Citations

Extravascular lung water (EVLW) is a basic symptom of congestive heart failure and other conditions. Computed tomography (CT) is standard method used to assess EVLW, but it requires ionizing radiation and radiology facilities. Lung ultrasound reverberation artifacts called B-lines have been used to assess EVLW. However, analysis of B-line artifacts depends on expert interpretation and is subjective. Lung ultrasound surface wave elastography (LUSWE) was developed to measure lung surface wave speed. This pilot study aimed at measureing lung surface wave speed due to lung water in an ex vivo swine lung model. The surface wave speeds of a fresh ex vivo swine lung were measured at 100 Hz, 200 Hz, 300 Hz, and 400 Hz. An amount of water was then filled into the lung through its trachea. Ultrasound imaging was used to guide the water filling until significant changes were visible on the imaging. The lung surface wave speeds were measured again. It was found that the lung surface wave speed increases with frequency and decreases with water volume. These findings are confirmed by experimental results on an additional ex vivo swine lung sample.

AbstractFor patients who qualify, simultaneous bilateral total knee arthroplasty (TKA) is a viable option for the treatment of bilateral symptoms. However, the incidence of chronic obstructive pulmonary disease (COPD) has been steadily rising over the past few decades and may impact those who qualify as candidates for bilateral TKA. As such, the aim of this study was to determine the impact of COPD on postoperative outcomes in patients who receive simultaneous bilateral TKA. A retrospective cohort study was conducted utilizing data provided through the American College of Surgeons National Surgical Quality Improvement Program. All patients who had undergone simultaneous bilateral TKA between 2007 and 2016 were identified and further stratified into groups based upon the COPD status. Incidence of adverse events after TKA in the acute postoperative period was evaluated with univariate and multivariate analyses. COPD was found to be an independent risk factor for the development of major (odds ratio [OR]: 2.5; p = 0.015), renal (OR: 5.1; p = 0.02), and thromboembolic complications (OR: 2.5; p = 0.027). In addition, patients with COPD were at increased risk for having an extended hospital length of stay (LOS; p < 0.001) and development of urinary tract infections (p < 0.001). Patients with COPD are at higher risk for development of overall major complications, as well as renal and thromboembolic complications after simultaneous bilateral TKA. Interestingly, patients were not at increased risk for the development of pulmonary or wound complications. When considering a staged versus simultaneous bilateral TKA, surgeons should be aware of the impact COPD status has on the postoperative complication rate.

AbstractBackgroundSignificant numbers of patients in the USA and UK die while waiting for solid organ transplant. Only 1–2% of deaths are eligible as donors with a fraction of the deceased donating organs. The form of consent to donation may affect the organs available. Forms of consent include: opt‐in, mandated choice, opt‐out, and organ conscription. Opt‐in and opt‐out are commonly practiced. A systematic review was conducted to determine the effect of opt‐in versus opt‐out consent on the deceased donation rate (DDR) and deceased transplantation rate (DTR).MethodsLiterature searches of PubMed and EMBASE between 2006 and 2016 were performed. Research studies were selected based on certain inclusion criteria which include USA, UK, and Spain; compare opt‐in versus opt‐out; primary data analysis; and reported DDR or DTR. Modeled effect on US transplant activity was conducted using public data from Organ Procurement and Transplantation Network and Centers for Disease Control WONDER from 2006 to 2015.ResultsA total of 2400 studies were screened and six studies were included. Four studies reported opt‐out consent increases DDR by 21–76% over 5–14 years. These studies compared 13–25 opt‐out countries versus 9–23 opt‐in countries. Three studies reported opt‐out consent increases DTR by 38–83% over 11–13 years. These studies compared 22–25 opt‐out versus 22–28 opt‐in countries. Modeled opt‐out activity on the USA resulted in 4753–17,201 additional transplants annually.ConclusionOpt‐out consent increases DDR and DTR and may be useful in decreasing deaths on the waiting list in the USA and other countries.Registration numberPROSPERO CRD42019098759.

In this work related to familial aggregation of familial venous thromboembolism, the investigators report genomic and transcriptomic association of 16 novel susceptibility loci for venous thromboembolism.