Impact of the Pre-Transplant Circulatory Supportive Strategy on Post-Transplant Outcome: Double Bridge May Work

Background: The number of waitlisted patients requiring mechanical circulatory support (MCS) as a bridge to heart transplantation is increasing. The data concerning the results of the double-bridge strategy are limited. We sought to investigate the post-transplant outcomes across the different bridge strategies. Methods: We retrospectively reviewed a heart transplantation database from Jan 2009 to Jan 2019. Intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), and ventricular assist devices (VAD) were the MCS that we investigated. The pre- and post-transplant characteristics and variables of patients bridged with the different types of MCS were collected. The post-transplant survival was compared using Kaplan–Meier survival analysis. Results: A total of 251 heart transplants were reviewed; 115 without MCS and 136 with MCS. The patients were divided to five groups: Group 1 (no MCS): n = 115; Group 2 (IABP): n = 15; Group 3 (ECMO): n = 33; Group 4 (ECMO-VAD): double-bridge (n = 59); Group 5 (VAD): n = 29. Survival analysis demonstrated that the 3-year post-transplant survival rates were significantly different among the groups (Log-rank p < 0.001). There was no difference in survival between group 4(ECMO-VAD) and group 1(no MCS)1 (p = 0.136), or between group 4(ECMO-VAD) and group 5(VAD) (p = 0.994). Group 3(ECMO) had significantly inferior 3-year survival than group 4(ECMO-VAD) and group 5(VAD). Conclusion: Double bridge may not lead to worse mid-term results in patients who could receive a transplantation. Initial stabilization with ECMO for critical patients before implantation of VAD might be considered as a strategy for obtaining an optimal post-transplant outcome.

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Impact of the Pre-transplant Circulatory Supportive Strategy on Post-transplant Outcome: Double Bridge May Work

10.20944/preprints202109.0106.v1 ◽

2021 ◽

Author(s):

Nai-Kuan Chou ◽

Heng-Wen Chou ◽

Chuan-I Tsao ◽

Chih-Hsien Wang ◽

Shu-Chien Huang ◽

...

Keyword(s):

Survival Analysis ◽

Heart Transplantation ◽

Ventricular Assist Devices ◽

Transplant Outcome ◽

Transplant Survival ◽

Post Transplant ◽

Group 4 ◽

Group 3 ◽

Group 5 ◽

Group 1

BACKGROUND: The number of waitlisted patients requiring mechanical circulatory support (MCS) as a bridge to heart transplantation is increasing. The data concerning the results of double-bridge strategy are limited. We sought to investigate the post-transplant outcomes across the different bridge strategies. METHODS: We retrospectively reviewed a heart transplantation database from Jan 2009 to Jan 2019. Intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), and ventricular assist devices (VAD) were the MCS that we investigated. The pre- and post-transplant characteristics and variables of patients bridged with the different types of MCS were collected. The post-transplant survival was compared using Kaplan-Meier survival analysis. RESULTS: A total of 251 heart transplants were reviewed; 115 without MCS and 136 with MCS. The patients were divided to five groups: Group 1 (no MCS): n=115; Group 2 (IABP): n=15; Group 3 (ECMO): n=33; Group 4 (ECMO-VAD): double-bridge (n=59); Group 5 (VAD): n=29. Survival analysis demonstrated that the 3-year post-transplant survival rates were significantly different among the groups (Log-rank p < 0.001). There was no difference in survival between group 4(ECMO-VAD) and group 1(no MCS)1 (p = 0.136), or between group 4(ECMO-VAD) and group 5(VAD) (p = 0.994). Group 3(ECMO) had significantly inferior 3-year survival than group 4(ECMO-VAD) and group 5(VAD). CONCLUSION: Double bridge may not lead to worse mid-term results in patients who could receive a transplantation. Initial stabilization with ECMO for critical patients before implantation of VAD might be considered as a strategy for obtaining an optimal post-transplant outcome.

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Does Perioperative Hemoglobin A1c Level Affect the Incidence, Pattern and Mortality of Lower Extremity Amputation?

