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We report the risks and benefits of utilizing HIV-positive organ donors.

The utilization of HIV-positive organs came with significant concerns including poor organ quality, increased risk of rejection, HIV disease progression, transmission of varying HIV strains and opportunistic infections, virologic failure due to antiretroviral resistance, increased risk for posttransplant malignancy, and recurrent HIV-associated nephropathy. Recently published data have shown, however, that despite the above mentioned risks, patient survival, and graft survival in persons living with HIV (PLWH) who received a kidney transplant from a HIV-positive donor (D+/R+) is similar to a kidney transplant from a HIV-negative donor (D-/R+).

To date, 268 PLWH have received an organ from a HIV-positive donor, including 198 kidney transplants and 70 liver/liver-kidney transplants. The utilization of HIV-positive donor organs has proven to be a safe and feasible approach to expanding the donor pool and improving access to lifesaving therapy for PLWH with end-stage organ disease.

To date, 268 PLWH have received an organ from a HIV-positive donor, including 198 kidney transplants and 70 liver/liver-kidney transplants. The utilization of HIV-positive donor organs has proven to be a safe and feasible approach to expanding the donor pool and improving access to lifesaving therapy for PLWH with end-stage organ disease.

Hemorrhagic shock (HS) and trauma induce endothelial barrier compromise, inflammation, and aberrant clotting. We have shown that fresh human platelets (Plts) and Plt extracellular vesicles mitigate vascular leak in murine models of injury. Here, we investigate the potential of freeze-dried platelets (FDPlts) to attenuate pulmonary vascular permeability, decrease inflammation, and promote clotting in a murine model of HS.

Human FDPlts were characterized using in vitro assays of Plt marker expression, aggregation, coagulation, and endothelial cell permeability. An intravital model of vascular injury in the mouse cremaster muscle was used to assess the ability of FDPlts to incorporate into clots. Mouse groups subjected to controlled hemorrhage for 90 minutes were (1) lactated Ringer solution (LR), (2) FDPlts, (3) fresh human Plts, (4) murine whole blood (WB), and (5) shams (only instrumented). Hemorrhagic shock mouse endpoints included coagulation, pulmonary vascular permeability, and lung injury.

Freeze-dble alternative to fresh Plts in modulating hemostasis and the endotheliopathy associated with injury.

FDPlts contribute to clot formation similar to fresh human Plts. FDPlts also attenuated vascular permeability in vitro and in vivo. Mouse WB resuscitation but not fresh human Plts attenuated vascular permeability after HS. These data suggest that the effect of FDPlts may be a suitable alternative to fresh Plts in modulating hemostasis and the endotheliopathy associated with injury.

Falls are the leading cause of traumatic brain injury (TBI) and TBI-related deaths for older persons (age, ≥65 years). Antiplatelet and/or anticoagulant therapy (antithrombotics [ATs]) is generally felt to increase this risk, but the literature is inconsistent. The purpose of this study was to determine the impact of AT use on the rate, severity, and outcomes of TBI in older patients following ground level falls.

Ground level fall patients from 90 hospitals’ trauma registries were selected. Patients were excluded if younger than 65 years or had an Abbreviated Injury Scale score of >2 in a region other than head. Electronic medical record data for preinjury AT therapy were obtained. Patients were grouped by regimen for no AT, single, or multiple agents. Groups were compared on rates of diagnosed TBI, TBI surgery, and mortality.

There were 33,710 patients (35% male; mean age, 80.5 years; mean Glasgow Coma Scale, 14.6), with 47.6% on single or combination AT therapy. read more The proportion of patients with TBI t, level II.

Therapeutic/care management, level II.

A recent guideline emphasizes the role of four indicators, including annular e´ velocity, E/e´, left atrial (LA) size, and peak tricuspid regurgitation (TR) velocity, in the assessment of left ventricular (LV) diastolic dysfunction. This study was performed to determine the relationships among these four parameters and obstructive coronary artery disease (CAD).

The study data were obtained from a nation-wide registry, composed of 1307 patients (age, 60.4 ± 10.8 years; 964 women) with normal LV ejection fraction (LVEF) who underwent invasive coronary angiography in the suspicion of CAD. Septal e´, E/e´, LA dimension (LAd), and TR velocity were assessed by transthoracic echocardiography.

Compared with patients without obstructive CAD, those with obstructive CAD showed changes in diastolic parameters indicating more progressed LV diastolic dysfunction in univariate analyses. In multiple logistic regression analysis, low septal e´ velocity (<7 cm/s) was identified as an independent risk factor associated with obstructive CAD (odd ratio, 1.91; 95% confidence interval, 1.08-3.36; P = 0.026). Receiver-operating characteristic curve analysis showed that septal e´ velocity had the most powerful value in the detection of obstructive CAD than the other three diastolic parameters (P < 0.01 for each comparison). Septal e´ velocity significantly increased diagnostic value of treadmill exercise test (TET) in the detection of obstructive CAD (P < 0.001 for integrated discrimination improvement index).

Among the four diastolic parameters, septal e´ velocity had the most powerful relationship with obstructive CAD in stable patients with normal LVEF. The addition of septal e´ velocity could improve the diagnostic value of TET.

Among the four diastolic parameters, septal e´ velocity had the most powerful relationship with obstructive CAD in stable patients with normal LVEF. The addition of septal e´ velocity could improve the diagnostic value of TET.

Patients with acute coronary syndrome (ACS) have about a three-fold risk for developing contrast-induced acute kidney injury(CI-AKI). Investigating studies on routine hydration therapy have frequently included patients with stable coronary artery disease and high risk of CI-AKI [estimated glomerular filtration rate (eGFR) < 60 ml/min]. However, data on routine hydration treatment in non-ST segment elevation myocardial infarction (NSTEMI) patients with eGFR ≥60 ml/min are insufficient. We aimed to investigate the association between routine hydration therapy and CI-AKI development in NSTEMI patients at low risk for nephropathy.

We randomly assigned a total of 401 NSTEMI patients to two groups the routine hydration group (198 patients) and the nonhydration group (control group) (203 patients). Intravenous hydration with isotonic saline (1 ml/kg/h, 0.9% sodium chloride) was given for 3-12 h before and 24 h after contrast exposure to the hydration group. CI-AKI was defined as the increase in serum creatinine values 0.