Journal of clinical pathology
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This review looks at the main issues around immediate hypersensitivity and the role and limitations of testing. The majority of literature on antibiotic hypersensitivity relates to β-lactam antibiotics, mainly because of the heavy usage of this class of drugs. ⋯ Reasonable data now exist in relation to β-lactam antibiotics and derivatives, which enable appropriate risk management to be undertaken. The available literature for other classes of antibiotics is also discussed.
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The pathogenic role of disseminated intravascular coagulation (DIC) during septic shock is incompletely understood. ⋯ The course of human septic shock, particularly inhibition of activated fibrinolysis during DIC, may be independently associated with hyperlactataemia; therefore a coagulation/fibrinolysis imbalance may contribute to tissue hypoxygenation and ultimately thereby to demise.
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Paragangliomas and phaeochromocytomas may occur in syndromic or sporadic forms. The former are well recognised with multiple endocrine neoplasia (MEN) type 2 and von Hippel-Lindau syndromes. A few cases are associated with neurofibromatosis type 1. ⋯ Patients with SDHD and SDHC mutations have a higher positive family history (66%) and have head and neck paragangliomas. SDHD patients present at 30 years with multiple tumours, while in SDHC mutation carriers, single tumours appear at around 38 years of age. A small percentage of patients with sporadic paragangliomas/phaeochromocytomas may have SDH mutations as well.
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With increasing numbers of lung transplants being performed worldwide, lung transplant allograft biopsies are becoming increasingly common. The evaluation of lung transplant biopsies typically focuses on the assessment of allograft rejection and infection, but other entities may also be seen in biopsy material. Presented here is an approach to lung transplant biopsies, in which there is an overview major diagnostic entities that may be encountered and discussion of findings that may present interpretive challenges.