ORCID Profile
0000-0002-0292-5512
Current Organisations
John Hunter Hospital
,
University of Newcastle Australia
,
The University of Newcastle
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Publications
Guillain‐Barré syndrome post renal transplant: A systematic review
Publisher: Wiley
Date: 28-11-2018
DOI: 10.1111/TID.13021
Abstract: Guillain-Barré syndrome (GBS) is a common ascending polyneuropathy in adults. It is often associated with preceding viral or diarrhoeal illness with cytomegalovirus (CMV), Epstein-Barr virus (EBV), or C ylobacter jejuni. Solid organ transplant recipients are more susceptible to opportunistic infections with CMV than the general population as a result of immunosuppressive therapies to prevent graft rejection. However, reports of GBS are rare in this population. To systematically review cases of GBS in renal transplant patients to evaluate causative pathogens or triggers, management and associated morbidity and mortality. We conducted a systematic search of the MEDLINE database uncovering 17 cases of GBS in renal transplant patients in the literature. The majority of cases were in males (81%) and patients who received deceased donor renal transplants (87%). The mean age was 44.7 years (SD 13). The time between transplant and onset of symptoms ranged from 2 days to 10 years (Mean = 720 days). GBS was commonly associated with antecedent viral (CMV 12 EBV 1) or diarrhoeal (2) illness while two cases were attributed to calcineurin inhibitor use. All patients recovered fully or partially after treatment with anti-viral or anti-bacterial agents, immunoglobulins, and/or plasma exchange. Cytomegalovirus is the most common trigger for GBS in the post-renal transplant setting. Other triggers include c ylobacter jejuni and calcineurin inhibitors. GBS should be considered in transplant patients presenting with weakness or paralysis in order to institute timely management.
Pulmonary lymphomatoid granulomatosis in a renal allograft recipient
Publisher: Wiley
Date: 19-05-2007
DOI: 10.1111/J.1399-3062.2007.00234.X
Abstract: Lymphomatoid granulomatosis (LYG) is a rare multisystemic angiocentric lymphoproliferative disease, which can masquerade as necrotic tissue. There is a paucity of reports of LYG in renal transplant recipients. Herein, we describe LYG in a 56-year-old renal allograft recipient 11 years after transplantation, on azathioprine and prednisolone maintenance immunosuppression, presenting to us with fever, weight loss, and nodular and patchy opacities in both lung fields. Initial percutaneous s les showed necrotic tissue while open biopsy revealed characteristic histopathology with evidence of Epstein-Barr virus. We have reviewed the radiological and pathological findings, and discussed clinical features, differential diagnosis, and treatment of LYG.
Impact of ACE gene polymorphisms on the progression of IgA nephropathy in India.
Publisher: Informa UK Limited
Date: 2007
Pediatric renal transplantation – A single center experience of 15 yr from India
Publisher: Wiley
Date: 29-08-2007
DOI: 10.1111/J.1399-3046.2007.00774.X
Abstract: Renal transplantation is the optimal treatment for children with ESRD. We undertook this study to establish the outcome of pediatric renal transplants in a resource-constrained environment in a developing country. A retrospective analysis on 90 pediatric renal transplants (age at transplant 2 rejection episodes (p = 0.05), while sepsis (p = 0.01) was the most important contributor to patient loss. Pediatric renal transplantation in India can be accomplished successfully. The graft and patient survival in our study, the largest from India, is comparable to those published from developed countries and is encouraging given the limited resources.
What is the best fluid type for management of patients with an identified acute kidney injury?
Publisher: Dustri-Verlgag Dr. Karl Feistle
Date: 05-2019
DOI: 10.5414/CN109699
Pulmonary Mucormycosis in a Nondiabetic Renal Allograft Recipient Successfully Managed by Medical Therapy Alone
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 27-06-2007
Presentation, prognosis and outcome of IgA nephropathy in Indian adults
Publisher: Wiley
Date: 10-2005
DOI: 10.1111/J.1440-1797.2005.00445.X
Abstract: IgA nephropathy (IgAN) is not well characterized in India. This retrospective study of 478 patients with IgAN was performed to clarify the presenting features, prognostic factors and the renal survival rates of the disease. Three hundred and forty-seven patients who had been followed on average for 27 months after diagnosis were ided into two groups based on renal function at diagnosis. In group 1 (229 patients), the creatinine clearance estimated by the Modification of Diet in Renal Disease formula was /=85 mL/min. The predominant modes of presentation were nephrotic syndrome, hypertension and renal failure. Twenty-nine percent of patients had more than a 20% decline in renal function at the last follow up. Multivariate analyses with stepwise logistic regression identified hypertension (odds ratio (OR) 3.5), nephrotic range proteinuria (OR 3.4) and sclerosed glomeruli on biopsy (OR 4.1) to be independently associated with progression in group 1 and hypertension (OR 2.3) in group 2. Seventeen percent of patients progressed to end-stage renal disease (ESRD). Using multivariate analysis by the Cox model, four risk factors for developing ESRD were identified: hypertension (hazard ratio (HR) 3.1) nephrotic proteinuria (HR 1.9) interstitial fibrosis (HR 2.5) and sclerosed glomeruli (HR 1.8). The renal survival rates at 1, 5 and 10 years were 84, 55 and 33%, respectively, with a median renal survival of 61 months from the time of biopsy. The relatively rapid rate of progression of IgAN in India is suggestive towards a 'malignant' nature of the disease in this country.
Dengue shock syndrome in a renal transplant recipient
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2004
Osmotic nephropathy resulting from maltose-based intravenous immunoglobulin therapy.
Publisher: Informa UK Limited
Date: 2006
DOI: 10.1080/08860220500531286
Abstract: Intravenous immunoglobulin preparations are being used for an increasing number of indications. To minimize adverse reactions, sugar additives such as sucrose, maltose, and glycine are added to some preparations to serve as stabilizing agents. Intravenous immunoglobulin infusion induces acute renal failure (ARF) via a mechanism of osmotic nephrosis. Most reported cases are related to the use of sucrose-based intravenous immunoglobulin. Herein, we describe a patient with lupus nephritis treated with an immunoglobulin preparation containing maltose who developed ARF with histologic changes characterized by vacuolization and swelling of renal proximal tubular cells. Our case draws nephrologists' attention to the potential of maltose-based immunoglobulin in producing renal failure. Awareness and exercising caution in high-risk groups is elementary to the prevention of this condition.
Electrode contact impedance sensitivity to variations in geometry
Publisher: IOP Publishing
Date: 24-04-2012
DOI: 10.1088/0967-3334/33/5/817
Abstract: Electrode contact impedance is a crucial factor in physiological measurements and can be an accuracy-limiting factor when performing electroencephalography and electrical impedance tomography. In this work, standard flat electrodes and micromachined multipoint spiked electrodes are characterized with a finite-element method electromagnetic solver and the dependence of the contact impedance on geometrical factors is explored. It is found that flat electrodes are sensitive to changes in the outer skin layer properties related to hydration and thickness, while spike electrodes are not. The impedance as a function of the effective contact area, number of spikes and penetration depth has also been studied and characterized.
Related Organisations
Related Funding Activities
No related grants have been discovered for Bobby Chacko.