Is rejection a diffuse or localized process in small-bowel transplantation?

Utilization of endoscopy to both visualize and selectively biopsy an intestinal allograft has become the standard for early recognition and treatment of intestinal allograft rejection. Despite the widespread acceptance of the need for selective mucosal biopsies, it has not been shown that the histological features of intestinal allograft rejection are either localized or occur as part of a more diffuse phenomenon within a tubular allograft. To resolve these issues, 88 ileoscopies were performed in 12 small-bowel allograft recipients and mucosal biopsy samples were obtained at 5, 10, and 15 cm, respectively, from the ileal stoma. Each mucosal biopsy was labeled, processed, and evaluated individually for the presence and severity of any evidence for allograft rejection. The data obtained suggest that intestinal allograft rejection is a diffuse process, and biopsies obtained randomly from an ileal graft are likely to demonstrate evidence of allograft rejection when such is present. © 1994 Springer-Verlag New York Inc

Quality Improvement in Liver Transplant Anesthesia: Early Extubation in the Operating Room

Presented as a poster at Indiana Society of Anesthesiologists Annual Meeting 2021

Medication Non-Adherence: An Invisible Epidemic An Exploration of Factors Contributing to the Psychology of Scarcity in an Urban Population of Disadvantaged Type 2 Diabetics

This thesis is an exploration of the stressors taxing mental bandwidth among disadvantaged patients with type 2 diabetes at an urban health center in central New Jersey. Though rates of medication non-adherence in the present study were significantly lower than found in studies with similar populations (Kuo et al., 2003; Parada, Horton, Cherrington, Ibarra, & Ayala, 2012; Sclar et al., 1999), lack of social support was found to be positively associated with greater medication non-adherence. This relationship suggests a need for sustained tangible support interventions that allow patients to ¿offload,¿ onto others, some of the chores taxing their mental bandwidths. Objective treatment complexity has been positively associated with medication nonadherence in the literature, as it has with increased cognitive load (Boff, Kaufman & Thomas, 1994; Salthouse, 1992). Our results suggest perceived treatment complexity may also affect medication non-adherence and might benefit from further study. Positive associations between comparatively rated health status, mood, and concern about medications with perceived treatment complexity suggest the potential need to address these variables specifically in adherence improvement efforts. Lastly, we emphasize the need for low bandwidth strategies, namely reminders, to overcome scarcity and improve medication adherence

Redistribution or Crony Capitalism? Favoritism in Public Procurement Contract Award Processes

status: publishe

Usage of HCV viremic organs in liver transplantation to anti-HCV negative recipients: The current status and review of literature

Liver transplantation is the main curative therapy for end-stage liver disease. The number of transplanted organs is increasing globally. However, the number of available organs in the pool is insufficient, considering the excessive number of patients on the waiting list, which is a major concern for transplant programs. Hepatitis C infection (HCV) is a common indication for liver transplantation, and in recent years, a major progress has been made in its treatment with direct-acting antiviral (DAA) agents. HCV-positive livers have been transplanted to HCV-positive recipients for a long time. The high rate of sustained virologic response through DAA has brought new treatment options for the patients during the pre- and post-transplantation periods. Recently, there have been few reports of transplanting the available HCV-positive organs to HCV noninfected recipients. However, there is not yet an agreement on the optimal selection of patients who would benefit from such transplantation, and this has become a current topic of interest. Thus, we aim to review the current literature on this evolving topic

Human Rights References in Norway’s Readmission Agreements: (How) Do They Protect?

orway is a country with one of the highest numbers of readmission agreements in Europe, concluded with a view to ‘combat’ irregular migration and to facilitate return procedures. Despite the widespread perception that such agreements in a sense are human rights ‘neutral’, this article takes as starting point that the return of irregular migrants is one of the most vexed aspects of migration management, raising not only questions of cooperation between states, but also issues of the protection, safety and dignity of migrants. This article is the first to explore the extent to which Norway’s more than 30 readmission agreements take an international human rights law approach. It analyses their scope of application; their specific and general human rights commitments; and issues linked to the return of specific groups of persons. It finds that there are considerable differences between Norway’s readmission agreements when it comes to human rights protection, and that even seemingly subtle differences can have important human rights implications. It argues for an overall stronger human rights focus in the drafting and implementation of readmission agreements, and suggests ways in which future agreements be designed with a view to better achieving human rights in practice