Repeat coronary angioplasty: Correlates of a second restenosis

AbstractTo identify the correlates of a second restenosis after repeat percutaneous coronary angioplasty, the records of 384 patients with single vessel disease who underwent repeat angioplasty for restenosis complicating a first elective angioplasty were examined. A second restenosis occurred in 47 (31%) of 151 patients having angiographic follow-up. Univariate correlates of a second restenosis were an interval between the first and the second angioplasty <5 months (41 versus 20% of patients had restenosis, p < 0.01), male gender (35 versus 12%, p < 0.05), lesion length ≥15 mm before the second angioplasty (62 versus 28%, p < 0.05), diameter stenosis >90% before the second angioplasty (67 versus 29%, p < 0.05), final gradient >20 mm Hg after the second angioplasty (52 versus 28%, p < 0.05) and an additional site requiring dilation at the time of the second angioplasty (50 versus 29%, p = 0.10).Multivarlate predictors of a second restenosis were an interval of <5 months between the first and the second angioplasty (p = 0.001), male gender (p = 0.001), lesion length ≥15 mm before the second angioplasty (p = 0.001) and the need to have an additional site dilated at the time of the second angioplasty (p = 0.002). Patients at increased risk of restenosis after the second angioplasty can be identified and may serve as a useful population for intervention studies

A Novel Approach in Combined Liver and Kidney Transplantation With Long-term Outcomes

Objective: The aim of this study was to compare the outcomes of simultaneous and delayed implantation of kidney grafts in combined liver-kidney transplantation (CLKT). Background Data: Delayed function of the renal graft (DGF), which can result from hypotension and pressor use related to the liver transplantation (LT), may cause worse outcomes in CLKT. Methods: A total of 130 CLKTs were performed at Indiana University between 2002 and 2015 and studied in an observational cohort study. All kidneys underwent continuous hypothermic pulsatile machine perfusion until transplant: 69 with simultaneous kidney transplantation (KT) (at time of LT, group 1) and 61 with delayed KT (performed at a later time as a second operation, group 2). All patients received continuous veno-venous hemodialysis during the LT. Propensity score match analysis in a 1: 1 case-match was performed. Results: Mean kidney cold ischemia time was 10 +/-3 and 50 +/-15 hours, for groups 1 and 2 (P 48 hours (P< 0.01). Patient survival was greater in group 2 at 1 year (91%), and 5 year (87%) post-transplantation (P = 0.0019). On multivariate analysis, DGF [hazard ratio (HR), 165.7; 95% confidence interval (CI), 9.4-2926], extended criteria donor kidneys (HR, 15.9; 95% CI 1.8-145.2), and recipient hepatitis C (HR, 5.5; 95% CI 1.7-17.8) were significant independent risk factors for patient survival. Conclusions: Delayed KT in CLKT (especially if delayed > 48 h) is associated with improved kidney function with no DGF post-KT, and improved patient and graft survival

Rapidly scalable mechanical ventilator for the COVID-19 pandemic

The SARS-CoV-2 pandemic is straining healthcare systems worldwide, and a global ventilator shortage is fueling the dire situation. As a response, the MIT E-Vent Team (S1) manufactured a scalable ventilator prototype for mass production and demonstrated basic clinical feasibility

Processes in Pathogenic Biocolloidal Contaminants Transport in Saturated and Unsaturated Porous Media: A Review

There are several classes of subsurface colloids, abiotic and biotic. Basically, small particles of inorganic, organic and pathogenic biocolloids variety exist in natural subsurface system. Transport of these pathogenic biocolloidal contaminants (Viruses, bacteria and protozoa) pose a great risk in water resources and have caused large outbreaks of waterborne diseases. Biocolloid transport processes through saturated and unsaturated porous media is of significant interest, from the perspective of protection of groundwater supplies from contamination, assessment of risk from pathogens in groundwater and for the design of better water treatment systems to remove biocolloids from drinking water supplies This paper has reviewed the large volume of work that has already been done and the progress that has been made towards understanding the various basic multi-processes to predicting the biocolloid transport in saturated and unsaturated porous media. There are several basic processes such as physical, chemical and biological processes which are important in biocolloid transport. The physical processes such as advection, dispersion, diffusion, straining and physical filtration, adsorption and biological processes such as growth/decay processes and include active adhesion/detachment, survival and chemotaxis are strongly affected on biocolloid transport in saturated and unsaturated porous media.The unsaturated zone may play an important role in protecting aquifers from biocolloidal contamination by retaining them in the solid phase during their transport through the zone. Finally, author here highlighted the future research direction based on his critical review on biocolloid transport in saturated and unsaturated porous media