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https://www.readbyqxmd.com/read/28731920/eye-movement-disorders-following-allogeneic-bone-marrow-transplantation-on-fk506-tacrolimus-and-ganciclovir
#1
Barbaros S Karagun, Tugana Akbas, Taner Arpaci, Bulent Antmen
FK506 (tacrolimus) is an immunosuppressive drug and more potent than cyclosporine. FK506 is widely used for immunosuppression in the prevention and treatment of graft-versus-host disease after allogeneic bone marrow transplantation and solid organ transplantation. Neurotoxicity is a recognized complication of FK506 therapy, but ptosis and weakness of eye abduction unilaterally has not been reported in association with FK506 administration to date. We discuss a 13-year-old male patient who developed ptosis and weakness of eye abduction unilaterally 90 days after transplantation with bone marrow from an unrelated donor, for acute lymphoblastic leukemia in this case report...
July 20, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28725131/oral-kaposi-sarcoma-in-hiv-seronegative-saudi-patient-literature-review-and-case-report
#2
Asmaa Faden, Manal AlSheddi, Mohammed AlKindi, Lama Alabdulaaly
Kaposi Sarcoma (KS) is an intermediate neoplasm affecting the endothelial cells of mucous membranes and skin. It arises most commonly among HIV-infected individuals. We present an intra-oral KS in an 80-year-old Saudi male patient, who is HIV-seronegative, non-immunosuppressed, and with no history of organ transplantation. The patient was treated with fractionated radiation therapy, and had no recurrence in the 48 months of follow-up. The clinical disease, histologic features, and treatment modality used, as well as the relative literature are presented in this paper...
July 2017: Saudi Dental Journal
https://www.readbyqxmd.com/read/28724765/translesion-polymerase-pol-%C3%AE-is-required-for-efficient-epstein-barr-virus-infectivity-and-is-regulated-by-the-viral-deubiquitinating-enzyme-bplf1
#3
Ossie F Dyson, Joseph S Pagano, Christopher B Whitehurst
Epstein-Barr Virus (EBV) infection and lytic replication are known to induce a cellular DNA damage response. Previously we showed that the virally encoded BPLF1 protein interacts with and regulates several members of the translesion synthesis pathway (TLS), a DNA damage tolerance pathway, and that these cellular factors enhance viral infectivity. BPLF1 is a late lytic cycle gene, but the protein is also packaged in the viral tegument indicating that BPLF1 may function both early and late during infection. BPLF1 expresses deubiquitinating activity that is strictly conserved across the Herpesviridae; mutation of the active-site cysteine results in loss of enzymatic activity...
July 19, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28724761/isg15-modulates-type-i-interferon-signaling-and-antiviral-response-during-hepatitis-e-virus-replication
#4
Harini Sooryanarain, Adam J Rogers, Dianjun Cao, Mary Etna R Haac, Yogesh A Karpe, Xiang-Jin Meng
Hepatitis E virus (HEV), a single-stranded positive-sense RNA virus, generally causes a self-limiting acute viral hepatitis, although chronic HEV infection has recently become a significant clinical problem in immunocompromised individuals especially in solid organ transplant recipients. Innate immunity, via type-I interferon (IFN) response, plays an important role during initial stages of a viral infection. ISG15, an IFN-induced ubiquitin-like protein, is known to have an immunomodulatory role, as well as can impart a direct antiviral effect against a wide spectrum of virus families...
July 19, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28722255/drug-drug-interactions-between-triazole-antifungal-agents-used-to-treat-invasive-aspergillosis-and-immunosuppressants-metabolized-by-cytochrome-p450-3a4
#5
REVIEW
Andreas H Groll, Robert Townsend, Amit Desai, Nkechi Azie, Mark Jones, Marc Engelhardt, Anne-Hortense Schmitt-Hoffman, Robert J Brüggemann
Patients undergoing treatment with immunosuppressant drugs following solid organ or hematopoietic stem cell transplantation are at particular risk for development of serious infections such as invasive aspergillosis. Four triazole antifungal drugs, voriconazole, posaconazole, itraconazole, and isavuconazole, are approved to treat invasive aspergillosis either as first- or second-line therapy. All of these agents are inhibitors of cytochrome P450 3A4, which plays a key role in metabolizing immunosuppressant drugs such as cyclosporine, tacrolimus, and sirolimus...
