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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
#1
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...
April 4, 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
#2
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 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...
April 5, 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
#3
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
#4
Marcela Krečmerová
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...
February 16, 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
#5
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...
February 15, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/26281129/25-years-of-kidney-transplantation-a-period-of-change
#16
Dirk L Stippel, Tülay Cingöz, Roger Wahbal, Roman-Ulrich Müller, Ursula Bauerfeind, Georg Dieplinger
At the University of Cologne Hospital, 1062 kidney transplants in adults and 136 pediatric transplants were performed between 1990 and 2014. Immunosuppressive therapy was changed during this time period from a therapy with anti-lymphocyte globulin induction followed by a triple therapy to a period using induction (IL2 receptor antagonists) followed by low dose tacrolimus, mycophenolate mofetil and steroids. Antiviral therapy has been constant during the 25 years, consisting of ganciclovir or valganciclovir...
2014: Clinical Transplants
https://www.readbyqxmd.com/read/26075755/treatment-of-myalgic-encephalomyelitis-chronic-fatigue-syndrome-a-systematic-review-for-a-national-institutes-of-health-pathways-to-prevention-workshop
#17
REVIEW
M E Beth Smith, Elizabeth Haney, Marian McDonagh, Miranda Pappas, Monica Daeges, Ngoc Wasson, Rongwei Fu, Heidi D Nelson
BACKGROUND: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a debilitating multisystem condition affecting more than 1 million adults in the United States. PURPOSE: To determine benefits and harms of treatments for adults with ME/CFS and identify future research needs. DATA SOURCES: MEDLINE, PsycINFO, and Cochrane databases (January 1988 to September 2014); clinical trial registries; reference lists; and manufacturer information...
June 16, 2015: Annals of Internal Medicine
https://www.readbyqxmd.com/read/25682092/cytomegalovirus-and-glioblastoma-controversies-and-opportunities
#18
REVIEW
Sean E Lawler
One of the more polarized ongoing debates in the brain tumor field over recent years has centered on the association of cytomegalovirus (CMV) with glioblastoma. Several laboratories have reported the presence of CMV antigens in glioblastoma patient specimens, whereas others have failed to detect them. CMV genomic DNA and mRNAs have been detected by PCR, but not in next-generation sequencing studies. CMV promotes high grade glioma progression in a mouse genetic model, and many CMV proteins promote cancer hallmarks in vitro, but actively replicating virus has not been isolated from tumor samples...
July 2015: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/25645790/effect-of-early-conversion-to-everolimus-together-with-prophylaxis-with-valganciclovir-in-the-prevention-of-cytomegalovirus-infection-in-heart-transplant-recipients
#19
B Díaz Molina, E Velasco Alonso, J L Lambert Rodríguez, M J Rodríguez Bernardo, J Rozado Castaño, R Padrón Encalada, M Martín Fernández, F Pun Chinchai, S Colunga Blanco, A García Campos
INTRODUCTION: Viral infections, especially cytomegalovirus (CMV), are a leading cause of early death and morbidity after heart transplantation. Several strategies have been used to minimize the risk, including universal prophylaxis with ganciclovir or valganciclovir and preemptive therapy. Lately, everolimus (EVE) efficacy studies have shown a protective effect against CMV infection. METHODS: We studied retrospectively a series of 223 heart transplant patients, dividing them into 5 groups according to CMV prevention strategy: 16 patients were at low risk for infection (negative recipient [R-]/negative donor [D-]) and received no treatment; 26 patients received prophylactic therapy with ganciclovir, 8 patients prophylaxis with valganciclovir, 145 patients received preemptive therapy and 28 patients prophylaxis with valganciclovir and early conversion to EVE...
January 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/25643140/evaluation-of-low-versus-high-dose-valganciclovir-for-prevention-of-cytomegalovirus-disease-in-high-risk-renal-transplant-recipients
#20
MULTICENTER STUDY
Steven Gabardi, Natalya Asipenko, James Fleming, Kevin Lor, Lisa McDevitt-Potter, Anisa Mohammed, Christin Rogers, Eric M Tichy, Renee Weng, Ruth-Ann Lee
BACKGROUND: Despite proven efficacy of prolonged cytomegalovirus (CMV) prophylaxis using valganciclovir 900 mg/day, some centers use 450 mg/day due to reported success and cost savings. This multicenter, retrospective study compared the efficacy and safety of 6 months of low-dose versus high-dose valganciclovir prophylaxis in high-risk, donor-positive/recipient-negative, renal transplant recipients (RTR). METHODS: Two hundred thirty-seven high-risk RTR (low-dose group = valganciclovir 450 mg/day [n = 130]; high-dose group = valganciclovir 900 mg/day [n = s7]) were evaluated for 1-year CMV disease prevalence...
July 2015: Transplantation
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