ABSTRACT
BACKGROUND AND AIMS: Most portal vein thromboses (PVT) in cirrhotics are discovered incidentally. While case series demonstrate improved portal vein patency with anti-coagulation, there is little information on impact of PVT on morbidity and mortality. This study aimed to compare morbidity and mortality in cirrhotics with untreated PVT with those without PVT. MATERIAL AND METHODS: Cirrhotics evaluated for orthotopic liver transplant in a single large transplant center were prospectively followed. Subjects had contrast CT or MRI at initial evaluation and serial imaging every 6 months until transplantation, removal from the list or death. Univariate and multivariate Cox regression analysis were used to assess associations between new PVT and factors of interest. RESULTS: Of the 290 prospectively followed cirrhotics who met inclusion criteria, PVT was detected in 70 (24.1%)-47 had PVT at the time of initial evaluation and 23 developed one during the pre-transplant study period. A third of the patients with PVT had re-canalization or spontaneous resolution of thrombus while awaiting transplantation. There was no difference in the pre or posttransplant mortality between cirrhotics with and without PVT. CONCLUSION: Cirrhotics with untreated PVT fared equally well as those without PVT before and after transplantation. Further studies with larger numbers of patients are needed to determine if anticoagulation therapy truly improves outcomes in cirrhotics with portal vein thrombosis.
Subject(s)
Liver Cirrhosis/surgery , Liver Transplantation , Portal Vein , Venous Thrombosis/epidemiology , Aged , Chi-Square Distribution , Female , Humans , Incidence , Kaplan-Meier Estimate , Liver Cirrhosis/diagnosis , Liver Cirrhosis/mortality , Liver Transplantation/adverse effects , Liver Transplantation/mortality , Magnetic Resonance Angiography , Male , Middle Aged , Multivariate Analysis , Ohio/epidemiology , Phlebography/methods , Portal Vein/diagnostic imaging , Portal Vein/pathology , Proportional Hazards Models , Prospective Studies , Remission, Spontaneous , Risk Factors , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Venous Thrombosis/diagnosis , Venous Thrombosis/mortality , Waiting ListsABSTRACT
The heavy cluster knockout reaction (16)O((12)C,2(12)C)(4)He performed for the first time, reveals the true nature of the (12)C-(12)C interaction. The observed cross section is enhanced by almost 2 orders of magnitude over the conventional zero range distorted wave impulse approximation (DWIA) predictions. An attractive (12)C-(12)C optical potential, as obtained in the folding model, does not explain the enhanced cross section in the finite range (FR) DWIA framework. The inclusion of a hard core of fairly long range â¼3.65 fm explains the data. The present investigation of (16)O((12)C,2(12)C)(4)He along with the (12)C-(12)C elastic scattering also proves beyond doubt that the folding model's deep attractive heavy ion potentials are unsuitable to describe the highly overlapping heavy ions. The application of FR-DWIA opens up new avenues to use the heavy core knockout for the detailed investigation of heavy as well as Borromean halo nuclei.
ABSTRACT
Zygomycosis is a rare but emerging mycosis. Because of the sub-optimal efficacy of the standard antifungal treatment for this disease, hyperbaric oxygen (HBO) has been used occasionally as an adjunctive therapeutic modality. A review of 28 published cases of zygomycosis indicates that adjunctive HBO may be beneficial in diabetic patients (94% survival), whereas its benefit in the small group of patients with haematological malignancies or bone marrow transplants is doubtful (33% survival; p 0.02). Prolonged courses of HBO were associated with a higher survival (100% survival; p 0.003). Additional studies are required to assess the optimal timing and dose for HBO treatment.
