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Adequate Exposure (adequate + exposure)
Selected AbstractsIndigenous and austere technique of self-retaining abdominal retraction for facilitating surgical exposureJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2006Sajid S. Qureshi MS Abstract Adequate exposure is of paramount importance in major abdominal surgeries. This is achieved by appropriately placed incision, proper position of the patients, and judicious use of retractors. A third assistant is usually required for retaining the retractors. Self-retaining retractors have also been utilized for assisting in adequate exposure of the operative field. However, these retractors are complex and unwieldy, causing hindrance in the movement of the surgeon. We describe a technique of self-retaining abdominal retraction that is simple and also obviates the need for an additional assistant. J. Surg. Oncol. 2006;93:420,421. © 2006 Wiley-Liss, Inc. [source] Adequate Early Cyclosporin Exposure is Critical to Prevent Renal Allograft Rejection: Patients Monitored by Absorption ProfilingAMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2002C. M. Clase This study used receiver operating characteristic analysis to investigate the properties of area under the concentration-time curve during the first 4 h after cyclosporin-microemulsion dosing (AUC0,4) and cyclosporin (CyA) levels immediately before and at 2 and 3 h after dosing (C0, C2 and C3) to predict the risk of biopsy-proven acute rejection (AR) at 6 months. Ninety-eight kidney transplant recipients treated with CyA-microemulsion-based triple therapy immunosuppression were studied on post-transplant days 3, 5, and 7, and at increasing intervals thereafter. The most sensitive and specific predictor of AR was AUC0,4. Of the single time-point measurements, the measurement properties of C2 were closest to those of AUC0,4, and superior to those of C3. The relationship between C0 and subsequent AR was weak and did not reach statistical significance. On day 3, CyA AUC0,4, 4400 ng . h/mL and C2, 1700 ng/mL were each associated with a 92% negative predictive value for rejection in the first 6 months. Pharmacokinetic measurements on or after day 5, and measurements on day 3 in patients with delayed graft function, were not predictive of AR. Adequate exposure within the first 3 days post transplantation may be critically important in preventing subsequent rejection. [source] Tricuspid Valvectomy to Facilitate Repair of Postinfarction Ventricular Septal DefectJOURNAL OF CARDIAC SURGERY, Issue 5 2008Elena A Ashikhmina M.D. Avoidance of ventriculotomy by transatrial repair may decrease risks of bleeding and impairment of ventricular function secondary to suture placement; however, adequate exposure of the defect through the tricuspid valve is not always possible. We present a case of successful transatrial repair of posterior postinfarction VSD with concurrent tricuspid valvectomy and coronary artery grafting. [source] Indigenous and austere technique of self-retaining abdominal retraction for facilitating surgical exposureJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2006Sajid S. Qureshi MS Abstract Adequate exposure is of paramount importance in major abdominal surgeries. This is achieved by appropriately placed incision, proper position of the patients, and judicious use of retractors. A third assistant is usually required for retaining the retractors. Self-retaining retractors have also been utilized for assisting in adequate exposure of the operative field. However, these retractors are complex and unwieldy, causing hindrance in the movement of the surgeon. We describe a technique of self-retaining abdominal retraction that is simple and also obviates the need for an additional assistant. J. Surg. Oncol. 2006;93:420,421. © 2006 Wiley-Liss, Inc. [source] Mycophenolate Blood Level Monitoring: Recent ProgressAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2009T. Van Gelder The concentration,effect relationship for mycophenolic acid (MPA), and the high variability in MPA concentrations in patients on standard dose mycophenolate mofetil (MMF) therapy, for some centers has provided enough evidence to implement therapeutic drug monitoring (TDM) for MMF in daily practice. Two randomized trials Adaption de Posologie du MMF en Greffe Renale (APOMYGRE) and fixed-dose versus concentration controlled (FDCC) investigated the added benefit of TDM for MMF in renal transplant recipients. The APOMYGRE study showed a significant reduction in the incidence of acute rejection in concentration-controlled patients, while the FDCC study had a negative outcome, despite a similar study design. Although it was expected that these prospective trials would give the final answer to the question of whether or not TDM for MMF would be of benefit, it seems that the studies have not had much impact on patient management. Several trials have shown the importance of early adequate exposure to MPA in the first week after transplantation. As it will be hard to improve MPA exposure with TDM, this early, ongoing study now investigates the use of an increased starting dose. The increased starting dose will avoid underexposure to MPA in higher proportions of patients shortly after transplantation but may result in more toxicity in patients with MPA exposures exceeding the upper threshold of the therapeutic window. [source] Tadalafil and vardenafil vs sildenafil: a review of patient-preference studiesBJU INTERNATIONAL, Issue 9 2009Vincenzo Mirone The immediate objective of phosphodiesterase type 5 (PDE5) inhibitor treatment is to restore the ability of a man to achieve and/or maintain an erection adequate for sexual intercourse. As erectile dysfunction (ED) generally develops in the second half of life, the ultimate objective generally is not procreation, but quality of sexual life. Indeed, ED is known to impair quality of life considerably; two-thirds of men report that ED has impaired their self-esteem and nearly a third claim that it has damaged the relationship with their partner. It follows that the therapeutic success of PDE5 inhibition has an important subjective component, which is compounded by the subjective nature and complexity of sexual life in humans. This makes it very difficult for physicians to be certain that they have selected the optimal therapy for a couple, even after a thorough evaluation. The 2007 European Association of Urology Guidelines stress the importance of educating the patient and claim that ,the patient will choose the final drug after his own experience'. However, PDE5 inhibitors are typically used twice a week, so a patient would have to spend ,3 months trying the various compounds and dosages to achieve adequate exposure to all three PDE5 inhibitors; this would seem an unrealistic strategy in normal clinical practice. The acknowledgement that the patient has an important role in therapeutic decisions for ED has fuelled interest in the concept of patient preference. It has been established that patient preference depends on three factors, i.e. personal characteristics, e.g. age, duration of ED, frequency and dynamics of sexual relations, and the characteristics of their partners, e.g. age, menopausal status and level of interest in sexual activity and medication profile. Medication features of interest include efficacy in terms of quality of erection, consistency of effects, rapid onset of action, long duration of action, side-effect profile and route of administration; drug costs must also be considered if the medicinal product is not reimbursed. [source] | ||||||||||