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https://www.readbyqxmd.com/read/28734808/-congenital-cytomegalovirus-infection-manifesting-as-neonatal-respiratory-distress-in-an-hiv-exposed-uninfected-newborn
#1
A Pham, H El Mjati, N Nathan, F Kieffer, D Mitanchez
BACKGROUND: Cytomegalovirus (CMV) is one of the most common intrauterine infections, affecting approximately 1% of all live births. There are few reports on congenital CMV infections manifesting as isolated pneumonitis. CASE REPORT: We report a case of congenital CMV with neonatal respiratory distress affecting an HIV-exposed uninfected infant. This infant required noninvasive ventilation beginning within the first 15min of life. The initial chest X-ray showed diffuse bilateral ground-glass opacifications...
July 19, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28719361/effectiveness-of-valganciclovir-900mg-versus-450mg-for-cytomegalovirus-prophylaxis-in-renal-transplantation-a-systematic-review-and-meta-analysis
#2
Wang Xin, Yang Hui, Zhang Xiaodong, Cui Xiangli, Wang Shihui, Liu Lihong
OBJECTIVES: Valganciclovir 900 mg/day is approved for cytomegalovirus (CMV) prophylaxis, but 450 mg/day is seems also effective. We systematically reviewed the efficacy and safety of low-dose versus high-dose valganciclovir prophylaxis in renal transplantation recipients. METHODS: An electronic search was conducted up to November 29, 2016. The primary outcomes were incidences of CMV, CMV disease, mortality and opportunistic infection. The second outcomes were acute rejection, allograft loss, adverse drug reaction (ADR)...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28613442/the-effect-of-different-immunoprophylaxis-regimens-on-post-transplant-cytomegalovirus-cmv-infection-in-cmv-seropositive-liver-transplant-recipients
#3
Chian Yong Low, Seyed Mohammadmehdi Hosseini-Moghaddam, Coleman Rotstein, Eberhard L Renner, Shahid Husain
BACKGROUND: The effects of different immunoprophylaxis regimens on cytomegalovirus (CMV) infection in liver transplant recipients (LTRs) have not been compared. METHODS: In a cohort, we studied 343 CMV-seropositive recipient (R+) and 83 seronegative donor/recipient (D-/R-) consecutive LTRs from 2004 to 2007. Immunoprophylaxis regimens included steroid-only, steroids plus rabbit anti-thymocyte globulin (rATG), and steroids plus basiliximab. Logistic regression analysis, Cox proportional hazards regression model, and log-rank test were performed for multivariate analysis as appropriate...
June 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#4
Jillian SY Lau, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Arthur Richard Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28437539/safety-and-efficacy-of-antiviral-therapy-for-prevention-of-cytomegalovirus-reactivation-in-immunocompetent-critically-ill-patients-a-randomized-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
Nicholas J Cowley, Andrew Owen, Sarah C Shiels, Joanne Millar, Rebecca Woolley, Natalie Ives, Husam Osman, Paul Moss, Julian F Bion
Importance: Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in body fluids such as blood) can occur in up to one-third of these individuals during episodes of critical illness. Objective: To determine whether antiviral therapy is safe and effective for preventing CMV reactivation in a general population of critically ill patients. Design, Setting, and Participants: A single-center, open-label, randomized, controlled clinical trial recruited 124 CMV-seropositive patients undergoing mechanical ventilation for at least 24 hours in the intensive care unit between January 1, 2012, and January 31, 2014...
June 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28389165/cytomegalovirus-retinitis-followed-by-immune-recovery-uveitis-in-an-elderly-patient-with-rheumatoid-arthritis-undergoing-administration-of-methotrexate-and-tofacitinib-combination-therapy
#6
Kunio Yanagisawa, Yoshiyuki Ogawa, Mayumi Hosogai, Daisuke Todokoro, Takeki Mitsui, Akihiko Yokohama, Shoji Kishi, Hiroshi Handa
Cytomegalovirus (CMV) retinitis is an opportunistic ocular infection most commonly observed in patients infected with human immunodeficiency virus (HIV). We present a rare case of CMV retinitis that developed in a non-HIV patient with rheumatoid arthritis (RA). Over the preceding 5 months, a family doctor had been treating the 78-year-old male patient with a combination therapy of methotrexate (MTX) and tofacitinib (TOF). CMV retinitis occurred when the patient's CD4+ T cells were low (196 cells/μl), and preceded the onset of Pneumocystis pneumonia...