July 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28716027/cytomegalovirus-viraemia-and-mortality-in-renal-transplant-recipients-in-the-era-of-antiviral-prophylaxis-lessons-from-the-western-australian-experience
#6
Linda A Selvey, Wai H Lim, Peter Boan, Ramyasuda Swaminathan, Claudia Slimings, Amy E Harrison, Aron Chakera
BACKGROUND: Cytomegalovirus (CMV) establishes a lifelong infection that is efficiently controlled by the immune system; this infection can be reactivated in case of immunosuppression such as following solid organ transplantation. CMV viraemia has been associated with CMV disease, as well as increased mortality and allograft failure. Prophylactic antiviral medication is routinely given to renal transplant recipients, but reactivation during and following cessation of antiviral prophylaxis is known to occur...
July 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28708218/microbial-characteristics-of-posttraumatic-infective-keratitis
#7
Blanche X Lim, Victor T C Koh, Manotosh Ray
PURPOSE: To determine the demographics, risk factors, clinical and microbiological characteristics, and treatment outcome of posttraumatic infective keratitis. METHODS: Consecutive patients with posttraumatic infective keratitis presenting to the Ophthalmology Department of a tertiary referral hospital in Singapore between March 2012 and March 2016 were prospectively identified. A standardized data collection form was used to document patient demographics, microbiological diagnosis, antibiotic sensitivity, and pretreatment and posttreatment ocular characteristics...
July 8, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28706972/fever-and-pancytopenia-in-a-liver-transplant-recipient-going-against-the-rules-of-occam-s-razor
#8
Lionel Hon Wai Lum, Fei Wen Chen, Louise Jackett, Simone I Strasser, Rebecca J Davis
The syndrome of fever and pancytopenia is not infrequently encountered postliver transplant, and a broad differential list of infectious and noninfectious aetiologies can be invoked. A transplant patient is susceptible to more than 1 opportunistic infection or disease process. We described the diagnostic conundrums in managing our patient who ran a complex protracted course postliver transplant. He was diagnosed to have both disseminated tuberculosis and graft-versus-host disease, a rare complication after solid organ transplantation...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28702025/cellular-and-molecular-defects-underlying-invasive-fungal-infections-revelations-from-endemic-mycoses
#9
REVIEW
Pamela P Lee, Yu-Lung Lau
The global burden of fungal diseases has been increasing, as a result of the expanding number of susceptible individuals including people living with human immunodeficiency virus (HIV), hematopoietic stem cell or organ transplant recipients, patients with malignancies or immunological conditions receiving immunosuppressive treatment, premature neonates, and the elderly. Opportunistic fungal pathogens such as Aspergillus, Candida, Cryptococcus, Rhizopus, and Pneumocystis jiroveci are distributed worldwide and constitute the majority of invasive fungal infections (IFIs)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28700465/alemtuzumab-versus-antithymocyte-globulin-induction-therapies-in-kidney-transplantation-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Jianming Zheng, Wenli Song
Alemtuzumab (ALEM) is widely used as an induction therapy for organ transplantation, and numerous randomized controlled trials (RCTs) have been published to evaluate its efficacy and safety in kidney transplantation as compared with antithymocyte globulin (ATG). The purpose of this study was to compare the benefits and safety of ALEM with those of ATG for induction therapy.A systematic literature search in three electronic databases, including PubMed, EmBase, and Cochrane Library, since inception through October 2016, was conducted to identify potential RCTs for inclusion...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28700391/human-t-lymphotropic-virus-type-1-infection-and-disease-in-spain
#11
Carmen de Mendoza, Estrella Caballero, Antonio Aguilera, Silvia Requena, Raúl Ortiz de Lejarazu, María Pirón, Rocío González, Ana Jiménez, Lourdes Roc, Ana Treviño, Rafael Benito, Miriam Fernández-Alonso, Aitziber Aguinaga, Carmen Rodríguez, Juan García-Costa, Lidia Blanco, José M Ramos, Enrique Calderón, José M Eirós, Silvia Sauleda, Pablo Barreiro, Vicente Soriano
: Human T-lymphotropic virus type 1 (HTLV-1) infection is a neglected disease despite roughly 15 million people are chronically infected worldwide. Lifelong less than 10% of carriers develop life-threatening diseases, mostly a subacute myelopathy known as tropical spastic paraparesis (TSP) and a lymphoproliferative disorder named adult T-cell leukemia (ATL). HTLV-1 is efficiently transmitted perinatally (breastfeeding), sexually (more from men to women) and parenterally (transfusions, injection drug user (IDU), and transplants)...
