Immunosuppression with Mycophenolic Acid: One Size Does Not Fit All

Immunosuppression with mycophenolic acid: one size does not fit all.

Over the past decade, immunosuppression for renal transplantation has shifted from predominantly azathioprine-based regimens to those containing mycophenolic acid (MMF, CellCept) (1). In most centers, MMF is combined with cyclosporine or tacrolimus (calcineurin inhibitors) plus corticosteroid therapy. These combinations have led to unprecedented patient and graft survivals over the near term (1...

Professionalism: one size does not fit all.

When a child is born with or acquires special needs, the parents may find some parental tasks more difficult. They may not know how to make their tasks easier, or that some parents find it exceptionally rewarding and meaningful to raise their children with special needs. This piece explores how clinicians might share this potentially life-altering information. It also explores when and why clin...

One-size MAP does not fit all

One-size mean arterial pressure does not fit all The Surviving Sepsis Campaign [1] advocates maintaining a mean arterial pressure (MAP) of at least 65 mm Hg in sepsis patients undergoing resuscitation. Leone and colleagues [2], in an article published in this journal, suggest considering higher MAP targets in the resuscitation of patients with a history of arterial hypertension so they do not p...

Does one size fit all?

Immunosuppression and herpes viral reactivation in intensive care unit patients: one size does not fit all

More than 20 years after the initial description of cytomegalovirus (CMV) pneumonia in “non-immunocompromised” ICU patients by Papazian et al. [1], the treatment of herpes viruse reactivation in ICU is still a matter of debate. Recently, Mirouse et al. [2] reported a unique cohort of varicella-zoster virus (VZV)-related community acquired pneumonia in the ICU over 20 years. This highlighted tha...