August 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28383392/valganciclovir-dosing-for-cytomegalovirus-prophylaxis-in-pediatric-solid-organ-transplant-recipients-a-prospective-pharmacokinetic-study
#7
Orit Peled, Matitiahu Berkovitch, Eran Rom, Efraim Bilavsky, Yael Bernfeld, Lev Dorfman, Adi Pappo, Tomer Ziv-Baran, Nurit Brandriss, Adina Bar-Haim, Jacob Amir, Liat Ashkenazi-Hoffnung
BACKGROUND: Valganciclovir is extensively used for prophylaxis and treatment of cytomegalovirus (CMV) infection in solid-organ transplant recipients. However, pharmacokinetic data in children are scarce, and the pediatric dosing regimen is uncertain. This study sought to prospectively evaluate the pharmacokinetic profile, the clinical efficacy and safety of oral valganciclovir in pediatric transplant recipients and compare different dosing regimens. METHODS: The cohort included solid-organ transplant recipients treated with valganciclovir for CMV prophylaxis in 2014-2015 at a tertiary pediatric medical center...
August 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28260458/successful-cost-effective-prevention-of-cytomegalovirus-disease-in-kidney-transplant-recipients-using-low-dose-valganciclovir
#8
Osama Gheith, Medhat A Halim, Torki Al-Otaibi, Hany Mansour, Ahmed Mosaad, Hassanein Abo Atteya, Zakaria Zakaria, Tarek Said, Prasad Nair, Narayanam Nampoory
OBJECTIVES: Low-dose valganciclovir prophylaxis is still under investigation in renal transplant procedures. Our aim was to assess the cost effectiveness of 450 mg versus 900 mg valganciclovir prophylaxis in kidney transplant recipients. MATERIALS AND METHODS: In this prospective trial, 201 kidney transplant patients were randomized (1:1) to receive 450 mg/d (group 1, n = 100) or 900 mg/d (group 2, n = 101) valganciclovir prophylaxis for the first 6 months after transplant...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28215138/amino-acid-ester-prodrugs-of-nucleoside-and-nucleotide-antivirals
#9
Marcela Krecmerova
OBJECTIVE: The review covers basic principles of the prodrug strategy applied to antiviral nucleoside drugs or drug candidates. Specific role of amino acids as promoieties is explained with respect to transport mechanisms, pharmacokinetics and a low toxicity of compounds. Synthetic approaches to the most important representatives (compounds under clinical investigations or available on the market) are described, including valacyclovir, valganciclovir, valomaciclovir stearate, valcyclopropavir, valtorcitabine, valopicitabine and several attempts to amino acid modifications of antiretroviral nucleosides...
2017: Mini Reviews in Medicinal Chemistry
https://www.readbyqxmd.com/read/28198039/combined-environmental-risk-assessment-for-the-antiviral-pharmaceuticals-ganciclovir-and-valganciclovir-in-europe
#10
Jürg Oliver Straub
Potential environmental risks of the old antiviral pharmaceuticals ganciclovir (GCV) and valganciclovir (VGCV) were reassessed based on new environmental fate and chronic ecotoxicity tests and on actual use data for Europe. Valganciclovir is hydrolyzed to GCV by intestinal and hepatic esterases, and hence the new environmental tests only refer to GCV. A sorption study showed that GCV will not sorb significantly, excluding the soil as a relevant environmental compartment. Despite earlier data suggesting nondegradability, a new water/sediment fate test showed GCV to be primarily and ultimately degraded and to be nonpersistent...
August 2017: Environmental Toxicology and Chemistry
https://www.readbyqxmd.com/read/27815572/phase-i-ii-study-of-lenalidomide-and-alemtuzumab-in-refractory-chronic-lymphocytic-leukemia-cll-effects-on-t-cells-and-immune-checkpoints
#11
Maria Winqvist, Fariba Mozaffari, Marzia Palma, Sandra Eketorp Sylvan, Lotta Hansson, Håkan Mellstedt, Anders Österborg, Jeanette Lundin
This phase I-II study explored safety, immunomodulatory and clinical effects of lenalidomide (weeks 1-16) and alemtuzumab (weeks 5-16) in 23 patients with refractory chronic lymphocytic leukemia. Most patients had Rai stage III/IV disease and were heavily pretreated (median 4 prior therapies), and 61% had del(17p)/del(11q). Eleven of 19 evaluable patients (58%) responded, with a median response duration of 12 months (1-29+); time to progression was short in non-responders. Lenalidomide had a narrow therapeutic dose range, 2...