July 31, 2017: AIDS
https://www.readbyqxmd.com/read/28699311/ganciclovir-resistant-cytomegalovirus-infection-in-abdominal-solid-organ-transplant-recipients-case-series-and-review-of-the-literature
#12
K E Rolling, M R Jorgenson, J L Fose, D A Mandelbrot, R R Redfield, J A Smith
Ganciclovir-resistant cytomegalovirus (GR-CMV) is emerging as a significant infection in the abdominal transplant population. GR-CMV is difficult to manage, and treatment options are limited. We report a descriptive case series of 15 patients who had documented GR-CMV at our center and review the literature on treatment of GR-CMV. The first case in this series was detected in 2012; the majority of cases occurred after January 1, 2014, with approximately 50% occurring in 2015. UL97 and UL54 viral genome mutations were present in 100% and 40% of CMV-infected patients, respectively...
July 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28696077/legionnaires-disease-in-transplant-recipients-a-15-year-retrospective-study-in-a-tertiary-referral-center
#13
Shobini Sivagnanam, Sara Podczervinski, Susan M Butler-Wu, Vivian Hawkins, Zach Stednick, Lois A Helbert, William A Glover, Estella Whimbey, Jeffrey Duchin, Guang-Shing Cheng, Steven A Pergam
Legionnaires' disease (LD) can be fatal among high-risk transplant recipients. To understand the epidemiology of LD, we reviewed 15-year, longitudinal data from a center in Seattle, Washington that cares for both solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients. We identified all laboratory-confirmed LD and extracted data on species, diagnostic modalities, clinical presentation, management, and outcomes from medical records. Among 32 patients with LD, transplant recipients made up the majority of diagnoses (22, 69%; SOT 10, HCT 12)...
July 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28695649/single-center-experience-of-antifungal-prophylaxis-for-coccidioidomycosis-in-heart-transplant-recipients-within-an-endemic-area
#14
Graham M Lohrmann, Darko Vucicevic, Romy Lawrence, D Eric Steidley, Robert L Scott, Shimon Kusne, Janis E Blair
In endemic regions, coccidioidomycosis causes substantial morbidity and mortality for patients receiving solid organ transplants. We aimed to demonstrate the effect of antifungal coccidioidal prophylaxis in heart transplant (HT) recipients. We retrospectively reviewed the electronic health records of all patients who received HTs between October 19, 2005, and December 13, 2014. We collected information regarding antifungal regimens and determined whether patients subsequently developed infections. Our 174-person cohort all received antifungal prophylaxis for at least 6 months (mean follow-up, 53...
