Notes

Peripheral eosinophilia along with hypoalbuminemia tend to be associated with a larger biopsy analysis deliver with regard to eosinophilic gastroenteritis.
BACKGROUND Transcatheter pulmonary valve replacement (TPVR) is associated with a risk of procedural serious adverse events (SAE) and exposure to ionizing radiation. OBJECTIVES The purpose of this study was to define the risk of, and associations with, SAE and high-dose radiation exposure using large-scale registry data. METHODS The analysis of the multicenter C3PO-QI registry was limited to patients who underwent TPVR from January 1, 2014, to December 31, 2016. SAE were defined as the occurrence of ≥1 moderate, major, or catastrophic events. Radiation dose was reported as dose area product adjusted for weight. Associations with outcome measures were explored in univariate and multivariable analyses. RESULTS A total of 530 patients (59% male) underwent TPVR at a median age of 18.3 years (interquartile range [IQR] 12.9 to 27.3 years) and weight of 58 kg (IQR 43 to 77 kg) at 14 centers. Implant substrate included homograft (41%), bioprosthesis (30%), native right ventricular outflow tract (RVOT) (27%) and other mmon during early follow-up. BACKGROUND Cardiac resynchronization therapy (CRT) is usually performed by biventricular (BiV) pacing. Previously, feasibility of transvenous implantation of a lead at the left ventricular (LV) endocardial side of the interventricular septum, referred to as LV septal (LVs) pacing, was demonstrated. OBJECTIVES The authors sought to compare the acute electrophysiological and hemodynamic effects of LVs with BiV and His bundle (HB) pacing in CRT patients. METHODS Temporary LVs pacing (transaortic approach) alone or in combination with right ventricular (RV) (LVs+RV), BiV, and HB pacing was performed in 27 patients undergoing CRT implantation. Electrophysiological changes were assessed using electrocardiography (QRS duration), vectorcardiography (QRS area), and multielectrode body surface mapping (standard deviation of activation times [SDAT]). Hemodynamic changes were assessed as the first derivative of LV pressure (LVdP/dtmax). RESULTS As compared with baseline, LVs pacing resulted in a larger reduction in QRS area (to 73 ± 22 μVs) and SDAT (to 26 ± 7 ms) than BiV (to 93 ± 26 μVs and 31 ± 7 ms; both p less then 0.05) and LVs+RV pacing (to 108 ± 37 μVs; p less then 0.05; and 29 ± 8 ms; p = 0.05). The increase in LVdP/dtmax was similar during LVs and BiV pacing (17 ± 10% vs. 17 ± 9%, respectively) and larger than during LVs+RV pacing (11 ± 9%; p less then 0.05). There were no significant differences between basal, mid-, or apical LVs levels in LVdP/dtmax and SDAT. In a subgroup of 16 patients, changes in QRS area, SDAT, and LVdP/dtmax were comparable between LVs and HB pacing. CONCLUSIONS LVs pacing provides short-term hemodynamic improvement and electrical resynchronization that is at least as good as during BiV and possibly HB pacing. These results indicate that LVs pacing may serve as a valuable alternative for CRT. BACKGROUND After renal transplantation (RTx) hepatitis C virus (HCV) is associated with higher morbidity and mortality resulting in lower patient and graft survival. Few studies have investigated the evolution of renal transplant patients with cirrhosis owing to HCV. The objectives were to evaluate the post-transplant evolution of cirrhotic patients and to compare them with noncirrhotic patients considering the outcomes, including hepatic decompensation, graft loss, and death. METHODS The retrospective-cohort study analyzed the data of patients undergoing RTx between 1993 and 2014, positive anti-HCV, HCV-RNA before RTx, and availability of data for assessment of cirrhosis. Demographic, clinical, and laboratory variables were compared between the groups according to the outcomes. The same were made between cirrhotic patients with and without portal hypertension (PH). Survival curves were constructed by the Kaplan-Meier test and compared by the log-rank test. Variables associated with the outcomes were analyzedr, no difference was observed in liver-related mortality, suggesting that RTx is a feasible option in cirrhotic patients without decompensation, even if they have PH. PURPOSE Many types of preservation fluid were used in liver procurement. Undoubtedly, the gold standard is the University of Wisconsin (UW) solution. But the solution is expensive. The aim of this study was to evaluate the results of combined acetated Ringer solution, Euro-Collins solution, and UW solution. MATERIALS AND METHODS All patients undergoing adult liver transplantation from cadaveric donor during January 2013 to December 2017 in King Chulalongkorn Memorial Hospital were included in this study. Donor and recipient characteristics, preservation fluid, operative data, and postoperative outcomes were recorded. RESULTS A total of 102 patients receiving liver transplants were enrolled into the study. The mean age of donors was 34.2 years. The mean total ischemic time was 420.93 minutes. In recipients, posttransplantation complications were the following (1) primary nonfunction in 1 patient (0.98%); (2) early allograft dysfunction in 23 patients (22.5%); (3) hepatic artery thrombosis in 3 patients (2.7%); (4) hepatic venous outflow obstruction in 2 patients (1.96%); (5) biliary leakage in 1 patient (0.98%); (6) biliary anastomosis stenosis in 4 patients (3.92%); and (7) biliary nonanastomosis stenosis in 1 patient (0.98%). No inhospital mortality was occurred. Overall mortality rate is 7.8% (8/102). One-, 3-, and 5-year survival were 95.9%, 91.5%, and 88.4%, respectively. CONCLUSIONS The combination of acetated Ringer solution, Euro-Collins solution, and UW solution is effective and economic for liver preservation. Further study should be conducted. BACKGROUND Screening for