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PubMed1995

Comparison of susceptibility to extended-spectrum beta-lactam antibiotics and ciprofloxacin among gram-negative bacilli isolated from intensive care units.

The in vitro activities of extended-spectrum beta-lactam antibiotics (including piperacillin, cefotaxime, ceftriaxone, ceftazidime, cefepime, imipenem, and meropenems) were assessed and compared with the activity of ciprofloxacin against 366 clinical Gram-negative bacilli isolates from the intensive care units of Taichung Veterans General Hospital. The most prevalent species isolated were Pseudomonas aeruginosa and Acinetobacter baumannii. The activities of ceftazidime, cefepime, imipenem, and meropenem against these isolates were comparable to that of ciprofloxacin. Meropenem was found to be the most potent extended-spectrum beta-lactam antibiotic tested and the MIC50s and MIC90s for most of these multiresistant strains were lower than those of imipenem, ceftazidime, and cefepime, except for Stenotrophomonas maltophilia. The extended-spectrum beta-lactam antibiotics that were still active against S. maltophilia were piperacillin and ceftazidime. More than 50% of Enterobacter spp. were resistant to third-generation cephalosporins and piperacillin, but they remained susceptible to carbapenems and cefepime.

Anti-Bacterial Agents↗

PubMed1994

Effects of extended SSD on electron-beam depth-dose curves.

The effects of extended source-to-surface distance (SSD) on the electron-beam depth dose curves were examined for five electron beam energies ranging from 6 MeV to 20 MeV. The depth dose curves were measured with the water phantom surface set at 100 cm, 110 cm, and 120 cm from the source. Except for the dose in the build-up region, negligible depth dose curve changes due to extended SSD were observed for electron energies less than or equal to 12 MeV. For electron beams greater than 12 MeV, the percent surface dose decreases and, additionally, the depth of maximum dose shifts deeper into the phantom as the SSD increases. Changes in the rapid falloff region of the depth dose curves were apparent only for the higher energy electron beams, in particular 20 MeV. Extended SSD has no observable effect on the tail portion of the depth dose curves. As such, the energies of the electron beams are not changed significantly by increasing the SSD.

Electrons↗

PubMedDate not supplied

BPTI and N-terminal extended analogues generated by factor Xa cleavage and cathepsin C trimming of a fusion protein expressed in Escherichia coli.

A recombinant gene for BPTI (bovine pancreatic trypsin inhibitor) is expressed in Escherichia coli using a MBP (maltose-binding protein) fusion vector. BPTI is fused through an FXa (blood coagulation factor Xa protease) target sequence (Ile-Glu-Gly-Arg) to the C-terminus of MBP. The MBP moiety of the hybrid protein enables purification in one step utilizing MBP's affinity to cross-linked amylose, and the FXa target sequence allows specific cleavage of the hybrid protein. Effective FXa cleavage is achieved by spacing the FXa target sequence and Arg-1 of the BPTI sequence with four residues (Met-Glu-Ala-Glu). The resulting N-terminal extended BPTI is readily converted to the wild-type sequence by trimming with cathepsin C exopeptidase, for the activity of which the spacing tetrapeptide is optimized. FXa cleavage is prohibited when the target sequence is placed next to Arg-1. In this construction, off-target cleavage at a somewhat homologous sequence (Val-Pro-Gly-Arg) results in five- or six-residue extended BPTI, indicating new details of the FXa specificity. The yield of highly purified recombinant BPTI is 3-6 mg/liter of culture, making the MBP-BPTI expression system convenient for the production of sufficient amounts of protein for NMR studies. 1H NMR is used to analyze the N-extended BPTI analogues.

Amino Acid Sequence↗

PubMed2005

Road safety impact of extended drinking hours in Ontario.

PURPOSE: On 1 May 1996, Ontario, Canada amended the Liquor Licence Act to extend the hours of alcohol sales and service in licensed establishments from 1 to 2 a.m. The purpose of this study was to evaluate the road safety impact of extended drinking hours in Ontario. METHOD: A quasi-experimental design using interrupted time series with a nonequivalent no-intervention control group was used to assess changes. The analyzed data sets are total and alcohol-related, monthly, traffic fatalities for Ontario, for the 11-12 p.m., 12-1 a.m., 1-2 a.m. and 2-3 a.m. time windows, for Sunday through Wednesday nights and for Thursday through Saturday nights, for 4 years pre- and 3 years post-policy change, compared to neighbouring regions of New York and Michigan. RESULTS: The blood alcohol concentration positive driver fatality trends reflected downward trends for Sunday-Wednesday 12-2 a.m. and Thursday-Saturday 1-2 a.m. for Ontario and downward trends for Thursday-Saturday 12-1 a.m. and 2-3 a.m. for New York and Michigan after the extended drinking hour policy change. Ontario total fatality data showed similar trends to the Ontario blood alcohol positive trends. CONCLUSIONS: The multiple datasets converge in suggesting little impact on BAC positive fatalities with extension of the closing hours. These observations are consistent with other studies of small changes in alcohol availability.

