In India: (i) HBV infection is the predominant factor for the development of HCC, often related to mutant forms of HBV; (ii) a majority of the HCC patients have overt cirrhosis of the liver; and (iii) HCV and alcohol per se are uncommonly associated.
Although the well‐accepted lower limit of the graft‐to‐recipient weight ratio (GRWR) for successful living donor liver transplantation (LDLT) remains 0.80%, many believe grafts with lower GRWR may suffice with portal inflow modulation (PIM), resulting in equally good recipient outcomes. This study was done to evaluate the outcomes of LDLT with small‐for‐size grafts (GRWR <0.80%). Of 1321 consecutive adult LDLTs from January 2012 to December 2017, 287 (21.7%) had GRWR <0.80%. PIM was performed (hemiportocaval shunt [HPCS], n = 109; splenic artery ligation [SAL], n = 14) in 42.9% patients. No PIM was done if portal pressure (PP) in the dissection phase was <16 mm Hg. Mean age of the cohort was 49.3 ± 9.1 years. Median Model for End‐Stage Liver Disease score was 14, and the lowest GRWR was 0.54%. A total of 72 recipients had a GRWR <0.70%, of whom 58 underwent HPCS (1 of whom underwent HPCS + SAL) and 14 underwent no PIM, whereas 215 had GRWR between 0.70% and 0.79%, of whom 51 and 14 underwent HPCS and SAL, respectively. During the same period, 1034 had GRWR ≥0.80% and did not undergo PIM. Small‐for‐size syndrome developed in 2.8% patients. Three patients needed shunt closure at 1 and 4 weeks and 60 months. The 1‐year patient survival rates were comparable. In conclusion, with PIM protocol that optimizes postperfusion PP, low‐GRWR grafts can be used for appropriately selected LDLT recipients with acceptable outcomes.
A clinical association between exacerbation of asthma symptoms and Mycoplasma pneumoniae (M. pneumoniae) infection has long been suspected. We studied 80 children aged 5-15 years; 50 with asthma (Group 1) and 30 without an acute exacerbation of asthma (Group 2) for detection of M. pneumoniae by serology and polymerase chain reaction (PCR) on nasopharyngeal aspirates. Our study confirms that lower respiratory tract infections with M. pneumoniae are frequently associated with exacerbations of asthma in children.
Red blood cell volume was estimated indirectly from plasma volume and venous hematocrit measurements in 262 consecutively delivered premature infants of less than 37 weeks’ gestation. Infants with respiratory distress syndrome averaged lower red cell volumes (P0.02) than those without. Fatal cases had the lowest volumes. There was a 10.3% mortality from RDS (respiratory distress syndrome) among the one third of infants with the smallest red cell volumes, and only a 2.3% mortality among the one third with the largest volumes. Red cell volume was shown to be a direct correlate of time of cord clamping and thereby of the amount of placental transfusion, both in infants with and without RDS. From this study it is probable that delayed cord clamping, by allowing placental transfusion, decreases the risk of death from RDS in premature infants. Delay in clamping the umbilical cord for 1–1.5 min is advised in premature births.
Mycoplasma pneumoniae is known to be the chief causative organism for community-acquired non-lobar pneumonia in children of 5-15 years of age. M. pneumoniae as an aetiological agent for pneumonia among neonates and infants has rarely been reported. We report here a case of persistent pneumonia due to M. pneumoniae in a 3-week-old neonate.
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