05 ± 0.25 mg/dL vs 1.1 ± 0.39 mg/dL (P= .224) at 7, 30, and 365 days after transplantation. The estimated glomerular filtration rate at 1 year was 88 ± 18.2 vs 83 ± 12.2 mL/min/1.73 m
(P= .004). The mean donor operative times in groups A and B were 175.9 ± 24.9 minutes vs 199.88 ± 37.06 minutes (P= .0001), respectively, and the mean warm ischemia time was 5.2 ± 1.02 minutes vs 3.64 ± 1.38 minutes, respectively (P= .0001). The mean body mass index, the incidence of complex vascular anatomy, and the rate of complications were the same in the 2 donor groups.
The outcome of kidney transplantation after LESS DN is comparable to conventional LDN. LESS DN can be employed as the primary approach for kidney donation with low donor risk and without compromising recipient outcomes.
The outcome of kidney transplantation after LESS DN is comparable to conventional LDN. LESS DN can be employed as the primary approach for kidney donation with low donor risk and without compromising recipient outcomes.
Simultaneous pancreas-kidney (SPK) transplantation can be complicated by thrombosis in the early post-transplant period.
We performed a single-center retrospective study examining risk factors, management, and outcomes of modern era SPK transplants. We reviewed 235 recipients over 10 years (January 1, 2008, to September 1, 2017). We used multivariate analysis to examine donor, recipient, and operative risk factors for thrombosis.
Forty-one patients (17%) had a thrombosis diagnosed on postoperative imaging, but 61% of these patients (n= 25/41) did not lose their graft secondary to the thrombosis. Nine patients (22%) were managed with watchful waiting and serial imaging, 12 (29%) were managed with therapeutic anticoagulation, and 4 (10%) required laparotomy and graft thrombectomy. Sixteen of 235 pancreas grafts (6.8%) required pancreatectomy, and 10 of these cases occurred in the first half of the study, before 2012. The risk of thrombosis leading to graft loss increased 11.2-fold in recipients with a body mass index (calculated as weight in kilograms divided by height in meters squared) > 25 compared with others (odds ratio, 11.2; 95% CI, 1.1-116.7; P= .043).
The majority of SPK transplants (61%) complicated by thrombosis of the pancreatic graft were salvaged by use of imaging, anticoagulation, and in select cases, laparotomy and graft thrombectomy.
The majority of SPK transplants (61%) complicated by thrombosis of the pancreatic graft were salvaged by use of imaging, anticoagulation, and in select cases, laparotomy and graft thrombectomy.This paper studies the fixed-time stability of attitude coordination control for spacecraft formation flying (SFF) in the presence of some external disturbance. Firstly, to ensure that the states converge to the origin within a fixed time, a novel nonsingular terminal sliding mode surface (NTSMS) is designed. The convergence time is bounded by some predefined constants. Secondly, an attitude synchronization controller is proposed based on the designed NTSMS, which guarantees the fixed-time stability of SFF under an undirected communication topology. Finally, a fixed-time adaptive control law is designed for cases in which the boundary of the external disturbance is unknown. The fixed-time stability is guaranteed by a revised form of the proposed NTSMS. Simulation results show that the proposed controllers provide fixed-time stability and outperform existing finite-time controllers.Electrocardiogram (ECG) signals are used to diagnose cardiovascular diseases. During ECG signal acquisition, various noises like power line interference, baseline wandering, motion artifacts, and electromyogram noise corrupt the ECG signal. learn more As an ECG signal is non-stationary, removing these noises from the recorded ECG signal is quite tricky. In this paper, along with the proposed denoising technique using stationary wavelet transform, various denoising techniques like lowpass filtering, highpass filtering, empirical mode decomposition, Fourier decomposition method, discrete wavelet transform are studied to denoise an ECG signal corrupted with noise. Signal-to-noise ratio, percentage root-mean-square difference, and root mean square error are used to compare the ECG signal denoising performance. The experimental result showed that the proposed stationary wavelet transform based ECG denoising technique outperformed the other ECG denoising techniques as more ECG signal components are preserved than other denoising algorithms.Fibrinogen is a complex protein playing a major role in coagulation. Congenital afibrinogenemia, characterized by the complete absence of fibrinogen, is associated with major hemostatic defects. Even though the clinical course is unpredictable and can be completely different among patients, severe bleeding is the prominent symptom. Patients are also at increased risk of thrombosis and sometimes suffer from spontaneous spleen rupture, bone cysts and defective wound healing. Due to the relative rarity of afibrinogenemia, there are no evidence-based strategies for helping physicians in care of these patients. Fibrinogen supplementation is the keystone to prevent or treat bleeding events. In addition, fibrinogen, a pleiotropic protein with numerous physiological roles in immunity, angiogenesis and tissue repair, is involved in many diseases. Indeed, depletion of fibrinogen in animal models of infections, tumors and neurological diseases has an effect on the clinical course. The consequences for patients with afibrinogenemia still need to be investigated.Cardiac sympathetic denervation (CSD) for refractory ventricular tachycardia (VT) has been shown to decrease VT recurrence and defibrillator shocks in patients with ischemic and nonischemic cardiomyopathy. Here and in the accompanying Video, we demonstrate the technique for minimally invasive CSD, highlight important technical points, and report surgical outcomes. CSD is accomplished through bilateral resection of the inferior one-third to one-half of the stellate ganglion en bloc with T2-T4 sympathectomy. Despite the high potential for perioperative risk, most patients do not have serious complications. We find that surgical CSD can be performed safely in an attempt to liberate patients from refractory VT.learn more
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