Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
22
result(s) for
"Dholakia, Shamik"
Sort by:
The final hurdle : single best answers in clinical pharmacology and therapeutics
This book focuses on reinforcing core concepts, improving exam technique and developing confidence in answering the style of questions used in the examinations.
Book
Helminths in organ transplantation
With transplantation becoming an increasingly routine form of treatment for diverse populations, and with international travel becoming ever more accessible and affordable, the danger of transplantation-mediated helminth infections, exacerbated by coincident immunosuppression, must be considered. In this Review, we attempt to catalogue all clinically-relevant helminthiases that have been reported to coincide with transplantation, whether by transplantation-mediated transmission, reactivation of latent infections in an immunosuppressed context, or possible de-novo infection during the immunosuppressed peritransplant period. Helminthiasis has been reported in cases of kidney, liver, bowel, pancreas, heart, lung, and stem-cell transplant, and blood transfusion. For each helminthiasis, known risk factors, symptoms, and suggested options for screening and treatment are given. We conclude that helminths are a small but important and potentially severe source of disease after transplantation, and, with options for diagnosis and treatment, these pathogens warrant greater consideration during organ implantation. The achievement of immunological tolerance using helminth-derived products is also an exciting future prospect.
Journal Article
Facial cutaneous metastasis of colorectal adenocarcinoma
Facial cutaneous metastasis from carcinoma is a rare and late clinical finding that is associated with disseminated disease and a poor prognosis. Skin metastases predominantly originate from primary tumours of the lung and melanoma. Skin metastases from colon tumours occur in only 4–6.5% of cases of metastatic colorectal cancer. They are most often located on the abdominal skin. We present an unusual case in which a primary colorectal adenocarcinoma metastasised to the face. This cutaneous lesion occurred 4 years after diagnosis of the primary tumour. This case highlights the importance of prompt investigation of new or evolving skin lesions in patients with a history of malignancy. Early detection and initiation of treatment may prevent development of widespread skin metastases and extend life expectancy.
Journal Article
Osteogenesis imperfecta and congenital diaphragmatic hernia
Osteogenesis imperfecta and congenital diaphragmatic hernia are both conditions that can occur due to genetic mutation. We present the first case to be reported of a child with both osteogenesis imperfecta and congenital diaphragmatic hernias, showing that the incidence of this presentation may be more than chance.
Journal Article
Doctor, I have a sore throat
Lemierre's syndrome is a rare yet potentially fatal cause of sore throat. Recently published literature suggests an increase in the incidence of this ‘forgotten disease’, highlighting Lemierre's syndrome as a clinically important differential diagnosis of sore throat. We present a case report of an 85-year-old man who developed a sore throat, which illustrates the re-emergence of Lemierre's syndrome. Reducing the morbidity and mortality from this disease requires a high index of clinical suspicion to ensure prompt diagnosis and initiation of appropriate multidisciplinary management.
Journal Article
The NLRP3 Inflammasome: Relevance in Solid Organ Transplantation
The NOD, LRR, and pyrin domain-containing 3 (NLRP3) protein has been established as a central component of the inflammasome and regulates the inflammatory response to a myriad of environmental, microbial, and endogenous danger stimuli. Assembly of the NLRP3 inflammasome results in the cleavage and activation of caspase-1, in turn causing release of the pro-inflammatory interleukins 1-beta and 18. This activation response, while crucial to coordinated innate immune defense, can be aberrantly activated by the likes of cell-free DNA, and cause significant autoimmune pathology. Complications of autoimmunity induced by aberrant NLRP3 inflammasome activation have a great degree of mechanistic crossover with alloimmune injury in solid organ transplant, and stratagems to neutralize NLRP3 inflammasome activation may prove beneficial in solid organ transplant management. This article reviews NLRP3 inflammasome biology and the pathology associated with its hyperactivation, as well as the connections between NLRP3 inflammasome activation and allograft homeostasis.
Journal Article
A lumpy appendix
A De Garengeot hernia is a rare and interesting presentation of a groin lump, with the diagnosis usually only being identified during surgery. It still presents clinicians with diagnostic and therapeutic challenges, owing to the lack of signs associated with sepsis and so an important case to highlight. We present a case report of a 90-year-old woman who developed a De Garengeot hernia as part of her presentation of bowel obstruction illustrating the importance of careful examination and to ensure prompt diagnosis and initiation of appropriate multidisciplinary management.
Journal Article
Blind drunk
Purtscher's retinopathy is a haemorrhagic and vaso-occlusive retinal vasculopathy, caused by microembolisation occluding retinal and choroidal arterioles. This leads to retinal haemorrhages and ischaemia. The usual cause is severe trauma. 1 However, a variety of conditions including acute pancreatitis, childbirth, long bone fracture, chest trauma and systemic inflammatory vasculitides may cause similar retinal presentations. 1–4 This highlights Purtscher's retinopathy as a clinically important differential diagnosis of visual loss. We present a case report of a 43-year-old man who was diagnosed with acute pancreatitis. While in hospital he developed sudden onset unilateral loss of vision. This case highlights the need to ensure prompt diagnosis and initiation of appropriate multidisciplinary management.
Journal Article
Effect of Tyrosine Kinase Inhibitors on Wound Healing and Tissue Repair: Implications for Surgery in Cancer Patients
Small-molecule tyrosine kinase inhibitors (TKIs) represent a major advance in the treatment of certain forms of cancer. Unexpectedly, however, their use is associated with serious toxic effects on many vital organs and functions. Some of these effects, such as venous thromboembolism, haemorrhage, gastric perforation and a potential for impaired tissue healing, have direct implications for the safety of surgery in cancer patients. A number of currently approved TKIs are suspected or have been reported to impair wound healing but, understandably, there have been no formal pre- or post-approval clinical trials to evaluate the extent of the risk. Consequently, drug labels typically recommend discontinuation of the TKI concerned prior to elective surgery. In patients with gastric perforation, permanent discontinuation is advised. These recommendations, which are based on a precautionary principle, raise a dilemma, especially in patients with TKI-responsive tumours. This review focuses on the labelled potential of these novel antineoplastic agents to impair tissue repair and wound healing, and the evidence concerning the likely mechanisms involved. At present, because of the lack of formal clinical data, there are no evidence-based guidelines on the management of surgery in patients treated with TKIs. There is a need for a central registry of clinical outcomes following emergency surgery in cancer patients receiving TKIs and TKI-naïve matched controls. Analysis of outcomes data from such registries will assist in formulating guidelines on the management of elective surgery in TKI-treated patients. If TKIs are shown to significantly impair wound healing, patients receiving TKI therapy will require special monitoring and a collaborative approach between oncologists and surgeons for individualized reappraisal of the risk/benefit of the TKI treatment.
Journal Article
Helminths in organ transplantation – Authors' reply
Galán-Puchades suggested that only Strongyloides stercoralis poses a serious threat to transplanted patients; yet we have drawn attention to other fatal cases of helminthiasis resulting from transplantation.1 Transplantation is time-critical, with global variations in practice, which occasionally results in incomplete information at time of donation; remaining cautious is thus appropriate. The intention of the table of risk factors, screening options, and recommended responses in our Review is to highlight key alarm bells for any candidate,...
Journal Article