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Buell JF Gross TG Thomas MJ Neff G Muthiah C Alloway R Ryckman FC Tiao GM Woodle ES 《Seminars in Pediatric Surgery》2006,15(3):179-187
Malignancy is a well defined complication of chronic immunosuppression. Post transplant malignancies appear to be related to cumulative doses of immunosuppression, and in pediatric patients, acute infection of previously naive patients. The most commonly encountered malignancy in this age population is Post Transplant Lymphoproliferative Disorder (PTLD). PTLD is not a single entity but rather represents a continuum of disease. Treatment of PTLD should be initiated with immunosuppression reduction. Standard dose chemotherapy leads to significant morbidity. With the introduction of anti-CD20 antibody treatment with rituximab, chemotherapy has become second line therapy. The occurrence of solid malignancy appears to be associated with chronic immunosuppression. These cancers include those of skin, gynecologic organs, and the rectum, all of which appear to have the strongest association with viral mediators. Several strategies have been postulated to minimize the occurrence of malignancy. These include ganciclovir prophylaxis for the prevention of PTLD and the use of mychophenolic acid and TOR inhibitor maintenance to diminish the incidence of PTLD and solid malignancies. This leaves transplant physicians with several new and novel immunosuppressive agents with uncertain oncologic potentials that will need to be examined over the next decade. 相似文献
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Plasma renin activity,response to aliskiren,and clinical outcomes in patients hospitalized for heart failure: the ASTRONAUT trial
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Mark D. Muthiah MBBS Ng Cheng Han Arun J. Sanyal MD 《Diabetes, obesity & metabolism》2022,24(Z2):3-14
Non-alcoholic fatty liver disease (NAFLD) has a rapidly rising prevalence worldwide and is the most common cause of liver disease in developed countries. In this article, we discuss the spectrum of disease of NAFLD with a focus on the earlier spectrum of the disease that is commonly encountered by non-specialists, as well as the hepatic and extra-hepatic associations of the disease. We discuss in detail the two common presentations of NAFLD, incidentally detected hepatic steatosis and asymptomatic raised liver enzymes, and provide an algorithm for management and continued to follow up for these patients. Considerations for the management of cardiovascular comorbidities in these patients are also discussed. Finally, we cover the topic of screening for NAFLD in high-risk populations. 相似文献
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Sundar Varun Emmanuel Bhaskar Georgi Abraham Anandabhavan Sukumaramenon Arunkumar Muthiah Kothandaramanujam Renuka 《Indian Journal of Critical Care Medicine》2013,17(1):28-33