Liver cell therapy: is this the end of the beginning?

The prevalence of liver diseases is increasing globally. Orthotopic liver transplantation is widely used to treat liver disease upon organ failure. The complexity of this procedure and finite numbers of healthy organ donors have prompted research into alternative therapeutic options to treat liver disease. This includes the transplantation of liver cells to promote regeneration. While successful, the routine supply of good quality human liver cells is limited. Therefore, renewable and scalable sources of these cells are sought. Liver progenitor and pluripotent stem cells offer potential cell sources that could be used clinically. This review discusses recent approaches in liver cell transplantation and requirements to improve the process, with the ultimate goal being efficient organ regeneration. We also discuss the potential off-target effects of cell-based therapies, and the advantages and drawbacks of current pre-clinical animal models used to study organ senescence, repopulation and regeneration

How to perform a below knee amputation

Eventhough modem techniques have improved patient survival and limb salvage rates in patients with critical limb ischaemia and end-stage vascular disease, amputation is sometimes the only possible treatment. In younger patients with traumatic avulsion of a foot, infected gangrene of the foot or a peripheral tumour, amputation is out of discussion and commonly accepted. In older vascular patients, amputation should rather be considered as the starting point for revalidation and rehabilitation than as failure of a revascularization technique. The evolution in prostheses permits a rapid revalidation in most patients. However, an accurate amputation technique is still required to produce a good quality stump allowing early fitting of prosthetics

Cost-benefit analysis of endovascular versus open abdominal aortic aneurysm treatment

Objective: To compare the costs and benefits of open versus endovascular repair of abdominal aortic aneurysm (AAA). Methods: a consecutive series of 29 elective patients (open treatment, N = 20 and endovascular treatment, N = 9) were compared retrospectively. Results: operating time was significantly shorter for endovascular treatment (mean 90 vs. 125 min, p = 0,026). No endovascular procedure was converted to open surgery; one early endoleak was seen which sealed spontaneously. Endovascular treatment resulted in a shorter ICU and hospital stay (0 days vs. 2 days, p.0,001 and 5 days vs. 11 days, p = 0,01 respectively). Mean total cost did not differ 361 938 BEF (9 048 Euro) vs. 382 995 BEF (9 575 Euro), p = 0,46. Endovascular treatment generated significantly less hospitalization costs (73 162 BEF or 1 829 Euro vs. 18 2740 BEF or 4 568 Euro, p = 0,001) but required a more expensive implant (153 293 BEF or 3 832 Euro vs. 38 296 BEF or 957 Euro, p = 0,001). Mean total cost for the patient was significantly higher in the endovascular treatment group (66 309 BEF or 1 658 Euro vs. 24969 BEF or 624 Euro, p = 0,003). Conclusion : our experience confirms the feasibility and safety of endovascular AAA treatment. It is associated with a shorter ICU and hospital stay and less morbidity. Overall cost for society does not differ significantly as the benefit of lower hospitalization costs is undone by the high cost of the endovascular graft

Single-stage angioplasty and vascular reconstruction

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Discovery of a Novel and Selective Indoleamine 2,3-Dioxygenase (IDO-1) Inhibitor 3-(5-Fluoro-1 H -indol-3-yl)pyrrolidine-2,5-dione (EOS200271/PF-06840003) and Its Characterization as a Potential Clinical Candidate

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