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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The recent threat of post-transfusion AIDS and increased awareness of blood-related hepatitis have compelled surgeons to minimize the use of homologous blood products during aortic aneurysm repair. Reducing or eliminating homologous blood transfusion can be achieved by aggressive attention to three aspects of patient care: (1) routine use of autologous transfusion; (2) careful surgical technique, emphasizing the minimum dissection needed to expose the aneurysm adequately; and (3) a higher threshold for use of any blood products. In a prospective study of 100 consecutive aortic reconstructions, 80 per cent of patients undergoing aneurysm repair received only their own blood during hospitalization. Routine intraoperative autologous red-cell salvage has also conserved the bank blood supply by reducing usage of homologous blood by 75 per cent. The key to minimizing homologous blood requirements for aneurysm repair has been the development of rapid cell-washing autotransfusion devices.
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PMID:Minimizing the use of homologous blood products during repair of abdominal aortic aneurysms. 266 48

A fusiform thoracoabdominal aortic aneurysm involving celiac, superior mesenteric and renal arteries was successfully replaced in a 53-year-old female with Marfan's syndrome who also had annuloaortic ectasia, dissecting aneurysm of descending aorta and bilateral subclavian arterial aneurysms. Exposure of the aneurysm was obtained with a thoracoabdominal incision by reflecting the abdominal viscera to the right. First the limbs of a 24 X 12mm dacron bifurcated prosthesis were attached to common iliac arteries in an end-to-side fashion. Then renal arteries were anastomosed end-to-end to the branches previously attached to the body of the prosthesis. With the temporary bypass from left subclavian to left limb of the dacron graft, reconstruction of the celiac and superior mesenteric arteries was performed by direct suture of orifices to the opening made in the graft. Proximal anastomosis between descending aorta and the graft was made in an end-to-end fashion. The dissecting lesion of the proximal descending aorta was wrapped by dacron mesh. The immediate postoperative course was uneventful except transient hepatitis and pneumonia. The patient was discharged 49 days after operation. One month later, however, she died suddenly. Autopsy could not reveal the exact cause of death. Retrograde revascularization combined with Crawford's method was useful in shortening the occlusion time.
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PMID:[Surgical treatment of fusiform thoracoabdominal aortic aneurysm with Marfan's syndrome. A report on reconstruction of 4 major abdominal visceral branches]. 398 78

Seven patients are described in whom chronic Q fever was detected by serology (Coxiella burneti phase I antibody titre greater than 1:200) during routine screening at admission for cardiac catheterisation. None had clinical evidence of endocarditis, hepatitis or other foci of infection. Three of the patients were kept under observation without antibiotic treatment for periods of six, 18 and 20 months. In two patients of this group, cardiac tissue was obtained at operation and in one patient seroconversion following guinea-pig inoculation indicated the presence of Coxiella burneti infection. Four patients were given antibiotic treatment when Q fever was confirmed by serology. Courses of antibiotic treatment with a combination of two drugs were maintained for four to six years and in three of these patients phase I antibody titres fell to very low levels with no appearance of overt infection. The fourth patient died after resection of an aortic aneurysm, seven months after starting antibiotic treatment. Cases reported in the literature indicate that while endocarditis is the most common manifestation of chronic Q fever, the infection can persist at other sites. Of the seven cases of subclinical chronic Q fever reported here, the infection was localised in only one. Patients with this subclinical form of infection pose the therapeutic dilemma of whether or not they should receive antibiotic treatment.
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PMID:Subclinical chronic Q fever. 408 Sep 56

Transplant tourism, a form of transplant commercialization, has resulted in serious short-term adverse outcomes that explain reduced short-term kidney allograft survival. However, the nature of longer-term outcomes in commercial kidney transplant recipients is less clear. To study this further, we identified 69 Canadian commercial transplant recipients of 72 kidney allografts transplanted during 1998 to 2013 who reported to our transplant center for follow-up care. Their outcomes to 8 years post-transplant were compared with 702 domestic living donor and 827 deceased donor transplant recipients during this period using Kaplan-Meier survival plots and multivariate Cox regression analysis. Among many complications, notable specific events included hepatitis B or C seroconversion (7 patients), active hepatitis and/or fulminant hepatic failure (4 patients), pulmonary tuberculosis (2 patients), and a type A dissecting aortic aneurysm. Commercial transplantation was independently associated with significantly reduced death-censored kidney allograft survival (hazard ratio 3.69, 95% confidence interval 1.88-7.25) along with significantly delayed graft function and eGFR 30 ml/min/1.73 m(2) or less at 3 months post-transplant. Thus, commercial transplantation represents an important risk factor for long-term kidney allograft loss. Concerted arguments and efforts using adverse recipient outcomes among the main premises are still required in order to eradicate transplant commercialization.
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PMID:Commercial kidney transplantation is an important risk factor in long-term kidney allograft survival. 2708 75