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Sydney, Australia

Bourke M.,Westmead Hospital
Techniques in Gastrointestinal Endoscopy

Endoscopic mucosal resection (EMR) is an important therapy for large sessile lesions and advanced mucosal neoplasia of the colon. Careful pre-resection assessment against established classification systems including Paris and lesion granularity is mandatory to formulate a treatment plan, predict technical success and stratify for the risk of invasive disease. Lesions at high risk for invasive disease are best removed en bloc and this finding may dictate a change in the therapeutic strategy. Meticulous technique is crucial to maximise procedural success. This chapter will provide a comprehensive step by step approach to colonic EMR including equipment selection, lesion assessment, endoscopic technique, post procedural care and early detection and management of complications. © 2011 Elsevier Inc. Source

Doggett S.L.,ICPMR | Dwyer D.E.,University of Sydney | Penas P.F.,Westmead Hospital | Russell R.C.,University of Sydney
Clinical Microbiology Reviews

Since the late 1990s, bed bugs of the species Cimex lectularius and Cimex hemipterus have undergone a worldwide resurgence. These bed bugs are blood-sucking insects that readily bite humans. Cutaneous reactions may occur and can start out as small macular lesions that can develop into distinctive wheals of around 5 cm in diameter, which are accompanied by intense itching. Occasionally, bullous eruptions may result. If bed bugs are numerous, the patient can present with widespread urticaria or eythematous rashes. Often, bites occur in lines along the limbs. Over 40 pathogens have been detected in bed bugs, but there is no definitive evidence that they transmit any disease-causing organisms to humans. Anemia may result when bed bugs are numerous, and their allergens can trigger asthmatic reactions. The misuse of chemicals and other technologies for controlling bed bugs has the potential to have a deleterious impact on human health, while the insect itself can be the cause of significant psychological trauma. The control of bed bugs is challenging and should encompass a multidisciplinary approach utilizing nonchemical means of control and the judicious use of insecticides. For accommodation providers, risk management procedures should be implemented to reduce the potential of bed bug infestations. © 2012, American Society for Microbiology. All Rights Reserved. Source

Bendall L.J.,University of Sydney | Bradstock K.F.,Westmead Hospital
Cytokine and Growth Factor Reviews

G-CSF was among the first cytokines to be identified and rapidly transitioned into clinical medicine. Initially used to promote the production of neutrophils in patients with chemotherapy-induced neutropenia it helped to revolutionize the delivery of cancer therapy. Its ability to mobilize hematopoietic stem cells from the bone marrow into the blood was subsequently exploited, changing the face of hematopoietic stem cell transplantation. Today the knowledge gained in unraveling the mechanisms of stem cell mobilization by G-CSF is being explored as a means to increase chemosensitivity in hematological malignancies. This review provides a brief history of G-CSF and then focuses on recent advances in our understanding of G-CSF-induced stem cell mobilization and the potential clinical application of this knowledge in chemo-sensitization. © 2014 The Authors. Source

Favaloro E.J.,Westmead Hospital

In this issue of Blood, Linkins et al report on a prospective cohort study evaluating the combination of 4Ts (magnitude of thrombocytopenia, timing of onset of thrombocytopenia, thrombosis or other clinical sequelae, and the likelihood of other causes of thrombocytopenia) score and platelet factor 4/heparin particle gel immunoassay (PF4/H-PaGIA) for diagnosis and management of heparin-induced thrombocytopenia (HIT). © 2015 by The American Society of Hematology. Source

Duodenal lesions that should be considered for endoscopic resection comprise a heterogeneous group of disorders. Most are adenomas, primarily located in the descending duodenum. In comparison to lesions of a similar size elsewhere in the gastrointestinal tract, the risk of major complications from endoscopic resection of duodenal lesions is magnified. The unique anatomical features of the duodenum are largely responsible for this, but despite this we continue to apply conventional endoscopic therapies when a more sophisticated approach is required. Many other important clinical questions in relation to duodenal adenomas remain unanswered. This review aims to identify the gaps in the knowledge base and therapeutic approach and propose some solutions and directions for future research. © Georg Thieme Verlag KG Stuttgart · New York. Source

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