January 2017: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/27639246/multicenter-evaluation-of-efficacy-and-safety-of-low-dose-versus-high-dose-valganciclovir-for-prevention-of-cytomegalovirus-disease-in-donor-and-recipient-positive-d-r-renal-transplant-recipients
#12
MULTICENTER STUDY
Seth Heldenbrand, Chenghui Li, Rosemary P Cross, Kelly A DePiero, Travis B Dick, Kara Ferguson, Miae Kim, Erin Newkirk, Jeong M Park, Janice Sudaria-Kerr, Eric M Tichy, Kimi R Ueda, Renee Weng, Jesse Wisniewski, Steven Gabardi
BACKGROUND: The cytomegalovirus (CMV) donor-positive/recipient-positive (D+/R+) population is the largest proportion of renal transplant recipients (RTR). Guidelines for prevention of CMV in the intermediate-risk D+/R+ population include prophylaxis with valganciclovir (VGCV) 900 mg/day for 3 months. This study is the first head-to-head analysis, to our knowledge, comparing the efficacy and safety CMV prophylaxis of VGCV 450 vs 900 mg/day for 3 months in D+/R+ RTR. METHODS: A multicenter, retrospective analysis evaluated 478 adult RTR between January 2008 and October 2011...
December 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27569944/extended-low-dose-valganciclovir-is-effective-prophylaxis-against-cytomegalovirus-in-high-risk-kidney-transplant-recipients-with-near-complete-eradication-of-late-onset-disease
#13
S A Fayek, E Beshears, R Lieber, N Alvey, A Sauer, J Poirier, E F Hollinger, O K Olaitan, S Jensik, J Geyston, M M Brokhof, A C Hodowanec, M Hertl, D M Simon
BACKGROUND: Cytomegalovirus (CMV)-seronegative kidney transplant (KTx) recipients of organs from CMV-seropositive donors (D+/R-) are at increased risk for CMV infection. Despite valganciclovir (VGCV) prophylaxis (900 mg daily for 200 days), late-onset CMV (LO-CMV) occurs at excessive rates. VGCV-associated cost and toxicities remain problematic. METHODS: We retrospectively evaluated 50 D+/R- adult KTx recipients from August 2008 to August 2014 who received low-dose VGCV (450 mg daily) prophylaxis for an extended duration...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27321236/a-minireview-usefulness-of-transporter-targeted-prodrugs-in-enhancing-membrane-permeability
#14
Teruo Murakami
Orally administered drugs are categorized into 4 classes depending on the solubility and permeability in a Biopharmaceutics Classification System. Prodrug derivatization is one of feasible approaches in modifying the physicochemical properties such as low solubility and low permeability without changing the in vivo pharmacological action of the parent drug. In this article, prodrug-targeted solute carrier (SLC) transporters were searched randomly by PubMed. Collected SLC transporters are amino acid transporter 1, bile acid transporter, carnitine transporter 2, glucose transporter 1, peptide transporter 1, vitamin C transporter 1, and multivitamin transporter...
September 2016: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27310254/efficacy-and-safety-of-low-dose-versus-standard-dose-valganciclovir-for-prevention-of-cytomegalovirus-disease-in-intermediate-risk-kidney-transplant-recipients
#15
RANDOMIZED CONTROLLED TRIAL
Medhat A Halim, Torki Al-Otaibi, Osama Gheith, Hani Adel, Ahmed Mosaad, Abu-Atteya Hasaneen, Zakaria Zakaria, Yahya Makkeya, Tarek Said, Prasad Nair
OBJECTIVES: Prophylaxis for cytomegalovirus infection is highly recommended for kidney transplant recipients. The use of daily 900 mg valganciclovir is the usual prophylactic dose, whereas 450 mg daily is under investigation. We evaluated the outcome of using 2 different doses of valganciclovir prophylaxis for cytomegalovirus infection after kidney transplant. MATERIALS AND METHODS: We randomized kidney transplant recipients (1:1) to receive 450 mg daily valganciclovir (group 1) or 900 mg daily valganciclovir (group 2) for the first 6 months after kidney transplant...