Accidents, Traffic↗

PubMed2005

Effects of extender, incubation temperature, and added seminal plasma on capacitation of cryopreserved, thawed boar sperm as determined by chlortetracycline staining.

The effect on apparent capacitation status of frozen-thawed (FT), washed boar sperm was examined in capacitation-supporting medium at 39 degrees C without added seminal plasma (SP) or supplemented with either 10 or 20% (v/v) boar SP. The thawed sperm from three boars were washed to remove the egg yolk-based freezing medium (EY) and then incubated for 1-8h after addition of SP. Capacitation status of the sperm was determined microscopically using chlortetracycline staining patterns. At 1h after the addition of 10 or 20% (v/v) SP, capacitated sperm decreased from 59.7 to 30.3% and from 59.5 to 26.8%, respectively (P<0.001). Subsequent studies examined the effect of 10% SP on capacitation status of FT sperm extended in either phosphate buffered saline or commercial thawing extender with or without prior washing of sperm to remove EY and incubated at 17 or 39 degrees C. No effect of SP resulted from addition to sperm when EY remained or when the temperature was maintained at 17 degrees C (P>0.1). These results indicate that SP appears able to reverse capacitation of FT boar sperm, but that this effect is dependent on both temperature and composition of the thawing extender.

Animals↗

PubMed2006

The effects of container size, frequency and extended horizontal reach on maximum acceptable weights of lifting for female industrial workers.

In the development of our present manual materials handling (MMH) guidelines (Snook, S.H., Ciriello, V.M., 1991. The design of manual tasks: revised tables of maximum acceptable weights and forces. Ergonomics 34, 1197-1213), the assumption was made that the effects of frequency on maximum acceptable weights (MAWs) of lifting with a large box (hand distance, 38 cm from chest) were similar to that of lifting with a small box (hand distance, 17 cm from chest). The first purpose of the present experiment was to investigate this assumption with female industrial workers. The second purpose was to study the effects of extended horizontal reach lifting (hand distance, 44.6 cm from chest) on MAWs as a confirmation of the results of a previous studies on this variable with males (Ciriello, V.M., Snook, S.H., Hughes, G.J., 1993. Further studies of psychophysically determined maximum acceptable weights and forces. Hum. Factors 35(1), 175-186; Ciriello, V.M., 2003. The effects of box size, frequency, and extended horizontal reach on maximum acceptable weights of lifting. Int. J. Ind. Ergon. 32, 115-120). Lastly, we studied the effects of high frequency (20 lifts/min) on MAWs of lifting. Ten female industrial workers performed 15 variations of lifting using our psychophysical methodology whereby the subjects were asked to select a workload they could sustain for 8h without "straining themselves or without becoming unusually tired weakened, overheated or out of breath". The results confirmed that MAWs of lifting with the large box was significantly effected by frequency. The frequency factor pattern in this study was similar to the frequency pattern from a previous study using the small box (Ciriello, V.M., Snook, S.H., 1983. A study of size distance height, and frequency effects on manual handling tasks. Hum. Factors 25(5), 473-483) for all fast frequencies down to one lift every 2 min with deviations of 7%, 15%, and 13% for the one lift every 5 and 30 min tasks and the one lift in 8h task, respectively. The effects of lifting with an extended horizontal reach decreased MAW 22% and 18% for the mid and center lift and the effects of the 20 lifts/min frequency resulted in a MAW that was 47% of a 1 lift/min MAW. Incorporating these results in future guidelines should improve the design of MMH tasks for female workers.

Female↗

PubMed2006

[Benefit of the extended-release methylphenidate formulations: a comparative study in childhood].

