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https://www.readbyqxmd.com/read/29470687/surgical-management-of-extensive-dissecting-thoracic-aortic-aneurysm-via-the-semi-clamshell-approach
#1
Hiroshi Furukawa, Takeshi Honda, Takahiko Yamasawa, Hisao Masaki, Kazuo Tanemoto
BACKGROUND: We retrospectively evaluated the initial clinical experience of the surgical management of extensive dissecting thoracic aortic aneurysm (TAA) via the semi-clamshell approach. METHODS: Thirteen patients (3 women and 10 men, mean age 67 ± 15 years) who underwent elective surgical intervention for extensive dissecting TAA via semi-clamshell approach in our institute between May 2007 and April 2017 participated in this study. Regarding surgical techniques, left thoracotomy with transverse sternotomy was initially performed via the third or fourth intercostal space following an incision from the right sternal borderline to the anterior axillary line on the left sternal borderline...
February 22, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29470354/poor-survival-after-retransplantation-in-nash-cirrhosis
#2
Avesh J Thuluvath, Po-Hung Chen, Paul J Thuluvath, Sergey Kantsevoy, Yulia Savva
BACKGROUND: Nonalcoholic steatohepatitis (NASH) cirrhosis is a common indication for liver transplantation (LT) in the U.S. There is a paucity of data on retransplantation (re-LT) in those who were initially transplanted for NASH. METHODS: We queried the UNOS data sets from 2002-2016 to analyze the outcomes of adults with NASH (n=128) and compared them to groups that received re-LT for cryptogenic cirrhosis (CC, n=189), alcoholic cirrhosis (AC, n=300) or autoimmune hepatitis cirrhosis (AIH-C, n=118) after excluding multiple-organ re-LT and individuals with HCC...
February 20, 2018: Transplantation
https://www.readbyqxmd.com/read/29470351/severe-unresolved-cholestasis-due-to-unknown-aetiology-leading-to-early-allograft-failure-within-the-first-3-months-of-liver-transplantation
#3
Roberta Angelico, Undine A Gerlach, Bridget K Gunson, Desley Neil, Hynek Mergental, John Isaac, Paolo Muiesan, Darius Mirza, M Thamara Pr Perera
BACKGROUND: Causes of severe cholestasis following liver transplantation(LT) are multi-factorial; whilst the aetiology is predictable in some, others culminate in graft/patient loss without a definitive cause identified. Severe cholestasis is usually associated with overlapped histological findings of rejection and biliary features, and diagnostic interpretation may pose a challenge. METHODS: This is 10-year retrospective analysis of patients with unexplained severe cholestasis resulting in death/graft loss within 90-days of LT...
February 20, 2018: Transplantation
https://www.readbyqxmd.com/read/29470232/intraoperative-extracorporeal-irradiation-and-frozen-treatment-on-tumor-bearing-autografts-show-equivalent-outcomes-for-biologic-reconstruction
#4
Po-Kuei Wu, Cheng-Fong Chen, Chao-Ming Chen, Yu-Chi Cheng, Shang-Wen Tsai, Tain-Hsiung Chen, Wei-Ming Chen
BACKGROUND: Immediately recycling the resected bone segment in a biologic limb salvage reconstruction is an option after wide resection of bone. Intraoperative extracorporeal irradiation and freezing are the two major tumor-killing techniques applied on the fresh tumor-bearing autografts. However, graft-derived tumor recurrence and complications are concerns affecting graft survival. QUESTIONS/PURPOSES: We therefore asked: (1) Is there a difference in the proportion of patients achieving union by 18 months after surgery between the groups with extracorporeal-irradiated autografts and frozen-treated autografts? (2) Is there any difference in the frequency of graft-related complications for patients receiving either an extracorporeal-irradiated or a frozen-treated autograft? (3) Is there a difference between the techniques in terms of graft-derived recurrence? (4) Are there differences in failure-free grafts, and limb and overall survivorship between autografts treated by extracorporeal irradiation or by freezing? METHODS: During the study period we treated a total of 333 patients with high-grade osteosarcoma...
February 21, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29469632/hybrid-reconstruction-of-the-aortic-arch-using-a-double-branched-stent-graft-in-a-canine-model
#5
Fan Qiao, Cunhua Su, Qingqi Han, Mengwei Tan, Jun Wang, Yang Liu, Fanglin Lu, Lin Han, Zhiyun Xu
PURPOSE: To report the results of a hybrid approach to aortic arch repair using an innovative unibody double-branched stent graft in a canine model. MATERIALS AND METHODS: The stent-graft system consists of two parts: the main body and two branches for reconstruction of the supra-arch branches. There is a 2-cm-long suturing portion at the proximal end of the main body. Twenty adult German sheep dogs underwent a hybrid surgical treatment to place the stent-grafts into the proximal descending aorta and the supra-arch branches...
