American family physician
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Exciting new advances in transplant surgery are arising from the research laboratory and from clinical experimentation. Methods of immunosuppression and operative techniques have become standardized for renal transplantation. Pretransplant blood transfusions, immunosuppressive therapy with cyclosporin A and a closed-circuit method of thoracic duct filtration hold promise for improved results in graft survival. Segmental pancreatic transplantation has recently been developed and may provide a brighter outlook for the multitude of patients with diabetes.
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Dissecting aneurysm is the most common acute disease of the aorta. Men are more likely than women to develop aortic dissection. ⋯ In general, the treatment of choice for dissection originating in the ascending aorta is prompt surgical intervention. Medical therapy to lower elevated blood pressure and to reduce the force of myocardial contractility is sufficient for dissection of the descending aorta.
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The differential diagnosis of chronic facial pain is facilitated by a knowledge of anatomy. Nasal and dental conditions are prevalent causes of facial pain. ⋯ Previously, chronic iatrogenic trigeminal neuralgia has been erroneously included in the category of lower-half headaches. This disabling condition is due to repeated trauma to the trigeminal nerve.