July 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28694422/development-of-graft-site-candidiasis-in-3-solid-organ-transplant-recipients-from-the-same-donor
#15
Nasrin El-Bandar, Daniela C Kroy, Tom Florian Fuller, Jürgen Kramer, Lutz Liefeldt, Klemens Budde, Conrad Blobel, Kurt Miller, Frank Friedersdorff
BACKGROUND Graft-site candidiasis rarely develops in solid organ transplant recipients; however, severe life-threatening complications can occur. We report the course of 3 solid organ transplant recipients developing graft-site candidiasis. CASE REPORT All grafts, consisting of 2 kidneys and 1 liver, were procured from a single donor. Patient data were collected from our database. Candida albicans was isolated from a swab taken during multiple-organ recovery. Complications associated with candidiasis occurred in all 3 recipients with preservation of the liver transplant...
July 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28693626/surgical-site-infections-after-liver-transplantation-prospective-surveillance-and-evaluation-of-250-transplant-recipients-in-canada
#16
Yoichiro Natori, Rawan Kassar, Aled Iaboni, Seyed M Hosseini-Moghaddam, James Vu, Shahid Husain, Eberhard L Renner, David Grant, Coleman Rotstein
OBJECTIVE To evaluate the incidence of surgical-site infections (SSIs) in a cohort of liver transplant recipients and to assess risk factors predisposing patients to these infections. DESIGN Prospective observational cohort study. SETTING Single transplant center in Canada. PATIENTS Patients who underwent liver transplantation between February 2011 and August 2014. METHODS Multivariate logistic regression was used to identify independent risk factors for SSIs in liver transplant patients. RESULTS We enrolled 250 liver transplant recipients...
July 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28691996/fecal-microbiota-therapy-with-a-focus-on-c-difficile-infection
#17
Lawrence J Brandt
There has been a paradigm shift in our view of bacteria away from their role as just pathogens. We now have a deepening appreciation of their critical influences in our health maintenance, including energy harvest, metabolism, intestinal development, cell proliferation, nervous system and immune function, as well as their role to protect against intestinal and other infections. A perturbed intestinal microbiome has been associated with an increasing number of gastrointestinal (GI) and non-GI diseases but particularly with C...
July 7, 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28691772/successful-liver-transplantation-despite-donor-transmitted-esbl-producing-klebsiella-pneumoniae-infection-case-report-and-review-of-the-literature
#18
Laura Escolà-Vergé, Ibal Los-Arcos, Junajo González, Mayli Lung, Itxarone Bilbao, Mercè Farré, Teresa Pont, Alberto Sandiumenge, Joan Gavalda, Oscar Len
Donor-derived bacterial infection is a recognized complication of solid organ transplantation. Patients admitted to the intensive care unit are increasingly exposed to infection with multidrug-resistant microorganisms. However, no specific recommendations are available about their suitability as donors. We report a case of donor-transmitted extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in a liver recipient, and review the related literature. This article is protected by copyright...
July 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28688155/critical-care-management-of-the-cirrhotic-patient-awaiting-liver-transplant-in-the-intensive-care-unit
#19
REVIEW
J C Olson, C J Karvellas
Patients with cirrhosis who are awaiting liver transplantation are at high risk for development of critical illness. Current liver allocation policies which dictate a "sickest first" approach coupled with a mismatch between need and availability of organs results in longer wait times and thus, patients are becoming increasingly ill while awaiting organ transplantation. Even patients with well compensated cirrhosis may suffer acute deterioration, the syndrome of acute-on-chronic liver failure (ACLF) results in multi-system organ dysfunction and a marked increase in associated short-term morbidity and mortality...
July 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28687212/sepsis-and-challenging-infections-in-the-immunosuppressed-patient-in-the-intensive-care-unit
#20
REVIEW
Diana F Florescu, Uriel Sandkovsky, Andre C Kalil
In 2017, most intensive care units (ICU) worldwide are admitting a growing population of immunosuppressed patients. The most common causes of pre-ICU immunosuppression are solid organ transplantation, hematopoietic stem cell transplantation, and infection due to human immunodeficiency virus. In this article, we review the most frequent infections that cause critical care illness in each of these 3 immunosuppressed patient populations.
July 5, 2017: Infectious Disease Clinics of North America
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