February 22, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29466487/high-intensity-interval-training-in-heart-transplant-recipients-a-systematic-review-with-meta-analysis
#6
Raphael José Perrier-Melo, Fernando Augusto Marinho Dos Santos Figueira, Guilherme Veiga Guimarães, Manoel da Cunha Costa
Heart transplantation (HTx) is considered an efficient and gold-standard procedure for patients with end-stage heart failure. After surgery, patients have lower aerobic power (VO2max) and compensatory hemodynamic responses. The aim of the present study was to assess through a systematic review with meta-analysis whether high-intensity interval training (HIIT) can provide benefits for those parameters. This is a systematic review with meta-analysis, which searched the databases and data portals PubMed, Web of Science, Scopus, Science Direct and Wiley until December 2016 (pairs)...
February 19, 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29465439/intestinal-re-transplantation-indications-techniques-and-outcomes
#7
Armando Ganoza, Neslihan Celik, George V Mazariegos
PURPOSE OF REVIEW: The field of intestinal transplantation has shown significant growth and has become the gold standard therapy for patients that suffer from the complications of total parenteral nutrition due to irreversible intestinal failure. In the early years of intestinal transplant, retransplantation was associated with extremely high morbidity and mortality. The purpose of this review is to summarize recent encouraging reports, showing significant improvement in outcomes after intestinal retransplantation...
February 19, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29464837/isolated-vascular-v-lesions-in-liver-allografts-how-to-approach-this-unusual-finding
#8
H L Stevenson, M M Prats, K Isse, A Zeevi, Y Avitzur, V L Ng, A J Demetris
According to the Banff criteria for kidney allografts, isolated vascular or "v" lesions are defined as intimal inflammation, age-inappropriate fibro-intimal hyperplasia, or both, without the presence of associated interstitial T cell-mediated rejection (TCMR). In general, these lesions portend a worse outcome for kidney allografts, particularly in those where the "v" lesions are identified in patients with co-existent donor specific antibodies (DSA) or later after transplantation. Although affected arteries are rarely sampled in liver allograft biopsies, we identified 9 patients at a mean of 1,805 days post-transplantation and compared these to matched controls...
February 21, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29464832/differential-effects-of-donor-specific-hla-antibodies-in-living-versus-deceased-donor-transplantation
#9
E G Kamburova, B W Wisse, I Joosten, W A Allebes, A van der Meer, L B Hilbrands, M C Baas, E Spierings, C E Hack, F E van Reekum, A D van Zuilen, M C Verhaar, M L Bots, A C A D Drop, L Plaisier, M A J Seelen, J S F Sanders, B G Hepkema, A J Lambeck, L B Bungener, C Roozendaal, M G J Tilanus, C E Voorter, L Wieten, E M van Duijnhoven, M Gelens, M H L Christiaans, F J van Ittersum, S A Nurmohamed, N M Lardy, W Swelsen, K A van der Pant, N C van der Weerd, I J M Ten Berge, F J Bemelman, A Hoitsma, P J M van der Boog, J W de Fijter, M G H Betjes, S Heidt, D L Roelen, F H Claas, H G Otten
The presence of donor-specific anti-HLA antibodies (DSA) is associated with increased risk of graft failure after kidney transplantation. We hypothesized that DSA against HLA class-I, -II or both indicate a different risk for graft loss between deceased- and living-donor transplantation. In this study we investigated the impact of pretransplant DSA, assessed using single antigen bead assays, on long-term graft survival in 3237 deceased- and 1487 living-donor kidney transplantations with a negative complement-dependent crossmatch...
February 21, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29464830/dietary-approach-to-stop-hypertension-dash-diet-and-risk-of-renal-function-decline-and-all-cause-mortality-in-renal-transplant-recipients
#10
Maryse C J Osté, António W Gomes-Neto, Eva Corpeleijn, Rijk O B Gans, Martin H de Borst, Else van den Berg, Sabita S Soedamah-Muthu, Daan Kromhout, Gerjan J Navis, Stephan J L Bakker
Renal transplant recipients (RTR) are at risk of decline of graft function and premature mortality, with high blood pressure as important risk factor for both. To study the association of the Dietary Approach to Stop Hypertension (DASH) diet with these adverse events, we conducted a prospective cohort study of adult RTR. Dietary data was collected using a validated 177-item food frequency questionnaire and an overall DASH-score was obtained. We included 632 stable RTR (mean±SD age: 53.0±12.7 y, 57% men). Mean DASH score was 23...
