Native-vessel disease

Some patients will be seen for multiple reasons therefore, the pharmacist may need to record more than one ICD-9-CM code to fully describe the patient visit. For example, if a client with coronary artery disease (CAD) is referred to a pharmacist, it may not be uncommon that the physician requests education on lowering cholesterol through both diet and medications and education on weight loss and smoking cessation. All three conditions (CAD, obesity, and tobacco use) can be coded to represent the health conditions discussed. Example ICD-9 codes for these conditions include 414.01 (native-vessel disease), 272.2 (mixed hyperlipidemia), and 305.1 (tobacco-use disorder) (Buck and Lockyear, 2007). The specific ICD-9 code used on the claim form should be the same code used by the physician to decrease the risk of claim rejection owing to mismatched codes. Therefore, the ICD-9 code should be requested on the referral form from the physician (Snella et ah, 2004). 

Another tactic has been to use de-cellularized arterial matrices as a scaffold for TEVGs. Advantages include blood compatibility and an ECM with correctly ahgned collagen and elastin fibers. Native vessels are treated with trypsin and ethylenediaminetetraacetic acid to remove cells [44]. This leaves an intact matrix that can be used for implantation. Cells maybe seeded in the matrix and conditioned under pulsatile flow [45]. Fibrosis was a problem in these types of grafts, and concern remains over immune response and disease transmission with the xenogenic materials used in acellular matrices. 

Before Europeans arrived in America, echinacea was a popular herbal drug among Native Americans, who used it to treat respiratory infections, inflammation of the eyes, toothache, and snakebite. European colonists quickly adopted the herb. In the nineteenth century, European Americans used echinacea as a blood purifier, believing that it cleared the blood of disease-causing toxins. Europeans used echinacea to treat diseases such as eczema, veneral diseases, lymphangitis (swelling of the lymph vessels), and sepsis (infection of the blood with microorganisms). 

Close ntimiciy of native blood vessels may ultimately also be important in the engineering of other tissues that depend on vasculature to sustain function. As oiu imderstanding of the factors involved in cardiovascular development and function improves, we may one day develop TEVGs that will greatly improve the lives of people with vascular disease and other life-threateiung conditions. 

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