October 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/26970406/successful-treatment-with-foscarnet-for-ganciclovir-resistant-cytomegalovirus-infection-in-a-kidney-transplant-recipient-a-case-report
#16
Daiki Iwami, Yayoi Ogawa, Hiromi Fujita, Ken Morita, Hajime Sasaki, Yuichiro Oishi, Haruka Higuchi, Kanako Hatanaka, Nobuo Shinohara
Cytomegalovirus (CMV) infection is the most common infectious complication following solid organ transplantation. Ganciclovir (GCV)-resistant CMV infection may be fatal, and is difficult to treat while avoiding allograft rejection. A 31-year-old woman received a second ABO-incompatible kidney transplant, from her father. Induction therapy consisted of basiliximab and rituximab followed by maintenance immunosuppression with tacrolimus, mycophenolate mofetil, and methylprednisolone. Her CMV serostatus was D(+) /R(-) at second transplant and she received prophylactic low-dose valganciclovir (VGCV)...
July 2016: Nephrology
https://www.readbyqxmd.com/read/26907821/cmv-disease-complicating-induction-immunosuppressive-treatment-for-anca-associated-vasculitis
#17
James Tollitt, Edmond O'Riordan, Dimitrios Poulikakos
We present a case of a 71-year-old woman who initially presented with renal-limited antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Following standard therapy with cyclophosphamide, steroids and plasma exchange, her renal function began to improve. However, despite appropriate treatment, her renal function subsequently deteriorated and she suffered haemoptysis. Owing to diagnostic uncertainty, bronchoscopy and a repeat renal biopsy were performed. The bronchoscopy washings demonstrated positivity for cytomegalovirus (CMV) DNA, and in combination with a positive serum CMV PCR, immunosuppression was withheld...
February 23, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26426641/a-method-to-prepare-a-descemet-s-stripping-automated-endothelial-keratoplasty-dsaek-graft-using-donor-corneas-with-narrow-scleral-rims-a-case-report
#18
Tzu-Yu Lin, Yih-Shiou Hwang, David Hui-Kang Ma
Donor corneas with narrow scleral rims are often disqualified for Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK), mainly because of fluid leak and low pressure when they are mounted onto an artificial anterior chamber (AAC). This report describes a novel method to tight-lock a donor cornea with a narrow scleral rim so that microkeratome cutting is possible, allowing a DSAEK procedure to be completed. A 50-year-old male suffering from Epstein-Barr virus (EBV) endotheliitis with resulting corneal edema in his left eye was the subject of this study...
September 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26354293/occurrence-of-adverse-events-caused-by-valganciclovir-as-pre-emptive-therapy-for-cytomegalovirus-infection-after-allogeneic-stem-cell-transplantation-is-reduced-by-low-dose-administration
#19
M Takahata, S Hashino, M Nishio, J Sugita, A Shigematsu, M Onozawa, K Fujimoto, T Endo, T Kondo, J Tanaka, M Imamura, T Teshima
BACKGROUND: Pre-emptive therapy with valganciclovir (VGCV) has become the standard therapy for preventing cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (HSCT). The effectiveness of low-dose VGCV (900 mg per day) has been shown to be equal to that of standard-dose VGCV (900 mg twice daily); however, individualized optimal dosing and toxicity of VGCV have not been reported. METHODS: We conducted a retrospective study to evaluate the optimal dose of VGCV as pre-emptive therapy for preventing CMV infection by comparing the frequency of adverse events (AEs) and clinical efficacy in a low-dose VGCV group with those in a standard-dose VGCV group...
December 2015: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/26318605/prospective-long-term-study-on-primary-cmv-infections-in-adult-liver-transplant-d-r-patients-after-valganciclovir-prophylaxis
#20
Irmeli Lautenschlager, Raisa Loginov, Heikki Mäkisalo, Krister Höckerstedt
BACKGROUND: Cytomegalovirus (CMV) can cause severe infections in transplanted patients. To prevent CMV infection, most liver centers use prophylaxis for CMV-seronegative recipients receiving an organ from a seropositive donor (D+/R-). Valganciclovir is mostly given for 3-6 months after transplantation. However, the patients may develop primary CMV infection after the cessation of prophylaxis and late-onset CMV disease may occur. OBJECTIVES: A prospective long-term follow-up of CMV (D+/R-) adult liver transplant recipients after 3 months valganciclovir prophylaxis was investigated...
October 2015: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
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