February 21, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29464784/total-nasal-reconstruction-with-3d-custom-made-porous-titanium-prosthesis-and-free-thoracodorsal-artery-perforator-flap-a-case-report
#11
Quentin Qassemyar, Nathaniel Assouly, Yoni Madar, Stéphane Temam, Frédéric Kolb
Total nasal reconstruction is a challenging surgical procedure which usually involves a free flap, forehead flap, and cartilage grafts. In certain failure situations where patients do not accept the idea of anaplastology, possibilities become very limited. We report the case of a patient who underwent several reconstruction steps with multiple failures including free and local flaps and cartilage harvests which showed recurrent episodes of necrosis and infection leading to melting and collapse of reconstructed structures...
February 21, 2018: Microsurgery
https://www.readbyqxmd.com/read/29464765/delay-of-alternative-antiviral-therapy-and-poor-outcomes-of-acyclovir-resistant-herpes-simplex-virus-infections-in-recipients-of-allogeneic-stem-cell-transplant
#12
Ella J Ariza-Heredia, Roy F Chemaly, Lokesh R Shahani, Ying Jang, Richard Champlin, Victor E Mulanovich
Acyclovir is commonly used to prevent and treat herpes simplex virus (HSV) reactivation after hematopoietic cell transplant (HCT), and only few reports have been published on acyclovir-resistant HSV in HCT recipients. We reviewed the medical records of patients with a microbiologic diagnosis of acyclovir-resistant HSV by plaque reduction test who received an HCT from 2002 through 2014. A total of 4028 HCTs were performed during the study period, and 18 of the recipients met the diagnostic criteria for acyclovir-resistant HSV...
February 21, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29464714/development-of-heart-failure-in-patients-with-rheumatoid-arthritis-a-danish-population-based-study
#13
Brian B Løgstrup, Torkell Ellingsen, Alma B Pedersen, Anders Statistician Kjaersgaard, Hans-Erik Bøtker, Michael Maeng
OBJECTIVES: To investigate the incidence of heart failure (HF) and ischemic heart disease (IHD) in different time-spans following incident rheumatoid arthritis (RA). Furthermore, to investigate the impact of IHD on the development of HF and the impact of different treatment era's of RA. METHODS: This matched cohort study used nationwide, prospectively collected data. From the total Danish population of approximately 5.7 million inhabitants we identified 51,859 patients (between 1995 and July 2016) with incident RA and a sex and age matched cohort from the general population (256,653 persons)...
February 21, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29463396/-renal-transplantation
#14
L Rostaing
Renal transplantation is the best option for patients with end stage renal failure, since it significantly improves their duration and quality of life. The number of patients waiting for a kidney transplant continues to increase while the overall rate of organ procurement in France is stable. The graft shortage is worsening, as is the waiting time on list. Identifying the causes of this crisis and discussing the various options for addressing the kidney graft shortage is the aim of this talk. Among the solutions: (i) improving identification of potential donors through a national and hospitals policy to promulgate organ donation and understanding better the grounds for refusal; (ii) using infusion machines for all grafts with extended criteria; (iii) developing transplantation programs from deceased donors after cardiac arrest; (iv) developing transplantation programs from living donors...
June 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29463251/kidney-autotransplantation-after-nephrectomy-and-work-bench-surgery-as-an-ultimate-approach-to-nephron-sparing-surgery
#15
Martin W W Janssen, Johannes Linxweiler, Ines Philipps, Zentia Bütow, Stefan Siemer, Michael Stöckle, Carsten-Henning Ohlmann
BACKGROUND: Kidney autotransplantation (KAT) is the ultimate approach for nephron-sparing surgery. It is a rarely used method in renal tumor surgery today as minimal invasive and open techniques for nephron-sparing surgery improve constantly. In this publication, the complication rate and the long-term functional and oncological outcome at a single center are analyzed. METHODS: A prospectively constructed database of patients with renal tumors who underwent renal surgery was retrospectively analyzed to identify patients with KAT and describe surgical and oncological outcomes and to obtain long-term follow-up...