UNLABELLED: Methylphenidate (MPH) is a potential therapeutic tool for Attention Deficit with Hyperactivity Disorders (ADHD). In addition to the immediate-release formulation, Ritalin, two extended-release formulations, Ritalin LA and Concerta are available and allow a once-daily administration. We compared the respective benefits of both formulations for the patients and their family in terms of efficacy, handling and tolerance. PATIENTS AND METHODS: This prospective study was based on 30 children aged 6 to 15 years. All patients had a confirmed ADHD and were efficiently treated with Ritalin. The children were consecutively treated with Ritalin LA and Concerta, with a comparable MPH daily dosage, during 2 months for each molecule. The 3 drugs were evaluated individually and comparatively through a battery of questionnaires submitted to the parents and the teachers of each child. RESULTS: Extended-release MPH efficacy was comparable to the immediate-release formulation, Ritalin. For both of them, the once-daily administration appeared beneficial. Concerta was finally prescribed in 18 children, Ritalin LA in 8 cases and Ritalin in 4 cases. In each case the medical choice was consistent with the parents preference. Concerta was appreciated for its persisting efficacy in late afternoon during homework. Concerta and Ritalin LA did not induce significant adverse effects, especially regarding alimentation and sleep. CONCLUSIONS: MPH therapy in ADHD carries an excellent risk/benefit ratio without addictive induced behaviours. The extended-release MPH formulations provide an improvement for the patients in keeping with Ritalin efficacy through a once-daily administration. Regardless of its formulation, MPH indications and guidelines must be respected.

Adolescent↗

PubMed2005

Extended trochanteric osteotomy for 2-stage revision of infected total hip arthroplasty.

We evaluate the rate of osteotomy healing, implant stability, and eradication of infection when an extended trochanteric osteotomy, with interval placement of an antibiotic-impregnated cement spacer and delayed osteotomy fixation, is used to treat the chronically infected total hip arthroplasty. Thirteen cases were followed for a minimum of 2 years. All patients had complete healing of the extended trochanteric osteotomy within 6 months. At an average follow-up of 39 months, recurrent infection occurred in 3 (23%) patients. Femoral component subsidence of 5 mm occurred in 2 patients, both of which had recurrent infection. Extended trochanteric osteotomy with interval placement of an articulating antibiotic-impregnated cement spacer and delayed osteotomy fixation permits reliable healing of the osteotomy.

Adult↗

PubMed2006

Use of the extended V-Y latissimus dorsi myocutaneous flap for chest wall reconstruction in locally advanced breast cancer.

The extended V-Y latissimus dorsi myocutaneous flap described by Micali and Carramaschi provides an innovative method of closing large anterior chest defects after resection of breast cancer. The technique provides robust chest wall coverage that is able to withstand immediate postoperative radiotherapy. The aim of this article is to confirm the usefulness of the flap's design and describe modifications to the technique. The modifications to technique include: a curvilinear design that recruited more skin for closure in patients with wounds extending laterally or superiorly, routine transposition of latissimus dorsi insertion inferio-medially onto the chest wall to maximize pedicle reach, and the use of small split skin grafts or delayed primary closure if there was tension in closing. Twelve patients who underwent resection of locally advanced breast cancer had immediate chest wall reconstruction with the extended V-Y latissimus dorsi musculocutaneous flap. The V to Y design of the flap's cutaneous island allowed primary closure of chest wound and donor defect. There were no instances of chest wound dehiscence. The chest wounds healed, allowing patients to undergo adjuvant radiotherapy in a mean time interval of 6 weeks after surgery.

Adult↗

PubMed2006

Outcomes after 151 extended transcervical thymectomies for myasthenia gravis.

BACKGROUND: The ideal operative technique for thymectomy in myasthenia gravis (MG) remains controversial. We present the largest series of extended transcervical thymectomy to provide outcomes data to compare with transsternal procedures. METHODS: A retrospective chart review/interview was made of 164 patients operated upon from 1992 to 2004. Complete remission (CR) was defined as asymptomatic off medication for 6 months or asymptomatic on low-dose single-drug therapy (< or = 10 mg/d prednisone or < or = 150 mg/d azathioprine). A modified Osserman classification based upon the Myasthenia Gravis Foundation of America quantitative disease severity score was employed. RESULTS: The overall complication rate was 7.3%, and nearly all procedures were outpatient. Mean age at surgery was 43 years, and mean preoperative Osserman class was 2.3 (21% class 1; 39% class 2; 28% class 3; 12% class 4). Mean length of follow-up was 53 months. Mean postoperative Osserman class was 1.0. Nineteen percent of patients failed to improve. The crude cumulative CR rate was 37% (n = 58). Kaplan-Meier estimates of CR were 43% and 45% at 3 and 6 years, respectively. On multivariate analysis, only preoperative disease severity was significantly (inversely) associated with Kaplan-Meier CR rates. Longer-term follow-up (83 months) of only the earlier patients shows preserved CR rates (46%). CONCLUSIONS: This largest series of extended transcervical thymectomy for MG confirms that the 5-year Kaplan-Meier CR rate is comparable with that obtained after transsternal procedures. Patients with less severe disease have higher CR rates. Complete responses are durable, as the CR rate remains stable with extended follow-up.