Current Vascular Pharmacology ◽

10.2174/1570161116666180123112529 ◽

2019 ◽

Vol 17 (4) ◽

pp. 354-364

Author(s):

Hassan Al-Thani ◽

Moamena El-Matbouly ◽

Maryam Al-Sulaiti ◽

Noora Al-Thani ◽

Mohammad Asim ◽

...

Keyword(s):

Glycemic Control ◽

Lower Extremity ◽

Hazard Ratio ◽

Lower Extremity Amputation ◽

Group 4 ◽

Group 3 ◽

Group 5 ◽

Group 2 ◽

Extremity Amputation ◽

Group 1

Background: We hypothesized that perioperative HbA1c influenced the pattern and outcomes of Lower Extremity Amputation (LEA). Methods: A retrospective analysis was conducted for all patients who underwent LEA between 2000 and 2013. Patients were categorized into 5 groups according to their perioperative HbA1c values [Group 1 (<6.5%), Group 2 (6.5-7.4%), Group 3 (7.5-8.4%), Group 4 (8.5-9.4%) and Group 5 (≥9.5%)]. We identified 848 patients with LEA; perioperative HbA1c levels were available in 547 cases (Group 1: 18.8%, Group 2: 17.7%, Group 3: 15.0%, Group 4: 13.5% and Group 5: 34.9%). Major amputation was performed in 35%, 32%, 22%, 10.8% and 13.6%, respectively. Results: The overall mortality was 36.5%; of that one quarter occurred during the index hospitalization. Mortality was higher in Group 1 (57.4%) compared with Groups 2-5 (46.9%, 38.3%, 36.1% and 31.2%, respectively, p=0.001). Cox regression analysis showed that poor glycemic control (Group 4 and 5) had lower risk of mortality post-LEA [hazard ratio 0.57 (95% CI 0.35-0.93) and hazard ratio 0.46 (95% CI 0.31-0.69)]; this mortality risk persisted even after adjustment for age and sex but was statistically insignificant. The rate of LEA was greater among poor glycemic control patients; however, the mortality was higher among patients with tight control. Conclusion: The effects of HbA1c on the immediate and long-term LEA outcomes and its therapeutic implications need further investigation.

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Donor Recipient Chimeric Cells Induce Chimerism and Extend Survival of Vascularized Composite Allografts

Archivum Immunologiae et Therapiae Experimentalis ◽

10.1007/s00005-021-00614-9 ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Joanna Cwykiel ◽

Arkadiusz Jundzill ◽

Aleksandra Klimczak ◽

Maria Madajka-Niemeyer ◽

Maria Siemionow

Keyword(s):

Bone Marrow ◽

Bone Marrow Cells ◽

Fluorescent Microscopy ◽

Study Endpoint ◽

Solid Organ ◽

Post Transplant ◽

Group 4 ◽

Cell Based Therapy ◽

Group 3 ◽

Group 1

AbstractThis study evaluated the efficacy of donor recipient chimeric cell (DRCC) therapy created by fusion of donor and recipient derived bone marrow cells (BMC) in chimerism and tolerance induction in a rat vascularized composite allograft (VCA) model. Twenty-four VCA (groin flaps) from MHC-mismatched ACI (RT1a) donors were transplanted to Lewis (RT1l) recipients. Rats were randomly divided into (n = 6/group): Group 1—untreated controls, Groups 2—7-day immunosuppression controls, Group 3—DRCC, and Group 4—DRCC with 7-day anti-αβTCR monoclonal antibody and cyclosporine A protocol. DRCC created by polyethylene glycol-mediated fusion of ACI and Lewis BMC were cultured and transplanted (2–4 × 106) to VCA recipients via intraosseous delivery route. Flow cytometry assessed peripheral blood chimerism while fluorescent microscopy and PCR tested the presence of DRCC in the recipient’s blood, bone marrow (BM), and lymphoid organs at the study endpoint (VCA rejection). No complications were observed after DRCC intraosseous delivery. Group 4 presented the longest average VCA survival (79.3 ± 30.9 days) followed by Group 2 (53.3 ± 13.6 days), Group 3 (18 ± 7.5 days), and Group 1 (8.5 ± 1 days). The highest chimerism level was detected in Group 4 (57.9 ± 6.2%) at day 7 post-transplant. The chimerism declined at day 21 post-transplant and remained at 10% level during the entire follow-up period. Single dose of DRCC therapy induced long-term multilineage chimerism and extended VCA survival. DRCC introduces a novel concept of customized donor-recipient cell-based therapy supporting solid organ and VCA transplants.

