D Hosking — Page 2 | PubMed Health

PubMed1988

Transplantation in Manitoba.

1. Renal transplantation can be performed at small regional centers as successfully as at large centers. 2. Immunosuppression should be individualized for the patient thereby avoiding the use of costly and often clinically complicated immunosuppressive regimens. 3. Small centers need to participate in large regional pools in order to give highly presensitized patients a reasonable chance of successful transplantation. 4. Long-term patient compliance is a major problem and requires careful surveillance of patients' adherence to their prescribed therapy. Frequent follow-up also allows for the detection of late rejection episodes which can often be reversed.

Graft Survival↗

PubMed1983

Management of blunt injury to the lower urinary tract.

Rupture of the bladder and of the urethra are serious injuries, which, if not recognized or treated adequately, can cause considerable morbidity, even death. The possibility of such injuries should be considered in patients who have lower abdominal trauma, especially in association with a fractured pelvis. Retrograde urethrography should be done when urethral injury is likely. A properly performed cystogram is reliable in diagnosing bladder rupture, which, with the possible exception of small extraperitoneal tears, should be treated by surgical exploration. Treatment of urethral injury remains controversial and the choice of primary repair or primary suprapubic cystostomy will depend on the philosophy and experience of the surgeon. Posterior urethral injury is associated with a high rate of stricture, incontinence and impotence. Suprapubic cystostomy and delayed treatment of any resulting stricture yields excellent long-term results and should be the treatment of choice when the patient is seriously ill or the surgeon inexperienced in urethral surgery.

Adolescent↗