Adolescent↗

PubMed2004

Ex-vivo study of flow dynamics and endothelial cell structure during extended hypothermic machine perfusion preservation of livers.

Liver transplantation is often the only effective treatment for end stage liver diseases resulting from cirrhosis, hepatitis, progressive jaundice, and biliary atresia. Hypothermic machine perfusion (HMP) preservation may enhance donor pool by extending preservation time and reclaiming marginal donor livers including those from non-heart beating donors (NHBD), as demonstrated in the kidney. However, current HMP protocols have not been successful in improving extended preservation of livers and the major cause of preservation injury remains unknown. An intravital microscopy study was conducted to understand the flow dynamics of sinusoidal perfusion during 24h HMP with cold modified University of Wisconsin (UW) solution. Fluorescein isothiocynate (FITC) labeled albumin was utilized to visualize microvascular space and FITC labeled red blood cells (RBCs) were used to visualize flow dynamics during HMP. A heterogeneous flow pattern with regions of red cell stasis was observed after 24-h HMP. To examine the cause of red cell stasis, intravital and confocal microscopy studies of endothelial cells (ECs) structure labeled with DiI acetylated low-density lipoprotein (DiI acLDL) were conducted. These studies suggest that morphological changes in EC structures occurred during 24h HMP, which may cause obstruction to the sinusoidal flow. Histological findings confirm these results. As a result, heterogeneous flow pattern, red cell stasis, and edema occur, which may lead to the failure of these tissues following extended HMP.

Adenosine↗

PubMed2005

Extended pulmonary resections of advanced thoracic malignancies with support of cardiopulmonary bypass.

OBJECTIVE: Complete resection of advanced pulmonary malignancies infiltrating the heart or the great vessels may require the application of cardiopulmonary bypass (CPB). Extracorporal circulation, however, is known to cause lung injury and may be harmful especially in pneumonectomies. METHODS: Over a period of 10 years extended pulmonary resections requiring cardiopulmonary bypass were analyzed in a retrospective study. RESULTS: From August 1993 to August 2003, 13 patients underwent an extended pulmonary resection for curative indications, requiring support by CPB. Underlying diseases were sarcomas (n=8), non-small cell lung carcinomas (n=3), and others (n=2). Pneumonectomies were performed in nine and lobectomies in four cases. In the majority of cases, several cardiac structures, predominantly the left atrium (n=9), were affected. In four patients (31%), the indication for a CPB-supported procedure was not electively planned, but made intraoperatively. Complete en-bloc resection (R0) was achieved in 12 of 13 cases (92%). The 30-day mortality rate was 15% (n=2). Major complications observed were acute lung injury (n=4), right heart failure (n=1), and multi-organ failure (n=1). The cumulative survival at 1, 3, and 5 years in patients presenting with sarcomas was 62.5% compared to 33%, 0%, and 0%, respectively, in patients with non-small cell carcinoma (n=3). CONCLUSIONS: Our results encourage the application of CPB in extended pulmonary resections to achieve complete resections. In carefully selected patients, especially those with sarcomas, the radical surgical procedure associated with increased pulmonary complications allows for significantly prolonged survival and quality of life.

Adult↗

PubMed2006

Complete stable remission after extended transsternal thymectomy in myasthenia gravis.

