What Infectious Diseases are Important to Consider in Transplantation Patients?
Discussion Transplantation is not a common problem for primary care physicians but when a child’s disease has progressed to end-stage organ failure, transplantation can be the only treatment available. While the primary care provider usually is not involved in the daily management of patients before, during and after transplantation, they can be involved in many areas. These can include providing appropriate primary and acute care, ordering and obtaining necessary medical tests, medications and equipment, assisting with medical insurance, providing medical history and records to consultants, translating medical information for the family, general patient and family support, and encouraging and facilitating medical adherence. Pediatricians may have many questions regarding the primary care of a child with a transplant including: What affects the child’s growth?, How efficacious are vaccines after transplant?, What are the outcomes for children with additional problems such as intellectual disability?, and What are the rates of adherence to medical treatment? There are multiple factors that affect a child’s growth after transplantation including: Type of organ transplanted Patient age at transplant Transplant function Height/weight status pre-transplantation Pubertal stage Medications – particularly corticosteroids A 2017 systemic analysis of use of corticosteroids, found early withdrawal or avoidance protocols significantly improve final adult heigh...
We report here a huge ADPKD case of kidney transplantation concomitant with simple nephrectomy through thoracoabdominal approach that allows surgeons to manipulate the renal vessels, the adrenal grand, the trigonal ligament, and the lower pole of the kidney under the wide operative field. Because of the direct recognition of the surgical anatomy, it might be safe and feasible for simple nephrectomy in huge ADPKD patients undergoing concomitant kidney transplantation despite of the wide skin incision required by this approach.
Authors: Medeiros CSP, Pacheco TBF, Cavalcanti FADC, Cacho RO, Bezerra AMDS Abstract Primary Objective: To compare the level of motor, sensory and functional impairment of individuals hospitalized in a stroke unit in Brazil at the time of admission and the profile observed at hospital discharge. Design: Observational and longitudinal outcome study. Methods and Procedure: We assessed 41 patients with ischemic stroke at admission and hospital discharge by using the National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Physical Performance Scale (FM), Functional Independence Measure (FIM) and Modified Rankin S...
ConclusionThese results highlight areas that local units can focus on to reduce their litigation burden. Targeted initiatives aimed at improving patient-clinician communication, the consent process and improving local organisational efficiency will address a significant proportion of claims. Re-examination of this data on a regular basis can serve as a useful adjunct in assessing the impact of quality improvement initiatives and implementation of best practiseswithin the speciality.
ConclusionVascular surgery in TA cases becomes an option when the patient does not improve clinically after administration of medical treatment. Although endovascular management has fewer complications, the rate of restenosis is higher. Patients at risk of restenosis and who have increased perioperative vascular risk can benefit from open surgical procedures. Surgical management should be tailored to the patient’s needs.
ConclusionThis case is one of few cases reported in the literature highlighting the rarity of this injury pattern.
ConclusionNo conclusion can be drawn on the contribution of somatostatin analogs and immunosuppressant in the occurrence of severe cholecystitis. Prophylactic cholecystectomy is not indicated in patients with this medication.
ConclusionThe incidence of midline and lateral port site recurrence after laparoscopy for diagnosis or resection of ovarian cancer has not been determined. Limitation of trochar sites to the midline may reduce the extent of abdominal wall disease spread.
ConclusionThere is some previous caution in using a laparoscopic approach for cystic masses due to potential seeding intra-operatively, in case of fluid spillage of a possible malignant neoplasm. We show through our case that it is possible to efficiently and safely use such an approach.
ConclusionWe successfully treated a penile denudation with Manuka honey following a failed STSG. Wounds, ulcers, and burns may be infected, and can be challenging, time consuming, and expensive to treat. Manuka honey may be a good alternative to reconstructive surgery and can be managed on an out-patient basis.
ConclusionThe report aims at pointing out the possibility of undergoing this kind of surgery not only in case of pulmonary mass (on which the previous literature has focused) but also when mediastinum lesions occur, as in our case.
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