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A modified influenza pandemic plan might include the following components: 1) Before a pandemic, expand indications for and decrease barriers to receipt of vaccination against S. pneumoniae (36 – 38, 40 ).
Microbial growth and metabolism also can more drastically improve herb efficacy, reduce toxicity, and expand indications than physical or chemical methods and can also improve the extraction, absorption, and utilization rate of the active ingredient (Zhang et al. 2012b).
Incidental evidence of FMT benefit in comorbidities may further expand indications to conditions previously not associated with gastrointestinal dysbiosis and for which therapeutic GiMb manipulation may play a role.
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These concepts are illustrated in three innovative case studies, in which pharmacometrics has been used to understand phase III failures, expand indication statement through bridging of data, and balance the needs of patients with the needs for information on dose response.
This has led to expanding indications of TAVI from inoperable to high surgical to now even lower surgical risk patients.
Additionally, improving clinical outcomes and increasing surgeon confidence have also expanded indications to include cases of unilateral visual impairment and paediatric age.
Certain large colorectal tumors satisfy expanded indications for endoscopic submucosal dissection (ESD); however, the resulting large mucosal defects may contribute to complications such as delayed bleeding and perforation.
Prosthesis design and surgical techniques have evolved over time, as have the expanded indications, leading to improved outcomes and decreased complications.
The future of this field will not only be in technological advances with devices but in optimization of patient selection and expanding indications such as permanent replacement therapy.
With expanding indications for cardiac implantable electronic devices (CIEDs) capable of treating bradycardias, complex cardiac tachyarrhythmias and heart failure, the number of patients requiring regular long-term specialized care is growing rapidly.
Advances in the design of fixators and bone pins have expanded indications — external fixation as definitive fracture treatment is a real alternative for trauma surgeons.
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