Scarless Nephrectomy By Transgastric And Transvesical Combined Approach Piroxicam? For what? Useful medical advises.

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Scarless Nephrectomy By Transgastric And Transvesical Combined Approach

UroToday. com - Dr. Lima from Porto, Portugal presented the novel concept of " natural orifices translumenal endoscopic surgery " ( NOTES ) as applied to nephrectomy in an experimental model. Their team assessed the feasibility of a combined transgastric and transvesical approach for performing nephrectomy in a porcine model.

In a non-survival study, a transgastric and transvesical combined approach was applied in 6 female pigs. Under ureteroscopic control, they placed a transvesical 5-mm over tube into peritoneal cavity, and a flexible gastroscope was passed orally into the peritoneal cavity by a gastrotomy. Four right and two left nephrectomies were performed using instruments introduced by both devices. The pigs suffered no complications during creation of transvesical and transgastric access. In all animals, they visualized both kidneys, and renal vessels and ureter were identified and ligated separately with ultrasonic scissors, which were introduced through transvesical port. In two early cases, mild bleeding occurred after ultrasonic ligation. Complete renal release and mobilization to stomach was achieved in all animals. During discussion, it became apparent that none of " resected " kidneys were removed from porcine bodies, and this would require some sort of incision.

Presented by: E. Lima, MD, et al, at European Association of Urology - 23rd Annual EAU Congress - March 26 - 29, 2008 - Milan, Italy

Reported by UroToday. com Contributing Editor, Christopher P. Evans, MD

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Piroxicam? For what?

Piroxicam: uses Piroxicam is used to reduce pain, swelling, and joint stiffness from arthritis. Piroxicam is known as a nonsteroidal anti-inflammatory drug ( NSAID ) .

Piroxicam: how to use Read the Medication Guide provided by your pharmacist before we start using Piroxicam and each time you get a refill. If we have any questions regarding the information, consult your doctor or pharmacist.

Take Piroxicam by mouth usually once daily with a full glass of water ( 8 ounces or 240 milliliters ) , unless your doctor directs we otherwise. Don't lie down for at least 30 minutes after taking Piroxicam. If stomach upset occurs while taking Piroxicam, take it with food, milk, or an antacid.

Dosage is based on your medical condition and response to therapy. To reduce your risk of stomach bleeding and other side effects, take Piroxicam at lowest effective dose for shortest possible time. Don't increase your dose, take it more frequently or take it for a longer time than prescribed.

In certain conditions ( e. g. , arthritis ) , it may take several weeks before your symptoms improve when Piroxicam is taken regularly. It may take several months before full benefits of Piroxicam take effect.

If we are taking Piroxicam on an " as needed " basis ( not on a regular schedule ) , remember that pain medications work best if they're used as first signs of pain occur. If we wait until pain has significantly worsened, medicine mayn't work as well.

Inform your doctor if your condition persists or worsens.

Piroxicam: other used This section contains uses of Piroxicam that are not listed in approved professional labeling for drug but that may be prescribed by your health care professional. Use Piroxicam for a condition that's listed in this section only if it has been so prescribed by your health care professional.

Piroxicam may also be used to treat other conditions including gouty arthritis, arthritis of spine, and muscle injuries.

Piroxicam: side effects Upset stomach, gas, constipation, diarrhea, nausea, vomiting, fatigue, dizziness, or headache may occur while use Piroxicam. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed Piroxicam because he or she has judged that the benefit to you is greater than risk of side effects. Many people using Piroxicam don't have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

Tell your doctor immediately if any of these rare but very serious side effects occur:

Piroxicam may rarely cause serious ( possibly fatal ) liver disease. If you notice any of following highly unlikely but very serious side effects, stop taking Piroxicam and consult your doctor or pharmacist immediately:

A very serious allergic reaction to Piroxicam is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include:

This isn't a complete list of possible side effects. If we notice other effects not listed above, contact your doctor or pharmacist.

Piroxicam: precautions Before taking Piroxicam, tell your doctor or pharmacist if we are allergic to it; or to aspirin or other NSAIDs ( e. g. , ibuprofen, naproxen, celecoxib ) ; or if you have any other allergies.

Piroxicam shouldn't be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if we have:

Before using Piroxicam, tell your doctor or pharmacist your medical history, especially of:

Before having surgery, tell your doctor or dentist that we are taking Piroxicam.

Piroxicam may make we dizzy; use caution engaging in activities requiring alertness such as driving or using machinery.

This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.

Piroxicam may make we more sensitive to sun. Avoid prolonged sun exposure, tanning booths or sunlamps. Use a sunscreen and wear protective clothing when outdoors.

Caution is advised when using Piroxicam in elderly because they may be more sensitive to its side effects, especially stomach bleeding and kidney effects.

Piroxicam should be used only when clearly needed during first 6 months of pregnancy. It's not recommended for use during the last 3 months of pregnancy due to possible harm to an unborn baby and interference with normal labor/delivery. Discuss risks and benefits with your doctor.

Piroxicam passes into breast milk. Breast-feeding while using Piroxicam isn't recommended. Consult your doctor before breast-feeding.

Piroxicam: interactions Your healthcare professionals ( e. g. , doctor or pharmacist ) may already be aware of any possible drug interactions and may be monitoring we for it. Do not start, stop, or change dosage of any medicine before checking with them first.

Piroxicam should not be used with following medications because very serious interactions may occur while use Piroxicam:

If we are currently using any of these medications listed above, tell your doctor or pharmacist before starting Piroxicam.

Before using Piroxicam, tell your doctor or pharmacist of all prescription and nonprescription/herbal products we may use, especially of:

Check all prescription and nonprescription medicine labels carefully for other pain/fever drugs ( NSAIDs such as aspirin, celecoxib, ibuprofen ) . These drugs are similar to Piroxicam, so taking one of these drugs while also taking Piroxicam may increase your risk of side effects. However, if your doctor has prescribed low doses of aspirin to prevent heart attack or stroke ( usually at dosages of 81-325 milligrams a day ) , we should continue to take aspirin. Daily use of NSAIDs ( e. g. , ibuprofen ) may decrease aspirin’s ability to prevent heart attack/stroke. Consult your doctor or pharmacist for more details and to discuss other possible treatments ( e. g. , acetaminophen ) for your pain/fever.

This document doesn't contain all possible interactions. Therefore, before using Piroxicam, tell your doctor or pharmacist of all products we use. Keep a list of all your medications with you, and share list with your doctor and pharmacist.