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The purpose of this study was to evaluate the association between aortic endograft diameter and long-term outcomes following endovascular aneurysm repair (EVAR) performed in accordance with manufacturer instructions for use (IFU).A retrospective review of consecutive patients undergoing on-IFU EVAR (2000-2018) was performed to facilitate a comparative analysis of long-term patient outcomes based on device diameter. "Large diameter" devices were defined as34 mm. The primary outcome of interest was freedom from sac expansion throughout long-term follow-up. Analyses included standard bivariate analyses, Kaplan-Meier with log-rank comparison, and Cox proportional hazards multivariate analysis.A total of 1,099 underwent on-IFU EVAR from 2000-2018. Follow-up data were available for 980 patients. Of these, 75 patients (7.6%) were treated with34-mm devices. There were no significant differences in demographics or comorbidities between the 2 groups, although preoperative abdominal aortic aneurysm size was greater in patients undergoing implantation of34-mm devices (58 ± 8.5 mm vs. 56 ± 17.4 mm; P = 0.05). Median follow-up was 10.3 years. Patients with grafts34 mm had reduced freedom from sac expansion throughout follow-up (P = 0.038). There were no significant differences in reintervention rates, open conversion, or rupture when stratified by graft diameter. A multivariate Cox regression identified patient age, preoperative abdominal aortic aneurysm size, need for reintervention, and use of34-mm endografts as independent factors associated with expansion.The use of large diameter aortic endografts is associated with higher rates of sac expansion during long-term follow-up. Although there is undoubtedly a role for large diameter graft use in selected patients, it is important to recognize that these devices were typically approved post hoc without the same regulatory scrutiny of smaller endografts. These findings underscore the importance of ongoing surveillance for patients treated with34-mm grafts, irrespective of compliance with manufacturer IFU.

Market researchers are used to asking questions. It is their job to query and probe “to gather information about markets or customers” (McQuarrie, 2016), but how adept are they at turning those questions inward? Have health care-related market researchers synthesized what is currently known about health literacy to inform their study designs or their participant recruitment goals?

A hemodialysis patient with insulin-dependent diabetes mellitus and a non-functioning renal allograft in whom fever, low blood pressure, and confusion developed is reported. She underwent extensive evaluation and allograft nephrectomy for emphysematous pyelonephritis that was diagnosed by the presence of air in the collecting system of the transplanted kidney during computerized tomography of the abdomen. In nine patients with emphysematous pyelonephritis in renal allografts reported previously, this is the first instance of emphysematous pyelonephritis in a renal allograft with coagulase-negative staphylococcus.

The cornea consists of three important layers, from the point of view of barrier properties. Two outer layers are cellular membranes which have characteristic high perm-selectivity. Under normal conditions, over 85% of the thickness is occupied by the corneal stroma. The corneal stroma seems to be a simpler barrier material than cellular membranes; however, because of its structure the stroma has a strong tendency to imbibe water and swells in the direction of the thickness. A theory based on the thermodynamic consideration of surface activity is developed in this paper to explain the imbibing property of the stroma, and the transport of water across the cornea is examined by the principles of irreversible thermodynamics. A bulk flow of water occurs in the cornea if a pressure gradient, both hydrostatic and osmotic, exists across the cornea. Because of this bulk flow and the selective permeability of the two cellular membranes, neither the flow conductivity measured under pressure; gradient nor the diffusion constant observed under the concentration gradient of solutes alone can account for the transport phenomena across the cornea. Normal corneal thickness and hydration seems to be maintained by the steady state flow of water from aqueous to tears. Any changes in either internal or external conditions which may alter the balance between the inflow and the outflow will shift the steady state flow accompanying the swelling or deswelling of the corneal stroma.

The blood chemistry of fifty normal Rhodesian natives was investigated. The tests made were sugar, chlorides, non-protein nitrogen urea, cholesterol, calcium and phosphorus. Comparison of various groups showed: 1. 1. The possibility of bringing low blood cholesterol figures to the normal value by feeding with cholesterol-rich foods. 2. 2. The probability that low blood cholesterol can be caused by a lack of sufficient cholesterol in the diet. 3. 3. A serious deficiency in calcium intake, with resultant low blood calciums. This is probably due to the following factors: 3.1. (a) A lack of Ca in the soil, and, therefore, in local foods. 3.2. (b) A lack of calcium-rich foods in the average native dietary. 4. 4. A low blood phosphorus in some cases, but not to the same extent as in calcium. 5. 5. Blood sugars and chlorides tend to a low European normal, while N.P.N.'s and ureas are for the most part mid-normal. The low ureas seen in some of the police are probably due to a large consumption of Kaffir beer, which acts as a powerful diuretic.

Milk-borne or transmammary infection has been observed to occur in several host-parasite systems. In the order of their observation, these are Uncinaria lucasi -fur seal; Strongyloides ransomi -swine; Ancylostoma caninum -dog; Toxocara canis -dog; Strongyloides westeri -horse; Neoascaris vitulorum -cow; Strongyloides papillosus -cow and -sheep; and Toxocara cati -cst. Some of these parasites are largely dependent on milk-borne infection of neonatal animals. All have a tissue migratory phase in their life cycle. Most of these parasites also utilize other modes or combinations of modes in infecting new hosts. The potential importance of milk-borne infection as a factor in human hookworm disease is pointed out as is the need for complete assessment of this avenue of infection.

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The rapid curative action of sulfanilamide in cases of inclusion conjunctivitis in infants and adults was described in two previous reports. 1 It was found that infants responded in the first few days of treatment and were usually cured within a week. In adults the papillary type of the disease responded equally rapidly, but in cases with predominant follicular hypertrophy several weeks were required for the conjunctiva to return completely to normal. The inclusion bodies characteristic of the disease could not be found after the first few days of treatment. There were no recurrences in cases in which the treatment was continued six days or longer. Local therapy with 0.8 per cent sulfanilamide solution produced temporary improvement in 1 of 2 cases but failed to effect a cure. In spite of the demonstrable efficacy of the administration of small doses of sulfanilamide over a comparatively short period in curing inclusion

Ophthalmologists in a national survey reported case histories of 14 eyes lost or blinded in patients wearing contact lenses. All of the eye losses were due to infections, four of which were by fungi. There were 157 other eyes permanently damaged and 7,607 with reversible changes. These physiologic and pathologic eye changes indicated the medical problems of diagnosis, treatment, and routine follow-up of these patients.