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Book chapterBrown SGA, Turner PJ, 2017,
Critical Criteria for Diagnosing Anaphylaxis
, Middleton S Allergy Essentials, Pages: 345-360Anaphylaxis is a severe, immediate-type generalized hypersensitivity reaction affecting multiple organ systems and characterized at its most severe by bronchospasm, upper airway angioedema, hypotension and collapse. Lifetime prevalence is estimated to be 0.05–2%, but while anaphylaxis can be life-threatening, fatal anaphylaxis is rare. Drugs, foods and insect stings are the commonest triggers. The cornerstones of emergency management are support of the airway and/or ventilation, a supine position, epinephrine, and volume expansion. In the community setting, early administration of rescue epinephrine and contact with Emergency Services are of equal importance. Following an episode of anaphylaxis, prevention of further episodes requires identification of likely trigger(s) and co-factors, optimizing the management of comorbidities, allergen avoidance strategies, and immunotherapy if available. Patient education including an Anaphylaxis Action Plan and an epinephrine auto-injector should be considered where an allergen may be encountered unexpectedly (food and insect sting anaphylaxis, idiopathic anaphylaxis).
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Book chapterTurner PJ, Campbell DE, 2017,
Egg allergy
, Food Allergy Molecular and Clinical Practice, Pages: 70-9471Allergy to hen’s egg is perhaps the most common paediatric food allergy worldwide. This is certainly true for Australia and North America. It is unclear what makes this otherwise nutritious, innocuous and widely consumed food quite so allergenic. In this chapter we will examine the molecular characteristics and biochemistry of hen’s egg and the epidemiology, diagnosis, management and prevention of both IgE- and non-IgE mediated egg allergies.
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Book chapterBrown SGA, Turner PJ, 2017,
Anaphylaxis
, Middleton S Allergy Essentials First Edition, Pages: 345-360Anaphylaxis is a severe, immediate-type generalized hypersensitivity reaction affecting multiple organ systems and characterized at its most severe by bronchospasm, upper airway angioedema, hypotension and collapse. Lifetime prevalence is estimated to be 0.05-2%, but while anaphylaxis can be life-threatening, fatal anaphylaxis is rare. Drugs, foods and insect stings are the commonest triggers. The cornerstones of emergency management are support of the airway and/or ventilation, a supine position, epinephrine, and volume expansion. In the community setting, early administration of rescue epinephrine and contact with Emergency Services are of equal importance. Following an episode of anaphylaxis, prevention of further episodes requires identification of likely trigger(s) and co-factors, optimizing the management of comorbidities, allergen avoidance strategies, and immunotherapy if available. Patient education including an Anaphylaxis Action Plan and an epinephrine auto-injector should be considered where an allergen may be encountered unexpectedly (food and insect sting anaphylaxis, idiopathic anaphylaxis).
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Conference paperJohnston S, Carpio J, Panuto J, et al., 2017,
Spiritus: A Phase 2b Trial To Assess The Efficacy And Safety Of Vapendavir In Moderate And Severe Asthmatics With Rhinovirus Upper Respiratory Tract Infection
, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X -
Book chapterMaher TM, 2017,
Idiopathic interstitial pneumonias other than idiopathic pulmonary fibrosis
, Clinical Handbook of Interstitial Lung Disease, Pages: 209-220The idiopathic interstitial pneumonias (IIPs) represent a group of diffuse parenchymal lung diseases comprising a number of distinct clinic-pathological entities. The most common of the IIPs, idiopathic pulmonary fibrosis (IPF) is dealt with elsewhere in this book. The remaining entities were first formally classified in an American Thoracic Society and European Respiratory Society joint guideline published in 2002 with a further update published in 2013 (1, 2). The genesis for the 2002 guidelines was the observation that distinct histopathologic forms of idiopathic interstitial lung disease manifest distinct clinical syndromes with differences in radiologic appearances and, importantly, prognosis. The 2013 update reflected improved understanding of the IIPs gained following publication of the 2002 document. The key changes were the separation of IIPs into groups of major and rare disorders with further sub-division of the major group into chronic fibrosing, smoking-related and acute/subacute IIPs. With this in mind, this chapter provides an overview of the currently accepted IIP diagnostic entities with a focus on clinical presentation, diagnosis, clinical course and treatment (with the caveat that there are no approved or evidence-based treatments for this disparate group of disorders).