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Association between serum oestradiol level on the hCG administration day and neonatal birthweight after IVF-ET among 3659 singleton live births

Scientific Reports ◽

10.1038/s41598-021-85692-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yu Liu ◽

Jing Li ◽

Wanyu Zhang ◽

Yihong Guo

Keyword(s):

Birth Weight ◽

Ovarian Stimulation ◽

Group 4 ◽

Group 6 ◽

Group 3 ◽

Group 5 ◽

Group 2 ◽

The Impact ◽

Ivf Et ◽

Group 1

AbstractOestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E2 levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E2 levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.

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Timing of melatonin treatment: differential effects on oestrus and coat growth in goats

Animal Science ◽

10.1017/s135772980001657x ◽

1997 ◽

Vol 65 (2) ◽

pp. 267-273 ◽

Cited By ~ 4

Author(s):

I. A. Forsyth ◽

F. E. Gebbie ◽

J. Arendt

Keyword(s):

Goat Milk ◽

Normal Weight ◽

Ovarian Activity ◽

Plasma Prolactin ◽

Dairy Goats ◽

Group 4 ◽

Group 3 ◽

Group 5 ◽

Group 2 ◽

Group 1

AbstractTo avoid winter scarcity of fresh goat milk, simple methods of advancing the season of kidding would be commercially valuable. A combination of long-day light treatment followed by melatonin is successful but other aspects of seasonality including coat growth are also reset. To investigate whether effects on breeding season and coat growth can be dissociated, British Saanen dairy goats (no. = 30) were randomly allocated to one of six groups. Control goats were untreated. Goats in the other five groups received 2 months of treatment with 20 h light: 4 h darkness (20L: 4D) and were then given 3 mg melatonin orally at 16.00 hfor 2 months. The treatments started on 11 January (group 1), 29 March (group 2), 14 June (group 3), 30 August (group 4) and 8 November (group 5). Weekly blood samples were taken for the measurement of progesterone to monitor ovarian activity and prolactin. Side patches (10 cm ×10 cm) were clipped monthly from alternate sides and weighed to measure coat growth. The onset of ovarian activity was advanced from a median date of 15 November in controls to 24 May in group 1 (P < 0·01), 16 August in group 2 (P < 0·05) and 18 October in group 3 (? < 0·05). Groups 4 and 5 showed no significant change in the onset of oestrus (median onset dates 8 November and 1 November, respectively). Group 1 goats came into season again with controls in November. In all except group 5, treatment interacted with time to affect significantly the growth of the coat. The pattern of coat growth was most altered (P < 0·001) in groups 1 and 2. This was associated with effects on plasma prolactin concentrations of light stimulation and melatonin suppression. Group 1 goats resynchronized with control goats to show a coat of normal weight in the winter following treatment. Division of milking goat herds into spring and autumn kidding groups is, therefore, a practical possibility, but effects on overall milk yield require study.

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THE EFFECTS OF SLAUGHTER WEIGHT AND SEX ON THE COOKING LOSSES FROM AND PALATABILITY ATTRIBUTES OF PORK LOIN CHOPS

Canadian Journal of Animal Science ◽

10.4141/cjas84-005 ◽

1984 ◽

Vol 64 (1) ◽

pp. 39-43 ◽

Cited By ~ 7

Author(s):

L. E. JEREMIAH ◽

G. M. WEISS

Keyword(s):

