Clinical value of assessing prednisolone pharmacokinetics before and after renal transplantation

1984 ◽  
Vol 26 (3) ◽  
pp. 363-369 ◽  
Author(s):  
L. Öst ◽  
I. Björkhem ◽  
C. von Bahr
Keyword(s):  
Renal Transplantation ◽  
Clinical Value ◽  
Before And After

scholarly journals Path of least resistance: how computerised provider order entry can lead to (and reduce) wasteful practices

2018 ◽  
Vol 7 (2) ◽  
pp. e000345 ◽  
Author(s):  
Joseph Choi ◽  
Cori Rebecca Atlin
Keyword(s):  
Blood Count ◽  
Complete Blood Count ◽  
Clinical Care ◽  
Work Flow ◽  
Quality Improvement Initiative ◽  
Order Entry ◽  
Clinical Value ◽  
Careful Planning ◽  
Order Sets ◽  
Before And After

BackgroundComputerised provider order entry (CPOE) is rapidly becoming the mainstay in clinical care and has the potential to improve provider efficiency and accuracy. However, this hinges on careful planning and implementation. Poorly planned CPOE order sets can lead to undetected errors and waste. In our emergency department (ED), lactate dehydrogenase (LDH) was bundled into various blood work panels but had little clinical value.ObjectivesThis quality improvement initiative aimed to reduce unnecessary LDH testing in the ED.MethodsA group of ED physicians reviewed CPOE blood work panels and uncoupled LDH in conditions where it was deemed not to provide any clinically useful information. We measured the daily number of LDH tests performed before and after its removal. We tracked the frequency of other serum tests as controls. We also analysed the number of add-on LDH (ie, to add LDH to samples already sent to the lab) as a balancing measure, since this can disrupt work flow and delay care.ResultsThrough this intervention, we reduced the number of LDH tests performed by 69%, from an average of 75.1 tests per day to 23.2 (P<0.0005). The baseline controls did not differ after the intervention (eg, a complete blood count was performed 197.7 and 196.1 times per day preintervention and postintervention, respectively (P=0.7663)). There was less than one add-on LDH per day on average.ConclusionsCPOE care templates can be powerful in shaping behaviours and reducing variability. However, close oversight of these panels is necessary to prevent errors and waste.

scholarly journals P0299EVALUATION OF THE CORRELATION BETWEEN VITAMIN D LEVELS AND THROMBOCYTE MARKERS IN PATIENTS WITH DİALYSİS, CHRONIC RENAL DISEASE AND RENAL TRANSPLANTATION PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
KÖNÜL AHMEDOVA ◽  
Garip SAHIN ◽  
Cengiz Bal ◽  
Rüya Mutluay
Keyword(s):  
Vitamin D ◽  
Renal Transplantation ◽  
Renal Disease ◽  
Negative Correlation ◽  
Chronic Renal Disease ◽  
Significant Negative Correlation ◽  
Vitamin D Supplementation ◽  
Control Group ◽  
Before And After ◽  
Grade 3

Abstract Background and Aims 25(OH)D3 levels are known to be lower in patients with chronic renal disease (CRD). Vitamin D supplementation has been shown to have beneficial effects on mortality in these patients. In our study, we have evaluated the pleiotropic effect of vitamin D on thrombocyte markers, which is known very little by most. Method The main thrombocyte function markers (MPV, PDW and PCT) were obtained in patients which underwent dialysis, renal transplantation and patients with grade 3-4 CRD before and after vitamin D supplementation. 40 healthy individuals were chosen as control group and 24 patients underwent renal transplantation, 25 patients underwent dialysis for at least 3 months, 32 patients were diagnosed as Grade 3-4 CRD. All of the patients above had 25(OH)D3 levels &lt;20ng/mL (&lt;50nmol/L). Thrombocyte markers were evaluated before and after vitamin D supplementation (which was given 50.000 IU orally once a week for 8 weeks). Results Statistically no significant difference were found between MPV values in- and across- group comparison before and after vitamin D supplementation. After the correlation analyses were reviewed, statistically significant negative correlation was found (r=-0,422 p&lt;0.05) between ΔMPV and ΔVitamin D in renal transplantation group. Also statistically significant positive correlation was found between ΔPDW and ΔVitamin D. In the control group with healty participants, a statistically significant negative correlation was found (r=-0,493 p&lt;0.05) between ΔVitamin D and ΔThrombocyte count. In the dialysis group a statistically significant negative correlation was found (r=-0,422 p&lt;0.05) between ΔVitamin D and ΔMPV. Conclusion A significant correlation was found particularly between Vitamin D and MPV in dialysis and renal transplantation patients. In order to prevent cardiovascular events due to thrombosis caused by Vitamin D deficiency which increases MPV, it has been thought that Vitamin D supplementation and antiaggregant therapy might be beneficial.