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Journal articleLomax-Browne HJ, Visconti A, Pusey CD, et al., 2017,
IgA1 glycosylation is heritable in healthy twins
, Journal of the American Society of Nephrology, Vol: 28, Pages: 64-68, ISSN: 1533-3450IgA Nephropathy (IgAN) is the most common form of primary glomerulonephritis and an important cause of kidney failure. Characteristically, IgAN patients have increased serum levels of under-galactosylated IgA1 (gd-IgA1). We assessed the degree to which serum gd-IgA1 levels are genetically determined in healthy individuals. Serum IgA and gd-IgA1 level were determined by ELISA in a sample of 148 healthy female twins including 27 monozygotic and 47 dizygotic pairs. Using the classical twin model, the heritability of serum gd-IgA1 and IgA levels were 80% (95% CI: 66-89%) and 46% (95% CI: 15-69%) respectively. These data indicate that serum gd-IgA1 levels are highly heritable. Elucidating the genetic basis of this heritability will be important in understanding the pathogenesis of IgAN.
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Journal articleSwisher EM, Lin KK, Oza AM, et al., 2017,
Rucaparib in relapsed, platinum-sensitive high-grade ovarian carcinoma (ARIEL2 Part 1): an international, multicentre, open-label, phase 2 trial
, Lancet Oncology, Vol: 18, Pages: 75-87, ISSN: 1470-2045BackgroundPoly(ADP-ribose) polymerase (PARP) inhibitors have activity in ovarian carcinomas with homologous recombination deficiency. Along with BRCA1 and BRCA2 (BRCA) mutations genomic loss of heterozygosity (LOH) might also represent homologous recombination deficiency. In ARIEL2, we assessed the ability of tumour genomic LOH, quantified with a next-generation sequencing assay, to predict response to rucaparib, an oral PARP inhibitor.MethodsARIEL2 is an international, multicentre, two-part, phase 2, open-label study done at 49 hospitals and cancer centres in Australia, Canada, France, Spain, the UK, and the USA. In ARIEL2 Part 1, patients with recurrent, platinum-sensitive, high-grade ovarian carcinoma were classified into one of three predefined homologous recombination deficiency subgroups on the basis of tumour mutational analysis: BRCA mutant (deleterious germline or somatic), BRCA wild-type and LOH high (LOH high group), or BRCA wild-type and LOH low (LOH low group). We prespecified a cutoff of 14% or more genomic LOH for LOH high. Patients began treatment with oral rucaparib at 600 mg twice per day for continuous 28 day cycles until disease progression or any other reason for discontinuation. The primary endpoint was progression-free survival. All patients treated with at least one dose of rucaparib were included in the safety analyses and all treated patients who were classified were included in the primary endpoint analysis. This trial is registered with ClinicalTrials.gov, number NCT01891344. Enrolment into ARIEL2 Part 1 is complete, although an extension (Part 2) is ongoing.Findings256 patients were screened and 206 were enrolled between Oct 30, 2013, and Dec 19, 2014. At the data cutoff date (Jan 18, 2016), 204 patients had received rucaparib, with 28 patients remaining in the study. 192 patients could be classified into one of the three predefined homologous recombination deficiency subgroups: BRCA mutant (n=40), LOH high (n=82), or LOH low (n=70). Tum
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Journal articleBussel JB, Cooper N, 2017,
Immune thrombocytopenia: a need for assisted suicide
, British Journal of Haematology, Vol: 176, Pages: 154-154, ISSN: 0007-1048 -
PosterGennatas S, Lu SK, Anbunathan H, et al., 2017,
Somatic BAP1 and NF2 mutations in pleural malignant mesothelioma and their correlation with clinical phenotype
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Book chapterRodgers FH, Gendrin M, Christophides GK, 2017,
The Mosquito Immune System and Its Interactions With the Microbiota: Implications for Disease Transmission
, ARTHROPOD VECTOR: CONTROLLER OF DISEASE TRANSMISSION, VOL 1: VECTOR MICROBIOME AND INNATE IMMUNITY OF ARTHROPODS, Editors: Wikel, Aksoy, Dimopoulos, Publisher: ACADEMIC PRESS LTD-ELSEVIER SCIENCE LTD, Pages: 101-122, ISBN: 978-0-12-805350-8- Author Web Link
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