Key Words ◽

Slaughter Weight ◽

Cooking Properties ◽

Group 4 ◽

Practical Standpoint ◽

Group 3 ◽

Pork Loin ◽

Group 5 ◽

Group 2 ◽

Group 1

A total of 130 barrows and 113 gilts were slaughtered over a range of liveweights from 65.6 to 143.9 kg. These animals were randomly assigned to six different liveweight groups (group 1, less than 79.5 kg; group 2, 79.5 through 93.1 kg; group 3, 93.2 through 106.7 kg; group 4, 106.8 through 120.4 kg; group 5, 120.5 through 134.0 kg; and group 6, 134.1 kg and over) and utilized to evaluate the effects of slaughter weight and sex on palatability and cooking properties. The composite results indicated that the slaughter weight of both barrows and gilts can, from a practical standpoint, be increased to take advantage of potential economic advantages without meaningfully altering cooking losses or palatability attributes. Key words: Pork, slaughter weight, sex, palatability, cooking losses

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Fracture resistance of incisal tooth fragment reattached with different adhesive materials and retentive techniques

Revista Odonto Ciência ◽

10.15448/1980-6523.2017.4.28095 ◽

2018 ◽

Vol 32 (4) ◽

pp. 163

Author(s):

Fábio Herrmann Coelho-de-Souza ◽

Guilherme Fossá ◽

Flávia Ávila Pereira ◽

Celso Afonso Klein-Júnior ◽

Maria Carolina Guilherme Erhardt ◽

...

Keyword(s):

Bond Strength ◽

Fracture Resistance ◽

Shear Bond Strength ◽

Composite Resin ◽

Adhesive System ◽

Group 4 ◽

Group 3 ◽

Group 5 ◽

Adhesive Materials ◽

Group 1

OBJECTIVE: This study evaluated in vitro the shear bond strength of experimentally fractured human tooth fragments reattached with different adhesive materials and retentive techniques.METHODS: Forty-eight sound mandibular incisors were randomly divided into 6 groups (n=8). Their incisal edges were cut off in 5 groups, representing an enamel-dentin fracture. Intact teeth were used as control (Group 1). The fragment edges were reattached with adhesive system (Scotch Bond Multipurpose – 3M ESPE) (Group 2), adhesive system and composite resin (ICE – SDI) (Group 3), adhesive system and composite resin with circumferential bevel (Group 4), adhesive system and composite resin with internal dentin groove (Group 5), and adhesive system and composite resin with the circumferential bevel and internal dentin groove (Group 6). Shear bond strength was determined in a universal testing machine. Fracture modes were identified by light microscope. Kruskal-Wallis was used to analysis resistance to fracture and fracture patterns.RESULTS: The results showed statistically significant differences (p<0.05) among groups. The intact teeth (Group 1) showed higher fracture resistance than the other groups. Groups 2 and 6 did not differ and were statistically superior to other techniques. Group 4 presented statistically higher than in Group 5, which in turn was more resistant than Group 3.CONCLUSIONS: None of the fragment reattachment techniques was able to achieve the strength of sound teeth. Fragments reattached only with adhesive system or with adhesive system and composite resin with the circumferential bevel and internal dentin groove showed the best performance for resistance to fracture.

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Zingerone Ameliorates Hepatotoxicity

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i1.1817 ◽

2020 ◽

Vol 11 (1) ◽

pp. 280-284 ◽

Cited By ~ 1

Author(s):

Julietpoornamathy J ◽

Parameswari C.S.

Keyword(s):

The Body ◽

Control Group ◽

Medical Sciences ◽

Toxic Compounds ◽

Group 4 ◽

Group 3 ◽

Group 5 ◽

Group 2 ◽

Insight Into ◽

Group 1

In medical sciences, toxicity is an area wherein extensive studies have been carried to improve the diseases as well as to prevent. So, there is a high requirement for novel and improved alternative therapeutic strategies to manage diseases. The liver is the largest gland in the body, which executes several important mechanisms; it stores minerals and vitamins and releases them in periods of need. The main aim of this study was to give a closer insight into potent non- toxic compounds that is capable of modifying the responses. Animals were divided into five equal groups viz control (Group 1), administered with food and water ad libitum, (Group 2) administered with olive oil, (Group 3) administered with zingerone, (Group 4) administered with concanavalin A, (Group 5) administered with cyclosporine A followed by zingerone. Our results revealed significant changes in liver marker enzymes and liver histology of zingerone treated rats when compared to control rats. A corollary, zingerone has no toxic effect on hepatocytes and was found to be safe at a dose of 10mg/kg b wt and also ameliorates hepatotoxicity.