EVALUATION OF PATIENTʼS SEXUAL FUNCTION BEFORE AND AFTER RENAL TRANSPLANTATION

2010 ◽  
Vol 90 ◽  
pp. 932
Author(s):  
Darabi M.R. Mahboub ◽  
R. Taghavi ◽  
M. H. Shakibi
Keyword(s):  
Renal Transplantation ◽  
Sexual Function ◽  
Before And After

scholarly journals Impact of Changing Trend in Cold Ischaemic Time on Operating Times in Renal Transplantation

2006 ◽  
Vol 88 (7) ◽  
pp. 667-671 ◽  
Author(s):  
Ying-Ying Seow ◽  
Hany Riad ◽  
Philip Dyer
Keyword(s):  
Renal Transplantation ◽  
Working Hours ◽  
Out Of Hours ◽  
Time Of Surgery ◽  
European Working ◽  
Before And After ◽  
Changing Trend ◽  
Cadaver Kidney ◽  
Time Periods ◽  
Working Time Directive

INTRODUCTION The European Working Time Directive (EWTD) is calling for reduction in the working hours of doctors. Renal transplantation is well-recognised as an out-of-hours specialty. Our study looks at whether our renal transplant centre's attempt to reduce cold ischaemic time (CIT) has impacted on the pattern of operating times since this may have implications on the surgeons' working hours. PATIENTS AND METHODS We studied 883 adult cadaver kidney transplants performed between 1 January 1992 and 31 December 2002. CIT and time of surgery was obtained from a local audit database (< www.nwkta.org >) and that held by UK Transplant. Time of surgery was divided into 07:30–17:59 (day),18:00–23:59 (evening) and 00:00–07:29 (night). RESULTS CIT has decreased since 1992, with a significant reduction after 1998 (P = 0.0001). There was, however, no difference in the percentage of operations performed during the three time periods before and after 1998. Between 1999–2002, 51.4% of transplants took place out of hours (i.e. 18:00–07:29). CONCLUSIONS Reduction in CIT does not appear to have impacted on our operating times. The large amount of out-of-hours work is, however, not compliant with EWTD requirements.

Role Of The Fibrinolytic System In Renal Transplantation

1981 ◽  
Author(s):  
P Glas-Greenwalt ◽  
M H Goldman
Keyword(s):  
Renal Transplantation ◽  
Endothelial Damage ◽  
Fibrinolytic System ◽  
The Other ◽  
Group Vi ◽  
Significant Drop ◽  
Group V ◽  
Group Iii ◽  
Group I ◽  
Before And After

To determine the importance of the fibrinolytic system in renal transplantation on the one hand, and to establish a correlation between possible endothelial damage due to treatment of the renal graft and fibrinolytic parameters on the other, dogs were divided in six groups. Group I dogs were subjected to anesthesia only. Group II was sham operated. In group III, kidneys were perfused with the supernatant of either autologous or homologous cryo-precipitated plasma, and in group IV with albumin. In group V kidneys were cold stored. This was followed by autotransplantation. In group VI kidneys were perfused with albumin and allografted. Before and after transplantation, total plasma plasminogen (pro) activator activities in systemic and renal circulations were measured on fibrin plates after the addition of dextran sulfate and flufenamate to euglobulin fractions. Vascular activator (VA) was measured by adding Cl-inactivator. There was no marked difference between groups III, IV and VI. In comparing, however, group V with any of the perfused groups, an overall higher fibrinolytic activity was recorded both for intrinsic activators (p<.001) and VA (p<.001). in group I a significant drop in both activities (p<.01 -<.02) could be directly related to the duration of anesthesia with recovery within 24 hours. This pattern, though highly accentuated, revealed itself in all the other groups studied, with VA temporarily reaching zero-levels in the renal circulation in group VI. This data indicates the participation of the fibrinolytic system, in particular of the VA, in determining the fate of renal grafts.

Longitudinal Analysis of Vascular Function and Biomarkers of Metabolic Bone Disorders before and after Renal Transplantation

2013 ◽  
Vol 37 (2) ◽  
pp. 126-134 ◽  
Author(s):  
Mahmut Ilker Yilmaz ◽  
Alper Sonmez ◽  
Mutlu Saglam ◽  
Halil Yaman ◽  
Selim Kilic ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Longitudinal Analysis ◽  
Vascular Function ◽  
Bone Disorders ◽  
Metabolic Bone ◽  
Before And After
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