Presurgical evaluation

Dey D, Slomka P, Chien D et al. (2006) Direct quantitative in vivo comparison of calcified atherosclerotic plaque on vascular MRI and CT by multimodality image registration. J Magn Reson Imaging 23(3) 345-354 Feichtinger M, Holl A, Korner E et al. (2002) Future aspects of the presurgical evaluation in epilepsy. Acta Neurochir Suppl 84 17-26... 

The principal cause of graft loss after the first year is chronic allograft nephropathy (CAN), followed by patient death, late acute rejections, nephropathy recurrence and polyomavirus infection (Hariharan 2001). However, prolongation of graft survival also means extended exposure of the patient to side-effects associated with immunosuppressive therapies, mainly infections and cancers, and other late-onset cardiovascular, bone and/or metabolic complications. The first year after transplantation is special, as it is characterized by the highest rates of acute rejection and opportunistic infections, such as cytomegalovirus. In this review, we successively address the presurgical evaluation of the patient, the operation itself and its possible complications, then the early (first year) and late (after the first year) medical complications. 

Arzoxifene, a third-generation SERM, has demonstrated in experimental, preclinical, and presurgical studies its ability to inhibit tumoral proliferation and prevent bone loss. A randomized trial of arzoxifene vs. placebo has been initiated in late postmenopausal women to evaluate its preventive effect on breast cancer and vertebral fractures. 

These include those issues covered in the preoperative skin-preparation portion of this chapter. However, because surgical staff members actually use the product on themselves, the aesthetic attributes tend to be more important than with preoperative skin preparations. One important aspect of development in surgical scrub formulations is a brushless application, which will certainly change the perspective of the presurgical wash process. It is important that relevant, but unknown product attributes be identified by potential product users. This may include subjective testing to evaluate the sensory attributes of the product—its container, its packaging, and other aesthetic concerns—in order to engineer a more desirable product [4]. Some of the areas of interest are presented in Table 1. 

In our evaluations with 4% CHG, adequate logio reductions to meet FDA requirements have been observed in wash procedures without the use of a scrub brush. Several manufacturers have combined alcohol [>60%] with 1, 2, 3, and 4% CHG, also satisfying the current FDA requirements for a presurgical scrub formulation without the use of a scrub brush. 

Arthroscopic classification and evaluation methods for remnants are extremely important factors in the selection of the surgical technique and can result in conflicting opinions. As described above, presurgical imaging alone does not... 

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