Do all patients with left costal margin injuries require radiographic evaluation for intraabdominal injury?

Study Objective: We determine whether all patients with pain or tenderness to the left lower ribs after blunt traumatic injury require abdominal computed tomography (CT) scanning for the detection of splenic injury.

Methods: This was a prospective, observational cohort of all blunt-trauma patients who had pain or tenderness to the left lower ribs and presented to the emergency department (ED) of a Level I trauma center. Patients were enrolled if they had a Glasgow Coma Scale (GCS) score greater than 13 and pain or tenderness to the left lower ribs (ribs 7 to 12).

Tacrolimus dose requirement in renal transplant recipients is significantly higher when used in combination with corticosteroids.

Aims: To evaluate the effect of corticosteroids on tacrolimus pharmacokinetics.

Methods: In a randomized trial, kidney transplant recipients were treated with tacrolimus and mycophenolate mofetil with either daclizumab (n = 31) or 3 months of prednisone (n = 34). Tacrolimus dose-adjusted predose concentrations (C0) at month 1-6 were compared between both groups and within the corticosteroid group before and after prednisone withdrawal.