OBJECTIVE: This study sought to determine the efficacy and prognostic factors of extended transsternal thymectomy as a treatment for myasthenia gravis (MG). METHODS: Medical records of 147 patients who underwent extended transsternal thymectomy for MG from January 1991 to December 2002 were reviewed retrospectively. The complete stable remission (CSR) rate and prognostic factors for CSR were assessed in 106 female and 41 male patients. RESULTS: The median age was 35 years (range 11-75 years). Ninety-eight patients had non-thymomatous MG and 49 patients had thymomatous MG. The median follow-up time was 89.7 months (range 12-167 months). Both non-thymomatous MG and thymomatous MG exhibited significant differences in population characteristics and CSR rates (29.6% vs 13.3% at 5 years, 45.2% vs 27.7% at 10 years, p = 0.022). Steroid therapy (hazard ratio: 0.234, p = 0.003) was a poor prognostic factor, while early onset (hazard ratio: 3.519, p = 0.048) was a good prognostic factor for CSR in non-thymomatous MG. In contrast, steroid therapy (hazard ratio: 0.061, p = 0.034) was poor prognostic factor for thymomatous MG. CONCLUSIONS: Extended transsternal thymectomy is a good treatment tool to achieve CSR in MG. Thymomatous MG and non-thymomatous MG were significantly different in patient characteristics and prognosis. Prognostic factors were steroid therapy and age of onset in non-thymomatous MG, and steroid therapy in thymomatous MG.

Adolescent↗

PubMed2004

Social adjustment in generalised anxiety disorder: a long-term placebo-controlled study of venlafaxine extended release.

The objective of this analysis was to evaluate the short- (8 weeks) and long-term (24 weeks) efficacy of three fixed doses of venlafaxine extended release (ER) and placebo on the social adjustment of patients with generalised anxiety disorder (GAD). We analysed data from 544 outpatients who participated in a 24-week, double-blind, multicentre, parallel-group, placebo-controlled study conducted at 55 centres in five countries. All patients meet the DSM-IV criteria for GAD and were randomly assigned to receive venlafaxine ER 37.5, 75, and 150 mg or matched placebo administered orally once daily. Social adjustment was measured using the Social Adjustment Scale-Self Report, which explores social adaptation in the areas of work, social and leisure, extended family, primary relationship (marital), parental, and family unit. At baseline, the GAD patients had a high level of social dysfunction. Venlafaxine ER showed a dose-related improvement in social impairment during short-term treatment and in sustaining this improvement over the long-term. In the most severely socially impaired subgroup, placebo remission rates on the HAM-A were low, and the magnitude of the venlafaxine-placebo difference on the mean HAM-A total score was high, reaching more than 7 points. The benefits of venlafaxine ER treatment of GAD extend beyond that of improvement of anxiety symptoms to a significant improvement in the impairment of functioning that is associated with the illness.

Adjustment Disorders↗

PubMed2005

Extended 12-core prostate biopsy increases both the detection of prostate cancer and the accuracy of Gleason score.

OBJECTIVE: To evaluate the effect of extended 12-core prostate biopsy in improving the detection rate of prostate cancer and increasing the accuracy of Gleason score. METHODS: This study included 113 patients who underwent TRUS-guided lateral sextant biopsy (group I) and 176 patients who underwent extended 12-core biopsy (group II). Inclusion criteria for prostate biopsy were elevated serum PSA levels (>3.0 ng/ml) and/or suspicious digital rectal examination (DRE). RESULTS: Clinical characteristics were similar in both groups. Cancer was detected in 28 (24.8%) and 64 (36.4%) patients in group I and II respectively, chi2=4.26, p=0.039. Among patients with cancer in group I, 14 were treated by radical prostatectomy (RP). The median Gleason sum was 6 (range 3-8) and 7 (range 5-9) for needle and prostatectomy specimens respectively. There was an agreement between the biopsy and prostatectomy Gleason sum in 7 (50%) patients while the biopsy Gleason sum was lower in 7 (50%) cases. Among patients with cancer in group II, 27 were treated by RP. The median and the range of Gleason sum was the same for needle and prostatectomy specimen (median 6, range 4-9). There was an agreement between the biopsy and prostatectomy specimen in 23 (85.2%) patients while the biopsy sum was lower than prostatectomy in 4 (14.8%) patients. The agreement between the biopsy and prostatectomy specimen was significantly higher in group II (82.5%) than group I (50%), Fisher's Exact Test, p=0.026. CONCLUSION: Extended 12-core prostate biopsy significantly increases both the detection rate of prostate cancer and the accuracy of biopsy Gleason score.

Aged↗

PubMed2005

Extended longevity and insulin signaling in adipose tissue.