neoplastic lesions is mandatory as a part of the evaluation process of potential candidates for liver transplant (LT). This work aimed at identifying the main findings in screening colonoscopy and their risk factors. METHODS Endoscopic and pathologic findings of the biopsied lesions of 311 potential candidates for living donor liver transplant were collected and analyzed. RESULTS Colorectal polyps (8.7%) were the most common colonoscopic finding, of which 4.18% were diagnosed as adenomas. Other findings included hemorrhoids (7.7%), portal hypertensive colopathies (3.5%), angiomatous malformations (2.6%), rectal varices (1.6%), and diverticulosis (1.6%). The univariate analysis revealed that the prevalence of colonic adenoma was significant in patients 50 years and older (P = .03; odds ratio, 1.178; 95% CI, 1.016-1.365) and in patients who had hepatocellular carcinoma (P = .043; odds ratio, 6.5; 95% CI, 1.002-42.172). In the multivariate analysis, age was found to be the single best predictor of the presence of adenoma (P = .044; odds ratio, 1.178; 95% CI, 1.005-1.382). CONCLUSION We can conclude that a screening colonoscopy prior to liver donor liver transplant should be performed at least in every LT candidate 50 years or older. Colonic polyps were the most common findings on screening colonoscopy prior to LT. BACKGROUND Organ transplantation is an important method to save the lives of patients suffering from organ failure. However, the low rate of organ donation is a common problem worldwide. Many potential organ donors in the intensive care unit (ICU) are not properly identified, which is one reason for the low donation rate. ICU nurses play a key role in organ donation but may be uncertain regarding some issues. In this study, an analysis of the reasons why ICU nurses in western China are reluctant to encourage patients and their families to donate organs is performed, providing a reference for promoting ICU nurse participation in organ donation work. METHODS From August to November of 2017, using a purposive sampling method, we conducted semi-structured, in-depth interviews using a phenomenological research method with 18 ICU nurses who were working in 4 large hospitals with organ transplant accreditation in Chongqing City, China, and analyzed the data with phenomenology. Tefinostat mouse RESULTS Reasons for the reluctance of ICU nurses in encouraging patients to donate organs were categorized into the following 4 themes limitation of the nurses' professional role, influence of the family's negative emotions, lack of training regarding organ donation in medical institutions, and impact of a conservative social attitude. CONCLUSION Chinese medical and health institutions need to attach importance to the duties and roles of ICU nurses in organ donation work, the creation of a good death culture, the implementation of training for organ donation specialist nurses, and the strengthening of advocacy efforts for organ donation so that ICU nurses' reluctance in engaging in organ donation coordination in China can be mitigated and the nurses can better participate in promoting organ donation to potential donors. OBJECTIVE The purpose of this study is to analyze varying predictive factors for improved graft function among renal transplant recipients. METHODS Two hundred eleven consecutive donor and recipient pairs who underwent renal transplantation between January 2011 and December 2015 were enrolled in our study. Factors that affected renal graft function were analyzed. Statistical analyses were performed using SPSS version 16.0 software (SPSS Inc, Chicago, IL, United States). RESULTS The mean age of donors in years was 30 (range, 17-62), with a mean body mass index (BMI) of 23.20 kg/m2 (range, 16.10-39.50). Mean total warm ischemic time in minutes was 44.80 (range, 26.10-83.45). The mean age of the recipients in years was 48 (range, 12-78) with a mean BMI of 22 kg/m2 (range, 14.80-37.30). Estimated glomerular filtration rate at 6 and 12 months post-transplantation were 69 mL per minute per 1.73 m2 (range, 10-137) and 65 (range, 16-110), respectively. Based on several parameters, there was no significant factor that improved renal graft function at 6 and 12 months after transplant. Total warm ischemic time almost showed statistical significance in predicting improved renal graft function after transplant. Future study with a longer period of observation and a larger sample size should be done for further investigation. CONCLUSIONS Total warm ischemic time is a promising parameter to predict improved renal graft function post-transplantation. BACKGROUND Decreased masticatory performance leads to deterioration of overall health among older adults. However, maintaining and improving masticatory performance in ways other than maintenance of natural teeth and appropriate prosthodontic treatment remains unclear. If the factors related to the mixing and shearing abilities for masticatory performance are clarified, it may be possible to maintain and improve the masticatory performance of older adults. We aimed to clarify the association among mixing ability, shearing ability, and masticatory performance-related factors. METHODS Of the 707 community-dwelling older adults in Kusatsu Town, Japan, 344 who had been treated for any dental defects were enrolled in this study. Masticatory performance was evaluated on the basis of mixing ability and shearing ability. The number of natural teeth and artificial teeth, occlusal force, tongue pressure, and oral diadochokinesis /ta/ were measured as masticatory performance-related factors. Their relationship with mixing ability, shearing ability, and masticatory performance-related factors was examined by means of Spearman rank correlation coefficient and path analysis.
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