitate exploration of the molecular biochemistry of auditory mechanosensation. This may eventually allow for novel diagnostic and therapeutic approaches to human hereditary hearing loss.

ABS is a unique acute cardiac syndrome and a recently recognized form of transient left ventricular dysfunction. It mimics ACS in clinical presentation (chest pain and dyspnea) and specific ECHO findings in the absence of significant coronary lesions. This rare entity accounts for 2.2% of ST segment elevation ACS. Pathophysiology mostly correlates to stress-induced catecholamine release. The syndrome is predominant in females, mostly in the postmenopausal age group. It should be initially managed according to the guidelines of ACS. The prognosis for apical ballooning syndrome is generally favorable with inpatient hospital mortality less than 2%. Reports of a single episode of ABS are common in recent medical literature; we report a rare case of recurrence that provides more insight into the nature of this unique syndrome.

Objective To report a case of pseudohyperkalemia due to a pneumatic tube transport system. Case Summary A 75-year-old male presented to the emergency medicine department with chest pain and intermittent vision loss over the previous 2 days. Laboratory studies revealed a potassium value of 9.6 mEq/L and a white blood cell (WBC) count of 262 × 109/L. An electrocardiogram did not reveal changes consistent with hyperkalemia. Emergent treatment for the hyperkalemia was instituted. Repeat plasma potassium values obtained after treatment for the hyperkalemia remained significantly elevated. It was eventually recognized that the hyperkalemia was due to the combination of undiagnosed leukemia causing a significantly elevated WBC count and transport of the patient's specimen to the laboratory via a pneumatic tube transport system. Manual transport of the specimen to the laboratory repeatedly revealed normal or hypokalemic values. Discussion Hyperkalemia is a potentially fatal electrolyte abnormality that must be differentiated from pseudohyperkalemia. Pseudohyperkalemia is defined as a spurious elevation of potassium levels usually due to mechanical trauma during venipuncture resulting in hemolysis and release of potassium from the cellular elements of blood. Pneumatic tube transport systems should be listed in the scientific literature as another potential cause of pseudohyperkalemia, especially in patients with high WBC and/or platelet counts. Conclusion Pharmacists and other health care providers should be aware of pneumatic tube transport systems potentially causing pseudohyperkalemia, because regular treatments for hyperkalemia for this problem may cause patient harm.