In high-risk patients the autologous transposed brachiobasilic fistula has equivalent patency and lower complication rates than those reported for polytetrafluoroethylene interposition grafts.

BACKGROUND & AIMS:Nonalcoholic steatohepatitis (NASH) is associated with an increase in healthcare resource use and poor health-related quality of life (HRQoL). We assessed the humanistic and economic burden of NASH, disease management, and patient journey. METHODS:We performed a cross-sectional analysis of data, collected from July through November 2017, from the Growth from Knowledge Disease Atlas Real-World Evidence program, reported by physicians in United States, France, and Germany. We extracted demographic and medical data from medical records. Some patients voluntarily completed a survey that provided information on disease history, treatment satisfaction, and patient-reported outcomes. RESULTS:We analyzed data from 1216 patients (mean age, 54.9-12.3 years; 57.5% male; mean body mass index, 31.7-6.9); 64.6% had biopsy-confirmed NASH and comorbidities were recorded for 41.3%. Treatments included lifestyle modification (64.6%) or use of statins (25.0%), vitamin E (23.5%), or metformin (20.2%). Patients with biopsy-confirmed NASH reported more physician (4.5 vs 3.7) and outpatient visits (1.8 vs1.4) than patients with suspected NASH not confirmed by biopsy. Among the 299 patients who completed the survey, 47.8% reported various symptoms associated to their NASH. Symptomatic patients reported significantly lower HRQoL than patients without symptoms. CONCLUSIONS:In an analysis of data from 3 countries, we found NASH to be associated with regular use of medical resources; patients with symptoms of NASH had reduced HRQoL. The burden of NASH appears to be underestimated. Studies are needed to determine the burden of NASH by fibrosis stage and disease severity.

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In September 1998, a 48 year old male underwent bilateral renal transplantation from a 51 year old non-heart beating donor (NHBD) with ischemic heart disease. The grafts exhibited delayed graft function, otherwise short term results have been good, with a three month serum creatinine of 80 mumol/l, three month GFR of 79 ml/min per 1.73 m2 BSA, and no episodes of acute rejection. We advocate dual transplantation when sub-optimal NHBD kidneys are otherwise in danger of being discarded.

In September 1998, a 48 year old male underwent bilateral renal transplantation from a 51 year old non-heart beating donor (NHBD) with ischemic heart disease. The grafts exhibited delayed graft function, otherwise short term results have been good, with a three month serum creatinine of 80 pmol/l, three month GFR of 79 ml/min per 1.73m2 BSA, and no episodes of acute rejection. We advocate dual transplantation when sub-optimal NHBD kidneys are otherwise in danger of being discarded.

guided me through this process and taught me so much, but made this an enjoyable experience as well. With her help, I have grown both professionally and personally. I would also like to thank Dr. Mary Clyde Pierce for her insight into the clinical problem that inspired this project and for helping me see the importance of this research and its iv ABSTRACT The purpose of this study was to determine the risk of severe head and neck injury in short distance falls for a 12-month-old child. A series of free falls and falls from standing were experimentally simulated using an instrumented anthropomorphic test device (ATD) representing a 12-month-old child. Three different falls heights, five different impact surfaces, and two levels of joint stiffness were tested to determine their effect on injury risk. Linear head accelerations were measured and angular head accelerations were calculated using the base of the neck as the pivot point. Head Injury Criteria (HIC) values and impact durations were also determined for each fall. Neck loads were measured and used to compute N ij values to be compared with injury thresholds.The falls from standing generally were associated with a greater head injury risk than the free falls. In the free falls, ground-based falls were associated with a greater head injury risk than the higher fall heights tested. However, for the falls from standing, greater falls heights were associated with a greater head injury risk. Head injury risk also increased with stiffer surfaces and was greater for tightened joints than for joints adjusted to normal specifications. Neck injury risk also tended to increase with greater fall

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