Caloric restriction and leanness have been shown to increase longevity in organisms ranging from yeast to mammals. Adipose tissue seems to be a pivotal organ in the aging process and in determination of lifespan. We have recently shown that fat-specific disruption of the insulin receptor gene is sufficient to increase lifespan in FIRKO mice, suggesting that reduced adiposity, even in the presence of normal or increased food intake, can extend lifespan. The model also suggests a special role for the insulin-signaling pathway in adipose tissue in the longevity process. Reduced fat mass has an impact on the duration of life in several other model organisms. In Drosophila, a specific reduction in the fat body through overexpression of forkhead type transcription factor (dFOXO) extends lifespan. Furthermore, sirtuin1 (SIRT1), the mammalian ortholog of the life-extending yeast gene silent information regulator 2 (SIR2), was proposed to be involved in the molecular mechanisms linking lifespan to adipose tissue. In the control of human aging and longevity, one of the striking physiological characteristics identified in centenarians is their greatly increased insulin sensitivity even compared with younger individuals. The effect of reduced adipose tissue mass on lifespan could be due to the prevention of obesity-related metabolic disorders including type 2 diabetes and atherosclerosis.

Adipose Tissue↗

PubMed2005

Effectiveness of two-sided UV-C treatments in inhibiting natural microflora and extending the shelf-life of minimally processed 'Red Oak Leaf' lettuce.

The use of UV-C radiation treatments to inhibit the microbial growth and extend the shelf-life of minimally processed 'Red Oak Leaf' lettuce was investigated. Initially, UV-C resistance of 20 bacterial strains from different genera often associated with fresh produce (Enterobacter, Erwinia, Escherichia, Leuconostoc, Pantoea, Pseudomonas, Rahnela, Salmonella, Serratia and Yersinia) were tested in vitro. Most of the bacterial strains were inhibited with the minimum dose (30 J m(-2)). Erwinia carotovora, Leuconostoc carnosum, Salmonella typhimurium, and Yersinia aldovae were the most resistant strains requiring a UV-C dose of 85 J m(-2) to completely inhibit growth. An in vivo study consisted of treating minimally processed 'Red Oak Leaf' lettuce (Lactuca sativa) with UV-C at three radiation doses (1.18, 2.37 and 7.11 kJ m(-2)) on each side of the leaves and storing the product under passive MAP conditions at 5 degrees C for up to 10 days. The gas composition inside packages varied significantly among the treatments, with CO2 concentrations positively and O2 concentrations negatively correlating with the radiation dose. All the radiation doses were effective in reducing the natural microflora of the product, although the highest doses showed the greatest microbial inhibitions. Taking into account the microbial limit set by Spanish legislation [Boletín Oficial del Estado (BOE), 2001. Normas de higiene para la elaboración, distribución y comercio de comidas preparadas, Madrid, Spain, Real Decreto 3484/2000, pp. 1435-1441], all UV-C treatments extended the shelf-life of the product. However, the 7.11 kJ m(-2) dose induced tissue softening and browning after 7 days of storage at 5 degrees C. Therefore, the use of two sided UV-C radiation, at the proper dose, is effective in reducing the natural microflora and extending the shelf-life of minimally processed 'Red Oak Leaf' lettuce.

Bacteria↗

PubMed2005

Successful outcome with extended allograft ischemic time in pediatric heart transplantation.

BACKGROUND: Many cardiac transplant programs have liberalized donor eligibility criteria in an attempt to maximize donor supply and to accommodate increasing demand. Although many studies have evaluated the potential adverse effects of prolonged donor ischemic time (DIT) in adults undergoing cardiac transplantation, relatively few have focused specifically on pediatric recipients that include a substantial number of patients and long-term follow-up. The focus of this study was to examine the effect of extended DIT on mortality after pediatric heart transplantation. METHODS: We conducted a retrospective review of our pediatric cardiac transplant experience in the past 11 years, comparing patients who received allografts and had ischemic times >240 minutes with those who had ischemic times <240 minutes. RESULTS: A total of 129 pediatric patients (<19 years) underwent orthotopic heart transplantation, of whom 78 (60.5%) had DIT <240 minutes and 51 (39.5%) had DIT >240 minutes. We found no statistically significant difference in age, sex, race, height, weight, or donor age between the groups (p = not significant). Post-transplant survival at 1, 5, and 10 years was similar for both groups: 91.2%, 88.0%, and 85.2%, respectively, for patients with DIT <240 minutes vs 89.6%, 87.2%, and 79.8%, respectively, for patients with DIT >240 minutes (p = 0.433). Additionally, using Cox proportional hazard models, extended DIT >240 minutes was not a statistically significant independent predictor of post-transplant mortality (odds ratio, 0.655; 95% confidence interval, 0.518-0.972; p = 0.684; standard error = 0.468). CONCLUSION: Procurement of hearts from distant locations with associated extended DIT is justified in the setting of increased demand and a fixed donor population.

Adolescent↗