February 20, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29459640/self-assembled-collagen-fibrin-hydrogel-reinforces-tissue-engineered-adventitia-vessels-seeded-with-human-fibroblasts
#16
Bijal Patel, Zhengfan Xu, Cameron B Pinnock, Loay S Kabbani, Mai T Lam
Efforts for tissue engineering vascular grafts focuses on the tunica media and intima, although the tunica adventitia serves as the primary structural support for blood vessels. In surgery, during endarterectomies, surgeons can strip the vessel, leaving the adventitia as the main strength layer to close the vessel. Here, we adapted our recently developed technique of forming vascular tissue rings then stacking the rings into a tubular structure, to accommodate human fibroblasts to create adventitia vessels in 8 days...
February 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29459617/ngal-neutrophil-gelatinase-associated-lipocalin-is-an-early-predictor-of-acute-kidney-injury-after-cardiac-surgery-and-variation-of-ngal-values-in-homogenous-study-subject
#17
O F Miah, F A Dowel, A Latif, A N Hai, M A Mahmud, M A Razzak, T Ahammod
Isolated CABG (coronary artery bypass grafting) has the lowest incidence of AKI (Acute Kidney Injury), followed by valvular surgery and then, combined CABG with valvular surgery. Due to the difference in baseline characteristics and in surgery type, the range of incidence is between 8.9 and 39% based on RIFLE (Risk Injury failure loss end stage kidney disease) or AKIN (Acute Kidney Injury Network) criteria. The advent of novel biomarkers of kidney injury has opened a new era of early detection and prognosis prediction for AKI...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29459462/sex-difference-in-patients-with-ischemic-heart-failure-undergoing-surgical-revascularization-results-from-the-stich-trial-surgical-treatment-for-ischemic-heart-failure
#18
Ileana L Piña, Qi Zheng, Lilin She, Hanna Szwed, Irene M Lang, Pedro S Farsky, Serenella Castelvecchio, Jolanta Biernat, Alexandros Paraforos, Dragana Kosevic, Liliana E Favaloro, José C Nicolau, Padmini Varadarajan, Eric J Velazquez, Ramdas G Pai, Nicole Cyrille, Kerry L Lee, Patrice Desvigne-Nickens
BACKGROUND: Female sex is conventionally considered a risk factor for coronary artery bypass grafting (CABG) and has been included as a poor prognostic factor in multiple cardiac operative risk evaluation scores. We aimed to investigate the association of sex and the long-term benefit of CABG in patients with ischemic left ventricular dysfunction enrolled in the prospective STICH trial (Surgical Treatment for Ischemic Heart Failure Study). METHODS: The STICH trial randomized 1212 patients (148 [12%] women and 1064 [88%] men) with coronary artery disease and left ventricular ejection fraction ≤35% to CABG+medical therapy (MED) versus MED alone...
February 20, 2018: Circulation
https://www.readbyqxmd.com/read/29458741/sleep-disordered-breathing-is-associated-with-disturbed-cardiac-repolarization-in-patients-with-a-coronary-artery-bypass-graft-surgery
#19
Christina Schmidleitner, Michael Arzt, Maria Tafelmeier, Sarah Ripfel, Miriam Fauser, Teresa Weizenegger, Bernhard Flörchinger, Daniele Camboni, Sigrid Wittmann, Florian Zeman, Christof Schmid, Lars S Maier, Stefan Wagner, Christoph Fisser
BACKGROUND: The development of malignant ventricular arrhythmias due to abnormal cardiac repolarization is a major complication after coronary artery bypass graft surgery (CABG). Sleep-disordered breathing (SDB) is linked to prolonged cardiac repolarization in non-surgical patients. This study evaluates cardiac repolarization in patients with and without SDB who underwent CABG. METHODS: 100 patients who had received CABG (84% men, age 68 ± 10 years, body-mass-index [BMI] 28...
February 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29458071/b-cells-in-operational-tolerance
#20
REVIEW
M Chesneau, R Danger, J-P Soulillou, S Brouard
Transplantation is currently the therapy of choice for endstage organ failure even though it requires long-term immunossuppresive therapy, with its numerous side effects, for acceptance of the transplanted organ. In rare cases however, patients develop operational tolerance, that is, graft survival without immunosuppression. Studies conducted on these patients reveal genetic, phenotypic, and functional signatures. They provide a better understanding of the immunological mechanisms involved in operational tolerance and define biomarkers that could be used to adapt immunosuppressive treatment to the individual, safely reduce immunosuppression doses, and ideally and safely guide immunosuppression withdrawal...
February 16, 2018: Human Immunology
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