Heart transplantation and in ‐hospital outcomes in adult congenital heart disease patients with Fontan: A decade nationwide analysis from 2004 to 2014

AbstractIntroductionTreatment of adult congenital heart disease patients who require advanced therapies remains challenging due to high perioperative and wait ‐list mortality and limited donors. Patients palliated with Fontan are at the highest risk of early mortality due to multiorgan involvement and few centers able to safely transplant them. We sought to evaluate the early outcomes of heart transplants in these adult Fontan patients.MethodsUsing the Nationwide Inpatient Sample database, we identified all adults aged at least 18 years old who underwent heart transplantation across U.S. hospitals from 2004 to 2014. We then identified those with specific ICD ‐9 codes to include tricuspid atresia, hypoplastic left heart syndrome and common ventricle. Multivariate regression models were created to adjust for potential confounders.ResultsA total of 93 Fontan patients underwent heart transplant during the study time (0.5% of all heart transplants). Compared to non ‐Fontan heart transplantations, Fontan patients were younger, with a higher incidence of liver disease and coagulopathy. Fontan patients receiving heart transplant had higher mortality during transplant hospitalization compared to non‐Fontan patients (26.3% vs 5.3% OR, 18.10, CI, 5.06‐65.0P 
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research

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Congenital thumb hypoplasia is a rare deformity of the upper extremity. The classification of thumb hypoplasia was created by Blauth in 1967 (types I to V). The base of the first metacarpal bone is absent for hypoplasia types IIIb to V, therefore, toe-to-hand transplantation is not recommended. A stable first carpometacarpal joint has been considered a mandatory factor for a successful toe-to-hand transplantation. The aim of this study is to describe a new technique for thumb reconstruction with the second toe transfer and metatarsophalangeal joint (MTPJ) arthrodesis, which can provide a five-digit hand and restore thumb f...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Technique Source Type: research
CONCLUSION About one third of the injuries previously classified as grade III will be upgraded to grade IV using the 2018 AAST, which adds to the heterogeneity of grade IV injuries. Although the 2018 AAST grading provides more anatomic details on injury patterns and includes important radiologic findings, it did not outperform the 1989 AAST grading in predicting bleeding interventions. LEVEL OF EVIDENCE Prognostic and Epidemiological Study, level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: AAST 2019 PODIUM PAPER Source Type: research
INTRODUCTION Admission computed tomography (CT) is a widely used diagnostic tool for patients with pelvic fractures. In this pilot study, we hypothesized that pelvic hematoma volumes derived using a rapid automated deep learning-based quantitative visualization and measurement algorithm predict interventions and outcomes including (a) need for angioembolization (AE), pelvic packing (PP), or massive transfusion (MT), and (b) in-hospital mortality. METHODS We performed a single-institution retrospective analysis of 253 patients with bleeding pelvic fractures who underwent admission abdominopelvic trauma CT between 2008 ...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research
Conclusions: This is the first case that reports stabilization of a descemetocele with a PROSE device. For patients at high risk for postsurgical complications, PROSE treatment could be considered as an alternative to corneal transplantation and as an adjunct to other ocular therapies in patients with descemetocele formation.
Source: Eye and Contact Lens: Science and Clinical Practice - Category: Opthalmology Tags: Case Report Source Type: research
Conclusion: Autologous RPE–choroid patch achieved long-lasting BCVA improvement and central fixation, in eyes with choroidal neovascular membrane and intact external limiting membrane. Atrophic maculopathies only obtained temporary visual benefit.
Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research
The antiplatelet landscape for the secondary prevention of ischemic stroke has changed significantly over the past decade. Poststroke dual antiplatelet regimens are becoming increasingly routine as supported by recent literature and guideline recommendations. Dual antiplatelet therapy after stroke generally consists of aspirin and clopidogrel and is considered in the short term after stroke in select populations including those with mild stroke or transient ischemic attack and in patients with severe intracranial atherosclerosis. When initiating dual antiplatelet therapy, factors that may increase a patient's risk of bleed...
Source: Critical Care Nursing Quarterly - Category: Nursing Tags: Original Articles Source Type: research
Authors: Morishita S, Nakano J, Fu JB, Tsuji T Abstract Many studies have reported that physical exercise can improve the levels of function, quality of life (QoL), and fatigue in patients with hematologic malignancies. However, exercises should be prescribed with caution in patients with thrombocytopenia to prevent exercise-related bleeding. Some studies have suggested threshold platelet counts at which physical exercise can safely be performed. Herein, we review the current literature to determine the platelet count thresholds and types of physical exercise that may be prescribed to reduce the risk of exercise-re...
Source: Hematology - Category: Hematology Tags: Hematology Source Type: research
ConclusionsWe identified diabetes and hyperlipidemia as potential risk factors for development of high BK viremia and/or BKVN. IVIG was seen to be effective in reducing viral titers. The period 3–9 months post-transplantation was identified as important for development of BKVN from high BK viremia.
Source: Microbial Pathogenesis - Category: Infectious Diseases Source Type: research
Publication date: Available online 21 February 2020Source: Pharmacological ResearchAuthor(s): Xuanyan Cai, Jiajia Wang, Jincheng Wang, Qian Zhou, Bo Yang, Qiaojun He, Qinjie WengAbstractLiver fibrosis is a dynamic wound-healing process characterized by the net accumulation of extracellular matrix. There is no efficient antifibrotic therapy other than liver transplantation to date. Activated hepatic stellate cells (HSCs) are the major cellular source of matrix-producing myofibroblasts, playing a central role in the initiation and progression of liver fibrosis. Paracrine signals from resident and inflammatory cells such as h...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research
Authors: Kim MS, Kim GH, Lee CH, Park JS, Lee JY, Tae K Abstract Objectives: The aim of this study was to evaluate the effectiveness of subtotal parathyroidectomy for patients with renal hyperparathyroidism. Methods: We studied 25 patients with renal hyperparathyroidism who underwent subtotal parathyroidectomy from October 2002 to October 2017. We analyzed serum intact parathyroid hormone (iPTH), calcium, and inorganic phosphorus levels before and at multiple time points following surgery, and evaluated the surgical outcomes and complications. Results: Of the 25 patients, 13 (52%) were male and 12 (48%) wer...
Source: Clinical and Experimental Otorhinolaryngology - Category: ENT & OMF Tags: Clin Exp Otorhinolaryngol Source Type: research
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