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NMO-IgG and Devic's neuromyelitis optica: a French experience

Multiple Sclerosis Journal ◽

10.1177/1352458507084595 ◽

2008 ◽

Vol 14 (4) ◽

pp. 440-445 ◽

Cited By ~ 82

Author(s):

Romain Marignier ◽

Jérôme De Sèze ◽

Sandra Vukusic ◽

Françoise Durand-Dubief ◽

Hélène Zéphir ◽

...

Keyword(s):

Multiple Sclerosis ◽

Staining Pattern ◽

Transverse Myelitis ◽

Group 4 ◽

Acute Transverse Myelitis ◽

Group 3 ◽

Group 5 ◽

Group 2 ◽

Devic’S Neuromyelitis Optica ◽

Group 1

Background A serum autoantibody biomarker, NMO-IgG has been recently described in patients with Devic's neuromyelitis optica (DNMO) and so called `high-risk' patients for this disease. Our objectives were to replicate the test and to assess its usefulness. Methods Indirect immunofluorescence with a substrate of adult rat cerebellum and midbrain was used to identify the distinctive NMO-IgG staining pattern. We tested masked sera from 26 patients with DNMO (group 1), 21 patients with idiopathic acute transverse myelitis (ATM) (group 2), 21 patients with bilateral and/or recurrent idiopathic optic neuritis (group 3), 52 patients with classical multiple sclerosis (MS) (group 4), 36 patients with HTLV-1 infection (group 5) and 7 patients with miscellaneous disorders (group 6). Results We identified a vascular staining pattern typical of NMO-IgG. This particular staining was observed in 14/26 samples in group 1, 7/21 in group 2 (positive only in longitudinally extensive acute transverse myelitis: 7/13), 4/21 in group 3 (with bilateral loss of vision in all seropositive cases), 5/52 in group 4 (none of them suggestive of DNMO), 0/36 in group 5 and 0/7 in group 6. Sensitivity of the test was 54% considering detection of DNMO (group 1), and specificity was respectively 94% and 90% when considering groups 4, 5 and 6 altogether or group 4 of MS patients only. Conclusion Detection of NMO-IgG is contributory to the distinction of DNMO and `DNMO high-risk' syndromes from MS. This test may allow earlier diagnosis and help therapeutic decisions. Multiple Sclerosis 2008; 14: 440—445. http://msj.sagepub.com

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Low Dose X-Ray Sources and High Quantum Efficiency Sensors: The Next Challenge in Dental Digital Imaging?

Radiology Research and Practice ◽

10.1155/2014/543524 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7

Author(s):

Arnav R. Mistry ◽

Daniel Uzbelger Feldman ◽

Jie Yang ◽

Eric Ryterski

Keyword(s):

Low Dose ◽

Image Resolution ◽

X Ray ◽

Imaging Technologies ◽

Group 4 ◽

X Ray Imaging ◽

Group 3 ◽

Group 5 ◽

Group 2 ◽

Group 1

Objective(s). The major challenge encountered to decrease the milliamperes (mA) level in X-ray imaging systems is the quantum noise phenomena. This investigation evaluated dose exposure and image resolution of a low dose X-ray imaging (LDXI) prototype comprising a low mA X-ray source and a novel microlens-based sensor relative to current imaging technologies.Study Design. A LDXI in static (group 1) and dynamic (group 2) modes was compared to medical fluoroscopy (group 3), digital intraoral radiography (group 4), and CBCT scan (group 5) using a dental phantom.Results. The Mann-Whitney test showed no statistical significance(α=0.01)in dose exposure between groups 1 and 3 and 1 and 4 and timing exposure (seconds) between groups 1 and 5 and 2 and 3. Image resolution test showed group 1 > group 4 > group 2 > group 3 > group 5.Conclusions. The LDXI proved the concept for obtaining a high definition image resolution for static and dynamic radiography at lower or similar dose exposure and smaller pixel size, respectively, when compared to current imaging technologies. Lower mA at the X-ray source and high QE at the detector level principles with microlens could be applied to current imaging technologies to considerably reduce dose exposure without compromising image resolution in the near future.

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